Pertinence des indicateurs de risques psychosociaux à l’hôpital pour la prévention du burnout

- Introduction - The European study NEXT-PRESST questions the validity of the models of workplace stress from samples of nurses from 10 European countries. The re-use of this 2008 questionnaire in a Parisian University hospital confirms the validity of reports. Furthermore, the French study Health and Satisfaction of Physicians at Work adopted the same scales for physicians. It is possible to find out whether the relations found initially are persistent, and to define propositions for the prevention of psychosocial risks, valid for the whole caring community. - Method - With this aim, several relations were clarified: between the scores of Karasek and Theorell's model and of Siegrist's model, quality of the teamwork and uncertainty regarding treatments, and between these four scores and burnout. The statistical analyses, carried out with the software SPSS 12.0. Allowed to clarify the respective roles of several dimensions and their respective links: psychosocial dimensions of the work, personal characteristics, work/ family balance, burnout. - Results - According to multivariate analyses, Siegrist's model and quality of teamwork score are very relevant to take into account the psychosocial determinants of stress and burnout. Working conditions, in particular the effort / reward ratio, have an essential influence on burnout ; adjusted odds ratios rise from 2.00 to 2.88, and 4.25 with the degradation of the effort / reward ratio. Burnout is particularly problematic for the nursing aids. Two other explanatory variables for burnout, each with a clear gradient according to exposure levels, almost double its occurrence: quality of the teamwork and exposure to violence. Variables describing the relations at work and the circulation of information increase by 20 % the occurrence of burnout. Among European nurses, the personal situation and especially the work / family conflicts are also essential in its appearance. Family situation, in couple with child and especially single with child, is very much related to burnout. Results are similar to the longitudinal data. The same risk factors are found among physicians often to a larger extent. - Conclusion - The circulation of information within a cohesive team is essential to improve the influence at work of each health care worker and the perception of a recognition of his competence. More efficient work organization and association of the health care worker his work rest planning allow to reduce work / family imbalance