Las características familiares y la salud percibida en médicas y médicos de familia de Andalucía

Abstract

Objetivo: Conocer las relaciones de un conjunto de características profesionales y familiares con los componentes de salud física y psíquica en médicas y médicos de familia que trabajan en centros de salud en Andalucía. Método: Descriptivo, transversal y multicéntrico. Población: médicas y médicos de familia de centros urbanos. Muestra: 500 profesionales, 50% por sexo. Se consideró el sexo, la edad, las características profesionales (formación posgraduada en medicina de familia, ejercer la dirección del centro de salud, ser tutor/a de formación posgraduada, y carga asistencial según tamaño del cupo y pacientes/día), las responsabilidades familiares, dos dimensiones de las relaciones familia-trabajo (sobrecarga y conflicto familia-trabajo) y la salud percibida física y psíquica. Fuente: cuestionario postal autoadministrado. Análisis: regresión múltiple para salud física y psíquica, conjunta para la muestra y por sexo. Resultados: Responden 368 profesionales (73,6%). Las médicas presentan peor salud psíquica que los médicos, sin diferencias en la salud física. El conflicto familia-trabajo se asocia con salud física y psíquica en médicas y médicos. La salud física empeora al aumentar la edad en ambos sexos, mejora en médicas tutoras y disminuye en médicos al aumentar el conflicto familia-trabajo. La salud psíquica disminuye en ambos sexos al aumentar las horas dedicadas al hogar los fines de semana y el conflicto familia trabajo. En los médicos, la salud psíquica empeora si tienen formación posgraduada y mejora si son directores de centro de salud. Conclusiones: La carga de trabajo y las características profesionales tienen escasa relación con la salud de médicos y médicas de familia. Desempeñan un papel más relevante las características familiares.

Objective: To determine the relationships between a group of professional and family characteristics and the components of physical and mental health in female and male primary care physicians working in health centers in Andalusia (Spain). Methods: A descriptive, cross-sectional, multicenter study was performed. The population consisted of urban health centers in Andalusia and their physicians. The sample comprised 88 health centers and 500 physicians. Measurements consisted of sex, age, professional characteristics (postgraduate training in family medicine, position of health center manager, accreditation as a residents’ tutor, and workload based on patient quota and the mean number of patients/day); family responsibilities, defined by two dimensions of the family-work relationship (support overload-family support deficit and family work conflict); and perceived physical and mental health. The data source was a self administered questionnaire sent by surface mail. Multiple regression analyses were performed for physical and mental health for the whole sample and by gender. Results: Responses were obtained from 368 physicians (73.6%). Mental health was worse in female physicians than in male physicians; no differences were found between genders in physical health. The family-work conflict was associated with physical and mental health in physicians of both genders. Physical health deteriorated with increasing age in both genders, improved in the female tutors of residents, and decreased with increasing family-work conflict in male physicians. Mental health decreased with increasing housework on the weekends and with family-work conflict in both genders. In male physicians, mental health deteriorated with postgraduate training in family medicine and improved if they were health center managers. Conclusions: Workload and professional characteristics have little relationship with the health of primary care physicians. Family characteristics play a greater role.