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Newman LR, Nagler A, Rudd M, Blanchard RD, Whicker SA, Winn AS, Cohen AP, Parry G, Leichtner AM, Kesselheim JC. Lost in the pandemic: COVID-19's impact on health professions educators. CLINICAL TEACHER 2024; 21:e13764. [PMID: 38663909 DOI: 10.1111/tct.13764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 03/04/2024] [Indexed: 09/03/2024]
Abstract
BACKGROUND Minimal research has explored the pandemic's impact on health professions educators (HPEs). Given that health professions educator academies provide centralised support and professional development to HPEs through communities of practice and promoting education at their institutions, it is important to examine how academies met HPEs' needs during the pandemic. This study investigates the COVID-19 pandemic's effects on HPEs and examines how academies supported HPEs' educational roles during the pandemic. METHODS Using a mixed-methods approach, the authors surveyed United States educator academy members on changes in HPEs' activities, emphasising clinical and educational tasks and work-life integration. Participants shared their academies' innovations and support responses. Data were analysed using chi-square and content analyses. FINDINGS Twenty percent of 2784 recipients (n = 559) completed the survey. Most respondents indicated the pandemic caused them to spend more time on clinical and education leadership/administration than before the pandemic. HPEs integrated innovative instructional strategies, yet many shifted away from teaching, mentoring and scholarship. Over half were dissatisfied with work-life integration during the pandemic. Females, especially, reported that professional work was compromised by personal caregiving. Academies increased their range of member services; however, they did not fully meet their members' needs, including providing expanded professional development and advocating on HPE's behalf for increased protected time dedicated to educator responsibilities. DISCUSSION HPEs faced unprecedented challenges in their personal and professional lives during the COVID-19 pandemic. Neglecting the needs of HPEs amidst global crises poses a substantial threat to the quality of education for upcoming generations of health care professionals.
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Affiliation(s)
- Lori R Newman
- Department of Pediatrics, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Academy for Teaching and Educational Innovation and Scholarship, Center for Educational Excellence and Innovation, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Alisa Nagler
- Trauma Education Programs, American College of Surgeons, Chicago, Illinois, USA
| | - Mariah Rudd
- Office of Continuing Professional Development and TEACH (Teaching Excellence Academy for Collaborative Healthcare), Carilion Clinic and Virginia Tech Carilion School of Medicine, Roanoke, Virginia, USA
| | - Rebecca D Blanchard
- Zamierowski Institute for Experiential Learning, Kansas City, Kansas, USA
- University of Kansas School of Medicine, Kansas City, Kansas, USA
| | - Shari A Whicker
- Office of Continuing Professional Development and TEACH (Teaching Excellence Academy for Collaborative Healthcare), Carilion Clinic and Virginia Tech Carilion School of Medicine, Roanoke, Virginia, USA
- Department of Pediatrics, Virginia Tech Carilion, School of Medicine, Roanoke, Virginia, USA
| | - Ariel S Winn
- Department of Pediatrics, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Amy P Cohen
- Department of Health Policy and Management, Harvard Chan School of Public Health, Boston, Massachusetts, USA
| | - Gareth Parry
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
- Health Equity Research Lab, Cambridge Health Alliance, Cambridge, Massachusetts, USA
| | - Alan M Leichtner
- Department of Pediatrics, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Academy for Teaching and Educational Innovation and Scholarship, Center for Educational Excellence and Innovation, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Jennifer C Kesselheim
- Department of Pediatrics, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Cancer and Blood Disorders Center, Dana-Farber Cancer Institute|Boston Children's Hospital, Boston, Massachusetts, USA
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Carlasare LE, Wang H, West CP, Trockel M, Dyrbye LN, Tutty M, Sinsky C, Shanafelt TD. Associations Between Organizational Support, Burnout, and Professional Fulfillment Among US Physicians During the First Year of the COVID-19 Pandemic. J Healthc Manag 2024; 69:368-386. [PMID: 39240266 DOI: 10.1097/jhm-d-23-00124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/07/2024]
Abstract
GOAL This research aimed to evaluate variations in perceived organizational support among physicians during the first year of the COVID-19 pandemic and the associations between perceived organizational support, physician burnout, and professional fulfillment. METHODS Between November 20, 2020, and March 23, 2021, 1,162 of 3,671 physicians (31.7%) responded to the study survey by mail, and 6,348 of 90,000 (7.1%) responded to an online version. Burnout was assessed using the Maslach Burnout Inventory, and perceived organizational support was assessed by questions developed and previously tested by the Stanford Medicine WellMD Center. Professional fulfillment was measured using the Stanford Professional Fulfillment Index. PRINCIPAL FINDINGS Responses to organizational support questions were received from 5,933 physicians. The mean organizational support score (OSS) for male physicians was higher than the mean OSS for female physicians (5.99 vs. 5.41, respectively, on a 0-10 scale, higher score favorable; p < .001). On multivariable analysis controlling for demographic and professional factors, female physicians (odds ratio [OR] 0.66; 95% CI: 0.55-0.78) and physicians with children under 18 years of age (OR 0.72; 95% CI: 0.56-0.91) had lower odds of an OSS in the top quartile (i.e., a high OSS score). Specialty was also associated with perceived OSS in mean-variance analysis, with some specialties (e.g., pathology and dermatology) more likely to perceive significant organizational support relative to the reference specialty (i.e., internal medicine subspecialty) and others (e.g., anesthesiology and emergency medicine) less likely to perceive support. Physicians who worked more hours per week (OR for each additional hour/week 0.99; 95% CI: 0.99-1.00) were less likely to have an OSS in the top quartile. On multivariable analysis, adjusting for personal and professional factors, each one-point increase in OSS was associated with 21% lower odds of burnout (OR 0.79; 95% CI: 0.77-0.81) and 32% higher odds of professional fulfillment (OR 1.32; 95% CI: 1.28-1.36). PRACTICAL APPLICATIONS Perceived organizational support of physicians during the COVID-19 pandemic was associated with a lower risk of burnout and a higher likelihood of professional fulfillment. Women physicians, physicians with children under 18 years of age, physicians in certain specialties, and physicians working more hours reported lower perceived organizational support. These gaps must be addressed in conjunction with broad efforts to improve organizational support.
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Affiliation(s)
| | - Hanhan Wang
- Stanford University School of Medicine, Palo Alto, California
| | - Colin P West
- Mayo Clinic, Department of General Internal Medicine, Rochester, Minnesota
| | - Mickey Trockel
- Stanford University School of Medicine, Palo Alto, California
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Thakore NL, Lan M, Winkel AF, Vieira DL, Kang SK. Best Practices: Burnout Is More Than Binary. AJR Am J Roentgenol 2024. [PMID: 39016454 DOI: 10.2214/ajr.24.31111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2024]
Abstract
Burnout among radiologists is increasingly prevalent, with potential for substantial negative impact on physician well-being, care delivery, and health outcomes. To evaluate this phenomenon using reliable and accurate means, validated quantitative instruments are essential. Variation in measurement can contribute to wide-ranging findings. This article evaluates radiologist burnout rates globally and dimensions of burnout as reported using different validated instruments and provide guidance on best practices to characterize burnout. Fifty-seven studies between 1990 and 2023 were included in a systematic review, and 43 studies were included in a meta-analysis of burnout prevalence using random effects models. Reported burnout ranged from 5% to 85%. With the Maslach Burnout Inventory (MBI), burnout prevalence varied significantly depending on instrument version. Among MBI subcategories, the prevalence of emotional exhaustion was 54% (95% CI, 45-63%), depersonalization was 52% (95% CI, 41-63%), and low personal accomplishment was 36% (95% CI, 27-47%). Other validated burnout instruments showed less heterogeneous results; studies using the Stanford Professional Fulfillment Index yielded burnout prevalence of 39% (95% CI, 34-45%), whereas the Validated Single-Item instrument yielded 34% (95% CI, 29-39%). Standardized instruments for prevalence alongside multidimensional profiles capturing experiences may better characterize radiologist burnout, including change over time.
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Affiliation(s)
| | - Michael Lan
- NYU Grossman School of Medicine, New York, NY
| | | | - Dorice L Vieira
- Health Sciences Library, NYU Grossman School of Medicine, New York, NY
| | - Stella K Kang
- Associate Professor, Department of Radiology, NYU Langone Health, New York, NY
- Department of Population Health, NYU Langone Health, New York, NY
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Hopkins H, Eggett D, Patten EV. Investigation of Precepting-Related Burnout in Dietetics Preceptors. J Acad Nutr Diet 2024:S2212-2672(24)00544-6. [PMID: 39002858 DOI: 10.1016/j.jand.2024.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 06/27/2024] [Accepted: 07/09/2024] [Indexed: 07/15/2024]
Abstract
BACKGROUND Dietetics preceptors are at risk of abandoning their role because of potential burnout. Identifying factors associated with greater and lesser burnout can help key stakeholders identify and implement strategies to prevent or mitigate burnout in dietetics preceptors. OBJECTIVE The purpose of this study was to identify factors associated with the burnout preceptors attribute specifically to the work of precepting. DESIGN This study used a cross-sectional study design. A survey instrument including burnout measures, precepting measures, and items querying personal and work characteristics was distributed via e-mail to a random sample of 10 000 credentialed nutrition and dietetics practitioners. PARTICIPANTS SETTING Respondents who lived in the United States, were currently practicing, and had precepted during the past year were included in the sample (n = 310). The survey was conducted in October and November of 2022. MAIN OUTCOME MEASURES Precepting-related burnout was measured using scores on the Copenhagen Burnout Inventory; scores ranged from 0 to 100 and higher numbers indicated greater burnout. STATISTICAL ANALYSES PERFORMED Factors associated with precepting-related burnout were identified using an analysis of covariance. Pairwise comparisons with Tukey adjustments were done to determine differences across categories for the categorical variable in the model (ie, percent of interns requiring additional coaching). A stepwise variable selection process was performed to determine the best analytic models. RESULTS Factors associated with lower precepting-related burnout in dietetics preceptors included higher Commitment to the Preceptor Role scores, lower percentages of interns requiring additional coaching, feeling appreciated by the dietetic interns, and higher Preceptors' Perceptions of Support scores. A factor associated with higher precepting-related burnout was precepting a greater number of dietetic interns in the past year. For every 1-point change in each variable, the degree of change in precepting-related burnout was -7.9 for Commitment to the Preceptor Role, -3.2 for feeling appreciated by dietetic interns, -4.5 for Preceptors' Perceptions of Support, and +1.2 for number of dietetic interns per year. The mean ± SE difference in precepting-related burnout scores between preceptors who reported < 10% of dietetic interns requiring additional coaching and those who reported > 50% of dietetic interns requiring additional coaching was -13.7 ± 3.7. CONCLUSIONS The factors found to be associated with precepting-related burnout scores in dietetics preceptors are potentially modifiable, suggesting this burnout might be prevented or mitigated to some degree.
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Affiliation(s)
- Holly Hopkins
- Department of Nutrition, Dietetics, and Food Science, Brigham Young University, Provo, Utah
| | - Dennis Eggett
- Department of Statistics, Brigham Young University, Provo, Utah
| | - Emily Vaterlaus Patten
- Department of Nutrition, Dietetics, and Food Science, Brigham Young University, Provo, Utah.
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Shahwan S, Tay EH, Shafie S, Tan YB, Gunasekaran S, Tan RHS, Satghare P, Zhang Y, Wang P, Tan SC, Subramaniam M. The protective role of resilience and social support against burnout during the COVID-19 pandemic. Front Public Health 2024; 12:1374484. [PMID: 38746007 PMCID: PMC11091290 DOI: 10.3389/fpubh.2024.1374484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 04/04/2024] [Indexed: 05/16/2024] Open
Abstract
Background The COVID-19 pandemic brought on a range of stressors in homes and workplaces. With no sign of ending after one year, burnout was a concern. Resilience has been known to shield against the effects of stress. While often thought of as an individual trait, previous studies have shown social support to improve resilience. The study aimed to examine the extent of burnout in the Singapore population and whether social support and resilience cushioned the impact of COVID-19 related stressors a year into the pandemic. Methods Participants were 858 Singapore residents who participated in a larger study between October 2021 and September 2022. The Copenhagen Burnout Inventory provided Work-and Personal-related burnout scores. Multivariable linear regression was used to identify demographic variables associated with burnout. Path analysis revealed the associations between COVID-19 stressors, social support, resilience and burnout. Results 22 and 19% of the sample reported work and personal burnout respectively, with younger adults being more burnt out than older adults. Higher stress was associated with higher burnout and higher social support was associated with lower burnout. Path analysis revealed that the relationship between social support and burnout was partially accounted for by increased resilience. Conclusion Managing altered work arrangements, career expectations, and increased responsibilities at home may contribute to greater levels of burnout in the younger adults. Increased employer support and targeted interventions could mitigate the impact of these stressors. The study also highlighted the importance of maintaining social connections even while physically distancing.
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Affiliation(s)
- Shazana Shahwan
- Research Division, Institute of Mental Health, Singapore, Singapore
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Akhavan AR, Zhan T, Lall MD, Barton MA, Reisdorff EJ, Hu Y, Bilimoria KY, Lu DW. Suicidal ideation, perception of personal safety, and career regret among emergency medicine residents during the COVID-19 pandemic. AEM EDUCATION AND TRAINING 2024; 8:e10955. [PMID: 38516253 PMCID: PMC10951625 DOI: 10.1002/aet2.10955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 01/02/2024] [Accepted: 01/08/2024] [Indexed: 03/23/2024]
Abstract
Objectives The COVID-19 pandemic was disruptive for trainees and may have affected career decisions for some learners. This study examined the impact of the pandemic on emergency medicine (EM) resident perceptions of their mental health, perceptions of personal safety, and career choice regret. Methods This was a cross-sectional survey study administered following the 2021 American Board of Emergency Medicine In-Training Examination (ITE). Survey measures included suicidal ideation (SI), COVID concerns in terms of infection prevention and control (IPC) training, COVID risk to self and/or COVID risk to family, and COVID-related career regret. COVID concerns were compared by gender and race/ethnicity using Pearson's chi-square tests. Multivariable logistic regression models were used to test the association between SI and COVID concerns, resident characteristics, and program characteristics. Results A total of 6980 out of 8491 EM residents (82.2%) from 244 programs completed the survey. Only 1.1% of participants reported insufficient training in COVID IPC practices. Participants were concerned about COVID risk to themselves (40.3%) and to their families (63.3%) due to their job roles. These concerns were more common among women or nonbinary (vs. men); all other races/ethnicities (vs. non-Hispanic Whites); senior residents (vs. PGY-1, PGY-2 residents); and residents who were married or in relationships (vs. single or divorced). A total of 6.1% of participants reported that COVID made them reconsider choosing EM as their career. Career regret in this cohort was higher than that in the proportion (3.2%) expressing career regret in the 2020 ITE (p < 0.001). Career regret was more common among women or nonbinary (vs. men); all other races/ethnicities (vs. non-Hispanic Whites); and senior residents (vs. PGY-1, PGY-2 residents). The overall SI rate was 2.6%, which did not differ from that of the 2020 sample of EM residents (2.5%, p = 0.88). Conclusions Many EM residents reported concerns about COVID risks to themselves and their families. Although the rate of SI remained unchanged, more EM residents reported career regret during the COVID pandemic.
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Affiliation(s)
- Arvin R. Akhavan
- Department of Emergency MedicineUniversity of WashingtonSeattleWashingtonUSA
| | - Tiannan Zhan
- Department of SurgeryNorthwestern UniversityChicagoIllinoisUSA
| | - Michelle D. Lall
- Department of Emergency MedicineEmory UniversityAtlantaGeorgiaUSA
| | | | | | - Yue‐Yung Hu
- Department of SurgeryNorthwestern UniversityChicagoIllinoisUSA
| | - Karl Y. Bilimoria
- Department of SurgeryIndiana University School of MedicineIndianapolisIndianaUSA
| | - Dave W. Lu
- Department of Emergency MedicineUniversity of WashingtonSeattleWashingtonUSA
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de Laat K, Kaplan S, Lu L. Accelerating progress towards gender equity in health and science. Lancet 2024; 403:883-886. [PMID: 38458211 DOI: 10.1016/s0140-6736(24)00404-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 02/26/2024] [Indexed: 03/10/2024]
Affiliation(s)
- Kim de Laat
- Stratford School of Interaction Design and Business, University of Waterloo, Stratford, ON N5A 0C1, Canada.
| | - Sarah Kaplan
- Rotman School of Management, University of Toronto, Toronto, ON, Canada
| | - Lechin Lu
- Institute for Gender and the Economy, University of Toronto, Toronto, ON, Canada
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Hutchings HA, Rahman M, Carter K, Islam S, O'Neill C, Roberts S, John A, Fegan G, Dave U, Hawkes N, Ahmed F, Hasan M, Azad AK, Rahman MM, Kibria MG, Rahman MM, Mia T, Akhter M, Williams JG. Did the COVID-19 pandemic affect levels of burnout, anxiety and depression among doctors and nurses in Bangladesh? A cross-sectional survey study. BMJ Open 2024; 14:e079350. [PMID: 38453200 PMCID: PMC10921535 DOI: 10.1136/bmjopen-2023-079350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 02/14/2024] [Indexed: 03/09/2024] Open
Abstract
INTRODUCTION COVID-19 has caused severe disruption to clinical services in Bangladesh but the extent of this, and the impact on healthcare professionals is unclear. We aimed to assess the perceived levels of anxiety, depression and burnout among doctors and nurses during COVID-19 pandemic. METHODS We undertook an online survey using RedCap, directed at doctors and nurses across four institutions in Bangladesh (The Sheikh Russel Gastro Liver Institute & Hospital (SRNGIH), Dhaka Medical College Hospital (DMCH), Mugda Medical College Hospital (MMCH) and M Abdur Rahim Medical College (MARMC) Hospital). We collected information on demographics, awareness of well-being services, COVID-19-related workload, as well as anxiety, depression and burnout using two validated questionnaires: the Hospital Anxiety and Depression Scale (HADS) and the Maslach Burnout Inventory (MBI). RESULTS Of the 3000 participants approached, we received responses from 2705 (90.2%). There was a statistically significant difference in anxiety, depression and burnout scores across institutions (p<0.01). Anxiety, depression and burnout scores were statistically worse in COVID-19 active staff compared with those not working on COVID-19 activities (p<0.01 for HADS anxiety and depression and MBI emotional exhaustion (EE), depersonalisation (DP) and personal accomplishment (PA)). Over half of the participants exhibited some level of anxiety (SRNGIH: 52.2%; DMCH: 53.9%; MMCH: 61.3%; MARMC: 68%) with a high proportion experiencing depression (SRNGIH: 39.5%; DMCH: 38.7%; MMCH: 53.7%; MARMC: 41.1%). Although mean burnout scores were within the normal range for each institution, a high proportion of staff (almost 20% in some instances) were shown to be classified as experiencing burnout by their EE, DP and PA scores. CONCLUSION We identified a high prevalence of perceived anxiety, depression and burnout among doctors and nurses during the COVID-19 pandemic. This was worse in staff engaged in COVID-19-related activities. These findings could help healthcare organisations to plan for future similar events.
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Affiliation(s)
| | - Mesbah Rahman
- Swansea Bay University Health Board, Port Talbot, UK
| | | | | | | | | | | | | | - Umakant Dave
- Swansea Bay University Health Board, Port Talbot, UK
| | - Neil Hawkes
- Cwm Taf Morgannwg University Health Board, Abercynon, UK
| | - Faruque Ahmed
- Department of Gastroenterology, Sheikh Russel National Gastroliver Institute and Hospital, Dhaka, Bangladesh
| | | | | | | | - Md Golam Kibria
- Sheikh Russel National Gastroliver Institute, Dhaka, Bangladesh
| | | | - Titu Mia
- Mugda Medical College and Hospital, Dhaka, Bangladesh
| | | | - John G Williams
- Faculty of Medicine, Health and Life Science, Swansea University, Swansea, UK
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Akinleye D, Wu M, Efferen LS, McCauley S, Allen A, Bennett H, Snitkoff LS, Cleary LM, Bliss K, Martiniano R, Wang S, McNutt LA, Osinaga A. Newly Acquired Burnout During the Coronavirus Disease 2019 (COVID-19) Pandemic: A Retrospective Cohort Study on the Experiences of New York State Primary Care Clinicians. J Community Health 2024; 49:34-45. [PMID: 37382837 DOI: 10.1007/s10900-023-01247-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2023] [Indexed: 06/30/2023]
Abstract
The well-being of primary care clinicians represents an area of increasing interest amid concerns that the COVID-19 pandemic may have exacerbated already high prevalence rates of clinician burnout. This retrospective cohort study was designed to identify demographic, clinical, and work-specific factors that may have contributed to newly acquired burnout after the onset of the COVID-19 pandemic. An anonymous web-based questionnaire distributed in August 2020 to New York State (NYS) primary care clinicians, via email outreach and newsletters, produced 1,499 NYS primary care clinician survey respondents. Burnout assessment was measured pre-pandemic and early in the pandemic using a validated single-item question with a 5-point scale ranging from (1) enjoy work to (5) completely burned out. Demographic and work factors were assessed via the self-reporting questionnaire. Thirty percent of 1,499 survey respondents reported newly acquired burnout during the early pandemic period. This was more often reported by clinicians who were women, were younger than 56 years old, had adult dependents, practiced in New York City, had dual roles (patient care and administration), and were employees. Lack of control in the workplace prior to the pandemic was predictive of burnout early in the pandemic, while work control changes experienced following the pandemic were associated with newly acquired burnout. Low response rate and potential recall bias represent limitations. These findings demonstrate that reporting of burnout increased among primary care clinicians during the pandemic, partially due to varied and numerous work environment and systemic factors.
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Affiliation(s)
- Dean Akinleye
- Bureau of Clinical Research and Evaluation, Office of Quality and Patient Safety, New York State Department of Health, Empire State Plaza, Corning Tower, Room 1955, Albany, NY, 12237, USA.
| | - Meng Wu
- Bureau of Clinical Research and Evaluation, Office of Quality and Patient Safety, New York State Department of Health, Empire State Plaza, Corning Tower, Room 1955, Albany, NY, 12237, USA
| | - Linda S Efferen
- Office of Quality and Patient Safety, New York State Department of Health, ESP Corning Tower, Room 2019, Albany, NY, 12237, USA
| | - Susan McCauley
- Office of Quality and Patient Safety, New York State Department of Health, ESP Corning Tower, Room 2019, Albany, NY, 12237, USA
| | - Amanda Allen
- Communications, New York Chapter of the American College of Physicians, PO Box 38237, Albany, NY, 12203, USA
| | - Heather Bennett
- Diversity Equity and Inclusion Task Force, New York Chapter of the American College of Physicians, PO Box 38237, Albany, NY, 12203, USA
| | - Louis S Snitkoff
- Albany Medical College, New York Chapter of the American College of Physicians, PO Box 38237, Albany, NY, 12203, USA
| | - Lynn M Cleary
- Upstate Medical University, 750 East Adams Street, Syracuse, NY, 13210, USA
| | - Kate Bliss
- Office of Health Insurance Programs, New York State Department of Health, ESP Corning Tower, Room, Albany, NY, 12237, USA
| | - Robert Martiniano
- Center for Health Workforce Studies, University at Albany School of Public Health, 1 University Plaza, Pl #220, Rensselaer, NY, 12144, USA
| | - Shen Wang
- Center for Health Workforce Studies, University at Albany School of Public Health, 1 University Plaza, Pl #220, Rensselaer, NY, 12144, USA
| | - Louise-Ann McNutt
- Institute for Health and the Environment, University at Albany, State University of New York, 5 University Place, Room A217, Rensselaer, NY, 12144, USA
| | - Alda Osinaga
- Office of Quality and Patient Safety, New York State Department of Health, ESP Corning Tower, Room 2019, Albany, NY, 12237, USA
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Patel S, Ghebre R, Dwivedi R, Macheledt K, Watson S, Duffy B, Rogers E, Pusalavidyasagar S, Guo C, Misono S, Evans M, Lingras K, Kunin-Batson A, McCarty C, Sandoval-Garcia C, Nakib N, Johnson C, Barker S, Hutto S, Church A, Vezys V, Girard A, Spencer S, Berge J. Academic clinician frontline-worker wellbeing and resilience during the COVID-19 pandemic experience: Were there gender differences? Prev Med Rep 2023; 36:102517. [PMID: 38116283 PMCID: PMC10728464 DOI: 10.1016/j.pmedr.2023.102517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 11/16/2023] [Accepted: 11/18/2023] [Indexed: 12/21/2023] Open
Abstract
Prior research suggests COVID-19 has amplified stress on Academic Clinician Frontline-Workers (ACFW). The aim of this paper is: (1) to better understand the experiences of ACFW during the COVID-19 pandemic including their mental-emotional wellbeing, academic productivity, clinical experiences, and (2) to examine any gender differences. A cross-sectional survey was administered to University of Minnesota/M Health Fairview systems' faculty February-June 2021. Of the 291 respondents, 156 were clinicians, with 91 (58 %) identifying as Frontline-Workers (ACFW). Faculty wellbeing was assessed using validated measures in addition to measures of productivity and sociodemographics. For example, ACFW reported a higher Work-Family Conflict (WFC) scores compared to non-ACFW (26.5 vs. 24.1, p = 0.057) but did not report higher Family-Work Conflict (FWC) scores (17.7 vs. 16.3, p = 0.302). Gender sub-analyses, revealed that women ACFW compared to men ACFW reported higher WFC scores (27.7 vs. 24.1, p = 0.021) and FWC (19.3 vs. 14.3, p = 0.004). Academically, ACFW reported submitting fewer grants and anticipated delays in promotion and tenure due to the COVID-19 (p = 0.035). Results suggest COVID-19 has exacerbated ACFW stress and gender inequities. Reports of anticipated delay in promotion for ACFW may pose a challenge for the long-term academic success of ACFW, especially women ACFW. In addition, women may experience higher FWC and WFC as compared to men. Schools of academic medicine should consider re-evaluating promotion/tenure processes and creating resources to support women ACFW as well as ACFW caregivers.
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Affiliation(s)
- S.I. Patel
- Department of Neurology, lead of Salary, Resource, and Leadership Equity Action Group of the Center for Women in Medicine and Science, and member of the DEI Council at the University of Minnesota Medical School, Minneapolis, MN, USA
| | - R. Ghebre
- Department of Obstetrics and Gynecology, Associate Director for Diversity, Equity and Inclusion at Masonic Cancer Center and a member of the Retention and Recruitment Action Group in the Center for Women in Medicine and Science at the University of Minnesota Medical School, Minneapolis, MN, USA
| | - R. Dwivedi
- Department of Family Medicine and Community Health and member of the Center for Women in Medicine and Science Mentoring Action Group at the University of Minnesota Medical School, Minneapolis, MN, USA
| | - K. Macheledt
- Center for Women’s Health Research at the University of Minnesota Medical School, Minneapolis, MN, USA
| | - S. Watson
- Center for Women in Medicine and Science and Program Coordinator for the Center for Global Health and Social Responsibility at the University of Minnesota, Minneapolis, MN, USA
| | - B.L. Duffy
- Department of Medicine and a member of the Retention and Recruitment Action Group in the Center for Women in Medicine and Science at the University of Minnesota Medical School, Minneapolis, MN, USA
| | - E.A. Rogers
- Departments of Medicine and of Pediatrics, and member of the Salary, Resource, and Leadership Equity Action Group in the Center for Women in Medicine and Science at the University of Minnesota Medical School, Minneapolis, MN, USA
| | - S. Pusalavidyasagar
- Department of Medicine and member of the Center for Women in Medicine and Science Mentoring Action Group at the University of Minnesota Medical School, Minneapolis, MN USA
| | - C. Guo
- Department of Radiology and member of the Center for Women in Medicine and Science Strategic Communications and Collaborations Action Group at the University of Minnesota Medical School, Minneapolis, MN, USA
| | - S. Misono
- Department of Otolaryngology and member of the Center for Women in Medicine and Science Mentoring Action Group at the University of Minnesota Medical School, Minneapolis, MN, USA
| | - M.D. Evans
- Biostatistical Design and Analysis Center, Clinical and Translational Science Institute, University of Minnesota, Minneapolis, MN, USA
| | - K. Lingras
- Department of Psychiatry and Behavioral Sciences and a member of the Retention and Recruitment Action Group in the Center for Women in Medicine and Science at the University of Minnesota Medical School, Minneapolis, MN, USA
| | - A. Kunin-Batson
- Department of Pediatrics and member of the Center for Women in Medicine and Science Salary, Resource, and Leadership Equity Action Group at the University of Minnesota Medical School, Minneapolis, MN, USA
| | - C.A. McCarty
- Department of Family Medicine and Biobehavioral Health and Associate Dean for Research at the Duluth campus of the University of Minnesota, USA
| | - C. Sandoval-Garcia
- Departments of Neurosurgery and Pediatrics and member of the Center for Women in Medicine and Science Salary, Resource, and Leadership Equity Action Group at the University of Minnesota Medical School, Minneapolis, MN, USA
| | - N. Nakib
- Female Urology and Urodynamics in the Department of Urology, and the Strategic Communications and Collaborations Action Group Lead for the Center for Women in Medicine and Science at the University of Minnesota Medical School, Minneapolis, MN, USA
| | - C. Johnson
- University of Minnesota and an MPH student at the Harvard TH Chan School of Public Health, USA
| | - S. Barker
- Department of Radiology and a member of the Center for Women in Medicine and Science Salary, Resource, and Leadership Equity Action Group at the University of Minnesota Medical School, Minneapolis, MN, USA
| | - S. Hutto
- Department of Obstetrics, Gynecology and Women’s Health and a member of the Center for Women in Medicine and Science Salary, Resource, and Leadership Equity Action Group at the University of Minnesota Medical School, Minneapolis, MN, USA
| | - A.L. Church
- Department of Radiology and the Mentoring Action Group Lead for the Center for Women in Medicine and Science at the University of Minnesota Medical School, Minneapolis, MN, USA
| | - V. Vezys
- Department of Microbiology and Immunology, a member of the Center for Immunology and a member of the Center for Women in Medicine and Science Salary, Resource, and Leadership Equity Action Group at the University of Minnesota Medical School, Minneapolis, MN, USA
| | - A. Girard
- Department of Family Medicine and Community Health and member of the Center for Women in Medicine and Science Salary, Resource, and Leadership Equity Action Group at the University of Minnesota Medical School, Minneapolis, MN, USA
| | - S. Spencer
- Department of Pharmacology and the Retention and Recruitment Action Group Lead for the Center for Women in Medicine and Science at the University of Minnesota Medical School, Minneapolis, MN, USA
| | - J.M. Berge
- Department of Family Medicine and Community Health, Director of the Center for Women in Medicine and Science, and Director of the Women’s Health Research Program/Building Interdisciplinary Research Careers in Women’s Health (BIRCWH) Program at the University of Minnesota Medical School, Minneapolis, MN, USA
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11
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Sinsky CA, Trockel M, Carlasare LE, West CP, Wang H, Tutty M, Dyrbye LN, Shanafelt TD. Politicization of Medical Care, Burnout, and Professionally Conflicting Emotions Among Physicians During COVID-19. Mayo Clin Proc 2023; 98:1613-1628. [PMID: 37923520 DOI: 10.1016/j.mayocp.2023.07.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 06/19/2023] [Accepted: 07/06/2023] [Indexed: 11/07/2023]
Abstract
OBJECTIVE To evaluate the association of politicization of medical care with burnout, professional fulfillment, and professionally conflicting emotions (eg, less empathy, compassion; more anger, frustration, resentment). PARTICIPANTS AND METHODS Physicians in select specialties were surveyed between December 2021 and January 2022 using methods similar to our prior studies, with additional assessment of politicization of medical care; moral distress; and having had to compromise professional integrity, workload, and professionally conflicting emotions. RESULTS In a sample of 2780 physicians in emergency medicine, critical care, noncritical care hospital medicine, and ambulatory care, stress related to politicization of medical care was reported by 91.8% of physicians. On multivariable analysis, compromised integrity (odds ratio [OR], 3.64; 95% CI, 2.31 to 5.98), moral distress (OR, 2.82; 95% CI, 2.16 to 3.68), and feeling more exhausted taking care of patients with coronavirus disease 2019 (COVID-19) (OR, 3.46; 95% CI, 2.63 to 4.54) were associated with burnout. Compromised integrity, moral distress, and feeling more exhausted taking care of patients with COVID-19 were also statistically significantly associated with lower odds of professional fulfillment and professionally conflicting emotions. Stress related to conversations about non-approved COVID-19 therapies (OR, 1.74; 95% CI, 1.08 to 2.89), patient resistance to mask wearing (OR, 1.84; 95% CI, 1.35 to 2.55), and working more hours due to COVID (OR, 0.66; 95% CI, 0.49 to 0.89) were associated with professionally conflicting emotions. CONCLUSION Most physicians experienced intrusion of politics into medical care during the pandemic. These experiences are associated with professionally conflicting emotions, including less compassion and empathy, greater frustration, and resentment. COVID-19-related moral distress and compromised integrity were also associated with less professional fulfillment and greater occupational burnout.
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Affiliation(s)
| | | | | | | | - Hanhan Wang
- American Medical Association, Chicago, IL, USA
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12
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Constantino E, Spina T. Psychiatric Treatment of Medical Colleagues and Their Families: Potential Risks. J Psychiatr Pract 2023; 29:489-492. [PMID: 37948174 DOI: 10.1097/pra.0000000000000745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
Clinicians treating "very important persons" face potential problems that can negatively impact the quality of care they provide. Mental health professionals face similar pressures, particularly when asked to treat a particular kind of patient who is a very important person: medical colleagues or their family members. The authors present 3 cases that exemplify possible risks associated with the psychiatric treatment of these individuals, including negative effects on the physician-patient relationship, lapses in patient confidentiality, and violations of medical ethics. Preventive and mitigative steps to avoid these pitfalls are discussed. Awareness of these issues when treating fellow physicians or their family members is an important consideration for any mental health clinician.
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Affiliation(s)
- Eduardo Constantino
- CONSTANTINO and SPINA: Department of Psychiatry and Behavioral Health, Stony Brook Medicine, Stony Brook, NY
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13
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Mann A, Shah AN, Thibodeau PS, Dyrbye L, Syed A, Woodward MA, Thurmon K, Jones CD, Dunbar KS, Fainstad T. Online Well-Being Group Coaching Program for Women Physician Trainees: A Randomized Clinical Trial. JAMA Netw Open 2023; 6:e2335541. [PMID: 37792378 PMCID: PMC10551770 DOI: 10.1001/jamanetworkopen.2023.35541] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 08/21/2023] [Indexed: 10/05/2023] Open
Abstract
Importance Physician burnout disproportionately affects women physicians and begins in training. Professional coaching may improve well-being, but generalizable evidence is lacking. Objective To assess the generalizability of a coaching program (Better Together Physician Coaching) in a national sample of women physician trainees. Design, Setting, and Participants A randomized clinical trial involving trainees in 26 graduate medical education institutions in 19 states was conducted between September 1, 2022, and December 31, 2022. Eligible participants included physician trainees at included sites who self-identified as a woman (ie, self-reported their gender identity as woman, including those who reported woman if multiple genders were reported). Intervention A 4-month, web-based, group coaching program. Main Outcomes and Measures The primary outcomes were change in burnout (measured using subscales for emotional exhaustion, depersonalization, and personal achievement from the Maslach Burnout Inventory). Secondary outcomes included changes in impostor syndrome, moral injury, self-compassion, and flourishing, which were assessed using standardized measures. A linear mixed model analysis was performed on an intent-to-treat basis. A sensitivity analysis was performed to account for the missing outcomes. Results Among the 1017 women trainees in the study (mean [SD] age, 30.8 [4.0] years; 540 White participants [53.1%]; 186 surgical trainees [18.6%]), 502 were randomized to the intervention group and 515 were randomized to the control group. Emotional exhaustion decreased by an estimated mean (SE) -3.81 (0.73) points in the intervention group compared with a mean (SE) increase of 0.32 (0.57) points in the control group (absolute difference [SE], -4.13 [0.92] points; 95% CI, -5.94 to -2.32 points; P < .001). Depersonalization decreased by a mean (SE) of -1.66 (0.42) points in the intervention group compared with a mean (SE) increase of 0.20 (0.32) points in the control group (absolute difference [SE], -1.87 [0.53] points; 95%CI, -2.91 to -0.82 points; P < .001). Impostor syndrome decreased by a mean (SE) of -1.43 (0.14) points in the intervention group compared with -0.15 (0.11) points in the control group (absolute difference [SE], -1.28 (0.18) points; 95% CI -1.63 to -0.93 points; P < .001). Moral injury decreased by a mean (SE) of -5.60 (0.92) points in the intervention group compared with -0.92 (0.71) points in the control group (absolute difference [SE], -4.68 [1.16] points; 95% CI, -6.95 to -2.41 points; P < .001). Self-compassion increased by a mean (SE) of 5.27 (0.47) points in the intervention group and by 1.36 (0.36) points in the control group (absolute difference [SE], 3.91 [0.60] points; 95% CI, 2.73 to 5.08 points; P < .001). Flourishing improved by a mean (SE) of 0.48 (0.09) points in the intervention group vs 0.09 (0.07) points in the control group (absolute difference [SE], 0.38 [0.11] points; 95% CI, 0.17 to 0.60 points; P < .001). The sensitivity analysis found similar findings. Conclusions and Relevance The findings of this randomized clinical trial suggest that web-based professional group-coaching can improve outcomes of well-being and mitigate symptoms of burnout for women physician trainees. Trial Registration ClinicalTrials.gov Identifier: NCT05222685.
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Affiliation(s)
- Adrienne Mann
- Division of Hospital Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora
- Veterans’ Health Administration, Eastern Colorado Health Care System, Aurora
| | - Ami N. Shah
- Division of Pediatric Surgery, Department of Surgery, Rush University Medical Center, Chicago, Illinois
| | - Pari Shah Thibodeau
- Department of Psychiatry, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora
| | - Liselotte Dyrbye
- Division of General Internal Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora
| | - Adnan Syed
- University of Colorado School of Medicine, Aurora
- Veterans’ Health Administration, Eastern CO Health Care System, Denver-Seattle Center of Innovation for Veteran-Centered and Value Driven Care, Aurora, Colorado
| | | | - Kerri Thurmon
- Division of Urology, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora
| | - Christine D. Jones
- Division of Hospital Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora
- Veterans’ Health Administration, Eastern Colorado Health Care System, Aurora
- Division of Geriatrics, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora
| | - Kimiko S. Dunbar
- Children’s Hospital of Colorado, Section of Hospital Medicine, University of Colorado, School of Medicine, Aurora
| | - Tyra Fainstad
- Division of General Internal Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora
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14
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Silistraru I, Ciubară A, Olariu O, Ciureanu IA, Checheriță LE, Drugus D, Dănilă R, Roșca Ș. Burnout and Intention to Change Profession among Romanian Dentists during COVID-19: A Cross Sectional Study Using the Maslach Burnout Inventory. Healthcare (Basel) 2023; 11:2667. [PMID: 37830704 PMCID: PMC10573021 DOI: 10.3390/healthcare11192667] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 09/23/2023] [Accepted: 09/27/2023] [Indexed: 10/14/2023] Open
Abstract
This study aims to examine the relationship between burnout and dentists' intentions to change careers during the COVID-19 pandemic. The MBI-Human Services Survey for Medical Personnel-MBI-HSS (MP) was used to measure burnout levels and investigate how they relate to dentists' intentions to change their profession. The sample included 69 Romanian dentists, 56 of whom were women and 13 of whom were men. Self-reported questionnaires provided to the participants were used to collect the data. Female participants reported higher levels of emotional Exhaustion and Depersonalisation than males. However, there were no substantial differences in Personal Accomplishment levels between genders. As for the intentions to change careers, 41 expressed a clear intention to change their profession, 15 were still determining if they would choose the same speciality, and 28 indicated they would not choose the medical field. The study's findings provide insight into how dentists' thoughts about perceived burnout during the COVID-19 pandemic significantly influenced their attitudes regarding their career paths. The results suggest concerns regarding burnout in the dental field and emphasise the necessity for burnout interventions and support services, particularly during healthcare crises. Further research and interventions to mitigate burnout and promote well-being among dentists are needed to ensure the sustainability and quality of dental healthcare services in Romania.
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Affiliation(s)
- Ioana Silistraru
- Faculty of Social Sciences and Humanities, Lucian Blaga University of Sibiu, 550025 Sibiu, Romania;
| | - Anamaria Ciubară
- Clinical Medical Department, School of Medicine and Pharmacy, Dunărea de Jos University of Galați, 800008 Galati, Romania
| | - Oana Olariu
- Clinical Medical Department, School of Medicine and Pharmacy, Dunărea de Jos University of Galați, 800008 Galati, Romania
| | - Ioan-Adrian Ciureanu
- Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania; (I.-A.C.); (L.-E.C.); (D.D.)
| | | | - Daniela Drugus
- Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania; (I.-A.C.); (L.-E.C.); (D.D.)
| | - Radu Dănilă
- Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania; (I.-A.C.); (L.-E.C.); (D.D.)
| | - Ștefan Roșca
- Clinical Medical Department, School of Medicine and Pharmacy, Dunărea de Jos University of Galați, 800008 Galati, Romania
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15
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Mohr DC, Apaydin EA, Li BM, Molloy-Paolillo BK, Rinne ST. Changes in Burnout and Moral Distress Among Veterans Health Administration (VA) Physicians Before and During the COVID-19 Pandemic. J Occup Environ Med 2023; 65:605-609. [PMID: 37043388 PMCID: PMC10332509 DOI: 10.1097/jom.0000000000002861] [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] [Indexed: 04/13/2023]
Abstract
BACKGROUND We investigated the impacts of workload, resources, organizational satisfaction, and psychological safety on changes in physician burnout and moral distress among physicians during the early pandemic. METHODS We obtained national administrative and survey data on burnout, moral distress, organizational satisfaction, psychological safety, COVID-19 burden, and state-level restrictions for 11,877-14,246 Veterans Health Administration (VA) physicians from 2019 and 2020. We regressed the changes in burnout and moral distress on the changes in reasonable workload, appropriate job resources, organizational satisfaction, and psychological safety, controlling for COVID-19 burden and restrictions, and individual and medical center characteristics. RESULTS Burnout and moral distress were not related to COVID-19 cases or restrictions but were reduced by improvements in workload, organizational satisfaction, and psychological safety. CONCLUSIONS Health systems should be conscious of factors that can harm or improve physician well-being, especially in the context of external stressors.
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16
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Benjamin T, Gulati A, Zebolsky AL, Seth R, Knott PD, Okuyemi O, Park AM. Assessing the Prevalence of Burnout Among Female Microvascular Head and Neck Surgeons. Facial Plast Surg Aesthet Med 2023; 25:298-303. [PMID: 37162749 DOI: 10.1089/fpsam.2022.0312] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023] Open
Abstract
Background: Research has not explicitly explored differences between male and female microvascular head and neck (MHN) surgeon burnout, which should be identified and addressed to ensure career satisfaction and longevity. Objective: To measure and compare the prevalence of burnout among male versus female MHN surgeons. Methods: A prospective questionnaire based on the Maslach Burnout Inventory (MBI) was distributed through a web-based survey to the American Association of Facial Plastic and Reconstructive Surgeons and American Head and Neck Society in 2021 and 2022. Additional variables collected included demographics, relationship and parental status, academic rank, annual salary, and COVID-19-related questions. Results: One hundred thirteen surveys were collected. Twenty-nine (25.7%) were women and all completed MHN surgery fellowships. Women trended toward more emotional exhaustion than men (2.8 mean MBI vs. 2.3 mean MBI) but reported similar personal achievement (4.8 mean MBI vs. 4.9 mean MBI). Men experienced less workplace sexual harassment (p < 0.001). Women experienced more burnout (69% vs. 39%, p = 0.006) during the COVID-19 pandemic. Conclusion: Female MHN surgeons reported in this survey to experience more workplace sexual harassment and higher COVID-19-related burnout than their male counterparts.
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Affiliation(s)
- Tania Benjamin
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, San Francisco, California, USA
| | - Arushi Gulati
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, San Francisco, California, USA
| | - Aaron L Zebolsky
- Homer Stryker M.D. School of Medicine, Western Michigan University, Kalamazoo, Michigan, USA
| | - Rahul Seth
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, San Francisco, California, USA
| | - P Daniel Knott
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, San Francisco, California, USA
| | - Oluwafunmilola Okuyemi
- Department of Otolaryngology-Head and Neck Surgery, University of Nevada Las Vegas, Las Vegas, Nevada, USA
| | - Andrea M Park
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, San Francisco, California, USA
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17
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Gambaro E, Gramaglia C, Marangon D, Probo M, Rudoni M, Zeppegno P. Health Workers' Burnout and COVID-19 Pandemic: 1-Year after-Results from a Repeated Cross-Sectional Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6087. [PMID: 37372674 DOI: 10.3390/ijerph20126087] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 05/07/2023] [Accepted: 05/29/2023] [Indexed: 06/29/2023]
Abstract
(1) Background: This study evaluates, one year later, the levels of burnout, anxious-depressive, and post-traumatic symptoms and the general health status in the Health Workers (HWs) involved in the SARS-COVID-19 pandemic in the Novara area. (2) Methods: The survey was sent via a link in an email to doctors, nurses, and other operators during the period between June and August 2021. The survey collected socio-demographic data and contained some self-administered questionnaires. (3) Results: A total of 688 HWs completed the survey, 53% were aged 30-49 years, 68% were female, 76% were cohabiting, 55% had children, 86% reported family habit changes, and 20% had non-COVID related health problems. Only a few of the respondents had a follow-up by a specialist (12%), of which there were even less in recent times (6%). It was observed that the respondents had undergone burnout; a poor state of general mental health (62%); depressive symptoms (70%); post-traumatic symptoms (29%); and less frequently, anxious symptoms (16%). The data of this study are in line with other studies in the literature. (4) Conclusions: The data indicate that psychological-based suffering was no longer markedly concentrated in some specific bands of HWs. In conclusion, it would be essential to enhance HW support strategies.
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Affiliation(s)
- Eleonora Gambaro
- Department of Translational Medicine, Università del Piemonte Orientale, 13100 Vercelli, Italy
| | - Carla Gramaglia
- Department of Translational Medicine, Università del Piemonte Orientale, 13100 Vercelli, Italy
- Psychiatry Unit, Maggiore della Carità Hospital, 28100 Novara, Italy
| | - Debora Marangon
- Department of Translational Medicine, Università del Piemonte Orientale, 13100 Vercelli, Italy
| | - Manuela Probo
- Department of Mental Health, ASL NOVARA, 28100 Novara, Italy
| | - Marco Rudoni
- Department of Mental Health, ASL NOVARA, 28100 Novara, Italy
| | - Patrizia Zeppegno
- Department of Translational Medicine, Università del Piemonte Orientale, 13100 Vercelli, Italy
- Psychiatry Unit, Maggiore della Carità Hospital, 28100 Novara, Italy
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Shaffer KM, Turner KL, Siwik C, Gonzalez BD, Upasani R, Glazer JV, Ferguson RJ, Joshua C, Low CA. Digital health and telehealth in cancer care: a scoping review of reviews. Lancet Digit Health 2023; 5:e316-e327. [PMID: 37100545 PMCID: PMC10124999 DOI: 10.1016/s2589-7500(23)00049-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 01/06/2023] [Accepted: 02/23/2023] [Indexed: 04/28/2023]
Abstract
The COVID-19 pandemic necessitated remote cancer care delivery via the internet and telephone, rapidly accelerating an already growing care delivery model and associated research. This scoping review of reviews characterised the peer-reviewed literature reviews on digital health and telehealth interventions in cancer published from database inception up to May 1, 2022, from PubMed, Cumulated Index to Nursing and Allied Health Literature, PsycINFO, Cochrane Reviews, and Web of Science. Eligible reviews conducted a systematic literature search. Data were extracted in duplicate via a pre-defined online survey. Following screening, 134 reviews met the eligibility criteria. 77 of those reviews were published since 2020. 128 reviews summarised interventions intended for patients, 18 addressed family caregivers, and five addressed health-care providers. 56 reviews did not target a specific phase of the cancer continuum, whereas 48 reviews tended to address the active treatment phase. 29 reviews included a meta-analysis, with results showing positive effects on quality of life, psychological outcomes, and screening behaviours. 83 reviews did not report intervention implementation outcomes but when reported, 36 reported acceptability, 32 feasibility, and 29 fidelity outcomes. Several notable gaps were identified in these literature reviews on digital health and telehealth in cancer care. No reviews specifically addressed older adults, bereavement, or sustainability of interventions and only two reviews focused on comparing telehealth to in-person interventions. Addressing these gaps with rigorous systematic reviews might help guide continued innovation in remote cancer care, particularly for older adults and bereaved families, and integrate and sustain these interventions within oncology.
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Affiliation(s)
- Kelly M Shaffer
- Center for Behavioral Health and Technology, School of Medicine, University of Virginia, Charlottesville, VA, USA.
| | - Kea L Turner
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Chelsea Siwik
- Osher Center for Integrative Health, University of California San Francisco, San Francisco, CA, USA
| | - Brian D Gonzalez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Rujula Upasani
- Center for Behavioral Health and Technology, School of Medicine, University of Virginia, Charlottesville, VA, USA
| | - Jillian V Glazer
- Center for Behavioral Health and Technology, School of Medicine, University of Virginia, Charlottesville, VA, USA
| | - Robert J Ferguson
- Division of Hematology/Oncology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Catherine Joshua
- Center for Behavioral Health and Technology, School of Medicine, University of Virginia, Charlottesville, VA, USA
| | - Carissa A Low
- Division of Hematology/Oncology, University of Pittsburgh, Pittsburgh, PA, USA
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Abstract
OBJECTIVE This study aimed to investigate the prevalence of burnout experiences and factors associated with burnout among Korean health care workers during the coronavirus disease 2019 (COVID-19) pandemic. METHODS A nationwide survey was conducted in 2021, and the sample comprised 1000 public health center employees. Multivariate linear regression was used to examine the factors associated with burnout among the participants during the COVID-19 pandemic. Perceived factors contributing to burnout were also analyzed using an open-ended question. RESULTS Personal (e.g., age, gender, and self-rated health) and work-related factors (e.g., type of job tasks and COVID-19-related discrimination experience) affected burnout among health care workers. However, organizational support, including emotional support and sufficient financial compensation, was associated with lower burnout. CONCLUSIONS Ensuring sufficient support and rewards for health care workers is essential to guaranteeing their well-being during the current public health crisis.
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20
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Cankurtaran CZ, Reddy S, Cen SY, Lei X, Walker DK. Work-Life Experience of Academic Radiologists: Food for Thought. Acad Radiol 2023; 30:579-584. [PMID: 36775667 DOI: 10.1016/j.acra.2023.01.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 01/08/2023] [Accepted: 01/10/2023] [Indexed: 02/13/2023]
Abstract
RATIONALE AND OBJECTIVES Work-life experience of physicians is a driver of work engagement vs. burnout. We aimed to determine individual and institutional factors affecting work-life experience of the clinical faculty at a large tertiary care academic medical center. MATERIALS AND METHODS The Department of Radiology clinical faculty (n = 62) were surveyed electronically in October 2022. Twenty-three questions, consisting of multiple choice, Yes/No, and Likert scale ratings were administered to obtain demographic information and data for life outside of work, life at work, and work-life integration for the prior 12 months. Work engagements in terms of clinical, research, administrative, and education; work practices including engagement in extra work and remote work; life responsibilities; and utilization of work-life balance strategies were analyzed for percentages and differences in seniority levels and genders. Ratings of faculty work engagement and life integration strategies were assessed utilizing a 1-5 Likert scale. Descriptive statistics were utilized to report mean, standard deviation, median, Q1 and Q3 for continuous measurements, while count and percentage for categories measurements. Comparisons between seniority and gender categories were conducted using independent t-test or Wilcoxon rank sum test depending on data normality assessed through histogram analysis. Chi-square test was used to make comparisons for categorical data. When encountered with small cell (category with <5 count), Fisher's exact test was used for 2 × 2 table analysis and Freeman-Halton test was used for comparisons with more than two categories. SAS 9.4 was used for the data analysis. RESULTS Twenty-eight faculty (M:F = 17:11) responded to the survey (survey response rate 45%). The vast majority of faculty reported working extra hours, with 40% working at least 10 hours extra per week. Total of 42.9% reported performing clinical work in the extra hours worked. Total 70.4% of faculty had caregiver responsibilities and 64.3% reported other individual stresses (e.g., financial, family/social, health-related), which required consistent demand of time and effort. A total of 35.7% of faculty reported not being able to balance competing life and work demands. A total of 21.4% respondents reported not utilizing any individual healthy lifestyle choices on a consistent basis over the prior 12 months. Protected time off work and remote work were perceived as effective strategies to provide adequate work-life balance; however, remote work engagement was relatively minor and 35.7% bought back vacation. Total 53.6% respondents reported a level 4 (out of 5) rating for work being meaningful and being positively engaged in their work. CONCLUSION Institutions should invest in providing the infrastructure for physician work-life balance and in facilitating healthy lifestyle choices for physicians.
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Affiliation(s)
- Ceylan Z Cankurtaran
- Department of Radiology, Division of Neuroradiology, Keck School of Medicine of USC, 1500 San Pablo Street, LL Radiology HCC2, Los Angeles, CA, 90033.
| | | | - Steven Yong Cen
- Departments of Radiology and Neurology, Keck School of Medicine of USC
| | - Xiaomeng Lei
- Department of Radiology, Keck School of Medicine of USC
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Nishizaki Y, Nagasaki K, Shikino K, Kurihara M, Shinozaki T, Kataoka K, Shimizu T, Yamamoto Y, Fukui S, Nishiguchi S, Katayama K, Kobayashi H, Tokuda Y. Relationship between COVID-19 care and burnout among postgraduate clinical residents in Japan: a nationwide cross-sectional study. BMJ Open 2023; 13:e066348. [PMID: 36639218 PMCID: PMC9842597 DOI: 10.1136/bmjopen-2022-066348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVE The relationship between the care of patients with COVID-19 and mental health among resident physicians in Japan is imperative for ensuring appropriate care of patients with COVID-19 and should be clarified. We herein assessed the relationship between the care of patients with COVID-19 and mental health among postgraduate year 1 (PGY-1) and PGY-2 resident physicians and factors associated with mental health. DESIGN This nationwide cross-sectional study analysed data obtained using the clinical training environment self-reported questionnaire. SETTING An observational study across Japan among resident physicians (PGY-1 and PGY-2) from 583 teaching hospitals. PARTICIPANTS Examinees who took the general medicine in-training examination of academic year 2020. PRIMARY AND SECONDARY OUTCOME MEASURES The Patient Health Questionnaire and Mini-Z 2.0 were used to assess mental health, and experience of caring for patients with COVID-19 was divided into three groups (none, 1-10 and ≥11). The prevalence of mental conditions in the three groups was compared using the 'modified' Poisson generalised estimating equations by adjusting for prefecture-level, hospital-level and resident-level variables. RESULTS Of the 5976 participants analysed, 50.9% were PGY-1. The prevalence of burnout was 21.4%. Moreover, 47.0% of all resident physicians had no experience in the care of patients with COVID-19. The well-experienced group accounted for only 7.9% of the total participants. A positive association was found between the number of caring patients with COVID-19 and burnout (prevalence ratio 1.25; 95% CI 1.02 to 1.53). Moreover, the shortage of personal protective equipment was identified as a major contributor to burnout (prevalence ratio 1.60; 95% CI 1.36 to 1.88). CONCLUSIONS Resident physicians who experienced more care of patients with COVID-19 had slightly greater burnout prevalence than those who did not. Approximately half of resident physicians did not participate in the care of patients with COVID-19, which posed a challenge from an educational perspective.
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Affiliation(s)
- Yuji Nishizaki
- Division of Medical Education, Juntendo University School of Medicine, Tokyo, Japan
| | - Kazuya Nagasaki
- Department of Internal Medicine, Mito Kyodo General Hospital, University of Tsukuba, Ibaraki, Japan
| | - Kiyoshi Shikino
- Department of General Medicine, Chiba University Hospital, Chiba, Japan
| | - Masaru Kurihara
- Department of Patient Safety, Nagoya University Hospital, Aichi, Japan
| | - Tomohiro Shinozaki
- Department of Information and Computer Technology, Faculty of Engineering, Tokyo University of Science, Tokyo, Japan
| | - Koshi Kataoka
- Division of Medical Education, Juntendo University School of Medicine, Tokyo, Japan
| | - Taro Shimizu
- Department of Diagnostic and Generalist Medicine, Dokkyo Medical University Hospital, Tochigi, Japan
| | - Yu Yamamoto
- Division of General Medicine, Center for Community Medicine, Jichi Medical University, Tochigi, Japan
| | - Sho Fukui
- Department of Emergency and General Medicine, Kyorin University, Tokyo, Japan
| | - Sho Nishiguchi
- Department of General Internal Medicine, Shonan Kamakura General Hospital, Kanagawa, Japan
| | - Kohta Katayama
- Division of General Internal Medicine, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Hiroyuki Kobayashi
- Department of Internal Medicine, Mito Kyodo General Hospital, University of Tsukuba, Ibaraki, Japan
| | - Yasuharu Tokuda
- Muribushi Okinawa Center for Teaching Hospitals, Okinawa, Japan
- Tokyo Foundation for Policy Research, Tokyo, Japan
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22
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Relationships and resilience at work and at home: Impact of relational coordination on clinician work-life balance and well-being in times of crisis. Health Care Manage Rev 2023; 48:80-91. [PMID: 36279316 PMCID: PMC9704816 DOI: 10.1097/hmr.0000000000000355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND The COVID-19 pandemic has been an unusually comprehensive crisis that has taken a toll on people in their roles both at work and at home, giving rise to a new normal. PURPOSE Relational coordination theory shows how communicating and relating for the purpose of task integration drives positive outcomes for workers, their clients, and their employers. The ecological theory of work-family spillover shows how relational dynamics from work spillover into family life, and vice versa. We build upon these two theories to understand how relationships at work impact work-life balance and worker well-being, especially in times of crisis. METHODOLOGY This study was based on surveys of clinicians affiliated with a large California health system during the COVID-19 pandemic. Mediation and multilevel logistic regression models were used to assess how relational coordination among colleagues impacts well-being (job satisfaction and lack of burnout) through its effects on work-life balance (schedule control and personal time). RESULTS A 1-point increase in relational coordination tripled clinician odds of having schedule control ( OR = 3.33, p < .001) and nearly doubled the odds of having adequate personal time ( OR = 1.83, p < .001). A 1-point increase in relational coordination nearly quadrupled odds of being satisfied with their job ( OR = 3.92, p < .001) and decreased odds of burnout by 64% ( OR = 0.36, p < .001). The impact of relational coordination on worker well-being was mediated by greater schedule control and personal time. CONCLUSION Relational coordination among colleagues impacts worker well-being by enabling greater control over one's schedule and more personal time, thus creating a positive spillover from work to home in times of crisis. PRACTICE IMPLICATIONS In times of crisis, leaders should prioritize relational coordination among colleagues in order to support their resilience both at work and at home.
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23
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Rosen CS, Kaplan AN, Nelson DB, La Bash H, Chard KM, Eftekhari A, Kehle-Forbes S, Wiltsey Stirman S, Sayer NA. Implementation context and burnout among Department of Veterans Affairs psychotherapists prior to and during the COVID-19 pandemic. J Affect Disord 2023; 320:517-524. [PMID: 36191645 PMCID: PMC9523596 DOI: 10.1016/j.jad.2022.09.141] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 09/22/2022] [Accepted: 09/27/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND The first goal of this study was to assess longitudinal changes in burnout among psychotherapists prior to (T1) and during the COVID-19 pandemic (T2). The second objective was to assess the effects of job demands, job resources (including organizational support for evidence-based psychotherapies, or EBPs) and pandemic-related stress (T2 only) on burnout. METHOD Psychotherapists providing EBPs for posttraumatic stress disorder in U.S. Department of Veterans Affairs (VA) facilities completed surveys assessing burnout, job resources, and job demands prior to (T1; n = 346) and during (T2; n = 193) the COVID-19 pandemic. RESULTS Burnout prevalence increased from 40 % at T1 to 56 % at T2 (p < .001). At T1, stronger implementation climate and implementation leadership (p < .001) and provision of only cognitive processing therapy (rather than use of prolonged exposure therapy or both treatments; p < .05) reduced burnout risk. Risk factors for burnout at T2 included T1 burnout, pandemic-related stress, less control over when and how to deliver EBPs, being female, and being a psychologist rather than social worker (p < .02). Implementation leadership did not reduce risk of burnout at T2. LIMITATIONS This study involved staff not directly involved in treating COVID-19, in a healthcare system poised to transition to telehealth delivery. CONCLUSION Organizational support for using EBPs reduced burnout risk prior to but not during the pandemic. Pandemic related stress rather than increased work demands contributed to elevated burnout during the pandemic. A comprehensive approach to reducing burnout must address the effects of both work demands and personal stressors.
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Affiliation(s)
- Craig S. Rosen
- National Center for Posttraumatic Stress Disorder Dissemination & Training Division, VA Palo Alto Health Care System, Menlo Park, CA, USA,Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA,Corresponding author at: VAPAHCS (334-PTSD), 795 Willow Road, Menlo Park, CA 94025, USA
| | - Adam N. Kaplan
- Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN, USA,Department of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - David B. Nelson
- Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN, USA,Department of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Heidi La Bash
- National Center for Posttraumatic Stress Disorder Dissemination & Training Division, VA Palo Alto Health Care System, Menlo Park, CA, USA
| | - Kathleen M. Chard
- Cincinnati VA Medical Center, Cincinnati, OH, USA,University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Afsoon Eftekhari
- National Center for Posttraumatic Stress Disorder Dissemination & Training Division, VA Palo Alto Health Care System, Menlo Park, CA, USA
| | - Shannon Kehle-Forbes
- Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN, USA,National Center for PTSD Women's Health Sciences Division, Boston MA, USA
| | - Shannon Wiltsey Stirman
- National Center for Posttraumatic Stress Disorder Dissemination & Training Division, VA Palo Alto Health Care System, Menlo Park, CA, USA,Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Nina A. Sayer
- Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN, USA,Department of Medicine, University of Minnesota, Minneapolis, MN, USA,Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA
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24
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Shanafelt TD, West CP, Dyrbye LN, Trockel M, Tutty M, Wang H, Carlasare LE, Sinsky C. Changes in Burnout and Satisfaction With Work-Life Integration in Physicians During the First 2 Years of the COVID-19 Pandemic. Mayo Clin Proc 2022; 97:2248-2258. [PMID: 36229269 PMCID: PMC9472795 DOI: 10.1016/j.mayocp.2022.09.002] [Citation(s) in RCA: 181] [Impact Index Per Article: 90.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 09/02/2022] [Accepted: 09/06/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To evaluate the prevalence of burnout and satisfaction with work-life integration (WLI) in US physicians at the end of 2021, roughly 21 months into the COVID-19 pandemic, with comparison to 2020, 2017, 2014, and 2011. METHODS Between December 9, 2021, and January 24, 2022, we surveyed US physicians using methods similar to those of our prior studies. Burnout, WLI, depression, and professional fulfillment were assessed with standard instruments. RESULTS There were 2440 physicians who participated in the 2021 survey. Mean emotional exhaustion and depersonalization scores were higher in 2021 than those observed in 2020, 2017, 2014, and 2011 (all P<.001). Mean emotional exhaustion scores increased 38.6% (2020 mean, 21.0; 2021 mean, 29.1; P<.001), whereas mean depersonalization scores increased 60.7% (2020 mean, 6.1; 2021 mean, 9.8; P<.001). Overall, 62.8% of physicians had at least 1 manifestation of burnout in 2021 compared with 38.2% in 2020, 43.9% in 2017, 54.4% in 2014, and 45.5% in 2011 (all P<.001). Although these trends were consistent across nearly all specialties, substantial variability by specialty was observed. Satisfaction with WLI declined from 46.1% in 2020 to 30.2% in 2021 (P<.001). Mean scores for depression increased 6.1% (2020 mean, 49.54; 2021 mean, 52.59; P<.001). CONCLUSION A dramatic increase in burnout and decrease in satisfaction with WLI occurred in US physicians between 2020 and 2021. Differences in mean depression scores were modest, suggesting that the increase in physician distress was overwhelmingly work related. Given the association of physician burnout with quality of care, turnover, and reductions in work effort, these findings have profound implications for the US health care system.
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25
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Quigley DD, Slaughter ME, Qureshi N, Gidengil C, Hays RD. Associations of pediatric nurse burnout with involvement in quality improvement. J Pediatr Nurs 2022; 70:e9-e16. [PMID: 36402601 DOI: 10.1016/j.pedn.2022.11.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 11/03/2022] [Accepted: 11/03/2022] [Indexed: 11/18/2022]
Abstract
PURPOSE Burnout among nurses negatively impacts patient care experiences and safety. Inpatient pediatric nurses are high-risk for burnout due to high patient volumes, inadequate staffing, and needing to balance the demands of patients, families and team members. We examined the associations of inpatient pediatric nurse burnout with their perspectives on the importance of quality at the hospital, patient experience measurement, quality improvement (QI), unit culture, and staffing. METHODS We conducted a cross-sectional study at an urban children's hospital. We surveyed pediatric nurses about their perspectives including the single-item Maslach Burnout Inventory. We fit separate regression models, controlling for role, location and unit, predicting outcome measures from the dichotomized burnout scale. RESULTS Twenty-seven percent of pediatric nurses reported burnout. Nurses who had more confidence in patient experience measurement, received frequent patient experience performance reports, felt included in QI, and experienced QI efforts as integrated into patient care reported not being burned out (compared to those reporting burnout; all p-values<0.05). More open communication among nurses (e.g., about possible problems with care) and unit-level teamwork were also associated with not being burned out, whereas a larger QI workload was associated with burnout (p-values<0.05). CONCLUSIONS Open communication among nurses and nurses being more involved and valued in QI efforts were related to not being burned out. Research is needed to further examine aspects of QI involvement that reduce burnout. PRACTICE IMPLICATIONS Supporting open communication among pediatric nurses, engaging them in QI and integrating QI into patient care while minimizing QI workload may decrease burnout.
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Affiliation(s)
- Denise D Quigley
- Behavior and Policy Sciences, RAND Corporation, 1776 Main Street, Santa Monica, CA 90401, United States.
| | - Mary Ellen Slaughter
- Economics, Sociology & Statistics, RAND Corporation, 1776 Main Street, Santa Monica, CA 90401, United States.
| | - Nabeel Qureshi
- Pardee RAND, RAND Corporation, 1776 Main Street, Santa Monica, CA 90401, United States.
| | - Courtney Gidengil
- RAND Boston Office, Behavioral & Policy Sciences, RAND Corporation, 20 Park Plaza, Suite 920, Boston, MA 02116, United States.
| | - Ron D Hays
- Medicine, Health Policy and Management, University of California Los Angeles, David Geffen School of Medicine, United States.
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26
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Gadek L, Dammann C, Savich R, Mmuo-Oji C, Barrera L, Gallagher PG, Machut K. Gender analysis of Journal of Perinatology authorship during COVID-19. J Perinatol 2022; 43:518-522. [PMID: 36335276 PMCID: PMC9638437 DOI: 10.1038/s41372-022-01551-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 10/19/2022] [Accepted: 10/20/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To examine authorship gender distributions before and during COVID-19 in the Journal of Perinatology. STUDY DESIGN We collected data from the Journal of Perinatology website. The author gender was determined using Genderize.io or a systematic internet search. Our primary outcome was the difference between the number of published articles authored by women during the pandemic period (March 2020-May 2021, period two), compared with the preceding 15-month period (period one). We analyzed the data using chi-square tests. RESULTS Publications increased from period one to two by 8.9%. There were slightly more female than male first (62%) and overall (53%) authors, but fewer last authors (43%) for the combined time periods. Female authorship distribution was not different between periods. CONCLUSIONS Though publications increased overall, authorship gender distribution did not change significantly during the COVID-19 pandemic. Women authors remain underrepresented overall and specifically as last author, considering the majority of neonatologists are women.
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Affiliation(s)
- Lauren Gadek
- University of Wisconsin-Madison, Madison, WI, USA
| | | | - Renate Savich
- Department of Pediatrics, University of New Mexico, Albuquerque, NM, USA
| | | | - Leonardo Barrera
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | | | - Kerri Machut
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.
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27
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Kwan JM, Noch E, Qiu Y, Toubat O, Christophers B, Azzopardi S, Gilmer G, Wiedmeier JE, Daye D. The Impact of COVID-19 on Physician-Scientist Trainees and Faculty in the United States: A National Survey. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2022; 97:1536-1545. [PMID: 35921163 PMCID: PMC9547818 DOI: 10.1097/acm.0000000000004802] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
PURPOSE Physician-scientists have long been considered an endangered species, and their extended training pathway is vulnerable to disruptions. This study investigated the effects of COVID-19-related challenges on the personal lives, career activities, stress levels, and research productivity of physician-scientist trainees and faculty. METHOD The authors surveyed medical students (MS), graduate students (GS), residents/fellows (R/F), and faculty (F) using a tool distributed to 120 U.S. institutions with MD-PhD programs in April-June 2020. Chi-square and Fisher's exact tests were used to compare differences between groups. Machine learning was employed to select variables for multivariate logistic regression analyses aimed at identifying factors associated with stress and impaired productivity. RESULTS The analyses included 1,929 respondents (MS: n = 679, 35%; GS: n = 676, 35%; R/F: n = 274, 14%; F: n = 300, 16%). All cohorts reported high levels of social isolation, stress from effects of the pandemic, and negative impacts on productivity. R/F and F respondents were more likely than MS and GS respondents to report financial difficulties due to COVID-19. R/F and F respondents with a dual degree expressed more impaired productivity compared with those without a dual degree. Multivariate regression analyses identified impacted research/scholarly activities, financial difficulties, and social isolation as predictors of stress and impaired productivity for both MS and GS cohorts. For both R/F and F cohorts, impacted personal life and research productivity were associated with stress, while dual-degree status, impacted research/scholarly activities, and impacted personal life were predictors of impaired productivity. More female than male respondents reported increased demands at home. CONCLUSIONS This national survey of physician-scientist trainees and faculty found a high incidence of stress and impaired productivity related to the COVID-19 pandemic. Understanding the challenges faced and their consequences may improve efforts to support the physician-scientist workforce in the postpandemic period.
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Affiliation(s)
- Jennifer M Kwan
- J.M. Kwan is a cardiologist, Yale School of Medicine, New Haven, Connecticut, and director, Board of Directors, American Physician Scientists Association, Westford, Massachusetts; ORCID: https://orcid.org/0000-0002-4715-1848
| | - Evan Noch
- E. Noch is a neurologist, Weill Cornell School of Medicine, New York, New York, and director, Board of Directors, American Physician Scientists Association, Westford, Massachusetts; ORCID: https://orcid.org/0000-0002-4561-1169
| | - Yuqing Qiu
- Y. Qiu is a biostatistician, Weill Cornell School of Medicine, New York, New York; ORCID: https://orcid.org/0000-0002-4561-1169
| | - Omar Toubat
- O. Toubat is an MD-PhD student, University of Southern California, Los Angeles, California; ORCID: https://orcid.org/0000-0002-3377-1384
| | - Briana Christophers
- B. Christophers is an MD-PhD student, Weill Cornell Medicine, New York, New York; ORCID: https://orcid.org/0000-0001-5248-069X
| | - Stephanie Azzopardi
- S. Azzopardi is an MD-PhD student, Weill Cornell Medicine, New York, New York; ORCID: https://orcid.org/0000-0002-9585-9234
| | - Gabrielle Gilmer
- G. Gilmer is an MD-PhD student, University of Pittsburgh, Pittsburgh, Pennsylvania; ORCID: https://orcid.org/0000-0002-9039-4183
| | - Julia Erin Wiedmeier
- J.E. Wiedmeier is a hematology/oncology fellow, Mayo Clinic Arizona, Phoenix, Arizona; ORCID: https://orcid.org/0000-0001-9434-5269
| | - Dania Daye
- D. Daye is an interventional radiologist, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, and director, Board of Directors, American Physician Scientists Association, Westford, Massachusetts; ORCID: https://orcid.org/0000-0002-2230-7199
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28
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Nagasaki K, Seo E, Maeno T, Kobayashi H. Diagnostic accuracy of the Single-item Measure of Burnout (Japanese version) for identifying medical resident burnout. J Gen Fam Med 2022; 23:241-247. [PMID: 35800639 PMCID: PMC9249940 DOI: 10.1002/jgf2.535] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 02/27/2022] [Accepted: 03/01/2022] [Indexed: 11/11/2022] Open
Abstract
Background Burnout is a psychological syndrome consisting of emotional exhaustion, cynicism, and decreased professional efficacy. The Maslach Burnout Inventory (MBI) is widely used as the standard measure. However, the MBI is lengthy and not free to use, which makes it a less than ideal tool for regularly assessing burnout. The single question burnout measure (SMB) is a novel and simple measure of burnout, which is associated well with emotional exhaustion and has sufficient diagnostic performance for burnout. This study aimed to evaluate the concurrent and convergent validity of the Japanese version of the single-item measure of burnout (SMB-J) compared with the MBI. Methods Ninety-four medical residents volunteered to complete the MBI-General Survey (MBI-GS) and the SMB-J. We assessed the concurrent (sensitivity and specificity) and convergent validity of the SMB-J compared with the MBI-GS. Results The sensitivity for identifying burnout using the SMB-J was 53.8%, and the specificity was 88.2%. The area under the receiver operating characteristic curve (AUC) was 0.71. MBI-GS scores on the subscales of Emotional Exhaustion (r = 0.509, p < 0.0001) and Cynicism (r = 0.57, p < 0.0001) strongly correlated with the SMB-J scores. Conclusions We concluded that for identifying burnout among Japanese medical residents, the psychometric properties of the SMB-J are comparable to those of the original version of the SMB. Although the SMB-J has low sensitivity to detect burnout, it is more convenient to use than the MBI.
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Affiliation(s)
- Kazuya Nagasaki
- Department of Internal MedicineMito Kyodo General HospitalUniversity of TsukubaIbarakiJapan
| | - Emiko Seo
- Center for Medical Education and TrainingUniversity of Tsukuba HospitalIbarakiJapan
| | - Tetsuhiro Maeno
- Department of General Medicine and Primary CareUniversity of Tsukuba HospitalIbarakiJapan
| | - Hiroyuki Kobayashi
- Department of Internal MedicineMito Kyodo General HospitalUniversity of TsukubaIbarakiJapan
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29
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Bell K, Shah SGS, Henderson LR, Kiparoglou V. Translational researchers' training and development needs, preferences, and barriers: A survey in a National Institute for Health Research Biomedical Research Centre in the United Kingdom. Clin Transl Sci 2022; 15:1737-1752. [PMID: 35570378 PMCID: PMC9283734 DOI: 10.1111/cts.13289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 04/12/2022] [Accepted: 04/14/2022] [Indexed: 11/30/2022] Open
Abstract
The objective was to identify translational researchers’ training and development needs, preferences, and barriers to attending training. This cross‐sectional study involved an online questionnaire survey. The research population comprised a convenience sample of translational researchers and support staff (N = 798) affiliated with the National Institute for Health Research Oxford Biomedical Research Centre. The response rate was 24%. Of 189 respondents, 114 were women (60%) and 75 were men (40%). The respondents were mainly research scientists (31%), medical doctors and dentists (17%), and research nurses and midwives (16%). Many of the respondents had attended at least one training course in the last year (68%). Training in statistics and data analysis was the most common training received (20%). Leadership training was the most wanted training (25%). Morning was the most preferred time of training (60%). Half a day was the ideal duration of a training course (41%). The main teaching hospital site was the most preferred location of training (46%). An interactive workshop was the most favored delivery style of training (52%). Most common barriers to attending training were the lack of time (31%), work (21%) and clinical commitments (19%), and family and childcare responsibilities (14%). Some differences in training needs, preferences, and barriers were found by gender and role, though these were not statistically significant. Translational researchers want short, easily accessible, and interactive training sessions during the working day. The training needs, preferences, and barriers to attending training need to be considered while developing inclusive training programs in biomedical research settings.
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Affiliation(s)
- Karen Bell
- National Institute for Health Research Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, UK
| | - Syed Ghulam Sarwar Shah
- National Institute for Health Research Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, UK.,Radcliffe Department of Medicine, Medical Sciences Division, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Lorna R Henderson
- National Institute for Health Research Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, UK.,Radcliffe Department of Medicine, Medical Sciences Division, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Vasiliki Kiparoglou
- National Institute for Health Research Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, UK.,Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Oxford, UK
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30
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Psychological impact of the COVID-19 outbreak in community pharmacists: A longitudinal study. J Am Pharm Assoc (2003) 2021; 62:1359-1363. [PMID: 35090815 PMCID: PMC8669975 DOI: 10.1016/j.japh.2021.12.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 12/10/2021] [Accepted: 12/10/2021] [Indexed: 02/03/2023]
Abstract
Background Coronavirus disease 2019 (COVID-19) has negatively affected the mental health of frontline health care workers, including pharmacists. Objectives The aim of this longitudinal study was to assess the psychological impact of the COVID-19 outbreak in French owner community pharmacists. Methods We conducted a postal-based survey to assess the psychological difficulties of the COVID-19 outbreak in French owner community pharmacists based on 3 psychologically validated self-report questionnaires: Perceived Stress Scale (PSS), Impact of Event Scale-revised (IES-R), and Maslach Burnout Inventory. The baseline assessment was during the first sanitary lockdown period and the second one 5 months later. Results The sample consists of 135 owner community pharmacists. At follow-up, 67 answered the questionnaires (response rate: 49.6%). The mean scores of the PSS and IES-R significantly decreased (P = 0.002). Fifteen pharmacists reported significant posttraumatic stress symptoms (23.1%) at baseline and 11 at follow-up (16.4%, P = 0.02). Age and sex were not significantly associated with persistent posttraumatic stress or burnout symptoms. Conclusion This is the first longitudinal study that showed the psychological impact of owner community pharmacists as health care workers dealing with their community’s COVID-19 outbreak. Based on validated self-report questionnaires, stress, posttraumatic stress, and burnout symptoms decreased during follow-up. It is necessary to continue monitoring psychological difficulties for health care workers, especially during consecutive waves of the COVID-19 outbreak.
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