Long working hours and burnout in health care workers: Non-linear dose-response relationship and the effect mediated by sleeping hours-A cross-sectional study

Evaluation of the prevalence and risk factors of burnout syndrome among healthcare workers: A cross-sectional study

BACKGROUND

Burnout syndrome is a significant issue among healthcare professionals worldwide, marked by depersonalization, emotional exhaustion, and a reduced sense of personal achievement. This psychological and physical burden profoundly affects healthcare professionals' quality of care and overall well-being. In Somalia, where the healthcare system faces numerous challenges, the escalating demand for medical services and inadequate resources, coupled with overwhelming workloads, long hours, and high-stress levels, make healthcare providers particularly vulnerable to burnout syndrome. This, in turn, affects both the mental health of healthcare personnel and the quality of care they provide.

AIM

To examine the prevalence and determinants of burnout syndrome among healthcare practitioners in Mogadishu, Somalia.

METHODS

This cross-sectional prospective study was performed among 246 healthcare providers employed at a tertiary care hospital in Mogadishu, Somalia, who were recruited via random sampling. Data were collected using questionnaires that covered sociodemographic, psychological, work-related characteristics, and burnout syndrome. Bivariate and multivariate logistic regression analyses were performed to identify the variables that correlated with burnout syndrome. The results were presented using adjusted odds ratios (AORs), 95%CIs, and P values, with a cutoff of 0.05 for identifying significant associations.

RESULTS

Among the participants, 24% (95%CI: 18.8%–29.8%) exhibited symptoms of burnout syndrome. Factors associated with burnout included female gender (AOR = 6.60; 95%CI: 2.29-19.04), being married (AOR = 3.07; 95%CI: 1.14-8.28), being divorced or widowed (AOR = 5.84; 95%CI: 1.35-25.35), working more than 7 night shifts (AOR = 3.19; 95%CI: 1.30–7.82), having less than 5 years of job experience (AOR = 5.28; 95%CI: 1.29-21.65), experiencing poor sleep quality (AOR = 5.29; 95%CI: 1.88-14.89), and exhibiting depressive (AOR = 4.46; 95%CI: 1.59-12.53) and anxiety symptoms (AOR = 7.34; 95%CI: 2.49-21.60).

CONCLUSION

This study found that nearly one in four healthcare professionals suffers from burnout syndrome. Improving sleep quality, monitoring, and providing mental health support could enhance their well-being and patient care.

Objective alertness, rather than sleep duration, is associated with burnout and depression: A national survey of Japanese physicians

Approximately 40% of Japanese physicians report working more than 960 hr of overtime annually, with 10% exceeding 1860 hr. To protect their health, annual overtime limits went into effect in 2024. The objective of this study was to investigate associations of self-reported sleep duration with psychological health and objective alertness. This was a cross-sectional National Survey for The Work Style Reform of Long Working Physicians. Physicians self-reported daily sleep duration, burnout (Abbreviated Maslach Burnout Inventory), depression (Center for Epidemiologic Studies Depression Scale) and traffic accidents. Alertness was then evaluated using the brief Psychomotor Vigilance Test. Of 20,382 physicians invited, 1226 completed the survey and brief Psychomotor Vigilance Test. Daily sleep duration was inversely associated with weekly work hours (β = -5.4; 95% confidence interval -6.8 to -4.0, p < 0.0001). Sleep duration < 6 hr and ≥ 8 hr per day was associated with slower responses on the brief Psychomotor Vigilance Test (adjusted p < 0.05). An additional 10 hr worked per week was associated with a 0.40 point (95% confidence interval 0.08-0.72) increase in burnout severity and a 1.7% (95% confidence interval 0.1-3.3%) increase in odds of reporting a traffic accident. Increased brief Psychomotor Vigilance Test lapses, indicating lower alertness, were associated with worse symptoms of depression (β = 0.23 points; 95% confidence interval 0.14-0.31, p < 0.0001) and burnout (β = 0.25 points; 95% confidence interval 0.13-0.36, p < 0.0001). This study emphasizes the importance of sufficient sleep to maintain alertness, and supports limiting work hours for Japanese physicians to protect psychological health. Performance on the brief Psychomotor Vigilance Test may be a useful indicator of psychological health.

Burnout in Practicing Neurologists: A Systematic Review and Meta-Analysis

Purpose of Review

Burnout is a context-dependent, global issue among physicians in the medical field who often face job-related stressors, high workloads, and limited or lack of social support or autonomy. Within medicine, neurology is a specialty with high levels of burnout and low levels of work-life satisfaction. We, therefore, conducted this study to evaluate burnout rates among neurologists globally and identify the tools used to evaluate it.

Recent Findings

Among the 14 articles analyzed, the mean burnout prevalence rate among neurologists ranged from 18.1% to 94% (N = 8,735) across 6 countries (the United States, China, Philippines, Spain, Greece, and Brazil). Assessment of burnout using the Maslach Burnout Inventory (MBI) revealed that almost two-thirds (65.9%) of neurologists (N = 7,816) report experiencing burnout. Ten studies (71.4%) assessed burnout by using the MBI; the other 4 studies used the Copenhagen Burnout Inventory, a survey questionnaire generated by the American Academy of Neurology Stroke Practice Resources Workgroup, the Mini-Z survey, and a single question from the Physician Work Life Study. Among the 5 studies that used the same tool for measuring burnout (22-item MBI) and burnout criteria cutoff (emotional exhaustion [EE] ≥ 27 and/or depersonalization (DP) ≥ 10 subscale), the mean burnout rate ranged from 45% to 67% (p < 0.05, N = 7,816) across 3 countries (China, the United States, and Brazil). Of the studies that used the MBI and reported the 3 subscales of EE, DP, and personal accomplishment (PA), only the mean EE score was statistically different between studies. There were no significant differences detected in burnout rates among residents, among attending physicians, or residents compared with attendings.

Summary

This meta-analysis of burnout among practicing neurologists reveals that available published data span different levels of training, different sample sizes, and different survey tools with different cutoffs used for burnout within the same tool. Although burnout rates among neurologists were found to differ by country, it is evident from this systematic review that a great deal of neurology physicians are experiencing burnout across the globe. This systematic review may inform future approaches to reduce burnout among neurologists.

Exploring occupational well-being profiles, outcomes, and predictors among Chinese teachers: A mixed-methods approach using latent profile and decision tree analysis

Understanding the varied profiles of occupational well-being, their outcomes, and predictors is key to formulating effective strategies for enhancing teachers' occupational health and well-being. This study employed latent profile analysis (LPA) to identify distinct occupational well-being profiles and their outcomes among 366 Chinese teachers, and decision tree analysis to explore the factors predicting each profile. The results showed three occupational well-being profiles: burnout, engaged, and burnout-engaged. The "engaged" group exhibited normal ranges for depression and stress, along with mild anxiety. The "burnout" group demonstrated moderate depression and stress, coupled with severe anxiety. The "burnout-engaged" group was near the threshold of mild depression and moderate anxiety. The result of the decision tree model revealed that marital status, teaching experience, income, role as a class teacher, school type, and working hours significantly influenced these occupational well-being profiles. Specific combinations of variables were associated with each occupational well-being profile, offering a nuanced understanding of the risky and protective factors for teacher occupational well-being. By identifying distinct occupational well-being profiles among Chinese teachers and their outcomes, and elucidating the key predictors and their interrelations, this study provides insights into how to quickly screen for teachers in need of help at work, and how to design targeted interventions for different teachers.

Laypeople's Perspective on Physician Work-Hour Restrictions in Japan: A Cross-Sectional Study

The aim of the study was to examine laypeople's perspectives on the impending implementation of physician work-hour restrictions in Japan, which had received limited research attention. We conducted a nationwide cross-sectional study in January 2024. The participants were monitors of an internet survey company who responded to closed questions regarding the expected effect of work-hour regulations, along with an open-ended question regarding their expectations or concerns about these restrictions. The data were analyzed using descriptive statistics for closed questions and content analysis for the open-ended questions. The study included 484 laypeople. A significant portion (25.4%) was unaware of the scheduled start of work-hour restrictions. Approximately half of the participants had a neutral view of the overall impact of the restrictions. Content analysis of the open-ended responses identified 130 (60.2%) comments as "expectations" and 70 (32.4%) as expressing "concerns," with a notable number of comments deemed to indicate that the respondents were "unsure" or found the changes "irrelevant" to them. This study indicates a substantial gap between the views of physicians and laypeople on this issue.

Validation of the scale compassion fatigue inventory in health professional Spanish-speaking: a cross-sectional study

OBJECTIVES

To validate the Compassion Fatigue Inventory in Spanish-speaking health personnel, its psychometric properties were tested, and the influencing factors were investigated.

METHOD

This was a cross-sectional validation study. Information was collected through a survey of 733 nurses, physician and medical residents using the Compassion fatigue Inventory (CFI), Secondary Traumatic Stress Questionnaire (CETS), The physician burnout syndrome scale (PhBS), the quality-of-life index (SQL -sp) and the reduced Moral Stress Scale (MMDHPr). The psychometric properties of the CFI were tested via exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and internal consistency analysis. The final version of the translated CFI was correlated with other scales.

RESULTS

An EFA was performed to evaluate the translated CFI, resulting in 15 items in three dimensions, as reported in the literature: reduced compassion, social life, and workplace. The CFA showed good fit indices and psychometric values (Cronbach´s alpha = 0.87, Omega = 0.87, Comparative Fit Index = 0.99, Tucker Lewis = 0.99, root mean square error of approximation = 0.045, Standardized Root Mean Square Residual = 0.05). The CFI had a negative correlation with the SQL-sp and a positive correlation with the other subscales. Work experience is predictive of a small reduction in CFI scores.

CONCLUSION

The adaptation of the CFI in a sample of Latino health professionals shows satisfactory psychometric indices in the evaluation of compassion fatigue and can be proposed as a specific inventory to differentiate compassion fatigue from other occupational syndromes.

Characteristics of hospital pediatricians and obstetricians/gynecologists working long hours in Tokushima, Japan: A cross-sectional study

BACKGROUND

This study aimed to determine the actual working conditions, including working hours and desired future working styles of hospital pediatricians and obstetricians/gynecologists (OB/GYNs) in Tokushima Prefecture.

METHOD

This cross-sectional study used a self-administered questionnaire. Pediatricians and OB/GYNs (n = 96) working at 14 hospitals in Tokushima Prefecture were surveyed. The questionnaire included items related to working hours, working status, number of medical institutions, task-shifting/task-sharing status, and preferred work style. Factors associated with work hours were analyzed.

RESULTS

Approximately 40% and 10% of pediatricians and OB/GYNs worked ≥60 h/week and ≥80 h/week, respectively. Their weekly working hours were significantly positively associated with the number of nights and holidays worked and concurrent medical facilities they worked at. Multiple regression models showed that weekly working hours were significantly associated with working at night and day-off duties and the number of working medical institutions being worked at concurrently. Pediatricians and OB/GYNs who worked ≥60 h/week were not implementing a "multiple attending physician system" or "on-call system," and task-shifting/task-sharing was inadequate. A significantly higher proportion of physicians who worked long hours (≥60 h/week or ≥80 h/week) wanted to reduce the number of night and day-off duties and work hours compared with those who did not.

CONCLUSIONS

The results of this study suggest that many pediatricians and OB/GYNs work long hours, and it is essential to improve their work environment, including task-shifting/task-sharing. Further enhanced recruitment and retention of hospital pediatricians and OB/GYNs is required. A detailed and large-scale study of pediatricians and OB/GYNs' working environments is essential in the future.

Level of burnout and associated factors among healthcare workers in central Uganda: A facility-based cross-sectional study

BACKGROUND

Burnout among healthcare workers is a global concern with significant implications for both the well-being of the workforce and the quality of patient care. This facility-based cross-sectional study aimed to identify factors associated with burnout among healthcare workers in central Uganda.

METHODS

The study, conducted between June and July 2023, utilized a cross-sectional design involving physicians, nurses, and technicians. The study covered both public and private hospitals in central Uganda, incorporating urban and rural settings. A sample size of 550 healthcare workers was selected using a simple random sampling. Data collection involved a socio-demographic survey, the Professional Quality of Life (ProQOL-5). Descriptive statistics, Pearson Chi-square test, and ordinal regression models were employed to analyze demographic factors associated with burnout.

RESULTS

Of 548 participants, 218(39.8%) experienced high burnout levels. Factors significantly associated with high burnout levels included having over 10 years of work experience (OR: 2.04, 95% CI: 1.12-3.73), working more than 40 hours per week (AOR: 4.46, 95% CI: 1.20-16.62), lack of management support (AOR: 14.45, 95% CI: 3.83-54.56), not experiencing workplace violence (AOR: 2.22, 95% CI: 1.31-3.76), and reporting inadequate sleep (AOR: 6.96, 95% CI: 3.86-12.57).

CONCLUSION

Addressing burnout among healthcare workers in central Uganda requires targeted interventions tailored to the specific challenges faced in the region, including workload distribution, managerial support enhancement, violence prevention strategies, and promotion of adequate sleep. Urgent attention to these factors is essential for enhancing the well-being of healthcare professionals and maintaining quality patient care.

An optimized method for dose-effect prediction of traditional Chinese medicine based on 1D-ResCNN-PLS

We introduce a one-dimensional (1D) residual convolutional neural network with Partial Least Squares (1D-ResCNN-PLS) to solve the covariance and nonlinearity problems in traditional Chinese medicine dose-effect relationship data. The model combines a 1D convolutional layer with a residual block to extract nonlinear features and employs PLS for prediction. Tested on the Ma Xing Shi Gan Decoction datasets, the model significantly outperformed conventional models, achieving high accuracies, sensitivities, specificities, and AUC values, with considerable reductions in mean square error. Our results confirm its effectiveness in nonlinear data processing and demonstrate potential for broader application across public datasets.

Association between residential noise exposure and burnout among healthcare workers in Taiwan: a cross-sectional study

Few studies have explored the association between residential noise exposure and burnout. In this study, we investigated the association between residential noise exposure and burnout prevalence among 5416 health-care workers in Taiwan from 2012 to 2017. Burnout was evaluated using the Mandarin version of the Copenhagen Burnout Inventory by considering both continuous and binary measures. We applied ordinary Kriging models to calculate the annual average residential noise exposure at an individual level. Multivariable linear regression models and logistic regression models were employed. Restricted cubic splines were used to explore dose-response relationships. The median age of the health-care workers was 31.5 years. In the multivariable linear regression models, exposure to residential noise (per 1 dBA) was associated with increases in personal burnout and work-related burnout scores by 1.59 ± 0.25 and 1.38 ± 0.20, respectively. In the multivariable logistic regression models, the adjusted odds ratios were 1.24 (95% confidence interval [CI]: 1.16, 1.32) for personal burnout and 1.19 (95% CI: 1.13, 1.26) for work-related burnout per 1-dBA increase in residential noise exposure. Linear dose-response associations of burnout with residential noise level were detected. Our findings suggest that exposure to residential noise may increase the risk of burnout among health-care workers.

Association of Psychological Safety with Burnout and Intent to Leave Among Physician Faculty in New York City

BACKGROUND

Data on the potential protective effect of psychological safety (PS) on well-being and satisfaction among physicians are lacking.

OBJECTIVE

We sought to examine (1) prevalence of PS; (2) relationship between PS, burnout, and intent to leave one's job (ILJ); and (3) demographic and occupational factors associated with PS within our physician faculty.

DESIGN

Participants: An institution-wide survey was sent to all faculty within our eight-hospital health system, between July and September 2022.

MAIN MEASURES

PS was assessed using the seven-item Fearless Organization Questionnaire and burnout with the Maslach Burnout Inventory-2. Demographics and a measure of ILJ were assessed. Multivariable logistic regression analyses were conducted to determine associations between PS, burnout, ILJ, and demographic and occupational correlates of PS.

KEY RESULTS

A total of 867 out of 3086 total estimated clinical faculty members (28.1%) participated in the survey. The majority were 40 and older (67.4%), female (51.9%), white (60.0%), and married/partnered (80.4%); worked in ambulatory care departments (53.7%); and ranked assistant or associate professors (75.8%). On average, 57.6% of physicians evaluated their workplace as psychologically safe (range across items = 40.9-69.9%), with 35.2% screening positive for burnout and 13.4% reporting ILJ. After adjusting for demographic and occupational characteristics, each standard deviation unit increase in PS scores was associated with 27% lower odds of screening positive for burnout (odds ratio (OR) = 0.73, 95% confidence interval (CI) = 0.63-0.84) and 38% lower odds of ILJ (OR = 0.62, 95% CI = 0.52-0.74). Female gender was associated with lower scores of PS.

CONCLUSIONS

A majority of faculty physicians reported working in a psychologically safe environment. Greater PS was associated with lower odds of burnout and ILJ. Investment in gender and diversity equity training may be one concrete step in advancing PS in the workplace.

The association of long working hours and short sleep duration on mental health among Japanese physicians

This cross-sectional study investigates the association between long working hours, short sleep duration, and mental health among Japanese physicians. We enrolled 232 Japanese physicians. We used the Brief Job Stress Questionnaire to assess high-stress status, and the Japanese version of the Center for Epidemiologic Studies Depression scale to assess depressive status. Daily sleep duration (DSD) and weekly working hours (WWHs) were collected using a self-administered questionnaire. Multivariable-adjusted logistic regression analysis was performed to examine the association of the combined categories of DSD and WWHs with high-stress and depressive status. Compared to physicians with WWHs <80 h and DSD ≥6 h, the multivariable-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of high-stress status for those with WWHs ≥80 and DSD ≥6, WWHs <80 and DSD <6, and WWHs ≥80 and DSD <6 were 2.76 (0.97-7.87), 3.36 (1.53-7.40), and 3.92 (1.52-10.14), respectively. The respective ORs (CIs) of depressive status were 1.82 (0.42-7.81), 4.03 (1.41-11.53), and 4.69 (1.33-16.62). The results showed that regardless of working long hours or not, physicians with DSD <6 h had significantly higher stress and depressive status, suggesting that not only regulating long working hours but also ensuring adequate sleep duration is important for preventing physicians' mental health.

The independent and interactive effects of changes in overtime and night shifts during the COVID-19 pandemic on burnout among nurses: a longitudinal study

OBJECTIVES

This study aimed to evaluate the independent and interactive effects of changes in overtime and night shifts on burnout among nurses during the COVID-19 pandemic.

METHODS

Nurses working in an Italian university hospital (N=317) completed the Maslach Burnout Inventory in September 2019 and again in December 2020. Based on hospital administrative data, changes in overtime and night shifts in the same years were categorized into three groups each. Linear regressions were used to estimate 2020 burnout differences between exposure groups, controlling for 2019 burnout levels, demographic and work-related characteristics, and to test the interaction between the two exposures.

RESULTS

Nurses in the onset of high overtime group had higher emotional exhaustion [4.33, 95% confidence interval (CI) 1.74-6.92], depersonalization (2.10, 95% CI 0.49-3.71), and poor personal accomplishment (2.64, 95% CI 0.55-4.74) compared to stable low overtime nurses. Nurses in the increase in night shifts group had lower emotional exhaustion (-4.49, 95% CI -7.46- -1.52) compared to no night shift nurses. Interaction analyses revealed that this apparently paradoxical effect was limited to stable low overtime nurses only. Moreover, increases in night shifts were associated with higher depersonalization and poor personal accomplishment in nurses in the stable high overtime group.

CONCLUSIONS

Increase in overtime is an independent risk factor for burnout among nurses, highlighting the need for specific regulations and actions to address it. Long-standing guidelines for the assignment of night shifts might have contributed to attenuate the impact of their increase on nurses' mental health.

The prevalence of sleep deprivation and its impact among medical officers in a tertiary hospital, a cross-sectional study from Malaysia

Sleep deprivation (SD), defined as an inability to get a minimum of 7 hours of regular sleep at night is a serious health problem that impacts the performance of medical professionals. This study aims to determine the impact of sleep deprivation on perceived performance among medical officers (MOs). A cross-sectional study design involved 231 MOs from six disciplines in Hospital Tuanku Ja'afar, a tertiary center in the south of Malaysia. A self-administered questionnaire was introduced in the English language. The questionnaire involved the sociodemographic characteristics; job-related factors, and the Sleep Deprivation Impact Scale (SDIS). The SDIS is a 12-question scale, rated on a 5-point Likert scale from strongly disagree to strongly agree. A higher SDIS score reflected a higher impact of sleep deprivation. A total of 206 MOs returned the completed questionnaire yielding a response rate of 89.17%. The mean age of respondents was 31.68 (±3.49) years. Most of the respondents were female, of Malay ethnicity, and married. More than three-quarters (78.64%) reported sleep deprivation. Being less effective in communication and formulating diagnosis (3 (1.01) vs 2.5 (1.15),p = 0.005); taking longer time to do things (3.44 (1.07) vs 2.8 (1.34),p = 0.001); and feeling unsafe while driving (3.56 (1.25) vs 2.93 (1.55),p = 0.006) manifested significantly higher mean among sleep-deprived respondents. In conclusion, sleep deprivation is a prevalent problem; that adversely affects crucial functioning domains that may endanger patients and healthcare providers alike. Radical countermeasures are required to ensure satisfactory sleep duration and address areas jeopardizing MO safety.

Professional burnout among expert physicians, patient-focused care, and trust in top management: Moving forward

INTRODUCTION

Professional burnout in physicians is perceived as an inevitable occupational hazard inhibiting patient-focused care, the preferred approach of care, which enhances satisfaction of physicians with their work and improves clinical outcomes. Burnout jeopardizes the physical, mental, and emotional health of physicians, inhibiting high-quality care. Most individual-driven interventions and job-level interventions to reduce burnout proved inefficient or reduced burnout for only a short term. The potential of organizational processes to reduce burnout was acknowledged but is yet to be empirically tested. Drawing on social exchange theory, this study investigates the role of an organizational phenomenon, organizational trust among physicians in top management, on burnout.

METHODS

Data were collected across specialties in 10 out of 20 Israeli public general hospitals. The sample comprised 798 senior expert physicians. Measures were all previously published. Structural equation modeling was performed.

RESULTS

Response rates ranged from 17% to 77% across the 10 hospitals. Mean burnout was 4.7 (SD = 0.68), mean patient-focused care was 3.9 (SD = 0.79), and mean organizational trust was 3.7 (SD = 0.84). Mean burnout for women was 5.6 and for physicians from internal medicine was 5.5. The structural equation modeling supported the proposed study model, which explained 45% of burnout. Organizational trust reduced burnout by 14%.

DISCUSSION

Efforts to reduce burnout should integrate effective individual-level and job-level interventions with building trust among physicians in top management through implementing the paramount professional value of patient-focused care.

CONCLUSIONS

Perceiving management, among physicians, as facilitating the value of patient-focused care led to organizational trust in top management, which was negatively associated with burnout.

Work-Life Conflict, Burnout, and Associated Factors Among Hydroelectric Power Plant Employees: A Cross-Sectional Study in Turkey

INTRODUCTION

Power plants are associated with numerous occupational health and safety risk factors, with psychosocial risks being particularly significant. This study examines work-life conflict and burnout among power plant employees and discusses the factors associated with these issues.

MATERIALS AND METHODS

This cross-sectional study focused on employees at three hydroelectric power plants in Turkey. The inclusion criteria included employees with at least one year of tenure. Using cluster sampling, three plants were selected in Adana, Ankara, and Samsun. The sample size was determined to be 262, and 201 employees participated, yielding a 76.7% response rate. Data were collected via face-to-face interviews using a structured questionnaire, which encompasses the sub-dimensions of a valid and reliable scale: The Work-Life Conflict and Burnout sub-dimensions of the Copenhagen Psychosocial Questionnaire-III (COPSOQ-III) were used to measure the dependent variables. The independent variables included age, education level, total and weekly working hours, perceived health status, and department. The dependent variables were work-life conflict and burnout. Ethical approval was obtained from the Gazi University Ethics Committee. Statistical analysis compared the Pearson chi-square test, Fisher's exact test, and Yates correction with a significance threshold of p < 0.05.

RESULTS

The mean age was 40.83 years, with an average tenure of 11.54 years and a weekly work time of 43.51 hours. Most participants (94.5%) were male; technical unit workers comprised 71.6%. Health issues included smoking (39.8%) and chronic diseases (19.9%). Concerns about the working environment include insufficient knowledge about safety (25.4%) and lack of knowledge about risk assessments (32.3%). Many workers reported lacking personal protective equipment (11.4%) and rest areas (15.4%). Negative health impacts from work were noted by 31.8%. In addition, 51.2% believed that noise levels were outside the acceptable range. Two-thirds of employees reported inadequate measures against physical risks in the workplace. Many participants experienced work-life conflict (13.9%) and burnout (14.5%). High work-life conflict was significantly associated with younger age groups, less tenure, and negative perceived health status. Burnout was significantly related to the duration of employment, weekly working hours, and perceived health status.

CONCLUSION

The study highlights the seriousness of burnout and work-life conflict among hydropower plant workers, emphasizing the need for administrative and organizational interventions to alleviate these issues. Regular occupational health and safety training, involvement in risk assessments, fair workload distribution, supportive work environments, and counseling services are recommended to reduce burnout and improve work-life balance.

The Effect of Coronavirus (COVID-19) on Job Satisfaction, Work Stress and Burnout of Healthcare Workers: A Systematic Review and Meta-Analysis

Background

We aimed to examine the job satisfaction (JS), work stress (WS) and burnout (B) levels of healthcare workers (HCWs), who are at the forefront of the fight against the coronavirus (COVID-19) epidemic process, which negatively affects the whole world, by meta-analysis.

Methods

Articles, theses and papers in the literature before the COVID-19 (2014-2019) and during COVID-19 (2020-2022) were systematically reviewed. The sample size of 54 studies conducted from 13 countries was 49.139. Data analysis was performed with the Comprehensive Meta-analysis (CMA) 3.0 Version program.

Results

According to the random effect model analysis result, a negative, significant and low-level relationship was found between WS and JS, before and during COVID-19. There was a negative, significant and medium level relationship between JS and B. It was found positive, significant and high-level relationship between WS and B. Human development level (HDL) has a moderating effect on WS and B. In addition, sample size has moderating effect on WS and JS.

Conclusion

During the prolonged COVID-19 pandemic, HCWs have experienced more burnout due to strict isolation, working conditions requiring overtime, fatigue, insomnia and concerns about virus transmission. Intense work tempo, inadequate health equipment, patient deaths, and low wages are the factors that decrease JS and increase WS and B. It is recommended to improve working conditions globally and provide financial support and mental health protection for HCWs.

Prevalence of burnout and associated factors among midwives, 2023: institution-based cross-sectional study

Background

One of the main characteristics of the mental health condition known as burnout syndrome is an overwhelming feeling of physical and emotional tiredness, particularly with regard to one's work. Midwives are the group most prone to burnout because they work in emergency situations to save two lives at a time, share the stress of laboring women, and put in extra hours without enough payment. Besides this, there is little information on burnout among Ethiopian midwives.

Objectives

To assess burnout and associated factors among midwives working in public health facilities in West Arsi Zone, Ethiopia.

Methods and materials

A census method cross-sectional study was conducted among all 467 midwives working in public health facilities found in the West Arsi Zone, Ethiopia, from September 1 and 30, 2023. A pretested, validated face-to-face interviewer-administered structured questionnaire was used to collect data. Then, binary logistic regression was used for analysis. Bi-variable and multivariable logistic regression analyses were employed to identify factors associated with burnout. The level of statistical significance was declared at p < 0.05 with a 95% CI.

Results

Overall, the prevalence of burnout among midwives was 47.10% (95% CI: 42.55, 51.75%). Marital status not in union 2.03 (95% CI: 1.32-3.13), working more than 40 h per week 2.00 (95% CI: 1.29-3.08), conflict with their metron 2.33 (95% CI: 1.54-3.54), not satisfied with their current job 2.39 (95% CI: 1.56-3.66) and having depression symptoms 1.71 (95% CI: 1.06-2.74) were factors significantly associated with burnout.

Conclusion

This study found that in the study area, almost half of the midwives experienced burnout. Thus, it is recommended that midwives should develop respectful interactions with both their mentors and colleagues. Secondly, we suggest that zonal health offices set up systems that by shortening working hours and boost job satisfaction by creating conducive working environment, provide opportunities for career advancement and increase employee engagement.

Burnout during the COVID-19 pandemic among nurses in Taiwan: the parental role effect on burnout

BACKGROUND

During the COVID-19 pandemic, medical workers were concerned about the care of their children or family members and the impact of being separated from them. This increased stress could harm the relationship between nurses and patients. This study assessed how medical workers' parental role may affect burnout during such a high-stress period.

METHODS

This cross-sectional observational study was carried out in 2021 during the COVID-19 pandemic. The client burnout (CB) scale of the Copenhagen Burnout Inventory, the Nordic Musculoskeletal Questionnaire, and a demographic questionnaire were used. Statistical methods such as the t-test, one-way ANOVA, and univariable/multiple linear regression were applied.

RESULTS

A total of 612 nurses were included in this study. The likely risk factors of CB were identified and the parenthood effect was found to be associated with reduced CB. The parental role and leisure activity with family and friends on CB were found to have an impact. Engaging in leisure activity with family and playing the role of a parent diligently will help relieve nurses' burnout from frequent contact with patients and their families, thus lowering the risk of clinical burnout.

CONCLUSION

The parental role, family/friends relationships, and a complex work environment associated with nurses' burnout during the COVID-19 pandemic. This finding allows us to re-examine the importance of family life and parent-child relationships in high-stress work environments.

Fear of COVID-19 associated with burnout syndrome in dentists of the Health Directorate of the National Police of Peru: a cross-sectional study at national level under multivariable regression model

BACKGROUND

During the pandemic, many police dentists had the crucial responsibility of ensuring law and order while providing dental care by taking government-approved health measures to stop the spread of the coronavirus. The aim of this study was to assess the association between the fear of COVID-19 and Burnout syndrome in Peruvian dentists belonging to the Health Department of the National Police of Peru (PNP), taking into account possible confounding variables.

METHODS

This cross-sectional and analytical study included 182 PNP dentists. The Fear COVID-19 Scale assessed fear of COVID-19 and the Maslach Burnout Inventory Test assessed burnout syndrome. The association between the fear of COVID-19 and Burnout syndrome (self-fulfilment) was analyzed using Spearman's Rho. A multivariable Poisson regression model with a robust variance estimation method was employed to evaluate the impact of fear of COVID-19 on the various dimensions of Burnout syndrome, considering possible confounding variables. The statistical significance level was set at p < 0.05.

RESULTS

Under bivariate analysis, fear of COVID-19 was significantly linked with low direct intensity toward emotional exhaustion (Rho = 0.325, p < 0.001), very low direct intensity toward depersonalization (Rho = 0.180, p = 0.015), and very low inverse intensity toward self-fulfilment (Rho =-0.186, p = 0.012). Under multivariable analysis, it was observed that dentists who exhibited fear of COVID-19 were 3.4 and 3.7 times more likely to experience emotional exhaustion and depersonalization, respectively (APR = 3.40, 95% CI: 1.74-6.63 and APR = 3.68, 95% CI: 1.31-10.37), as compared to those who did not display fear of COVID-19. Moreover, none of the potential confounding factors were found to have a significant impact on emotional exhaustion (p > 0.05), depersonalization (p > 0.05), and self-fulfilment (p > 0.05).

CONCLUSION

Fear of COVID-19 was significantly associated with emotional exhaustion and depersonalization, and inversely associated with self-fulfilment. PNP dentists who exhibited fear of COVID-19 were at greater risk for emotional exhaustion and depersonalization. In developing Burnout syndrome, no significant impact was observed from factors such as age, gender, marital status, children, hierarchy, years of service, work area, private practice, work over 40 h per week, type of service, work performed, sport practice and daily exercise time.

The Gartland classification for expediting supracondylar humerus fracture triage: a collaborative approach to structured reporting between pediatric radiologists and orthopedists

BACKGROUND

The modified Gartland classification is an important tool for evaluation of pediatric supracondylar humerus fractures (SCHF) because it can direct treatment decisions. Gartland type I can be managed outpatient, while emergent surgical consult occurs with type II and III. This study assesses the interobserver reliability of the Gartland classification between pediatric radiologists and orthopedic providers.

METHODS

A retrospective review of 320 children diagnosed with a SCHF at a single tertiary children's hospital during 2022 was conducted. The Gartland classification documented in the radiographic report by a pediatric radiologist and the classification documented in the first encounter with an orthopedic provider was collected. Kappa value was used to assess interobserver reliability of classifications between radiologists and orthopedic providers. A second group of 76 Gartland type I SCHF from 2015, prior to our institution's implementation of structured reporting, was reviewed for comparison of unnecessary orthopedic consults at initial presentation.

RESULTS

The Gartland classification has excellent interobserver reliability between radiologists and orthopedic providers with 90 % (289/320) agreement and kappa of 0.854 (confidence interval: 0.805-0.903). The most frequent disagreement that occurred was fractures classified as type II by radiology and type III by orthopedics. There were similar rates of consults for the 2015 and 2022 cohorts (p = 0.26).

CONCLUSION

The Gartland classification system is a reliable and effective tool for communication between radiologists and orthopedic providers. Implementing a structured reporting system has the potential to improve triage efficiency for SCHF.

Exposure to Stress and Burnout Syndrome in Healthcare Workers, Expert Workers, Professional Associates, and Associates in Social Service Institutions

Background and Objectives: Workplace burnout syndrome is often as sociated with particular aspects of certain job positions, especially those that entail working with people with special needs. The burnout syndrome in healthcare jobs is a serious problem that has grown into an epidemic among healthcare workers and associates. The aim of this research is to assess the presence of stress and burnout syndrome at work with healthcare workers, expert workers, professional associates, and associates in social service institutions in Belgrade. Materials and Methods: This research was conducted in the form of a cross-sectional study of a representative sample in social institutions in Belgrade. It was conducted from March to the end of June of 2023. The sample of the study had 491 participants. The questionnaires used were a structured instrument with social-demographic and social-economic characteristics, workplace characteristics, lifestyle characteristics, and the following questionnaires: DASS-21, Copenhagen, Brief Resilience Scale, and Brief Resilient Coping Scale. Results: The end results indicate the following to be significant risk factors for the occurrence of workplace burnout syndrome: overtime (OR = 2.62; CI = 1.50-4.56), BRS average score (OR = 0.28; CI = 0.17-0.44), DASS21 D heightened depression (OR = 2.09; CI = 1.1-4.04), DASS21 A heightened anxiety (OR = 2.38; CI = 1.34-4.21), and DASS21 S heightened stress (OR = 2.08; CI = 1.11-3.89). The only protective risk factor that stood out was the self-assessment of health levels (OR = 0.60; CI = 0.42-0.85). Conclusion: Overtime is a significant factor associated with workplace burnout. Apart from it, other significant factors associated with workplace burnout were heightened depression, anxiety, and stress levels.

Prevalence and associated factors of burnout among working adults in Southeast Asia: results from a public health assessment

The COVID-19 pandemic has spotlighted the mental health crisis among employees worldwide. However, burnout research is often industry- or occupation-specific, and limited knowledge currently exists on the prevalence of burnout in the general working population of Southeast Asia. This study aims to examine the prevalence of employee burnout and its associated factors among working adults in Southeast Asia using secondary data. 4,338 full-time employees aged 18-65 years old living in Malaysia, Singapore, Philippines, and Indonesia were assessed for burnout, depression, anxiety, stress, and sociodemographic characteristics as part of an online public health assessment in October 2022. The prevalence of burnout in the region was 62.91%. Burnout was highest among employees in the Philippines (70.71%) and lowest in Malaysia (58.13%). Experiencing burnout was associated with severe or extremely severe depression (AOR = 6.48 [95% CI = 5.06-8.33]), anxiety (AOR = 2.22 [1.74-2.85]), and stress (AOR = 5.51 [4.13-7.39]). Working more than 50 hours a week (AOR = 1.38 [1.04-1.82]) and being very dissatisfied with the job led to higher odds of burnout (AOR = 16.46 [8.99-30.53]). Alarmingly, more than half of working adults in the region are reporting increased levels of burnout, and improving employee mental health and work conditions may be key to improving employee burnout in the region. Findings contribute to existing research on burnout prevalence in the region and provide more comprehensive insights into understanding the factors driving employee burnout in the working population of Southeast Asia 2 years after the onset of the pandemic.

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.

Having Children and Being Married Are Predictors of Burnout and Obesity Among Working Men: Effects of Latent Profile Analysis

Emergency call-takers and dispatchers' (ECDs) work makes them vulnerable to occupational burnout and health problems. The aim of this research was to apply a Person-Oriented approach in order to examine the relationships between burnout risk factors (having children), personal resources (being married), and health consequences (overweight and obesity) among men working in these positions. The burnout syndrome was assessed among 228 Polish ECDs using The Link Burnout Questionnaire and the method of latent profile analysis (LPA). All ECDs were characterized by high levels of occupational burnout exhibited in 3 out of its 4 dimensions. The LPA allowed us to differentiate 4 patterns of burnout, taking into account socio-demographic variables, the length of employment as ECD and body weight. The need to balance the demands of professional work with having children and marital roles played an important role in predicting the level of professional burnout. There was a relationship between the dimensions of occupational burnout and age, being married, and having children. Being married was associated with a greater intensity of emotional exhaustion, and the level of exhaustion was higher if the employee had children in their care. Health consequences in the form of overweight and obesity can be associated with levels of emotional exhaustion and professional effectiveness. The application of the Person-Oriented approach presents hidden correlations between burnout predictors and health consequences.

Work-related burnout and its associated factors among midwives working at public hospitals in northwest Ethiopia: a multi-centered study

Introduction

Work-related burnout (WRB) is defined as the degree of physical and psychological fatigue and exhaustion that is perceived by the person as related to work. Midwives are vulnerable to work-related burnout due to their physically and emotionally demanding nature of their job. It affects the health of professionals and the quality of care provided. However, there is limited evidence on the burden and predictors associated with work-related burnout among midwives in developing countries, including Ethiopia. This study investigated the burden and contributing factors of work-related burnout among midwives in northwest Ethiopia.

Methods

A facility-based cross-sectional study was conducted from February 7 to April 30, 2022. A simple random sampling method was used to enroll 640 study participants. The Copenhagen burnout inventory tool was used to assess the magnitude of work-related burnout. A self-administered questionnaire was used to collect data, which was then entered into Epi Data 4.6 software and exported to SPSS version 25 for analysis. A multivariable logistic regression analysis model was fitted to identify factors associated with work-related burnout. The Adjusted Odds Ratio (AOR) with 95% confidence interval (CI) was reported to declare the factors that are significantly associated with work-related burnout.

Results

The prevalence of work-related burnout was found to be 60.47% (95% CI = 56.6-64.2). Workplace violence (AOR = 3.33, CI: 2.02, 5.48), working hours over 60 h a week (AOR = 4.55, CI: 2.78, 7.43), emotional demand of the job (AOR = 8.85, 95% CI: 4.48, 17.47), exposure to blood and body fluids/sharp injuries (AOR = 5.13, CI: 3.12, 7.13), good superior support (AOR = 0.38, CI: 0.23, 0.63), Job rotation of ≤6 months (AOR = 2.30, CI: 1.28, 4.14) and being stressed (AOR = 2.64, CI: 1.63, 4.26) were all found to be strongly linked to work-related burnout.

Conclusion and recommendation

This study found a significant level of work-related burnout among midwives working in public hospitals. Experiencing workplace violence, a job rotation of less than or equals to six months, working hours over 60 h a week, good superior support, exposure to blood and body fluids or needle stick injuries and experiencing stress were significant factors that influenced work-related burnout. Therefore, reducing prolonged working hours, promoting supportive management, creating a safe working environment, and applying effective stress prevention strategies are some of the interventions to prevent or alleviate work-related burnout.

Antecedents and components of burnout among Hungarian teachers in a cross-sectional study: Development of the Burnout Antecedents and Components Questionnaire

BACKGROUND

Studies have focused more on the outcome than on the antecedents of burnout. We aimed to develop a new measurement tool for burnout, including the antecedents and different components drawing from theories of the developmental aspect of burnout.

METHODS

In this cross-sectional study we tested the Burnout Antecedents and Components Questionnaire on a convenience sample of teachers (n = 618, 83.9 % women; mean age 44.52 years). We used confirmatory factor analyses to test our measurement model. We examined the concurrent validity with the Maslach Burnout Inventory. We also tested construct validity with depression, overcommitment, demographic characteristics and work-related factors.

RESULTS

The confirmatory factor analyses supported our measurement model with seven primary factors (need to prove oneself, overload of tasks, neglecting one's needs, conflict between values, interpersonal conflicts, passivity, and emotional drain) and three second-order factors (excessive effort, conflict, and total depletion). The covariates in the Maslach Burnout Inventory showed that emotional exhaustion had a strong relationship with the first- and second-order factors. Overcommitment showed a stronger relationship with factors at the beginning whereas depression showed a stronger relationship with factors at the end of the process. Demographic characteristics and work-related factors did not show strong associations.

CONCLUSIONS

The Burnout Antecedents and Components Questionnaire is a promising measurement tool with good convergent validity. Future research should further validate our questionnaire for burnout research, prevention, and screening. It adds a new dimension to the measurement of burnout. The approach involving the antecedents in measuring burnout among teachers can guide future research and tailored prevention programs.

Adverse Childhood Experiences and Burnout in Athletic Trainers: An Exploratory Study

CONTEXT

Burnout, a state of physical or emotional exhaustion, is a concern within athletic training, as between 17% and 40% of athletic trainers (ATs) report high levels of burnout. Adverse childhood experiences (ACEs) are linked with higher levels of burnout in other health professions.

OBJECTIVE

To compare burnout with ACEs in ATs.

DESIGN

Cross-sectional study.

SETTING

Web-based survey.

PATIENTS OR OTHER PARTICIPANTS

One thousand ATs were selected at random to participate in the study. Of these, 78 ATs started the survey, and 75 ATs completed it.

MAIN OUTCOME MEASURE(S)

Burnout, as measured by the Copenhagen Burnout Inventory (CBI) overall and subscale scores, was compared across groups based on the number of adverse experiences as measured by the ACEs survey. Multiple analysis of variance tests were used to determine the association between ACEs score and overall, personal, work-related, and patient-related burnout.

RESULTS

At least 1 adverse experience was reported by 37 (49.33%) participants. Those with ≥4 ACEs had higher odds of describing overall, personal, and work-related burnout than those with 0 to 3 ACEs. Moderate burnout (CBI score ≥ 50.00) was noted in 27 (36.00%, overall), 44 (58.67%, personal), 34 (45.3%, work related), and 15 (20.00%, patient related) ATs. Participants with 4 ACEs had higher overall burnout (67.11 ± 19.89; F6,68 = 2.59, P = .03) than those with 0 (40.53 ± 17.12, P = .04), 1 (38.42 ± 20.99, P = .04), or 7 (19.08 ± 12.09, P = .03) ACEs. The same pattern existed with personal burnout, as participants with 4 ACEs (76.67 ± 17.33) had higher scores (F6,68 = 3.40, P = .00) than those with 0 (46.60 ± 17.49, P = .02), 1 (42.78 ± 21.48, P = .01), or 7 (27.08 ± 20.62, P = .03) ACEs. No other differences were observed.

CONCLUSIONS

Between 20.00% and 58.67% of ATs surveyed reported some form of burnout. Higher levels of overall and personal burnout were found in those with 4 ACEs. Although we expected to see lower levels of burnout in those with fewer ACEs, it was surprising that those with 7 ACEs had some of the lowest CBI scores. Athletic trainers with childhood trauma may find it beneficial to engage in self-regulation exercises to reduce or limit triggers and burnout. Additionally, employers should explore developing trauma-informed workplaces to better support employees.

Missed nursing care: A cross-sectional and multi-centric study from Turkey

AIM

The aim of this study is to explore the extent of missed nursing care in Turkey and identify its predictors.

DESIGN

This was a descriptive, cross-sectional, multicentre study.

METHODS

A total of 477 nurses working in seven public hospitals participated in this study from March to July 2019. The survey included two components: a personal and professional characteristics data form and the MISSCARE survey.

RESULTS

The study revealed that emotional support, patient bathing and ambulation were the most frequently missed nursing care activities. An inadequate number of assistive personnel and staff, along with an unexpected increase in patient volume, were identified as the primary reasons for missed nursing care. Of the 21 missed nursing care activities, nine predictive models showed statistical significance (p < 0.05). Factors such as the type of unit, years of work experience, working hours, number of patients cared for in a shift and intention to leave the unit were found to be significant predictors of seven missed nursing care activities (p < 0.05).

CONCLUSION

This study found that numerous variables influence each care activity, which suggests the need to devise more targeted and specific strategies to minimize missed nursing care. Thorough investigation into the impact of these strategies on each care activity is essential.

Why is Turkey losing its doctors? A cross-sectional study on the primary complaints of Turkish doctors

In 2022, Turkey encountered the formidable task of addressing an unprecedented loss of medical doctors and seeking remedies for potential issues within the healthcare system. This study set out to explore the inclination of 402 actively practicing Turkish doctors to depart from Turkey, assess the socio-demographic and socio-economic factors influencing this trend, and establish the hierarchy of raised concerns among doctors. Employing a cross-sectional and analytical approach, the study drew comparisons between doctors' demographic characteristics and the significance of their grievances, while also examining the correlation between the importance of complaints and the desire to remain in Turkey. The doctors' primary complaints encompassed financial challenges, instances of violence in the healthcare sector, and insufficient examination durations. The migration of doctors poses a substantial risk to healthcare accessibility, public health, and the sustainability of Turkey's healthcare delivery capacity. To mitigate this risk and curb doctor migration, corrective measures must be implemented to improve working conditions. Additionally, there is a need for further scientific research focusing on doctors' concerns, particularly in developing countries like Turkey, to expand the current body of literature on this subject.

The association between experience of COVID-19-related discrimination and psychological distress among healthcare workers for six national medical research centers in Japan

BACKGROUND

Discrimination is an important determinant of negative mental health outcomes. This study determined the association between the experience of COVID-19-related discrimination and psychological distress among healthcare workers (HCWs) in Japan.

METHODS

This cross-sectional study conducted a health survey among 5703 HCWs of six national medical and research centers in Japan from October 2020 to March 2021. COVID-19-related discrimination was defined either when participants or their family members were badmouthed or when they felt discriminated against in some way. We used the Kessler Psychological Distress Scale (K6) to assess the presence of severe psychological distress (≥ 13 points). We used logistic regression models to examine the association between discrimination and psychological distress. We also identified factors associated with discrimination.

RESULTS

Of the participants, 484 (8.4%) reported COVID-19-related discrimination and 486 (8.5%) had severe psychological distress. HCWs who were female vs. male (adjusted odds ratio [AOR] = 1.41, 95% confidence interval [CI] = 1.28-1.55), had high vs. low viral exposure (AOR = 2.31, 95% CI = 1.81-2.93), and worked for 11 or more hours/day vs. 8 or less hours/day (AOR = 1.42, 95% CI = 1.35-1.49) were more likely to have experienced COVID-19-related discrimination. The AOR (95% CI) of severe psychological distress was 1.83 (1.29-2.59) among those who experienced discrimination. In the stratified analysis by sociodemographic and job-related factors, all the interactions did not reach statistical significance (p for interaction > 0.20).

CONCLUSION

Experience of COVID-19-related discrimination was associated with severe psychological distress among HCWs. During the pandemic, effective measures should be taken to prevent the development of negative mental health outcomes in HCWs who experience discrimination.

Healthcare policy changes in an era of health workforce shortage

In their recent IJHPR article, Wimpfheimer and colleagues outline the implications for the field of anesthesia of two major healthcare policy changes in Israel: The Yatziv Reform in licensing foreign medical graduates and the efforts to reduce residents' on-call shift duration. We argue that these reforms are necessary to strengthen the healthcare workforce and improve the quality of care in the long term, even though they may limit the availability of healthcare personnel for several years, particularly in the field of anesthesia. In this commentary, we examine the background to these policy changes, their likely impact on the medical workforce in Israel in general, and propose steps to reconcile these reforms with the global and national shortage of physicians. We urge policymakers to allocate the required resources and begin preparing for an era of continuous mismatch between physician supply and demand, which will necessitate creative solutions, increased reliance on technology, and the introduction of paramedical professionals to help offload tasks and better utilize the scarce physician workforce.

A narrative review of the physiology and health effects of burnout associated with veterinarian-pertinent occupational stressors

Chronic workplace stress and burnout are serious problems in veterinary medicine. Although not classified as a medical condition, burnout can affect sleep patterns and contributes to chronic low grade systemic inflammation, autonomic imbalance, hormonal imbalances and immunodeficiencies, thereby increasing the risks of physical and psychological ill health in affected individuals. Cultural misconceptions in the profession often lead to perceptions of burnout as a personal failure, ideas that healthcare professionals are somehow at lower risk for suffering, and beliefs that affected individuals can or should somehow heal themselves. However, these concepts are antiquated, harmful and incorrect, preventing the design of appropriate solutions for this serious and growing challenge to the veterinary profession. Veterinarians must first correctly identify the nature of the problem and understand its causes and impacts before rational solutions can be implemented. In this first part of two companion reviews, burnout will be defined, pathophysiology discussed, and healthcare and veterinary-relevant occupational stressors that lead to burnout identified.

Relationship between burnout levels of nurses and their circadian preference, sleep quality, and personality traits

Occupational stress and burnout are widely encountered among many healthcare professionals, including nurses and doctors, as well as among members of other professions. For example, nurses, who have disrupted circadian rhythms, are seen to have sleep problems. In addition, their personality traits are also considered to be related with burnout. This study aimed to identify nurses' circadian preference and personality traits along with their effects on sleep quality and their relationship with burnout. In this study, 211 nurses (40 male, 171 female) using the correlational model from quantitative research methods was used since the variables of morningness/eveningness, personality trait, sleep quality, and burnout were aimed to be investigated at once, without intervention, within the predictivity context of the relationship among them. When the scores obtained from the burnout scale were examined, it was observed that the emotional exhaustion and personal accomplishment subdimensions were so close to the median value and mean, while depersonalization was quite low compared to these sub-dimensions. The participants' sleep quality was seen to be at the lowest step of the poor sleep quality class. When the scores obtained from the MESSI scale are examined, it is seen that the scores obtained from the morning affect dimension are above the median value, and the highest average according to the Five-Factor Personality Traits Scale is obtained in the subdimensions of agreeableness and conscientiousness. Female gender, constantly work at night, having a high number of weekly working hours increased burnout level. Additionally Evening chronotype, poor sleep quality, neuroticism, agreeableness, extroversion and conscientiousness personality traits were found to be associated with burnout in this study. In the study, being of different chronotypes, having other personality traits, and varying sleep quality scores were seen to affect the sub-dimensions of burnout.

[Physician working hours and effects on health, satisfaction and healthcare]

Changes in the working environment with respect to innovative working time models are also increasingly affecting patient care. The number of physicians working part-time, for example, is continuously rising. At the same time, a general increase in chronic diseases and multimorbid conditions as well as the growing shortage of medical staff, leads to more workload and dissatisfaction among this profession. This short overview summarizes the current study situation and associated consequences regarding working hours of physicians and gives a first explorative overview of possible solutions.

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.

Work-Related Burnout, Compassion Fatigue, and Nurse Intention to Leave the Profession During COVID-19

The purpose of this mixed-method study was to understand the relationships between work-related burnout (WRB), compassion fatigue (CF), and intention to leave the nursing profession. The Job Demands-Resources model was used to predict intention to leave as a function of WRB, CF, and caring for COVID-19 patients in a sample of 1299 US nurses. Greater WRB and CF scores were associated with intention to leave the profession. Contrary to prior research, working with COVID-19 patients was associated with greater intention to stay in nursing. Personal finances may represent the rationale for nurses to choose to stay nurses despite burnout.

Physician burnout levels and associated factors in The Covid-19 pandemic

Introduction: Burnout, characterized by emotional exhaustion, depersonalization, and low personal accomplishment, is frequently observed in physicians. Aim: The purpose of this study was to determine burnout levels and associated factors in physicians during the pandemic. Material and Method: This cross-sectional study was performed online with 288 physicians from various fields in Erzurum. Sociodemographic questions and the Maslach Burnout Inventory represented the data collection tools. The data were collected online in May and June 2021. Statistical analysis: Descriptive statistics, Student's t and ANOVA tests And Multiple ordinal logistic regression analysis were used. p values <0.05 were regarded as significant. Analysis was performed on SPSS 22. Results: Physicians' mean emotional exhaustion, depersonalization, and personal accomplishment component scores were 20.1±8.3, 6.7±4.5, and 21.1±4.5, respectively. Analysis showed that 49.7% of physicians exhibited moderate-high emotional exhaustion, 35.8% high-moderate depersonalization, and 69.8% signs of low personal accomplishment. Job title, regret concerning selecting the medical profession, satisfaction with the working environment, number of additional monthly out-of-hours shifts worked, regular sporting activity, and assessment of the physical conditions in the working environment emerged as factors affecting burnout components at regression analysis. Conclusion: The participants' burnout levels were high. The planning of effective interventions addressing individual and work-related factors with a holistic approach is essential to halt this rapidly growing epidemic.

"Out of office": Availability norms and feeling burned out during the COVID-19 pandemic: The mediating role of autonomy and telepressure

Introduction

Digital innovations make it possible to work anywhere and anytime using any kind of device. Given these evolutions, availability norms are emerging at work. These norms specifically refer to the experienced beliefs or expectations from colleagues or superiors to be available for work-related communication after regular work hours. We rely on the Job-Demands Resources Model as we aim to investigate the relationship between these availability norms and burnout symptoms during the COVID-19 pandemic. We first of all study to what extent availability norms are associated with heightened burnout symptoms. Secondly, we study how both a personal demand, namely telepressure, and a job resource, namely autonomy, could offer distinct and relevant explanations for the role these availability norms play in experiencing burnout symptoms.

Method

We collected data through a survey study with 229 employees from various organizations in the second half of 2020.

Results

The findings indicated that indeed availability norms are significantly associated with more burnout symptoms and that both heightened telepressure and reduced autonomy mediated this relationship.

Discussion

This study contributes to theory and practice as we offer insight into how availability norms at work could be detrimental for the occupational health of employees, which can be taken into account when setting up rules and regulations at work.

Prevalence and correlates of burnout among Lebanese health care workers during the COVID-19 pandemic: a national cross-sectional survey

BACKGROUND

The COVID-19 pandemic has harshly burdened the healthcare systems. Health care workers (HCWs) are at substantial risk of infection and confronted several stressors as well leading them to experience burnout. This study aimed to assess the prevalence of burnout among Lebanese health HCWs and to identify its associated factors.

METHODS

A cross-sectional online survey was conducted between the first of November and the end of December 2020 among Lebanese HCWs working in all active hospitals operating across the country. Data were collected using an Arabic, anonymous, self-reported questionnaire comprising four sections: (a) basic sociodemographic characteristics, (b) exposure to COVID-19 covariates, (c) occupational factors, and (d) the measurements including the Copenhagen Burnout Inventory (CBI). CBI subscale cut-off score of 50 was used to assess the prevalence of burnout among HCWs. Multinomial logistic regression analyses were performed to examine the factors associated with the different aspects of burnout.

RESULTS

Out of the 1751 respondents, personal burnout (PB) was detected in its moderate and high-level aspects among 86.3% of Lebanese HCWs. Moderate and high levels of work-related burnout (WB), and client-related burnout (CB) hit 79.2% and 83.3% of HCWs, respectively. HCWs who were females, married, physicians, having a poor health status and specific living conditions (dependent child, elderly at home, family member with comorbidities, and a low income) were more likely to exhibit a high level of PB compared to no/low burnout level. Moreover, frontline HCWs, those infected by COVID-19 or those having a colleague infected by COVID-19, and those exhibiting a high perception of threat were more prone to experience a high-level PB rather than a low/no burnout. Working in a public hospital, extensive working hours, and insufficient sleeping hours were also found positively associated with high PB. However, older age and altruism were negatively associated with high PB compared to no/low PB among HCWs. As for WB, similar factors were found either positively or negatively associated with a high level of WB except health status and living conditions factors (dependent child or family member). As for CB, older age of HCWs (> 30 years) and altruism were negatively associated with high CB compared to no/low burnout level. However, working in the frontline, high threat perception, extensive working hours, insufficient sleeping hours, and low income were positively associated with high CB among HCWs compared to no/low burnout.

CONCLUSION

The prevalence of burnout among Lebanese HCWs during the pandemic was significant and alarming. Enacting and implementing preventive policies and effective interventions are urgently needed to cultivate wellness among HCWs.

Relationship between COVID-19-specific occupational stressors and mental distress in frontline and non-frontline staff

This study investigated the difference in the severity of mental distress and factors contributing to mental distress in frontline and non-frontline healthcare professionals during the coronavirus disease (COVID-19) pandemic. A cross-sectional web-based survey of medical staff collected by snow-ball sampling was performed in Japan in October 2020 using the Kessler Psychological Distress Scale (K6) as an outcome measure for mental distress. Originally developed items asking about the degree of change in psychological and physical burdens, COVID-19-related fear, and experience of discrimination were obtained. The median score of the K6 was 7 in the frontline staff group (n = 86) and 6 in the non-frontline staff group (n = 504), without a statistically significant difference. Multiple regression analyses showed that among the participants, an increase in psychological burden and COVID-19-related fear was significantly associated with mental distress in both groups. Experience of discrimination was significantly associated with mental distress only in the frontline staff group. However, an increase in physical burden was significantly associated with mental distress only in the non-frontline staff group. The results indicate that the factors contributing to mental distress between frontline and non-frontline staff can be different, although the severity of mental distress is comparable between them.

Occupational Burnout Symptoms and Its Relationship With Workload and Fear of the SARS-CoV-2 Pandemic Among Hospital Nurses

Introduction

The pandemic has intensified physical and psychological work demands experienced by nurses in a hospital environment. The purpose of this study was to examine personal and work environmental risk factors associated with occupational burnout among hospital nurses.

Methods

We conducted a cross-sectional from April to November 2020. Data from 831 nurses who worked professionally in four educational hospitals were compiled through survey questionnaires to report the prevalence of burnout, occupational and individual factors. Independent t-test and Mann–Whitney test measured the link between the scopes of occupational burnout and risk factors.

Results

About half of the participants indicated moderate symptoms of burnout. The fear of the nurses correlated significantly with emotional exhaustion (r = 0.71, p = 0.001), depersonalization (r = 0.67, p = 0.02), and personal accomplishment (r = 0.63, p = 0.05). Mental demand (r = 0.74, p = 0.01) and effort at work (r = 0.68, 0.001) correlated significantly with emotional exhaustion (r = 0.51, p = 0.03).

Conclusion

The findings indicated a high prevalence of burnout symptoms, particularly emotional exhaustion, among hospital nursing professionals. Occupational health services should consider burnout as an occupational-related condition and provide interventions to reduce workplace chronic stressors and burnout in hospitals.

Association of 5-item Brief Symptom Rating Scale scores and health status ratings with burnout among healthcare workers

This cross-sectional study evaluated and quantified the possible association of psychological symptoms and health status ratings on the burnout of healthcare workers from a tertiary medical center. Demographic data were obtained through a questionnaire survey. We evaluated their psychological symptoms using a 5-item Brief Symptom Rating Scale (BSRS-5) and burnout was measured using the Chinese version of the Maslach Burnout Inventory–Health Services Survey. The study began in Nov. 2018 and ended in Nov. 2020. A total of 2813 participants (men = 296, 10.5%; women = 2517, 89.5%) completed the questionnaires between December 2018 and March 2019. The response rate and complete rate were 71.7% and 93.2%. The multivariate analysis showed that, as the BSRS-5 level added, the odds ratio (OR) of burnout increased (BSRS-5 scores 6–9, 10–14, and 15–20; OR = 1.83, 3.23, and 9.15, separately; p value < 0.05). Overall, men (≥ 30 years of age) and women staffs with BSRS-5 scores ≥ 6; women with longer working hours (more than 46 h/week), men and women (≥ 30 years of age) working night shifts, and poor health status ratings were highly associated with burnout. The findings highlight the importance of screening for the BSRS-5 scores and health status ratings level for healthcare professionals at high risk of burnout, especially men ≥ 30 years of age and women with stressful working conditions.

Gender Differences in Burnout Among Endocrinologists in China

Objective

To survey the prevalence of burnout in a national sample of endocrinologists in China and to examine its correlates, with a special focus on gender differences.

Methods

An anonymous online survey was conducted among endocrinologists in 31 provincial government-owned “People’s Hospitals” of each province in mainland China. Demographic and work-related factors were collected from participants. The Maslach Burnout Inventory-Human Services Survey (MBI-HSS) was used to assess burnout, including emotional exhaustion (EE), depersonalization (DP), and reduced personal accomplishment (PA).

Results

A total of 711 endocrinologists (72.1% were female and mean age was 39.63 ± 8.51 years old) completed the survey. Burnout was reported by 32.8% of the participants. There were no significant gender differences in the overall prevalence of burnout or EE, DP, and PA (all p > 0.05). A multi-level linear regression revealed: (1) In male participants, PA was significantly associated with age (β = 0.03, p = 0.003), DP was inversely associated with age (β = −0.06, p = 0.005), EE was significantly associated with shorter sleep duration (β = −0.25, p = 0.006), and longer work hours (β = 0.01, p = 0.016). (2) In females, PA was significantly associated with age (β = 0.01, p = 0.038), EE and DP were both significantly associated with shorter sleep duration (β = −0.19, p = 0.001; and β = −0.15, p = 0.011, respectively). EE and DP were also associated with work hours (β = 0.02, p < 0.001; and β = 0.01, p < 0.001, respectively).

Conclusion

Nearly one-third of endocrinologists in China experienced burnout. Although there were no significant gender differences in the prevalence of overall burnout or EE, DP, and PA scores, male and female participants differed in factors associated with EE, DP, and PA. Interventions need to be tailored to target different aspects in male and female endocrinologists and target different subgroups.

A qualitative investigation of resilience and well-being among medical physics residents

Purpose

Medical physics residents (MPRs) will define and shape the future of physics in medicine. We sought to better understand the residency experience, as related to resilience and well‐being, through the lens of current MPRs and medical physicists (MPs) working with residents.

Methods and materials

From February–May 2019, we conducted 32, 1‐h, confidential, semi‐structured interviews with MPs either currently enrolled in an accredited residency (n = 16) or currently employed by a department with an accredited residency (n = 16). Interviews centered on the topics of mentorship, work/life integration, and discrimination. Qualitative analysis methods were used to derive key themes from the interview transcripts.

Results

With regard to the medical physics residency experience, four key themes emerged during qualitative analysis: the demanding nature of medical physics residencies, the negative impacts of residency on MPRs during training and beyond, strategies MPRs use to cope with residency stress, and the role of professional societies in addressing residency‐related change.

Conclusions

Residency training is a stress‐inducing time in the path to becoming a board‐certified MP. By uncovering several sources of this stress, we have identified opportunities to support the resiliency and well‐being of MPs in training through recommendations by professional societies, programmatic changes, and interventions at the department and residency program director level for residency programs, as well as strategies that MPRs themselves can use to support well‐being on their career journey.

Profiles of Burnout, Job Demands and Personal Resources among Emergency Call-Takers and Dispatchers

According to scientific research, emergency call-takers and dispatchers are particularly vulnerable to burnout syndrome. There are no data describing specific burnout patterns or allowing for the definition of subgroups of workers who are particularly at risk. The aim of this research was to apply a person-oriented approach to characterize burnout profiles using job-related variables and personal resources. A cross-sectional survey study was conducted on 553 call-takers and dispatchers aged between 19 and 65, from 14 public safety answering points in Poland. The Link Burnout Questionnaire, the 10-item Perceived Stress Scale, the Generalized Self-Efficacy Scale, and an independent questionnaire were used to gather information. K-means cluster analysis was used, which allowed us to highlight three distinct burnout risk profiles: high risk of burnout, without full-blown pattern of burnout with high inefficacy, and no risk of burnout with an increased sense of disappointment. Several variables which coexisted with occupational burnout included work experience, weekly working hours, intensity of perceived stress, and self-efficacy level. The application of a person-oriented approach made it possible to identify groups of call takers characterized by a high risk of burnout syndrome, and to indicate the areas in which preventive measures, focused on each of their specific needs, should be taken.

The Nurse Leader's Role in Nurse Substance Use, Mental Health, and Suicide in a Peripandemic World

Nurses are known to be at an increased risk of death by suicide, and recent studies have found links between nurse suicide, substance use, mental health issues, and job problems. Because of stigma, inaccessibility of resources, and regulatory and legal issues, nurses are unlikely to seek help unless a crisis forces them into treatment. The purpose of this article is to review the current understanding of nurse suicide, the psychological impact of the novel coronavirus (COVID-19) pandemic, the strategic planning approach to identify the needs of nurses, and promising interventions and practices. Evidence-based strategies to intervene at the personal, institutional, and regulatory levels should be employed to reduce nurse suicide by focusing not only on suicide but also on treatment of substance and mental health issues, as well as a renewed focus on disciplinary procedures that may place nurses in immediate danger of death by suicide. Nurse leaders have a moral obligation to provide proactive, meaningful interventions to reduce the risk of death by suicide among nurses.