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          "es" => "<p class="elsevierStyleSimplePara elsevierViewall">Relaci&#243;n entre el n&#250;mero mensual de guardias totales y en urgencias y la puntuaci&#243;n en el cansancio emocional&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><span class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Introducci&#243;n</span><p class="elsevierStylePara elsevierViewall">El s&#237;ndrome de <span class="elsevierStyleItalic">burnout</span> es una respuesta inapropiada a un estr&#233;s laboral cr&#243;nico que afecta marcadamente a aquellos colectivos cuyo &#225;mbito de trabajo implica la atenci&#243;n al p&#250;blico de forma mantenida&#46; Fue definido por Maslach y Jackson<a class="elsevierStyleCrossRef" href="#bib1"><span class="elsevierStyleSup">1</span></a> en 1981 y se caracteriza por un alto nivel de cansancio emocional&#44; despersonalizaci&#243;n y falta de realizaci&#243;n personal&#46;</p><p class="elsevierStylePara elsevierViewall">Entre los colectivos afectados destaca el personal sanitario&#44; y entre ellos especialmente los residentes&#44; dado que la sobrecarga asistencial que soportan es elevada<a class="elsevierStyleCrossRef" href="#bib2"><span class="elsevierStyleSup">2</span></a>&#46; Esta sobrecarga asistencial puede verse agravada por la existencia en muchos de nuestros hospitales de jornadas de trabajo de 24<span class="elsevierStyleHsp" style=""></span>h &#40;y en ocasiones m&#225;s&#41; consecutivas englobadas dentro del concepto cl&#225;sico de guardia&#46; Si a ello le a&#241;adimos que algunas &#40;o todas&#41; estas guardias se realizan en el Servicio de Urgencias&#44; el cual se encuentra en muchos de los hospitales espa&#241;oles en situaci&#243;n de pl&#233;tora asistencial permanente<a class="elsevierStyleCrossRefs" href="#bib3"><span class="elsevierStyleSup">3&#44;4</span></a>&#44; el resultado puede ser un elevado grado de <span class="elsevierStyleItalic">burnout</span> entre el colectivo de residentes&#46; Aunque alg&#250;n estudio realizado en residentes ha encontrado que hasta el 93&#37; de ellos puede presentar cierto grado de <span class="elsevierStyleItalic">burnout</span><a class="elsevierStyleCrossRef" href="#bib5"><span class="elsevierStyleSup">5</span></a>&#44; no se han investigado en profundidad los factores relacionados con dicho <span class="elsevierStyleItalic">burnout</span>&#46; El objetivo del presente estudio es profundizar en esta cuesti&#243;n&#46;</p></span><span class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">M&#233;todo</span><p class="elsevierStylePara elsevierViewall">Se realiz&#243; el estudio entre todos los residentes del Hospital Cl&#237;nic de Barcelona durante el periodo enero-marzo de 2007&#46; Para valorar el grado de <span class="elsevierStyleItalic">burnout</span> se utiliz&#243; el <span class="elsevierStyleItalic">Maslach Burnout Inventory</span> &#40;MBI&#41; considerado como el patr&#243;n oro de los cuestionarios para objetivar el <span class="elsevierStyleItalic">burnout&#44;</span> el cual ha sido previamente validado en Espa&#241;a<a class="elsevierStyleCrossRef" href="#bib6"><span class="elsevierStyleSup">6</span></a>&#46; Se trata de un cuestionario creado y validado por la Dra&#46; Maslach<a class="elsevierStyleCrossRef" href="#bib2"><span class="elsevierStyleSup">2</span></a> que valora las 3 esferas relacionadas con el <span class="elsevierStyleItalic">burnout</span> &#40;cansancio emocional&#44; despersonalizaci&#243;n y desrealizaci&#243;n personal&#41;&#46; Consta de 22 &#237;tems&#44; cada uno de los cuales se valora con una escala del tipo Likert &#40;en la que se pide que se especifique el grado de acuerdo o desacuerdo con una afirmaci&#243;n&#44; de 0&#8211;6 puntos&#41;&#46; De estos 22 &#237;tems&#44; 9 de ellos hacen referencia al cansancio emocional&#44; 5 a la despersonalizaci&#243;n&#44; y 8 a la realizaci&#243;n personal&#46; Siguiendo los mismos criterios empleados en trabajos previos<a class="elsevierStyleCrossRef" href="#bib7"><span class="elsevierStyleSup">7</span></a>&#44; se define la existencia de <span class="elsevierStyleItalic">burnout</span> cuando se obtiene una puntuaci&#243;n alta en las escalas de cansancio emocional y&#47;o despersonalizaci&#243;n&#44; y se excluye la escala de realizaci&#243;n personal por tratarse de una esfera muy influenciable por eventos ajenos al &#225;mbito laboral&#46; Esta fue considerada la variable dependiente del presente estudio&#46;</p><p class="elsevierStylePara elsevierViewall">Como variables independientes&#44; se recogieron variables epidemiol&#243;gicas &#40;edad&#44; sexo y lugar de nacimiento&#41; y laborales &#40;especialidad&#44; a&#241;o de residencia&#44; n&#250;mero de guardias al mes&#44; si existe libranza postguardia&#44; d&#237;as desde la &#250;ltima guardia y lugar de realizaci&#243;n de las guardias&#41;&#46; Respecto al lugar de realizaci&#243;n&#44; se dividieron los residentes entre aquellos que en los &#250;ltimos 3 meses solo hab&#237;an realizado guardias en la planta de hospitalizaci&#243;n&#44; los que solo las hab&#237;an hecho en Urgencias y los que hab&#237;an combinado guardias de hospitalizaci&#243;n con guardias de Urgencias &#40;patr&#243;n mixto&#41; No se acept&#243; la contestaci&#243;n del cuestionario el d&#237;a posterior a una guardia&#44; para excluir el sesgo causado por el cansancio f&#237;sico y ps&#237;quico de la guardia&#46; Se entregaron los cuestionarios de forma personalizada al colectivo de residentes&#44; y se solicit&#243; que los cumplimentaran de forma an&#243;nima&#46;</p><p class="elsevierStylePara elsevierViewall">Para el an&#225;lisis estad&#237;stico de los datos se utiliz&#243; el software SPSS &#40;15&#46;0&#41;&#46; Las variables cualitativas se expresaron en porcentaje y las cuantitativas seg&#250;n la mediana &#40;percentil 25&#8211;75&#41;&#46; Se utiliz&#243; el test de la ji al cuadrado &#40;o test exacto de Fisher para las tablas de 2&#215;2 si los efectivos calculados eran inferiores a 5&#41; para la comparaci&#243;n de las variables cualitativas&#44; y la chi cuadrado de tendencia lineal cuando exist&#237;a gradaci&#243;n de categor&#237;as&#46; Cuando fue necesario&#44; las variables se dicotomizaron&#46; La relaci&#243;n entre variables cuantitativas se investig&#243; mediante el un test de regresi&#243;n lineal&#46; En todos los casos&#44; se acept&#243; que exist&#237;an diferencias significativas cuando el valor de p era inferior a 0&#44;05&#46;</p></span><span class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStylePara elsevierViewall">Del total de 290 residentes que en aquel momento se encontraban trabajando en el Hospital Cl&#237;nic de Barcelona&#44; un total de 132 &#40;45&#44;5&#37;&#41; respondieron a la encuesta&#46; Las caracter&#237;sticas de los encuestados se recogen en la <a class="elsevierStyleCrossRef" href="#tbl1">tabla 1</a>&#46; En t&#233;rminos de especialidad de los residentes no se detectaron diferencias significativas entre respondedores y no respondedores &#40;datos no mostrados&#41; en tanto que el resto de variables no se analizaron&#46; Las puntuaciones del cuestionario se recogen en la <a class="elsevierStyleCrossRef" href="#tbl2">tabla 2</a>&#46; El 40&#44;2&#37; de los encuestados presentaron cansancio emocional&#44; el 64&#44;4&#37; despersonalizaci&#243;n y el 39&#44;4&#37; falta de realizaci&#243;n personal&#46; De acuerdo a la definici&#243;n previamente comentada&#44; se consider&#243; que el 69&#44;7&#37; de los residentes se encontraban en situaci&#243;n de <span class="elsevierStyleItalic">burnout</span>&#46;</p><elsevierMultimedia ident="tbl1"></elsevierMultimedia><elsevierMultimedia ident="tbl2"></elsevierMultimedia><p class="elsevierStylePara elsevierViewall">En la <a class="elsevierStyleCrossRef" href="#tbl3">tabla 3</a> se compara la relaci&#243;n entre las diferentes variables epidemiol&#243;gicas y las 3 dimensiones que explora el MBI&#46; Aunque no existi&#243; ninguna asociaci&#243;n estad&#237;sticamente significativa&#44; se observ&#243; un tendencia a incrementarse dicho cansancio emocional entre los residentes que no libraban &#40;o lo hac&#237;an ocasionalmente&#41; tras la guardia &#40;p&#61;0&#44;08&#41;&#46; En relaci&#243;n a la despersonalizaci&#243;n&#44; observamos algo similar&#58; aunque no hubo ninguna variable que se asociara de forma significativa&#44; los residentes menores de 30 a&#241;os y los de medicina interna y especialidades m&#233;dicas mostraron cierta tendencia a un mayor grado de la misma &#40;p&#61;0&#44;08 y p&#61;0&#44;05&#44; respectivamente&#41;&#46; Finalmente&#44; en cuanto a la realizaci&#243;n personal&#44; solo observamos una tendencia a que esta fuese mayor entre los residentes que contestaron la encuesta 7 o m&#225;s d&#237;as despu&#233;s de la realizaci&#243;n de su &#250;ltima guardia y entre los residentes que no eran de medicina interna o especialidades m&#233;dicas &#40;p&#61;0&#44;05 en ambos casos&#41;&#46; La relaci&#243;n entre el n&#250;mero total de guardias mensuales y la puntuaci&#243;n en las diferentes dimensiones del MBI tan solo guard&#243; una relaci&#243;n positiva y significativa con el cansancio emocional &#40;p&#60;0&#44;05&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig1">fig&#46; 1</a>&#41;&#44; mientras que cuando se analizaron estas relaciones en funci&#243;n del n&#250;mero total de guardias realizadas en Urgencias&#44; no se observ&#243; una asociaci&#243;n estad&#237;sticamente significativa en ning&#250;n caso &#40;datos no mostrados&#41;&#46;</p><elsevierMultimedia ident="tbl3"></elsevierMultimedia><elsevierMultimedia ident="fig1"></elsevierMultimedia><p class="elsevierStylePara elsevierViewall">La existencia de <span class="elsevierStyleItalic">burnout</span> entre los residentes se asoci&#243; &#250;nicamente al n&#250;mero total de guardias&#44; de manera que aquellos que realizaban 5 o m&#225;s guardias presentaron <span class="elsevierStyleItalic">burnout</span> con mayor frecuencia que los que realizaban menos de 5 guardias &#40;76&#44;6 vs&#46; 60&#44;0&#37;&#44; p&#60;0&#44;05&#59; <a class="elsevierStyleCrossRef" href="#tbl4">tabla 4</a>&#41;&#46; Aunque de forma no significativa&#44; es tambi&#233;n destacable la tendencia &#40;p&#61;0&#44;06&#41; a un mayor <span class="elsevierStyleItalic">burnout</span> entre los residentes de medicina interna y especialidades m&#233;dicas con respecto al resto&#46;</p><elsevierMultimedia ident="tbl4"></elsevierMultimedia></span><span class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Discusi&#243;n</span><p class="elsevierStylePara elsevierViewall">Los principales hallazgos del presente estudio son 3&#46; En primer lugar&#44; m&#225;s de dos tercios de los residentes de un hospital universitario presentan criterios de <span class="elsevierStyleItalic">burnout</span> evaluado a trav&#233;s del MBI&#44; el cual &#250;nicamente se asocia de forma significativa al hecho de realizar m&#225;s de 4 guardias mensuales&#46; Segundo&#44; el n&#250;mero total de guardias se asocia de forma directa con el cansancio emocional pero no con la despersonalizaci&#243;n ni con el grado de realizaci&#243;n personal&#46; Finalmente&#44; el hecho que las guardias del residente se realicen en Urgencias no se relaciona con ninguna de estas 3 dimensiones&#46;</p><p class="elsevierStylePara elsevierViewall">Respecto al porcentaje observado de residentes con <span class="elsevierStyleItalic">burnout</span> Thomas realiz&#243; en el a&#241;o 2004 una revisi&#243;n sistem&#225;tica de los art&#237;culos publicados hasta esa fecha acerca del <span class="elsevierStyleItalic">burnout</span> en el colectivo de residentes incluyendo 15 estudios que abarcaban desde el a&#241;o 1984 hasta el a&#241;o 2004<a class="elsevierStyleCrossRef" href="#bib7"><span class="elsevierStyleSup">7</span></a>&#46; Los resultados globales demostraron una presencia de <span class="elsevierStyleItalic">burnout</span> elevada en todos los estudios&#44; con un m&#225;ximo del 76&#37; en un colectivo de residentes de Medicina Interna<a class="elsevierStyleCrossRef" href="#bib8"><span class="elsevierStyleSup">8</span></a>&#46; Asimismo&#44; cabe destacar un estudio realizado por Castelo-Branco et al&#46; En residentes de Ginecolog&#237;a de 8 hospitales universitarios espa&#241;oles en los cuales se incluy&#243; nuestro centro&#46; El 58&#37; de los encuestados cumpli&#243; criterios de <span class="elsevierStyleItalic">burnout</span><a class="elsevierStyleCrossRef" href="#bib9"><span class="elsevierStyleSup">9</span></a>&#46; Finalmente&#44; hay que mencionar el estudio realizado en Granada por Fern&#225;ndez Mart&#237;nez et al en el a&#241;o 2006 seg&#250;n el cual hasta un 43&#37; de los residentes cumplir&#237;an criterios de <span class="elsevierStyleItalic">burnout</span> alto y un 50&#37; cumplir&#237;a criterios de <span class="elsevierStyleItalic">burnout</span> moderado&#46; Sin embargo&#44; estos resultados no ser&#237;an directamente comparables con el presente estudio puesto que los criterios utilizados definitorios de <span class="elsevierStyleItalic">burnout</span> a partir de la puntuaci&#243;n obtenida en el cuestionario MBI no son exactamente los mismos que los utilizados aqu&#237; y en el resto de estudios de la literatura recientes&#46; Por tanto&#44; los niveles observados en nuestro centro son comparables con los de la literatura previa&#44; si bien se hallan entre los m&#225;s altos publicados hasta ahora&#46; Asimismo tampoco resultan an&#243;malos cuando se comparan con otros estudios basados en el personal m&#233;dico de plantilla de los centros<a class="elsevierStyleCrossRefs" href="#bib10"><span class="elsevierStyleSup">10&#44;11</span></a>&#46;</p><p class="elsevierStylePara elsevierViewall">Los motivos de este elevado grado de <span class="elsevierStyleItalic">burnout</span> en el colectivo de residentes no han sido incluidos en los objetivos del presente estudio&#46; Cabe hipotetizar&#44; sin embargo&#44; una posible relaci&#243;n con el n&#250;mero de horas totales que el residente permanece en el hospital dado que el &#250;nico factor claramente relacionado es el n&#250;mero de guardias mensuales y la posible interferencia en la vida privada del residente que esto conlleva&#46; Asimismo&#44; la importante sobrecarga laboral que el colectivo m&#233;dico sufre por un importante aumento de las tareas administrativas junto a unos recursos inadecuados para la atenci&#243;n del alto n&#250;mero de pacientes atendidos probablemente puedan contribuir a una sensaci&#243;n de verse desbordado en las tareas diarias&#46; Esto puede constituir&#44; a la larga&#44; una causa predictora de <span class="elsevierStyleItalic">burnout</span><a class="elsevierStyleCrossRef" href="#bib12"><span class="elsevierStyleSup">12</span></a>&#46;</p><p class="elsevierStylePara elsevierViewall">El &#250;nico factor relacionado con la presencia de <span class="elsevierStyleItalic">burnout</span> en los residentes fue el n&#250;mero total de guardias&#44; el cual tambi&#233;n se asoci&#243; de forma lineal con la presencia de cansancio emocional&#46; La libranza de guardia en nuestro estudio no se relacion&#243; con el <span class="elsevierStyleItalic">burnout&#44;</span> a diferencia de lo hallado en el estudio de Fern&#225;ndez Mart&#237;nez et al<a class="elsevierStyleCrossRef" href="#bib5"><span class="elsevierStyleSup">5</span></a>&#46; Otros estudios han hallado diferentes asociaciones que no han sido reproducidas uniformemente en estudios posteriores&#46; Cabe destacar&#44; por la proximidad a nuestro hospital&#44; la relaci&#243;n encontrada entre <span class="elsevierStyleItalic">burnout</span> y el n&#250;mero de pacientes atendidos en Urgencias<a class="elsevierStyleCrossRefs" href="#bib9"><span class="elsevierStyleSup">9&#44;12</span></a> y la ausencia de supervisi&#243;n en la atenci&#243;n de los mismos en el estudio de Castelo-Branco et al<a class="elsevierStyleCrossRef" href="#bib9"><span class="elsevierStyleSup">9</span></a>&#46; Estos hallazgos podr&#237;an contribuir a la sensaci&#243;n de verse desbordado&#44; comentada anteriormente&#44; e influir a la larga al desarrollo de <span class="elsevierStyleItalic">burnout</span>&#46; Asimismo&#44; el otro factor que se asoci&#243; en el citado estudio fue el estado conyugal&#44; ya que la solter&#237;a fue un factor predisponente para el desarrollo de <span class="elsevierStyleItalic">burnout</span><a class="elsevierStyleCrossRef" href="#bib9"><span class="elsevierStyleSup">9</span></a>&#46; Otros estudios<a class="elsevierStyleCrossRefs" href="#bib13"><span class="elsevierStyleSup">13&#44;14</span></a> han encontrado una asociaci&#243;n con alteraciones de la personalidad&#44; y en la revisi&#243;n de Thomas<a class="elsevierStyleCrossRef" href="#bib8"><span class="elsevierStyleSup">8</span></a> se sugiere que las especialidades quir&#250;rgicas podr&#237;an sufrir un mayor grado de <span class="elsevierStyleItalic">burnout</span>&#46; Sin embargo&#44; en nuestro centro hubo tendencia a un mayor grado de <span class="elsevierStyleItalic">burnout</span> en las especialidades m&#233;dicas&#44; aunque nuestro estudio cont&#243; con un n&#250;mero bajo de residentes de cirug&#237;a &#40;18&#44;9&#37;&#41; que limita las posibilidades de comparaci&#243;n entre especialidades m&#233;dicas y quir&#250;rgicas&#46;</p><p class="elsevierStylePara elsevierViewall">En todo caso&#44; parece que existen elementos para pensar que esta situaci&#243;n de <span class="elsevierStyleItalic">burnout</span> debiera descender en los pr&#243;ximos a&#241;os&#44; ya que tanto la limitaci&#243;n del n&#250;mero de horas semanales trabajadas a 48 como&#44; especialmente&#44; la limitaci&#243;n del n&#250;mero y el formato de guardias de 24<span class="elsevierStyleHsp" style=""></span>h<a class="elsevierStyleCrossRef" href="#bib15"><span class="elsevierStyleSup">15</span></a>&#44; dictados durante los &#250;ltimos a&#241;os por la legislaci&#243;n europea&#44; debiera seguirse de un descenso en el porcentaje de residentes que se encuentran afectados por este s&#237;ndrome&#46; Respecto a esta suposici&#243;n existe controversia en la literatura dado que hay publicados al menos 4 estudios intervencionistas en los que se analiz&#243; el grado de <span class="elsevierStyleItalic">burnout</span> entre colectivos de residentes antes y despu&#233;s de modificar su carga laboral&#46; Algunos autores<a class="elsevierStyleCrossRefs" href="#bib16"><span class="elsevierStyleSup">16&#44;17</span></a> han encontrado una reducci&#243;n significativa en el cansancio emocional gracias a la aplicaci&#243;n de un programa de limitaci&#243;n del horario laboral&#46; Otros<a class="elsevierStyleCrossRefs" href="#bib18"><span class="elsevierStyleSup">18&#44;19</span></a> encontraron reducciones no significativas en la puntuaci&#243;n obtenida en el MBI y en el grado de cansancio emocional&#46; Sin embargo&#44; un estudio reciente no hall&#243; reducci&#243;n del grado de <span class="elsevierStyleItalic">burnout</span> pese a una reducci&#243;n significativa de las horas de trabajo semanales medias &#40;de 100&#44;7&#8211; 82&#44;6<span class="elsevierStyleHsp" style=""></span>h&#41;<a class="elsevierStyleCrossRef" href="#bib20"><span class="elsevierStyleSup">20</span></a>&#46; Dada esta controversia&#44; ser&#237;a interesante medir el grado de <span class="elsevierStyleItalic">burnout</span> tras la aplicaci&#243;n de la nueva normativa europea para contribuir a identificar si existen otros factores a&#241;adidos a la sobrecarga de horario laboral susceptibles de ser modificados para mejorar la calidad percibida de vida de los residentes&#46;</p><p class="elsevierStylePara elsevierViewall">A pesar de que cl&#225;sicamente se ha atribuido al trabajo en Urgencias un plus a&#241;adido en cuanto a estr&#233;s por las especiales condiciones de trabajo de la mayor&#237;a de Servicios de Urgencias&#44; tanto en los hospitales espa&#241;oles<a class="elsevierStyleCrossRefs" href="#bib21"><span class="elsevierStyleSup">21&#8211;24</span></a> como en otros pa&#237;ses<a class="elsevierStyleCrossRefs" href="#bib25"><span class="elsevierStyleSup">25&#44;26</span></a>&#44; en nuestro centro no parece que esta carga adicional exista&#44; ya que no observamos ninguna relaci&#243;n entre las guardias en Urgencias y la mayor presencia de <span class="elsevierStyleItalic">burnout&#44;</span> o el n&#250;mero de guardias que all&#237; se realizan y el cansancio emocional&#44; la despersonalizaci&#243;n o la falta de realizaci&#243;n personal&#46;</p><p class="elsevierStylePara elsevierViewall">El presente estudio tiene una serie de limitaciones que merecen ser comentadas&#46; En primer lugar&#44; es unic&#233;ntrico y quiz&#225;s no sea directamente extrapolable a otros centros con otra estructura de guardias y otra organizaci&#243;n distinta del trabajo&#46; Sin embargo&#44; creemos que nuestro hospital comparte las mismas caracter&#237;sticas con muchos de los grandes hospitales universitarios espa&#241;oles&#44; por lo que&#44; al menos para este grupo&#44; los resultados ser&#237;an exportables&#46; Segundo&#44; la tasa de respuesta fue del 45&#37;&#46; Aunque esto pueda parecer en principio bajo&#44; hay que tener en cuenta que la tasa de respuesta para los trabajos basados en encuestas rara vez superan el 50&#37;&#44; y en trabajos previos similares al nuestro realizados esta se situ&#243; entre el 18&#8211;100&#46; &#37;<a class="elsevierStyleCrossRef" href="#bib7"><span class="elsevierStyleSup">7</span></a>&#46; Sin embargo&#44; no se puede descartar que haya existido un cierto sesgo de antiselecci&#243;n a favor de los residentes m&#225;s afectados&#46; Por &#250;ltimo&#44; el MBI es uno de los test que existen y ha recibido alguna cr&#237;tica puesto que de las 3 escalas que mide&#44; solo 2 de ellas se utilizan para definir <span class="elsevierStyleItalic">burnout</span>&#44; ya que la escala de realizaci&#243;n personal aparentemente podr&#237;a medir par&#225;metros al margen de los estrictamente laborales<a class="elsevierStyleCrossRef" href="#bib1"><span class="elsevierStyleSup">1</span></a>&#46; Adem&#225;s&#44; tambi&#233;n se ha criticado la subdivisi&#243;n en 5 categor&#237;as para cada uno de los &#237;tems preguntados&#46; En nuestro centro una alta proporci&#243;n de los sujetos interrogados expresaron la dificultad de decantarse por una categor&#237;a u otra&#44; por carecer de un punto medio entre ellas para contestar&#46; Pese a todo&#44; el cuestionario del MBI ha sido perfeccionado durante m&#225;s de 20 a&#241;os por la Dra&#46; Maslach&#46; La inmensa mayor&#237;a de estudios realizados acerca del <span class="elsevierStyleItalic">burnout</span> se basan en la respuesta al mismo y actualmente se considera el patr&#243;n oro para detectar la presencia o no de <span class="elsevierStyleItalic">burnout&#46;</span></p><p class="elsevierStylePara elsevierViewall">En conclusi&#243;n&#44; el presente estudio permite afirmar que en nuestro centro la presencia de <span class="elsevierStyleItalic">burnout</span> entre los residentes es elevada y se relaciona fundamentalmente con el n&#250;mero de guardias realizadas&#46; Ser&#237;a aconsejable investigar si esta relaci&#243;n se da en la mayor&#237;a de centros espa&#241;oles o por el contrario es una excepcionalidad&#46;</p></span><span class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Conflicto de intereses</span><p class="elsevierStylePara elsevierViewall">Los autores declaran no tener ning&#250;n conflicto de intereses&#46;</p></span></span>"
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          "titulo" => "Conflicto de intereses"
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          "titulo" => "Bibliograf&#237;a"
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    "fechaRecibido" => "2009-04-25"
    "fechaAceptado" => "2009-12-19"
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        0 => array:4 [
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          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec17996"
          "palabras" => array:3 [
            0 => "Residentes"
            1 => "Guardias"
            2 => "<span class="elsevierStyleItalic">Burnout</span>"
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        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
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            1 => "Call"
            2 => "<span class="elsevierStyleItalic">Burnout</span>"
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    "resumen" => array:2 [
      "es" => array:2 [
        "titulo" => "Resumen"
        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivos</span><p class="elsevierStyleSimplePara elsevierViewall">Investigar el grado de <span class="elsevierStyleItalic">burnout</span> entre los residentes de un hospital universitario y los factores asociados al mismo&#46;</p> <span class="elsevierStyleSectionTitle">Material y m&#233;todo</span><p class="elsevierStyleSimplePara elsevierViewall">Se envi&#243; a todos los residentes el <span class="elsevierStyleItalic">Maslach Burnout Inventory</span> que valora cansancio emocional&#44; despersonalizaci&#243;n y realizaci&#243;n personal&#46; Existe <span class="elsevierStyleItalic">burnout</span> ante un grado de cansancio emocional o de despersonalizaci&#243;n altos&#46; Se consignaron variables epidemiol&#243;gicas &#40;edad&#44; sexo&#44; nacionalidad&#44; a&#241;o de residencia&#44; especialidad&#44; n&#250;mero de guardias totales y en urgencias&#44; d&#237;as postguardia&#44; libranza postguardia&#44; posici&#243;n de guardia&#41;&#46; Se investig&#243; la relaci&#243;n de estas con la puntuaci&#243;n en las dimensiones del <span class="elsevierStyleItalic">Maslach Burnout Inventory</span> con el <span class="elsevierStyleItalic">burnout</span> &#40;chi cuadrado&#41; y la asociaci&#243;n con el n&#250;mero de guardias &#40;regresi&#243;n lineal&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Contestaron 132 de 290 residentes &#40;45&#44;5&#37;&#41;&#58; el 40&#44;2&#37; presentaba un alto cansancio emocional y el 64&#44;4&#37; una alta despersonalizaci&#243;n&#46; En total&#44; el 69&#44;7&#37; de los residentes presentaba <span class="elsevierStyleItalic">burnout</span>&#46; No existieron asociaciones estad&#237;sticamente significativas entre las variables epidemiol&#243;gicas y las dimensiones del <span class="elsevierStyleItalic">Maslach Burnout Inventory</span>&#46; El n&#250;mero total de guardias se relacion&#243; significativamente con el cansancio emocional &#40;p&#60;0&#44;05&#41;&#44; sin relaci&#243;n con las guardias en Urgencias&#46; La realizaci&#243;n de 5 o m&#225;s guardias al mes condicion&#243; <span class="elsevierStyleItalic">burnout</span> con mayor frecuencia &#40;76&#44;6 vs&#46;60&#44;0&#37;&#44; p&#60;0&#44;05&#41;&#46; Se observ&#243; una tendencia a un mayor <span class="elsevierStyleItalic">burnout</span> entre los residentes de medicina interna y especialidades m&#233;dicas con respecto al resto &#40;75&#44;6 vs&#46; 60&#44;0&#37;&#44; p&#61;0&#44;05&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">La prevalencia de <span class="elsevierStyleItalic">burnout</span> entre los residentes es elevada y se relaciona fundamentalmente con el n&#250;mero de guardias realizadas&#46;</p>"
      ]
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        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle">Objectives</span><p class="elsevierStyleSimplePara elsevierViewall">To investigate the degree of <span class="elsevierStyleItalic">burnout</span> among resident physicians of a university hospital and the factors associated with it&#46;</p> <span class="elsevierStyleSectionTitle">Materials and Methods</span><p class="elsevierStyleSimplePara elsevierViewall">Maslach <span class="elsevierStyleItalic">burnout</span> Inventory &#40;MBI&#41; was sent to all residents&#44; which assesses emotional exhaustion&#44; depersonalization and personal accomplishment&#46; B<span class="elsevierStyleItalic">urnout</span> exists when high degree of emotional exhaustion or depersonalization are obtained&#46; Several variables were analyzed &#40;age&#44; sex&#44; nationality&#44; year of residency&#44; speciality&#44; total monthly calls and in emergency departments&#44; days since last call&#44; duty-free day after calls&#44; position at calls&#41;&#46; It&#8242;s relationship with the score on the different dimensions of MBI and <span class="elsevierStyleItalic">burnout</span> was analyzed through the test of the chi-square&#44; whereas the association between scores of MBI and the number of calls were analyzed using linear regression&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">132 of 290 residents answered &#40;45&#46;5&#37;&#41;&#58; 40&#46;2&#37; had a high emotional exhaustion and a 64&#46;4&#37; presented depersonalization&#46; In total&#44; 69&#46;7&#37; of the residents had <span class="elsevierStyleItalic">burnout</span>&#46; There was no statistically association between the epidemiological variables and the different dimensions of the MBI&#46; The total number of calls per month were significantly associated with emotional exhaustion &#40;p&#60;0&#46;05&#41;&#46; There wasn&#8217;t any relation to the number of calls in emergency departments&#46; Resident physicians who had 5 or more calls per month showed <span class="elsevierStyleItalic">burnout</span> more often than the rest &#40;76&#46;6&#37; versus 60&#46;0&#37;&#44; p&#60;0&#46;05&#41;&#46; A trend towards a higher <span class="elsevierStyleItalic">burnout</span> was present among residents of Internal medicine and medical specialities than the rest &#40;75&#46;6&#37; versus 60&#46;0&#37;&#44; p&#61;0&#46;05&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">The prevalence of <span class="elsevierStyleItalic">burnout</span> among the group of residents is high and relates mainly to the monthly number of calls</p>"
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Servicios centrales&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">5 &#40;4&#8211;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">N&#250;mero total de guardias en Urgencias</span> &#40;mediana &#91;percentil 25&#8211;75&#93;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2 &#40;0&#8211;4&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">D&#237;as desde la &#250;ltima guardia</span> &#40;mediana &#91;percentil 25&#8211;75&#93;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">4 &#40;3&#8211;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>A menudo&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">37 &#40;32&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Ocasionalmente&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Nunca&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">17 &#40;14&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No contesta&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Lugar de realizaci&#243;n de las guardias</span> &#40;n &#91;&#37;&#93;&#41;</td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">37 &#40;28&#44;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Mixto &#40;algunas en Urgencias y algunas en planta&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23 &#40;17&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Bajo &#40;&#8804;18 puntos&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Moderado &#40;19&#8211;26 puntos&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Alto &#40;&#8805;27 puntos&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">53 &#40;40&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Despersonalizaci&#243;n &#40;puntos&#44; mediana &#40;percentil 25&#8211;75&#41;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">11 &#40;7&#8211;16&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Despersonalizaci&#243;n</span> &#40;n &#91;&#37;&#93;&#41;</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Baja &#40;&#8804;5 puntos&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Moderada &#40;6&#8211;9 puntos&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Alta&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Realizaci&#243;n personal</span> &#40;puntos&#44; mediana &#91;percentil 25&#8211;75&#93;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t  " colspan="2" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Realizaci&#243;n personal</span> &#40;n &#91;&#37;&#93;&#41;</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Moderada&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Alta&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t  " colspan="2" align="" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>S&#237;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">92 &#40;69&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">40 &#40;30&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">Moderado</span> &#40;n&#61;40&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">Baja</span> &#40;n&#61;21&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">Moderada</span> &#40;n&#61;26&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">Alta</span> &#40;n&#61;85&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">Baja</span> &#40;n&#61;52&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">Moderada</span> &#40;n&#61;41&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">Alta</span> &#40;n&#61;39&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Edad</span> &#40;n &#91;&#37;&#93;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;61&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;08&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;43&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Inferior a 30 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">34 &#40;31&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">33 &#40;30&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">41 &#40;38&#44;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15 &#40;13&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21 &#40;19&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">72 &#40;66&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">40 &#40;37&#44;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">35 &#40;32&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">A&#241;o de residencia</span> &#40;n &#91;&#37;&#93;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Residente de primer-segundo a&#241;o&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Residente de tercer a&#241;o o superior&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Especialidad de la residencia</span> &#40;n &#91;&#37;&#93;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Medicina interna y especialidades m&#233;dicas&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">N&#250;mero total de guardias mensuales</span> &#40;n &#91;&#37;&#93;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Inferior a 5&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Igual o superior a 5&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">D&#237;as desde la &#250;ltima guardia</span> &#40;n &#40;&#37;&#41;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;56&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;05&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Inferior a 7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">23 &#40;27&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">30 &#40;36&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">30 &#40;36&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">11 &#40;13&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">15 &#40;18&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">57 &#40;68&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">36 &#40;43&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">28 &#40;33&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">19 &#40;22&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Igual o superior a 7&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">9 &#40;27&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">9 &#40;27&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">15 &#40;45&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">7 &#40;21&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">7 &#40;21&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">19 &#40;57&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">10 &#40;30&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">9 &#40;27&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">14 &#40;42&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " colspan="13" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Libranza posguardia</span> &#40;n &#91;&#37;&#93;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">0&#44;08&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;53&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">0&#44;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Siempre o a menudo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">27 &#40;34&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">21 &#40;26&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">30 &#40;38&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">11 &#40;14&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">13 &#40;16&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">54 &#40;69&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">31 &#40;39&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">10 &#40;27&#44;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14 &#40;37&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Nunca u ocasionalmente&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">6 &#40;16&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">13 &#40;35&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">18 &#40;48&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">6 &#40;16&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">8 &#40;21&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">23 &#40;62&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">19 &#40;29&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">45 &#40;70&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Mujer&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">21 &#40;30&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">47 &#40;69&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Nacionalidad</span> &#40;n &#91;&#37;&#93;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">0&#44;87&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Espa&#241;ola&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">36 &#40;30&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">81 &#40;69&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Extranjera&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">4 &#40;28&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">10 &#40;71&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">A&#241;o de residencia &#40;n &#91;&#37;&#93;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;41&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Residente de primer-segundo a&#241;o&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22 &#40;33&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">43 &#40;66&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Residente de tercer a&#241;o o superior&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18 &#40;27&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">48 &#40;72&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Especialidad de la residencia</span> &#40;n &#91;&#37;&#93;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;06&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Medicina interna y especialidades m&#233;dicas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20 &#40;24&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">62 &#40;75&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Resto de especialidades&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20 &#40;40&#44;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30 &#40;60&#44;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">N&#250;mero total de guardias mensuales</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#44;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Inferior a 5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22 &#40;40&#44;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">33 &#40;60&#44;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Igual o superior a 5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18 &#40;23&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">59 &#40;76&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">D&#237;as desde la &#250;ltima guardia</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;64&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Inferior a 7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24 &#40;28&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">59 &#40;71&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Igual o superior a 7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;33&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22 &#40;66&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="" valign="\n
                  \t\t\t\t\ttop\n
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ORIGINAL
Residentes, guardias y síndrome de burnout
Residents, duties and burnout syndrome
M. Fonseca
,
, G. Sanclemente, C. Hernández, C. Visiedo, E. Bragulat, O.. Ò. Miró
Àrea de Urgencias, Hospital Clínic, Barcelona, España
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          "es" => "<p class="elsevierStyleSimplePara elsevierViewall">Relaci&#243;n entre el n&#250;mero mensual de guardias totales y en urgencias y la puntuaci&#243;n en el cansancio emocional&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><span class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Introducci&#243;n</span><p class="elsevierStylePara elsevierViewall">El s&#237;ndrome de <span class="elsevierStyleItalic">burnout</span> es una respuesta inapropiada a un estr&#233;s laboral cr&#243;nico que afecta marcadamente a aquellos colectivos cuyo &#225;mbito de trabajo implica la atenci&#243;n al p&#250;blico de forma mantenida&#46; Fue definido por Maslach y Jackson<a class="elsevierStyleCrossRef" href="#bib1"><span class="elsevierStyleSup">1</span></a> en 1981 y se caracteriza por un alto nivel de cansancio emocional&#44; despersonalizaci&#243;n y falta de realizaci&#243;n personal&#46;</p><p class="elsevierStylePara elsevierViewall">Entre los colectivos afectados destaca el personal sanitario&#44; y entre ellos especialmente los residentes&#44; dado que la sobrecarga asistencial que soportan es elevada<a class="elsevierStyleCrossRef" href="#bib2"><span class="elsevierStyleSup">2</span></a>&#46; Esta sobrecarga asistencial puede verse agravada por la existencia en muchos de nuestros hospitales de jornadas de trabajo de 24<span class="elsevierStyleHsp" style=""></span>h &#40;y en ocasiones m&#225;s&#41; consecutivas englobadas dentro del concepto cl&#225;sico de guardia&#46; Si a ello le a&#241;adimos que algunas &#40;o todas&#41; estas guardias se realizan en el Servicio de Urgencias&#44; el cual se encuentra en muchos de los hospitales espa&#241;oles en situaci&#243;n de pl&#233;tora asistencial permanente<a class="elsevierStyleCrossRefs" href="#bib3"><span class="elsevierStyleSup">3&#44;4</span></a>&#44; el resultado puede ser un elevado grado de <span class="elsevierStyleItalic">burnout</span> entre el colectivo de residentes&#46; Aunque alg&#250;n estudio realizado en residentes ha encontrado que hasta el 93&#37; de ellos puede presentar cierto grado de <span class="elsevierStyleItalic">burnout</span><a class="elsevierStyleCrossRef" href="#bib5"><span class="elsevierStyleSup">5</span></a>&#44; no se han investigado en profundidad los factores relacionados con dicho <span class="elsevierStyleItalic">burnout</span>&#46; El objetivo del presente estudio es profundizar en esta cuesti&#243;n&#46;</p></span><span class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">M&#233;todo</span><p class="elsevierStylePara elsevierViewall">Se realiz&#243; el estudio entre todos los residentes del Hospital Cl&#237;nic de Barcelona durante el periodo enero-marzo de 2007&#46; Para valorar el grado de <span class="elsevierStyleItalic">burnout</span> se utiliz&#243; el <span class="elsevierStyleItalic">Maslach Burnout Inventory</span> &#40;MBI&#41; considerado como el patr&#243;n oro de los cuestionarios para objetivar el <span class="elsevierStyleItalic">burnout&#44;</span> el cual ha sido previamente validado en Espa&#241;a<a class="elsevierStyleCrossRef" href="#bib6"><span class="elsevierStyleSup">6</span></a>&#46; Se trata de un cuestionario creado y validado por la Dra&#46; Maslach<a class="elsevierStyleCrossRef" href="#bib2"><span class="elsevierStyleSup">2</span></a> que valora las 3 esferas relacionadas con el <span class="elsevierStyleItalic">burnout</span> &#40;cansancio emocional&#44; despersonalizaci&#243;n y desrealizaci&#243;n personal&#41;&#46; Consta de 22 &#237;tems&#44; cada uno de los cuales se valora con una escala del tipo Likert &#40;en la que se pide que se especifique el grado de acuerdo o desacuerdo con una afirmaci&#243;n&#44; de 0&#8211;6 puntos&#41;&#46; De estos 22 &#237;tems&#44; 9 de ellos hacen referencia al cansancio emocional&#44; 5 a la despersonalizaci&#243;n&#44; y 8 a la realizaci&#243;n personal&#46; Siguiendo los mismos criterios empleados en trabajos previos<a class="elsevierStyleCrossRef" href="#bib7"><span class="elsevierStyleSup">7</span></a>&#44; se define la existencia de <span class="elsevierStyleItalic">burnout</span> cuando se obtiene una puntuaci&#243;n alta en las escalas de cansancio emocional y&#47;o despersonalizaci&#243;n&#44; y se excluye la escala de realizaci&#243;n personal por tratarse de una esfera muy influenciable por eventos ajenos al &#225;mbito laboral&#46; Esta fue considerada la variable dependiente del presente estudio&#46;</p><p class="elsevierStylePara elsevierViewall">Como variables independientes&#44; se recogieron variables epidemiol&#243;gicas &#40;edad&#44; sexo y lugar de nacimiento&#41; y laborales &#40;especialidad&#44; a&#241;o de residencia&#44; n&#250;mero de guardias al mes&#44; si existe libranza postguardia&#44; d&#237;as desde la &#250;ltima guardia y lugar de realizaci&#243;n de las guardias&#41;&#46; Respecto al lugar de realizaci&#243;n&#44; se dividieron los residentes entre aquellos que en los &#250;ltimos 3 meses solo hab&#237;an realizado guardias en la planta de hospitalizaci&#243;n&#44; los que solo las hab&#237;an hecho en Urgencias y los que hab&#237;an combinado guardias de hospitalizaci&#243;n con guardias de Urgencias &#40;patr&#243;n mixto&#41; No se acept&#243; la contestaci&#243;n del cuestionario el d&#237;a posterior a una guardia&#44; para excluir el sesgo causado por el cansancio f&#237;sico y ps&#237;quico de la guardia&#46; Se entregaron los cuestionarios de forma personalizada al colectivo de residentes&#44; y se solicit&#243; que los cumplimentaran de forma an&#243;nima&#46;</p><p class="elsevierStylePara elsevierViewall">Para el an&#225;lisis estad&#237;stico de los datos se utiliz&#243; el software SPSS &#40;15&#46;0&#41;&#46; Las variables cualitativas se expresaron en porcentaje y las cuantitativas seg&#250;n la mediana &#40;percentil 25&#8211;75&#41;&#46; Se utiliz&#243; el test de la ji al cuadrado &#40;o test exacto de Fisher para las tablas de 2&#215;2 si los efectivos calculados eran inferiores a 5&#41; para la comparaci&#243;n de las variables cualitativas&#44; y la chi cuadrado de tendencia lineal cuando exist&#237;a gradaci&#243;n de categor&#237;as&#46; Cuando fue necesario&#44; las variables se dicotomizaron&#46; La relaci&#243;n entre variables cuantitativas se investig&#243; mediante el un test de regresi&#243;n lineal&#46; En todos los casos&#44; se acept&#243; que exist&#237;an diferencias significativas cuando el valor de p era inferior a 0&#44;05&#46;</p></span><span class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStylePara elsevierViewall">Del total de 290 residentes que en aquel momento se encontraban trabajando en el Hospital Cl&#237;nic de Barcelona&#44; un total de 132 &#40;45&#44;5&#37;&#41; respondieron a la encuesta&#46; Las caracter&#237;sticas de los encuestados se recogen en la <a class="elsevierStyleCrossRef" href="#tbl1">tabla 1</a>&#46; En t&#233;rminos de especialidad de los residentes no se detectaron diferencias significativas entre respondedores y no respondedores &#40;datos no mostrados&#41; en tanto que el resto de variables no se analizaron&#46; Las puntuaciones del cuestionario se recogen en la <a class="elsevierStyleCrossRef" href="#tbl2">tabla 2</a>&#46; El 40&#44;2&#37; de los encuestados presentaron cansancio emocional&#44; el 64&#44;4&#37; despersonalizaci&#243;n y el 39&#44;4&#37; falta de realizaci&#243;n personal&#46; De acuerdo a la definici&#243;n previamente comentada&#44; se consider&#243; que el 69&#44;7&#37; de los residentes se encontraban en situaci&#243;n de <span class="elsevierStyleItalic">burnout</span>&#46;</p><elsevierMultimedia ident="tbl1"></elsevierMultimedia><elsevierMultimedia ident="tbl2"></elsevierMultimedia><p class="elsevierStylePara elsevierViewall">En la <a class="elsevierStyleCrossRef" href="#tbl3">tabla 3</a> se compara la relaci&#243;n entre las diferentes variables epidemiol&#243;gicas y las 3 dimensiones que explora el MBI&#46; Aunque no existi&#243; ninguna asociaci&#243;n estad&#237;sticamente significativa&#44; se observ&#243; un tendencia a incrementarse dicho cansancio emocional entre los residentes que no libraban &#40;o lo hac&#237;an ocasionalmente&#41; tras la guardia &#40;p&#61;0&#44;08&#41;&#46; En relaci&#243;n a la despersonalizaci&#243;n&#44; observamos algo similar&#58; aunque no hubo ninguna variable que se asociara de forma significativa&#44; los residentes menores de 30 a&#241;os y los de medicina interna y especialidades m&#233;dicas mostraron cierta tendencia a un mayor grado de la misma &#40;p&#61;0&#44;08 y p&#61;0&#44;05&#44; respectivamente&#41;&#46; Finalmente&#44; en cuanto a la realizaci&#243;n personal&#44; solo observamos una tendencia a que esta fuese mayor entre los residentes que contestaron la encuesta 7 o m&#225;s d&#237;as despu&#233;s de la realizaci&#243;n de su &#250;ltima guardia y entre los residentes que no eran de medicina interna o especialidades m&#233;dicas &#40;p&#61;0&#44;05 en ambos casos&#41;&#46; La relaci&#243;n entre el n&#250;mero total de guardias mensuales y la puntuaci&#243;n en las diferentes dimensiones del MBI tan solo guard&#243; una relaci&#243;n positiva y significativa con el cansancio emocional &#40;p&#60;0&#44;05&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig1">fig&#46; 1</a>&#41;&#44; mientras que cuando se analizaron estas relaciones en funci&#243;n del n&#250;mero total de guardias realizadas en Urgencias&#44; no se observ&#243; una asociaci&#243;n estad&#237;sticamente significativa en ning&#250;n caso &#40;datos no mostrados&#41;&#46;</p><elsevierMultimedia ident="tbl3"></elsevierMultimedia><elsevierMultimedia ident="fig1"></elsevierMultimedia><p class="elsevierStylePara elsevierViewall">La existencia de <span class="elsevierStyleItalic">burnout</span> entre los residentes se asoci&#243; &#250;nicamente al n&#250;mero total de guardias&#44; de manera que aquellos que realizaban 5 o m&#225;s guardias presentaron <span class="elsevierStyleItalic">burnout</span> con mayor frecuencia que los que realizaban menos de 5 guardias &#40;76&#44;6 vs&#46; 60&#44;0&#37;&#44; p&#60;0&#44;05&#59; <a class="elsevierStyleCrossRef" href="#tbl4">tabla 4</a>&#41;&#46; Aunque de forma no significativa&#44; es tambi&#233;n destacable la tendencia &#40;p&#61;0&#44;06&#41; a un mayor <span class="elsevierStyleItalic">burnout</span> entre los residentes de medicina interna y especialidades m&#233;dicas con respecto al resto&#46;</p><elsevierMultimedia ident="tbl4"></elsevierMultimedia></span><span class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Discusi&#243;n</span><p class="elsevierStylePara elsevierViewall">Los principales hallazgos del presente estudio son 3&#46; En primer lugar&#44; m&#225;s de dos tercios de los residentes de un hospital universitario presentan criterios de <span class="elsevierStyleItalic">burnout</span> evaluado a trav&#233;s del MBI&#44; el cual &#250;nicamente se asocia de forma significativa al hecho de realizar m&#225;s de 4 guardias mensuales&#46; Segundo&#44; el n&#250;mero total de guardias se asocia de forma directa con el cansancio emocional pero no con la despersonalizaci&#243;n ni con el grado de realizaci&#243;n personal&#46; Finalmente&#44; el hecho que las guardias del residente se realicen en Urgencias no se relaciona con ninguna de estas 3 dimensiones&#46;</p><p class="elsevierStylePara elsevierViewall">Respecto al porcentaje observado de residentes con <span class="elsevierStyleItalic">burnout</span> Thomas realiz&#243; en el a&#241;o 2004 una revisi&#243;n sistem&#225;tica de los art&#237;culos publicados hasta esa fecha acerca del <span class="elsevierStyleItalic">burnout</span> en el colectivo de residentes incluyendo 15 estudios que abarcaban desde el a&#241;o 1984 hasta el a&#241;o 2004<a class="elsevierStyleCrossRef" href="#bib7"><span class="elsevierStyleSup">7</span></a>&#46; Los resultados globales demostraron una presencia de <span class="elsevierStyleItalic">burnout</span> elevada en todos los estudios&#44; con un m&#225;ximo del 76&#37; en un colectivo de residentes de Medicina Interna<a class="elsevierStyleCrossRef" href="#bib8"><span class="elsevierStyleSup">8</span></a>&#46; Asimismo&#44; cabe destacar un estudio realizado por Castelo-Branco et al&#46; En residentes de Ginecolog&#237;a de 8 hospitales universitarios espa&#241;oles en los cuales se incluy&#243; nuestro centro&#46; El 58&#37; de los encuestados cumpli&#243; criterios de <span class="elsevierStyleItalic">burnout</span><a class="elsevierStyleCrossRef" href="#bib9"><span class="elsevierStyleSup">9</span></a>&#46; Finalmente&#44; hay que mencionar el estudio realizado en Granada por Fern&#225;ndez Mart&#237;nez et al en el a&#241;o 2006 seg&#250;n el cual hasta un 43&#37; de los residentes cumplir&#237;an criterios de <span class="elsevierStyleItalic">burnout</span> alto y un 50&#37; cumplir&#237;a criterios de <span class="elsevierStyleItalic">burnout</span> moderado&#46; Sin embargo&#44; estos resultados no ser&#237;an directamente comparables con el presente estudio puesto que los criterios utilizados definitorios de <span class="elsevierStyleItalic">burnout</span> a partir de la puntuaci&#243;n obtenida en el cuestionario MBI no son exactamente los mismos que los utilizados aqu&#237; y en el resto de estudios de la literatura recientes&#46; Por tanto&#44; los niveles observados en nuestro centro son comparables con los de la literatura previa&#44; si bien se hallan entre los m&#225;s altos publicados hasta ahora&#46; Asimismo tampoco resultan an&#243;malos cuando se comparan con otros estudios basados en el personal m&#233;dico de plantilla de los centros<a class="elsevierStyleCrossRefs" href="#bib10"><span class="elsevierStyleSup">10&#44;11</span></a>&#46;</p><p class="elsevierStylePara elsevierViewall">Los motivos de este elevado grado de <span class="elsevierStyleItalic">burnout</span> en el colectivo de residentes no han sido incluidos en los objetivos del presente estudio&#46; Cabe hipotetizar&#44; sin embargo&#44; una posible relaci&#243;n con el n&#250;mero de horas totales que el residente permanece en el hospital dado que el &#250;nico factor claramente relacionado es el n&#250;mero de guardias mensuales y la posible interferencia en la vida privada del residente que esto conlleva&#46; Asimismo&#44; la importante sobrecarga laboral que el colectivo m&#233;dico sufre por un importante aumento de las tareas administrativas junto a unos recursos inadecuados para la atenci&#243;n del alto n&#250;mero de pacientes atendidos probablemente puedan contribuir a una sensaci&#243;n de verse desbordado en las tareas diarias&#46; Esto puede constituir&#44; a la larga&#44; una causa predictora de <span class="elsevierStyleItalic">burnout</span><a class="elsevierStyleCrossRef" href="#bib12"><span class="elsevierStyleSup">12</span></a>&#46;</p><p class="elsevierStylePara elsevierViewall">El &#250;nico factor relacionado con la presencia de <span class="elsevierStyleItalic">burnout</span> en los residentes fue el n&#250;mero total de guardias&#44; el cual tambi&#233;n se asoci&#243; de forma lineal con la presencia de cansancio emocional&#46; La libranza de guardia en nuestro estudio no se relacion&#243; con el <span class="elsevierStyleItalic">burnout&#44;</span> a diferencia de lo hallado en el estudio de Fern&#225;ndez Mart&#237;nez et al<a class="elsevierStyleCrossRef" href="#bib5"><span class="elsevierStyleSup">5</span></a>&#46; Otros estudios han hallado diferentes asociaciones que no han sido reproducidas uniformemente en estudios posteriores&#46; Cabe destacar&#44; por la proximidad a nuestro hospital&#44; la relaci&#243;n encontrada entre <span class="elsevierStyleItalic">burnout</span> y el n&#250;mero de pacientes atendidos en Urgencias<a class="elsevierStyleCrossRefs" href="#bib9"><span class="elsevierStyleSup">9&#44;12</span></a> y la ausencia de supervisi&#243;n en la atenci&#243;n de los mismos en el estudio de Castelo-Branco et al<a class="elsevierStyleCrossRef" href="#bib9"><span class="elsevierStyleSup">9</span></a>&#46; Estos hallazgos podr&#237;an contribuir a la sensaci&#243;n de verse desbordado&#44; comentada anteriormente&#44; e influir a la larga al desarrollo de <span class="elsevierStyleItalic">burnout</span>&#46; Asimismo&#44; el otro factor que se asoci&#243; en el citado estudio fue el estado conyugal&#44; ya que la solter&#237;a fue un factor predisponente para el desarrollo de <span class="elsevierStyleItalic">burnout</span><a class="elsevierStyleCrossRef" href="#bib9"><span class="elsevierStyleSup">9</span></a>&#46; Otros estudios<a class="elsevierStyleCrossRefs" href="#bib13"><span class="elsevierStyleSup">13&#44;14</span></a> han encontrado una asociaci&#243;n con alteraciones de la personalidad&#44; y en la revisi&#243;n de Thomas<a class="elsevierStyleCrossRef" href="#bib8"><span class="elsevierStyleSup">8</span></a> se sugiere que las especialidades quir&#250;rgicas podr&#237;an sufrir un mayor grado de <span class="elsevierStyleItalic">burnout</span>&#46; Sin embargo&#44; en nuestro centro hubo tendencia a un mayor grado de <span class="elsevierStyleItalic">burnout</span> en las especialidades m&#233;dicas&#44; aunque nuestro estudio cont&#243; con un n&#250;mero bajo de residentes de cirug&#237;a &#40;18&#44;9&#37;&#41; que limita las posibilidades de comparaci&#243;n entre especialidades m&#233;dicas y quir&#250;rgicas&#46;</p><p class="elsevierStylePara elsevierViewall">En todo caso&#44; parece que existen elementos para pensar que esta situaci&#243;n de <span class="elsevierStyleItalic">burnout</span> debiera descender en los pr&#243;ximos a&#241;os&#44; ya que tanto la limitaci&#243;n del n&#250;mero de horas semanales trabajadas a 48 como&#44; especialmente&#44; la limitaci&#243;n del n&#250;mero y el formato de guardias de 24<span class="elsevierStyleHsp" style=""></span>h<a class="elsevierStyleCrossRef" href="#bib15"><span class="elsevierStyleSup">15</span></a>&#44; dictados durante los &#250;ltimos a&#241;os por la legislaci&#243;n europea&#44; debiera seguirse de un descenso en el porcentaje de residentes que se encuentran afectados por este s&#237;ndrome&#46; Respecto a esta suposici&#243;n existe controversia en la literatura dado que hay publicados al menos 4 estudios intervencionistas en los que se analiz&#243; el grado de <span class="elsevierStyleItalic">burnout</span> entre colectivos de residentes antes y despu&#233;s de modificar su carga laboral&#46; Algunos autores<a class="elsevierStyleCrossRefs" href="#bib16"><span class="elsevierStyleSup">16&#44;17</span></a> han encontrado una reducci&#243;n significativa en el cansancio emocional gracias a la aplicaci&#243;n de un programa de limitaci&#243;n del horario laboral&#46; Otros<a class="elsevierStyleCrossRefs" href="#bib18"><span class="elsevierStyleSup">18&#44;19</span></a> encontraron reducciones no significativas en la puntuaci&#243;n obtenida en el MBI y en el grado de cansancio emocional&#46; Sin embargo&#44; un estudio reciente no hall&#243; reducci&#243;n del grado de <span class="elsevierStyleItalic">burnout</span> pese a una reducci&#243;n significativa de las horas de trabajo semanales medias &#40;de 100&#44;7&#8211; 82&#44;6<span class="elsevierStyleHsp" style=""></span>h&#41;<a class="elsevierStyleCrossRef" href="#bib20"><span class="elsevierStyleSup">20</span></a>&#46; Dada esta controversia&#44; ser&#237;a interesante medir el grado de <span class="elsevierStyleItalic">burnout</span> tras la aplicaci&#243;n de la nueva normativa europea para contribuir a identificar si existen otros factores a&#241;adidos a la sobrecarga de horario laboral susceptibles de ser modificados para mejorar la calidad percibida de vida de los residentes&#46;</p><p class="elsevierStylePara elsevierViewall">A pesar de que cl&#225;sicamente se ha atribuido al trabajo en Urgencias un plus a&#241;adido en cuanto a estr&#233;s por las especiales condiciones de trabajo de la mayor&#237;a de Servicios de Urgencias&#44; tanto en los hospitales espa&#241;oles<a class="elsevierStyleCrossRefs" href="#bib21"><span class="elsevierStyleSup">21&#8211;24</span></a> como en otros pa&#237;ses<a class="elsevierStyleCrossRefs" href="#bib25"><span class="elsevierStyleSup">25&#44;26</span></a>&#44; en nuestro centro no parece que esta carga adicional exista&#44; ya que no observamos ninguna relaci&#243;n entre las guardias en Urgencias y la mayor presencia de <span class="elsevierStyleItalic">burnout&#44;</span> o el n&#250;mero de guardias que all&#237; se realizan y el cansancio emocional&#44; la despersonalizaci&#243;n o la falta de realizaci&#243;n personal&#46;</p><p class="elsevierStylePara elsevierViewall">El presente estudio tiene una serie de limitaciones que merecen ser comentadas&#46; En primer lugar&#44; es unic&#233;ntrico y quiz&#225;s no sea directamente extrapolable a otros centros con otra estructura de guardias y otra organizaci&#243;n distinta del trabajo&#46; Sin embargo&#44; creemos que nuestro hospital comparte las mismas caracter&#237;sticas con muchos de los grandes hospitales universitarios espa&#241;oles&#44; por lo que&#44; al menos para este grupo&#44; los resultados ser&#237;an exportables&#46; Segundo&#44; la tasa de respuesta fue del 45&#37;&#46; Aunque esto pueda parecer en principio bajo&#44; hay que tener en cuenta que la tasa de respuesta para los trabajos basados en encuestas rara vez superan el 50&#37;&#44; y en trabajos previos similares al nuestro realizados esta se situ&#243; entre el 18&#8211;100&#46; &#37;<a class="elsevierStyleCrossRef" href="#bib7"><span class="elsevierStyleSup">7</span></a>&#46; Sin embargo&#44; no se puede descartar que haya existido un cierto sesgo de antiselecci&#243;n a favor de los residentes m&#225;s afectados&#46; Por &#250;ltimo&#44; el MBI es uno de los test que existen y ha recibido alguna cr&#237;tica puesto que de las 3 escalas que mide&#44; solo 2 de ellas se utilizan para definir <span class="elsevierStyleItalic">burnout</span>&#44; ya que la escala de realizaci&#243;n personal aparentemente podr&#237;a medir par&#225;metros al margen de los estrictamente laborales<a class="elsevierStyleCrossRef" href="#bib1"><span class="elsevierStyleSup">1</span></a>&#46; Adem&#225;s&#44; tambi&#233;n se ha criticado la subdivisi&#243;n en 5 categor&#237;as para cada uno de los &#237;tems preguntados&#46; En nuestro centro una alta proporci&#243;n de los sujetos interrogados expresaron la dificultad de decantarse por una categor&#237;a u otra&#44; por carecer de un punto medio entre ellas para contestar&#46; Pese a todo&#44; el cuestionario del MBI ha sido perfeccionado durante m&#225;s de 20 a&#241;os por la Dra&#46; Maslach&#46; La inmensa mayor&#237;a de estudios realizados acerca del <span class="elsevierStyleItalic">burnout</span> se basan en la respuesta al mismo y actualmente se considera el patr&#243;n oro para detectar la presencia o no de <span class="elsevierStyleItalic">burnout&#46;</span></p><p class="elsevierStylePara elsevierViewall">En conclusi&#243;n&#44; el presente estudio permite afirmar que en nuestro centro la presencia de <span class="elsevierStyleItalic">burnout</span> entre los residentes es elevada y se relaciona fundamentalmente con el n&#250;mero de guardias realizadas&#46; Ser&#237;a aconsejable investigar si esta relaci&#243;n se da en la mayor&#237;a de centros espa&#241;oles o por el contrario es una excepcionalidad&#46;</p></span><span class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Conflicto de intereses</span><p class="elsevierStylePara elsevierViewall">Los autores declaran no tener ning&#250;n conflicto de intereses&#46;</p></span></span>"
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            2 => "Material y m&#233;todo"
            3 => "Resultados"
            4 => "Conclusiones"
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec17996"
          "titulo" => "Palabras clave"
        ]
        2 => array:2 [
          "identificador" => "xres15716"
          "titulo" => array:5 [
            0 => "Abstract"
            1 => "Objectives"
            2 => "Materials and Methods"
            3 => "Results"
            4 => "Conclusions"
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec17995"
          "titulo" => "Keywords"
        ]
        4 => array:1 [
          "titulo" => "Introducci&#243;n"
        ]
        5 => array:1 [
          "titulo" => "M&#233;todo"
        ]
        6 => array:1 [
          "titulo" => "Resultados"
        ]
        7 => array:1 [
          "titulo" => "Discusi&#243;n"
        ]
        8 => array:1 [
          "titulo" => "Conflicto de intereses"
        ]
        9 => array:2 [
          "identificador" => "xack1409"
          "titulo" => "Agradecimientos"
        ]
        10 => array:1 [
          "titulo" => "Bibliograf&#237;a"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2009-04-25"
    "fechaAceptado" => "2009-12-19"
    "PalabrasClave" => array:2 [
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec17996"
          "palabras" => array:3 [
            0 => "Residentes"
            1 => "Guardias"
            2 => "<span class="elsevierStyleItalic">Burnout</span>"
          ]
        ]
      ]
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec17995"
          "palabras" => array:3 [
            0 => "Residents"
            1 => "Call"
            2 => "<span class="elsevierStyleItalic">Burnout</span>"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "es" => array:2 [
        "titulo" => "Resumen"
        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivos</span><p class="elsevierStyleSimplePara elsevierViewall">Investigar el grado de <span class="elsevierStyleItalic">burnout</span> entre los residentes de un hospital universitario y los factores asociados al mismo&#46;</p> <span class="elsevierStyleSectionTitle">Material y m&#233;todo</span><p class="elsevierStyleSimplePara elsevierViewall">Se envi&#243; a todos los residentes el <span class="elsevierStyleItalic">Maslach Burnout Inventory</span> que valora cansancio emocional&#44; despersonalizaci&#243;n y realizaci&#243;n personal&#46; Existe <span class="elsevierStyleItalic">burnout</span> ante un grado de cansancio emocional o de despersonalizaci&#243;n altos&#46; Se consignaron variables epidemiol&#243;gicas &#40;edad&#44; sexo&#44; nacionalidad&#44; a&#241;o de residencia&#44; especialidad&#44; n&#250;mero de guardias totales y en urgencias&#44; d&#237;as postguardia&#44; libranza postguardia&#44; posici&#243;n de guardia&#41;&#46; Se investig&#243; la relaci&#243;n de estas con la puntuaci&#243;n en las dimensiones del <span class="elsevierStyleItalic">Maslach Burnout Inventory</span> con el <span class="elsevierStyleItalic">burnout</span> &#40;chi cuadrado&#41; y la asociaci&#243;n con el n&#250;mero de guardias &#40;regresi&#243;n lineal&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Contestaron 132 de 290 residentes &#40;45&#44;5&#37;&#41;&#58; el 40&#44;2&#37; presentaba un alto cansancio emocional y el 64&#44;4&#37; una alta despersonalizaci&#243;n&#46; En total&#44; el 69&#44;7&#37; de los residentes presentaba <span class="elsevierStyleItalic">burnout</span>&#46; No existieron asociaciones estad&#237;sticamente significativas entre las variables epidemiol&#243;gicas y las dimensiones del <span class="elsevierStyleItalic">Maslach Burnout Inventory</span>&#46; El n&#250;mero total de guardias se relacion&#243; significativamente con el cansancio emocional &#40;p&#60;0&#44;05&#41;&#44; sin relaci&#243;n con las guardias en Urgencias&#46; La realizaci&#243;n de 5 o m&#225;s guardias al mes condicion&#243; <span class="elsevierStyleItalic">burnout</span> con mayor frecuencia &#40;76&#44;6 vs&#46;60&#44;0&#37;&#44; p&#60;0&#44;05&#41;&#46; Se observ&#243; una tendencia a un mayor <span class="elsevierStyleItalic">burnout</span> entre los residentes de medicina interna y especialidades m&#233;dicas con respecto al resto &#40;75&#44;6 vs&#46; 60&#44;0&#37;&#44; p&#61;0&#44;05&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">La prevalencia de <span class="elsevierStyleItalic">burnout</span> entre los residentes es elevada y se relaciona fundamentalmente con el n&#250;mero de guardias realizadas&#46;</p>"
      ]
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle">Objectives</span><p class="elsevierStyleSimplePara elsevierViewall">To investigate the degree of <span class="elsevierStyleItalic">burnout</span> among resident physicians of a university hospital and the factors associated with it&#46;</p> <span class="elsevierStyleSectionTitle">Materials and Methods</span><p class="elsevierStyleSimplePara elsevierViewall">Maslach <span class="elsevierStyleItalic">burnout</span> Inventory &#40;MBI&#41; was sent to all residents&#44; which assesses emotional exhaustion&#44; depersonalization and personal accomplishment&#46; B<span class="elsevierStyleItalic">urnout</span> exists when high degree of emotional exhaustion or depersonalization are obtained&#46; Several variables were analyzed &#40;age&#44; sex&#44; nationality&#44; year of residency&#44; speciality&#44; total monthly calls and in emergency departments&#44; days since last call&#44; duty-free day after calls&#44; position at calls&#41;&#46; It&#8242;s relationship with the score on the different dimensions of MBI and <span class="elsevierStyleItalic">burnout</span> was analyzed through the test of the chi-square&#44; whereas the association between scores of MBI and the number of calls were analyzed using linear regression&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">132 of 290 residents answered &#40;45&#46;5&#37;&#41;&#58; 40&#46;2&#37; had a high emotional exhaustion and a 64&#46;4&#37; presented depersonalization&#46; In total&#44; 69&#46;7&#37; of the residents had <span class="elsevierStyleItalic">burnout</span>&#46; There was no statistically association between the epidemiological variables and the different dimensions of the MBI&#46; The total number of calls per month were significantly associated with emotional exhaustion &#40;p&#60;0&#46;05&#41;&#46; There wasn&#8217;t any relation to the number of calls in emergency departments&#46; Resident physicians who had 5 or more calls per month showed <span class="elsevierStyleItalic">burnout</span> more often than the rest &#40;76&#46;6&#37; versus 60&#46;0&#37;&#44; p&#60;0&#46;05&#41;&#46; A trend towards a higher <span class="elsevierStyleItalic">burnout</span> was present among residents of Internal medicine and medical specialities than the rest &#40;75&#46;6&#37; versus 60&#46;0&#37;&#44; p&#61;0&#46;05&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">The prevalence of <span class="elsevierStyleItalic">burnout</span> among the group of residents is high and relates mainly to the monthly number of calls</p>"
      ]
    ]
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        "descripcion" => array:1 [
          "es" => "<p class="elsevierStyleSimplePara elsevierViewall">Relaci&#243;n entre el n&#250;mero mensual de guardias totales y en urgencias y la puntuaci&#243;n en el cansancio emocional&#46;</p>"
        ]
      ]
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                  \t\t\t\t"><span class="elsevierStyleItalic">Edad &#40;</span>a&#241;os&#59; mediana &#91;percentil 25&#8211;75&#93;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">27 &#40;26&#8211;29&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Sexo</span> &#40;n &#91;&#37;&#93;&#41;</td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Hombre&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">64 &#40;48&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Mujer&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">68 &#40;51&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Nacionalidad</span> &#40;n &#91;&#37;&#93;&#41;</td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Espa&#241;ola&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">117 &#40;88&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Extranjera&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15 &#40;11&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">A&#241;o de residencia</span> &#40;n &#91;&#37;&#93;&#41;</td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Residente de primer a&#241;o&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">32 &#40;24&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Residente de segundo a&#241;o&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">33 &#40;25&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Residente de tercer a&#241;o&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">33 &#40;25&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Residente de cuarto a&#241;o&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">21 &#40;15&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Residente de quinto a&#241;o&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">13 &#40;9&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="" valign="\n
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                  \t\t\t\t  " colspan="2" align="" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Especialidad de la residencia</span> &#40;n &#91;&#37;&#93;&#41;</td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">17 &#40;12&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Especialidades m&#233;dicas&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">65 &#40;49&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Cirug&#237;a general y digestiva y especialidades quir&#250;rgicas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25 &#40;18&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Especialidades m&#233;dico-quir&#250;rgicas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 &#40;9&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Servicios centrales&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12 &#40;9&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">N&#250;mero total de guardias</span> &#40;mediana &#91;percentil 25&#8211;75&#93;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;4&#8211;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">N&#250;mero total de guardias en Urgencias</span> &#40;mediana &#91;percentil 25&#8211;75&#93;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;0&#8211;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">D&#237;as desde la &#250;ltima guardia</span> &#40;mediana &#91;percentil 25&#8211;75&#93;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;3&#8211;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Libranza posguardia</span> &#40;n &#91;&#37;&#93;&#41;</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Siempre&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">41 &#40;35&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>A menudo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">37 &#40;32&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Ocasionalmente&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20 &#40;17&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Nunca&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17 &#40;14&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No contesta&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Lugar de realizaci&#243;n de las guardias</span> &#40;n &#91;&#37;&#93;&#41;</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>En Urgencias&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">37 &#40;28&#44;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>En planta&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">72 &#40;54&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Mixto &#40;algunas en Urgencias y algunas en planta&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23 &#40;17&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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                  \t\t\t\t\tvoid\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">Dimensiones del Marslach Burnout Inventory</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Cansancio emocional</span> &#40;puntos&#44; mediana &#91;percentil 25&#8211;75&#93;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">24 &#40;17&#8211;31&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Cansancio emocional</span> &#40;n &#91;&#37;&#93;&#41;</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Bajo &#40;&#8804;18 puntos&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39 &#40;29&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Moderado &#40;19&#8211;26 puntos&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">40 &#40;30&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Alto &#40;&#8805;27 puntos&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">53 &#40;40&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Despersonalizaci&#243;n &#40;puntos&#44; mediana &#40;percentil 25&#8211;75&#41;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;7&#8211;16&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Despersonalizaci&#243;n</span> &#40;n &#91;&#37;&#93;&#41;</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Baja &#40;&#8804;5 puntos&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21 &#40;15&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Moderada &#40;6&#8211;9 puntos&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26 &#40;19&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Alta&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">85 &#40;64&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Realizaci&#243;n personal</span> &#40;puntos&#44; mediana &#91;percentil 25&#8211;75&#93;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">36 &#40;28&#8211;41&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Realizaci&#243;n personal</span> &#40;n &#91;&#37;&#93;&#41;</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Baja&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">52 &#40;39&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Moderada&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">41 &#40;31&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Alta&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39 &#40;29&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Presencia de burnout</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">92 &#40;69&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">40 &#40;30&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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        ]
      ]
      3 => array:7 [
        "identificador" => "tbl3"
        "etiqueta" => "Tabla 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
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                  \t\t\t\t\tvoid\n
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                  \t\t\t\t  " colspan="3" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">Cansancio emocional</span></td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">Despersonalizaci&#243;n</span></td><td class="td" title="\n
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                  \t\t\t\t  " colspan="3" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Realizaci&#243;n personal</td><td class="td" title="\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">Bajo</span> &#40;n&#61;39&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">Moderado</span> &#40;n&#61;40&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">Alto</span> &#40;n&#61;53&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">Baja</span> &#40;n&#61;21&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">Moderada</span> &#40;n&#61;26&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">Alta</span> &#40;n&#61;85&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">Baja</span> &#40;n&#61;52&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">Moderada</span> &#40;n&#61;41&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">Alta</span> &#40;n&#61;39&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Edad</span> &#40;n &#91;&#37;&#93;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;61&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;08&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">0&#44;43&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Inferior a 30 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">34 &#40;31&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">33 &#40;30&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">41 &#40;38&#44;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15 &#40;13&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21 &#40;19&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">72 &#40;66&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">40 &#40;37&#44;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">35 &#40;32&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">33 &#40;30&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Igual o superior a 30 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">4 &#40;23&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">6 &#40;35&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;41&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;29&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;23&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">8 &#40;47&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">9 &#40;52&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">3 &#40;17&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">5 &#40;29&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="13" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Sexo</span> &#40;n &#91;&#37;&#93;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">0&#44;87&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">0&#44;49&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Residente de primer-segundo a&#241;o&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Residente de tercer a&#241;o o superior&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Especialidad de la residencia</span> &#40;n &#91;&#37;&#93;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Medicina interna y especialidades m&#233;dicas&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Resto de especialidades&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">15 &#40;30&#44;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">16 &#40;32&#44;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">19 &#40;38&#44;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="13" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">N&#250;mero total de guardias mensuales</span> &#40;n &#91;&#37;&#93;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">0&#44;61&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">0&#44;16&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">0&#44;42&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Inferior a 5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">19 &#40;34&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">19 &#40;34&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">17 &#40;30&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">9 &#40;16&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">15 &#40;27&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">31 &#40;56&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">19 &#40;34&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">15 &#40;27&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">21 &#40;38&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Igual o superior a 5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">33 &#40;42&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">22 &#40;28&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">22 &#40;28&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">12 &#40;15&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">11 &#40;19&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">54 &#40;70&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">20 &#40;26&#44;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">25 &#40;32&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">32 &#40;41&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="13" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">D&#237;as desde la &#250;ltima guardia</span> &#40;n &#40;&#37;&#41;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">0&#44;56&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">0&#44;22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">0&#44;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Inferior a 7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23 &#40;27&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">30 &#40;36&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">30 &#40;36&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">11 &#40;13&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">15 &#40;18&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">57 &#40;68&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">36 &#40;43&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">28 &#40;33&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19 &#40;22&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Igual o superior a 7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">9 &#40;27&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Siempre o a menudo&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Nunca u ocasionalmente&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Realiza guardias en Urgencias</span> &#40;n &#91;&#37;&#93;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">0&#44;64&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Inferior a 30 a&#241;os&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">32 &#40;29&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">76 &#40;73&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Igual o superior a 30 a&#241;os&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">6 &#40;35&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">11 &#40;64&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="" valign="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">45 &#40;70&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Mujer&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21 &#40;30&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">47 &#40;69&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Nacionalidad</span> &#40;n &#91;&#37;&#93;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t">0&#44;87&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Espa&#241;ola&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">36 &#40;30&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">81 &#40;69&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Extranjera&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;28&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 &#40;71&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">A&#241;o de residencia &#40;n &#91;&#37;&#93;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;41&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Residente de primer-segundo a&#241;o&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22 &#40;33&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">43 &#40;66&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Residente de tercer a&#241;o o superior&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18 &#40;27&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">48 &#40;72&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Especialidad de la residencia</span> &#40;n &#91;&#37;&#93;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;06&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Medicina interna y especialidades m&#233;dicas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20 &#40;24&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">62 &#40;75&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Resto de especialidades&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20 &#40;40&#44;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30 &#40;60&#44;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">N&#250;mero total de guardias mensuales</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#44;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Inferior a 5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22 &#40;40&#44;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">33 &#40;60&#44;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Igual o superior a 5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18 &#40;23&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">59 &#40;76&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">D&#237;as desde la &#250;ltima guardia</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;64&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Inferior a 7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24 &#40;28&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">59 &#40;71&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Igual o superior a 7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;33&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22 &#40;66&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Libranza posguardia</span> &#40;n &#91;&#37;&#93;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;99&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Siempre o a menudo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21 &#40;26&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">57 &#40;73&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Nunca o ocasionalmente&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 &#40;27&#44;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27 &#40;73&#44;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Realiza guardias en Urgencias</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;88&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21 &#40;30&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">45 &#40;70&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19 &#40;29&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">47 &#40;69&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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ISSN: 00142565
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