Mindfulness Among Genetic Counselors Is Associated with Increased Empathy and Work Engagement and Decreased Burnout and Compassion Fatigue

Human resource management at the intensive care unit: A pragmatic review and future research agenda for building a learning health system

Recently, the importance of efficient and effective health care has been recognized, especially during the acute phase of the Coronavirus Disease-2019 (COVID-19) pandemic. Intensive care units (ICUs) have faced an immense workload, with massive numbers of patients being treated in a very short period of time. In general, ICUs are required to deliver high-quality care at all times during the year. At the same time, high-quality organizational goals may not be aligned with the interests, motivation, and development of individual staff members (eg, nurses, and doctors). For management of the ICU, it is important to balance the organizational goals and development of the staff members ("their human capital"), usually referred to as human resource management. Although many studies have considered this area, no holistic view of the topic has been presented. Such a holistic view may help leadership and/or other stakeholders at the ICU to design a better learning health system. This pragmatic review aims to provide a conceptual model for the management of ICUs. Future research may also use this conceptual model for studying important factors for designing and understanding human resources in an ICU.

The effect of perceived professional benefits on health professionals' job engagement: the role of psychological availability and future perceived professional benefits

BACKGROUND

Improving the job engagement of health professionals can effectively enhance the quality of their medical services. However, few studies have investigated whether and how perceived professional benefits affect job engagement. Based on resource conservation theory, this study explored the effect of the influence of perceived professional benefits on job engagement, and also examined the mediating role of psychological availability and the moderating role of future perceived professional benefits.

METHODS

A cross-sectional study was conducted in six tertiary hospitals and seven secondary hospitals in Liu Panshui, a city in western China. A total of 1,406 valid questionnaires were obtained and analysed by using correlation analysis, hierarchical regression analysis, and bootstrap tests.

RESULT

The study found a significant positive association between health professionals' perceived professional benefits and their job engagement. Additionally, psychological availability was found to mediate this relationship. Future perceived professional benefits not only positively moderate this relationship between perceived professional benefits on health professionals' psychological availability but also positively moderate the mediating role of psychological availability between perceived professional benefits and job engagement.

CONCLUSION

Improving health professionals' perceived professional benefits can enhance their job engagement by increasing their psychological availability. However, for health professionals with low future perceived professional benefits, this improvement may disappear. Therefore, it is important to enhance both their current and future perceived professional benefits to improve their job engagement.

Does mindfulness reduce perceived stress in healthcare professionals?

BACKGROUND

Healthcare professionals (HCPs) are exposed to multiple psychosocial risks that may lead to high levels of stress and low levels of life satisfaction and well-being. Mindfulness, defined as the awareness that arises by intentionally paying attention in the present moment and in a non-judgmental way, seems to be a moderator in the causal association between life stressors and well-being.

AIMS

The aim of the present study was to test the model of relationships between self-reported mindfulness, perceived stress, well-being index and life satisfaction in a sample of Tunisian HCPs.

METHODS

We performed a correlational cross-sectional study on a sample of HCPs at Hedi Chaker University Hospital, Tunisia. We used validated self-reporting instruments: the Mindful Attention Awareness Scale (MAAS), the Perceived Stress Scale (PSS), the World Health Organisation Well-Being Index (WHO-5) and the Satisfaction with Life Scale (SWLS). For data analysis, the SPSS version 23 program was used.

RESULTS

Participants (n=297) included staff nurses (49.2%), medical technicians (19.2%) and doctors (31.6%). The overall model revealed that reduced perceived stress (β=-0.30, P<0.000) and high levels of well-being (β=0.13, P=0.03) were associated with mindfulness, explaining 14% of the variance. Individually, perceived stress significantly predicted mindfulness explaining 13% of the variance.

CONCLUSION

The study explores a variety of elements that can support the development of mindfulness interventions for stress prevention, staff well-being, and improvement of services as a whole.

A scoping review on the relationship between mental wellbeing and medical professionalism

BACKGROUND

Mental wellbeing issues among medical students are common, and their relationship to medical professionalism is debated. Few studies have attempted to link such issues with undergraduate medical education. This review aimed to advance the knowledge on this matter by exploring the relationship between mental wellbeing and medical professionalism in undergraduate medical education.

METHODS

We collected the literature about mental wellbeing and medical professionalism (published from 1 January 1986 to 31 March 2021) from the Web of Science, PubMed, Scopus and ScienceDirect databases using the search terms 'mental wellbeing' and 'medical professionalism'.We included all peer-reviewed articles in which mental wellbeing and medical professionalism in the undergraduate medical education context were the central topics regardless of the age range, nationality, race and gender of the participants.

RESULTS

From the 13,076 Iinitially found articles, 16 were included. These 16 articles were from nine countries in four different continents, which all together helped us find answer to our research question using extracted points relating to the main study themes (mental wellbeing and medical professionalism). Under theme 1 (mental wellbeing), six subthemes emerged: burnout, stress, depression, disappointment, depersonalisation and conscientiousness. Theme 2 (medical professionalism), on the other hand, had five subthemes: empathy, academic performance, compassion, unprofessional behaviour and professionalism. A significant inverse association was found between empathy and burnout. Academic performance was also related to burnout. At the same time, empathy was found to have a varied association with stress. Moreover, compassion was found to alleviate burnout and nurture professional gratification.

CONCLUSION

The medical professionalism attributes were found to deteriorate as the mental wellbeing issues grow. This can harm medical students' overall health, current learning abilities and future attitudes towards their patients. Explicit primary research is thus required to examine and intervene in the cause-effect relationship between medical professionalism and mental wellbeing.

Clients' and genetic counselors' perceptions of empathy in Japan: A pilot study of simulated consultations of genetic counseling

The rapidly increasing availability of genetic testing is driving the acceleration of genetic counseling implementation. Empathy is important in medical encounters in general and forms a core component of a successful genetic counseling session; however, empirical evidence on empathy in genetic counseling is minimal. This study aimed to explore the perceptions of empathy in simulated genetic counseling consultations from the perspectives of clients and genetic counselors. Semi-structured interviews and interpersonal process recall were used with participants of simulated genetic counseling consultations to elicit their experiences of empathy. A constructivist grounded theory was used for data analysis. A total of 15 participants, including 10 clients and 5 genetic counselors, participated in 10 simulated counseling sessions. The genetic counselors attempted to demonstrate empathy and were sensitive toward detecting changes in clients. Meanwhile, the clients' perceptions represented their feelings and thoughts elicited through the counselors' empathic approaches. This was the first process study to examine empathy in simulated genetic counseling sessions. Our model of communication of empathy is a process in which counselors try to address implicit aspects of clients, and clients are provided with time and a safe place for introspection, which contributes to discussions on building good relationships with patients. There is also a suggestion of the utility of simulated consultations for healthcare providers to learn empathic communication.

Mindfulness and burnout among Chinese college students: mediation through sleep quality and perceived stress

College students often face challenges and obstacles which leads them vulnerable to burnout. Though numerous studies have supported an association between mindfulness and burnout, yet little is known about the potential mediating role of mindfulness exerts its effect in this link. This study aimed to explore the relationship between mindfulness and burnout among Chinese college students and investigated the sleep quality and perceived stress as two potential mediators of that relationship. A total of 536 college students (mean age = 21.93, 66.2% female) were investigated and completed the Five Facet of Mindfulness Questionnaire, Pittsburgh Sleep Quality Index, Perceived Stress Scale and Academic Burnout Scale of College Students. Path analyses were employed to examine the mediating effect. Results indicated that mindfulness had significant negative correlation with burnout (r=-.584, p < 0.001). Sleep quality and perceived stress were significant mediators of the observed relationship between mindfulness and burnout. These findings shed light upon the mediating role of sleep quality and perceived stress, and suggest that college students' mindfulness may facilitate their sleep quality and decrease perceived stress, which, in turn, may help prevent and reduce burnout.

The Mediating Effect of Empathy between Mindfulness and Self-Leadership in Female University Students: A Cross-Sectional Study

(1) Background: Acknowledging scant research on integrating mindfulness, empathy, and self-leadership among female university students, this study aimed to investigate the relationships among these three variables, as well as the mediating effect of empathy. (2) Methods: A cross-sectional design was employed with 127 female sophomores in a mindfulness-based liberal arts class at K Women's University in South Korea. Participants completed a self-reported questionnaire measuring levels of mindfulness, empathy, and self-leadership. Data were analyzed with descriptive statistics and correlations between the variables using the SPSS 28 program. The Jamovi 2.2.5 program was used to analyze the mediating effect of empathy. (3) Results: The levels of mindfulness, empathy, and self-leadership were higher than in previous studies. Mindfulness was positively related to empathy (r = 0.407, p < 0.001) and self-leadership (r = 0.635, p < 0.001); empathy was also positively associated with self-leadership (r = 0.635, p < 0.001). Furthermore, empathy mediated the relationship between mindfulness and self-leadership (β = 0.187, p < 0.001). (4) Conclusions: The findings indicate that mindfulness is helpful in improving university students' self-leadership by reinforcing their empathy, and that an integrated training program of mindfulness and empathy could produce positive effects on promoting self-leadership. The findings can be utilized as a basis for developing programs to improve mindfulness and empathy, eventually improving students' self-leadership.

Distress Tolerance and Emotion Regulation as Potential Mediators Between Secondary Traumatic Stress and Maladaptive Coping

The extant literature has illustrated that protective service workers experience negative repercussions associated with their job (including the development of secondary traumatic stress; STS) and may utilize maladaptive coping mechanisms. Developing an improved understanding of factors that might explain the relationship between STS and the utilization of maladaptive coping mechanisms is warranted. This study sought to examine emotion regulation and distress tolerance as potential mediators between STS and the utilization of maladaptive coping mechanisms. Participants were 152 elder protective service workers and 105 child protective service workers who completed an online survey of self-report measures of emotion regulation, distress tolerance, STS, and coping behaviors. A parallel multiple mediator model was analyzed using structural equation modeling (SEM) to examine the hypothesis that distress tolerance and emotion regulation would mediate the relationship between STS and the utilization of maladaptive coping. Our hypothesis was partially supported as the effect of STS on maladaptive coping was mediated by emotion regulation but not by distress tolerance. The results from this study have both prevention and intervention implications. From a prevention perspective, efforts could be directed at teaching emotion regulation skills to those at risk for developing STS as a mechanism for decreasing the probability of denial, substance use, behavioral disengagement, and self-blame that may occur as a consequence of STS. From an intervention perspective, some of the negative sequelae of exposure to STS may be averted by teaching EPS and CPS workers who present with STS symptoms, emotion regulation skills.

Psychological Well-being Structure of Indonesian Soldiers: Systematic Review

BACKGROUND. Work-related stress can increase maladaptive coping behavior, like smoking behavior, in Indonesian soldiers. Pressure to achieve maximum performance might affect psychological condition of soldiers at work place. Most research results discuss negative psychological well-being, while positive well-being of Indonesian soldiers is still rarely discussed. OBJECTIVE. to elaborate structure of psychological well-being of Indonesian soldiers regarding their coping ability during military duty. METHOD. Research method used in this research is systematic review. Sources of database are retrieved from Google Scholar, Medline, PubMeds, Wiley Library, ScienceDirect, and Emerald with limitation in articles published between 2010 and 2018. Inclusion criteria of scientific articles reviewed are articles about soldiers, who are active-duty and retired, which are written in English and Indonesian. RESULTS. In 11 articles regarding psychological well-being in Indonesian soldiers that can elaborate six structures: autonomy, environmental mastery, personal growth, positive relations with others, purpose in life, and self-acceptance. These six structures of psychological well-being can explain adaptive and maladaptive coping skills in Indonesian soldiers while they do military duty. CONCLUSION. Structure of positive psychological well-being based on evidence in Indonesian soldiers is critically needed during military duty. Improving adaptive coping skill in soldiers might be able to banish negative thoughts in order to maintain their mental health.    

Sustaining the Quality of Life for University Employees with Obesity Using Mindfulness Activities and Work Engagement: A Quasi-Experimental Design

Using an e-calendar, a web-based intervention program, informal mindfulness activities, and work engagement, this study evaluated the sustainability of the quality of life for staff with obesity at a Malaysian public university. The participants were identified through the human resources department of the university. The inclusion criteria required an age of 20–59 years and BMI ≥ 25. The exclusion criteria were pregnancy, the use of weight loss pills or supplements that can influence weight, chronic illness, and the use of medication that requires physician monitoring. Thirty-one university staff were assessed for quality of life using a within-subject repeated-measures design. The participants were asked to use the study website for 10 to 15 min/day for 36 weeks. Data was captured by a pretest, posttest, and two follow-up surveys. The results showed an increase in the posttest mean scores for all domains representing the quality of life. As expected, three domains increased at follow-up 1 and were maintained at follow-up 2. This suggests that informal mindfulness practices and work engagement using an e-calendar are practical means to increase and sustain the quality of life of employees. In conclusion, the quality of life among university staff with obesity can be improved using informal mindfulness activities and work engagement, and an e-calendar is another alternative method of practicing mindfulness at home and at the workplace. The implications of this study are also discussed.

Contributors to and consequences of burnout among clinical genetic counselors in the United States

Prior research has found that many genetic counselors (GCs) experience burnout. Studies of other clinicians have demonstrated that burnout can have significant detrimental consequences for clinicians, patients, and the healthcare system. We sought to explore the prevalence of, contributors to, and consequences of burnout among GCs. We performed a secondary data analysis of baseline data from Me-GC, a randomized controlled trial of meditation for GCs. We applied a systems model of burnout proposed by the National Academy of Medicine (NAM), which depicts burnout arising from a combination of contributors that include both work system and individual mediating factors, and then leading to consequences. Validated self-report scales were used to measure burnout and most contributors and consequences. Female and white GCs were over-represented in our sample. Over half (57.2%) of the 397 participants had Professional Fulfillment Index scores indicative of burnout. Multiple potential contributors were associated with burnout, consistent with its known multifactorial nature. Among work system factors, higher levels of burnout were associated with insufficient administrative support, lack of autonomy, and not feeling valued by non-GC colleagues. Individual mediating factors associated with greater burnout included higher levels of anxiety, depression, and stress. Participants with lower levels of burnout reported greater mindfulness, resilience, and use of professional self-care behaviors. Among variables categorized as consequences, higher levels of burnout were associated with lower levels of empathy, counseling alliance, and positive unconditional regard, as well as higher reactive distress, and a greater desire to reduce the amount of time spent on clinical care. Given the prevalence and potential consequences of burnout observed here, it is imperative that the field take steps to mitigate burnout risk.

A call for unity in DEIJ efforts using a proposed framework for education, Recruitment, Retainment, Research, and Active outreach (ERA) for genetic counselors in the United States

Genetic counselors, like many other healthcare providers, play a vital role in genomic health care. As a profession, we, along with our colleagues and students, have recognized the need to improve and incorporate diversity, equity, inclusion, and justice (DEIJ) within our daily ways of practice to help create access to genomic technologies. In order to create systemic change and focus on unity, open communication, and transparency, we introduce a suggested framework called ERA (Education, Recruitment, Retainment, Research, and Active Outreach). This framework would benefit a genetic counselor throughout various stages of their career, from student to practicing genetic counselor, and can be broadly applied to all specialties of genomic medicine. Different iterations of DEIJ efforts have arisen in the National Society of Genetic Counselors (NSGC), from the D&I (Diversity and Inclusion) Task Force to the J.E.D.I (justice, equity, diversity, and inclusion) committee. The lack of recorded history of these previous efforts and the lack of communication between current DEIJ organizations is one of the many reasons the ERA framework demands unity and transparency to achieve sustainable positive change. Genetic counselors must unite and work collaboratively to conduct and promote DEIJ efforts, so the benefits of genomic medicine can be realized by all.

Building a foundation in self-awareness: Genetic counseling students' experiences with self-care, reflection, and mindfulness

Stress and anxiety are significant concerns for practicing genetic counselors as well as genetic counseling students and can have downstream effects on patient care. Prior research suggests graduate-level training in self-awareness practices such as self-care, reflection, and mindfulness could have lasting effects for genetic counselors, their patients, and the profession as a whole. This mixed-methods study assessed self-awareness among 154 genetic counseling graduate students using the Self-Reflection and Insight Scale (SRIS), the Mindfulness Attention Awareness Scale (MAAS), and self-described experiences with self-awareness practice. Genetic counseling students had significantly lower mean scores on the MAAS and the Insight subscale of the SRIS compared with other health professionals, indicating that genetic counseling students have lower levels of mindfulness and may lack insight into their thoughts and feelings. After starting genetic counseling graduate programs, students were more likely to reduce participation in active self-awareness practices such as physical activity and mental health counseling. Most students reported having structured practice in self-care (n = 97, 63%), reflection (n = 125, 81.2%), and mindfulness (n = 77, 50%) as a part of their training programs. Second-year genetic counseling students reporting mindfulness practices had significantly higher scores on the Insight subscale of the SRIS than those who did not, indicating that students engaged in mindfulness practice are better able to understand their thoughts, feelings, and behavior. The majority of students reported benefitting from structured practice in self-care (n = 63, 64.9%), reflection (n = 101, 80%), and mindfulness (n = 54, 70.1%). Open-ended responses regarding students' perceived benefits and limitations of structured practice were analyzed for recurrent themes. Students reported improved self-awareness which enhanced their counseling relationships during clinical rotations. However, they also perceived that implementation of self-awareness practices may have been inconsistent. Findings from this study have implications for integrating self-awareness practices into genetic counseling graduate curriculum.

Therapeutic role of yoga in neuropsychological disorders

Yoga is considered a widely-used approach for health conservation and can be adopted as a treatment modality for a plethora of medical conditions, including neurological and psychological disorders. Hence, we reviewed relevant articles entailing various neurological and psychological disorders and gathered data on how yoga exerts positive impacts on patients with a diverse range of disorders, including its modulatory effects on brain bioelectrical activities, neurotransmitters, and synaptic plasticity. The role of yoga practice as an element of the treatment of several neuropsychological diseases was evaluated based on these findings.

Differences in genetic counseling student responses to intense patient affect: A study of students in North American programs

Research indicates genetic counseling patients often experience intense emotions. No studies, however, have investigated how genetic counseling students respond to patient affect. This survey study investigated student responses to patient emotions and select factors affecting their responses. One-hundred fifty-one genetic counseling students in North American programs wrote a response to each of three hypothetical prenatal scenarios, identical except for the patient affect expressed (anger, fear, or sadness). They also completed measures of empathy tendency and tolerance of negative affect and demographic questions. Multivariate analysis of covariance (MANCOVA), used to analyze the effects of major study variables on the types of responses given by participants, was significant. Follow-up univariate ANCOVAs indicated small to moderate effect sizes for student clinical experience, race/ethnicity, and relationship status within and across scenarios. For example, as number of patients counseled increased, participants used more feeling reflections and fewer self-involving statements. There were no significant differences in responses due to empathy tendency or affect tolerance. Most common responses were information provision and feeling reflections for the Anger scenario, information provision for the Fear scenario, and influencing responses for the Sadness scenario. Responses to each scenario typically involved multiple thoughts (range: 1-14; means ranged from 3.25 in the Sadness scenario to 3.62 in the Fear scenario). Most students (82%) reported the Anger scenario was the most difficult. Thematic analysis of reasons a scenario was difficult yielded four themes: Discomfort with situation/emotion, Positive countertransference, Uncertain how to respond, and Negative countertransference. Findings that clinical experience affects how participants responded to patient affect support the essential role of applied experience. Findings also support training and supervision to help genetic counseling students in North America learn ways to respond to strong patient emotions and recognize and manage countertransference.

Compassion and empathy in community social workers: A qualitative study in Spain

Compassion and empathy are considered to be elements of paramount importance in professionals working with individuals in need. However, the term 'compassion' generates controversy among social workers, while the term 'empathy' seems to be more universally accepted among these professionals. This qualitative study used a hermeneutic approach and aimed to explore and understand social workers' experiences with empathy and compassion in the community setting. Between January and June 2019, nine in-depth interviews and two focus group sessions were conducted with social workers from community social centres and primary healthcare centres in the province of Almería (Spain), with a total of 23 participants. The software Atlas.ti 8.0 was used for discourse analysis. Professionals reported that it was necessary for them to have an empathic attitude towards service users, and claimed that being empathic towards individuals in need was a moral obligation. They also reported that, although being empathic is a trait of these professionals, they have to avoid being affected by it, and that there are situations that block empathy. With respect to their perception of compassion, different interpretations of the concept were found: some professionals understand compassion as pity; other professionals have difficulty understanding the term and other professionals understand compassion as help. It has become necessary to change and develop the very conceptualisation of compassion and to create compassion promotion programmes, as this is fundamental for the protection and satisfaction of social workers themselves and for the sustainability of the support they provide to individuals who are in great distress.

Results of the Genetic Counselor SARS-CoV-2 Impact Survey from the National Society of Genetic Counselors: Progress and penalty during the COVID-19 pandemic

The Genetic Counselor SARS‐CoV‐2 Impact Survey (GCSIS) describes the impact of the pandemic on genetic counselors and genetic counseling services. With this information, the National Society of Genetic Counselors (NSGC) can better: (1) support advocacy and access efforts for genetic counseling services at both federal‐ and state‐level; (2) promote effective billing and reimbursement for genetic counseling services provided via telemedicine; and (3) make decisions about how to best support genetic counselors.

The survey was hosted on a novel data collection and analysis platform from LunaDNA and was open to all genetic counselors (n = 5,531 based on professional society membership). Survey response rate was approximately 3.8% (n = 212/5,531), with a demographic distribution broadly representative of the North American genetic counseling field. Genetic counselors remained largely employed, providing genetic counseling services throughout the pandemic, although almost one in five respondents (17%, n = 35/211) reported experiencing some degree of pandemic‐related financial hardship. Nearly all respondents (90%, n = 104/115) transitioned, at least in part, to remote work settings, with about half (47%. n = 88/189) reporting restrictions in the care they were able to provide. These shifts came at a cost: existing gaps in Medicare status for genetic counselors and attendant reimbursement concerns led to uncertainty about whether genetic counselors' work will be reimbursed. Outside of work, caregiving responsibilities increased for 34% (n = 74/212) of respondents.

The results of the GCSIS amplify the importance of federal‐ and state‐level advocacy efforts for genetic counselors and their employers. They also highlight the impact of broader cultural intransigence on our majority‐female profession. During the pandemic, genetic counselors continued to provide care, but without consistent financial support or expectation of reimbursement. The ability to attract and retain talented professionals to the genetic counseling field will hinge on the success of continued advocacy efforts.

Evaluation of empathy and fatigue among physicians and surgeons in tertiary care hospitals of Rawalpindi

Background and Objectives:

Clinicians need to build an astute doctor-patient relationship. The term clinical empathy is the ability of doctor to cognitively appreciate a patient’s perspective, experiences, and deliver such an understanding back to patient. Studies associate high physician empathy with improved patient trust and clinical outcomes. In Pakistan, there is paucity of research data on this relationship. This study assessed the empathy and its relation to fatigue levels among physicians and surgeons.

Methods:

This was a cross-sectional analytical study involving 262 Physicians and Surgeons (1:1) chosen by convenience sampling method. Physicians and Surgeons were included from three hospitals in Rawalpindi from September 2017 to February 2018 and RAO soft sample calculator was used. The Jefferson Scale for Physician empathy (JSPE) (score range 20-140) and Multidimensional Fatigue Inventory (MFI-20) (score range 20-100) were used as data collection tools. The data was analyzed using SPSS version 23. Statistical tests including T-test and Pearson Correlation were used.

Results:

Overall, mean score of empathy was found to be 98.8±21.9 (range; 46-138). The empathy in Physicians (106.8±18.3) was found to be greater than Surgeons (89.4±22.1) and the difference was statistically significant (p value <0.01). Mean score of fatigue was 50.6±16.0. The fatigue level in Surgeons was greater than Physicians and the difference was found to be statistically significant (p value < 0.01). Strong negative correlation was observed between empathy and fatigue (r= -0.5, p=<0.01) using Pearson correlation.

Conclusion:

Overall, physicians had better empathy than surgeons, while fatigue scores were higher among surgeons. Fatigue is associated with empathy decay. This research provides an understanding of empathy deterioration and other factors responsible for it.

Self-Reported Assessment of Empathy and Its Variations in a Sample of Greek Social Workers

The aim of the study was twofold: (a) to examine the way in which professional social workers perceive and apply in their practice the concept of empathy; (b) to explore sociodemographic factors, education/special training and work characteristics associated with their empathic skills. This is a cross-sectional study with a purposive sample of 203 Greek social workers. For the assessment of empathy, the Empathy Scale for Social Workers (ESSW) was used. The sample consisted mainly of female social workers with a mean age of 43.8 years. More than 70% of them were practicing the profession for more than 10 years. Nearly one-third participated in psychotherapy courses, and only half of them have been certified. On average, they reported high levels of empathy. Initial univariate analyses showed that empathy scores were significantly higher for older social workers, married, the more experienced, those who referred to working experience with disabled people or people having problems with substance use and the professionals who had obtained a certification in psychotherapy. 'Having a middle work experience of 10-19 years' was a significant correlate in all scales and related negatively to empathy indicating a burnout effect. The implications for social work education and future training are discussed.

Work engagement and psychological distress of health professionals during the COVID-19 pandemic

AIMS

To describe the level of work engagement of active health care professionals during the COVID-19 pandemic, and its relationship with psychological distress according to the professional category.

BACKGROUND

Health care professionals working on the front line of the COVID-19 pandemic are at risk of psychological distress, and work engagement could be a positive attitude that could serve as a protective factor.

METHODS

Cross-sectional observational study of 1,459 health care professionals. Psychological distress was measured with the General Health Questionnaire and work engagement with the Utrecht Work Engagement Scale. Data were analysed with bivariate analyses and correlations.

RESULTS

Psychological distress was reported by 80.6% of health care professionals. Work engagement as high with a total mean score of 5.04 (SD = 1.14). The results showed that distressed professionals showed significantly lower levels of work engagement.

CONCLUSIONS

The present study identified psychological distress and work engagement experienced by health care professionals during the COVID-19 pandemic. Most of the variables included in the study revealed a significant relationship with psychological distress and work engagement.

IMPLICATIONS FOR NURSING MANAGEMENT

The relationship between the working conditions with psychological distress and work engagement suggests that improvements in the workplace are needed to promote protective measure for the mental health of health care professionals.

Self-Oriented Empathy and Compassion Fatigue: The Serial Mediation of Dispositional Mindfulness and Counselor's Self-Efficacy

This study aimed to explore the association between self-oriented empathy and compassion fatigue, and examine the potential mediating roles of dispositional mindfulness and the counselor's self-efficacy. A total of 712 hotline psychological counselors were recruited from the Mental Health Service Platform at Central China Normal University, Ministry of Education during the outbreak of Corona Virus Disease 2019, then were asked to complete the questionnaires measuring self-oriented empathy, compassion fatigue, dispositional mindfulness, and counselor's self-efficacy. Structural equation modeling was utilized to analyze the possible associations and explore potential mediations. In addition to reporting confidence intervals (CI), we employed a new method named model-based constrained optimization procedure to test hypotheses of indirect effects. Results showed that self-oriented empathy was positively associated with compassion fatigue. Dispositional mindfulness and counselor's self-efficacy independently and serially mediated the associations between self-oriented empathy and compassion fatigue. The findings of this study confirmed and complemented the etiological and the multi-factor model of compassion fatigue. Moreover, the results indicate that it is useful and necessary to add some training for increasing counselor's self-efficacy in mindfulness-based interventions in order to decrease compassion fatigue.

The Relationship Between Present-Centered Awareness and Attention, Burnout, and Compassion Fatigue in Oncology Health Professionals

Objectives

Oncology health professionals experience high levels of burnout and compassion fatigue, affecting their health and the care they provide. This study aimed to establish whether present-centered awareness and attention (a component of mindfulness) is uniquely associated with burnout and compassion fatigue in oncology professionals.

Methods

An international sample of oncology professionals (n = 118) completed an online questionnaire with validated measures of present-centered awareness and attention, empathy, compassion fatigue, and burnout. Hierarchical multiple regressions were used to model relations among the independent variable (present-centered awareness and attention) and the criterion variables of burnout (disengagement, exhaustion) and compassion fatigue (compassion satisfaction, compassion burnout, secondary traumatic stress) after statistically controlling for empathy, age, gender, years of experience, and patient contact hours.

Results

Mean hours of patient contact per week was 23.52 (SD = 13.62), with 26 (22.03%) reporting 40 h or more. Higher hours of patient contact per week were positively associated with secondary traumatic stress. Present-centered awareness and attention was associated with lower disengagement, lower emotional exhaustion, higher compassion satisfaction, lower secondary traumatic stress, and lower compassion burnout. In each model, present-centered awareness accounted for unique variance after controlling for age, gender, years of experience, patient contact hours per week, and empathy scores. The amount of unique variance accounted for by present-centered awareness ranged from 4 to 10%.

Conclusions

Oncology professionals reporting higher levels of present-centered awareness and attention reported higher compassion satisfaction and lower secondary traumatic stress, compassion burnout, exhaustion, and disengagement. Promoting present-centered awareness may be a mechanism that contributes to less burnout in oncology professionals.

Exploring empathy in genetic counseling students and new genetic counselors

Although empathy is widely recognized as an important trait for healthcare professionals, little research has examined empathy attributes in genetic counselors. Decreases in empathy levels have been recognized in other healthcare professionals over the span of their professional education program. This research sought to characterize empathy levels in first- and second-year genetic counseling students and recent (2017) graduates, and to determine whether there are differences in empathy levels displayed by genetic counseling students at different points in their training. Additionally, this research examined whether experiences prior to graduate school, including specific aspects of advocacy experience, correlated with differences in self-reported empathy levels among genetic counseling students and new genetic counselors. An online survey was administered to first- and second-year genetic counseling students and practicing genetic counselors to determine whether there were differences in empathy levels between these groups, and to analyze for associations between pre-graduate school advocacy work and levels of empathy as measured by the Interpersonal Reactivity Index (IRI). We identified significant differences in self-reported empathy levels in several of the subscales of the IRI between first-year students and second-year students, and between first-year students and recent graduates. Furthermore, we identified significantly lower scores on the personal distress subscale of the IRI in participants who engaged in advocacy work for longer than 12 months when compared to participants who engaged in advocacy work for between 6 and 12 months. Other advocacy and educational characteristics were also examined for correlations with IRI scores, and no significant associations were identified between these additional factors and self-reported empathy scores. Practice implications and recommendations for future research are discussed.

Mindfulness, Compassion, and Self-Compassion Among Health Care Professionals: What's New? A Systematic Review

Health care professionals (HCPs) are a population at risk for high levels of burnout and compassion fatigue. The aim of the present systematic review was to give an overview on recent literature about mindfulness and compassion characteristics of HCPs, while exploring the effectiveness of techniques, involving the two aspects, such as MBSR or mindfulness intervention and compassion fatigue-related programs. A search of databases, including PubMed and PsycINFO, was conducted following the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines and the methodological quality for this systematic review was appraised using AMSTAR-2 (A MeaSurement Tool to Assess systematic Reviews-2). The number of articles that met the inclusion criteria was 58 (4 RCTs, 24 studies with pre-post measurements, 12 cross-sectional studies, 11 cohort studies and 7 qualitative studies). MBSR intervention was effective at improving, and maintaining, mindfulness and self-compassion levels and to improve burnout, depression, anxiety, stress. The most frequently employed interventional strategies were mindfulness-related trainings that were effective at improving mindfulness and self-compassion, but not compassion fatigue, levels. Compassion-related interventions have been shown to improve self-compassion, mindfulness and interpersonal conflict levels. Mindfulness was effective at improving negative affect and compassion fatigue, while compassion satisfaction may be related to cultivation of positive affect. This systematic review summarized the evidence regarding mindfulness- and compassion-related qualities of HCPs as well as potential effects of MBSR, mindfulness-related and compassion-related interventions on professionals' psychological variables like mindfulness, self-compassion and quality of life. Combining structured mindfulness and compassion cultivation trainings may enhance the effects of interventions, limit the variability of intervention protocols and improve data comparability of future research.

Mindfulness training for tourism and hospitality frontline employees

Purpose

The purpose of this paper is to explore mindfulness training as a viable intervention for frontline employees in tourism and hospitality as a way to aid in the regulation of emotions and reduce or prevent employee burnout while increasing levels of work engagement.

Design/methodology/approach

By reviewing related literature, the authors explored the relationships between mindfulness training and emotional labor, and mindfulness, burnout and work engagement.

Findings

The authors suggested the following propositions: mindfulness training can potentially help to regulate emotional labor of tourism and hospitality frontline employees, and mindfulness training can potentially reduce burnout and enhance levels of work engagement of tourism and hospitality frontline employees.

Research limitations/implications

This study can guide scholars to initiate empirical research to examine the influence of mindfulness training on diverse outcomes related to tourism and hospitality employees.

Practical implications

This study can help to improve the awareness of leaders and managers of mindfulness training as an intervention to alleviate emotional exhaustion of frontline employees in tourism and hospitality.

Originality/value

This study provides theoretical insights and useful practical implications for ways to establish a suitable work environment that encourages frontline employees to perform genuine or deep acting while minimizing incidents of surface acting and the consequences of emotional labor.

Mindfulness training in the workplace: exploring its scope and outcomes

Purpose

As the concept of mindfulness gains popularity in the workplace, there is a need to understand the extent to which mindfulness-related practices are integrated into training and development activities and the impact of these practices on employees and organizations. The purpose of this study is to provide an overview of the scope of mindfulness as an intervention in the workplace and to identify outcomes of mindfulness-related training activities at the individual, job/work, team/group and organizational levels.

Design/methodology/approach

Torraco (2005) and Briner and Denyer's (2012) four steps (search, selection, analysis and synthesis) for conducting an integrative literature review were used for this study. This method enabled us to compare and contrast relevant articles, integrate distributed information, create new knowledge and provide research directions on mindfulness practices in work settings.

Findings

Through a revision of 28 empirical studies, the authors found that mindfulness-based training is an effective intervention for organizations to improve mental health, wellbeing and performance of employees. A total of 51 significant outcomes of mindfulness-related training categorized at the individual (23), job/work (17), group/team (7) and organizational (4) levels were identified.

Practical implications

Despite the benefits of mindfulness training, according to the research, only a handful of organizations have rolled-out this program for employees. The authors recommend that industry leaders and managers take a proactive approach and incorporate mindfulness-related practices as part of their professional development training for employees at all levels to improve personal and professional growth and performance.

Originality/value

This paper extends the emerging literature on mindfulness by providing a comprehensive summary of the consequences of mindfulness training at a multilevel context within the human resource development domain.

Empathy, burnout, life satisfaction, correlations and associated socio-demographic factors among Chinese undergraduate medical students: an exploratory cross-sectional study

BACKGROUND

Medical education is widely known to be a demanding process that may cause various mental health problems, such as burnout, which can lead to lowered levels of life satisfaction among medical students. Research shows that empathy is negatively correlated with burnout, but there are few studies on the relationship among empathy, burnout and life satisfaction in medical students. The objective of the present study is to explore the correlations of empathy and burnout with life satisfaction and the associated socio-demographic factors among Chinese undergraduate medical students.

METHODS

In this cross-sectional study, 1271 undergraduate medical students (age 19.42 ± 1.34 years, 36% male) from 1st to 4th grades completed questionnaires including the Interpersonal Reactivity Index Chinese version (IRI-C), the Maslach Burnout Inventory Modified Chinese version (MBI-MC), the Satisfaction With Life Scale (SWLS) and socio-demographic characteristics. Statistical analyses included Student's t-test, one-way ANOVA, post hoc Bonferroni tests, hierarchical linear regression analysis and general linear model-univariate full factorial model.

RESULTS

Over four academic years, medical students' empathy levels declined, but their burnout levels almost plateaued and their life satisfaction levels witnessed an initial fall before a rebound. Empathy was correlated with students' age and grade, and burnout was associated with students' maternal education. Significant differences in life satisfaction were detected with regard to medical students' age, academic year, the number of children in the family, place of residence and parents' educational levels.

CONCLUSIONS

Empathy explained 0.6% of the variance in life satisfaction in contrast to 13.7% of the variance explained by burnout in life satisfaction. Although empathy did not have a main effect on life satisfaction, there was an interaction effect of empathy and burnout on life satisfaction among students of high and low empathy and burnout levels. Students with high levels of empathy and low levels of burnout were most satisfied with life. Medical institutions and related authorities need to find effective measures to enhance students' empathy levels and reduce burnout to improve their life satisfaction.

Establishment of Specialized Clinical Cardiovascular Genetics Programs: Recognizing the Need and Meeting Standards: A Scientific Statement From the American Heart Association

Cardiovascular genetics is a rapidly evolving subspecialty within cardiovascular medicine, and its growth is attributed to advances in genome sequencing and genetic testing and the expanding understanding of the genetic basis of multiple cardiac conditions, including arrhythmias (channelopathies), heart failure (cardiomyopathies), lipid disorders, cardiac complications of neuromuscular conditions, and vascular disease, including aortopathies. There have also been great advances in clinical diagnostic methods, as well as in therapies to ameliorate symptoms, slow progression of disease, and mitigate the risk of adverse outcomes. Emerging challenges include interpretation of genetic test results and the evaluation, counseling, and management of genetically at-risk family members who have inherited pathogenic variants but do not yet manifest disease. With these advances and challenges, there is a need for specialized programs combining both cardiovascular medicine and genetics expertise. The integration of clinical cardiovascular findings, including those obtained from physical examination, imaging, and functional assessment, with genetic information allows for improved diagnosis, prognostication, and cascade family testing to identify and to manage risk, and in some cases to provide genotype-specific therapy. This emerging subspecialty may ultimately require a new cardiovascular subspecialist, the genetic cardiologist, equipped with these combined skills, to permit interpretation of genetic variation within the context of phenotype and to extend the utility of genetic testing. This scientific statement outlines current best practices for delivering cardiovascular genetic evaluation and care in both the pediatric and the adult settings, with a focus on team member expertise and conditions that most benefit from genetic evaluation.