Burnout and physical and mental health among Swedish healthcare workers

Older nurses and work-related factors that impact their mental health and wellbeing: a qualitative systematic review

BACKGROUND

The COVID-19 pandemic has placed a significant pressure on the nursing workforce, leading to an increased risk of infection and work-related issues impacting nurses' mental health. This review aims to explore the workplace challenges faced by older nurses and their impact on mental health.

METHOD

This qualitative systematic review followed the Joanna Briggs Institute methodology.

RESULTS

The review included 32 studies and identified three interconnected themes: heavy workload and nature of nursing, lack of recognition and feeling undervalued, and challenges in balancing personal life and work. These themes illustrated the complexity of the workplace challenges faced by older nurses.

DISCUSSION AND CONCLUSION

Workplace demands and shift work were common negative contributors to mental health and wellbeing. The physical and cognitive capacity of older nurses may diminish due to age-related changes, making the workload more challenging. Recognition and support from the organisation, especially from management and leadership, played a crucial role in nurses' resilience.

An urgent call to address work-related psychosocial hazards and improve worker well-being

Work-related psychosocial hazards are on the verge of surpassing many other occupational hazards in their contribution to ill-health, injury, disability, direct and indirect costs, and impact on business and national productivity. The risks associated with exposure to psychosocial hazards at work are compounded by the increasing background prevalence of mental health disorders in the working-age population. The extensive and cumulative impacts of these exposures represent an alarming public health problem that merits immediate, increased attention. In this paper, we review the linkage between work-related psychosocial hazards and adverse effects, their economic burden, and interventions to prevent and control these hazards. We identify six crucial societal actions: (1) increase awareness of this critical issue through a comprehensive public campaign; (2) increase etiologic, intervention, and implementation research; (3) initiate or augment surveillance efforts; (4) increase translation of research findings into guidance for employers and workers; (5) increase the number and diversity of professionals skilled in preventing and addressing psychosocial hazards; and (6) develop a national regulatory or consensus standard to prevent and control work-related psychosocial hazards.

Downside of Helping Professions: A Comparative Study of Health Indicators and Health Behaviour among Nurses and Early Childhood Educators

The activities of health care workers and early childhood educators have received increased attention both in lay public discourse and in scientific discourse. These professional groups play a significant role in shaping the health behaviours of those they interact with; thus, understanding the patterns they convey is of paramount importance. The aim of our study is a comparative analysis of health conditions and health behaviours of professionals working in Hungarian early childhood education and nurses working in the healthcare system (n = 1591). We carried out our quantitative, cross-sectional research using convenience sampling among healthcare professionals working in nursing job positions (n = 581) and as early childhood educators (n = 1010), in south-west Hungary. Diagnosed chronic illnesses affect early childhood educators at a significantly higher rate (p < 0.05): the prevalence of musculoskeletal disorders is particularly high among them, as a result of which they reported a significant degree of physical limitation in relation to work. In the context of mental health, comparing the professional groups, nurses' indicators were significantly (p < 0.001) more unfavourable in all examined dimensions. Moreover, the comparison in terms of educational attainment directed attention to the worse indicators of non-graduates. In this context, early childhood educators are less affected by all three dimensions of burnout (p < 0.001). As for health behaviour, the smoking habits of nurses are more unfavourable (p < 0.05). Regarding screening tests, participation in cytological testing was significantly higher among nurses, whereas early childhood educators showed increased participation in mammography (p < 0.001). Our findings draw attention to the fact that early childhood educators are primarily affected by chronic musculoskeletal disorders, while healthcare workers are more affected by problems related to mental health. Mental well-being can be further endangered by the fact that both professional groups perceive low social appreciation for the work they carry out.

Clinical teaching self-efficacy positively predicts professional fulfillment and negatively predicts burnout amongst Thai physicians: a cross-sectional survey

BACKGROUND

Clinician teachers (physicians who teach in clinical settings) experience considerable psychological challenges in providing both educational training and patient care. This study aimed to determine the prevalence of physician burnout and professional fulfillment, and to identify internal and external factors associated with mental health outcomes among Thai clinician teachers working in non-university teaching hospitals.

METHOD

A one-time online questionnaire was completed by physicians at 37 governmental, non-university teaching hospitals in Thailand, with 227 respondents being assessed in the main analyses. Four outcomes were evaluated including burnout, professional fulfillment, quality of life, and intentions to quit.

RESULTS

The observed prevalence of professional fulfillment was 20%, and burnout was 30.7%. Hierarchical regression analysis showed a significant internal, psychological predictor (clinical teaching self-efficacy) and external, structural predictors (multiple roles at work, teaching support), controlling for the background variables of gender, years of teaching experience, family roles, and active chronic disease, with clinical teaching self-efficacy positively predicting professional fulfillment (b = 0.29, p ≤.001) and negatively predicting burnout (b = - 0.21, p =.003).

CONCLUSIONS

Results highlight the importance of faculty development initiatives to enhance clinical teaching self-efficacy and promote mental health among Thai physicians.

Occupation type, family demands and mental health: analysis of linked administrative data

BACKGROUND

While employment generally promotes positive health and wellbeing, some jobs may be less salutogenic than others. Few studies have examined mental health across a range of broadly defined occupation types using a large population sample.

AIMS

To examine the prevalence of mental health problems across a wide range of occupation types, and further examine the association of family demands, controlling for key social determinants and health-related factors.

METHODS

We used linked administrative data from 2011 NI Census returns; NI Properties data; and Enhanced Prescribing Data (EPD) 2011/12. We examined self-reported mental health problems and receipt of psychotropic medication among 553,925 workers aged 25 and 59 years.

RESULTS

Self-reported chronic mental ill health was more prevalent among workers in lower paid occupations, while "public- facing" occupations had the highest rates of medication. In fully adjusted models, informal caregivers were less likely to report mental health problems but more likely to be in receipt of psychotropic medication, as were lone parents. The association of family demands also varied across occupational groupings.

CONCLUSION

Future development of mental health at work plans should take cognisance of occupation specific mental health risk and wider family circumstances to support workers' mental wellbeing most effectively.

Spanish validation of the Stigma of Occupational Stress Scale for Doctors (SOSS-D) and factors associated with physician burnout

OBJECTIVES

The aim of this study was to investigate the psychometric properties of the Spanish version of the Stigma of Occupational Stress Scale for Doctors (SOSS-D) and the factors associated with Physician Burnout in Paraguay.

METHODS

Participants included 747 Paraguayan healthcare workers, aged 24-77 years old, of both sexes. SOSS-D was translated into Spanish and validated through an exploratory and confirmatory factor analysis. Participants were also scored with the Oldenburg Burnout Inventory (OLBI), the CAGE questionnaire, and the stigma subscale of the Perceived Barriers to Psychological Treatment (PBPT) measure.

RESULTS

Three factors had a raw eigenvalue greater than 1, and explained 61.7% of total variance. The confirmatory analysis confirmed that the scale is three-dimensional. The model adjustment was good, according to all fit indices. OLBI results indicate clinically significant disengagement in 85.9% and clinically significant exhaustion in 91.6% of participants. Of the 747 participants, 57.6% reported alcoholic beverage consumption and among those, 19.3% had problematic alcohol consumption according to the CAGE questionnaire. The correlation between SOSS-D and the stigma subscale of the PBPT was statistically significant (r = 0.245, p < 0.001).

CONCLUSIONS

The Spanish version of the SOSS-D was found to have good psychometric properties and adequately reproduces the three-dimensional model of the original English version.

A network analysis bridging the gap between the big five personality traits and burnout among medical staff

BACKGROUND

Burnout is a common issue among medical professionals, and one of the well-studied predisposing factors is the Big Five personality traits. However, no studies have explored the relationships between these traits and burnout from a trait-to-component perspective. To understand the specific connections between each Big Five trait and burnout components, as well as the bridging effects of each trait on burnout, we employed network analysis.

METHODS

A cluster sampling method was used to select a total of 420 Chinese medical personnel. The 15-item Chinese Big Five Personality Inventory-15 (CBF-PI-15) assessed the Big Five personality traits, while the 15-item Maslach Burnout Inventory-General Survey (MBI-GS) assessed burnout components. Network analysis was used to estimate network structure of Big Five personality traits and burnout components and calculate the bridge expected influence.

RESULTS

The study revealed distinct and clear relationships between the Big Five personality traits and burnout components. For instance, Neuroticism was positively related to Doubt significance and Worthwhile, while Conscientiousness was negatively related to Accomplish all tasks. Among the Big Five traits, Neuroticism displayed the highest positive bridge expected influence, while Conscientiousness displayed the highest negative bridge expected influence.

CONCLUSIONS

The network model provides a means to investigate the connections between the Big Five personality traits and burnout components among medical professionals. This study offers new avenues for thought and potential targets for burnout prevention and treatment in medical personnel, which can be further explored and tested in clinical settings.

Burnout in trauma and orthopaedics: a cross-sectional study of surgeons from across the United Kingdom

INTRODUCTION

Improving psychological wellbeing in healthcare professionals has demonstrable links with improvements in system-performance and patient outcomes. The aims of this study were to determine the prevalence of burnout among orthopaedic surgeons within the United Kingdom (UK) and to identify any influencing factors.

METHODS

This prospective, cross-sectional nationwide study used the Oldenburg Burnout Inventory to assess burnout among orthopaedic registrars, middle grades and consultants from across the UK. In total, 369 participants completed an anonymised online survey. Reasons for burnout were assessed using a list of 20 stressors followed by a white-space box for elaboration.

RESULTS

Respondents included 204 (55.3%) consultants, 100 (27.1%) registrars and 65 (17.6%) who were an associate specialist, trust grade or fellow. Some 252 (68.3%) participants experienced moderate-level burnout and 81 (22.0%) high-level burnout. There was no significant association between burnout and grade (p = 0.283), gender (p = 0.433), marital status (p = 0.932), years since graduation (p = 0.397), overseas training (p = 0.642), hours worked (p = 0.601), region (p = 0.699) or hospital type (p = 0.813). A high level of disengagement and exhaustion were identified, with the latter being a greater contributory factor. The most common reasons for burnout were insufficient staff numbers, an overload of administrative work and limited time to see patients.

CONCLUSION

There was a moderate to high level of burnout among orthopaedic surgeons within the UK. Clinical and management teams should focus on improving staff numbers, reducing administrative work and increasing clinic consultation times to limit any further disengagement and exhaustion from surgeons. Reducing burnout may help to improve mental wellbeing, work satisfaction and workforce productivity.

Health impacts in pathology workforce during mergers and acquisitions (M&A)

AIMS

To compare burn-out in laboratory professionals (LPs) with exposure to consolidation to those without, and to investigate the role of social support as a moderator in the exposure to mergers and acquisitions (M&A).

METHODS

Surveys were sent to the clinical LPs, including 732 with exposure to M&A and 819 without. The dependent variable was burn-out, and the independent variable was exposure to M&A. In investigating the role of social support in exposure group, a logistic regression was used with education, time since M&A, gender, merger types, practice setting, lab hierarchy and race as covariates.

RESULTS

Exposure to M&A was associated with higher levels of burn-out (p<0.05). In logistic regression of the workforce exposed to M&A, the odds for LP developing a high level of burn-out are lowered by 7.1% for every unit of increase in social support (OR 0.93; 95% CI 0.88 to 0.98; p=0.004).

CONCLUSION

LPs exposed to M&A are more likely to experience higher levels of burn-out but having social support can protect against burn-out, which has policy implications for leadership managing laboratories in times of M&A.

Work Engagement, Burnout, and Well-being in Nursing Professional Development Practitioners

Work engagement, burnout, and well-being in nursing professional development practitioners during the second year of COVID-19 were explored. Increased levels of work engagement were associated with decreased burnout and higher levels of well-being. Significant differences were noted in work engagement and burnout among those with more than 1 year of nursing professional development experience. Examining the health of the specialty highlights current concerns and provides insight into developing interventions to address the consequences of the pandemic.

Protective and risk factors associated with substance use coping among healthcare workers during the COVID-19 pandemic

Background

Healthcare workers (HCWs) experienced high levels of stress and mental health consequences associated with the COVID-19 pandemic, which may have contributed to unhealthy coping behaviors, such as substance use coping (SUC). This study aimed to understand the extent of and predictors of SUC.

Methods

The sample consisted of 263 HCWs in North Central Florida. Univariable and multivariable logistic regression analyses investigated whether moral injury and other work risk factors, protective factors, and clinically relevant symptoms (i.e., work exhaustion, interpersonal disengagement, depression, anxiety, and/or PTSD) were associated with likelihood of SUC.

Results

Clinically relevant levels of interpersonal disengagement and anxiety increased the likelihood of SUC. Mediational analyses found that interpersonal disengagement and anxiety explained 54.3% of the relationship between Self Moral Injury and SUC and explained 80.4% of the relationship between professional fulfillment and SUC.

Conclusion

Healthcare supervisors should be aware that providers who are experiencing moral injury and less professional fulfillment may be experiencing significant interpersonal disengagement and anxiety, which could lead to SUC. Future studies should examine the effects of implementing targeted prevention and treatment interventions, along with longitudinal outcomes related to SUC behaviors.

Workplace wellbeing among health care workers providing HIV services in primary care in Johannesburg: a mixed methods study

Background

Burnout among Health Care workers (HCWs) impacts on provider-patient relations and quality of care. Anova Health Institute (Anova) is a large South African non-profit organization and PEPFAR/USAID implementing partner. We conducted a study among HCWs providing HIV-related services in primary care settings in Johannesburg, South Africa, to examine levels of burnout, understand factors affecting workplace wellbeing, and explore strategies to prevent burnout.

Methods

We used a sequential mixed-method approach. Data were collected between February and April 2022. The first phase consisted of a survey using the Maslach Burnout Inventory Human Services Survey (MBI-HSS) to measure levels of burnout. We then interviewed a subset of survey participants to understand the experiences that may affect wellbeing. We used descriptive statistics to quantify burnout rates for each MBI dimension (emotional exhaustion, personal accomplishment, and depersonalization). Qualitative data analysis was guided by the Job Demands-Resources Framework that explores the interactions between demands and resources in the workplace.

Results

Survey findings (n = 194) revealed that although depersonalization rates were low at 6%, 21% of participants had high emotional exhaustion and 24% reported low professional accomplishment. Less than half (41%, n = 80) had scores in the high category for any one of the three MBI-HSS dimensions. The MBI-HSS dimensions differed significantly by type of work and job title. Roving positions (HCW working in more than one health facility) were more likely to experience higher emotional exhaustion and lower professional accomplishment. Qualitative findings (n = 25) indicate that a number of job demands, including high workload, inadequate mental health support, and challenging relationships with stakeholders, had a negative effect on HCWs' wellbeing. However, finding meaningfulness in their work, working as a team, and practicing autonomy were experienced as resources that reduced the negative effect of these demands.

Conclusion

While measured burnout syndrome rates were low, various experiences negatively impacted at least one in five HCW. We identified key resources that provided buffering against workplace stressors. We recommend that as well as addressing key drivers of burnout, access to these resources should be fostered, for example by strengthening interventions that offer recognition, and promoting team interactions through social activities and support groups.

Healthcare in distress: A survey of mental health problems and the role of gender among nurses and physicians in Sweden

INTRODUCTION

The present article aimed to investigate 1) if mental health problems (depression and burnout including the dimensions; emotional exhaustion, mental distance and cognitive and emotional impairment) differed between nurses and physicians in Sweden, 2) if any differences were explained by differences in sex compositions, and 3) if any sex differences were larger within either of the two professions.

METHOD

Data were derived from a representative sample of nurses (n = 2903) and physicians (n = 2712) in 2022. Two scales were used to assess burnout (KEDS and BAT) and one to assess depression (SCL-6). The BAT scale has four sub-dimensions. Descriptive statistics and logistic regression were used to analyse each scale and dimension separately.

RESULTS

Results showed that 16-28 % of nurses and physicians reported moderate to severe symptoms of burnout. The prevalence differed between occupations across the scales and dimensions used. Nurses reported higher scores on KEDS while physicians reported higher scores on BAT including the four dimensions. Also, 7 % of nurses' and 6 % of physicians' scores were above the cut-off for major depression. The inclusion of sex in the models changed the odds ratios of differences between doctors and nurses in all mental health dimensions except mental distance and cognitive impairment.

LIMITATIONS

This study was based on cross-sectional survey data which has some limitations.

CONCLUSION

Our study suggests that the prevalence of mental health problems is prominent among nurses and physicians in Sweden. Sex plays an important role in the difference in the prevalence of mental health problems between the two professions.

Stress, Burnout, and General Mental Health among Healthcare Workers in Poland during the Long-Lasting COVID-19 Pandemic

Medical professions are characterized by a great responsibility for human health and life; they are also vulnerable to burnout. The outbreak of the COVID-19 pandemic has brought new challenges and threats. This study aimed to assess the mental health of healthcare workers after a year and a half of working in COVID-19 pandemic conditions. The Perceived Stress Scale (PSS-10), the Link Burnout Questionnaire (LBQ), and the General Health Questionnaire (GHQ-28) were utilized in this cross-sectional investigation. A total of 335 healthcare employees from Polish hospitals (median age 44 years) filled out online questionnaires between the 16 August 2021 and the 30 March 2022. Most of the sample was female (86%). In this study, 40.0% of the surveyed healthcare workers reported a high stress intensity. Burnout was reported by 9.6% of the workers, and the most frequently experienced symptom was psychophysical exhaustion. Almost half of the healthcare workers surveyed (49.6%) reported health disorders at both the mental and physiological levels. Interestingly, working in a COVID-19 ward did not significantly differentiate healthcare workers in any of the evaluated variables: PSS-10 (gr. A F = 1.21; gr. B F = 0.71; p > 0.05), LBQ (gr. A F = 1.89, F = 0.94, F = 1.08, F = 2.57; gr. B F = 0.32, F = 1.14, F = 0.77, F = 0.36; p > 0.05), and GHQ-28 (gr. A F = 0.85, F = 0.52, F = 0.57, F = 0.31; gr. B F = 0.31, F = 0.06, F = 0.06, F = 0.54; p > 0.05). Furthermore, there were no statistically significant differences between the compared occupational groups of healthcare workers: PSS-10 (F = 1.08; p > 0.05) and GHQ-28 (F = 1.78; F = 0.85; F = 0.62; F = 0.54; p > 0.05). The mental health of healthcare workers is alarming, and psychophysical conditions can affect the quality of work and relations with patients. Psychological care in workplaces and workshops that build resources for dealing with difficult situations are necessary.

Evaluation of a Telehealth-Enabled Pilot Program to Address Intensive Care Unit Health Care Worker Mental Health Distress

Introduction

Health care workers (HCWs) are at heightened risk of adverse mental health events (AMHEs) and burnout with resultant impact on health care staffing, outcomes, and costs. We piloted a telehealth-enabled mental health screening and support platform among HCWs in the intensive care unit (ICU) setting at a tertiary care center.

Methods

A survey consisting of validated screening tools was electronically disseminated to a potential cohort of 178 ICU HCWs. Participants were given real-time feedback on their results and those at risk were provided invitations to meet with resiliency clinicians. Participants were further invited to engage in a 3-month longitudinal assessment of their well-being through repeat surveys and a weekly text-based check-in coupled with self-help tips. Programmatic engagement was evaluated and associations between at-risk scores and engagement were assessed. Qualitative input regarding programmatic uptake and acceptance was gathered through key informant interviews.

Results

Fifty (28%) HCWs participated in the program. Half of the participants identified as female, and most participants were white (74%) and under the age of 50 years (93%). Nurses (38%), physicians-in-training (24%), and faculty-level physicians (20%) engaged most frequently. There were 19 (38%) requests for an appointment with a resiliency clinician. The incidence of clinically significant symptoms of AMHEs and burnout was high but not clearly associated with engagement. Additional programmatic tailoring was encouraged by key informants while time was identified as a barrier to program engagement.

Discussion

A telehealth-enabled platform is a feasible approach to screening at-risk HCWs for AMHEs and can facilitate engagement with support services.

Resilient, but for how long? The relationships between temperament, burnout, and mental health in healthcare workers during the Covid-19 pandemic

Introduction

Dispositional traits of wellbeing and stress-reaction are strong predictors of mood symptoms following stressful life events, and the COVID-19 pandemic introduced many life stressors, especially for healthcare workers.

Methods

We longitudinally investigated the relationships among positive and negative temperament group status (created according to wellbeing and stress-reaction personality measures), burnout (exhaustion, interpersonal disengagement), COVID concern (e.g., health, money worries), and moral injury (personal acts, others' acts) as predictors of generalized anxiety, depression, and post-traumatic stress symptoms in 435 healthcare workers. Participants were employees in healthcare settings in North Central Florida who completed online surveys monthly for 8 months starting in October/November 2020. Multidimensional Personality Questionnaire subscale scores for stress-reaction and wellbeing were subjected to K-means cluster analyses that identified two groups of individuals, those with high stress-reaction and low wellbeing (negative temperament) and those with the opposite pattern defined as positive temperament (low stress-reaction and high wellbeing). Repeated measures ANOVAs assessed all time points and ANCOVAs assessed the biggest change at timepoint 2 while controlling for baseline symptoms.

Results and Discussion

The negative temperament group reported greater mood symptoms, burnout, and COVID concern, than positive temperament participants overall, and negative participants' scores decreased over time while positive participants' scores increased over time. Burnout appeared to most strongly mediate this group-by-time interaction, with the burnout exhaustion scale driving anxiety and depression symptoms. PTSD symptoms were also related to COVID-19 health worry and negative temperament. Overall, results suggest that individuals with higher stress-reactions and more negative outlooks on life were at risk for anxiety, depression, and PTSD early in the COVID-19 pandemic, whereas individuals with positive temperament traits became more exhausted and thus more symptomatic over time. Targeting interventions to reduce mood symptoms in negative temperament individuals and prevent burnout/exhaustion in positive temperament individuals early in an extended crisis may be an efficient and effective approach to reduce the mental health burden on essential workers.

Examining factors affecting self-care-self-regulation among registered nurses using path analysis

BACKGROUND

Practicing self-care is a requisite for nurses as they face the extreme physical, mental, and emotional challenges presented by the pandemic era. This study aimed to examine factors that contribute to self-care-self-regulation (SCSR) and investigate the mediation effect of psychological and physical health in the relationship between work stress and SCSR among registered nurses in the United States.

MATERIALS AND METHODS

This cross-sectional study was conducted on the data collected from 386 registered nurses who completed an online survey over a 3-week period during the COVID-19 pandemic (April 19 to May 6, 2020). The survey assessed demographic and work-related characteristics, work stress, depressive mood, self-rated health, and SCSR. The model was tested with depressive mood as the first mediator and self-rated health as the second mediator. The potential serial mediation effect was analyzed using PROCESS macros adjusting for covariates.

RESULTS

The sequential indirect effect of work stress on SCSR through depressive mood and self-rated health in series was significant, while its direct effect was not.

CONCLUSION

The findings of the path analysis demonstrate that psychological and physical health status is important to promote self-care behaviors when nurses experience high work stress.

Heat stress associated with aerosol PPE and its impact

BACKGROUND

Aerosol personal protective equipment (PPE) is subjectively reported to negatively impact healthcare workers' performance and well-being, but this has not been assessed objectively.

AIMS

This randomized controlled crossover study aimed to quantify the heat stress associated with aerosol PPE and to investigate its impact upon mood, cognitive and motor function, and task performance.

METHODS

Sixteen healthy, young, lean participants (eight males) undertook an exercise protocol, which simulated the metabolic expenditure of hospital work: once wearing aerosol PPE (PPE visit) and once wearing standard surgical attire (control visit). Participants walked on a treadmill for 2 h followed by 30-min rest. Core temperature, heart rate, urine specific gravity, weight, grip strength, mood (Bond-Lader scale) and task performance (Intubation of a Manikin) were recorded. Values are between-visit mean (standard deviation) differences.

RESULTS

On the PPE visit core temperature (+0.2 (0.3)°C; P < 0.01), heart rate (+12 (13) bpm; P < 0.001), urine specific gravity (+0.003 (0.005); P < 0.05) and intubation task time (+50 (81) s; P < 0.01) were greater than on the control visit; and alertness (-14 (21) mm; P < 0.001), contentment (-14 (15) mm; P < 0.001) and grip strength (-4 (4) N; P < 0.01) were less.

CONCLUSIONS

This study demonstrates that wearing aerosol PPE in a simulated hospital environment results in heat exhaustion and has a negative impact upon mood, motor function, and task performance. Whilst wearing PPE is important to prevent disease transmission, strategies should be developed to limit its impact upon healthcare workers' performance and well-being.

High levels of burnout among health professionals treating COVID-19 patients in two Nile basin countries with limited resources

Burnout syndrome is a real cause for concern in African health facilities. Healthcare professionals (HCPs) burnout is considered a great public health problem and especially during pandemics as several physical and emotional stressors on this population can lead to increased burnout. This study aimed to investigate the frequency and associated factors of occupational burnout among HCPs working at COVID-19 isolation facilities in Egypt and Sudan. This is important to summarize lessons learned and inform relevant interventions for future pandemic responses. A cross-sectional survey was conducted among frontline HCPs from May 2021 to July 2021. An online, anonymous, self-administered questionnaire was used for data collection. Occupational burnout was estimated using  the Oldenburg Burnout Inventory. A total of 362 HCPs participated in the study and were equally recruited from Egypt (181) and Sudan (181) with a mean age of (31.84 ± 8.32) years. More than half of HCPs were females (60%) and physicians (58.3%). Most HCPs included in the study had high levels of work disengagement (75.4%) and emotional exhaustion (98.6%). Burnout syndrome was present in 75% of the HCPs with 77% among Egyptian HCPs and 71% among Sudanese HCPs. Multivariate logistic regression was used to determine predictors of burnout, working hours per week were the parameters associated with burnout syndrome among Egyptian HCPs; while for Sudanese HCPs, these were age and number of days off. The study revealed a high level of burnout syndrome among HCPs working at COVID-19 isolation facilities in both Egypt and Sudan. Appropriate actions should be taken to preserve the mental health status of HCPs through the establishment of effective and efficient coping strategies.

Investigating the mediating effect of anxiety and fear of a third wave of COVID-19 among students in South India

The COVID-19 pandemic, which is a global health emergency, has potentiality had a serious impact on students' mental health. An online cross-sectional survey design that included 534 senior year college students from South India revealed a significant and direct positive effect of the fear of a third wave of COVID-19 on academic anxiety which in turn showed a significant and direct positive effect on COVID-19 burnout. Academic anxiety was also found to mediate the relationship between the fear of a third wave of COVID-19 and subsequent cases of burnout. The study suggested measures to be taken by policy makers for the broader interest and wellbeing of student communities. Managerial implications, limitations and future studies were also examined in the paper.

Somatic symptoms in burnout in a general adult population

OBJECTIVE

Burnout results in individual suffering and high societal costs, and is associated with somatic symptoms, anxiety and depression, calling for prevention by early identification. The objectives were to (i) determine prevalence of specific somatic symptoms in burnout, (ii) identify the symptoms, referred to as somatic symptoms of burnout (SS-B), that are particularly associated with burnout, (iii) determine their extent of association with burnout, and (iv) determine how well a certain number of SS-B differentiates participants with and without burnout in a general Swedish adult population.

METHODS

Cross-sectional, population-based data were used from 687 participants high on burnout, and 2544 referents based on the Shirom-Melamed Burnout Questionnaire. The Patient Health Questionnaire 15-item Somatic Symptom Severity Scale was used to assess common somatization symptoms, and the Hospital Anxiety and Depression Scale to assess anxiety and depression.

RESULTS

Feeling tired/having low energy, back pain, joint/limb pain, trouble sleeping, headaches, stomach pain, nausea/gas/indigestion, and constipation/loose bowels/diarrhea were most prevalent in burnout (57.2-95.0%). These symptoms, except for joint/limb pain, and dizziness, were also identified as the SS-B, with odds ratios of 2.34-12.74 and 1.95-9.11 when adjusted for background variables, and for anxiety and depression, respectively. Corresponding odds ratios for each additional number of SS-B were 1.69 and 1.52, respectively. The highest balanced accuracy (71.6%) for predicting burnout was found for ≥4 SS-B.

CONCLUSION

Fatigue, pain and gastrointestinal symptoms are particularly common in burnout. Further studies may show whether clinicians should consider screening for burnout when patients present with SS-B without pathophysiological explanations.

How Resilience and Wellness Behaviors Affected Burnout and Academic Performance of First-Year Pharmacy Students During COVID-19

Objective. To determine whether students' levels of resilience and self-reported wellness behaviors predicted burnout and grade point average at the end of the first fall semester of the COVID-19 pandemic.Methods. We measured first-year students' resilience, burnout (exhaustion and disengagement), and self-reported wellness behaviors (sleep, nutrition, social time, and self-care activities) at the beginning and end of the fall 2020 semester of pharmacy school. We also collected students' demographic information and end-of-semester grade point average from their academic records. Using multivariable regression, we assessed whether students' resilience and wellness behaviors predicted burnout and grade point average at the end of the semester. We also assessed for changes in burnout and wellness behaviors over time.Results. Resilience was positively associated with older age and was lower among students of color. Exhaustion and disengagement were high at baseline and continued to worsen over time. Students' self-reported wellness behaviors also decreased over time, except for ratings of sleep adequacy. Resilience predicted lower levels of disengagement at the end of the semester, but its relationship with exhaustion was inconsistent. The only wellness behaviors associated with lower burnout were nutrition and sleep adequacy. Students' end-of-semester grade point average was also related to nutrition and sleep adequacy but not resilience or burnout.Conclusion. Resilience offered some protection from burnout, but its relationship to immutable factors suggests that individual-focused interventions to improve student well-being (eg, wellness behaviors such as mindfulness meditation) should be complemented by organizational support, especially for younger students and students of color.

Burnout, Depression, and Job Stress Factors in Healthcare Workers of a Romanian COVID-19 Dedicated Hospital, after Two Pandemic Years

The COVID-19 pandemic put unprecedented pressure on all areas of activity, especially healthcare workers. Understanding the psychological response to the pandemic in healthcare workers is an important challenge. This study aims to investigate burnout, depression, and job stress factors in the medical personnel of a COVID-19-dedicated hospital, two years after the beginning of the pandemic. The survey was performed between the fifth and sixth pandemic waves in Romania. Employees of the Clinical Hospital for Infectious Diseases, Cluj-Napoca, completed an online survey using four tools: Maslach Burnout Inventory (MBI), Copenhagen Burnout Inventory (CBI), the Karasek Job factors questionnaire, and the Patient Health Questionnaire-9 (PHQ-9). A total of 114 employees completed the questionnaire (10.83% of total employees). The results showed 100% prevalence of Maslach burnout (56.1% moderate and severe burnout) and 63.1% prevalence of depression. The infectious disease resident doctors had the highest prevalence of burnout scores, depression, and perceived Karasek job demands. The 22- to 30-year-old age group and the group with fewer than ten years of professional experience had a significantly higher prevalence of burnout and depression than older employees or employees with more professional experience. The COVID-19 pandemic continues to have a high impact on the mental health of healthcare workers.

Long-term associations of psychosocial working conditions with depressive symptoms and work-related emotional exhaustion: comparing effects in a 5-year prospective study of 1949 workers in Germany

OBJECTIVE

To test the hypothesis that psychosocial working conditions are more strongly associated with subsequent work-related emotional exhaustion (core component of burnout) than with depressive symptoms at follow-up.

METHODS

A 5-year cohort study (2011/2012-2017), based on a random sample of persons in employment subject to payment of social contributions aged 31-60 years (Study on Mental Health at Work; S-MGA; N = 1949), included self-reported measures of organisational demands (organisational layoffs and restructuring), task-level demands (work pace and amount of work) and job resources (influence at work, possibilities for development, control over working time, role clarity), all taken from the COPSOQ, except the organisational demands that were single-item measures. Work-related emotional exhaustion and depressive symptoms were measured with the Oldenburg Burnout Inventory and the Patient Health Questionnaire-9, respectively.

RESULTS

Cochrane Q tests revealed stronger associations between psychosocial working conditions and work-related emotional exhaustion only for the amount of work (p = 0.013) and control over working time (p = 0.027). No differences were observed for the Demands and Resources Indexes, capturing overall exposure to psychosocial working conditions. The same differences were observed in a subsample including only participants who remained at the same employer from baseline to follow-up, although more psychosocial working conditions were associated with work-related emotional exhaustion than with depressive symptoms. Supplementary analyses employing dichotomous measures of work-related emotional exhaustion and depressive symptoms confirmed these results.

CONCLUSIONS

Overall, the findings provide limited evidence supporting the hypothesis that psychosocial working conditions are more strongly associated with work-related emotional exhaustion than with depressive symptoms.

A Comparison of the Self-Perceived Organisational and Social Work Environment among Swedish Occupational Therapists in Different Job Sectors: An Observational Study

Sick leave due to mental health problems is increasing, and there is evidence that it is associated with the individual's self-perceived organisational and social work environment. The aim of this study was to compare occupational therapists' self-perceived organisational and social work environments in different job sectors. The goal is to identify the sectors with the most unfavourable work environment and thus where the need to improve the work environment, to prevent mental health problems, is greatest. A web survey was emailed to working members of the Swedish Association of Occupational Therapists in February 2018 (n = 7600). The response rate was 48% (n = 3658). Studied job sectors were somatic specialist health care; elderly care; habilitation; psychiatric health care; primary health care; and university (n = 2648). This sample is representative of Swedish occupational therapists with respect to age, gender, and job sector. The web survey included questions on their sociodemographic characteristics and self-perceived organisational and social work environment regarding workload, control, community in the workplace, reward, justice, and values. Questions on the self-perceived organisational and social work environment were assessed by the QPS mismatch questionnaire. Differences in work environmental conditions between the job sectors were tested with ANOVA and post hoc multiple-group analysis. The results showed that occupational therapists working in psychiatric health care perceived the highest proportion of unfavourable working conditions. Occupational therapists who worked at universities perceived a higher workload than occupational therapists in most of the other studied job sectors. These job sectors need to be specifically addressed with adjustments to prevent mental health problems.

Assessment of the risk of burnout and its associated factors in healthcare professionals during the COVID-19 pandemic: A prospective cohort study

Introduction

The COVID-19 pandemic resulted in tremendous physical and psychological pressure on healthcare professionals, especially on those working in intensive care units (ICUs) and Emergency Departments (EDs). The present study intended to characterize the profile of these professionals which is associated with burnout and determine the potential predictors of such condition.

Methods

A Prospective cohort study was carried out in a tertiary hospital between March 2020 and March 2021, in Salvador, Brazil. A standardized and validated version of the Oldenburg Burnout inventory (OLBI) was applied to assess risk of burnout together with data forms designed to collect information on sociodemographic characteristics and religious beliefs. ICU and ED healthcare professionals were evaluated during off-hours at two distinct periods of the COVID-19 pandemic, in 2020 and in 2021. Differences in the results obtained from each study participant between the timepoints were compared. A binary logistic regression analysis was performed to identify the predictors of burnout development independent of other confounding factors.

Results

Seventy-seven healthcare professionals with a median age of 33 (interquartile range [IQR]: 31-37.5) years and predominantly female (72.7%; n = 56) were enrolled. There were 62 professionals at risk of developing burnout through the OLBI. Those had a median age of 33 (IQR: 31-37) and female predominance (71%, n = 44). Disengagement and burnout were the only features which frequencies significantly changed over time, with increasing detection at the latest timepoint. Alcohol consumption was found to be an important risk factor for burnout development [adjusted odds ratio (aOR): 10.8 (95% CI: 1.8-64.2)]. Importantly, working in the ICU [aOR: 0.04 (95%CI: 0.01-0.32)] and the habit of praying daily [aOR: 0.07 (95%CI: 0.01-0.41)] were characteristics linked to reduced odds of burnout.

Discussion

Disengagement substantially increased during the COVID-19 pandemic in healthcare professionals. Alcohol consumption favors the onset of burnout whereas habit of praying daily and working in the ICU are protective against such outcome. Institutional policies aimed at minimizing etilism may positively impact mental health of these professionals.

Investigating burn-out contributors and mitigators among intensive care unit nurses during COVID-19: a focus group interview study

OBJECTIVE

Past literature establishes high prevalence of burn-out among intensive care unit (ICU) nurses, and the influence of the COVID-19 pandemic in intensifying burn-out. However, the specific pandemic-related contributors and practical approaches to address burn-out have not been thoroughly explored. To address this gap, this work focuses on investigating the effect of the COVID-19 pandemic on the burn-out experiences of ICU nurses and identifying practical approaches for burn-out mitigation.

DESIGN

Semistructured focus group interviews were conducted via convenience sampling and qualitatively analysed to identify burn-out contributors and mitigators. Maslach Burnout Inventory for Medical Personnel (MBI-MP) and Post-traumatic Stress Disorder Checklist (PCL-5) were employed to quantify the prevalence of burn-out of the participants at the time of study.

SETTING

Two ICUs designated as COVID-19 ICUs in a large metropolitan tertiary care hospital in the Greater Houston area (Texas, USA).

PARTICIPANTS

Twenty registered ICU nurses (10 from each unit).

RESULTS

Participants experienced high emotional exhaustion (MBI-MP mean score 32.35, SD 10.66), moderate depersonalisation (M 9.75, SD 7.10) and moderate personal achievement (M 32.05, SD 7.59) during the pandemic. Ten out of the 20 participants exhibited post-traumatic stress disorder symptoms (PCL-5 score >33). Regarding contributors to burn-out in nurses during the pandemic, five thematic levels emerged-personal, patient related, coworker related, organisational and societal-with each factor comprising several subthemes (eg, emotional detachment from patients, constant need to justify motives to patients' family, lack of staffing and resources, and politicisation of COVID-19 and vaccination). Participants revealed several practical interventions to help overcome burn-out, ranging from mental health coverage to educating public on the severity of the pandemic and importance of vaccination.

CONCLUSIONS

By identifying the contributors to burn-out in ICU nurses at a systems level, the study findings inform the design and implementation of effective interventions to prevent or mitigate pandemic-related burn-out among nurses.

The Protective Effect of Fair and Supportive Leadership against Burnout in Police Employees

Background

This study investigated the association between fair and supportive leadership and symptoms of burnout and insomnia in police employees. Burnout and insomnia can have negative consequences for health, performance, and safety among employees in the police profession, and risk and protective factors should be thoroughly investigated.

Methods

Data were collected in a police district in Norway through questionnaires administered in October 2018 and May 2019. The sample consisted of 206 police employees (52% males), with an average age of 42 years and 16 years of experience in the police occupation.

Results

The results showed that a high degree of fair and supportive leadership was associated with lower levels of burnout and insomnia six months later. Fair and supportive leadership explained a greater amount of variance in burnout compared to insomnia. This finding indicates that fair and supportive leadership is a more important buffer factor against burnout than it is against insomnia. Stress was positively associated with burnout and insomnia, whereas quantitative job demands had no significant association with the concepts.

Conclusion

Fair and supportive leadership can help protect employees from adverse consequences of stress and contribute to improved occupational health, whereas a low degree of support and fair treatment from leaders can both represent a stressor by itself and contribute to poorer coping of stressful events at work. The important role of leadership should be incorporated in measures aimed at preventing and reducing burnout and sleep problems.

Resilience and Wellbeing Strategies for Pandemic Fatigue in Times of Covid-19

The COVID-19 pandemic is truly one of the greatest collective health crises in history which have altered our life and living. For years, people have felt fatigued from following public health directives such as social distancing, wearing masks, washing hands frequently, and working or studying remotely without in-person interactions. In this paper, we explore strategies for resilience and wellbeing which can mitigate pandemic-caused stress and behavioural fatigue. We start with individual level strategies including reworking stress appraisals, the importance of psychological flexibility, reducing loneliness through adaptive online platform use, optimizing familial relationships when living in close quarters for a prolonged period, reducing symptoms of burnout and using adaptive distractions, using specific evidence-based resilience strategies. We discuss specific considerations which tap on our shared identities and shared responsibilities which can enhance a sense of community, especially for individuals from marginalized backgrounds and how suicide risks can be minimized.

Comparative Analysis of Radiology Trainee Burnout Using the Maslach Burnout Inventory and Oldenburg Burnout Inventory

BACKGROUND

Burnout is an individualized response to imbalances between job demands and resources that has predominantly been evaluated with the Maslach Burnout Inventory (MBI). There are other instruments not validated among healthcare providers that may be comparable to the MBI. Utilizing alternative measurements can allow researchers to assess wellness with a larger array of questions.

OBJECTIVE

We explored differences between the MBI- Human Services Survey for Medical Personnel (MBI-HSS [MP]) and Oldenburg Burnout Inventory (OLBI) in evaluating emotional exhaustion (EE)/exhaustion and depersonalization (DP)/disengagement.

METHODS

We administered the MBI-HSS (MP) and OLBI to United States (US) radiology trainees during three,1-month intervals in April 2018, October 2018, and April 2019. Student's T-tests or ANOVA was used to evaluate differences between demographic groups and burnout scores in the MBI-HSS (MP) and OBLI. Non-inferiority analysis was completed to evaluate if the OBLI was not inferior to the MBI-HSS (MP) in how its subscales measure exhaustion and disengagement. The MBI-HSS (MP) subtotals for EE and DP were compared with the OLBI scores for exhaustion and disengagement using two-tailed paired T-tests for each trainee.

RESULTS

Of 2823 trainees emailed, 770 (27.3%) responded. The mean EE Maslach score was 21/54, and the mean DP Maslach score was 8/30. The average OBLI exhaustion and disengagement score was 2.38 and 2.22, respectively. Comparative analysis of completed MBI-HSS (MP) and OLBI subscales yielded no significant difference between the EE/exhaustion (t(496)=1.038; p=0.30) or DP/disengagement (t(498)=0.084; p=0.933) subscales.

CONCLUSIONS

Our national study of radiology trainees demonstrated that the OLBI was not inferior in assessing exhaustion and disengagement to the EE and DP subscales of the MBI-HSS (MP).

Positive psychology in the working environment. Job demands-resources theory, work engagement and burnout: A systematic literature review

The purpose of the present systematic review is to examine the Job Demands-Resources (JD-R) model in order to pinpoint how applicable and relevant is the present theoretical framework in the 21st Century workplace environment. Initially, there will be an examination of the key concepts of the theory, followed by a brief investigation of the empirical validity and importance of the theory in the workplace environment. Then, there will be an empirical investigation of various studies of both cross-sectional and longitudinal nature in the form of a methodology, offering substantial empirical evidence that attests to the validity and effectiveness of the JD-R model in predicting work engagement and burnout-two independent and contrasting states of employee wellbeing, covering the entire spectrum from employee wellness to employee ill-health. We hope this review contributes to the advancement of the JD-R model, aiding researchers and practitioners to obtain a better understanding of the current state of the JD-R model, whilst also offering avenues for future development of the theory, ultimately resulting in a better prediction of employee wellbeing.

How Medical Staff Alleviates Job Burnout through Sports Involvement: The Mediating Roles of Health Anxiety and Self-Efficacy

In the current healthcare environment, job burnout among medical staff is increasingly evident. Burnout not only affects the mental and physical health and career development of individuals but also affects the quality of care and the doctor-patient relationship. This paper investigates the influence of sports involvement on burnout in medical staff based on the job demands-resources theory, focusing on the mediating role of health anxiety and self-efficacy in the relationship between sports involvement and job burnout. A questionnaire survey was used to collect data from 444 medical staff in public hospitals in Wuhan, China. Structural equation modeling (SEM) with a bootstrapping approach was conducted to test the hypothesis and mediating effects. It was found that health anxiety and self-efficacy played a significant mediating role between sports involvement and job burnout. The results indicate the important role that sports involvement plays in addressing burnout, revealing that decreasing health anxiety and increasing self-efficacy attenuated job burnout. This finding suggests that hospital administrators should not only pay attention to medical staff's health conditions and improve their enthusiasm for work but also encourage them to become more engaged in sports.

Stratification of burnout in health‐system pharmacists during the COVID ‐19 pandemic: A focus on the ambulatory care pharmacist

Introduction

Burnout is defined as high emotional exhaustion and depersonalization, and low personal accomplishment from work. Prevalence of burnout among health‐system and ambulatory care pharmacists is unknown during the COVID‐19 pandemic.

Objectives

The purpose of this research is to analyze burnout prevalence among health‐system pharmacists (HSPs) and ambulatory care pharmacists (ACPs) using the Oldenburg Burnout Inventory and Maslach Burnout Inventory.

Methods

An electronic survey was sent to HSPs at two academic health systems in Chicago, IL. Demographics, risk of burnout based on two validated assessments (the Oldenburg Burnout Inventory [OLBI] and the Maslach Burnout Inventory [MBI]), burnout contributors, burnout mitigation strategies, and change in burnout due to COVID‐19 were collected. Burnout was defined as meeting any one criterion for high burnout on the following dimensions: exhaustion score and disengagement on the OLBI, and emotional exhaustion and depersonalization on the MBI. The co‐primary outcomes were the prevalence of burnout among HSPs, and the comparison of ACP burnout to that of non‐ambulatory HSPs. Secondary outcomes were comparison of burnout between the OLBI and MBI assessments, conceptualization of the causes and contributors of burnout and mitigation strategies among HSPs, and the self‐perceived effect of COVID‐19 on burnout severity.

Results

Of the 113 pharmacists included in the study, HSP burnout prevalence as defined above was 87.6%, ACP burnout was 88.4%, and non‐ambulatory HSP burnout was 87.1%. There was no statistical difference between ACP and non‐ambulatory HSP burnout prevalence, either overall or in any specific burnout dimension. The OLBI and MBI captured similar rates of burnout. The commonly reported burnout causes were staffing and scheduling issues, precepting requirements, and patient needs. Participants' most reported coping strategies were spending time with family/friends, sleep, exercise, and recreational/relaxation activities. A majority of HSPs (78.2%) reported higher levels of burnout due to COVID‐19.

Conclusion

HSP burnout during COVID‐19 pandemic is higher than cited in the pre‐COVID literature. Individual coping strategies are poor buffers for work‐related burnout.

Wellbeing, psychiatric morbidity and psychological distress amongst medical students in Denmark

BACKGROUND

Medical students in Denmark undertake a demanding 6-year course which is generally during a critical age for the development of psychiatric disorder and harmful substance or alcohol use behaviours. Previous literature has highlighted significant rates of distress in Danish students.

AIMS

We surveyed medical students in Denmark to better understand wellbeing, psychiatric morbidity, sources of stress, substance and alcohol use, psychological distress and burnout.

METHODS

Medical students were invited to participate in a single survey via email and social media which was completed through an online form, available for a 6-month period. The survey used a mixture of pre-defined answer options alongside free-text responses. Embedded within the survey were standardised and reliable specific instruments related to alcohol use (the CAGE questionnaire), overall psychological wellbeing and burnout.

RESULTS

There were 647 respondents, with a quite even year-group distribution, representing just over 16% of total number of students attending medical school in Denmark. Prior to medical school 35% had visited a professional regarding their mental health. While at medical school 16% reported a diagnosis of a mental health condition. 83% reported significant stress from study. Around 7 in 10 met case criteria using instruments designed to test for minor psychiatric morbidity and burnout. 13% tested CAGE positive, whilst 4% reported concerns from themselves or others about their substance use.

CONCLUSIONS

Our study demonstrates high levels of psychiatric morbidity and worrying levels of burnout in this population. The striking 13% CAGE positive rate suggests this demographic is at risk of harm from alcohol. Our results suggest a high level of need to support this population - with further study required to demonstrate which interventions would be of most benefit for this population in light of our findings.

Wellbeing and mental health among medical students in Indonesia: A descriptive study

BACKGROUND

Medical students face high pressures to perform academically, which may lead to poor psychological well-being, burnout, and even mental illness.

AIMS

This study aims to evaluate the mental health, degree of burnout and substance misuse among medical students in Indonesia in order to to build a system that supports the prosperity of future doctors.

METHODS

In February to March 2020, we conducted an online survey of Indonesian medical students to assess burnout (using Oldenburg Burnout Inventory, OLBI), minor psychiatric illness (General Health Questionnaire 12, GHQ12), and alcohol abuse (CAGE questionnaire).

RESULTS/CONCLUSION

A total of 1,729 students from 29 universities participated in the study; 93% felt disengaged, 95% felt exhausted, and 74% were identified to have mild psychiatric illness. We discuss potential factors that need to be explored in further research, including further concerns related to developments since the pandemic, and the need for potential interventions at both local and national levels to enhance the wellbeing of medical students.

Wellbeing, burnout and substance use amongst medical students: A summary of results from nine countries

OBJECTIVE

There has been increasing interest in the physical health, mental wellbeing and burnout afflicting medical students over recent years. This paper describes the overall results from phase two of an international study including a further nine countries across the world.

METHODS

We sampled large groups of medical students in nine countries at the same time and with exactly the same method in order to aid direct comparison of demographics, burnout and mental wellbeing through validated instruments.

RESULTS

A total of 4,942 medical students from these countries participated in this study. Around 68% of respondents screened positive for mild psychiatric illness using the General Health Questionnaire-12. Around 81% and 78% of respondents were found to be disengaged or exhausted respectively using the Oldenburg Burnout Inventory. Around 10% were found to be CAGE positive and 14% reported cannabis use. The main source of stress reported by medical students was their academic studies, followed by relationships, financial difficulties and housing issues.

CONCLUSION

Cultural, religious and socioeconomic factors within each country are important and understanding their effects is fundamental in developing successful local, regional and national initiatives. Further quantitative and qualitative research is required to confirm our results, clarify their causes and to develop appropriate preventative strategies.

Quality of work-life among advanced practice nurses who manage care for patients with heart failure: The effect of resilience during the Covid-19 pandemic

Background Clinician burnout, stress and job dissatisfaction among Advance Practice Registered Nurses (APRNS) may have impacted work-related quality of life (WRQoL) during the COVID-19 pandemic. No studies describe burnout and resilience in APRNs who manage care for patients with HF. Objectives Among APRNs who manage care for patients with HF, study aims included: 1) Describe burnout and WRQoL levels; 2) Determine the relationship between burnout and WRQoL; 3) Examine whether resilience moderates the association between WRQoL and burnout.

METHODS

 An online survey of American Association of Heart Failure Nurses and the Heart Failure Society of America APRN members were queried.

INCLUSION CRITERIA

APRN's who practiced in ambulatory or inpatient cardiology settings at least 8 h weekly.

OUTCOMES MEASURED

Burnout, WRQoL, and resilience. Results Participants' (N = 101) mean age was 50 (±10) years and 93% identified as female. APRNs worked more than 42 h weekly and reported moderate levels of resilience, high levels of personal (M = 51.7, norm-referenced mean: 35.9) and work-related burnout (M = 50.1, norm-referenced mean: 33.0). Correlations between high levels of burnout and low WRQoL (r range: -0.74 - -0.39 -, p<.001) were found. Burnout moderated the relationships among resilience and WRQoL. Conclusion APRNs had high levels of burnout during the COVID-19 pandemic. Patient-related burnout was not high. Level of burnout influenced the relationships among resilience and WRQoL suggesting that burnout is from workplace and personal sources, and that level of resilience could not overcome the effect of burnout. Interventions are needed regarding systems changes to uplift and support our workforce.

Wellbeing and mental health amongst medical students in Canada

RESEARCH

There is abundant data revealing that there is significant rate of rates of Psychiatric morbidity, psychological stress, and burnout in the medical student population. A core study group in the UK collaborated with 12 countries around the world to review medical student wellness. In this context we surveyed 101 medical students at the Cummings medical school, Calgary, Canada during the height of the COVID pandemic regarding their wellbeing and mental health.

RESULTS/MAIN FINDINGS

Prior to medical school 27% reported a diagnosis with a mental disorder. Whilst at medical school 21% reported a mental health condition, most commonly an anxiety disorder and or depressive disorder. The most commonly reported source of stress was study at 81%, the second being relationships at 62%, money stress was a significant source of stress for 35%, and finally 10% reported accommodation or housing as stressful. Interestingly only 14% tested CAGE positive but 20% of students reported having taken a non-prescription substance to feel better or regulate their mood. Seventy-five percent of medical students met specific case criteria for exhaustion on the Oldenburg Burnout inventory 74% met criteria for the GHQ questionnaire.

CONCLUSIONS

These findings confirm that medical students are facing significant stressors during their training. These stressors include, in order of frequency, study, relational, financial, and accommodation issues. Nonprescription Substance use was a common finding as well as exhaustion and psychiatric morbidity. Future interventions pursued will have to address cultural issues as well as the organizational and individual determinates of stress.

Aesthetic experiences and flourishing in science: A four-country study

In response to the mental health crisis in science, and amid concerns about the detrimental effects of the COVID-19 pandemic on scientists, this study seeks to identify the role of a heretofore under-researched factor for flourishing and eudaimonia: aesthetic experiences in scientific work. The main research question that this study addresses is: To what extent is the frequency of encountering aesthetics in terms of beauty, awe, and wonder in scientific work associated with greater well-being among scientists? Based on a large-scale (N = 3,061) and representative international survey of scientists (biologists and physicists) in four countries (India, Italy, the United Kingdom, and the United States), this study employs sets of nested regressions to model the associations of aesthetic experiences with flourishing while controlling for demographic factors and negative workplace and life circumstances such as burnout, job/publication pressure, mistreatment, COVID-19 impacts, other stressful life events, serious psychological distress, and chronic health conditions. The results show that the frequency of aesthetic experiences in scientific work in the disciplines of biology and physics has a very large and statistically significant association with flourishing and eudaimonia that remains robust even when controlling for demographic factors and negative workplace and life circumstances, including COVID-19 impacts. Aesthetic experiences in scientific work are even as strongly associated with flourishing as the presence of serious psychological distress and are most strongly associated with the flourishing domain of meaning in life, thus pointing to a link with eudaimonic well-being. In line with neurophysiological evidence and positive psychological models of flow, self-transcendence, and intrinsic motivation, aesthetics are a key source of flourishing for scientists in the disciplines of biology and physics. While future research needs to test the causal mechanism, the strength of the findings could encourage leaders of scientific labs and research organizations generally to remove obstacles to experiencing the aesthetic dimensions of science. Fostering cultures in which the aesthetic experiences that are intrinsic to scientific practice are fully appreciated might potentially protect or boost flourishing by reducing the impacts of burnout, job/publication pressure, and mistreatment-related experiences in science.

Burnout syndrome among medical students in Kazakhstan

BACKGROUND

Burnout is a serious problem in the training and professional development of medical students. However, there is no known data on the prevalence of burnout among medical students in Kazakhstan. This study aims at investigating burnout and associated factors in a sample of students from Astana Medical University.

METHODS

The study included socio-demographic and personal questions, Oldenburg Burnout Inventory for college students (OLBI-S) and Copenhagen Burnout Inventory-Students survey (CBI-S) to measure burnout. Statistical analyses included measures of descriptive statistics and regression analysis for evaluating burnout-associated factors.

RESULTS

In total, 736 medical students responded. The prevalence of burnout syndrome was 28% (CBI-S) and 31% (OLBI-S). There was a significant association between the prevalence and the level of burnout and student's gender, year of study, thoughts of dropping out, suicidal ideation, satisfaction with the chosen profession and academic performance, interpersonal relationship problems, the decision to study in medical school, smoking, accommodation, parental expectations, alcohol use, extracurricular activities, part-time job, somatic symptoms, depression, and anxiety.

CONCLUSIONS

The factors associated with burnout were identified, which complements and expands the existing data on academic burnout. The data obtained can help in organizing psychological assistance for medical students in Kazakhstan.

Effects of COVID-19 lockdown on sleep duration, sleep quality and burnout in faculty members of higher education in Mexico

This paper aims to assess the differences and associations of the effect of COVID-19 on sleep habits, sleep quality, and burnout symptoms among faculty members of higher education in Mexico. This was a cross-sectional study with a total sample of 214 faculty members of higher education from Mexico between May 18th and June 10th of 2020. We applied questionnaires containing sociodemographic and specific questions regarding sleep habits, sleep quality, and burnout symptoms. The results show that during COVID-19 faculty members delayed their bedtime and rise time. No change was found with weekdays time in bed, however, during weekends, time in bed was more than an hour shorter. Social jetlag decreased significantly during COVID-19. Furthermore, during COVID-19, those who reported low sleep quality were more likely to report higher symptoms of emotional exhaustion and those who slept less on weekends were more likely to report higher symptoms of depersonalization. These results suggest that the COVID-19 pandemic may have an effect on sleep and sleep quality and burnout symptoms of faculty members from higher education in Mexico.

The Impact of Burnout on Police Officers’ Performance and Turnover Intention: The Moderating Role of Compassion Satisfaction

Burnout should be seen as an important phenomenon influencing the services provided by police forces, due to its high exposure to stressful events. The study sought to examine the impact of burnout on performance and turnover intention of Portuguese police forces, as well as to analyze the moderating effect of compassion satisfaction (CS) on this relationship. Data were collected in 2021 from 1.682 Portuguese police officers, using individual surveys. The results showed that (1) burnout is negatively related to performance; (2) burnout is positively related to turnover intention; (3) CS, although it has a positive effect on performance, does not assume a moderating role, as expected, in the relationship between burnout and performance; (4) CS assumes a moderating role in the relationship between burnout and turnover intention. That is, when a person who still suffers from burnout feels CS, it decreases the intention to leave the organization. The implications and the bearings of this study are discussed and presented regarding the theoretical, empirical and practical perspectives in order to better support both the comprehension of burnout in police officers and offer the best practical recommendations.

Buffering the Effects of Burnout on Healthcare Professionals' Health-The Mediating Role of Compassionate Relationships at Work in the COVID Era

Managing the COVID-19 pandemic posed several challenges for healthcare professionals, which likely heightened their risk of burnout (Amanullah and Ramesh Shankar, 2020) and, consequently, their general physical and mental health. Although it may not be possible to address and eliminate the causes of burnout, current research informs healthcare organizations about protective strategies to reduce its detrimental consequences. The promotion of compassionate interactions among healthcare professionals may play such a role. Compassion within healthcare organizations positively affects individual performance and well-being. Building on these considerations and within the framework of the Conservation of Resources theory, this study explores the relationships among burnout dimensions, received compassion at work, and general health in 711 Italian healthcare professionals (68.5% female), aged between 21 and 73 years (Mage = 36.4, SD = 11.2). Analyses were conducted to investigate the association between burnout and general well-being (H1) and between burnout symptoms and perceived compassion at work (H2); and the mediational role of compassion in the relationship between burnout symptoms and general well-being. H1 and H2 were confirmed (r < 0.01 for both), and a SEM model showed the mediating role of compassion at work in the association between burnout symptoms and general well-being (RMSEA < 0.08, SRMR < 0.08, CFI and TLI > 0.90). Theoretical and practical implications of the findings are discussed in the paper.

Job demands, resources, and task performance in Chinese social workers: Roles of burnout and work engagement

Social work is a rapidly developing occupation in China. In the early 2000s, there were merely a few hundred thousand social workers, but by 2020 there were over 1.5 million social workers in the field. However, research has indicated these social workers are also experiencing record high burnout and turnover rates. Thus, researchers have started to question the work engagement and task performance factors that could be contributing to these increasing rates. This study uses the Job Demands and Resources (JD-R) Theory to understand how 537 social workers from Guangzhou, China are impacted by burnout and how it influences work engagement and task performance. The results show JD-R directly affect task performance through burnout and work engagement via a dual process. First, job demands were associated with high burnout and low work engagement, which both were found to lead to low task performance. Second, job resources were related to low burnout rates and high work engagement, both of which were associated with high task performance. These findings call for healthcare interventions to reduce burnout and workplace policy changes to promote work engagement to support task performance in social workers in China. These factors can each have a crucial impact on the public health of both the affected social workers and the vulnerable clients these social workers serve.

Investigating the impact of modified mindfulness-based stress reduction (MBSR) program on occupational burnout and other mental health status among nonmedical staff in a hospital: a randomized controlled trial

OBJECTIVE

Burnout is a prolonged psychological response to a longstanding interpersonal stressor at work. It can progress to other mental illnesses, such as anxiety and depression. In today's society, burnout has become widespread, and it is currently a serious challenge in health systems. This study intended to investigate the impact of mindfulness training on burnout and depression, anxiety, and stress of nonmedical staff in a hospital in Shiraz-Iran.

METHOD

Fifty nonmedical staff in a Shiraz-Iran hospital were enrolled in this two groups' randomized controlled trial. The intervention group was trained by a modified mindfulness-based stress reduction (MBSR) program, and the control group received no intervention. The outcome was assessed by the Copenhagen burnout inventory (CBI) and DASS-21 questionnaire on three occasions including before T0, immediately after T1, and 3 months after the intervention T2.

RESULTS

Comparing the score changes between intervention and control groups showed that the reduction of work‑distaste‑related burnout, client‑related burnout, anxiety, and stress scores in the intervention group was significantly more than in the control group in the time interval from T0 to T1. The scores in the intervention group in three subscales of CBI, including work‑characteristic‑related burnout, work‑distaste‑related burnout, and client‑related burnout, decreased significantly immediately after the training (T1) compared to before (T0). Also, the scores did not change significantly after 3 months following training.

CONCLUSIONS

Mindfulness training can be used as an effective way to improve occupational burnout, anxiety, and stress in occupations other than health professionals. Its effect is stable for at least a few months. It is recommended that future studies focus on investigating the feasible way to integrate this training into the working environment. Forthcoming studies should also determine whether the impact of this intervention will last longer and find possible ways to extend its influence.

Impact of Covid-19 on dental hygiene educators: A national survey

PURPOSE

The purpose of this study was to assess the impact of the Covid-19 pandemic on dental hygiene (DH) educators' perception of personal and professional burnout and efficacy in the online/hybrid learning environment.

METHODS

A cross-sectional study of DH faculty members from 327 United States entry level DH programs was invited to participate in this study. A 36 item survey was disseminated in Qualtricsxm March 2021. The Copenhagen Burnout Inventory was used to measure personal, work-related, and burnout related to working with students. The Michigan Nurse Educators Sense of Efficacy for Online Teaching instrument was used to measure efficacy in online/hybrid learning.

RESULTS

The survey had an institutional response rate of 46%. Personal burnout scores had a significantly higher mean as compared to work-related and burnout working with students' scores. A majority (66%) of respondents reported often feeling tired. Only personal burnout scores had a significant negative correlation with teaching efficacy scores. Administrators/program directors and full-time faculty had significantly higher mean personal and work-related burnout scores as compared to part-time/adjunct clinical faculty. There were no significant differences in teaching efficacy scores by faculty position and institutional setting.

CONCLUSION

COVID-19 had significant impact on full-time DH educators' personal and professional burnout levels. Full-time administrators/program directors/DH educators reported higher levels of personal burnout. It seems that personal burnout has a negative relationship with teaching efficacy. Faculty position rather than institution impacted personal burnout. Despite personal and professional burnout, DH faculty reported low-levels of burnout related to working with students.

A qualitative assessment of dental hygiene educators' COVID-19 related burnout

Purpose

The purpose of this study was to elicit ideas or concerns influencing dental hygiene educators’ experiences of personal and professional burnout, burnout working with students, and teaching efficacy in an online/hybrid environment as a result of the COVID‐19 pandemic.

Methods

A qualitative, content‐analysis study included a convenience sample of dental hygiene educators emails. An invitation to participate in an August 2021 or October 2021 focus group was sent via Qualtrics^xm with informed consent, and focus groups were held over Zoom. Conversations were audio recorded, transcribed, and de‐identified. Consensus on a codebook by two coders achieved an 88% agreement.

Results

Fifty‐three were invited to the August 2021 focus groups for a 26% (n = 14) response rate, and 116 were invited to the October 2021 focus groups for an 11% (n = 13) response rate. Contributing factors to experiences of burnout expressed were: (1) work–life balance (n = 59), including (a) overwork, (b) pressure to be available, and (c) lack of boundaries; (2) change (n = 34) involving (a) developing new protocols, (b) constant uncertainty, (c) COVID‐19 requirements, and (d) new platforms; and (3) negative interactions (n = 32) with (a) students and (b) faculty.

Conclusion

A lack of work–life balance from overwork, pressure to be available at all times, no boundaries with students, and an absence of a sense of connection for workplace vitality were contributors to burnout. Work‐from‐home flexibility, a work environment that supported wellness and mental well‐being, and the ability to leave the workplace for periods of time were reported as helpful solutions to combatting burnout.

Thoughts of suicide or self-harm among healthcare workers during the COVID-19 pandemic: qualitative analysis of open-ended survey responses

BACKGROUND

Healthcare workers are at higher risk of suicide than other occupations, and suicidal thoughts appear to have increased during the COVID-19 pandemic.

AIMS

To understand the experiences of healthcare workers with frequent thoughts of suicide or self-harm during the pandemic, including factors that contributed to their distress, and the supports that they found helpful.

METHOD

We used content analysis to analyse free-text responses to the Australian COVID-19 Frontline Healthcare Workers Study, from healthcare workers who reported frequent thoughts that they would be better off dead or of hurting themselves, on the Patient Health Questionnaire-9.

RESULTS

A total of 262 out of 7795 healthcare workers (3.4%) reported frequent thoughts of suicide or self-harm in the preceding 2 weeks. They described how the pandemic exacerbated pre-existing challenges in their lives, such as living with a mental illness, working in an unsupportive environment and facing personal stressors like relationship violence or unwell family members. Further deterioration in their mental health was triggered by heavier obligations at home and work, amid painful feelings of loneliness. They reported that workplace demands rose without additional resources, social and emotional isolation increased and many healthful activities became inaccessible. Tokenistic offers of support fell flat in the face of multiple barriers to taking leave or accessing professional help. Validation of distress, improved access to healthcare and a stronger sense of belonging were identified as helpful supports.

CONCLUSIONS

These findings highlight the need for better recognition of predisposing, precipitating, perpetuating and protective factors for thoughts of suicide and self-harm among healthcare workers.

The Risk of Burnout Syndrome and Determining Factors in Dentists from Mureș County

Introduction: In our modern society, burnout syndrome develops over a long period of time because of constant stress and increased emotional pressure. Dentistry is known as one of the most stressful professions. The aim of this study was to determine the incidence of burnout syndrome among dentists in Mureș County, Romania, and to assess the determining factors associated with burnout. Material and methods: We conducted an online survey regarding burn-out syndrome among dentists. Results: The most frequent complaint among respondents was the loss of personal accomplishment, followed by emotional exhaustion and depersonalization. Higher levels of emotional exhaustion and depersonalization were seen in non-married, male dentists between 51–60 years, who worked more than 8 hours a day without an assistant. Conclusions: Based on the presented data, the risk factors for burnout syndrome should be brought to the attention of dentists and various preventive programs should be implemented.