Margarita V. Lysova

The professional activities of doctors specializing in therapeutic and surgical fields are characterized by high neuropsychological stress, as well as growing digitalization — specialists of different generations are not fully adapting to it, which provokes psychoemotional and physical overstrain. Coping strategies are behavioral and cognitive methods of overcoming stress and negative emotions; they are divided into adaptive and maladaptive. The aim of the study is to identify the specific features of the state of the psychoemotional sphere and to assess the level of use of adaptive and maladaptive coping strategies among doctors specializing in surgical and therapeutic fields. Materials and methods: the study involved gastroenterologists (n=52), general surgeons (n=71), cardiologists (n=58), surgeons of the cardiovascular profile (n=30), oncologists of the therapeutic profile (n=48), oncologists of surgical profile (n=65). The control group consisted of non-medical professionals (n=75). The study used the «Coping Test» methodology, which is designed to identify coping mechanisms in the cognitive, emotional, and behavioral spheres [Lazarus R., Folkman S., 1984], adapted by [Kryukova E. V., Kufyat E. V., 2007; Ersh E. V., 2021]. In the statistical analysis, the significance of the differences was determined using one‑way analysis of variance (ANOVA), and intergroup comparisons were made using the Dunnet criterion. The most commonly used coping strategies among gastroenterologists are taking responsibility; among cardiologists, confrontation, self-control, decision-making planning; among oncologists of a therapeutic profile, distancing, seeking social support, escape, avoidance; among surgeons of a general surgical profile, distancing, problem-solving planning; among surgeons cardiovascular profile — confrontation, escape-avoidance, positive reassessment; oncologists of surgical profile-self-control, search for social support, acceptance of responsibility. Excessive use of maladaptive coping strategies leads to maladjustment. The data obtained indicate the need to include questionnaires assessing the use of adaptive and maladaptive coping strategies in the diagnosis of professional burnout in the practice of periodic medical examinations of medical workers, with the aim of timely implementation of preventive measures and their personalization to preserve the health of medical workers.

In the modern world, medical personnel experience great psycho-emotional stress associated with professional communication with patients with various pathologies, empathy for them, the need to make decisions on which people’s health and lives depend, high information load, communication with colleagues, etc. These factors are the cause of psychoemotional burnout, one of the criteria of which is the development of personal and situational anxiety. The aim of the study was to assess the levels of personal and situational anxiety among doctors of therapeutic and surgical profile. The study included doctors of therapeutic (n=158) and surgical (n=166) specialties, as well as individuals who made up the control group (n=75). Personal and situational anxiety was assessed using an integrative anxiety test [Bizyuk A. P., Wasserman L. I., Iovlev B. V., 1997]. The study made it possible to identify the groups with the highest risk of developing personal and situational anxiety among medical personnel, which are doctors of surgical specialties: general surgeons, cardiac surgeons, operating oncologists. Their therapeutic colleagues (gastroenterologists, cardiologists, and non-operating oncologists) are less likely to develop anxiety. The data obtained can be used to compile preventive programs for professional burnout, taking into account the specialization and profile of medical activity.

The data obtained in the article allow us to recommend specialized rehabilitation measures as well as psychopharmacological drugs when identifying risk factors for a decrease in quality of life in medical specialists using relaxation techniques, art therapy, and professional adaptation programs, physiotherapeutic techniques such as electrosleep and reflexology, and, if possible, resort treatment in sanatoriums and health resorts, local sanatoriums, etc. with visits to psychotherapeutic offices and with the use of psychopharmacological drugs.

Professional burnout is one of the most acute problems in modern healthcare, which affects medical professionals of various specialties, and certainly affects the formation of human resources, as it entails the retirement of highly qualified interns from the profession. The aim is to evaluate the features of a decrease in the quality of life of specialist doctors under the influence of occupational stress and to provide opportunities for predicting and preventing a decrease in the quality of life of this category of employees. The study was conducted using the Sf-36 «Quality of Life» questionnaire [J. E. Ware, 1993], which is designed to study all components of quality of life. The study included doctors of therapeutic specialties — gastroenterology (52 people.), cardiology (58 people.), oncology of therapeutic profile (48 people.) and doctors of surgical specialties — surgeons of general surgical profile (71 people.), surgeons of cardiovascular profile (30 people.), oncology surgical profile (65 people.), as well as the control group — employees of engineering, technical and economic specialties (75 people.). It was found that the levels of general and mental health in general were significantly lower in the groups of doctors of the surgical profile, both compared with the control group and with their fellow internists of the concomitant specialization. The most pronounced decrease occurred in the group of cardiovascular surgeons. Also, in groups of different specialties, oncologists of both therapeutic and surgical profiles were distinguished by lower indicators, and when comparing the indicator of general health, there was no sufficient difference between oncologists of therapists and oncologists of surgeons. The study revealed the specific effects of occupational stress on the general and mental health of doctors of therapeutic and surgical specialties, requiring the development and implementation of a set of preventive measures to reduce the incidence of occupational pathology in these individuals.

In accordance with Decree No. 1 of the Chief State Sanitary Doctor of the Russian Federation dated January 11, 2011, "On the Approval of SP 3.1.5.2826-10 'Prevention of HIV Infection'" and Letter No. 30-05/84 of the Ministry of Health of the Samara Region dated March 25, 2015, "On the Organization of Post-Exposure Prophylaxis for Professional HIV Infection of Medical Workers in the Samara Region," the implementation of organizational, therapeutic, preventive, and sanitary-epidemiological measures to prevent occupational HIV infection is the responsibility of the heads of medical organizations, regardless of their legal form, type of ownership, or departmental affiliation [1-4]. The relevance of preventing accidental exposure during various types of work and procedures performed by medical staff is highlighted by the fact that the number of healthcare workers registered for follow-ups at the Samara Regional Center for the Prevention and Control of AIDS and Infectious Diseases after exposure while treating HIV-infected patients has remained consistently high in recent years [5-8]. Pursuant to current legislation, the following measures are conducted to prevent occupational HIV infection: a set of procedures to prevent accidental exposure; training and instruction of medical personnel on immediate actions in the event of an accident; and the recording of injuries and micro-injuries sustained by medical staff in the line of professional duty. An essential element is the organizational component, i.e. appointing, by official order of the medical organization, a specialist responsible for organizing post-exposure prophylaxis for HIV infection among medical workers, determining the scope of the victim's examination, and identifying indications for antiretroviral therapy based on epidemiological history [9-12]. critical aspect is the follow-up of medical workers who have sustained an injury. This is carried out at the place of employment and lasts for 12 months, with mandatory follow-up testing for HIV and parenteral hepatitis at 6 and 12 weeks, and 6 and 12 months. It is also necessary that the individual responsible for overseeing this preventive area be designated by an of ficial order within the medical organization.

The professional activity of doctors of therapeutic and surgical specialties is associated with the effects of chronic occupational stress, which leads to differences in the level of emotional intelligence, which is a protective factor that prevents the development of professional burnout, the severity of which is largely determined by the level of emotional intelligence. The aim of the work is to study the indicators of emotional intelligence in groups of doctors of therapeutic and surgical profile. The study included doctors: group 1 — gastroenterologists (n=52 people).; Group 2 — cardiologists (n=58 people); group 3 — oncologists of therapeutic profile (n=48 people); group 4 — group — surgeons of general surgical profile (n=71 people); group 5 — surgeons of cardiovascular profile (n=30 people); group 6 — surgeons oncologists of surgical profile (n=65 people); 7 — control group — employees of engineering, technical and economic specialties who are not related to work in medical organizations (healthy) (n=75 people). The assessment of the level of emotional intelligence was carried out according to the method of determining emotional intelligence (EI) by N. Hall, which is aimed at identifying the ability to understand personality relationships manifested in emotions and the ability to manage the emotional sphere based on decision-making. The results of the study showed that the doctors of the therapeutic profile had a more developed emotional intelligence compared to their colleagues, surgeons, whose distinctive feature was a high level of management of their own emotions. Knowledge of the differences in the severity of certain indicators of emotional intelligence for different groups of doctors of therapeutic and surgical profile, taking into account specialization, can be used in the preparation of a program for the prevention of professional burnout of doctors.

The authors present a review of literary sources in the field of professional burnout and health of workers in medical and educational organizations. Mental health is a state of well-being in which people realize their own abilities, can cope with the normal stresses of life, work productively, and make a contribution to their community (WHO, 2010). The problem of health problems associated with nervous and emotional stress among those in the helping professions will only increase in importance. There are a number of challenges in including these health conditions in the list of occupational diseases: inclusion in labor legislation and occupational health standards; lack of a methodology for quantitatively assessing risk factors.

The aim of the work is to study the emotional intelligence of therapeutic and surgical physicians depending on their specialty. Material and research methods. The study was carried out on the basis of the Department of Occupational Diseases and Clinical Pharmacology named after honored scientist of the Russian Federation professor V.V. Kosarev, FSBEI HE Samara State Medical University of the Ministry of Health of the Russian Federation, and the Department of Occupational Pathology, Regional Center for Occupational Pathology of the Samara City Hospital No. 5. The study was carried out within the framework of the complex topic of the Department of Occupational Diseases and Clinical Pharmacology named after honored scientist of the Russian Federation professor V.V. Kosarev, FSBEI HE Samara State Medical University, "Problems of polymorbidity, diagnostics, prognosis, and prevention of occupational and work-related diseases in workers with isolated combined exposure to factors of the production environment and the work process" (registration number 124053000016-4, date of registration 05/30/2024). Patient consent. Each study participant provided informed voluntary written consent to participate in the study and the publication of personal medical information in anonymized form. The study included: group 1 – gastroenterologists (n=52 participants); group 2 – cardiologists (n=58 participants); group 3 – oncologists of therapeutic profile (n=48 participants); group 4 – general surgeons (n=71 participants); group 5 – cardiovascular surgeons (n=30 participants); group 6 – oncological surgeons (n=65 participants); group 7 - control group: employees of engineering, technical, and economic specialties not related to medical organizations (healthy) (n=75 participants). The level of emotional intelligence was assessed using N.Hall's method for determining emotional intelligence (EI), which is aimed at identifying the ability to understand personal relationships manifested in emotions and the ability to manage the emotional sphere based on decision-making. Statistical analysis was performed using the RStudio programming language and environment (R v.4.4.1, RStudio 2024.09.1+394). Descriptive statistics for continuous data were calculated as mean, with 95% confidence intervals; for nonparametric data, median with 25% and 75% quartiles and interquartile range were employed. Although the data did not conform to a normal distribution, the groups were larger than 30 observations, which, according to the central limit theorem, allows us to use the mean and 95% confidence intervals to describe the variables. The χ2 test was used to compare percentages. When assessing differences in nonparametric data groups, the Mann-Whitney U test was applied for two comparison groups, and the Kruskal–Wallis test – for more than 2 groups. Results. The professional activities of GP and surgical physicians are associated with the impact of chronic occupational stress, leading to differences in the level of emotional intelligence, which is a protective factor preventing the development of professional burnout, the severity of which is largely determined by the level of emotional intelligence. Limitations of the study. The study has regional (Samara Region) and professional (in terms of detailing working conditions in the comparison groups studied) limitations. Conclusion. Thus, the obtained data indicate that when identifying risk factors for an increase in the level of emotional intelligence among healthcare workers including when using methods for assessing emotional intelligence, there is the need to use specialized rehabilitation measures for medical workers with relaxation techniques, art therapy, as well as professional adaptation programs, physiotherapeutic techniques, such as electrosleep and reflexology, and, if possible, resort treatment in health care centers, local sanatoriums, etc. with visits to psychotherapy offices, as well as psychopharmacological medications

Introduction: According to recent statistics, more than 80 % of medical doctors are currently subject to occupational burnout. Objective: To study the features of job burnout among physicians and surgeons in a specialized hospital. Materials and Methods: The study population comprised seven groups consisting of 52 gastroenterologists, 58 cardiologists, 48 medical oncologists, 71 general surgeons, 30 cardiac surgeons, 65 surgical oncologists, and 75 controls of engineering, technical and economic specialties. The level of occupational burnout among medical workers was assessed using the Boyko method. The statistical analysis was carried out using the programming language and environment R v.4.4.1, RStudio 2024.09.1+394. The chi-square test was used to compare the percentages. Results: Surgeons were noted for a more rapid formation of job burnout phases. Surgical oncologists were at the highest risk of rapid formation of phases leading to exhaustion. When assessing tension, resistance and exhaustion phases in cardiac surgeons based on the Boyko test, we established that the stress phase was forming in 70.0 % and had formed in 13.3 %, the resistance phase was forming in 40.0 % and had formed in 43.33 %, while the exhaustion phase was forming in 96.67 % of the respondents; no surgeons with an already developed exhaustion phase were identified in this group. Conclusion: Knowledge of the differences in the severity of occupational burnout for different groups of physicians and surgeons of various specialties can be used in developing burnout prevention programs for health professionals.

The purpose of the work is to study the features of professional development among internists and surgeons of general and specialized fields. Research materials and methods. The research was carried out within the framework of a comprehensive topic of the Department of Occupational Diseases and Clinical Pharmacology named after Professor V.V. Kosarev, Honored Scientist of the Russian Federation, Samara State Medical University, «Problems of polymorbidity, diagnosis, prognosis and prevention of occupational and production-related diseases in workers with isolated combined effects of factors of the industrial environment and the labor process» (registration number 124053000016-4), registration date 30.05.2024). Patient consent. Each participant in the study gave informed voluntary written consent to participate in the study and publish personal medical information in an impersonal form. The study included: group 1 — gastroenterologists (n=52 people); group 2 — cardiologists (n=58 people); group 3 — oncologists of therapeutic (TP) profile (n=48 people); group 4 — doctors of general surgery (HR) (n=71 people); group 5 — surgeons of the cardiovascular profile (n=30 people); group 6 — oncologists of the surgical (XP) profile (n=65 people); control group 7 — workers of engineering, technical and economic profiles, not related to the profile of activity-people with jobs in medical organizations (healthy) (n=75 people). The assessment of the level of professional burnout among medical workers was carried out using the MBI methodology developed by K. Maslach, S. Jackson, and adapted by N. E. Vodopyanova. The statistical analysis was performed using the R Studio programming language and environment (R v.4.4.1, RStudio 2024.09.1+394). Descriptive statistics for continuous data were calculated as the mean, 95% confidence intervals; for nonparametric data, the median, 25% and 75% quartiles, and the interquartile range. Although the data did not correspond to a normal distribution, the groups were larger than 30 observations, which, according to the central limit theorem, allows us to use the mean and 95% confidence intervals to describe the variables. The x2 criterion was used to compare the percentages. When evaluating differences in nonparametric data groups, the Mann- Whitney criteria were used for two comparison groups, and the Kraskel-Wallis criteria for more than 2 groups. Results. The professional activity of doctors of the TR and XP profile is associated with the effects of chronic occupational stress, leading to the development of professional burnout. Limitations of the study. The study has regional (Samara region) and professional (in terms of the detailed working conditions in the comparison groups studied) limitations. Conclusion. Thus, the data obtained indicate the need to use specialized rehabilitation measures for physicians using relaxation techniques, art therapy, as well as professional adaptation programs when identifying risk factors for increasing the level of occupational burnout among medical workers providing medical care in hospitals of therapeutic, general surgical, and specialized profiles.; physiotherapy methods, such as electrosleep and reflexotherapy, if possible, sanatorium-resort treatment in sanatoriums, local health resorts, etc. with visits to psychotherapy rooms, as well as psychopharmacological drugs.