SYSTEMS PSYCHOLOGY
AND SOCIOLOGY

    Views: 816

UDC 159.9.07

DOI 10.25688/2223-6872.2020.33.1.05

VIGILANCE IN MEDICAL DECISION MAKING AND BURNOUT IN DOCTORS

E. V. Sinbukhova,

N. N. Burdenko NMRCN, Moscow, ESinbukhova@nsi.ru, 

A. N. Zankovsky,

IP RAS, Moscow,

azankovsky@gmail.com,

D. N. Protsenko,

N. I. Pirogov MU, Moscow, ProtsenkoDN@zdrav. mos.ru

N. I. Sinbukhova,

CP JSC «Russian Railways», Moscow

Anesthesiology and intensive care are the most stressful medical disciplines, subjecting physicians to high responsibility daily in stressful situations such as managing life-threatening scenarios. The aim of the study: to study the effect of burnout on vigilance in decision-making among intensive care physicians and anesthe­siologists. This study involves 280 physicians (including 140 anesthesiologists, 140 intensive care physicians). Maslach Burnout Inventor (MBI), Melbourne decision making questionnaire (MDMQ), L. Mann, P. Burnett, M. Radford, S. Ford — is a personality questionnaire aimed at diagnosing individual decision-making style. The questionnaire is the result of an approbation of the earlier questionnaire Flinders' Decision Making Questionnaire (DMQ) (to the Russian language it was validated by T. V. Kornilova).

According to the MBI high burnout scores of all three subscales have anesthesiologists and intensive care physicians. High rates of emotional exhaustion, depersonalization and reduction of professional achievements have anesthesiologists, intensive care physicians respectively.

Regression analysis confirms in anesthesiologists, emotional exhaustion has a significant relationship with on vigilance in decision-making and procrastination. In intensive care physicians, emotional exhaustion has a significant relationship with on vigilance in decision-making, and the reduction of professional achievements with procrastination. However, it should be noted that vigilance in decision-making and procrastination cannot be explained only by emotional exhaustion and reduction.

Conclusion intensive care physicians and anesthesiologists maintain an adequate level of vigilance in deci­sion-making despite the high prevalence of burnout and depression.

Keywords: stress; fatigue; burnout; emotional exhaustion; medical staff; doctors; procrastination; decision making; vigilance.

For citation: Sinbukhova E. V, Zankovsky А. N., Protsenko D. N., Sinbukhova N. I. Vigilance in Medi­cal Decision Making and Burnout in Doctors // Systems Psychology and Sociology. 2020. № 1 (33). P. 64-73. DOI: 10.25688/2223-6872.2020.33.1.05

Sinbukhova Elena Vasilyevna, Medical Psychologist, Neuropsychologist at the N. N. Burdenko National Medical Research Center for Neurosurgery, Moscow, Russia. E-mail: ESinbukhova@nsi.ru

Zankovsky Anatoly Nikolayevich, Doctor of Psychological Sciences, Professor, Head of the Laboratory of Labour Psychology, Ergonomics, Engineering and Organizational Psychology at the Institute of Psychology of the Russian Academy of Sciences, Moscow, Russia.

E-mail: azankovsky@gmail.com

Protsenko Denis Nikolaevich, PhD in Medicine, Chief physician of the City Clinical Hospital № 40 of the Moscow Healthcare Department, Assosiate Professor at the Department of Anaesthesiology and Critical Care Medicine of the N. I. Pirogov Medical University, Moscow, Russia.

E-mail: ProtsenkoDN@zdrav.mos.ru

Sinbukhova Nadezhda Ivanovna,, Neurologist at the Central Polyclinic JSC «Russian Railways (RZhD)», Moscow, Russia.

References

1. Akopov V. I. Problema obosnovannogo riska v medicinskoj praktike [The problem of substantiated risk in medical practice] // Problems of Expertise in Medicine. 2001. № 1. P. 8-10.

2. Mikhel D. V. Filosofiya terapevticheskogo vy'bora: prinyatie medicinskix reshenij v kontekste socio-kuFturny'x transformacij [Philosophy of Therapeutic Choice: Medical Decision Making in the Context of Social and Cultural Transformations] // Izvestiya of Saratov University. Series: Philosophy. Psychology. Pedagogics. 2016. Т. 16. № 2. P. 155-161.

3. Kornaukhova T. A. Specifika professionaFnoj e tiki medicinskogo rabotnika [Specifics of professional ethics of a health worker] // Theory and Practice of Social Development. 2015. № 6. P. 159-162. URL: http:// teoriapractica.ru/rus/files/arhiv_zhurnala/2015/6/pedagogics/kornaukhova.pdf

4. Sinbukhova E. V. Otkrytye voprosy' udovletvorennosti zhiznyu i professionaFnogo vy'goraniya v anesteziologii i reanimacii [Open questions of life satisfaction and burnout in anesthesiology and resuscita­tion] / E. V. Sinbukhova et al. // Sklifosovsky Journal Emergency Medical Care. 2019. № 8 (3). С. 266-273. https://doi.org/10.23934/2223-9022-2019-8-3-266-273.

5. Dana L. Alden. Who decides: Me or we? Family involvement in medical decision making in Eastern and Western countries / Dana L. Alden et al. // Medical Decision Making. 2017. Vol. 38 (1). P. 14-25. DOI: 10.1177/0272989X17715628.

6. Emma A. Bateman, Ricardo Viana. Burnout among specialists and trainees in physi­cal medicine and rehabilitation: a systematic review // Journal of Rehabilitation Medicine. 2019. Oct 14. DOI: 10.2340/16501977-2614.

7. Bondurant R., Morton N. Implementing change to reduce depression, suicide, and burnout among physicians-in-training // Missouri Medicine. 2016. Jan.-Feb. № 113 (1) P. 16-18.

8. Ramon Boom. A medical decision making "List" // Medical Decision Making. 1982. Vol. 2. Issue 2.

P. 254-254.

9. Caryn Christensen, Larson Jr. Collaborative Medical Decision Making // Medical Decision Making. 1993. № 13. P. 339. DOI: 10.1177/0272989X9301300410.

10. Coombs D. M. Professional burnout in United States plastic surgery residents: is it a legitimate con­cern? / D. M. Coombs et al. // Aesthetic Surgery Journal. 2019. Oct. 17. Pii: sjz281. DOI: 10.1093/asj/sjz281.

11. Erin M. Ellise. Effects of emotion on medical decisions involving tradeoffs / Erin M. Ellise et al. // Medical Decision Making. 2018. Vol. 38. Issue 8. P. 1027-1039.

12. Wolfgang Gaissmaier. A cognitive-ecological perspective on risk perception and medical de­cision making // Medical Decision Making. 2019. № 1-4. First published September 26. DOI: 10.1177/ 0272989X19876267.

13. Laramee J., Kuhl D. Suicidal ideation among family practice residents at the University of British Columbia // Can Fam Physician. 2019. № 65(10). P. 730-735.

14. Makary M. A., Daniel M. Medical error-the third leading cause of death in the US // British Medical Journal. 2016. № 3. DOI: 10.1136/bmj.i2139.

15. Milenovic M. High rate of burnout among anaesthesiologists in Belgrade teaching hospitals: results of a cross-sectional survey / M. Milenovic et al. // European Journal Anaesthesiology. 2016. № 33 (3). P. 187-94. DOI: 10.1097/EJA.0000000000000383.

16. Robertson J. J., Long B. Suffering in silence: medical error and its impact on health care providers // Journal of Emergency Medicine. 2018. № 54 (4). P. 402-409. DOI: 10.1016/j.jemermed.2017.12.001.

17. Society for Medical Decision Making (SMDM): официальныйсайт. URL: https://smdm.org/ hub/about

18. Waterman A. D. The emotional impact ofmedical errors on practicing physicians in the United States and Canada / A. D. Waterman et al. // Joint Commission Journal on Quality and Patient Safety. 2007. № 33. P. 467-476. DOI: 10.1016/S1553-7250(07)33050-X.