EL NUEVO PROTECTOR (Spanish Edition)

The concept of time disappears and a greater sense of satisfaction is experienced. Do doctors work in this way? If we take the idea that professional efficacy acts opposite to emotional exhaustion and cynicism, we can expect flow and professional efficacy to form part of this same construct. Furthermore, it is possible, to consider professional efficacy as a protective factor.

We are also interested in the direction and relative importance of these relationships. Our research questions are: Physicians from the Emergency Unit were not considered for participating in the study due to the different type of tasks developed by them. Health professionals have to indicate the level of stress, tension and irritability generated by each of the situations on a scale 0 none to 4 very much , The test consists of seven factors relating to: Internal consistency of all sizes ranges from.

The inventory can also obtain an overall index of occupational stress in a hospital setting, which is used in this study.

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It has three subscales: This inventory has shown high levels of reliability from. This is perhaps the best known test for measuring coping strategies in Psychology. It consists of 66 items, with a response scale of four points 0 to 3 , which evaluates eight ways for coping with stressful situations. For this study, the following are used: It consists of 90 items on a five-point scale 0 to 4 , grouped into nine domains. In this study we focused on four: The reliability of the nine dimensions reaches values close to or above. It consists of the following scales: The scale allows for a total score of flow used in the study.

With the Spanish adaptation of the test, Cronbach's alpha values of over. A cover letter along with the project to be carried out was sent to the head of the hospitals and their ethics committees, who approved the study. Later, an interview was arranged with the hospital directors. Participants were volunteers and were informed in writing of the content of the study, duration, participation, the pros and cons of participating, and the possibility of receiving a personalized report of their results at the end of the study. It was clearly defined that the study was designed to investigate health in health professionals.

An informed consent was signed by each participant. A personal letter was also sent to department heads to inform them about the study. Personal reports were confidential and only general results were presented to the hospital direction. Tests were completed during shifts in spare time.

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When trying to cope with models in Psychology we almost always think of Structural Equation Modeling SEM as the ideal way to analyze data. But SEM has some limitations which can make this task very difficult or impossible. It is frequent to find low sample sizes when a researcher works with special samples where it is difficult to recruit participants. You can also find multicollinearity between variables, which causes serious problems for the analysis. Moreover, when coping with too many parameters, SEM has substantial problems in relation to parameter estimation and sample size, leading to non-identified models.

Assumption of univariate and multivariate normality is another important theme. Maximum likelihood is the most extended estimation method, but data has to be distributed normally. Finally, management of missing data is another problem in this methodology. What can be done in these cases?

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An interesting alternative statistical procedure, Partial Least Squares PLS , could be a potential solution to these issues. It is not sensitive to low sample size, does not require normality in the distribution of data, can work with missing data, multicollinearity is not a problem and it can cope with more complex models. So, as a whole, the PLS method demands significantly fewer requirements compared to that of covariance structure analysis, but nevertheless delivers consistent estimation results.

There are some examples with 85 and cases in Campbell and Ntobedzi and Karim and Weisz , respectively. The mean age of the sample was Mean years in the health profession was Mean years in current job was Mean hours spent at work was The mean number of patients in daily professional care was Night shifts per month were a mean of 3. The rest were permanent staff.

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First of all, a descriptive statistics table of the direct scores of the participants for all data analyzed is shown Table 1. The analysis began with a complete model Figure 1 containing all paths in the matrix between all variables of interest emotional exhaustion, cynicism, occupational stress, anxiety, depression, hostility, somatization, avoidance and distancing coping styles scales, professional efficacy and flow , then the least significant variables were dropped sequentially until all remaining paths were significant.

Scales from questionnaires were considered in order to define our models more precisely. The first steps were directed towards a model of vulnerability to anxiety and depression illnesses with burnout components. Data were scaled in a standardized format and the weighting scheme was centroid. Bootstrapping methodology was used in order to estimate standard errors and evaluate statistical significance of loadings, path coefficients and r-squared values.

One case with missing data was replaced by the mean. Results follow the recommendations by Chin Latent variable negative coping has one indicator: Latent variable burnout has two indicators: Latent variable stress has one indicator: Latent variable professional flow has two indicators: Evaluation of the reflective measurement outer model. Model fit and fit criteria model. Fit criteria assessment was made according to the criteria proposed by Chin and Gotz, Liehr-Gobbers and Krafft All the constructs show unidimensionality.

The first eigen-values were higher than 1 and the second eigen-values were lower than 1 see Table 2. All the loadings of the latent constructs on their indicator variables are higher than the other loadings on these indicators see Table 3. Loadings are above or near. The constructs are well explained by their indicators. All the construct's indicators jointly measure the construct adequately Table 2.

Average variance extracted AVE is higher than. For the global model, mean communality index is. Fornell and Larcker demonstrated that there is discriminant validity if a latent variable's AVE is larger than the common variances squared correlations of this latent variable with any other of the model's constructs. This is true in all cases see Table 2. Evaluation of the structural model inner model. Model fit and fit criteria. Figure 2 represents the inner structural model.

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R -squared indices of endogenous variables see Table 2 vary from. All paths were significant at. Table 2 also shows interconstruct correlations. The hypothesized model has an excellent fit, based on goodness of fit indices GoF by Tenenhaus, Amato and Esposito-Vinzi A GoF above the. Relative goodness of fit index GoF was.

This coping style was expected to be associated with burnout, but no findings were found in this sense. These are also commonly reported symptoms of burnout. It is interesting to consider that depression, anxiety, hostility and somatization can be symptoms found in physicians as a result of the influence of occupational stress, burnout and avoidance. Depression, anxiety, hostility and somatization can affect a physician's health and influence, what Wallace et al.

Avoidance is also an apparent characteristic in physicians, which is an important issue requiring further explanation and consideration with respect to interventions for improving physicians' health and the health system. The introduction to this study states that the factors influencing burnout in physicians were unclear Shanafelt et al. Regarding the models mentioned in the introduction, this model coincides with McManus et al. It also coincides with the model by Graham et al. These differences exist because job stress increases psychiatric morbidity indirectly, but not directly; and cynicism and emotional exhaustion act together.

To sum up, these results in general support the results from Graham et al. Other points to be considered in relation to the decrease of the effects of burnout are the importance of not having an avoidance coping style, the role of flow along with professional efficacy and a non-adequate coping style. Any potential interventions based in these conclusions can follow the suggestions contributed by Wallace et al. This study has of course limitations.

Sample size was restricted by the number of volunteers participating, so in the future it will be important to study better ways of recruiting more physicians to participate in the study. Having access to data from other hospitals in Spain, as well as private hospitals, could complete this study. Future studies should investigate if protective and vulnerability factors change over time and what variables they depend on apart from those studied.

A physician's personality traits can provide some ideas for this subject. Sources of stress in the national health services: A comparison of seven occupational groups.

Stress and the medical practitioner. Stress Medicine, 5, A way of handling difficult situations in daily care. Journal of Clinical Nursing, 16, Journal of Palliative Medicine, 12, Stress and women physicians. A PLS approach to developing a predictive model. Electronic Journal of Applied Psychology, 3 1 , University of Alicante, Alicante, Spain.

Job Stress in the Human Services. The partial least squares approach to structural equation modeling. How to write up and report PLS analyses. Concepts, methods and applications pp. The psychology of optimal experience. The psychology of engagement with everyday life. Administration and scoring procedures manual II. Administration, Scoring and Procedures Manual. Un estudio con entrevistas semiestructuradas. Handbook of partial least squares.

Concepts, methods and applications. Sex and culture in burnout and coping among human service professionals. Available to ship in days.

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