Burn-out as occupational phenomenon in the International Classification of Diseases

Burn-out has been included by the WHO as occupational phenomenon in the 11th revision of the International Classification of Diseases (ICD-11) in May 2019, and inserted among the Factors influencing health status or contact with health services: that is, those reasons why people contact healthcare services, but that are not classified as diseases or health conditions.

Burn-out is therefore defined as follows:

[…] is a syndrome conceptualised as resulting from chronic workplace stress that has not been successfully managed. It is characterized by three dimensions:

  • feelings of energy depletion or exhaustion;
  • increased mental distance from one’s job, or feelings of negativism or cynicism related to one’s job; and
  • reduced professional efficacy.

Burn-out refers specifically to phenomena in the occupational context and should not be applied to describe experiences in other areas of life. 

The WHO is about to address the development of evidence-based guidelines on mental well-being in the workplace.

One of the areas with an excessive negative imbalance in the quality of professional life remains healthcare, spreading not only among doctors, but over all the figures involved in the care team.

The 2019 Medscape National Physician Burnout, Depression and Suicide Report indicates that the burn-out issue remains urgent: 44% of the professionals interviewed reported feelings related to it, while 4% were declared clinically depressed. Neurology is among the specialisations most at risk (48%). ISTUD Foundation focused on neurologists’ experience within the SMART – Multiple Sclerosis: listening to the multi-professional realities of the neurological teams project, carried out under the patronage of the Italian Society of Neurology (SIN) and in partnership with Biogen Italia. The project aimed to address the listening of professionals taking care of people affected by Multiple Sclerosis, and investigating professional motivations and the risk of fatigue and burn-out.

In addition to the tools already present in literature – such as the Professional Quality of Life Scale (PROQOL)narrative is particularly useful as self-diagnosis of emotional suffering in the workplace. In particular, the parallel chart, a narrative medicine tool, allows the professional to safe a room sacrificed by healthcare bureaucratisation and “technocracy”: the one dedicated to reflection and care of the professional’s emotional well-being.

In fact, as already mentioned by Paola Chesi in another article,

Narrative Medicine, as we have already said many times, has the richness and the great potentiality to give voice to all the stakeholder around a pathway of care, so not only who lives with a disease, but also who lives with ill people, the caregiver, and who clinically takes care of them. What it is less frequently said, is that narrative medicine was born for healthcare professionals, as a caring approach, able to improve the relational skills, but also the organizational and therapeutic competencies.

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