Determinants and prevalence of burnout in emergency nurses: A systematic review of 25 years of research

Occupational Burnout in Healthcare Workers, Stress and Other Symptoms of Work Overload during the COVID-19 Pandemic in Poland

This study explored the level and selected determinants of burnout among five groups of healthcare workers (physicians, nurses, paramedics, other medical and nonmedical staff) working during the COVID-19 pandemic in Poland. This cross-sectional study was conducted from February to April 2022, with the use of a self-administered mostly online survey. The BAT-12 scale was used to measure burnout, and the PSS-4 scale was used to measure stress. The sample was limited to 2196 individuals who worked with patients during the COVID-19 pandemic. A series of multivariate logistic regression models with three to nine predictors was estimated. The prevalence of burnout ranged from 27.7% in other nonmedical staff to 36.5% in nurses. Adjusting for age and gender, both physicians (p = 0.011) and nurses (p < 0.001) were at higher risk of burnout. In the final model, elevated stress most likely increased the risk of burnout (OR = 3.88; 95%CI <3.13-3.81>; p < 0,001). Other significant predictors of burnout included traumatic work-related experience (OR =1.91, p < 0.001), mobbing (OR = 1.83, p < 0.001) and higher workload than before the pandemic (OR = 1.41, p = 0.002). Only 7% of the respondents decided to use various forms of psychological support during the pandemic. The presented research can contribute to the effective planning and implementation of measures in the face of crisis when the workload continues to increase.

The Factors Influencing Nurses' Clinical Decision-Making in Emergency Department

In an emergency, making the correct decision is vital. It is a necessary element of professional nursing care, and the ability of nurses to make successful clinical decisions is the most critical element influencing care quality. The purpose of this study was to assess the factors influencing nurses' clinical decision-making in the emergency department of Palestinan hospitals. A cross-sectional study was targeted at all nurses working in emergency departments at the Palestinian hospitals. The study was completed with 227 nurses, and collecting data was performed with the Clinical Decision Making in Nursing Scale. Results of the study revealed that the average score for the total clinical decision-making score was 3.3 (SD = 0.23). The subscales of clinical decision making were "search for alternatives or options," "canvassing of objectives and values," "evaluation and reevaluation of consequences," and "search for information and unbiased assimilation of new information." Furthermore, multiple linear regression analysis revealed that degree and work hours accounted for 11.7% of the variance in clinical decision-making. The study confirmed the average score for clinical decision-making was slightly higher than the average score. Also, it approved that nursing degree and work hours were predictors of clinical decision-making among nurses in emergency departments.

Demand-Resource Profiles and Job Satisfaction in the Healthcare Sector: A Person-Centered Examination Using Bayesian Informative Hypothesis Testing

Work characteristics may independently and jointly affect well-being, so that whether job demands deplete or energize employees depends on the resources available in the job. However, contradictory results on their joint effects have emerged so far in the literature. We argue that these inconsistencies can be partially explained by two arguments in the contemporary literature in the field. First, most studies in the job design domain are based on classic variable-centered methodologies which, although informative, are not well suited to investigate complex patterns of interactions among multiple variables. Second, these studies have mainly focused on generic work characteristics (e.g., workload, control, support), and are lacking in occupational specificity. Thus, to overcome these limitations, in the current research we include generic and occupation-specific work characteristics and adopt a person-centered approach to (a) identify different patterns of interactions of job demands and resources in a sample of healthcare employees, and (b) determine the degree to which these patterns are associated with employee well-being. We involved a sample of 1513 Italian healthcare providers and collected data on key job demands (workload, emotional dissonance, patient demands and physical demands) and resources (control, management support and peers' support). We focused on job satisfaction as a broad indicator of well-being. Latent profile analysis revealed four profiles of job demands and resources: high strain-isolated, resourceless, resourceful and active job on the ward. The results of Bayesian informative hypothesis testing showed the highest support for the hypothesis stating that healthcare employees belonging to the active job on the ward profile (medium-high demands, high resources) were the most satisfied. Conversely, employees belonging to the high strain-isolated profile (high demands, low resources) and the resourceless profile (medium-low demands, low resources) were the least satisfied. Overall, our study confirms the key role played by job resources in determining well-being in high-risk sectors, demonstrating that job satisfaction can develop both in challenging and less demanding situations. On a practical level, mapping the complexity of the healthcare psychosocial work environment has important implications, allowing for a better assessment process of employee well-being and helping to identify the most effective and fitting interventions.

Leadership emotion: how leaders influence employee wellbeing and performance in the disaster and emergency management context

Leaders play a unique role in the disaster management context as they address the safety needs of communities and manage the complexities of the response and recovery task. Leaders who effectively navigate the challenges of leading in this unique context bring hope and positivity, uniting the efforts of community and government to address the needs of those seeking safety and support. Positive affect is one aspect of effective leadership that receives considerable attention in the academic literature but has, as yet, received little attention in the disaster and emergency management area. This paper draws on contemporary literature on the understanding of positive affect in leadership, bringing together the limited current literature in the area of leader affect in the emergency management context and identifying a significant gap. It calls for a research focus on positive affect in the unique context of disaster and emergency management and consideration of the implications for wellbeing and performance.

Mental health status of mental health nurses in China: Results from a national survey

INTRODUCTION

It has been acknowledged in China that actions should be taken immediately to ease the critical shortage of psychiatric nurses. However, with national data lacking, little is known about nurses' mental health status.

AIM

To evaluate psychiatric nurses' mental health status by measuring their burnout, depression, anxiety and stress.

METHODS

All psychiatric nurses in the 41 selected hospitals in China were invited to participate in the survey. The Maslach Burnout Inventory-Human Service Survey and Depression Anxiety Stress Scale were used to assess variables of interest.

RESULTS

38.6% of psychiatric nurses met the criteria for burnout. The rates of depression, anxiety and stress were 26.3%, 36.4% and 12.5%, respectively. It was found that workplace region, educational level, working years, longer working hours and night shifts were associated with risk of burnout and DASS.

CONCLUSIONS

More than a quarter of psychiatric nurses are suffering from burnout, depression or anxiety in China. Policymakers and hospital administrators should design a flexible schedule and restrict working hours for psychiatric nurses to achieve work-life balance.

IMPLICATIONS FOR PRACTICE

The study informs policymakers and administrators on addressing the nursing shortage by identifying nurses immersed in negative emotions and preventing mental health problems.

Burnout Levels in Italian Nurses during the First and the Second Wave in the COVID-19 Outbreak: A Pilot Cohort-Data Comparison

(1) Background: Nurses show higher psychological distress associated with physical difficulties during the COVID-19 outbreak. To compare burnout levels among nurses engaged in the front line of patients with COVID-19 during the first wave and the second wave of the pandemic. (2) Methods: Two cohort online surveys were conducted thanks to the Google Modules function: the first one was administered from March 2020 to April 2020 and the second survey, which included the same questionnaire, was administered from September 2020 to October 2020. (3) Results: There were significant differences in the emotional exhaustion sub dimension (p < 0.001): The first wave group recorded higher levels than the second wave one. While, as regards to the values of the dimension of the depersonalization, the second wave group reported significantly higher values than the first wave group (p = 0.006). No significant difference was recorded for the personal accomplishment sub dimension (p = 0.108). By considering the gender variable, significant difference was reported in personal accomplishment sub dimension, as during the second wave, females recorded lower levels in personal accomplishment while males reported significantly higher levels in the same sub dimension than the first wave (p = 0.012); while no statistically significant differences were reported in burnout sub dimensions during the first and the second waves according to years of work experience. (4) Conclusions: The COVID-19 pandemic represents an important provocation for nurses all around the world and, at the same time, constitutes a learning lesson to improve better approaches for the subsequent waves. Several interventions could be introduced to moderate the mental health influence of the COVID-19 pandemic on nurses.

Chinese version of the stressor scale for emergency nurse: A methodological study design

AIM

The aim of this study was to modify and test the psychometric properties of the Chinese version of the stressor scale for emergency nurses.

DESIGN

The methodological design was carried out in two phases: (a) form the Chinese version by Delphi method and (b) test the psychometric properties by cross-sectional survey.

METHODS

The translated scale was administered to 420 nurses in Qingdao. Validity was assessed in terms of content validity, calibration correlation validity and construct validity using exploratory factor analysis and confirmatory factor analysis. Internal consistency was estimated using Cronbach α coefficients.

RESULTS

The Chinese version of the SSEN retains 27 items, four common factors were extracted by exploratory factor analysis, and the factor cumulative variance contribution rate was 78.463%. The fitting indexes of the four-factor model of CFA were all in the acceptable range[χ²  = 711.30, df = 312, p < 0.001, χ² /df = 2.280, CFI = 0.933, TLI = 0.924, IFI = 0.933, RMSEA = 0.079 (90% confidence interval = 0.071-0.086)].The item-level content validity index of the Chinese SSEN is 0.89 ~ 1.00; the scale-level content validity index is 0.98; the Cronbach α coefficient of the total table is 0.971 and the split-half reliability is 0.877.

PATIENT OR PUBLIC CONTRIBUTION

The C-SSEN can be used to help nursing managers accurately formulate management measures to improve the stress coping ability of nurses in the ED, stabilize the nursing team and ensure nursing safety.

Prevalence and associated factors of self-reported medical errors and adverse events among operating room nurses in China

Background

In recent decades, the prominence of medical errors (MEs) and adverse events (AEs) is fueled by several studies performed across the world. Correspondingly, a high prevalence of medical errors and adverse events have been reported. Operating room nurses (ORNs) were indispensable members of the operating process, and any kind of MEs or AEs from ORNs may cause serious results and even death to the patients. However, to the best of our knowledge, the prevalence and associated factors of MEs and AEs were never reported among ORNs in China, which is the largest country in population and health services quantity in the world.

Methods

This is a cross-sectional study, which was conducted among ORNs in China, and 787 valid questionnaires were analyzed in this study. MEs, AEs, gender, age, married status, religious belief, academic degree, manager or not, working years, working hours/week, physical disease, and mental health were evaluated in this study. MEs were evaluated by eight questions about the occurrence of eight kinds of MEs for the ORNs. For ORNs with MEs, further questions about clinical harm to the patients were interviewed, which analyzed AEs. Kessler 10 was used to evaluate the ORNs' mental health. Logistic regression was conducted to examine the factors associated with MEs and AEs.

Results

The prevalence of MEs and AEs was 27.7 and 13.9% among ORNs, respectively. The most frequent MEs that occurred among ORNs were from surgical instruments (9.1%), disinfection (9.0%), equipment and consumables (8.9%), and specimen management (7.8%). MEs were positively associated with lower working years, poor mental health, and physical disease. The physical disease was positively associated with AEs.

Conclusion

The prevalence of perceived MEs and AEs was at a higher level than other kinds of nurses. Fresh ORNs with physical and mental health problems were the risk population for MEs, and ORNs with physical disease were at a higher risk for AEs. All the findings implied that MEs and AEs were an important issue for ORNs, and ORNs with physical and mental health problems should be paid attention to control MEs and AEs.

A program for volunteers accompanying older patients with cognitive dysfunction to improve the quality of emergency department care: A pilot study

Admission to an emergency department (ED) is challenging for older patients with cognitive dysfunction (PWCD). Targeted patient-oriented approaches to improve the care for PWCD are needed. The aim of this pilot study was to design and evaluate a program for volunteers to support PWCD in the ED. Volunteers (N = 9) first received a training and during the following six months (N = 90 shifts), they accompanied PWCD (N = 112) during their stay. Results showed that the training increased volunteers' knowledge and expertise, but not shift-related self-efficacy. The most frequent strategies applied were conversations, holding hands and touching, and providing food and drinks. After six months, volunteers reported a great sense of meaningfulness and felt that they were highly appreciated by the patients. ED nurses' sceptical attitudes towards the program decreased. The program is beneficial for PWCD, appears to be meaningful for volunteers and is appreciated by ED nurses.

Factors related to work ability among nursing professionals from urgent and emergency care units: A cross-sectional study

BACKGROUND

Nursing professionals are on the front line of health systems in Brazil as well as worldwide. Studies on the work ability of nursing professionals are especially relevant as care demands increase and health care workforce shortages are expected. As the population of Brazil ages, the need for nursing care will increase.

OBJECTIVE

To identify levels and predictors of work ability among Brazilian nursing professionals.

METHODS

A cross-sectional study with 267 nursing professionals (72 nurses and 195 nursing technicians and nursing auxiliary) from public emergency and urgent care units was conducted. Measures included the following: Work Ability Index; Questionnaire of Socio-demographics, Lifestyle and Work and Health Aspects; and Violence at Work questionnaire. Generalized linear regression and Poisson models were used for data analysis.

RESULTS

The mean work ability was 40.4 (range: 22 to 49). Almost 79.6% (n = 211) of participants reported good or excellent work ability, and 20.4% (n = 54) reported moderate or poor work ability. Better perceptions of health and job satisfaction, absence of health issues (past 15 days), lower stress levels, and having a partner were associated with better work ability. Victims of workplace violence were less likely to have good or excellent work ability than non-victims (prevalence ratio = 0.80; 95% CI 0.72 to 0.90). Professionals with cumulative experiences of workplace violence were less likely to report better work ability.

CONCLUSIONS

The prevalence of good or excellent work ability was 79.6%. Our findings indicate that the following factors are predictors of work ability: self-reported perception of health, health issues in the last 15 days, workplace violence, job satisfaction, stress, and marital status.

A qualitative study of nursing practitioners' experiences with COVID-19 patients dying alone in Greece

Background

In Greece, there is still limited research on death in isolation due to COVID-19. This deserves attention because of the recent financial crisis, which profoundly impacted public health, and the high relevance of the Hippocratic tradition to the moral values of clinical practice.

Methods

A prospective qualitative study using in-depth interviews with 15 frontline nursing practitioners working in a COVID-19 ward or intensive care unit (ICU) was conducted from July 2021 to December 2021.

Results

The inability of family members to say a final goodbye before, during, or after death by performing proper mourning rituals is extremely inhuman and profoundly impacts the mental health status of patients, family members, and nursing practitioners. Patients and their family members strongly desire to see each other. Epidemiology, liability, and proper nursing performance emerged as reasons for the enforced strict visitation restrictions. Participants emphasized that visitations should be allowed on an individual basis and highlighted the need for the effective use of remote communication technology, which, however, does not substitute for in-person contact. Importantly, physicians allowed "clandestine" visits on an individual basis. Nursing practitioners had a strong empathic attitude toward both patients and their families, and a strong willingness to provide holistic care and pay respect to dead bodies. However, they also experienced moral distress. Witnessing heartbreaking scenes with patients and/or their families causes nursing practitioners to experience intense psychological distress, which affects their family life rather than nursing performance. Ultimately, there was a shift from a patient-centered care model to a population-centered care model. Furthermore, we identified a range of policy- and culture-related factors that exaggerate the negative consequences of dying alone of COVID-19.

Conclusion

These results reinforce the existing literature on several fronts. However, we identified some nuances related to political decisions and, most importantly, convictions that are deeply rooted in Greek culture. These findings are of great importance in planning tailored interventions to mitigate the problem of interest and have implications for other similar national contexts.

On the global and specific nature of psychological need satisfaction and work motivation in predicting employees' wellbeing: a self-determination theory perspective

Using data from 708 French-Canadian nurses, the present study relies on self-determination theory (SDT) and its proposed motivation mediation model to examine the associations between need satisfaction, work motivation, and various manifestations of psychological wellbeing (work satisfaction, emotional exhaustion, and turnover intentions). To increase the precision and accuracy of these analyses, we relied on analytic approaches that explicitly account for the dual global/specific nature of both work motivation and need satisfaction. Results revealed that nurses' global psychological need satisfaction, and their specific autonomy and competence satisfaction, were positively associated with their global self-determined work motivation and specific intrinsic motivation. In turn, global self-determined work motivation and specific intrinsic motivation were associated with more desirable outcome levels. Nurses' global need satisfaction and specific autonomy satisfaction were also directly associated with more desirable outcome levels. Our results provided support for a partially mediated version of SDT's motivation mediation model.

Burnout on the frontline: the impact of COVID-19 on emergency department staff wellbeing

BACKGROUND

Burnout is a syndrome resulting from chronic workplace stress that has not been successfully managed. Healthcare professionals are particularly susceptible to this occupational phenomenon. There is limited literature currently published addressing burnout in the context of the Irish frontline workers during the COVID-19 pandemic.

OBJECTIVES

Our study aims to determine the rate and degree of burnout present in the emergency department (ED) staff at St. James hospital Dublin (SJH) and at Cork University Hospital (CUH), in the context of the COVID-19 pandemic.

DESIGN

A cross-sectional study was performed on a convenience sample of medical staff and healthcare staff in the ED at Cork University Hospital and St. James Hospital Dublin, two major University Hospital EDs. Burnout was measured using the Oldenburg burnout inventory (OLBI) a standardised 16-question instrument. Participants also provided demographic data and answered several questions relating to the pandemic.

PARTICIPANTS

Ninety-nine participants across two departments responded (a response rate of 30%). All ED cohorts were represented.

RESULTS

Burnout was identified in almost three quarters of respondents (74%). The mean burnout scores were 2.42 (OLBI cut-off 2.18). There was mean disengagement level of 2.25 and a mean exhaustion level of 2.59. There was no statistically significant variance between staff, by demographics (i.e. occupation, years working in the ED, age, or gender). There was no significant difference in burnout rates or scores between St. James Hospital, Dublin, and Cork University Hospital, though the former tended to have a higher rate of burnout at 81% vs the 67% burnout observed in CUH.

CONCLUSIONS

The COVID-19 pandemic may be contributing to the long-established problem of health care burnout. The trajectory of this disease is still unclear. Consistent, progressive measures to address staff well-being, and support frontline workers, are imperative going forward.

Assessing the psychosocial work environment of migrant and non-migrant workers in inpatient mental health centres: A feasibility study

The number of migrant workers in Germany has increased over the last decades and will probably further increase in the context of a growing cultural diversity of the population and shortage of skilled professionals. Since migrant workers face different challenges, they may experience poorer psychosocial work environments than non-migrants. A negative psychosocial work environment can increase burnout and depression symptoms. To this date no study has investigated differences in the perceived psychosocial work environment in the mental health field. The aim of this study is to evaluate the feasibility of a cross sectional study comparing the perceived psychosocial work environment of migrants and non-migrant workers in inpatient mental health centres in Germany. The study was conducted in four inpatient mental health centres in Germany using the Copenhagen Psychosocial Questionnaire. All staff members (N = 659) categorized in seven professional groups were invited to participate in the study. The feasibility of the study was determined by four criteria (1) Implementation of the study in inpatient mental health centres (2) Representativity of the sample (3) Reliability and usability of the questionnaire and (4) Variability of collected data. Three of four feasibility criteria were achieved. The study was successfully implemented in four mental health centres, the usability of the used questionnaire was confirmed as well as the variability of the data. The targeted response rate was partially met, and the total number of migrant workers could not be provided, which limits the representativity of the sample. In conclusion, a main study is feasible, but an effort must be put in an effective recruitment strategy to obtain valid results.

The global prevalence of burnout among general practitioners: a systematic review and meta-analysis

BACKGROUND

Burnout among general practitioners (GPs) has attracted the attention of more and more researchers. An adequate understanding the prevalence and related factors of burnout to prevent and reduce burnout is necessary. This study systematically measured the global prevalence of burnout among GPs.

METHODS

Eligible original studies were identified from the PubMed, Ovid Embase, Ovid Medline (R), and Web of science databases. We searched the full-time period available for each database, up to 30 September 2021. The adjusted prevalence rate was estimated using a random-effects meta-analysis. The heterogeneity was evaluated using I2 statistic. Differences by study-level characteristics were estimated via subgroup analyses and meta-regression.

RESULTS

A total of 16 cross-sectional studies with 7,595 participants were included. The pooled burnout rate showed 37%, 28%, and 26% of general GPs suffer from high emotional exhaustion (EE), high depersonalization (DP), and low personal exhaustion (PA), respectively. Groups comparisons found that high EE, high DP, and low PA rate data obtained from 2001 to 2009, high DP rate data obtained from Europe, low PA rate data obtained from high-quality studies had much higher rates.

CONCLUSIONS

This study demonstrated the prevalence of burnout in the GPs and alert health managers to tailor their strategies to retain this community. Targeted initiatives are needed to provide adequate GPs' well-being and maintain primary health care.

Burnout among Health Care Professionals during COVID-19

The present study examined organizational, situational (i.e., COVID-19-related), and psychological factors associated with burnout during the COVID-19 pandemic among 268 health care professionals in Norway. A total burnout score based on the Burnout Assessment Tool (BAT), the four core BAT subscales (i.e., Exhaustion, Mental Distance, Cognitive Impairment, and Emotional Impairment), and the COVID-19 Burnout Scale served as the dependent variable. Among the results, organizational factors such as work-home conflict, workload, and role conflict were positively related to burnout. Although autonomy and colleague support were negatively related to burnout, support from leaders was positively related to it, which might suggest a suppressive effect. Organizational factors explained most of the variance in general burnout (i.e., BAT Total), whereas situational (i.e., COVID-19-related) factors (e.g., involvement with COVID-19, fear of COVID-19, and COVID-19-induced stress) seemed to better explain COVID-19 burnout. COVID-19-oriented actions were related only to Mental Distance. Psychological factors such as meaning were negatively related to BAT Total, Exhaustion, and Mental Distance, whereas a breach of the psychological contract was related to all subscales. Such results suggest that organizational and situational factors contribute differently to general and COVID-19 burnout and that administering pandemic-specific assessment tools can clarify how the pandemic has affected mental health.

Development of an Evidence-Informed Solution to Emotional Distress in Public Safety Personnel and Healthcare Workers: The Social Support, Tracking Distress, Education, and Discussion CommunitY (STEADY) Program

Public safety personnel (PSP) and healthcare workers (HCWs) are frequently exposed to traumatic events and experience an increased rate of adverse mental health outcomes compared to the public. Some organizations have implemented wellness programming to mitigate this issue. To our knowledge, no programs were developed collaboratively by researchers and knowledge users considering knowledge translation and implementation science frameworks to include all evidence-informed elements of posttraumatic stress prevention. The Social Support, Tracking Distress, Education, and Discussion Community (STEADY) Program was developed to fill this gap. It includes (1) peer partnering; (2) distress tracking; (3) psychoeducation; (4) peer support groups and voluntary psychological debriefing following critical incidents; (5) community-building activities. This paper reports on the narrative literature review that framed the development of the STEADY framework and introduces its key elements. If successful, STEADY has the potential to improve the mental well-being of PSP and HCWs across Canada and internationally.

Psychosocial working conditions and chronic low-grade inflammation in geriatric care professionals: A cross-sectional study

Background

Chronic low-grade inflammation has been suggested as a key factor in the association between stress exposure and long-term health. Care work is recognized as a profession with a high degree of job stress and health risks. However, for care professionals, the study base on inflammatory activity due to adverse working conditions is limited.

Objective

The aim of this study was to explore associations between self-reported psychosocial working conditions and care professionals’ biomarkers of systemic low-grade inflammation.

Methods

N = 140 geriatric care professionals (79.3% females, mean age = 44.1 years) of six care facilities were enrolled in a cross-sectional study consisting of standardized medical examinations and employee surveys. Standardized questionnaires were used for evaluation of psychosocial work characteristics (work overload, job autonomy, social support) based on Karasek’s job strain model. Blood samples were drawn for two biomarkers of inflammatory activity: C-reactive protein (CRP) and leukocyte count. Analyses comprised uni- and multivariate logistic and linear regression analyses.

Results

We determined a proportion of 5.4% of care professionals with increased low-grade inflammation. We further observed a relationship between job autonomy and CRP, such that reports of high job autonomy were associated with increased levels of CRP (adjusted OR = 4.10, 95% CI [1.10, 15.26], p = .035), which was robust in additional analyses on further potential confounders. No significant associations with participants’ leukocyte numbers were found.

Conclusions

This exploratory study contributes to the research base on links between workplace stress and ensuing illness in care professionals. Our findings may help to identify risk and protective factors of the work environment for chronic low-grade inflammation. The results require further scrutiny, and future prospective studies on associations of psychosocial working conditions, low-grade inflammation and long-term health outcomes in care professionals are needed.

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.

Expressions of Compassion Fatigue by Emergency Department Nurses Caring for Patients With Opioid and Substance Use Disorders

INTRODUCTION

The misuse of and addiction to opioids are a national public health crisis. The complexity of delivering patient care in emergency departments exposes nurses to stressful work situations with complex patient loads and increasing levels of compassion fatigue. Emergency nurses were asked about their feelings of compassion fatigue while caring for patients with opioid use and/or substance use disorders.

METHODS

Twenty-four focus groups with emergency nurses (N = 53) at a level I trauma center were conducted in late 2019 and early 2020 are used in this qualitative study using thematic analysis that identified 1 main theme of compassion fatigue with 3 subthemes (nurse frustration with addicted patients, emotional responses, and job satisfaction).

RESULTS

Findings highlight that emergency nurses working with patients with opioid use and/or substance use disorders are dealing with a number of negative emotional stressors and frustrations, which in turn has increased their levels of compassion fatigue. These nurses repeatedly expressed feelings of increasing frustration with addicted patients, negative emotional responses, and decreasing levels of job satisfaction as components of their compassion fatigue.

DISCUSSION

These emergency nurses identified 3 areas to improve their compassion: improved management support with encouragement across all work shifts, debriefing opportunities, and more education. Fostering a high level of self-awareness and understanding of how the work environment influences personal well-being are necessary strategies to avoid the frustrations and negative emotional responses associated with compassion fatigue.

No increase in burnout in health care workers during the initial COVID-19 outbreak: Systematic review and meta-analysis

BACKGROUND

For decades and before the coronavirus disease 2019 (COVID-19) pandemic, for health care workers (HCWs) burnout can be experienced as an upsetting confrontation with their self and the result of a complex a multifactorial process interacting with environmental and personal features.

AIM

To literature review and meta-analysis was to obtain a comprehensive understanding of burnout and work-related stress in health care workers around the world during the first outbreak of the COVID-19 pandemic.

METHODS

We performed a database search of Embase, Google Scholar and PubMed from June to October 2020. We analysed burnout risk factors and protective factors in included studies published in peer-reviewed journals as of January 2020, studying a HCW population during the first COVID-19 wave without any geographic restrictions. Furthermore, we performed a meta-analysis to determine overall burnout levels. We studied the main risk factors and protective factors related to burnout and stress at the individual, institutional and regional levels.

RESULTS

Forty-one studies were included in our final review sample. Most were cross-sectional, observational studies with data collection windows during the first wave of the COVID-19 surge. Of those forty-one, twelve studies were included in the meta-analysis. Of the 27907 health care professionals who participated in the reviewed studies, 70.4% were women, and two-thirds were either married or living together. The most represented age category was 31-45 years, at 41.5%. Approximately half of the sample comprised nurses (47.6%), and 44.4% were working in COVID-19 wards (intensive care unit, emergency room and dedicated internal medicine wards). Indeed, exposure to the virus was not a leading factor for burnout. Our meta-analytic estimate of burnout prevalence in the HCW population for a sample of 6784 individuals was 30.05%.

CONCLUSION

There was a significant prevalence of burnout in HCWs during the COVID-19 pandemic, and some of the associated risk factors could be targeted for intervention, both at the individual and organizational levels. Nevertheless, COVID-19 exposure was not a leading factor for burnout, as burnout levels were not notably higher than pre-COVID-19 levels.

Working Conditions and the Components of Burnout Among Nursing Staff in a Public Hospital in Mexico City

BACKGROUND

Working conditions in public hospitals in Mexico City are highly demanding. The need for healthcare is pressing, materials and instruments are scarce, and exposure to pain and suffering is constant. These adverse conditions have an adverse impact on the physical and mental health of healthcare professionals. The nursing staffs are among those who are most affected, and they frequently experience burnout syndrome or one of its several dimensions, including emotional exhaustion, depersonalization, and reduced personal accomplishment.

PURPOSE

The aim of this research was to analyze the relationship among working conditions, related stress, and the dimensions of burnout syndrome in a tertiary care public hospital in Mexico City.

METHODS

A cross-sectional design was applied on a random sample of 190 nurses in a public hospital in Mexico City. Working conditions and burnout syndrome were evaluated using standardized instruments. Adjusted prevalence ratios were calculated. Three clusters, one for each burnout dimension, were generated and then evaluated using a correspondence analysis with labor characteristics.

RESULTS

One quarter (25%) of the participants self-reported a sense of personal accomplishment, and 12% reported emotional exhaustion and depersonalization. The labor variables that were found to be associated with the dimensions of burnout were workload, performing potentially hazardous work, and conducting tedious tasks. Positive conditions were shown to decrease the prevalence of burnout in all three dimensions.

CONCLUSIONS/IMPLICATIONS FOR PRACTICE

Working conditions for nursing staff impact the mental health of nurses and affect the quality of the healthcare they provide. The set of work demands and stressors to which they are exposed should be controlled and modified to ensure a healthy work environment.

Attrition of Nursing Professionals in Ghana: An Effect of Burnout on Intention to Quit

Background

Burnout among nursing professionals at the workplace and how it influences their decision to quit the profession is crucial to the delivery of quality health service. The shortage of nursing professionals has serious consequences on the healthcare system.

Aim

To examine the effect of burnout on intention to quit the profession among nursing professionals.

Methods

A cross-sectional study among 375 randomly selected nursing professionals in active service at a tertiary healthcare setting in Kumasi, Ghana. The Maslach Burnout Inventory was used to determine burnout, and their intention to quit the profession was assessed by asking participants whether they ever thought about quitting the profession in the past 12 months. The effect of burnout on intention to quit was analyzed using logistic regression analysis.

Results

The overall prevalence of burnout among participants was 2.1% (8/375) with 10.1% (38/375), 24.0% (90/375), and 56.3% (211/375) experiencing high emotional exhaustion, depersonalisation, and low personal accomplishment, respectively. Nearly half (49.3%, 185/375) of the participants had intention to quit the profession. Emotional exhaustion (adjusted odds tatio, AOR = 5.46; 95% CI = 2.25-13.20), depersonalisation (AOR = 1.77 95% CI = 1.07-2.95), and personal accomplishment (AOR = 2.27; 95% CI = 1.30-3.96) were associated with intention to quit the profession.

Conclusion

Burnout has a negative effect causing intention to quit nursing profession. It is imperative to identify strategies such as occupational health surveillance that will aim at reducing the incidence of burnout at the workplace due to its consequences, one of them being the intention to quit.

The Mediating Role of Compassion between Social Job Resources, and Healthy Healthcare Professionals: A Cross-Sectional Study with Gender Perspective

The aim of this study is to examine the role of Compassion towards others as a mediator between Social Job Resources (social support climate, coordination, and positive leadership), Healthy Employees (psychological well-being such as resilience, engagement, and optimism) and Healthy Organisational Outcomes (in-role performance, extra-role performance and commitment) from a gender perspective in healthcare professionals. Through the multiple analyses of variance, structural equation models, and multiple-group analyses in a sample of 1420 healthcare professionals from different public and private hospitals in Spain, this study proved the existence of gender differences, with women perceiving higher levels of Compassion. Moreover, this study shows that Compassion partially mediates the relationship between Social Job Resources and Healthy Employees. In addition, Compassion partially mediates the relationship between Social Job Resources and Healthy Organisational Outcomes. Finally, Healthy Employees mediate the positive relationship between Social Job Resources and Healthy Organisational Outcomes. This is an innovative contribution to the limited research examining Compassion towards others as a personal resource that can have a positive impact in the workplace. The results also propose a way to develop and conduct interventions in order to increase Compassion towards others in the healthcare context.

Athlete Burnout Symptoms Are Increasing: A Cross-Temporal Meta-Analysis of Average Levels From 1997 to 2019

With the increasing prevalence of mental health difficulties in sport, athletes may be at greater risk of burnout than ever before. In the present study, we tested this possibility by examining whether average athlete burnout levels have changed over the past 2 decades, from 1997 to 2019. A literature search returned 91 studies (N = 21,012) and 396 effect sizes. Findings from cross-temporal meta-analysis suggested that burnout symptoms have increased over the past 2 decades. Specifically, we found that athletes' mean levels of reduced sense of athletic accomplishment and sport devaluation have increased. As burnout symptoms are now typically higher among athletes than in the past, we can expect more athletes to be prone to the negative effects of burnout. Sport is therefore in urgent need of prevention and intervention strategies to stop and reverse this trend.

Examining the quality of work-life of paramedics in northern Ontario, Canada: A cross-sectional study

BACKGROUND: Paramedics are exposed to multiple stressors in the workplace. They are more likely to develop occupational-related stress conditions compared to other occupations. This study focused on understanding the factors affecting QoWL of paramedics in northern Ontario, Canada; a particular focus was on understanding the personal and organizational factors, such as practicing community paramedicine (CP), which may be associated with Quality of Work Life (QoWL). METHODS: Paramedic QoWL was assessed using an online survey that was distributed to approximately 879 paramedics across northern Ontario. The survey included the 23-Item Work- Related Quality of Work Life Scale. Data analysis involved linear regressions with nine predictor variables deemed to be related to QoWL for paramedics with QoWL and its six subscales as dependent variables. Multiple linear regressions were used to assess the personal and organizational factors, such as practicing of CP, which predicted QoWL. RESULTS: One hundred and ninety-seven paramedics completed the questionnaire. Overall, the mean QoWL score of all paramedic participants was 73.99, and this average compared to relevant published norms for other occupations. Factors that were most associated with higher QoWL were, experience practicing CP (p < 0.05), number of sick days/year (p < 0.01), and higher self- rated mental health (p < 0.001). CONCLUSIONS: Higher paramedic QoWL appears to be associated with many factors such as number of sick days per year, self-rated mental health, and participation in CP. EMS organizations should consider establishing necessary workplace health promotion strategies that are targeted at improving QoWL for paramedics.

Sustainable Working Life in Intensive Care: A Qualitative Study of Older Nurses

To counteract the shortage of nurses in the workforce, healthcare organizations must encourage experienced nurses to extend their working lives. Intensive care (IC) has higher nurse-to-patient ratios than other settings, which includes a particular susceptibility to staff shortage. This qualitative study investigated how older IC nurses experienced their working life and their reflections on the late-career and retirement. Semi-structured interviews with 12 IC nurses in Sweden (aged 55-65 years) were analyzed using an interpretative phenomenological analysis approach. The results showed that nurses planned to continue working until the age of 65 and beyond. When reflecting on their late-career decisions, nurses considered nine areas covering individual, work, and organizational factors as being central to their ability and willingness to stay. Overall, the nurses had good health and were very satisfied and committed to their job and to the organization. They mentioned having both the job and personal resources required to cope with the physical and mental job demands, which were perceived as motivational challenges, rather than hinders. They also reflected on various human resource management practices that may promote aging-in-workplace. These findings may inform organizations aiming at providing adequate conditions for enabling healthy and sustainable working lives for IC nurses.

The Upshot of the SARS-CoV-2 Pandemic on Nursing Assistants: Evaluating Mental Health Indicators in Huelva

Healthcare professionals who work in front-line situations are among those under the highest risk of presenting negative mental health indicators. We sought to assess the prevalence of low personal realization, emotional exhaustion, and depersonalization as well as probable non-psychotic psychiatric pathologies during the pandemic in nursing assistants in the city of Huelva (Spain), and to study the association between these mental health indicators and sociodemographic and professional variables. A cross-sectional descriptive investigation with a quantitative approach was used. A representative sample of these professionals, consisting of 29 men and 284 women, completed the GHQ-12 questionnaire, including sociodemographic data and the MBI-HSS questionnaire, collecting information on situations of contact with SARS-CoV-2. Data analysis was conducted, and correlations were established. We found that emotional exhaustion, depersonalization and probable non-psychotic, psychiatric pathologies were related to contact with SARS-CoV-2. Moreover, personal realization, depersonalization and emotional exhaustion were related to just gender. We conclude that nursing assistants from public hospitals in the city of Huelva who had contact with patients with SARS-CoV-2 in the workplace, showed poor mental health indicators than those who did not come into contact with infected individuals.

Stress-Inducing Factors vs. the Risk of Occupational Burnout in the Work of Nurses and Paramedics

INTRODUCTION

Contemporary healthcare faces new challenges and expectations from society. The profession of a nurse, as well as a paramedic, is essential for the efficient functioning of healthcare. It has its importance not only in promoting and preserving health but also in prevention. With the increasing importance of providing medical care at the highest level, it is expected of these two professional groups to have more knowledge and skills than a few years earlier. The daily contact with patients and their families, the low level of control of the environment, the hierarchical system of professional dependence, and the dissatisfaction with remuneration are becoming extremely burdensome aspects of the nursing and paramedic professions. Long-term exposure to stressors associated with these medical professions may, in the long term, lead to the emergence of occupational burnout syndrome. The aim of this study is an attempt to answer the question of whether and how stress factors affect the occurrence of occupational burnout in the work of nurses and paramedics working in various medical entities.

MATERIAL AND METHODS

The study covered a group of 434 respondents, including 220 nurses and 214 paramedics, working professionally in hospital departments and care and treatment facilities as well as in hospital emergency departments and ambulance services. The study was carried out using a diagnostic survey based on the questionnaire technique using the authors' questionnaire and the standardized MBI Ch. Maslach. Two statistical values were used to statistically analyze the research results and verify the adopted hypotheses: the chi-square test and the Student's t-test.

RESULTS AND CONCLUSIONS

The current study showed that the phenomenon of occupational burnout among the studied group affects only nurses, while this problem does not apply to the studied paramedics. The main stressor among the nurses and paramedics is, above all, a very high level of responsibility. Nurses are overburdened by excessive demands and shift work, while paramedics are mostly burdened by an excess of duties. Both nurses and paramedics claim that their work is often stressful, which leads to physical and mental exhaustion.

"I love the job…" Thriving in nursing: A qualitative interview study with framework analysis

BACKGROUND

Burnout is a well-known issue among nurses in critical care settings, including emergency nurses. There are decades of research indicating that emergency nurses experience burnout in their work. However, many nurses have long careers in emergency settings, which suggests that burnout is not the only outcome for nurses. Thriving may also be part of nurses' experiences. The Model of Thriving at Work includes external factors (autonomy, climate of trust and respect, and information sharing) and internal factors (knowledge, personal outlook, and relationships). Thriving is characterized by the concepts of vitality and ongoing learning. Previous researchers suggest that thriving fits with some nurses' experiences, based on validated questionnaires. However, thriving has not been investigated among nurses using interview approaches.

AIMS

This article explores nurses' experiences of thriving and assesses the fit of Spreitzer et al.'s Model of Thriving at Work with nurses' experiences.

STUDY DESIGN

Qualitative interview study, using framework analysis.

METHODS

Eleven nurses, from a single site, completed semi-structured interviews. These interviews explored nurses' workplace experiences, both positive and negative.

RESULTS

Participants reported experiences that fit with the Model of Thriving at Work, consisting of vitality, ongoing learning, and external and internal factors. Nurses hesitated to describe themselves in positive ways, referring instead to being 'not burnt out'. Nurses could, however, readily identify qualities of thriving in others, and viewed those nurses as aspirational. In addition to the Model, participants highlighted their emotional burden, workload, and ethical issues as important contributors to thriving. The Model could potentially be expanded to include these factors.

CONCLUSIONS

Thriving at work could be part of a range of emergency nurses' workplace outcomes. External and internal factors contribute to thriving. Healthcare leaders could support thriving among emergency nurses by fostering a positive work environment.

Burden of treatment, emotion work and parental burnout of mothers to children with or without special needs: A pilot study

The psychological phenomenon of Parental Burnout (PB) results from an imbalance between continuous exposure to chronic parenting stress and available coping resources. The study’s aim was to examine relationships between mothers’ perceived burden of treatment and PB, and their ability to utilize emotion work (EW) as a psychological coping resource. Ninety-eight Israeli mothers (46 had children with special needs with disabilities—W-SND, and 52 had children without special needs—WO-SN) completed questionnaires assessing their perception of burden of treatment, EW and PB. According to the findings, mothers of children W-SND reported significantly higher PB, a higher perceived burden of treatment and deeper EW than mothers of children WO-SN. Additionally, among all the mothers, a positive significant correlation was found between perceived burden of treatment and PB, while among mothers of children W-SND, positive correlations were found between their perceived burden of treatment and deep EW, and between deep EW and PB. These findings suggest that among mothers of children W-SND, PB is related to their perception of the burden of treatment and to performing deep EW. Additional psychological, cultural and environmental factors should be investigated, in order to gain new perspectives regarding PB as a psychological phenomenon that affects parenting and the ability to utilize coping mechanisms for mothers generally and for mothers of children W-SND especially.

Work-Family Interaction, Self-Perceived Mental Health and Burnout in Specialized Physicians of Huelva (Spain): A Study Conducted during the SARS-CoV-2 Pandemic

BACKGROUND

The medical staff who work in specialized healthcare are among the professionals with a greater risk of presenting negative indicators of mental health. These professionals are exposed to numerous sources of stress that can have a negative influence on their personal life. Currently, SARS-CoV-2 poses an additional and relevant source of stress. The aim of this study was to identify the interactions between the work and family environments, as well as to analyze self-perceived mental health and burnout in physicians who, during the COVID-19 pandemic, carried out their jobs in public health in Huelva (Spain), also considering a series of sociodemographic variables.

METHODS

This is a descriptive, cross-sectional study. Information from 128 participants was collected using the SWING, MBI-HSS and GHQ-12 questionnaires, along with sociodemographic data and possible situations of contact with SARS-CoV-2. The data were analyzed, and correlations were established.

RESULTS

Most of the sample obtained a positive interaction result of work over family. Those who had been in contact with SARS-CoV-2 represented higher percentages of a positive result in GHQ-12, negative work-family interaction, burnout, emotional exhaustion and depersonalization. In general, the men showed a worse mental health state than women.

CONCLUSIONS

The medical staff of Huelva who had been in contact with situations of SARS-CoV-2 in their work environment presented worse indicators of mental health and greater negative interaction of work over family than those who had not been in contact with these situations.

The Impact of Job Stress and State Anger on Turnover Intention Among Nurses During COVID-19: The Mediating Role of Emotional Exhaustion

Based on the social exchange theory, the aim of this study is to identify the association between job stress state anger, emotional exhaustion and job turnover intention. This study postulates that job related stress and state anger among nurses during COVID-19 subsequently leads to their job turnover intentions. In addition, the study also aims to see the mediating role of emotional exhaustion between COVID-19-related job stress, state anger, and turnover intentions. The sample of this study is gathered from 335 registered nurses working in Pakistani hospitals dealing with COVID-19-related patients. The interrelationships between variables are checked by using structural equation modeling through AMOS. Key findings confirm that COVID-19-related job stress and state anger had a significant effect on nurses' turnover intentions. Furthermore, emotional exhaustion mediated the relationship between COVID-19-related job stress, state anger, and turnover intentions. There is a lack of research which has assessed the impact of Novel COVID-19-related job stress and state anger on nurses' turnover intentions in hospitals, providing empirical evidence from a developing country-Pakistan. This study offers managerial implications for hospital management and health policymakers. Moreover, nursing managers need to pay attention to nurses' turnover intentions who are facing the issue at the front line as patients receive their initial treatment from nurses in the COVID-19 outbreak.

Burnout: A Review of Theory and Measurement

A growing body of empirical evidence shows that occupational health is now more relevant than ever due to the COVID-19 pandemic. This review focuses on burnout, an occupational phenomenon that results from chronic stress in the workplace. After analyzing how burnout occurs and its different dimensions, the following aspects are discussed: (1) Description of the factors that can trigger burnout and the individual factors that have been proposed to modulate it, (2) identification of the effects that burnout generates at both individual and organizational levels, (3) presentation of the main actions that can be used to prevent and/or reduce burnout, and (4) recapitulation of the main tools that have been developed so far to measure burnout, both from a generic perspective or applied to specific occupations. Furthermore, this review summarizes the main contributions of the papers that comprise the Special Issue on "Occupational Stress and Health: Psychological Burden and Burnout", which represent an advance in the theoretical and practical understanding of burnout.

Personal, Work-, and Client-Related Burnout Within Strength and Conditioning Coaches and Personal Trainers

ABSTRACT

Snarr, RL and Beasley, VL. Personal, work-, and client-related burnout within strength and conditioning coaches and personal trainers. J Strength Cond Res 36(2): e31-e40, 2022-The purpose of this investigation was to examine the prevalence and influencing factors of personal, work-related, and client-related burnout within strength and conditioning coaches (SCCs) and personal trainers (PTs). Two hundred fifty-six SCCs (n = 141) and PTs (n = 115) completed the Copenhagen Burnout Inventory (CBI), a 19-item survey, measuring 3 subscales of personal, work-related, and client-related burnout. Information regarding other burnout-related factors (i.e., job satisfaction, social support, fitness level, and mental toughness) was solicited through single-item or multiple-item questionnaires. Correlational analyses and independent t-tests were conducted to assess associations and between-group differences between burnout and all continuous factors. Seventy-one subjects completed the survey before March 2020; after which, a worldwide pandemic (i.e., COVID-19) occurred possibly affecting employment workloads and work-related stress. Thus, post hoc analyses were conducted to assess differences in burnout scores pre-COVID-19 and post-COVID-19. Using a CBI subscale cutoff score of ≥50, fitness professionals reported 32.8% of personal burnout, 28.5% work-related burnout, and 18.0% client-related burnout. Factored by occupation, SCCs reported 32.6% personal burnout, 27.7% work-related burnout, and 18.4% client-related burnout. Within PTs, 33.0% reported personal burnout, 29.6% reported work-related burnout, and 17.4% reported client-related burnout. Higher levels of burnout, across all scales, were observed in those who were PTs, women, unmarried, living alone, would not choose to be a fitness professional again, and took the survey post-COVID as compared to their respective counterparts. Findings suggest that fitness professionals are not exempt from the stressors associated with personal and occupational burnout. Strength and conditioning coaches and PTs may reduce the risk of burnout by increasing social support, continuing education, and allowing for personal-care time with the intention of buffering these factors.

Emergency Department Nursing Burnout and Resilience

Burnout is a significant problem in emergency nursing, and it is associated with higher turnover rates than other disciplines of health care. Emergency nurses are highly susceptible to burnout due to continual exposure to traumatic events, varying work schedules, violence directed at staff, and, in recent times, due to the stressors of the COVID-19 pandemic. This literature review will (1) expose the causes of emergency department (ED) nurse burnout and (2) discuss strategies to build resilience in ED nurses. A systematic review of studies published in academic journals discussing burnout and resilience, specifically related to ED nurses, published in English between 2015 and 2019. The databases MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Education Source, Health Source: Nursing/Academic Edition, APA PsycArticles, Military and Government Collection, Gender Studies Database, SocINDEX, and PsycINFO were searched. Sixteen studies were included in this review. Work schedules and shift work, violence toward staff, and lack of management support were factors linked to burnout. Self-discipline, optimism, and goal-oriented behaviors evolved as characteristics of resilient ED nurses. Burnout rates among ED nurses are steep. Shift work, traumatic events, violence, and management support are determinants of burnout. Specialized actions can combat burnout and increase resilience. Nursing management can provide specific education to nurses to assist in this effort.

Burnout Assessment Tool (BAT): Validity Evidence from Brazil and Portugal

The Burnout Assessment Tool (BAT) has been gaining increased attention as a sound and innovative instrument in its conceptualization of burnout. BAT has been adapted for several countries, revealing promising validity evidence. This paper aims to present the psychometric properties of the Brazilian and Portuguese versions of the BAT in both the 23-item and 12-item versions. BAT’s validity evidence based on the internal structure (dimensionality, reliability, and measurement invariance) and validity evidence based on the relations to other variables are the focus of research. A cross-sectional study was conducted with two non-probabilistic convenience samples from two countries (N = 3103) one from Brazil (n_Brazil = 2217) and one from Portugal (n_Portugal = 886). BAT’s original structure was confirmed, and it achieved measurement invariance across countries. Using both classic test theory and item response theory as frameworks, the BAT presented good validity evidence based on the internal structure. Furthermore, the BAT showed good convergent evidence (i.e., work engagement, co-worker support, role clarity, work overload, and negative change). In conclusion, the psychometric properties of the BAT make this freely available instrument a promising way to measure and compare burnout levels of Portuguese and Brazilian workers.

COVID-19 pandemic effects on health worker's mental health: Systematic review and meta-analysis

BACKGROUND

Healthcare workers (HCWs) exposed to coronavirus 19 (COVID-19) are at high risk of developing mental health concerns across several domains. The aim of this study is to determine the updated, global frequency of these outcomes.

METHODS

A multistep literature search was performed from database inception until March 1, 2021. PRISMA/MOOSE-compliant systematic review and PROSPERO protocol were used to identify studies reporting on depression, anxiety, acute stress, post-traumatic symptoms, insomnia, and burnout in HCWs exposed to COVID-19. A quantitative meta-analysis with random effects was conducted to analyze the proportion rate of the mental health disorders. Sensitivity analyses were performed to investigate the effect of the different continents and scales. Meta-regression analyses were conducted to examine the effect of gender, age, and work position.

RESULTS

239 articles were included (n = 271,319 HCWs, mean age = 36.08 ± 8.33 (66.99% female). 33% HCWs exposed to COVID-19 reported depressive symptoms (95% confidence intervals [CI] = 28-38%), 42% anxiety features (95% CI = 35-48), 40% acute stress (95% CI = 32-47), 32% post-traumatic symptoms (95% CI = 26-37%), 42% insomnia (95% CI = 36-48), 37% burnout (95% CI = 31-42). Sensitivity analyses did not show statistically significant differences. Meta-regressions found a statistically significant lower prevalence of post-traumatic symptoms in Asia.

CONCLUSIONS

HCWs exposed to COVID-19 were found to have a significant prevalence of mental health concerns in all domains analyzed. The effects of COVID-19 on HCWs' mental health could be underestimated and the future consequences dismissed.

Loneliness, Complaining and Professional Burnout of Medical Personnel of Psychiatric Wards during COVID-19 Pandemic-Cross-Sectional Study

BACKGROUND

Professional burnout in the medical community has been present for a long time, also among mental health professionals. The aim of the study was to examine the links between loneliness, complaining and professional burnout among medical personnel in psychiatric care during a pandemic. Loneliness and complaining of the medical staff are not documented in the literature well enough.

METHODS

Oldenburg Burnout Questionnaire, the Loneliness Scale, the Complaint Questionnaire and author's questionnaire. The respondents: 265 medical employees-doctors (19.2%), nurses (69.8%), paramedics (4.9%), medical caregivers (5.7%).

RESULTS

Loneliness and complaining are significant predictors of exhaustion. The model explains 18% of exhaustion variance. Loneliness, complaining and job seniority are also predictors of disengagement; the model allows to predict 10% of the variance of disengagement. Women are more prone to complain. Complaining significantly correlates with direct support from management. A high rate of loneliness correlates, in a statistically significant way, with worse work organization, less management support, worse atmosphere in the team and with more irresponsible attitudes of colleagues.

CONCLUSIONS

Loneliness and complaining can be used to predict occupational burnout. Women and people without management support complain more often. Loneliness is connected with bad work organization and bad cooperation in a team.

Anxiety, depression, stress, burnout, and professional quality of life among the hospital workforce during a global health pandemic

PURPOSE

Working in a hospital setting during a global health pandemic can lead to increased levels of anxiety, stress, burnout, and depression. Anecdotal evidence exists, but there is little research utilizing clinically validated tools to measure hospital staff psychological distress.

METHODS

In Summer 2021, 771 hospital staff in North Dakota responded to an electronic survey collecting demographic data and employing validated behavioral health screening tools to assess anxiety, depression, emotional distress, and work-related quality of life.

FINDINGS

Compassion satisfaction was significantly higher for those who worked in rural areas than urban [t(769) = -1.99, P = .0467]. The burnout rating was significantly higher for those who worked in urban areas than rural [t(769) = 2.23, P = .0261)]. There was no significant geographic variation in stress, anxiety, or depression. Anxiety, depression, burnout, and stress were all significantly higher for those who worked directly with COVID-19 patients than those who did not, regardless of hospital location.

CONCLUSIONS

Hospital staff caring for COVID-19 patients experienced equitable (and high) levels of depression and anxiety. However, data indicate that rural providers experienced greater protective factors, resulting in lower rates of burnout and higher compassion satisfaction. Rural communities, hospitals, and health systems may have characteristics that could be duplicated in urban areas to support hospital staff well-being. Support and promotion of mental wellness must also come from the hospital system, and health care and policy leaders. If we do not care for our hospital staff, there will not be hospital staff left to care for the community.

Adaptability, cohesion and family functionality of nurses during state of emergency by COVID-19

Objective: To evaluate nurses’ family adaptability, cohesion, and functionality during the state of emergency. Materials and method: The following is an exploratory, quantitative, descriptive, and cross-sectional study. We used a snowball sample, non-probabilistic, and for convenience. For data collection, we used an instrument consisting of a sociodemographic questionnaire; a family, housing, and cohabitation characterization questionnaire; a Duvall’s Family Life Cycle Assessment Scale; a Family Adaptability and Cohesion Evaluation Scale (FACES II); and Family-Scale Adaptation, Partnership, Growth, Affection, and Resolve (APGAR) that measures family function. Results: 125 responses were obtained, being identified the following aspects as predictors of better APGAR, Cohesion, and Adaptability: better housing conditions; families with three or more members; mature families, with children or adult children; individuals teleworking and households in which no more than one member is socially isolated. Age is a predictor of lower adaptability and cohesion. Conclusions: Twenty percent of families (APGAR) have moderate or severe dysfunction; 4.8 % are classified as “extreme” families, and 39.2 % as “very balanced” (FACES II), therefore being at risk.

Examining boss phubbing and employee outcomes through the lens of affective events theory

Purpose

In this study, the impact of boss phubbing, or using a phone during interaction with subordinates, on important employee outcomes — work meaningfulness and employee phubbing behavior — through the mediating role of self-esteem threat was investigated using affective events theory. The moderating role of rejection sensitivity was also examined.

Design/methodology/approach

Data were collected in three time lags from head nurses (N = 178) working in public and private hospitals. The hypothesized relationships were tested using variance-based structural equation modeling with partial least squares.

Findings

Boss phubbing negatively affected employees' sense of work meaningfulness and had a positive direct and indirect relationship with employee phubbing behavior through self-esteem threat. The hypothesized moderating role of rejection sensitivity was not supported.

Practical implications

The authors recommend that organizations develop policies addressing boss phubbing in the workplace, particularly in contexts in which a high leader–member exchange is desired for organizational effectiveness, such as health-related services. Superiors, such as doctors, should review their mobile phone usage during interactions with subordinates because it is detrimental to employee outcomes.

Originality/value

This study is a nascent attempt to test the hypothesized relationships on the emerging phenomenon of phubbing at work in the human–computer interaction domain in Pakistan, a developing country, particularly in hospital settings where a high leader–member exchange is pivotal.

Compassion Fatigue in the Burn Unit: A Review of Quantitative Evidence

Healthcare staff across varied clinical settings are faced with varied stressors that can lead to compassion fatigue. However, there is currently no review examining the phenomenon in-depth in the burn unit. Thus, the current study sought to scope existing studies to ascertain the prevalence, contributing factors, and effects of compassion fatigue in the burn unit. Compassion fatigue was conceptualised as comprising of burnout and secondary traumatic stress. Arksey and O'Malley scoping review approach was used and reported according to the PRISMA extension guidelines. Searches were undertaken across peer-reviewed databases and grey literature sources for quantitative studies. Following the search and screening process, nine studies were retained. Codes were formulated across studies following which narrative synthesis was undertaken. Majority of the studies (n=5) focused on burn care nurses. High levels of emotional exhaustion and depersonalization and comparatively low level of personal achievement were reported among burn care staff which is indicative of burnout. Compassion fatigue was also observed to be high among burn care staff. Contributing factors are varied albeit some variables such as age, staffing levels, remuneration, nature of the work environment, and number of years worked were consistent across some studies. In conclusion, working in the burn unit is challenging with significant stressors that can lead to burnout, traumatic stress, and subsequently, compassion fatigue. Interventions to promote resilience, hardiness, optimal working environment, peer, and psychosocial support are greatly needed.

Exploring Global Research Trends in Burnout among Nursing Professionals: A Bibliometric Analysis

Nursing professionals are constantly exposed to several risk factors and high levels of stress that can affect their mental, emotional, and physical health, which can trigger burnout syndrome. This article aims to use bibliometric analysis to investigate burnout research trends among nursing professionals worldwide and to compare the contributions of different countries/institutions, scientific journals, authors, keywords, and citations. A bibliometric study was performed using the Scopus and Web of Science databases, in the period up to November 2021, aiming to search original and review articles in the English language regarding burnout in nursing professionals. The analysis was performed with a sample of 1406 articles. The most cited article indicated that 43% of nurses had high burnout scores, and a similar percentage were dissatisfied with their work. The most productive and most cited country in the world was the United States of America. Regarding the 10 most cited documents, there were no studies that could provide interventions to reduce burnout in nursing professionals, which can result in a need to develop studies on prevention capable of mitigating the problem, in view of the impacts generated on their mental, emotional, and physical health.

"Burnout syndrome and association with work stress in nursing staff in public hospital of the northern border of Mexico"

Currently in Mexico, there is a lack of published research assessing nursing burnout in a consistent manner. The pressure of having to provide quality care to low income patients can be a serious factor triggering work stress in the nursing professional. The aim of this study was to establish the connection between burnout, work stress and both demographic and labor factors in nursing staff. A sample of 424 nurses participated in the descriptive and cross-sectional study. Each of the participants answered a questionnaire with two validated instruments, the Maslach Burnout Inventory-Human Services Survey and the Nursing Stress Scale, both in their Spanish version, as well as a demographic and labor survey of the authors' own creation. A bivariate logistic regression analysis was used to determine any significant association between the variables. We found a prevalence of 65.09% in mid-level burnout syndrome among the female sex. Men, on the other hand, featured a high level of emotional exhaustion and depersonalization, whereas the female sex showed significantly lower levels of depersonalization. Most of the staff showed acute stress levels. Some factors found in the potential development of burnout were work shift, position, department and gender.

Work-related potential traumatic events and job burnout among operating room nurses: Independent effect, cumulative risk, and latent class approaches

AIMS

The objective of this study is to explore and compare the strength of associations between work-related potential traumatic events and burnout among operating room nurses based on three different approaches.

DESIGN

The study followed a multisite cross-sectional design.

METHODS

A stratified sampling method was conducted. Cities in the Shandong Province were divided into four groups, and two tertiary hospitals were randomly selected from all tertiary hospitals in cities of each group. A total of 361 eligible operating room nurses provided valid questionnaires between June and November 2019. Work-related potential traumatic events questionnaire and the Chinese version of the Maslach Burnout Inventory were conducted. Associations between individual, cumulative potential traumatic events, as well as latent class analysis-derived patterns of potential traumatic experiences with burnout were examined using logistic regression analysis.

RESULTS

Specific traumatic events (e.g., patients' sudden death, bullying and ostracism from colleagues) were independently associated with an increased risk of burnout. Work-related potential traumatic events had a cumulative effect on burnout, whereby operating room nurses exposed to cumulative potential traumatic events carried a higher risk for burnout than others. The "multiple work-related potential traumatic events" pattern derived by latent class analysis was related to an increased risk of high depersonalization.

CONCLUSION

Operating room nurses who reported specific or multiple work-related potential traumatic events were at high risk for burnout. It is of great significance to provide qualified and timely counselling or support.

IMPACT

This study is the first to focus on work-related potential traumatic events among operating room nurses and examine their relationship with burnout based on three perspectives. The findings could help identify those operating room nurses who are at high risk of burnout in clinical practice. Hospital managers should develop targeted interventions to prevent or mitigate the harmful impact of potential traumatic events on occupational health.