1
|
Williams CEC, Bracken L, Gill A, Oni L. Themes associated with uncollected paediatric prescriptions at a large tertiary children's hospital: a retrospective, observational study. BMJ Paediatr Open 2024; 8:e002366. [PMID: 38977354 DOI: 10.1136/bmjpo-2023-002366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 06/18/2024] [Indexed: 07/10/2024] Open
Abstract
OBJECTIVE This study aimed to assess the number of prescriptions that were uncollected by caregivers to identify any predisposing systemic themes that may act as barriers to children receiving medications. STUDY DESIGN AND SETTING Data were retrospectively collected on uncollected prescriptions at a single, tertiary paediatric centre over a 2-month period. This included type and classification of the drug, prescriber specialty, the timing of prescription and the child's registered postcode. Key themes were identified. RESULTS A total of 124 uncollected prescriptions involving 94 patients were included. 103 (83%) of these were clinic prescriptions, and azathioprine was the most frequently uncollected prescription (n=6, 5%). The uncollected prescriptions most commonly fell under the 'gastrointestinal system' (n=26, 21%) and 'skin' (n=24, 19%) categories, and similarly, 24 (19%) were prescribed by the gastroenterology department and 18 (15%) by dermatology. The mean distance from the child's registered postcode was 8.5±11.8 miles (range 0.5-73.4) with a considerable number of children having a registered postcode greater than 10 miles from the hospital (n=24, 27%). Many children lived in areas corresponding to the lowest decile of the Index of Multiple Deprivation (IMD) (n=38, 42%). CONCLUSION Urgent interventions and further prospective studies are needed to minimise the barriers that caregivers face in collecting their child's prescription.
Collapse
Affiliation(s)
- Chloe Elizabeth Charlotte Williams
- Royal Liverpool and Broadgreen Hospitals NHS Trust, Liverpool, UK
- Department of Women's and Children's Health, University of Liverpool Institute of Life Course and Medical Sciences, Liverpool, UK
| | - Louise Bracken
- Paediatric Medicines Research Unit, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - Andrea Gill
- Paediatric Medicines Research Unit, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - Louise Oni
- Department of Women's and Children's Health, University of Liverpool Institute of Life Course and Medical Sciences, Liverpool, UK
- Department of Paediatric Nephrology, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| |
Collapse
|
2
|
Nouraeinejad A. Visuospatial abilities can be affected in healthcare workers due to job burnout. Eur Arch Psychiatry Clin Neurosci 2024; 274:471-472. [PMID: 36864358 PMCID: PMC9980863 DOI: 10.1007/s00406-023-01577-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 02/20/2023] [Indexed: 03/04/2023]
Affiliation(s)
- Ali Nouraeinejad
- Faculty of Brain Sciences, Institute of Ophthalmology, University College London (UCL), London, UK.
| |
Collapse
|
3
|
Pihlaja M, Peräkylä J, Erkkilä EH, Tapio E, Vertanen M, Hartikainen KM. Altered neural processes underlying executive function in occupational burnout-Basis for a novel EEG biomarker. Front Hum Neurosci 2023; 17:1194714. [PMID: 37850039 PMCID: PMC10577205 DOI: 10.3389/fnhum.2023.1194714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 08/22/2023] [Indexed: 10/19/2023] Open
Abstract
Introduction As burnout has become a global pandemic, there is a call for improved understanding and detection of alterations in brain functions related to it. We have previously reported challenges in executive functions (EFs) in daily life, especially in metacognition, in subjects with occupational burnout, along with alterations in cardiac physiology. In the current study, we focused on the impact of burnout on brain physiology during a task requiring EF. Methods Fifty-four volunteers filled in inventories of burnout, depression, and EF in daily life (BBI-15, BDI, and BRIEF-A). Based on the BBI-15 score, subjects were divided into burnout and non-burnout groups. Subjects performed a Go/NoGo test (Executive RT test) engaging several EFs, while their EEG was recorded. The inventory scores, cognitive performance scores, and event-related potential (N2, P3) amplitudes, latencies, and interpeak latencies (IPLs) were compared between the groups. Results There were significant differences in the BDI and BRIEF-A scores between the groups, with more symptoms of depression and challenges in daily life in the burnout group. There were no differences in objective performance measures in the EF task between the groups. However, centroparietal P3 amplitude was larger, and while there were no differences in N2 or P3 latencies, N2-P3 IPL was longer in the Go condition in the burnout than in non-burnout group. Both ERP measures correlated significantly with burnout symptoms. A regression model from centroparietal P3 amplitude and N2-P3 IPL predicted significantly both the BBI-15 score and the BRIEF-A metacognition index. Discussion We conclude that burnout is linked with challenges in EF in daily life and alterations in the underlying neural processes. While cognitive performance in the task was equal, electrophysiological measures differed between the groups. Prolonged N2-P3 IPL points toward slowed transition from one cognitive process to another. Increased P3 amplitude, on the other hand, reflects increased allocation of neural processing resources. This may be a compensatory mechanism, allowing for equal performance with controls. These electrophysiological measures, obtained during the EF task, show promise as brain physiology-based biomarkers of burnout, contributing to its improved and objective detection. In addition, these results indicate occupational burnout is linked with objective alterations in brain physiology.
Collapse
Affiliation(s)
- Mia Pihlaja
- Behavioral Neurology Research Unit, Tampere University Hospital, Tampere, Finland
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Jari Peräkylä
- Behavioral Neurology Research Unit, Tampere University Hospital, Tampere, Finland
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Emma-Helka Erkkilä
- Behavioral Neurology Research Unit, Tampere University Hospital, Tampere, Finland
| | - Emilia Tapio
- Behavioral Neurology Research Unit, Tampere University Hospital, Tampere, Finland
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Maiju Vertanen
- Behavioral Neurology Research Unit, Tampere University Hospital, Tampere, Finland
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Kaisa M. Hartikainen
- Behavioral Neurology Research Unit, Tampere University Hospital, Tampere, Finland
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| |
Collapse
|
4
|
Bäckström T, Turkmen S, Das R, Doverskog M, Blackburn TP. The GABA system, a new target for medications against cognitive impairment-Associated with neuroactive steroids. J Intern Med 2023; 294:281-294. [PMID: 37518841 DOI: 10.1111/joim.13705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
The prevalence of cognitive dysfunction, dementia, and neurodegenerative disorders such as Alzheimer's disease (AD) is increasing in parallel with an aging population. Distinct types of chronic stress are thought to be instrumental in the development of cognitive impairment in central nervous system (CNS) disorders where cognitive impairment is a major unmet medical need. Increased GABAergic tone is a mediator of stress effects but is also a result of other factors in CNS disorders. Positive GABA-A receptor modulating stress and sex steroids (steroid-PAMs) such as allopregnanolone (ALLO) and medroxyprogesterone acetate can provoke impaired cognition. As such, ALLO impairs memory and learning in both animals and humans. In transgenic AD animal studies, continuous exposure to ALLO at physiological levels impairs cognition and increases degenerative AD pathology, whereas intermittent ALLO injections enhance cognition, indicating pleiotropic functions of ALLO. We have shown that GABA-A receptor modulating steroid antagonists (GAMSAs) can block the acute negative cognitive impairment of ALLO on memory in animal studies and in patients with cognitive impairment due to hepatic encephalopathy. Here we describe disorders affected by steroid-PAMs and opportunities to treat these adverse effects of steroid-PAMs with novel GAMSAs.
Collapse
Affiliation(s)
| | - Sahruh Turkmen
- Department of Clinical Sciences, University of Umeå, Umeå, Sweden
| | - Roshni Das
- Department of Clinical Sciences, University of Umeå, Umeå, Sweden
- Umecrine Cognition AB, Solna, Sweden
| | | | | |
Collapse
|
5
|
Renaud C, Lacroix A. Neuroticism, perfectionism, and emotion suppression in burnout: Implications for cognitive functioning. APPLIED NEUROPSYCHOLOGY. ADULT 2023:1-10. [PMID: 37572420 DOI: 10.1080/23279095.2023.2244623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/14/2023]
Abstract
This study aimed to investigate the relationship between burnout and cognitive functions, particularly memory, attention, and executive functions, which have been found to be negatively affected in most studies. However, the results are not consistent across studies, and there is often a discrepancy between self-reported cognitive function and objective assessment. Two possible explanations for this discrepancy are the heterogeneous profiles of individuals in burnout and their personality traits. The study administered neuropsychological tests and questionnaires to 29 participants with clinical burnout to assess their cognitive functions and the impact of perfectionism, neuroticism, and emotion suppression on subjective and objective cognitive scores. The main findings showed little or no deterioration in memory or executive functions, despite patients reporting severely impaired executive function. The study found that neuroticism and perfectionism were related to poorer self-reported executive function, while emotion suppression was related to better self-reported executive function. No relationship was found between personality traits and neuropsychological test scores, indicating a discrepancy between self-perception and objective evaluation.
Collapse
Affiliation(s)
- Charlie Renaud
- Laboratoire de Psychologie, Cognition, Comportement, Communication (LP3C), University of Rennes 2, Rennes, Bretagne, France
| | - Agnes Lacroix
- Laboratoire de Psychologie, Cognition, Comportement, Communication (LP3C), University of Rennes 2, Rennes, Bretagne, France
| |
Collapse
|
6
|
Cao J, Bhuvaneswari G, Arumugam T, Aravind BR. The digital edge: examining the relationship between digital competency and language learning outcomes. Front Psychol 2023; 14:1187909. [PMID: 37397293 PMCID: PMC10313065 DOI: 10.3389/fpsyg.2023.1187909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 05/29/2023] [Indexed: 07/04/2023] Open
Abstract
Introduction Technology in education, including language learning, is on the rise. Digital competency is essential for teachers to effectively integrate technology and enhance language teaching. It enables access to authentic materials, interactive exercises, and collaboration opportunities. However, integrating technology poses challenges for teachers. Objective This empirical research aimed to investigate the impact of digital competency on language learning outcomes in the context of "smart education," which incorporates sustainable practices and digital technologies in the language classroom. Methods The study adopted a quantitative approach to collect and analyze data. The sample population for the study comprised of 344 language teachers at various language schools in a metropolitan city. The data collection carried out with a digital competency questionnaire. The data were analyzed using descriptive statistics and multivariate technique, i.e., structural equation modeling. Findings The study found that digital competency positively correlated with language proficiency outcomes. Participants with higher levels of digital competency achieved better language learning outcomes compared to those with lower levels of digital competency. Additionally, the study found that incorporating sustainable practices, such as digitalized learning materials and virtual classrooms, positively contributed to language learning outcomes. The findings of this study suggest that digital competency plays a vital role in language learning outcomes in the context of "smart education." Discussion & Recommendation Teachers should consider incorporating digital tools and sustainable practices into their language teaching to enhance language learning outcomes. The study recommends that language educators should focus on developing digital competency and integrating sustainable practices into their language classroom to promote effective language learning.
Collapse
Affiliation(s)
- Jiafan Cao
- College of Education Science, Harbin Normal University, Harbin, China
- School of Foreign Languages, Changchun Normal University, Chuangchun, China
| | - G. Bhuvaneswari
- School of Social Sciences and Languages (SSL), Vellore Institute of Technology, Chennai, India
| | | | - B. R. Aravind
- School of Liberal Arts and Special Education (SLASE), Kalasalingam Academy of Research and Education, Krishnankoil, TN, India
| |
Collapse
|
7
|
Parker G, Tavella G, Hopcraft M. Exploring the validity of the Sydney Burnout Measure. Psychiatry Res 2023; 326:115271. [PMID: 37290365 DOI: 10.1016/j.psychres.2023.115271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 05/25/2023] [Accepted: 05/28/2023] [Indexed: 06/10/2023]
Abstract
This study aimed to examine the convergent validity of a new measure of burnout, the Sydney Burnout Measure (SBM) by comparison against the field standard measure - the Maslach Burnout Inventory (MBI). A second aim was to consider burnout's association with psychological distress. 1483 dental professionals completed the two burnout measures as well as two measures of psychological distress. The overall correlation between total scores on the two measures (and on shared constructs) was high, and thus the convergent validity of the SBM was supported. Further, the SBM and MBI total scores correlated highly with total scores on the two measures of distress. Exploratory structural equation modelling (ESEM) also identified substantial overlap between the measures, especially in relation to the exhaustion subscales of the burnout measures and their overlap with psychological distress items. While future research is required to determine which burnout measure and its associated burnout definition is most valid, our findings argue for further consideration of how burnout may best be conceptualized, as well as whether the syndrome is worthy of elevation to mental disorder status.
Collapse
Affiliation(s)
- Gordon Parker
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia.
| | - Gabriela Tavella
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia
| | - Matthew Hopcraft
- Melbourne Dental School, University of Melbourne, Melbourne, Australia; eviDent Foundation, Melbourne, Australia
| |
Collapse
|
8
|
Karanjkar A, Panse N, Panse S, Sahasrabudhe P. Indian Perspective of Burnout Among Plastic Surgeons. Indian J Plast Surg 2023; 56:153-158. [PMID: 37153331 PMCID: PMC10159714 DOI: 10.1055/s-0042-1759727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Abstract
Introduction Over the last decade, the term “Burnout” has become familiar term in all walks of life, particularly medicine. Emotional exhaustion, depersonalization, and a low sense of personal accomplishment make up the triad. At least a third of plastic surgeons are having burnout according to the western literature. Data on burnout in Indian plastic surgeons is lacking. We have made an attempt to analyze the incidence and factors responsible for burnout among plastic surgeons in India.
Materials and Methods An online survey was conducted in India to assess burnout among plastic surgeons from June to November 2019. Consent, demographic information, stress-related factors, the abbreviated Maslach Burnout Inventory (aMBI), and Satisfaction with Medicine were all included section wise in the survey. Both used scales were validated. Data were gathered using Google forms, then uploaded to an Excel file and analyzed. A multivariable and univariable analysis of factors associated with burnout was carried out.
Results Twenty-two percent of 330 plastic surgeons who responded were assessed to have moderate to high emotional exhaustion, 5% had moderate to high depersonalization, and 3% had low personal accomplishment. The overall burnout rate was 8.2%. Seventy-three percent of plastic surgeons enjoyed a good to very good quality of life. Great over-volume of work, mid-career practicing plastic surgeons and professional satisfaction with work were found to have a significant association with burnout on multivariate analysis.
Conclusions Plastic surgeons in India suffer an overall burnout rate of 8.2% with a multifactorial etiology. This occupational hazard is preventable and reversible. Plastic surgeons need to be vigilant about this and seek help whenever required.
Collapse
Affiliation(s)
- Ankur Karanjkar
- Department of Plastic & Reconstructive Surgery, BJ Government Medical College and Sassoon Hospital, Pune, Maharashtra, India
| | - Nikhil Panse
- Department of Plastic & Reconstructive Surgery, BJ Government Medical College and Sassoon Hospital, Pune, Maharashtra, India
| | - Smita Panse
- Department of Psychiatry, PCMC's Post Graduate Institute & YCM Hospital, Pimpri, Pune, India
| | - Parag Sahasrabudhe
- Department of Plastic & Reconstructive Surgery, BJ Government Medical College and Sassoon Hospital, Pune, Maharashtra, India
| |
Collapse
|
9
|
Ketvel L, Keltikangas-Järvinen L, Pahkala K, Juonala M, Ahola-Olli A, Lehtimäki T, Viikari J, Raitakari O, Rovio S, Saarinen A. Stress-Related Exhaustion, Polygenic Cognitive Potential, and Cognitive Test Performance - A General Population Study. COGNITIVE THERAPY AND RESEARCH 2023; 47:155-167. [PMID: 36945257 PMCID: PMC10023621 DOI: 10.1007/s10608-023-10354-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 01/11/2023] [Accepted: 01/12/2023] [Indexed: 02/06/2023]
Abstract
Background We investigated whether stress-related exhaustion (chronic or short-term, and co-occurring with depression or not) is related to cognitive performance and whether polygenic cognitive potential modifies these associations. Methods The participants were from the Young Finns Study (N = 541-1273). Stress-related exhaustion was assessed using the Maastricht Questionnaire, depressive symptoms with the Beck Depression Inventory, and cognitive performance with subtests of the Cambridge Neuropsychological Test Automated Battery, measuring visuospatial learning, reaction time, sustained attention, and executive function. Cognitive performance and depression were assessed in 2011, and exhaustion in 2001, 2007, and 2011. A polygenic score for cognitive potential was calculated based on a GWAS on intelligence. Results High stress-related exhaustion, especially chronic, was associated with slower reaction time. Only clinical levels of depression were related to slower reaction time. Polygenic cognitive potential did not modify these associations. There were no differences in cognitive performance between individuals with co-occurring exhaustion and depression vs. those with only either condition. Conclusion Stress-related exhaustion, especially if chronic, seems to relate to slower reactions. Co-occurring exhaustion and depression may not have additive effects on cognitive performance. High polygenic cognitive potential may not protect from or predispose to harmful effects of exhaustion or depression on reaction time. Supplementary Information The online version contains supplementary material available at 10.1007/s10608-023-10354-z.
Collapse
Affiliation(s)
- Laila Ketvel
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Haartmaninkatu 3, P.O. Box 21, 00014 Helsinki, Finland
| | - Liisa Keltikangas-Järvinen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Haartmaninkatu 3, P.O. Box 21, 00014 Helsinki, Finland
| | - Katja Pahkala
- Research Centre for Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Paavo Nurmi Centre and Unit for Health and Physical Activity, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku, Turku University Hospital, Turku, Finland
| | - Markus Juonala
- Department of Medicine, Division of Medicine, University of Turku, Turku University Hospital, Turku, Finland
| | - Ari Ahola-Olli
- Psychiatric and Neurodevelopmental Genetics Unit, Department of Psychiatry, Massachusetts General Hospital, Boston, MA USA
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- Department of Clinical Chemistry, Finnish Cardiovascular Research Center, Fimlab Laboratories, Tampere, Finland
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Finnish Cardiovascular Research Center, Fimlab Laboratories, Tampere, Finland
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Jorma Viikari
- Department of Medicine, Division of Medicine, University of Turku, Turku University Hospital, Turku, Finland
| | - Olli Raitakari
- Research Centre for Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku, Turku University Hospital, Turku, Finland
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - Suvi Rovio
- Research Centre for Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku, Turku University Hospital, Turku, Finland
| | - Aino Saarinen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Haartmaninkatu 3, P.O. Box 21, 00014 Helsinki, Finland
| |
Collapse
|
10
|
Chesley CF, Anesi GL, Chowdhury M, Schaubel D, Liu VX, Lane-Fall MB, Halpern SD. Characterizing Equity of Intensive Care Unit Admissions for Sepsis and Acute Respiratory Failure. Ann Am Thorac Soc 2022; 19:2044-2052. [PMID: 35830576 PMCID: PMC9743468 DOI: 10.1513/annalsats.202202-115oc] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 07/13/2022] [Indexed: 12/15/2022] Open
Abstract
Rationale: Patients who identify as from racial or ethnic minority groups who have sepsis or acute respiratory failure (ARF) experience worse outcomes relative to nonminority patients, but processes of care accounting for disparities are not well-characterized. Objectives: Determine whether reductions in intensive care unit (ICU) admission during hospital-wide capacity strain occur preferentially among patients who identify with racial or ethnic minority groups. Methods: This retrospective cohort among 27 hospitals across the Philadelphia metropolitan area and Northern California between 2013 and 2018 included adult patients with sepsis and/or ARF who did not require life support at the time of hospital admission. An updated model of hospital-wide capacity strain was developed that permitted determination of relationships between patient race, ethnicity, ICU admission, and strain. Results: After adjustment for demographics, disease severity, and study hospital, patients who identified as Asian or Pacific Islander had the highest adjusted ICU admission odds relative to patients who identified as White in both the sepsis and ARF populations (odds ratio, 1.09; P = 0.006 and 1.26; P < 0.001). ICU admission was also elevated for patients with ARF who identified as Hispanic (odds ratio, 1.11; P = 0.020). Capacity strain did not modify differences in ICU admission for patients who identified with a minority group in either disease population (all interactions, P > 0.05). Conclusions: Systematic differences in ICU admission patterns were observed for patients that identified as Asian, Pacific Islander, and Hispanic. However, ICU admission was not restricted from these groups, and capacity strain did not preferentially reduce ICU admission from patients identifying with minority groups. Further characterization of provider decision-making can help contextualize these findings as the result of disparate decision-making or a mechanism of equitable care.
Collapse
Affiliation(s)
- Christopher F. Chesley
- Division of Pulmonary, Allergy, and Critical Care, Department of Medicine, Perelman School of Medicine
- Palliative and Advanced Illness Research (PAIR) Center, Perelman School of Medicine
- Leonard Davis Institute of Health Economics, University of Pennslyvania, Philadelphia, Pennsylvania; and
| | - George L. Anesi
- Division of Pulmonary, Allergy, and Critical Care, Department of Medicine, Perelman School of Medicine
- Palliative and Advanced Illness Research (PAIR) Center, Perelman School of Medicine
- Leonard Davis Institute of Health Economics, University of Pennslyvania, Philadelphia, Pennsylvania; and
| | - Marzana Chowdhury
- Palliative and Advanced Illness Research (PAIR) Center, Perelman School of Medicine
| | - Doug Schaubel
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine
| | - Vincent X. Liu
- Division of Research, Kaiser Permanente, Oakland, California
| | - Meghan B. Lane-Fall
- Palliative and Advanced Illness Research (PAIR) Center, Perelman School of Medicine
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine
- Department of Anesthesiology and Critical Care, Perelman School of Medicine, and
- Leonard Davis Institute of Health Economics, University of Pennslyvania, Philadelphia, Pennsylvania; and
| | - Scott D. Halpern
- Division of Pulmonary, Allergy, and Critical Care, Department of Medicine, Perelman School of Medicine
- Palliative and Advanced Illness Research (PAIR) Center, Perelman School of Medicine
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine
- Department of Medical Ethics and Health Policy, Perelman School of Medicine, and
- Leonard Davis Institute of Health Economics, University of Pennslyvania, Philadelphia, Pennsylvania; and
| |
Collapse
|
11
|
Guran E, Yan M, Ho D, Vandse R. Evaluation of psychological impact of COVID-19 on anesthesiology residents in the United States. Heliyon 2022; 8:e11815. [PMID: 36451756 PMCID: PMC9683519 DOI: 10.1016/j.heliyon.2022.e11815] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 09/19/2022] [Accepted: 11/15/2022] [Indexed: 11/27/2022] Open
Abstract
The aim of our study was to evaluate the impact of COVID-19 on the mental health of in-training anesthesiology residents in the United States. A link containing validated survey tools including the Depression-Anxiety-Stress-Scale (DASS-21), the Abbreviated Maslach Burnout Inventory (aMBI), and the Brief Resilient Coping Scale (BRCS) along with questions related to work environment, and additional personal factors were emailed to 159 Anesthesiology residency programs across the US. 143 responses were received of which 111 were complete. The prevalence of depression, anxiety, stress and burnout was 42%, 24%, 31% and 71% respectively. Emotional exhaustion, depersonalization, and reduced feelings of personal accomplishment were experienced by 80%, 53%, and 65% of respondents, respectively. The BRCS scale showed 33% of respondents with low, 44% with moderate and 22% with high coping scales. Logistic regression analyses indicated those with a prior mental health diagnosis were 3 times more likely to have a non-normal DASS depression score, 4 times more likely to have a non-normal DASS anxiety score, and 11.74 times more prone to emotional exhaustion. Increased work hours and higher training levels were associated with increased levels of stress. In our survey, prior mental health illness, gender and increased work hours were the main drivers of increased risk .
Collapse
|
12
|
Wu L, Chen Y, Liu X, Fang P, Feng T, Sun K, Ren L, Liang W, Lu H, Lin X, Li Y, Wang L, Li C, Zhang T, Ni C, Wu S. The influence of job burnout on the attention ability of army soldiers and officers: Evidence from ERP. Front Neurosci 2022; 16:992537. [PMID: 36419460 PMCID: PMC9676458 DOI: 10.3389/fnins.2022.992537] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 10/18/2022] [Indexed: 10/19/2023] Open
Abstract
Job burnout is one of the most widespread mental problems in today's society and seriously affects the mental health and combat effectiveness of soldiers and officers. Herein, the effect of burnout on individual attention is studied from the perspective of neuroelectrophysiology. A total of 1,155 army soldiers and officers were included in this investigation and completed the Job Burnout Scale for Military Personnel. A total of 42 soldiers and officers were randomly selected from those with and without burnout to participate in an event-related potential (ERP) study using a visual oddball task. The characteristics of visual P3a and P3b at Fz, FCz, Cz, CPz, and Pz were recorded and analyzed by repeated-measures analysis of variance (ANOVA). P < 0.05 was the criterion for a significant difference. The total average score on the Job Burnout Scale for Military Personnel among the participants was 0.74 ± 0.46, and the detection rate of job burnout was 29.85%. In the Oddball task, the average number of target stimuli counted in the burnout group was lower than that in the control group, but no significant difference was found. For P3a, the Fz, FCz, Cz, CPz, and Pz amplitudes in the burnout group were significantly lower than those in the control group. The average amplitude of P3a evoked in the central parietal area was larger than that in the prefrontal area. For P3b, the amplitudes of the five electrodes in the burnout group were significantly lower than those in the control group. The average amplitude of P3b evoked in the parietal region was larger than those in the prefrontal and central parietal regions. A certain degree of job burnout is evident in army soldiers and officers. The voluntary attention and involuntary attention of individuals with burnout are both affected to some extent, as reflected by the lower amplitudes of P3a and P3b. The results suggest that P3a and P3b can be used as indicators to monitor cognitive neural function in soldiers and officers with burnout and can also be used as references for evaluating the effects of cognitive training and screening methods. In this study, ERP was used to research the attention ability of soldiers and officers with job burnout, and related issues were discussed from the aspects of the burnout results, behavioral results, ERP results, compensation effect of cognitive resources, application in the military field, limitations, and prospects.
Collapse
Affiliation(s)
- Lin Wu
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, China
| | - Yanfeng Chen
- Nursing School, Air Force Medical University, Xi’an, China
| | - Xufeng Liu
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, China
| | - Peng Fang
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, China
| | - Tingwei Feng
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, China
| | - Kewei Sun
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, China
| | - Lei Ren
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, China
| | - Wei Liang
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, China
| | - Huijie Lu
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, China
| | - Xinxin Lin
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, China
| | - Yijun Li
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, China
| | - Lingling Wang
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, China
| | - Chenxi Li
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, China
| | - Tian Zhang
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, China
| | - Chunping Ni
- Nursing School, Air Force Medical University, Xi’an, China
| | - Shengjun Wu
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, China
| |
Collapse
|
13
|
Skau S, Johansson B, Kuhn HG, Thompson WH. Segregation over time in functional networks in prefrontal cortex for individuals suffering from pathological fatigue after traumatic brain injury. Front Neurosci 2022; 16:972720. [PMID: 36161148 PMCID: PMC9492975 DOI: 10.3389/fnins.2022.972720] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 08/23/2022] [Indexed: 11/13/2022] Open
Abstract
Pathological fatigue is present when fatigue is perceived to continually interfere with everyday life. Pathological fatigue has been linked with a dysfunction in the cortico-striatal-thalamic circuits. Previous studies have investigated measures of functional connectivity, such as modularity to quantify levels of segregation. However, previous results have shown both increases and decreases in segregation for pathological fatigue. There are multiple factors why previous studies might have differing results, including: (i) Does the functional connectivity of patients with pathological fatigue display more segregation or integration compared to healthy controls? (ii) Do network properties differ depending on whether patients with pathological fatigue perform a task compared to periods of rest? (iii) Are the brain networks of patients with pathological fatigue and healthy controls differently affected by prolonged cognitive activity? We recruited individuals suffering from pathological fatigue after mild traumatic brain injury (n = 20) and age-matched healthy controls (n = 20) to perform cognitive tasks for 2.5 h. We used functional near-infrared spectroscopy (fNIRS) to assess hemodynamic changes in the frontal cortex. The participants had a resting state session before and after the cognitive test session. Cognitive testing included the Digit Symbol Coding test at the beginning and the end of the procedure to measure processing speed. We conducted an exploratory network analysis on these resting state and Digit Symbol Coding sessions with no a priori hypothesis relating to how patients and controls differ in their functional networks since previous research has found results in both directions. Our result showed a Group vs. Time interaction (p = 0.026, ηp2 = 0.137), with a post hoc test revealing that the TBI patients developed higher modularity toward the end of the cognitive test session. This work helps to identify how functional networks differ under pathological fatigue compared to healthy controls. Further, it shows how the functional networks dynamically change over time as the patient performs tasks over a time scale that affect their fatigue level.
Collapse
Affiliation(s)
- Simon Skau
- Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Pedagogical, Curricular and Professional Studies, Faculty of Education, University of Gothenburg, Gothenburg, Sweden
- *Correspondence: Simon Skau,
| | - Birgitta Johansson
- Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Hans-Georg Kuhn
- Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - William Hedley Thompson
- Department of Applied Information Technology, University of Gothenburg, Gothenburg, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
14
|
Khammissa RAG, Nemutandani S, Feller G, Lemmer J, Feller L. Burnout phenomenon: neurophysiological factors, clinical features, and aspects of management. J Int Med Res 2022; 50:3000605221106428. [PMID: 36113033 PMCID: PMC9478693 DOI: 10.1177/03000605221106428] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Burnout syndrome is a distinct “occupational phenomenon” rather than a
medical condition, comprising emotional exhaustion, physical fatigue,
and cognitive weariness. Both exogenous work-related and endogenous
personal factors determine the extent and the severity of symptoms in
burnout syndrome. Persistent burnout is a cause of reduced quality of
life and is associated with increased risk of sleep impairment and
with several medical disorders including mild cognitive impairment,
diabetes, and cardiovascular disease. Active coping strategies promoting mental resilience and adaptive
behavior, stress-reducing activities, improving work conditions, and
reducing exposure to work stressors together may alleviate the
distress of burnout and should be introduced early in the clinical
course of burnout syndrome. The purpose of this review was to explain
this complex and puzzling phenomenon and to describe burnout
management.
Collapse
Affiliation(s)
- Razia A G Khammissa
- School of Dentistry, Faculty of Health Sciences. University of Pretoria, Pretoria, South Africa
| | - Simon Nemutandani
- School of Oral Health Sciences. Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Gal Feller
- Department of Radiation Oncology, University of the Witwatersrand, Johannesburg and Charlotte Maxeke Academic Hospital, Johannesburg, South Africa
| | - Johan Lemmer
- Faculty of Dentistry, University of the Witwatersrand, Johannesburg, South Africa
| | - Liviu Feller
- School of Oral Health Sciences. Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| |
Collapse
|
15
|
Plasma levels of S100B and neurofilament light chain protein in stress-related mental disorders. Sci Rep 2022; 12:8339. [PMID: 35585111 PMCID: PMC9117317 DOI: 10.1038/s41598-022-12287-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 05/09/2022] [Indexed: 11/29/2022] Open
Abstract
The pathophysiological changes underlying stress-related mental disorders remain unclear. However, research suggests that alterations in astrocytes and neurons may be involved. This study examined potential peripheral markers of such alterations, including S100B and neurofilament light chain (NF-L). We compared plasma levels of S100B and NF-L in patients with chronic stress-induced exhaustion disorder (SED), patients with major depressive disorder (MDD), and healthy controls. We also investigated whether levels of S100B and NF-L correlated with levels of astrocyte-derived extracellular vesicles (EVs that indicate astrocyte activation or apoptosis) and with symptom severity. Only women had measurable levels of S100B. Women with SED had higher plasma levels of S100B than women with MDD (P < 0.001) and healthy controls (P < 0.001). Self-rated symptoms of cognitive failures were positively correlated with levels of S100B (rs = 0.434, P = 0.005) as were depressive symptoms (rs = 0.319, P < 0.001). Plasma levels of astrocyte-derived EVs were correlated with levels of S100B (rs = 0.464, P < 0.001). Plasma levels of NF-L did not differ between the groups and were not correlated with symptom severity or EV levels. Thus, long-term stress without sufficient recovery and SED may be associated with raised plasma levels of S100B, which may be evidence of pathophysiological changes in astrocytes. The findings also support the hypothesis that plasma levels of S100B are associated with cognitive dysfunction.
Collapse
|
16
|
Di-Giusto C, Martín-Palacio ME, García-Rodríguez MS, Sánchez-Sánchez FJ, de la Fuente-Anuncibay R, Avilés-Dávila AF, García-Rodríguez CG. Effective Personality as a Protective Factor in Teachers' Occupational Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:2907. [PMID: 35270602 PMCID: PMC8910527 DOI: 10.3390/ijerph19052907] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 02/21/2022] [Accepted: 02/28/2022] [Indexed: 02/04/2023]
Abstract
In recent decades, there has been a growing body of research showing the relationship between teaching work and several health problems, both physical and psychological. Some of these studies relate personal competencies and resources to teachers' occupational health. Based on the construct of Effective Personality, proposed by Martin del Buey, Martín Palacio, and Di Giusto, the aim was to analyse the relationship between the dimensions of the construct and Teachers' Occupational Health. A descriptive cross-sectional design was used. It was based on the application of the Teacher Health Questionnaire (CSD) and the Efficacy Personality Questionnaire-Adults (CPE-A). The sample consisted of 700 non-university teachers aged between 26 and 66 years, M = 47.65 SD = 8.68. Descriptive, correlational, linear regression, and structural equation analyses were carried out. The results confirmed the relationship between the Efficacy Personality construct and Teachers' Occupational Health (r = 0.45 **). In addition, the regression analysis indicated the relevance of each factor of Efficacy Personality in the factors of Teachers' Occupational Health. The variance of Self-efficacy is the most explained by the dimensions of Efficacy Personality (40.2%), with positive relationships. The structural equation analysis confirmed the influence between Efficacy Personality and the factors of Self-Efficacy and Satisfaction, explaining 55.0% of the variance. It is concluded, therefore, that Efficacy Personality has a protective function on Teacher Occupational Health; the higher the Efficacy Personality scores are, the better the results in health gain-Self-efficacy and satisfaction-and the lower the result in health loss-burnout, cognitive affections, musculoskeletal affections, and voice alterations. These results facilitate the design of prevention and intervention programmes for teachers' occupational health, which strengthen and improve personal and socio-affective competencies.
Collapse
Affiliation(s)
- Cristina Di-Giusto
- Department of Educational Sciences, University of Burgos, 09001 Burgos, Spain; (C.D.-G.); (R.d.l.F.-A.)
| | | | | | | | | | | | | |
Collapse
|
17
|
Shang Y, Yang Y, Zheng G, Zhao Z, Wang Y, Yang L, Han L, Yao Z, Hu B. Aberrant functional network topology and effective connectivity in burnout syndrome. Clin Neurophysiol 2022; 138:163-172. [DOI: 10.1016/j.clinph.2022.03.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 02/16/2022] [Accepted: 03/18/2022] [Indexed: 12/11/2022]
|
18
|
Bäckström T, Das R, Bixo M. Positive GABA A receptor modulating steroids and their antagonists: Implications for clinical treatments. J Neuroendocrinol 2022; 34:e13013. [PMID: 34337790 DOI: 10.1111/jne.13013] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 07/09/2021] [Accepted: 07/09/2021] [Indexed: 01/02/2023]
Abstract
GABA is the main inhibitory neurotransmitter in the brain and GABAergic transmission has been shown to be of importance for regulation of mood, memory and food intake. The progesterone metabolite allopregnanolone (Allo) is a positive GABAA receptor modulating steroid with potent effects. In humans, disorders such as premenstrual dysphoric disorder (PMDD), hepatic encephalopathy and polycystic ovarian syndrome are associated with elevated Allo levels and increased negative mood, disturbed memory and increased food intake in some individuals. This is surprising because Allo shares many properties with benzodiazepines and is mainly considered to be anxiolytic and anti-depressant. However, it is well established that, in certain individuals, GABAA receptor activating compounds could have paradoxical effects and thus be anxiogenic in low physiological plasma concentrations but anxiolytic at high levels. We have demonstrated that isoallopregnanolone (Isoallo), the 3β-OH sibling of Allo, functions as a GABAA receptor modulating steroid antagonist (GAMSA) but without any effects of its own on GABAA receptors. The antagonistic effect is noted in most GABAA subtypes investigated in vitro to date. In vivo, Isoallo can inhibit Allo-induced anaesthesia in rats, as well as sedation or saccadic eye velocity in humans. Isoallo treatment has been studied in women with PMDD. In a first phase II study, Isoallo (Sepranolone; Asarina Pharma) injections significantly ameliorated negative mood in women with PMDD compared with placebo. Several GAMSAs for oral administration have also been developed. The GAMSA, UC1011, can inhibit Allo induced memory disturbances in rats and an oral GAMSA, GR3027, has been shown to restore learning and motor coordination in rats with hepatic encephalopathy. In humans, vigilance, cognition and pathological electroencephalogram were improved in patients with hepatic encephalopathy on treatment with GR3027. In conclusion GAMSAs are a new possible treatment for disorders and symptoms caused by hyperactivity in the GABAA system.
Collapse
Affiliation(s)
- Torbjörn Bäckström
- Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, Umea, Sweden
| | - Roshni Das
- Department of Integrative Medical Biology, Umeå University, Umea, Sweden
| | - Marie Bixo
- Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, Umea, Sweden
| |
Collapse
|
19
|
Evans TR, Roskam I, Stinglhamber F, Mikolajczak M. Burnout across boundaries: Can parental burnout directly or indirectly influence work outcomes? CURRENT PSYCHOLOGY 2022; 42:1-11. [PMID: 35095247 PMCID: PMC8783659 DOI: 10.1007/s12144-021-02687-3] [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] [Accepted: 12/29/2021] [Indexed: 11/03/2022]
Abstract
Burnout, while historically considered a work-related condition, can be associated with parenting where it can have direct impacts upon parental outcomes and one's personal resources such as mental health. However, little is known about the domain-incongruent effects of burnout and thus whether parental burnout can manifest within the workplace. The current study uses longitudinal data collected from 499 parents over three intervals across an 8-month period to explore two possible mechanisms. Firstly, a direct relationship is explored by considering whether parental burnout provides incremental validity above job burnout in the prediction of three work outcomes: job satisfaction, turnover intentions, and counterproductive work behaviors. Secondly, it is explored whether depression mediates the relationship between parental burnout and work outcomes. Findings suggest parental burnout may have limited impacts upon work outcomes, providing the impetus for a new direction of research to better understand whether or how burnout in one domain of life can influence the outcomes in other life domains. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s12144-021-02687-3.
Collapse
|
20
|
Koutsimani P, Montgomery A. Cognitive functioning in non-clinical burnout: Using cognitive tasks to disentangle the relationship in a three-wave longitudinal study. Front Psychiatry 2022; 13:978566. [PMID: 36061283 PMCID: PMC9428402 DOI: 10.3389/fpsyt.2022.978566] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 08/01/2022] [Indexed: 11/13/2022] Open
Abstract
Burnout is often characterized by cognitive deficits and it has been associated with depression and anxiety. However, it is not clear whether cognitive impairment is a burnout consequence or employees with poor cognitive skills are more prone in developing burnout. Moreover, the exact nature of the association between burnout and depression, and burnout and anxiety is still unknown. Depression and anxiety are also related to cognitive impairments but their prospective associations are not fully understood. The aim of the present three-wave longitudinal study was to investigate the causality between cognitive functioning, burnout, depression, and anxiety among non-clinical burnout employees. The cause-effect associations of burnout with depression and anxiety were also explored. Perceived family support as a protective factor against cognitive decline, burnout, depression and anxiety was examined as well. A wide range of cognitive tasks tapping different cognitive domains were administered to employees of the general working population. Burnout, depression, anxiety, and perceived family support were assessed with self-reported questionnaires. Present results suggest that visuospatial functioning deficits are a burnout consequence and they indicate the role of automatic processing skills and executive functions in burnout onset. Additionally, current findings support that burnout is differentiated from depression and anxiety but it is reciprocally associated with the two psychological phenomena. Lastly, current results support the inclusion of perceived family support as an intervention to help individuals who suffer from mental health and cognitive difficulties.
Collapse
Affiliation(s)
- Panagiota Koutsimani
- Department of Educational and Social Policy, School of Social Sciences, Humanities and Arts, University of Macedonia, Thessaloniki, Greece
| | - Anthony Montgomery
- Department of Psychology, Northumbria University Newcastle, Newcastle upon Tyne, United Kingdom
| |
Collapse
|
21
|
Koutsimani P, Montgomery A. Burnout and Cognitive Functioning: Are We Underestimating the Role of Visuospatial Functions? Front Psychiatry 2022; 13:775606. [PMID: 35401261 PMCID: PMC8983930 DOI: 10.3389/fpsyt.2022.775606] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 02/28/2022] [Indexed: 11/21/2022] Open
Abstract
Job burnout is a psychological syndrome which results from chronic occupational stress and cognitive impairments are among its negative consequences. The demands of the COVID-19 pandemic have challenged the healthcare system increasing the risk of job burnout among healthcare professionals. The studies conducted so far have mainly focused on the effects of job burnout on executive functions. Visuospatial functions are a cognitive domain which plays an important role in healthcare workers' optimal performance. Healthcare workers are constantly relying on their visuospatial abilities in order to care for their patients as they are required to use techniques that involve manipulation of medical instruments, they need to have excellent hand-eye coordination and great perception of spatial anatomy, factors that can affect healthcare workers' performance is of significance and can put patient safety at risk. However, our understanding of how visuospatial functions are being affected in job burnout is limited. The scope of this mini-review is to examine the evidence concerning the relationship of job burnout with visuospatial functions. The sparsity of the relevant empirical evidence does not allow for definite conclusions. However, given the implications of diminished visuospatial abilities in patient safety we highlight the need for studies exploring the effects of job burnout on visuospatial functions. Limitations of studies are discussed.
Collapse
Affiliation(s)
- Panagiota Koutsimani
- Department of Educational & Social Policy, School of Social Sciences, Humanities and Arts, University of Macedonia, Thessaloniki, Greece
| | - Anthony Montgomery
- Department of Educational & Social Policy, School of Social Sciences, Humanities and Arts, University of Macedonia, Thessaloniki, Greece
| |
Collapse
|
22
|
Gavelin HM, Domellöf ME, Åström E, Nelson A, Launder NH, Neely AS, Lampit A. Cognitive function in clinical burnout: A systematic review and meta-analysis. WORK AND STRESS 2021. [DOI: 10.1080/02678373.2021.2002972] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
| | | | | | - Andreas Nelson
- Department of Social and Psychological Studies, Karlstad University, Karlstad, Sweden
| | - Nathalie H. Launder
- Academic Unit for Psychiatry of Old Age, University of Melbourne, Parkville, Australia
| | - Anna Stigsdotter Neely
- Department of Social and Psychological Studies, Karlstad University, Karlstad, Sweden
- Department of Social Sciences, Technology and Arts, Luleå University of Technology, Luleå, Sweden
- Department of Health, Education and Technology, Luleå University of Technology, Luleå, Sweden
| | - Amit Lampit
- Academic Unit for Psychiatry of Old Age, University of Melbourne, Parkville, Australia
| |
Collapse
|
23
|
Abstract
OBJECTIVES Burnout is a state of exhaustion resulting from prolonged and excessive workplace stress. We sought to examine biological underpinnings of burnout, focussing on mechanisms and physical consequences. METHODS We searched the literature on burnout and evaluated studies examining biological parameters in patient populations (i.e. 'clinical' burnout) as well as in individuals from the general population judged as having some degree of burnout evaluated using a dimensional approach. RESULTS Findings suggest that burnout is associated with sustained activation of the autonomic nervous system and dysfunction of the sympathetic adrenal medullary axis, with alterations in cortisol levels. Limited studies have also shown altered immune function and changes in other endocrine systems. Consequences of burnout include increased allostatic load, structural and functional brain changes, excito-toxicity, systemic inflammation, immunosuppression, metabolic syndrome, cardiovascular disease and premature death. Limitations of studies include variability in study populations, low specificity of burnout measures, and mostly cross-sectional studies precluding examination of changes across the course of burnout. CONCLUSIONS Further examination of biological mechanisms of burnout would benefit from more homogeneous clinical samples, challenge tests and prospective studies. This would assist in differentiation from conditions such as depression and aid with development of specific treatment targets for burnout.
Collapse
Affiliation(s)
- Adam Bayes
- School of Psychiatry, UNSW, Sydney, Australia.,Black Dog Institute, Sydney, Australia
| | | | | |
Collapse
|
24
|
Blackstone SR, Johnson AK, Smith NE, McCall TC, Simmons WR, Skelly AW. Depression, burnout, and professional outcomes among PAs. JAAPA 2021; 34:35-41. [PMID: 34448776 DOI: 10.1097/01.jaa.0000769676.27946.56] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE This study examined the effect of depression and burnout on PA professional fulfillment and medical errors. METHODS Eight hundred eighty PAs completed an online survey containing the Professional Fulfillment Index, PHQ-2, GAD-7, and demographic questions. Two serial mediation models examined the relationship between depression, burnout, and professional outcomes. RESULTS Burnout fully mediated the relationship between depression and outcomes in both models and the present research indicates that burnout plays a stronger role in job satisfaction than symptoms of depression. CONCLUSIONS Understanding the underpinnings of professional satisfaction may mitigate clinician turnover, which in turn may lead to cost savings for the organization, better resilience and mental health for clinicians, and potentially better patient outcomes.
Collapse
Affiliation(s)
- Sarah R Blackstone
- Sarah R. Blackstone is the family medicine research manager at University of Virginia School of Medicine in Charlottesville, Va. At the time this article was written, she was an assistant professor in the Department of Health Sciences at James Madison University in Harrisonburg, Va. Aimee K. Johnson is an assistant professor in the Department of Health Sciences at James Madison University. Noël E. Smith is senior director of PA and industry research and analysis at the American Academy of PAs (AAPA) in Alexandria, Va. Timothy C. McCall is research director at the National Association of County and City Health Officials in Washington, D.C., and director of health sciences undergraduate courses at George Washington University in Washington, D.C. Whitney R. Simmons and Ashley W. Skelly are assistant professors in the PA program at James Madison University. The authors have disclosed no potential conflicts of interest, financial or otherwise
| | | | | | | | | | | |
Collapse
|
25
|
Pakarinen S, Lohilahti J, Sokka L, Korpela J, Huotilainen M, Müller K. Auditory deviance detection and involuntary attention allocation in occupational burnout-A follow-up study. Eur J Neurosci 2021; 55:2592-2611. [PMID: 34415092 DOI: 10.1111/ejn.15429] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 07/25/2021] [Accepted: 08/06/2021] [Indexed: 11/30/2022]
Abstract
Here, we investigated the central auditory processing and attentional control associated with both recovery and prolongation of occupational burnout. We recorded the event-related brain potentials N1, P2, mismatch negativity (MMN) and P3a to nine changes in speech sounds and to three rarely presented emotional (happy, angry and sad) utterances from individuals with burnout (N = 16) and their matched controls (N = 12). After the 5 years follow-up, one control had acquired burnout, half (N = 8) of the burnout group had recovered, and the other half (prolonged burnout) still had burnout. The processing of acoustical changes in speech sounds was mainly intact. Prolongation of the burnout was associated with a decrease in MMN amplitude and an increase in P3a amplitude for the happy stimulus. The results suggest that, in the absence of interventions, burnout is a persistent condition, associated with alterations of attentional control, that may be amplified with the prolongation of the condition.
Collapse
Affiliation(s)
- Satu Pakarinen
- Finnish Institute of Occupational Health, Helsinki, Finland
| | | | - Laura Sokka
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Jussi Korpela
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Minna Huotilainen
- CICERO Learning, Faculty of Education, and Cognitive Brain Research Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Kiti Müller
- Faculty of Medicine, Department of Neurosciences, University of Helsinki, Helsinki, Finland
| |
Collapse
|
26
|
Wallensten J, Mobarrez F, Åsberg M, Borg K, Beser A, Wilczek A, Nager A. Isoforms of soluble vascular endothelial growth factor in stress-related mental disorders: a cross-sectional study. Sci Rep 2021; 11:16693. [PMID: 34404878 PMCID: PMC8370974 DOI: 10.1038/s41598-021-96313-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 08/03/2021] [Indexed: 12/17/2022] Open
Abstract
Vascular endothelial growth factor (VEGF) has been implicated in the pathophysiology of stress-related mental disorders. However, VEGF levels have seldom been compared across mental disorders and never by isoforms. Pathophysiological processes involving leakage of astrocyte-derived extracellular vesicles (EVs) across the blood–brain barrier could be associated with VEGF levels in patients with stress-related mental disorders. This cross-sectional study compared plasma levels of VEGF121, VEGF165, and VEGF121 + VEGF165 (VEGFtotal) in patients with stress-induced exhaustion disorder (SED) (n = 31), patients with major depressive disorder (MDD) (n = 31), and healthy controls (n = 61). It also analyzed the correlation between VEGF and astrocyte-derived EVs in plasma. An enzyme-linked immunosorbent assay (ELISA) was used to measure VEGF121 and VEGF165 in citrate plasma, and flow cytometry was used to measure astrocyte-derived EVs in plasma. The mean concentration of soluble VEGF121 (sVEGF121) was significantly higher in patients with SED than healthy controls (P = 0.043). Mean sVEGF165 was significantly lower in patients with MDD than patients with SED (P = 0.004) or healthy controls (P = 0.037). Mean sVEGFtotal was significantly higher in patients with SED than in patients with MDD (P = 0.021) and also higher in patients with SED than healthy controls (P = 0.040). Levels of sVEGF121 were positively correlated with levels of astrocyte-derived EVs only in patients with SED (P = 0.0128). The same was true of levels of sVEGFtotal and astrocyte-derived EVs (P = 0.0046). Differing levels of VEGF isoforms may reflect different pathophysiological mechanisms in SED and MDD. Further research is needed to better understand the potential roles of VEGF isoforms and astrocyte-derived EVs in mental disorders.
Collapse
Affiliation(s)
- Johanna Wallensten
- Academic Primary Health Care Centre, Region Stockholm, Solnavägen 1E, Box 45436, 104 31, Stockholm, Sweden. .,Department of Clinical Sciences, Karolinska Institutet, Danderyd University Hospital, 18288, Stockholm, Sweden.
| | - Fariborz Mobarrez
- Department of Medical Sciences, Uppsala University, 75185, Uppsala, Sweden
| | - Marie Åsberg
- Department of Clinical Sciences, Karolinska Institutet, Danderyd University Hospital, 18288, Stockholm, Sweden
| | - Kristian Borg
- Department of Clinical Sciences, Karolinska Institutet, Danderyd University Hospital, 18288, Stockholm, Sweden
| | - Aniella Beser
- Department of Clinical Sciences, Karolinska Institutet, Danderyd University Hospital, 18288, Stockholm, Sweden
| | - Alexander Wilczek
- Department of Clinical Sciences, Karolinska Institutet, Danderyd University Hospital, 18288, Stockholm, Sweden
| | - Anna Nager
- Division of Family Medicine and Primary Health Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 17177, Stockholm, Sweden
| |
Collapse
|
27
|
Tavella G, Hadzi-Pavlovic D, Parker G. Burnout: Redefining its key symptoms. Psychiatry Res 2021; 302:114023. [PMID: 34052460 DOI: 10.1016/j.psychres.2021.114023] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 05/15/2021] [Indexed: 12/11/2022]
Abstract
Burnout is currently operationalised as comprising of exhaustion, depersonalization and reduced personal accomplishment. However, questions have been raised as to whether this three-factor model accurately characterises the syndrome. We therefore sought to re-examine burnout's key symptoms and to develop a new model of the syndrome. 622 participants who self-identified as experiencing burnout completed a questionnaire covering a large item set of candidate burnout symptoms. Bifactor modelling identified a 34-item general factor that was dominated by items capturing exhaustion and cognitive dysfunction, but which also included items indicative of decreased work performance, insularity and a depressed mood. Five specific factors capturing additional data variance were identified and were interpreted as representing cognitive impairment, empathy loss, exhaustion, compromised work performance, and social withdrawal. Reliability indices indicated that the general factor alone accounted for most of the variance in observed scale scores for each specific factor, except for the loss of empathy specific factor. We concluded that burnout may therefore potentially be modelled as a unidimensional construct comprising exhaustion, cognitive impairment, compromised work performance, empathy loss and social withdrawal. Further, while those with burnout are likely to experience depressive symptoms, their presence is not of necessity indicative of clinical depression.
Collapse
Affiliation(s)
- Gabriela Tavella
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | | | - Gordon Parker
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia.
| |
Collapse
|
28
|
Exploring Individual Differences as Predictors of Performance Change During Dual-N-Back Training. JOURNAL OF COGNITIVE ENHANCEMENT 2021; 5:480-498. [DOI: 10.1007/s41465-021-00216-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
29
|
Holding BC, Ingre M, Petrovic P, Sundelin T, Axelsson J. Quantifying Cognitive Impairment After Sleep Deprivation at Different Times of Day: A Proof of Concept Using Ultra-Short Smartphone-Based Tests. Front Behav Neurosci 2021; 15:666146. [PMID: 33927603 PMCID: PMC8076531 DOI: 10.3389/fnbeh.2021.666146] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 03/19/2021] [Indexed: 11/28/2022] Open
Abstract
Cognitive functioning is known to be impaired following sleep deprivation and to fluctuate depending on the time of day. However, most methods of assessing cognitive performance remain impractical for environments outside of the lab. This study investigated whether 2-min smartphone-based versions of commonly used cognitive tests could be used to assess the effects of sleep deprivation and time of day on diverse cognitive functions. After three nights of normal sleep, participants (N = 182) were randomised to either one night of sleep deprivation or a fourth night of normal sleep. Using the Karolinska WakeApp (KWA), participants completed a battery of 2-min cognitive tests, including measures of attention, arithmetic ability, episodic memory, working memory, and a Stroop test for cognitive conflict and behavioural adjustment. A baseline measurement was completed at 22:30 h, followed by three measurements the following day at approximately 08:00 h, 12:30 h, and 16:30 h. Sleep deprivation led to performance impairments in attention, arithmetic ability, episodic memory, and working memory. No effect of sleep deprivation was observed in the Stroop test. There were variations in attention and arithmetic test performance across different times of day. The effect of sleep deprivation on all cognitive tests was also found to vary at different times of day. In conclusion, this study shows that the KWA's 2-min cognitive tests can be used to detect cognitive impairments following sleep deprivation, and fluctuations in cognitive performance relating to time of day. The results demonstrate the potential of using brief smartphone-based tasks to measure a variety of cognitive abilities within sleep and fatigue research.
Collapse
Affiliation(s)
- Benjamin C. Holding
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Sociology, University of Copenhagen, Copenhagen, Denmark
| | - Michael Ingre
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Predrag Petrovic
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Tina Sundelin
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - John Axelsson
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Psychology, Stockholm University, Stockholm, Sweden
| |
Collapse
|
30
|
Ellbin S, Jonsdottir IH, Eckerström C, Eckerström M. Self-reported cognitive impairment and daily life functioning 7-12 years after seeking care for stress-related exhaustion. Scand J Psychol 2021; 62:484-492. [PMID: 33728711 DOI: 10.1111/sjop.12722] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 12/17/2020] [Accepted: 01/31/2021] [Indexed: 11/27/2022]
Abstract
The overall aim of this study was to investigate self-reported cognitive difficulties, daily life activities, and health/sleep factors in former patients with exhaustion disorder (ED) who still fulfill the clinical criteria for exhaustion 7-12 years after seeking care. The Sahlgrenska Self-reported Cognitive Impairment Questionnaire (SASCI-Q) was used to measure cognitive difficulties, daily life activities, and health/sleep factors. Three groups were compared: previous patients still judged to be clinically exhausted seven years or more after seeking care (n = 51); previous patients considered clinically recovered (n = 98); and healthy controls (n = 50). Patients who still fulfilled the diagnostic criteria for ED reported widespread problems related to cognition, fatigue, and daily life functioning compared to the clinically recovered group. Furthermore, despite no longer fulfilling the clinical criteria, the recovered patients still reported more problems related to cognitive functioning and fatigue compared to healthy controls. Thus, this group appeared intermediary between the non-recovered group and healthy controls regarding self-reported cognitive functioning. To conclude, ED may have considerable negative long-term effects, and it is possible that some of these residual symptoms, particularly the cognitive problems and persistent fatigue, are permanent in some patients. Preventive measures should be the primary focus for all stakeholders, since the consequences of stress-related mental health problems seem to be extensive and long-lasting.
Collapse
Affiliation(s)
- Susanne Ellbin
- Institute of Stress Medicine, Region Västra Götaland, Gothenburg, Sweden
| | - Ingibjörg H Jonsdottir
- Institute of Stress Medicine, Region Västra Götaland, Gothenburg, Sweden.,School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Carl Eckerström
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.,Department of Immunology and Transfusion Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Marie Eckerström
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| |
Collapse
|
31
|
Mastering Stress: Mental Skills and Emotional Regulation for Surgical Performance and Life. J Surg Res 2021; 263:A1-A12. [PMID: 33678414 DOI: 10.1016/j.jss.2021.01.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 01/06/2021] [Accepted: 01/15/2021] [Indexed: 12/20/2022]
Abstract
Mental skills and emotional regulation training are gaining acceptance in surgical education as vital elements of surgeon development. These skills can effectively enhance technical skill development, improve well-being, and promote career longevity. There is evidence emerging in the surgical education literature to support the incorporation of mental skills and emotional regulation training curricula in residency training. In this study, we present the existing evidence supporting the use of this training with high performers to reduce stress and optimize well-being and performance. We also consider the recent research emerging in surgical education that offers validity evidence for use of mental skills training with surgeons. Finally, we provide a framework to guide the incorporation of these skills throughout the career of a surgeon and suggest methods to promote the development of mental skills training efforts nationally.
Collapse
|
32
|
Koutsimani P, Montgomery A, Masoura E, Panagopoulou E. Burnout and Cognitive Performance. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18042145. [PMID: 33671754 PMCID: PMC7926785 DOI: 10.3390/ijerph18042145] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 02/15/2021] [Accepted: 02/18/2021] [Indexed: 01/16/2023]
Abstract
The aim of this study was to investigate the relationship between burnout and cognitive functioning. The associations of depression, anxiety and family support with burnout and cognitive functioning were also examined both independently and as potential moderators of the burnout–cognitive functioning relationship. Seven different cognitive tasks were administered to employees of the general working population and five cognitive domains were assessed; i.e., executive functions, working memory, memory (episodic, visuospatial, prospective), attention/speed of processing and visuospatial abilities. Burnout, depression, anxiety and family support were assessed with the Maslach Burnout Inventory-General Survey, the Hospital Anxiety and Depression Scale and the Family Support Scale respectively. In congruence with the first and fourth (partially) Hypotheses, burnout and perceived family support are significantly associated with some aspects of cognitive functioning. Moreover, in line with the third Hypothesis, perceived family support is inversely related to burnout. However, in contrast to the second and fourth Hypotheses, depression, anxiety and perceived family support do not moderate the burnout–cognitive functioning relationship. Additional results reveal positive associations between burnout depression and anxiety. Overall findings suggest that cognitive deficits, depression and anxiety appear to be common in burnout while they underpin the role of perceived family support in both mental health and cognitive functioning. Implications for practice are discussed.
Collapse
Affiliation(s)
- Panagiota Koutsimani
- Department of Educational & Social Policy, School of Social Sciences, Humanities and Arts, University of Macedonia, Egnatia 156, 54636 Thessaloniki, Greece;
- Correspondence: ; Tel.: +30-2310-891-308
| | - Anthony Montgomery
- Department of Educational & Social Policy, School of Social Sciences, Humanities and Arts, University of Macedonia, Egnatia 156, 54636 Thessaloniki, Greece;
| | - Elvira Masoura
- Department of Experimental Cognitive Psychology, School of Psychology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Efharis Panagopoulou
- Laboratory of Hygiene, Medical School, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| |
Collapse
|
33
|
Baker FRL, Baker KL, Burrell J. Introducing the skills‐based model of personal resilience: Drawing on content and process factors to build resilience in the workplace. JOURNAL OF OCCUPATIONAL AND ORGANIZATIONAL PSYCHOLOGY 2021. [DOI: 10.1111/joop.12340] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
| | - Kevin L. Baker
- East Midlands Psychology Ltd Nottingham UK
- St Andrews Healthcare, William Wake House Northampton UK
| | - Jo Burrell
- East Midlands Psychology Ltd Nottingham UK
- Clinical Psychology Unit University of Sheffield UK
| |
Collapse
|
34
|
Wolpaw JT, Adair KC. Shoe Covers but Not Burnout? Making Burnout Reduction a Criteria for Centers for Medicare and Medicaid Services Funding Would Protect Patients. J Patient Saf 2021; 17:68-70. [PMID: 32217936 DOI: 10.1097/pts.0000000000000681] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT In the United States, hospitals must meet eligibility criteria to receive federal funding. Regulatory bodies, such as the Joint Commission, are approved by the government to give, or withhold, accreditation to hospitals. This accreditation is a requisite to continue receiving funding. Hospitals are frequently cited for items such as inadequate wearing of boot covers or covering of facial hair in the operating rooms. There are very little, if any, data to support an improvement in patient safety when these items are complied with. There is, however, a large amount of data showing the negative consequences for patient safety when providers are burned out. We therefore propose that regulatory agencies such as the Joint Commission require that hospital systems measure burnout and reduce concerning levels of burnout in their employees to continue receiving certification. We briefly review evidence-based methods that hospital systems might consider to accomplish this goal.
Collapse
Affiliation(s)
- Jed T Wolpaw
- From the Johns Hopkins Department of Anesthesiology and Critical Care Medicine, Baltimore, Maryland
| | - Kathryn C Adair
- The Duke Center for Healthcare Safety and Quality, Duke University Health System, Durham, NC
| |
Collapse
|
35
|
Skau S, Jonsdottir IH, Sjörs Dahlman A, Johansson B, Kuhn HG. Exhaustion disorder and altered brain activity in frontal cortex detected with fNIRS. Stress 2021; 24:64-75. [PMID: 32510268 DOI: 10.1080/10253890.2020.1777972] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Patients with stress-related Exhaustion Disorder (ED) have problems with memory and executive function. These problems have been associated with deviant activity in prefrontal cortex (PFC). We investigated cognitive performance and functional activity in the PFC during prolonged mental activity in patients with ED (n = 20, 16 women) with a mean duration since diagnosis of 46 ± 23 months in comparison to healthy individuals (n = 20, 12 women). A block of six neuropsychological tests was performed in a sequence that was repeated once. The brain imaging technique, functional near infrared spectroscopy (fNIRS) was used for all tests. There were no differences between the groups in terms of changes over time, i.e. difference between first and second test block. In the Stroop-Simon test, the controls showedhigher functional activity in the frontal cortex. In the left ventrolateral PFC, we observed an increased activity in controls in the incongruent compared to the congruent trials, whereas no changes were detected in the ED patient group. During processing speed tasks, only ED patients showed higher functional activity in right dorsolateral PFC. The ED patients reported lower subjective energy level and they also performed less well on a mental control task compared to healthy individuals. In conclusion, ED patients showed altered functional activity compared to controls, indicating that ED patients process information differently in the prefrontal cortex, but the functional activity did not change during the 2½ hr procedure, as revealed by the test-retest design. Lay summary In this paper we show that patient with exhaustion disorder have a reduced functional activity in the prefrontal cortex. This functional activity was not affected by 2.5 hours mental activity.
Collapse
Affiliation(s)
- Simon Skau
- Instituteof Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ingibjörg H Jonsdottir
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Institute of Stress Medicine, Gothenburg, Sweden
| | - Anna Sjörs Dahlman
- Institute of Stress Medicine, Gothenburg, Sweden
- Swedish National Road and Transport Research Institute, Gothenburg, Sweden
| | - Birgitta Johansson
- Instituteof Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - H Georg Kuhn
- Instituteof Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| |
Collapse
|
36
|
Kulikowski K. Cognitive abilities - a new direction in burnout research. EUROPEAN JOURNAL OF WORK AND ORGANIZATIONAL PSYCHOLOGY 2020. [DOI: 10.1080/1359432x.2020.1841284] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Konrad Kulikowski
- Faculty of Management, University of Social Sciences, Społeczna Akademia Nauk, Łódz, Poland
| |
Collapse
|
37
|
Abstract
INTRODUCTION Burnout is an occupational hazard for physicians at all stages of training and medical practice. The purpose of the current study was to determine whether residency factors, with the use of an activity monitor, including the amount of exercise, have any impact on burnout among orthopaedic surgery residents in varying years of training. METHODS Orthopaedic residents at a single institution were recruited immediately before beginning a new clinical rotation and followed for four weeks. On enrollment, the participants were given a wrist-worn activity monitor (Fitbit Flex) and instructed on its use for tracking physical activity. REDCap was used to collect burnout levels (as assessed by using the Maslach Burnout Inventory and the Patient Health Questionnaire-9), which were completed a total of five times, once at enrollment and weekly during the study period. RESULTS Twenty-seven residents were enrolled, including 13 junior residents (interns and second years) and 14 senior residents (third, fourth, and fifth years). Seven residents were on fracture rotations, whereas 20 were not. As measured by using the Maslach Burnout Inventory, juniors were more emotionally exhausted (P = 0.01) and depersonalized (P = 0.027). No difference in the objective physical activity data as measured by using the Fitbit Flex and no difference in the self-reported hours of sleep were observed. Residents on orthopaedic trauma rotations also reported significantly higher rates of emotional exhaustion and depersonalization (P < 0.001) than other residents and were more physically active on average (P < 0.030). DISCUSSION Although depersonalization and depression are common symptoms seen among orthopaedic surgery residents, this study demonstrated that quality of life improves markedly as they progress through their residency training. Residents on orthopedic trauma rotations have greater levels of emotional exhaustion and depersonalization. This pilot study suggests that burnout prevention programs should begin at the start of training to provide residents with strategies to combat and then reinforced while on orthopaedic trauma rotations. LEVEL OF EVIDENCE Level III Diagnostic Study.
Collapse
|
38
|
Marôco J, Assunção H, Harju-Luukkainen H, Lin SW, Sit PS, Cheung KC, Maloa B, Ilic IS, Smith TJ, Campos JADB. Predictors of academic efficacy and dropout intention in university students: Can engagement suppress burnout? PLoS One 2020; 15:e0239816. [PMID: 33119598 PMCID: PMC7595383 DOI: 10.1371/journal.pone.0239816] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 09/14/2020] [Indexed: 11/21/2022] Open
Abstract
In this study we modelled possible causes and consequences of student burnout and engagement on academic efficacy and dropout intention in university students. Further we asked, can student engagement protect against the effects of burnout? In total 4,061 university students from Portugal, Brazil, Mozambique, the United Kingdom, the United States of America, Finland, Serbia, and Macao SAR, Taiwan participated in this study. With the data collected we analyzed the influence of Social Support, Coping Strategies, and school/course related variables on student engagement and burnout using structural equation modeling. We also analyzed the effect of student engagement, student burnout, and their interaction, on Academic Performance and Dropout Intention. We found that both student engagement and burnout are good predictors of subjective academic performance and dropout intention. However, student burnout suppresses the effect of student engagement on these variables. This result has strong implications for practitioners and administrators. To prevent student dropout, it is not enough to promote student engagement-additionally, and importantly, levels of student burnout must be kept low. Other variables such as social support and coping strategies are also relevant predictors of student engagement and burnout and should be considered when implementing preventive actions, self-help and guided intervention programs for college students.
Collapse
Affiliation(s)
- João Marôco
- William James Center for Research, ISPA–Instituto Universitário, Lisbon, Portugal
| | - Hugo Assunção
- William James Center for Research, ISPA–Instituto Universitário, Lisbon, Portugal
| | | | - Su-Wei Lin
- Department of Education, The National University of Tainan, Tainan, Taiwan
| | - Pou-Seong Sit
- Faculty of Education, University of Macau, Taipa, Macau, China
| | | | | | - Ivana Stepanović Ilic
- Department of Psychology, Faculty of Philosophy, University of Belgrade, Belgrade, Serbia
| | - Thomas J. Smith
- Department of ETRA, Northern Illinois University, DeKalb, IL, United States of America
| | | |
Collapse
|
39
|
Demirci H, Durmus H, Toksoy G, Uslu A, Parman Y, Hanagasi H. Cognition of the mothers of patients with Duchenne muscular dystrophy. Muscle Nerve 2020; 62:710-716. [PMID: 32893363 DOI: 10.1002/mus.27057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 08/27/2020] [Accepted: 08/29/2020] [Indexed: 12/22/2022]
Abstract
Duchenne muscular dystrophy (DMD) has been found to be associated with cognitive impairment. However, few studies have addressed cognitive impairment among mothers of children with DMD. In the present study, the neuropsychological profiles of both carrier mothers (C-Ms) and noncarrier mothers (NC-Ms) were examined, and the findings were compared with healthy control mothers (HC-Ms). There were 90 participants, consisting of 31 C-Ms, 24 NC-Ms, and 35 HC-Ms, each of whom completed a neuropsychological test battery. C-Ms had poorer cognition performance in attention, working memory, immediate verbal memory, visuospatial skills, and executive functions than NC-Ms, and HC-Ms. This study provides evidence that there may be cognitive impairment in mothers of patients with DMD. The cognitive impairment of C-Ms has similarities to that seen in children with DMD.
Collapse
Affiliation(s)
- Hasan Demirci
- Department of Psychiatry, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Hacer Durmus
- Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Guven Toksoy
- Department of Medical Genetics, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Atilla Uslu
- Department of Physiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Yesim Parman
- Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Hasmet Hanagasi
- Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| |
Collapse
|
40
|
Horvat M, Tement S. Self-reported cognitive difficulties and cognitive functioning in relation to emotional exhaustion: Evidence from two studies. Stress Health 2020; 36:350-364. [PMID: 31957971 DOI: 10.1002/smi.2930] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 01/08/2020] [Accepted: 01/13/2020] [Indexed: 12/16/2022]
Abstract
Individuals with burnout often report having difficulties with concentration and memory in everyday life. However, empirical evidence on cognitive decline using performance-based measures is limited and often obtained on small clinical samples. The aim of the present two studies was to investigate cognitive correlates of emotional exhaustion on otherwise healthy populations at different life stages with varying degrees of burnout. A total of 201 graduate and undergraduate students participated in Study 1, and a heterogeneous sample (N = 203) of working individuals took part in Study 2. Cognitive performance was assessed by self-reported cognitive difficulties and three performance-based cognitive tests of sustained attention, inhibition of irrelevant information, and inhibition of prepotent responses. Controlling for gender, age, and depression symptoms, multiple regression analyses in Study 1 indicated a positive relationship between emotional exhaustion and self-reported cognitive difficulties but no correlation with the performance-based cognitive measures. A similar pattern of results emerged in Study 2. However, we found tentative evidence for cognitive impairment on the sustained attention measure. The results of these two studies partially support previous findings and extend the literature on cognitive aspects of burnout.
Collapse
Affiliation(s)
- Marina Horvat
- Department of Psychology, Faculty of Arts, University of Maribor, Maribor, Slovenia
| | - Sara Tement
- Department of Psychology, Faculty of Arts, University of Maribor, Maribor, Slovenia
| |
Collapse
|
41
|
Burzynska AZ, Ganster DC, Fanning J, Salerno EA, Gothe NP, Voss MW, McAuley E, Kramer AF. Occupational Physical Stress Is Negatively Associated With Hippocampal Volume and Memory in Older Adults. Front Hum Neurosci 2020; 14:266. [PMID: 32765239 PMCID: PMC7381137 DOI: 10.3389/fnhum.2020.00266] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 06/15/2020] [Indexed: 12/20/2022] Open
Abstract
Our jobs can provide intellectually and socially enriched environments but also be the source of major psychological and physical stressors. As the average full-time worker spends >8 h at work per weekday and remains in the workforce for about 40 years, occupational experiences must be important factors in cognitive and brain aging. Therefore, we studied whether occupational complexity and stress are associated with hippocampal volume and cognitive ability in 99 cognitively normal older adults. We estimated occupational complexity, physical stress, and psychological stress using the Work Design Questionnaire (Morgeson and Humphrey, 2006), Quantitative Workload Inventory and Interpersonal Conflict at Work Scale (Spector and Jex, 1998). We found that physical stress, comprising physical demands and work conditions, was associated with smaller hippocampal volume and poorer memory performance. These associations were independent of age, gender, brain size, socioeconomic factors (education, income, and job title), duration of the job, employment status, leisure physical activity and general stress. This suggests that physical demands at work and leisure physical activity may have largely independent and opposite effects on brain and cognitive health. Our findings highlight the importance of considering midlife occupational experiences, such as work physical stress, in understanding individual trajectories of cognitive and brain aging.
Collapse
Affiliation(s)
- Agnieszka Z. Burzynska
- Department of Human Development and Family Studies, Molecular, Cellular and Integrative Neurosciences Graduate Interdisciplinary Studies Program, Colorado State University, Fort Collins, CO, United States
| | - Daniel C. Ganster
- Department of Management, Colorado State University, Fort Collins, CO, United States
| | - Jason Fanning
- Department of Health & Exercise Sciences, Wake Forest University, Winston-Salem, NC, United States
| | - Elizabeth A. Salerno
- Cancer Prevention Fellowship Program, Division of Cancer Epidemiology & Genetics, National Cancer Institute, Bethesda, MD, United States
| | - Neha P. Gothe
- Department of Kinesiology and Community Health, University of Illinois at Urbana–Champaign, Urbana, IL, United States
| | - Michelle W. Voss
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, United States
| | - Edward McAuley
- Department of Kinesiology and Community Health, University of Illinois at Urbana–Champaign, Urbana, IL, United States
- Beckman Institute for Advanced Science & Technology, University of Illinois at Urbana–Champaign, Urbana, IL, United States
| | - Arthur F. Kramer
- Beckman Institute for Advanced Science & Technology, University of Illinois at Urbana–Champaign, Urbana, IL, United States
- Department of Psychology, Northeastern University, Boston, MA, United States
- Department of Mechanical and Industrial Engineering, Northeastern University, Boston, MA, United States
| |
Collapse
|
42
|
Andersson C, Marklund K, Walles H, Hagman G, Miley-Akerstedt A. Lifestyle Factors and Subjective Cognitive Impairment in Patients Seeking Help at a Memory Disorder Clinic: The Role of Negative Life Events. Dement Geriatr Cogn Disord 2020; 48:196-206. [PMID: 31982880 DOI: 10.1159/000505573] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 12/19/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS A large proportion of patients at memory disorders clinics are classified as having subjective cognitive impairment (SCI). Previous research has investigated whether particular lifestyle factors known to affect cognition can be useful in differentiating patients who do not show objective evidence of memory decline. There may also exist subgroups of patients with respect to lifestyle factors that could help clinicians to understand the patient group that presents to memory clinics. These may differ in diagnostic outcome. Very little is known about potential subgroups; however, but such information may help guide interventions and potentially eliminate unnecessary diagnostic procedures. The current study investigated patterns of lifestyle-related variables, including stress, sleep, sensory sensitivity, depression, and negative life events in patients presenting to a memory disorders clinic. The aim was to determine whether subgroups existed and whether it was possible to distinguish those with objectively impaired cognition. METHODS One hundred and seventy-eight patients (mean age 58 years) from a University Hospital Memory Disorders Clinic. RESULTS Cluster analysis identified three groups of lifestyle-related variables. Strong determinants of clusters were negative life events and age. Patients with a high number of negative life events also tended to have highest self-reported memory complaint, higher levels of stress, depression, and sensory sensitivity. However, they did not perform the worst on memory testing. In contrast, individuals who performed the worst on memory tests were older, tended to have the least memory complaints, and less negative lifestyle factors; this group also included the highest proportion of patients with mild cognitive impairment and had the lowest median amyloid A-beta 42 (Aβ42). The group with the best cognitive performance were younger, included the highest proportion of patients with SCI and the highest median Aβ42. On lifestyle variables, their ratings fell in between the other groups. CONCLUSIONS Lifestyle subgroups of patients were determined by stress, emotional problems, and age. The groups were significantly associated with Aβ42 and diagnostic outcome. This pattern may confound the differentiation between objective and subjective memory problems. Asking about lifestyle variables, in conjunction with neuropsychological testing, could potentially identify individuals who are not likely to have objective memory impairment and guide interventions.
Collapse
Affiliation(s)
- Christin Andersson
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.,Division of Medical Psychology, Karolinska University Hospital, Stockholm, Sweden
| | | | - Håkan Walles
- Department of Aging, Karolinska University Hospital, Stockholm, Sweden
| | - Göran Hagman
- Department of Aging, Karolinska University Hospital, Stockholm, Sweden.,Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
| | - Anna Miley-Akerstedt
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden, .,Department of Aging, Karolinska University Hospital, Stockholm, Sweden,
| |
Collapse
|
43
|
GABA-A receptor modulating steroids in acute and chronic stress; relevance for cognition and dementia? Neurobiol Stress 2019; 12:100206. [PMID: 31921942 PMCID: PMC6948369 DOI: 10.1016/j.ynstr.2019.100206] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 11/13/2019] [Accepted: 12/18/2019] [Indexed: 01/10/2023] Open
Abstract
Cognitive dysfunction, dementia and Alzheimer's disease (AD) are increasing as the population worldwide ages. Therapeutics for these conditions is an unmet need. This review focuses on the role of the positive GABA-A receptor modulating steroid allopregnanolone (APα), it's role in underlying mechanisms for impaired cognition and of AD, and to determine options for therapy of AD. On one hand, APα given intermittently promotes neurogenesis, decreases AD-related pathology and improves cognition. On the other, continuous exposure of APα impairs cognition and deteriorates AD pathology. The disparity between these two outcomes led our groups to analyze the mechanisms underlying the difference. We conclude that the effects of APα depend on administration pattern and that chronic slightly increased APα exposure is harmful to cognitive function and worsens AD pathology whereas single administrations with longer intervals improve cognition and decrease AD pathology. These collaborative assessments provide insights for the therapeutic development of APα and APα antagonists for AD and provide a model for cross laboratory collaborations aimed at generating translatable data for human clinical trials.
Collapse
|
44
|
A study on the characteristics of Maslach Burnout Inventory-General Survey (MBI-GS) of workers in one electronics company. Ann Occup Environ Med 2019; 31:e29. [PMID: 31737284 PMCID: PMC6850794 DOI: 10.35371/aoem.2019.31.e29] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 09/10/2019] [Indexed: 11/25/2022] Open
Abstract
Background This study investigated characteristics according to demographic, occupational factors of Maslach Burnout Inventory-General Survey (MBI-GS) and related scales to MBI-GS. Methods The subjects of the study were 3,331 workers in 3 different workplaces of one electronics company. They filled in demographic factors surveys, occupational factors surveys, MBI-GS, Korean Occupational Stress Scale-Short Form (KOSS-SF), Patient Health Questionnaire-9 (PHQ-9), and World Health Organization Quality Of Life-Abbreviated version (WHOQOL-BREF). The correlations between sub-scales of MBI-GS and KOSS-SF, PHQ-9, WHOQOL-BREF were analyzed respectively. And KOSS-SF, PHQ-9, and WHOQOL-BREF were categorized; mean scores of sub-scales of MBI-GS were compared; and the quartiles of sub-scales of MBI-GS were presented. Results A comparison of mean scores of MBI-GS according to demographic and occupational factors showed a significant difference according to age, problem drinking behavior, working time, and working duration in exhaustion regardless of sex. In professional efficacy, a significant difference was observed in age, marital status, working type, and working duration. And as a result of correlation analysis, the correlation coefficient between exhaustion and PHQ-9 was the highest regardless of sex. In addition, regardless of sex, exhaustion and cynicism scores tended to increase and professional efficacy score tended to decrease as the work stress level rose. Same tendency is shown in case of the more severe the symptom of depression and the lower quality of life. When the quartile for sub-scales' score of MBI-GS were investigated, the burnout was more pronounced in female than in male. Conclusions Many demographic and occupational factors affect burnout were identified in one electronics company, and we investigated which sub-scales of MBI-GS were affected. Through this study, burnout characteristics were identified in a few population group of Korea, and the results are expected to be useful for burnout risk group identification, counseling, etc.
Collapse
|
45
|
Wolpaw JT. It Is Time to Prioritize Education and Well-Being Over Workforce Needs in Residency Training. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2019; 94:1640-1642. [PMID: 31425182 DOI: 10.1097/acm.0000000000002949] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Residents inhabit an ambiguous world. They are no longer medical students but are still learners. They are not yet attendings but are still paid employees. This ambiguity leads to a misalignment of departmental incentives and trainee expectations. Trainees expect their learning and well-being to be prioritized, while departments are under pressure to meet staffing needs and cut costs. This sets up a fundamental disconnect between the "formal" Accreditation Council for Graduate Medical Education (ACGME) message of well-being and the dominant "hidden" workplace forces that pull in the opposite direction, possibly contributing to the epidemic of burnout in trainees. It is critical that all parties-health systems, graduate medical education (GME) programs, the ACGME, and residents-recognize this disconnect and collaborate to meaningfully implement current ACGME requirements to decompress work intensity and address well-being. Real change will require more than general directives. The ACGME will likely need to take the lead and consider taking a design-thinking approach to structuring regulations governing how and when residents work and how they are supported. It would also be worthwhile to revisit the Institute of Medicine recommendations on GME from 2014 related to funds flow and transformation initiatives. Taking a more comprehensive approach to residents as people, workers, and vital health care professionals is the right thing to do and may well improve retention, reduce burnout, decrease medical errors, and improve care.
Collapse
Affiliation(s)
- Jed T Wolpaw
- J.T. Wolpaw is assistant professor of anesthesiology and critical care medicine, Johns Hopkins University School of Medicine, Department of Anesthesia and Critical Care Medicine, Baltimore, Maryland; ORCID: http://orcid.org/0000-0002-7738-9291
| |
Collapse
|
46
|
Nangle MR, Henry JD, von Hippel C, Kjelsaas K. An empirical study of how emotion dysregulation and social cognition relate to occupational burnout in dentistry. Br Dent J 2019; 227:285-290. [PMID: 31444445 DOI: 10.1038/s41415-019-0620-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Introduction Dentists are frequently exposed to occupational stressors, including emotionally tense interactions with patients who are experiencing pain, anxiety and fear. Unsurprisingly, dentists are also a group that experience particularly high levels of occupational burnout. The present study provides the first empirical test of whether occupational burnout is higher, and general wellbeing is lower, for dental practitioners and students who have greater difficulties managing their own emotions (emotion dysregulation) and detecting and interpreting social cues from others (social cognitive difficulties).Materials and methods Ninety-six dental practitioners and 54 dental students completed validated measures of emotion regulation, social cognitive function, occupational burnout and wellbeing.Results Consistent with broader literature, rates of burnout were significantly higher in both dental practitioners and students, relative to normative standards. Importantly, the results also identified significant associations between rates of burnout with both emotion dysregulation, as well as one of the measures of social cognitive function: the empathic disposition to experience discomfort in response to the distress of others (personal distress). Ratings of emotion dysregulation and personal distress were also significantly higher for dental students relative to practitioners.Conclusion These data highlight the importance of being able to effectively manage difficult emotions in the dental practice.
Collapse
Affiliation(s)
- Matthew R Nangle
- School of Dentistry, University of Queensland, Herston, Queensland, Australia.
| | - Julie D Henry
- School of Psychology, University of Queensland, St Lucia, Australia
| | | | | |
Collapse
|
47
|
|
48
|
Golonka K, Gawlowska M, Mojsa-Kaja J, Marek T. Psychophysiological Characteristics of Burnout Syndrome: Resting-State EEG Analysis. BIOMED RESEARCH INTERNATIONAL 2019; 2019:3764354. [PMID: 31467886 PMCID: PMC6701350 DOI: 10.1155/2019/3764354] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 07/10/2019] [Indexed: 01/05/2023]
Abstract
INTRODUCTION The consequences of chronic work-related stress are related to various emotional, cognitive, and behavioral symptoms. Occupational burnout as a complex syndrome is characterized by exhaustion, cynicism, and lower professional efficacy. Moreover, the growing amount of research on the neural correlates of burnout broadens the existing knowledge on the mechanisms underlying this syndrome. AIM OF THE STUDY The aim of the study is to explore possible differences in brain activity between burnout and nonburnout employees. Frequency-specific EEG power analyses in a resting-state condition in burnout subjects and controls are presented. MATERIALS AND METHODS Burnout employees (N=46; 19 men) were matched with the control group (N=49; 19 men; mean age: 36.14 years, SD=7.89). The Maslach Burnout Inventory-General Survey (MBI-GS) and the Areas of Worklife Survey (AWS) scale were used to measure burnout symptoms and work conditions, respectively. A 256-channel EEG (EGI System 300) was used to collect psychophysiological data. A repeated measures ANOVA was performed with condition (eyes-open vs. eyes-closed) and region (6 levels: extracted scalp regions) factors; burnout (2 levels: burnout vs. no burnout) was the grouping factor. RESULTS A significant difference was observed only in the alpha frequency band: the burnout group revealed significantly lower alpha power in the eyes-open condition compared to the controls (p<0.05). The correlation analysis revealed that gender may significantly change the pattern of relations between EEG spectral characteristics and burnout symptoms. CONCLUSIONS Reduced alpha power in burnout individuals suggests cortical hyperactivity and may be related to greater mental effort and the possible development of compensatory mechanisms by burnout subjects.
Collapse
Affiliation(s)
- Krystyna Golonka
- Institute of Applied Psychology, Faculty of Management and Social Communication, Jagiellonian University, Łojasiewicza 4, 30-348 Kraków, Poland
| | - Magda Gawlowska
- Institute of Applied Psychology, Faculty of Management and Social Communication, Jagiellonian University, Łojasiewicza 4, 30-348 Kraków, Poland
| | - Justyna Mojsa-Kaja
- Institute of Applied Psychology, Faculty of Management and Social Communication, Jagiellonian University, Łojasiewicza 4, 30-348 Kraków, Poland
| | - Tadeusz Marek
- Institute of Applied Psychology, Faculty of Management and Social Communication, Jagiellonian University, Łojasiewicza 4, 30-348 Kraków, Poland
| |
Collapse
|
49
|
Golonka K, Mojsa-Kaja J, Marek T, Gawlowska M. Stimulus, response and feedback processing in burnout - An EEG study. Int J Psychophysiol 2018; 134:86-94. [PMID: 30359633 DOI: 10.1016/j.ijpsycho.2018.10.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Revised: 10/18/2018] [Accepted: 10/19/2018] [Indexed: 10/28/2022]
Abstract
Professional burnout is a syndrome that is characterized by psychophysical or emotional exhaustion, depersonalization and diminished professional efficacy. Research on burnout often indicates deficits in cognitive functioning, such as memory problems or impaired voluntary control over attention. Many studies focus on behavioral and self-reported measures of burnout consequences; however, a limited number have focused on its consequences on a neural level. In our EEG study (N = 88; 42 with burnout), we analyzed the event-related potentials (ERP) associated with stimulus, response and feedback processing using two experimental procedures - the Go/NoGo Task and the Doors Task. Our results show that while there is no difference in performance between burnout and control group, on the neural level there are significant differences in all analyzed aspects of information processing: stimulus, response and feedback processing, indicated by the N200 and P300, Pe, and P200 event-related potentials, respectively.
Collapse
Affiliation(s)
- Krystyna Golonka
- Department of Neurobiology and Neuropsychology, Institute of Applied Psychology, Jagiellonian University, Krakow, Poland
| | - Justyna Mojsa-Kaja
- Department of Neurobiology and Neuropsychology, Institute of Applied Psychology, Jagiellonian University, Krakow, Poland
| | - Tadeusz Marek
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, Krakow, Poland
| | - Magda Gawlowska
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, Krakow, Poland.
| |
Collapse
|
50
|
Wekenborg MK, Hill LK, Miller R, Stalder T, Thayer JF, Penz MS, Kirschbaum C. Reduced self-regulation mirrors the distorting effects of burnout symptomatology on task difficulty perception during an inhibition task. Stress 2018; 21:1-9. [PMID: 29886793 PMCID: PMC7135056 DOI: 10.1080/10253890.2018.1479393] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 05/13/2018] [Indexed: 10/14/2022] Open
Abstract
Burnout, a pathological consequence of chronic work stress, shows an increasing incidence rate in industrialized countries. Previous findings indicate that burnout may be linked to a detachment of the negative association between subjectively appraised task demand and cognitive performance, which is typically seen in healthy individuals. The present study sought to confirm this relationship and to investigate whether this dissociation is mirrored in a biological marker of self-regulation, i.e., resting vagally mediated heart rate variability (HRV). A heterogeneous sample (N = 65) of working adults (M age = 43.3, SD = 10; 23.1 % male) with varying degrees of burnout symptomatology completed three cognitive tasks (2-back, number-letter, and go/nogo) to assess different domains of executive functioning (updating, set-shifting, and inhibition), and respective demand ratings. Additionally, vagally mediated HRV at rest, operationalized as the root-mean square differences of successive R-R intervals (RMSSD), was recorded. Burnout symptomatology moderated the association between subjective task difficulty and performance parameters of the go/nogo task, such that higher burnout scores were associated with reductions in the naturally occurring negative association between self-rated task demand and response inhibition. Intriguingly, this pattern was mirrored when replacing burnout with HRV. These findings suggest that burnout symptomatology, and individual differences in self-regulatory capacities (indexed by resting HRV), may alter one's capacity for accurate task evaluation, a mechanism which could potentially underlie the dissociation between self-rated cognitive function and actual performance among individuals experiencing burnout.
Collapse
Affiliation(s)
| | - LaBarron K. Hill
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - Robert Miller
- Department of Psychology, Technical University Dresden, Dresden, Germany
| | - Tobias Stalder
- Department of Clinical Psychology, University of Siegen, Siegen, Germany
| | | | | | - Clemens Kirschbaum
- Department of Psychology, Technical University Dresden, Dresden, Germany
| |
Collapse
|