1
|
Delgado-Corcoran C, Wawrzynski SE, Mansfield K, Fuchs E, Yeates C, Flaherty BF, Harousseau M, Cook L, Epps JV. Grieving Children' Death in an Intensive Care Unit: Implementation of a Standardized Process. J Palliat Med 2024; 27:236-240. [PMID: 37878371 PMCID: PMC10825263 DOI: 10.1089/jpm.2023.0134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2023] [Indexed: 10/26/2023] Open
Abstract
Background: The grief that accompanies witnessing the death of a child puts health care professionals at risk of secondary trauma, burnout, and turnover when left unaddressed. Objective: Support staff well-being and promote resiliency. Methods: Descriptive implementation of a structured, peer-to-peer bereavement support program for intensive care unit (ICU) staff at a tertiary children's hospital. Results: Thirty-five virtual sessions were held over the period of one year.Through these sessions, participants shared perspectives and normalized reactions, and explored potential coping strategies. Post-session feedback surveys demonstrated the negative impact of a death on the personal or work life of ICU staff. Additionally, nearly all reported some level of burnout. Conclusions: The sessions were feasible and positively impacted staff coping and well-being. Barriers and facilitators to session attendance, as well as suggestions for improvement, were also explored. Implications for practice and future research are discussed. No clinical trial registration is applicable.
Collapse
Affiliation(s)
- Claudia Delgado-Corcoran
- Division of Critical Care, Department of Pediatrics, University of Utah, Salt Lake City, Utah, USA
- Division of Pediatric Palliative Care, Department of Pediatrics, University of Utah, Salt Lake City, Utah, USA
| | - Sarah E. Wawrzynski
- Center for HealthCare Delivery Science, Nemours Children's Hospital, Wilmington, Delaware, USA
| | - Kelly Mansfield
- College of Nursing, Division of Acute and Chronic Care, University of Utah, Salt Lake City, Utah, USA
| | - Erin Fuchs
- Division of Critical Care, Department of Pediatrics, University of Utah, Salt Lake City, Utah, USA
| | - Chelsea Yeates
- Division of Critical Care, Department of Pediatrics, University of Utah, Salt Lake City, Utah, USA
| | - Brian F. Flaherty
- Division of Critical Care, Department of Pediatrics, University of Utah, Salt Lake City, Utah, USA
| | - Mark Harousseau
- Division of Pediatric Palliative Care, Department of Pediatrics, University of Utah, Salt Lake City, Utah, USA
| | - Lawrence Cook
- Division of Critical Care, Department of Pediatrics, University of Utah, Salt Lake City, Utah, USA
| | - Jake Van Epps
- Department of Educational Psychology, University of Utah, Salt Lake City, Utah, USA
| |
Collapse
|
2
|
Ranasinghe PD, Zhou A. Women physicians and the COVID-19 pandemic: gender-based impacts and potential interventions. Ann Med 2023; 55:319-324. [PMID: 36594806 PMCID: PMC9815224 DOI: 10.1080/07853890.2022.2164046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Aim: These are extraordinary times caused by the first global pandemic in our modern era. Physicians and other frontline healthcare providers face unique challenges, for which they have had little formal preparation. This combination of challenge and deficit leads to significant negative impacts, not only on what medical practices and health care systems can deliver to the public, but also on the individual healthcare providers themselves.Methods: In this essay, we specifically address women physicians, and explore the considerable impact they bear from the COVID-19 pandemic, particularly in the contexts of response to stress, social isolation, work-life integration, and autonomy. Because the language we use is important, we think it necessary to clarify that when we refer to 'women physicians,' we are referring to physicians that self-identify as women, and we acknowledge that not all the references we cite may use the same definition.Results: We offer several potential interventions that turn the challenges women physicians are facing into opportunities to address longstanding inequity. These interventions include tackling barriers to work-life balance, addressing gender and maternal bias, and promoting women physician representation in leadership.Conclusion: The COVID-19 pandemic is likely to become a chronic part of our lives; protecting vulnerable populations, such as women physicians, through thoughtful intervention is paramount.KEY MESSAGESWomen physicians experience considerable adversity during the COVID-19 pandemic, particularly in the contexts of response to stress, social isolation, work-life integration, and autonomy.These challenges create opportunities for interventions to improve equity in medicine during the COVID-19 pandemic and in the long-term, including tackling barriers to work-life balance, addressing gender and maternal bias, and promoting women physician representation in leadership.
Collapse
Affiliation(s)
| | - Ashley Zhou
- School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| |
Collapse
|
3
|
Jit Singh GK, Low WY, Abdullah KL. Grief Support and Coping Mechanism Mediate the Effect of Grief on Burnout Among Intensive Care Unit Nurses: A Structural Equation Modeling Analysis. Dimens Crit Care Nurs 2023; 42:339-348. [PMID: 37756507 DOI: 10.1097/dcc.0000000000000610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Patients' death caused the intensive care unit (ICU) nurses to grieve, which led to their burnout. Intensive care unit nurses use various coping mechanisms and need support to overcome grief. OBJECTIVE The aim of this study was to identify the mediation effects of coping mechanisms and grief support on the impact of grief on burnout. METHOD This cross-sectional study among 660 ICU nurses from 9 hospitals used 4 self-reported instruments to collect data, apart from the sociodemographic and employment-related variables. A final model was developed through structural equation modeling after establishing the construct validities of the measures through confirmatory factor analysis. RESULTS The representation of ICU nurses from each hospital was greater than 50%, with the majority being female (90.8%) with a mean age of 27.27 years. Most nurses perceived the absence of grief, low burnout, and moderate to low grief support. The nurses use various coping mechanisms. Grief support significantly mediated the relationship between grief and burnout using a bootstrapping method with a mediation strength using the variance counted for (VAF) of 34.95%. The final model fit indices with acceptable values validated the direct and indirect relationships of grief, grief support, and coping mechanisms on burnout. DISCUSSION The significant influence of grief support in mediating the effect of grief on burnout is an important finding. The nursing and hospital management can use this finding to provide grief support to ICU nurses, enhance the grief support resources, and promote future studies to test the model's validity and applicability to health care professionals who frequently face patients' death.
Collapse
|
4
|
Rahmani F, Hosseinzadeh M, Gholizadeh L. Complicated grief and related factors among nursing staff during the Covid-19 pandemic: a cross-sectional study. BMC Psychiatry 2023; 23:73. [PMID: 36703151 PMCID: PMC9879561 DOI: 10.1186/s12888-023-04562-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 01/23/2023] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND The challenging working conditions during the Covid-19 pandemic created a perfect storm that can seriously impact nurses' physical and psychological well-being. Our study aimed to investigate complicated grief and its related factors among nursing staff during the Covid-19 pandemic. METHODS This is a cross-sectional study. The participants comprised 375 nurses selected by the convenience sampling method from designated wards for patients with Covid-19 in 3 hospitals in Tabriz, Iran. Participants completed a survey containing demographic and clinical questions, the Inventory of Complicated Grief, and the Multidimensional Scale of Perceived Social Support. Multiple regression analysis was used to identify the associates of nurses' grief. The STROBE guidelines were followed in reporting the study's findings. RESULTS A significant proportion of participants (57.6%) were found to be suffering from complicated grief. Gender, educational background, type of ward, type of nursing role, type of working shift, years of nursing work experience, and experience working in the Covid-19 settings remained the significant associates of nurses' grief in the regression analysis. CONCLUSION Due to frequent exposure to patients' deaths, healthcare providers are at increased risk of suffering from complicated grief during the Covid-19 and post-pandemic. If it remains unresolved, complicated grief can result in significant health problems and the experience of burnout among nurses. Governments, health authorities, and nursing managers should support nurses who work in Covid-19 settings to reduce the adverse impact of the pandemic on nurses' health and well-being.
Collapse
Affiliation(s)
- Farnaz Rahmani
- Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Mina Hosseinzadeh
- grid.412888.f0000 0001 2174 8913Department of Community Health Nursing, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Leila Gholizadeh
- grid.117476.20000 0004 1936 7611Faculty of Health, University of Technology, Sydney, NSW Australia
| |
Collapse
|
5
|
Roche N, Darzins S, Oakman J, Stuckey R. Worker Experiences of the Work Health and Safety Impacts of Exposure to Dying and Death in Clinical Settings: A Qualitative Scoping Review. OMEGA-JOURNAL OF DEATH AND DYING 2022:302228221117902. [PMID: 36476137 DOI: 10.1177/00302228221117902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2023]
Abstract
Workers employed in clinical healthcare settings often encounter dying and death of patients as a part of their role. This scoping review aimed to explore the physical and psychosocial OHS impacts on health workers exposed to death within their occupational role and their inherent coping strategies. Six electronic databases PsycINFO (Ovid), Medline (Ovid), AMED (EBSCO), CINAHL (EBSCO), and Proquest Social Sciences were searched for peer reviewed research articles published between March 1971 and April 2022. PRISMA-ScR guidelines were followed. Three authors independently assessed articles for inclusion. Fifty-three studies with focus settings in hospitals, hospice, general practice and residential care were identified. Five main themes were developed and organized using and ergonomic systems approach: Cultural Environment, Workplace, Job Demands, Impacts and Coping. The findings demonstrate that caring for dying patients, the dead and their families in clinical settings impacts workers emotionally, physically, behaviorally and spiritually.
Collapse
Affiliation(s)
- Natalie Roche
- Centre for Ergonomics and Human Factors, School of Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Susan Darzins
- School of Allied Health, Australian Catholic University, Melbourne, VIC, Australia
| | - Jodi Oakman
- Centre for Ergonomics and Human Factors, School of Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Rwth Stuckey
- Centre for Ergonomics and Human Factors, School of Public Health, La Trobe University, Melbourne, VIC, Australia
| |
Collapse
|
6
|
Granek L, Nakash O. Oncology Healthcare Professionals’ Mental Health during the COVID-19 Pandemic. Curr Oncol 2022; 29:4054-4067. [PMID: 35735432 PMCID: PMC9222050 DOI: 10.3390/curroncol29060323] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 05/26/2022] [Accepted: 05/31/2022] [Indexed: 11/16/2022] Open
Abstract
The paper begins by reviewing the literature on oncology healthcare professionals’ (HCP) mental health. We summarize and present the current data on HCP mental health in order to understand the baseline state of oncology HCPs’ mental health status prior to the COVID-19 pandemic. At each juncture, we will discuss the implications of these mental health variables on the personal lives of HCPs, the healthcare system, and patient care. We follow by reviewing the literature on these parameters during the COVID-19 pandemic in order to better understand the impact of COVID-19 on the overall mental health of HCPs working in oncology. By reviewing and summarizing the data before and after the start of the pandemic, we will get a fuller picture of the pre-existing stressors facing oncology HCPs and the added burden caused by pandemic-related stresses. The second part of this review paper will discuss the implications for the oncology workforce and offer recommendations based on the research literature in order to improve the lives of HCPs, and in the process, improve patient care.
Collapse
Affiliation(s)
- Leeat Granek
- School of Health Policy and Management and Department of Psychology, Faculty of Health, York University, 4700 Keele Street, Toronto, ON M3J 1P3, Canada
- Correspondence: ; Tel.: +1-416-736-2100
| | - Ora Nakash
- School for Social Work, Smith College, Northampton, MA 01063, USA;
| |
Collapse
|
7
|
Aljabri D, Alshatti F, Alumran A, Al-Rayes S, Alsalman D, Althumairi A, Al-Kahtani N, Aljabri M, Alsuhaibani S, Alanzi T. Sociodemographic and Occupational Factors Associated With Burnout: A Study Among Frontline Healthcare Workers During the COVID-19 Pandemic. Front Public Health 2022; 10:854687. [PMID: 35356019 PMCID: PMC8959574 DOI: 10.3389/fpubh.2022.854687] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 02/04/2022] [Indexed: 11/29/2022] Open
Abstract
Purpose To describe the prevalence of burnout among frontline healthcare workers (HCWs) during the COVID-19 pandemic and the associated sociodemographic and occupational factors. Methods A cross sectional survey study was carried out to study HCWs burnout using the 19-item Full Copenhagen Burnout Inventory (CBI) that includes personal, work, and patient-related burnout subscales. Bivariate analysis was used to test for associations and p < 0.05 was considered statistically significant. Results A total of 207 responses received; where the mean score of personal burnout was 67.23, the mean of work-related burnout was 61.38, and the mean of patient-related burnout was 54.55. Significant associations were found; where female HCWs, those working in rotating day-and-night shifts, working more than 55-h per week, and who had their shift time and hours changed during the pandemic, had higher levels of personal and work-related burnout (P < 0.05). Patient-related burnout was higher among those who were single (divorced or separated), nurses, non-Citizens, those with fewer years of experience, and who were infected by COVID-19 and have been quarantined (P < 0.05). Age was not a significant factor of burnout in any of the CBI subscales. Conclusions There is a prevalent level of burnout among frontline HCWs during the COVID-19 pandemic. Findings highlight key sociodemographic and occupational factors affecting burnout; which can help planning for psychological support strategies. Furthermore, effective administrative control is important to institute policies and mechanisms to identify, and freely report burnout symptoms among HCWs to promote their wellbeing.
Collapse
Affiliation(s)
- Duaa Aljabri
- Department of Health Information Management and Technology, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Fatimah Alshatti
- Department of Health Information Management and Technology, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Arwa Alumran
- Department of Health Information Management and Technology, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Saja Al-Rayes
- Department of Health Information Management and Technology, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Deema Alsalman
- Department of Health Information Management and Technology, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Arwa Althumairi
- Department of Health Information Management and Technology, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Nouf Al-Kahtani
- Department of Health Information Management and Technology, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Mohammad Aljabri
- General Administration of Medical Consultations, Ministry of Health, Riyadh, Saudi Arabia
| | - Shaheed Alsuhaibani
- Department of Urology, College of Medicine, King Fahd University Hospital, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Turki Alanzi
- Department of Health Information Management and Technology, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| |
Collapse
|
8
|
Velazquez AI, Gilligan TD, Kiel LL, Graff J, Duma N. Microaggressions, Bias, and Equity in the Workplace: Why Does It Matter, and What Can Oncologists Do? Am Soc Clin Oncol Educ Book 2022; 42:1-12. [PMID: 35649205 DOI: 10.1200/edbk_350691] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Despite efforts to embrace diversity, women and members of racial, ethnic, and gender minority groups continue to experience bias, inequities, microaggressions, and unwelcoming atmospheres in the workplace. Specifically, women in oncology have lower promotion rates and less financial support and mentorship, and they are less likely to hold leadership positions. These experiences are exceedingly likely at the intersection of identities, leading to decreased satisfaction, increased burnout, and a higher probability of leaving the workforce. Microaggressions have also been associated with depression, suicidal thoughts, and other health and safety issues. Greater workplace diversity and equity are associated with improved financial performance; greater productivity, satisfaction, and retention; improved health care delivery; and higher-quality research. In this article, we provide tools and steps to promote equity in the oncology workplace and achieve cultural change. We propose the use of tailored approaches and tools, such as active listening, for individuals to become microaggression upstanders; we also propose the implementation of education, evaluation, and transparent policies to promote a culture of equity and diversity in the oncology workplace.
Collapse
Affiliation(s)
- Ana I Velazquez
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA
| | | | | | - Julie Graff
- Veterans Affairs Portland Health Care System, Portland, OR
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR
| | | |
Collapse
|
9
|
Wang J, Zhang L, Jiang F, Liu Y, Wang M, Wu Y, Tang YL. Gender Differences in Burnout Among Endocrinologists in China. Front Psychol 2022; 13:845188. [PMID: 35300158 PMCID: PMC8921076 DOI: 10.3389/fpsyg.2022.845188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 02/07/2022] [Indexed: 11/21/2022] Open
Abstract
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.
Collapse
Affiliation(s)
- Jing Wang
- China Institute for Urban Governance, Shanghai Jiao Tong University, Shanghai, China.,School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China
| | - Lufa Zhang
- China Institute for Urban Governance, Shanghai Jiao Tong University, Shanghai, China.,School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China.,Institute of Healthy Yangtze River Delta, Shanghai Jiao Tong University, Shanghai, China
| | - Feng Jiang
- School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China.,Institute of Healthy Yangtze River Delta, Shanghai Jiao Tong University, Shanghai, China
| | - Yuanli Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Mingxiao Wang
- Department of Cardiology, Emergency General Hospital, Beijing, China
| | - Yinuo Wu
- Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yi-Lang Tang
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States.,Atlanta VA Medical Center, Decatur, GA, United States
| |
Collapse
|
10
|
Advancing Measurement of the Sources and Consequences of Burnout in a Comprehensive Cancer Center: A Structural Equation Modeling Analysis. Am J Med Qual 2021; 37:95-102. [PMID: 34310378 DOI: 10.1097/01.jmq.0000743676.35805.c0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Burnout is endemic among oncology clinicians and impacts quality of care. In order to develop institutional strategies to address burnout, psychometrically sensitive measurement within local cancer organizations is necessary to identify embedded causes of burnout and resulting effects. The authors administered the Mini-Z burnout survey to clinicians and staff (n = 160) at a National Cancer Institute-designated comprehensive cancer center. Structural equation modeling was used to examine workplace stressors that predicted burnout, and the pathway between burnout and 2 meaningful quality outcomes was tested: (1) lack of compassion and (2) thoughts of leaving one's job or specialty. Females and advanced practice practitioners had the highest prevalence of burnout. The structural equation model achieved excellent model fit, and indicated that workplace atmosphere, control over workload, values alignment, time for documentation, and team efficiency underlie burnout in this sample. The pathways from burnout to lack of compassion and to thoughts of leaving one's job were significant.
Collapse
|
11
|
Burnout, compassion fatigue and suicidal ideation in oncology healthcare professionals. JOURNAL OF SURGERY AND MEDICINE 2021. [DOI: 10.28982/josam.796290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
12
|
Assessment of professional bereavement: The development and validation of the Professional Bereavement Scale. Palliat Support Care 2021; 20:4-14. [PMID: 33729116 DOI: 10.1017/s1478951521000250] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES To develop and validate Professional Bereavement Scale (PBS), a specific measurement tool for professional bereavement experiences. METHODS An online cross-sectional survey collected data from 563 physicians and nurses from urban hospitals in Mainland China. Item consistency analysis, component factor analysis, exploratory factor analysis, and confirmatory factor analysis were run to develop and validate the scale. Correlational analysis was conducted to evaluate the psychometric property of the scale. RESULTS Two subscales of the PBS were developed: the 17-item Short-term Bereavement Reactions Subscale (PBS-SBR) and the 15-item Accumulated Global Changes Subscale (PBS-AGC). Four factors, namely, frustration and trauma, guilt, grief, and being moved, are involved in PBS-SBR. Five factors are involved in PBS-AGC, which are new insights, more acceptance of limitations, more death-related anxiety, less influenced by patient deaths, and better coping with patient deaths. Both subscales have good content validity, construct validity, and criterion validity, as well as satisfactory internal consistency and split-half reliability. SIGNIFICANCE OF RESULTS PBS is a specific assessment tool for professional bereavement which is clearly defined, comprehensive, rigorously tested, and generalizable to different professional caregivers from various departments. Unveiled constructs illustrate that professional bereavement experiences contain a professional dimension in addition to a personal dimension both in an event-specific and a global perspective, which distinguishes them from familial bereavement experiences.
Collapse
|
13
|
Lee SJ, Jung SI, Kim MG, Park E, Kim AR, Kim CH, Hwang JM, Jung TD. The Influencing Factors of Gender Differences on Mental Burdens in Young Physiotherapists and Occupational Therapist. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18062858. [PMID: 33799650 PMCID: PMC8000823 DOI: 10.3390/ijerph18062858] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 03/04/2021] [Accepted: 03/08/2021] [Indexed: 12/29/2022]
Abstract
Background: Gender differences in personal discrimination experience, burnout, and job stress among physiotherapists and occupational therapists are considered as associated factors of job loss, poor job quality, high turnover, and economic losses due to the outflow of medical personnel. Thus, the purpose of this study is to analyze the level of burnout, personal discrimination experience, and job stress according to gender differences for young physiotherapists and occupational therapists. Furthermore, we used regression analyses to determine the contribution of gender differences in personal discrimination experience and job stress to self-reported burnout, considering gender and two age groups (younger than 30 years old vs. 30 years old and over). Methods: A total of 325 professional physiotherapists and occupational therapists were part of this study (n = 325; male n = 131; female n = 194. Age: 20–29 years old, n = 178; ≥30 years old, n = 147). Data were collected using a questionnaire including our three study variables (scales: the Maslach Burnout Inventory (MBI), a modified version of the gender section of the Medical School Graduation Questionnaire from the Association of American Medical Colleges; and the Korean version of the Job Content Questionnaire (JCQ)). Further, data on socio-demographic factors, job-related factors, health-related factors, and subjective job satisfaction were also collected. Results: There were significant positive correlations between job stress and gender differences in personal discrimination experience and job stress and burnout in women 30 years old and over. Personal experience of gender discrimination (β = 0.179, p = 0.015) and job stress (β = 0.162, p = 0.028) explained a significant 42.4% of the variance in burnout in the case of younger female participants (20–29 years old). However, this model did not explain a significant amount of the variance in burnout in the case of younger male participants (R2 = 0.156, p = 0.072). Regarding participants aged 30 years and over, our results showed that only job stress (but no personal experience of gender discrimination) was a relevant predictor for both males (β = 0.471, p < 0.001) and females (β = 0.373, p = 0.001). Conclusion: In this study, female therapists showed higher levels of burnout than male therapists. In particular, personal discrimination experience and job stress significantly contributed to burnout in younger female therapists while job stress was the most relevant predictor variable of burnout for both males (under 30 years old and 30 years old and over) and females in their thirties and beyond. For young female physiotherapists and occupational therapists, safe working environments should be created to reduce work-related mental burdens. It is also necessary to consider policies and regulations that can prevent job stress for therapists and measures that can positively resolve the unavoidable job stress.
Collapse
Affiliation(s)
- Su-Jin Lee
- Graduate School of Public Health, Kyungpook National University, Daegu 41944, Korea; (S.-J.L.); (M.-G.K.)
| | - Sang In Jung
- Unit of Rehabilitation Therapy, Kyungpook National University Chilgok Hospital, Daegu 41404, Korea;
| | - Myung-Gwan Kim
- Graduate School of Public Health, Kyungpook National University, Daegu 41944, Korea; (S.-J.L.); (M.-G.K.)
- Clinical Omics Institute, School of Medicine, Hakjungdong Campus of Kyungpook National University, Daegu 41404, Korea
| | - Eunhee Park
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu 41944, Korea; (E.P.); (A.-R.K.); (C.H.K.)
- Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, Jung-gu, Daegu 41944, Korea
| | - Ae-Ryoung Kim
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu 41944, Korea; (E.P.); (A.-R.K.); (C.H.K.)
- Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, Jung-gu, Daegu 41944, Korea
| | - Chul Hyun Kim
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu 41944, Korea; (E.P.); (A.-R.K.); (C.H.K.)
- Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, Jung-gu, Daegu 41944, Korea
| | - Jong-Moon Hwang
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu 41944, Korea; (E.P.); (A.-R.K.); (C.H.K.)
- Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, Jung-gu, Daegu 41944, Korea
- Correspondence: (J.-M.H.); (T.-D.J.); Tel.: +82-10-4678-5400 (J.-M.H.); +82-10-8709-7161 (T.-D.J.); Fax: +82-53-423-0389 (J.-M.H. & T.-D.J.)
| | - Tae-Du Jung
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu 41944, Korea; (E.P.); (A.-R.K.); (C.H.K.)
- Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, Jung-gu, Daegu 41944, Korea
- Correspondence: (J.-M.H.); (T.-D.J.); Tel.: +82-10-4678-5400 (J.-M.H.); +82-10-8709-7161 (T.-D.J.); Fax: +82-53-423-0389 (J.-M.H. & T.-D.J.)
| |
Collapse
|
14
|
Leech M, Katz MS, Kazmierska J, McCrossin J, Turner S. Empowering patients in decision-making in radiation oncology - can we do better? Mol Oncol 2020; 14:1442-1460. [PMID: 32198967 PMCID: PMC7332211 DOI: 10.1002/1878-0261.12675] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 01/27/2020] [Accepted: 03/18/2020] [Indexed: 02/06/2023] Open
Abstract
The decision as to whether or not a patient should receive radiation therapy as part of their cancer treatment is based on evidence‐based practice and on recommended international consensus treatment guidelines. However, the merit of involving the patients' individual preferences and values in the treatment decision is frequently overlooked. Here, we review the current literature pertaining to shared decision‐making (SDM) in the field of radiation oncology, including discussion of the patient's perception of radiation therapy as a treatment option and patient involvement in clinical trials. The merit of decision aids during the SDM process in radiation oncology is considered, as are patient preferences for active or passive involvement in decisions about their treatment. Clarity of terminology, a better understanding of effective strategies and increased resources will be needed to ensure SDM in radiation oncology becomes a reality.
Collapse
Affiliation(s)
- Michelle Leech
- Applied Radiation Therapy Trinity Research GroupDiscipline of Radiation TherapySchool of MedicineTrinity CollegeDublinIreland
| | - Matthew S. Katz
- Department of Radiation MedicineLowell General HospitalMAUSA
| | | | | | - Sandra Turner
- Voluntary Patron, Targeting Cancer, BeyondFiveTROG Cancer ResearchSydneyNSWAustralia
- Radiation Oncology DepartmentWestmead HospitalSydneyNSWAustralia
| |
Collapse
|
15
|
Granek L, Buchman S. Improving physician well-being: lessons from palliative care. CMAJ 2020; 191:E380-E381. [PMID: 30962195 DOI: 10.1503/cmaj.190110] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Leeat Granek
- Department of Public Health (Granek), Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva Israel; Temmy Latner Centre for Palliative Care (Buchman), Sinai Health System; Department of Family and Community Medicine (Buchman), Division of Palliative Care, University of Toronto, Toronto, Ont.
| | - Sandy Buchman
- Department of Public Health (Granek), Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva Israel; Temmy Latner Centre for Palliative Care (Buchman), Sinai Health System; Department of Family and Community Medicine (Buchman), Division of Palliative Care, University of Toronto, Toronto, Ont
| |
Collapse
|
16
|
Chemali Z, Ezzeddine FL, Gelaye B, Dossett ML, Salameh J, Bizri M, Dubale B, Fricchione G. Burnout among healthcare providers in the complex environment of the Middle East: a systematic review. BMC Public Health 2019; 19:1337. [PMID: 31640650 PMCID: PMC6805482 DOI: 10.1186/s12889-019-7713-1] [Citation(s) in RCA: 74] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 09/30/2019] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Burnout is a syndrome characterized by emotional exhaustion, increased depersonalization, and a diminished sense of personal accomplishment due to chronic emotional stress at work. Burnout impacts job satisfaction, job performance, vulnerability to illnesses, and interpersonal relationships. There is a gap in the systematic data on the burden of burnout among healthcare professionals from different sectors of healthcare in Middle Eastern countries. Our objective was to examine the burden of burnout among healthcare providers in the Middle East, how it was assessed, which sectors were included, and what interventions have been used. METHODS Articles were found through a systematic review of search results including PubMed, Web of Science (Thomson Reuters), and PsycINFO (EBSCO) using search terms reflecting burnout in Middle Eastern countries among populations of healthcare providers. Studies were included if they examined a quantitative measure of burnout among healthcare providers in the Middle East. RESULTS There were 138 articles that met our inclusion criteria for this systematic review. Studies focused on burnout in the Middle East among physicians (N = 54 articles), nurses (N = 55), combined populations of healthcare workers (N = 22), and medical students (N = 7). The Maslach Burnout Inventory was the most common tool to measure burnout. Burnout is common among physicians, nurses, and other healthcare professionals, with prevalence estimates predominantly ranging between 40 and 60%. Burnout among healthcare providers in the Middle East is associated with characteristics of their work environments, exposure to violence and terror, and emotional distress and low social support. CONCLUSIONS Burnout is highly prevalent among healthcare providers across countries in the Middle East. Previous studies examining burnout in this region have limitations in their methodology. More thoroughly developed epidemiologic studies of burnout are necessary. Health system strengthening is needed in a region that has endured years of ongoing conflict, and there is an urgency to design and implement programs that tackle burnout among health professionals.
Collapse
Affiliation(s)
- Z. Chemali
- Departments of Neurology and Psychiatry, Massachusetts General Hospital, Boston, MA USA
- Harvard Medical School, Boston, MA USA
| | - F. L. Ezzeddine
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA USA
| | - B. Gelaye
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA USA
- The Chester M. Pierce, MD Division of Global Psychiatry, Massachusetts General Hospital, Boston, MA USA
| | - M. L. Dossett
- Benson-Henry Institute for Mind Body Medicine and, Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA USA
- Harvard Medical School, Boston, MA USA
| | - J. Salameh
- Department of Neurology, American University of Beirut Medical Center, Beirut, Lebanon
| | - M. Bizri
- Department of Psychiatry, American University of Beirut Medical Center, Beirut, Lebanon
| | - B. Dubale
- Department of Psychiatry, Addis Ababa University, College of Health Sciences, Addis Ababa, Ethiopia
| | - G. Fricchione
- Department of Psychiatry, Benson-Henry Institute for Mind Body Medicine, Massachusetts General Hospital, Boston, MA USA
- Harvard Medical School, Boston, MA USA
| |
Collapse
|
17
|
ffrench-O’Carroll R, Feeley T, Crowe S, Doherty EM. Grief reactions and coping strategies of trainee doctors working in paediatric intensive care. Br J Anaesth 2019; 123:74-80. [DOI: 10.1016/j.bja.2019.01.034] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 01/12/2019] [Accepted: 01/12/2019] [Indexed: 11/25/2022] Open
|
18
|
Murali K, Banerjee S. Burnout in oncologists is a serious issue: What can we do about it? Cancer Treat Rev 2018; 68:55-61. [DOI: 10.1016/j.ctrv.2018.05.009] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 05/14/2018] [Accepted: 05/15/2018] [Indexed: 11/24/2022]
|
19
|
Tetzlaff ED, Hylton HM, DeMora L, Ruth K, Wong YN. National Study of Burnout and Career Satisfaction Among Physician Assistants in Oncology: Implications for Team-Based Care. J Oncol Pract 2017; 14:e11-e22. [PMID: 29190209 DOI: 10.1200/jop.2017.025544] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE A high rate of burnout has been reported in oncology physicians. Physician assistants (PAs) may also face similar risks of burnout. We sought to measure the personal and professional characteristics associated with burnout and career satisfaction and the potential impact on the oncology PA workforce. PARTICIPANTS AND METHODS A national survey of PAs in oncology was completed by using the Maslach Burnout Inventory from September 2015 to January 2016. RESULTS In all, 855 PAs were contacted and 250 submitted complete surveys (response rate, 29.2%). Respondents were representative of PAs in oncology with a mean age of 41.8 years, females (88.8%), academic practice (55.2%), urban location (61.2%), outpatient (74.4%), medical oncology (75.2%), worked 41 to 50 hours per week (52.8%), and had a mean of 9.6 years as a PA in oncology. Burnout was reported in 34.8% of PAs, 30.4% reported high emotional exhaustion, 17.6% reported high depersonalization, and 19.6% reported a low sense of personal accomplishment. In multivariable analysis, age, time spent on indirect patient care, oncology subspecialty, and relationship with collaborating physician were factors associated with burnout. Career and specialty satisfaction was high (86.4% and 88.8%, respectively). In the next 2 years, only 3.6% of PAs plan to pursue a different career or specialty and only 2.0% plan to retire. CONCLUSION Despite high career and specialty satisfaction, burnout is reported in one third of PAs in oncology. Further exploration of the relationship between PAs and collaborating physicians may provide insight on methods to decrease burnout. Negligible short-term attrition of the current oncology PA workforce is anticipated.
Collapse
Affiliation(s)
- Eric Daniel Tetzlaff
- Fox Chase Cancer Center, Philadelphia, PA and Association of Physician Assistants in Oncology, Altamonte Springs, FL
| | - Heather Marie Hylton
- Fox Chase Cancer Center, Philadelphia, PA and Association of Physician Assistants in Oncology, Altamonte Springs, FL
| | - Lyudmila DeMora
- Fox Chase Cancer Center, Philadelphia, PA and Association of Physician Assistants in Oncology, Altamonte Springs, FL
| | - Karen Ruth
- Fox Chase Cancer Center, Philadelphia, PA and Association of Physician Assistants in Oncology, Altamonte Springs, FL
| | - Yu-Ning Wong
- Fox Chase Cancer Center, Philadelphia, PA and Association of Physician Assistants in Oncology, Altamonte Springs, FL
| |
Collapse
|