1
|
Li L, Wang X, Zhou J, Liu M, Wang S, Zhou Y, Li Y, Kang Y, Xie J, Cheng ASK. Factors associated with chronotype, job burnout, and perceived stress among nurses in Chinese tertiary hospitals: A multicenter cross-sectional study. Chronobiol Int 2024:1-10. [PMID: 38953516 DOI: 10.1080/07420528.2024.2373224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 06/23/2024] [Indexed: 07/04/2024]
Abstract
Shift work is a recognized work pattern for nurses worldwide. The disruption of shift workers' biological clocks usually leads to sleep disorders and affects their awareness at work. Eveningness and occupational stress might be effective in causing burnout syndrome. Therefore, this study aimed to evaluate the chronotype, job burnout and perceived stress among Chinese tertiary hospital nurses, and understand the predictors of circadian rhythm in this group. Between July and September 2020, 23 hospitals were randomly selected from 113 tertiary hospitals in Hunan Province. Twenty-five percent of the nurses working in each hospital were targeted for selection. 28.1% and 17.6% of nurses reported eveningness type and morningness type, respectively. The scores for emotional exhaustion, depersonalization, and perceived stress of eveningness nurses were higher than those of morningness counterparts. Eveningness nurses also reported a lower sense of personal accomplishment. Risk factors of eveningness included being under 30 years old, never exercising, having the stressors of late-night shifts and career development, higher levels of emotional exhaustion, sleep latency, sleep duration, and hypnotic use. Shifts may be unavoidable for nurses, nevertheless, understanding the predictors and related factors of chronotype for nurses is necessary for nursing educators and managers to develop a reasonable shift system and appropriate measures to assist nurses in adjusting their work.
Collapse
Affiliation(s)
- Lijun Li
- Nursing Department, The Third Xiangya Hospital of Central South University, Changsha, China
- Xiangya Nursing School, Central South University, Changsha, China
| | - Xingxing Wang
- Xiangya Nursing School, Central South University, Changsha, China
| | - Jian Zhou
- College of Mechanical and Vehicle Engineering, Hunan University, Changsha, China
| | - Min Liu
- Nursing Department, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Sha Wang
- Nursing Department, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Yi Zhou
- Nursing Department, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Yuxuan Li
- Xiangya Nursing School, Central South University, Changsha, China
| | - Yue Kang
- Xiangya Nursing School, Central South University, Changsha, China
| | - Jianfei Xie
- Nursing Department, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Andy S K Cheng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| |
Collapse
|
2
|
Vansoeterstede A, Cappe E, Ridremont D, Boujut E. School burnout and schoolwork engagement profiles among French high school students: Associations with perceived academic stress and social support. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2024. [PMID: 38952250 DOI: 10.1111/jora.12991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 05/12/2024] [Indexed: 07/03/2024]
Abstract
Adolescents' well-being at school is positively affected by social support from parents, teachers, and peers and negatively affected by academic stress. However, little is known about how specific academic stressors are related to study-related well-being profiles. This study used a person-centered approach to identify the profiles of high school students based on their school burnout (i.e., exhaustion and cynicism) and engagement levels to examine their associated levels of perceived academic stress, social support, and sociodemographic characteristics. Using cluster analysis on a sample of 540 high school students (67.8% girls), we identified five profiles labeled "Engaged" (22.4%), "Relaxed" (18.9%), "Overextended" (25.6%), "Disengaged" (17.6%), and "Burned out" (15.4%). The "Engaged" and "Relaxed" groups experienced similar levels of perceived social support, but the "Engaged" students showed higher academic stress levels. The "Overextended" group displayed high academic stress with lower social support, while the "Disengaged" group showed low stress with low social support. Finally, the "Burned out" group displayed the highest academic stress and the lowest perceived support. Results are discussed within the demands-resources model of school burnout and clinical implications are presented for each profile.
Collapse
Affiliation(s)
- Aline Vansoeterstede
- Conservatoire National des Arts et Métiers, Centre de Recherche sur le Travail et le Développement (EA 4132), Inetop, Paris, France
- Laboratoire de Psychopathologie et Processus de Santé, Université Paris Cité, Boulogne-Billancourt, France
| | - Emilie Cappe
- Laboratoire de Psychopathologie et Processus de Santé, Université Paris Cité, Boulogne-Billancourt, France
- Institut Universitaire de France (IUF), Paris, France
| | - Damien Ridremont
- Université Paris Cité and Univ Gustave Eiffel, LaPEA, Boulogne-Billancourt, France
| | - Emilie Boujut
- Laboratoire CHArt (Cognitions Humaine et Artificielle), Site Universitaire de Gennevilliers, Cergy Paris Université, Gennevilliers, France
| |
Collapse
|
3
|
Huang H, Yu T, Liu C, Yang J, Yu J. Poor sleep quality and overweight/obesity in healthcare professionals: a cross-sectional study. Front Public Health 2024; 12:1390643. [PMID: 38873287 PMCID: PMC11169736 DOI: 10.3389/fpubh.2024.1390643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 05/07/2024] [Indexed: 06/15/2024] Open
Abstract
Objective This study aimed to analyze the relationship between the sleep quality of healthcare professionals and the incidence of overweight and obesity, exploring the potential impact of sleep quality on the onset of overweight and obesity in order to provide a scientific basis for formulating effective health intervention measures. Methods A convenience sampling method was used to conduct a survey on the sleep characteristics and obesity status among healthcare professionals at Peking Union Medical College Hospital and Tianjin Dongli District Traditional Chinese Medicine Hospital. The survey was conducted via online questionnaires, which included demographic data, the Pittsburgh Sleep Quality Index (PSQI), height, weight, and related sleep, exercise, and dietary habits. Univariate and multivariate logistic regression analyses were applied to study the relationship between sleep quality and overweight/obesity among healthcare professionals. Results A total of 402 questionnaires were distributed, with a 100% retrieval rate, yielding 402 valid questionnaires. The average body mass index of the 402 participants was 23.22 ± 3.87 kg/m^2. Among them, 144 cases were overweight or obese, accounting for 35.8% (144/402) of the total. The prevalence of poor sleep quality among healthcare professionals was 27.4% (110/402), with an average PSQI score of 8.37 ± 3.624. The rate of poor sleep quality was significantly higher in the overweight and obese group compared to the normal weight group (36.1% vs. 22.5%, p = 0.003). The multivariate analysis indicated that gender, marital status, lower education level, sleep duration (odds ratio [OR] =1.411, 95% confidence interval [CI] 1.043-1.910, p = 0.026), and sleep disturbances (OR = 1.574, 95%CI 1.123-2.206, p = 0.008) were significant risk factors for overweight and obesity among healthcare professionals. Conclusion Overweight or obese healthcare professionals had poorer sleep quality compared to those with a normal weight. Sleep duration and sleep disorders were identified as independent risk factors for overweight or obesity in healthcare professionals. Increasing sleep duration and improving sleep disorders may play a positive role in controlling overweight and obesity among healthcare professionals.
Collapse
Affiliation(s)
- Hongyun Huang
- Department of General Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Tian Yu
- Department of General Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Chengyu Liu
- Department of General Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Jian Yang
- Department of General Surgery, Dongli District Traditional Chinese Medicine Hospital, Tianjin, China
| | - Jianchun Yu
- Department of General Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| |
Collapse
|
4
|
von Känel R, Princip M, Holzgang SA, Rossi A, Giannopoulos AA, Buechel RR, Zuccarella-Hackl C, Pazhenkottil AP. Association Between Global Sleep Quality and Coronary Microvascular Function in Male Physicians With Occupational Burnout. Psychosom Med 2024; 86:216-226. [PMID: 37982536 DOI: 10.1097/psy.0000000000001269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
OBJECTIVE Occupational burnout has been associated with an increased risk of coronary heart disease, although the mechanisms involved are elusive. We investigated whether poor global sleep quality is associated with impaired coronary microvascular function in male physicians, a professional group at increased risk of burnout. METHODS Study participants were 30 male physicians with clinical burnout and 30 controls without burnout defined by the Maslach Burnout Inventory. Global sleep quality was measured with the Pittsburgh Sleep Quality Index (PSQI). Endothelium-dependent (cold pressor test) and endothelium-independent (adenosine challenge) coronary microvascular functions were quantified with myocardial perfusion positron emission tomography. In multivariable analyses, the interaction between burnout and the PSQI global score was regressed on measures of coronary microvascular function, adjusting for age, body mass index, physical activity, alcohol consumption, and main effects of burnout and PSQI score. RESULTS The prevalence of poor sleepers (PSQI score >5) was 40% in the burnout group and 10% in the control group. Adjusting for covariates, burnout-by-global PSQI score interactions were observed for myocardial blood flow (MBF) at rest ( r partial = -0.30, p = .025), endothelium-dependent coronary flow reserve ( r partial = -0.26, p = .062), MBF response ( r partial = -0.30, p = .028), and hyperemic MBF ( r partial = -0.34, p = .012). The global PSQI score was inversely associated with these MBF measures in the burnout group relative to the control group. No significant interactions emerged for endothelium-independent MBF. CONCLUSIONS In male physicians with occupational burnout, poor global sleep quality was associated with reduced endothelium-dependent coronary microvascular function, suggesting a mechanism by which burnout may affect cardiovascular health.
Collapse
Affiliation(s)
- Roland von Känel
- From the Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine (von Känel, Princip, Holzgang, Zuccarella-Hackl, Pazhenkottil), Cardiac Imaging, Department of Nuclear Medicine (Rossi, Giannopoulos, Buechel, Pazhenkottil), and Department of Cardiology (Pazhenkottil), University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | | | | | | | | | | | | | | |
Collapse
|
5
|
Vaisman A, Guiloff R, Contreras M, Casas-Cordero JP, Calvo R, Figueroa D. Over 50% of self-reported burnout among Latin American orthopaedic surgeons: A cross-sectional survey on prevalence and risk factors. J ISAKOS 2024; 9:128-134. [PMID: 38036044 DOI: 10.1016/j.jisako.2023.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 11/10/2023] [Accepted: 11/22/2023] [Indexed: 12/02/2023]
Abstract
OBJECTIVE Assess the prevalence of self-reported burnout and identify risk and protective factors based on demographic and life quality aspects, among Latin American orthopaedic surgeons. METHODS This study employed a cross-sectional analytical design. An original design survey was developed using multiple-choice and Likert-scale questions to gather self-reported burnout, demographic, work-related, social, personal, and mood-related data. The survey was electronically distributed to the Chilean Orthopaedic Surgery Society and the Latin American Society of Arthroscopy, Knee Surgery, and Sports Medicine members. Statistical analysis included Chi-square and Fisher's exact tests to determine associations between self-reported burnout and other variables. Subsequently, a multivariate logistic regression was carried out to identify key risk and protective factors (p < 0.05). RESULTS The survey's response rate was 20 % (n = 358) out of the 1779 invitations that were sent. The most representative age range was 41-60 years (50 %) and 94 % were men. Of those surveyed, 50 % reported a burnout episode more than once per year, 60 % depersonalization when treating patients at least yearly, 13 % anhedonia, 11 % a depressive mood more than half of the month or almost every day, and 61 % weariness at the end of a working day. Burnout was statistically associated with age under 40 years old (p = 0.012), fewer years as a specialist (p = 0.037), fear of lawsuits (p < 0.001), a non-healthy diet (p = 0.003), non-doing recreational activities (p = 0.004), depersonalization when treating their patients (p < 0.001), weariness (p < 0.001), anhedonia (p < 0.001), depressive mood (p < 0.001), and career dissatisfaction (p < 0.001). The logistic regression demonstrated that fear of lawsuits (p < 0.001), weariness at the end of a workday (p = 0.016), and anhedonia (p = 0.019) were those variables with stronger direct associations with self-reported burnout. A healthy diet was the strongest protective variable (p < 0.001). CONCLUSION Over 50 % of the Latin American orthopaedic surgeons who participated in the survey reported experiencing burnout episodes more than once a year, along with depersonalization when treating their patients at least once a year. Additionally, nearly 10 % of respondents experienced weekly depressive symptoms. Among the noteworthy risk factors for self-reported burnout were fear of lawsuits, weariness at the end of the workday, and anhedonia. Conversely, maintaining a healthy diet emerged as the most potent protective factor. LEVEL OF EVIDENCE Level III.
Collapse
Affiliation(s)
- Alex Vaisman
- Facultad de Medicina Clínica Alemana - Universidad del Desarrollo, Departamento Traumatología, Av. Vitacura 5951, 7650568, Santiago, Chile
| | - Rodrigo Guiloff
- Facultad de Medicina Clínica Alemana - Universidad del Desarrollo, Departamento Traumatología, Av. Vitacura 5951, 7650568, Santiago, Chile.
| | - Martín Contreras
- Facultad de Medicina Clínica Alemana - Universidad del Desarrollo, Av. Plaza 680, 7610658, Las Condes, Santiago, Chile
| | - Juan Pablo Casas-Cordero
- Facultad de Medicina Clínica Alemana - Universidad del Desarrollo, Av. Plaza 680, 7610658, Las Condes, Santiago, Chile
| | - Rafael Calvo
- Facultad de Medicina Clínica Alemana - Universidad del Desarrollo, Departamento Traumatología, Av. Vitacura 5951, 7650568, Santiago, Chile
| | - David Figueroa
- Facultad de Medicina Clínica Alemana - Universidad del Desarrollo, Departamento Traumatología, Av. Vitacura 5951, 7650568, Santiago, Chile
| |
Collapse
|
6
|
Reeson EA, Salevitz D, Alcanzo B, Lin CY, Grimsby GM. Prevalence of and factors associated with burnout in pediatric urology fellows. J Pediatr Urol 2024:S1477-5131(24)00162-1. [PMID: 38582728 DOI: 10.1016/j.jpurol.2024.03.012] [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: 11/22/2023] [Revised: 03/09/2024] [Accepted: 03/12/2024] [Indexed: 04/08/2024]
Abstract
INTRODUCTION The 2016 AUA census found 39% of practicing urologists experienced burnout. Burnout is a syndrome of emotional exhaustion, depersonalization, and decreased feelings of personal accomplishment due to workplace stress. Despite the demands of training, little is known about the prevalence of burnout in pediatric urology fellows. OBJECTIVE To determine the prevalence of burnout in pediatric urology fellows and factors associated with higher levels of burnout. STUDY DESIGN The Maslach Burnout Inventory (MBI) and an anonymous survey of personal and training characteristics were distributed electronically to pediatric urology fellows in April 2023. The MBI is a standardized and validated 22-item questionnaire used to quantify burnout and is comprised of three subscales: Emotional Exhaustion (EE), Depersonalization (DP), and Personal Accomplishment (PA). As per prior literature, higher scores in EE (>27) or DP (>10) were defined as high burnout. Demographic and training characteristics were compared between fellows with high and low to moderate levels of burnout with t tests and Fischer's exact tests. RESULTS The survey response rate was 85% (29/34); 48% clinical fellows, 52% research fellows. Mean age of respondents was 31.4 years (SD 2.6), 59% female, 70% married, and 37% a parent. Mean scores for EE, DP, and PA were 15 (SD 10.2), 4 (SD 4.0), and 39 (SD 10.3), respectively, with no significant difference between year in fellowship. Nineteen percent of fellows met criteria for high burnout and 41% met criteria for moderate to high burnout based on EE or DP scores. Factors significantly associated with high burnout included number nights of call per month and number of projects required to complete in fellowship. Strategies fellows used most to combat burnout included quality time with family and friends, sleep, exercise, and watching TV/movies. DISCUSSION Nearly 20% of pediatric urology fellows scored for high levels of burnout and over 40% scored for moderate to high levels of burnout. There appears to be an association with increased call and project workload requirements with increased levels of burnout, and efforts to combat burnout could specifically address these factors. Fellows with more children at home had lower levels of burnout, and many trainees described quality time with family and friends as their preferred strategy to prevent burnout. CONCLUSION This survey-based study identifies risk factors for burnout in pediatric urology fellows. Fellows can use the information presented to consider personalized strategies to prevent burnout through training and into their careers.
Collapse
Affiliation(s)
- Emily A Reeson
- Creighton University School of Medicine Phoenix Regional Campus, Phoenix, AZ, USA
| | - Daniel Salevitz
- Department of Urology, Mayo Clinic Arizona, Phoenix, AZ, USA
| | - Bernice Alcanzo
- University of Arizona College of Medicine - Phoenix, Phoenix, AZ, USA
| | - Chung Yon Lin
- University of Arizona College of Medicine - Phoenix, Phoenix, AZ, USA
| | - Gwen M Grimsby
- Division of Urology, Phoenix Children's, Phoenix, AZ, USA.
| |
Collapse
|
7
|
Choi WS, Kang SW, Choi SB. The dark side of mobile work during non-work hours: moderated mediation model of presenteeism through conservation of resources lens. Front Public Health 2024; 12:1186327. [PMID: 38439760 PMCID: PMC10909990 DOI: 10.3389/fpubh.2024.1186327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 02/05/2024] [Indexed: 03/06/2024] Open
Abstract
Owing to the development of Information and Communication Technology (ICT) and the inevitability of telecommuting in the COVID-19 environment, the boundary between working and non-working hours has become blurred. mWork, that is, ICT-based off-hour work, which has increased through the pandemic, affects employees' work attitudes, such as presenteeism. Hence, we designed a study to investigate the antecedents and mechanisms of employee presenteeism from the perspective of the conservation of resources theory. We supported our hypothesis using a sample of 325 Korean office workers obtained through three rounds of time-delay surveys. The results show that presenteeism is higher among employees with high mWork. In addition, employees' mWork increases sleep deprivation and presenteeism, and the exchange ideology of employees reinforces the positive effect of sleep deprivation on presenteeism. Additionally, the higher the level of exchange ideology, the stronger the mediating effect of mWork on presenteeism through sleep deprivation. This study verified the conservation of resources theory by identifying the mechanism by which mWork affects an employee's life, which in turn affects their work, and provides practical implications for managing productivity loss due to presenteeism.
Collapse
Affiliation(s)
- Woo-Sung Choi
- College of Business, Gachon University, Seongnam, Republic of Korea
| | - Seung-Wan Kang
- College of Business, Gachon University, Seongnam, Republic of Korea
| | - Suk Bong Choi
- College of Global Business, Korea University, Sejong, Republic of Korea
| |
Collapse
|
8
|
Hassinger AB, Velez C, Wang J, Mador MJ, Wilding GE, Mishra A. Association between sleep health and rates of self-reported medical errors in intern physicians: an ancillary analysis of the Intern Health Study. J Clin Sleep Med 2024; 20:221-227. [PMID: 37767811 PMCID: PMC10835772 DOI: 10.5664/jcsm.10820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 08/31/2023] [Accepted: 09/01/2023] [Indexed: 09/29/2023]
Abstract
STUDY OBJECTIVES Reduced sleep duration and work hour variability contribute to medical error and physician burnout. This study assesses the relationships between physician performance, burnout, and the dimensions of sleep beyond hours slept. METHODS This was an ancillary analysis of 3 years of data from an international prospective cohort study: the Intern Health Study. Actigraphy data from 3,654 intern physicians capturing sleep timing, regularity, efficiency, and duration were used individually and combined as a composite sleep health index to measure the association of multidimensional sleep patterns on self-reported medical errors and burnout. RESULTS From 2017-2019, interns' work hours decreased by 4 hours per week and total sleep time also decreased (6.7 to 5.99 hours), and sleep efficiency, timing, and regularity all worsened (all P < .05). In the 21.2% of participants who committed an error, there was no difference in sleep duration, timing, or regularity. Lower sleep efficiency was associated with higher odds of committing an error (P = .003) and higher burnout scores (P < .001). Although overall sleep quality was poor in the entire cohort, interns in the lowest quintile of sleep duration, regularity, and efficiency had higher burnout scores than those in the best quintile. CONCLUSIONS Sleep efficiency, not duration, was associated with increased self-reported medical errors and burnout in intern physicians. Overall sleep quality and duration worsened despite fewer hours worked. Future studies on physician burnout should measure all aspects of sleep health. CITATION Hassinger AB, Velez C, Wang J, Mador MJ, Wilding GE, Mishra A. Association between sleep health and rates of self-reported medical errors in intern physicians: an ancillary analysis of the Intern Health Study. J Clin Sleep Med. 2024;20(2):221-227.
Collapse
Affiliation(s)
- Amanda B. Hassinger
- Department of Pediatrics, Division of Pediatric Pulmonology and Sleep Medicine, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, John R. Oishei Children’s Hospital, Buffalo, New York
| | - Chiara Velez
- Department of Pediatrics, Division of Pediatric Critical Care Medicine, Monroe Carell Jr. Children’s Hospital at Vanderbilt University Medical Center, Nashville, Tennessee
| | - Jia Wang
- Department of Biostatistics, University at Buffalo, Buffalo, New York
| | - M. Jeffery Mador
- Department of Medicine, Division of Pulmonology, Critical Care and Sleep Medicine, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York
| | - Gregory E. Wilding
- Department of Biostatistics, University at Buffalo School of Public Health and Health Professions, Buffalo, New York
| | - Archana Mishra
- Department of Medicine, Division of Pulmonology, Critical Care and Sleep Medicine, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York
| |
Collapse
|
9
|
Webber S, Coller RJ, Schultz R, Rogers EE, Olson ME, Moreno MA, Babal JC. Eight Domains of Pediatrician Wellness: A Stakeholder Informed Model. Acad Pediatr 2024:S1876-2859(23)00480-1. [PMID: 38215902 DOI: 10.1016/j.acap.2023.12.014] [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: 08/18/2023] [Revised: 12/22/2023] [Accepted: 12/28/2023] [Indexed: 01/14/2024]
Abstract
BACKGROUND Physician wellness is important to health care systems and quality patient care. There has been limited research clarifying the physician wellness construct. We aimed to develop a stakeholder-informed model of pediatrician wellness. METHODS We performed a group concept mapping (GCM) study to create a model of pediatrician wellness. We followed the four main steps of GCM and recruited pediatricians at multiple sites and on social media. During brainstorming, pediatricians individually responded to a prompt to generate ideas describing the concept of pediatrician wellness. Second, pediatricians sorted the list of brainstormed ideas into conceptually similar groups and rated them on importance. Sorted data were analyzed to create maps showing each idea as a point, with lines around groups of points to create clusters of wellness. Mean importance scores for each cluster were calculated and compared using pattern match. RESULTS Pediatricians in this study identified eight clusters of wellness: 1) Experiencing belonging and support at work, 2) Alignment in my purpose, my work, and my legacy, 3) Feelings of confidence and fulfillment at work, 4) Skills and mindset for emotional well-being, 5) Harmony in personal, professional, and community life, 6) Time and resources to support holistic sense of self, 7) Work boundaries and flexibility, and 8) Organizational culture of inclusion and trust. There were no significant differences in mean cluster rating score; the highest rated cluster was Harmony in personal, professional and community life (3.62). CONCLUSION Pediatricians identified eight domains of wellness, spanning professional and personal life, work, and individual factors.
Collapse
Affiliation(s)
- Sarah Webber
- Department of Pediatrics (S Webber, RJ Coller, R Schultz, MA Moreno, and JC Babal), University of Wisconsin School of Medicine and Public Health, Madison, Wis.
| | - Ryan J Coller
- Department of Pediatrics (S Webber, RJ Coller, R Schultz, MA Moreno, and JC Babal), University of Wisconsin School of Medicine and Public Health, Madison, Wis
| | - Roger Schultz
- Department of Pediatrics (S Webber, RJ Coller, R Schultz, MA Moreno, and JC Babal), University of Wisconsin School of Medicine and Public Health, Madison, Wis
| | - Elizabeth E Rogers
- Department of Pediatrics (EE Rogers), University of California San Francisco
| | - Maren E Olson
- Department of Pediatrics (ME Olson), University of Minnesota, Minneapolis, Minn
| | - Megan A Moreno
- Department of Pediatrics (S Webber, RJ Coller, R Schultz, MA Moreno, and JC Babal), University of Wisconsin School of Medicine and Public Health, Madison, Wis
| | - Jessica C Babal
- Department of Pediatrics (S Webber, RJ Coller, R Schultz, MA Moreno, and JC Babal), University of Wisconsin School of Medicine and Public Health, Madison, Wis
| |
Collapse
|
10
|
Feng S, Davis JA, Chowdhary A, Lomazow W, Yi JS, Huang J, Ding L, Taravati P. The effect of mandatory post-call relief on sleep and wellness in ophthalmology residents. BMC MEDICAL EDUCATION 2023; 23:955. [PMID: 38093220 PMCID: PMC10720055 DOI: 10.1186/s12909-023-04947-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 12/06/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND Multiple duty hour reforms have been implemented to optimize resident wellness through increasing opportunities for sleep recovery, but few studies have recorded objectively measured sleep or shown direct sleep and wellness benefits from such interventions. This study seeks to determine whether mandatory post-call relief policies with a partial night float system improved resident sleep, activity, and burnout among ophthalmology residents taking home call. METHODS We conducted a two group cohort study of ophthalmology residents at the University Washington comparing post graduate year-2 (PGY-2) resident sleep, activity, and burnout between the optional post-call relief group from July 1, 2017 to June 30, 2019 to the mandatory post-call relief group from July 1, 2019 to June 30, 2021. RESULTS Of twenty total residents participating in the survey portion, 18 residents participated in the sleep and activity tracking portion of the study, 9 in in the optional post-call relief cohort, and 9 in the mandatory post-call relief cohort. The mandatory post-call relief group recorded longer total sleep on call than the optional post-call relief group (p < 0.001). There was no difference in overnight sleep recorded on call (median 3.4 h), but residents recorded more time napping in the mandatory post-call relief cohort (p < 0.001). There was no significant difference between cohorts in amount of sleep while not on call. Residents in the mandatory post-call relief cohort recorded higher average daily steps, higher exercise time, and lower sedentary time than residents in the optional post-call relief cohort (p < 0.001). They also recorded lower median emotional exhaustion on the Maslach Burnout Inventory and lower stress in the Depression and Anxiety Stress Scale in the mandatory post-call relief cohort (p = 0.008). CONCLUSIONS Implementation of mandatory post-call relief policies with a partial night-float system among PGY-2 residents was associated with more post-call naps with more overall physical activity, lower emotional exhaustion scores, and lower stress scores, despite no changes to overnight sleep on call or total sleep. Although sample size limits interpretation of data, implementation of mandatory post call relief could be considered to improve post-call sleep in programs with home call.
Collapse
Affiliation(s)
- Shu Feng
- Department of Ophthalmology, University of Washington School of Medicine, Campus Box 359608, 325 9th Avenue, Seattle, WA, 98104, USA.
| | - John A Davis
- Oregon Health and Sciences University, Casey Eye Institute, Portland, USA
| | - Apoorva Chowdhary
- Department of Ophthalmology, University of Washington School of Medicine, Campus Box 359608, 325 9th Avenue, Seattle, WA, 98104, USA
| | - Whitney Lomazow
- Department of Ophthalmology, University of Washington School of Medicine, Campus Box 359608, 325 9th Avenue, Seattle, WA, 98104, USA
| | - Jonathan S Yi
- University of Miami Health System, Bascom Palmer Eye Institute, Miami, USA
| | - Johnson Huang
- Department of Ophthalmology, University of Washington School of Medicine, Campus Box 359608, 325 9th Avenue, Seattle, WA, 98104, USA
| | - Leona Ding
- Department of Ophthalmology, University of Washington School of Medicine, Campus Box 359608, 325 9th Avenue, Seattle, WA, 98104, USA
| | - Parisa Taravati
- Department of Ophthalmology, University of Washington School of Medicine, Campus Box 359608, 325 9th Avenue, Seattle, WA, 98104, USA
| |
Collapse
|
11
|
Kim ST, Xia Y, Cho PD, Ho JK, Patel S, Lee C, Ardehali A. Safety and efficacy of delaying lung transplant surgery to a morning start. JTCVS OPEN 2023; 16:1008-1017. [PMID: 38204689 PMCID: PMC10775029 DOI: 10.1016/j.xjon.2023.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 08/09/2023] [Accepted: 09/11/2023] [Indexed: 01/12/2024]
Abstract
Objective We aimed to evaluate the safety and efficacy of delaying lung transplantation until morning for donors with cross-clamp times occurring after 1:30 am. Methods All consented adult lung transplant recipients between March 2018 and May 2022 with donor cross-clamp times between 1:30 am and 5 am were enrolled prospectively in this study. Skin incision for enrolled recipients was delayed until 6:30 am (Night group). The control group was identified using a 1:2 logistic propensity score method and included recipients of donors with cross-clamp times occurring at any other time of day (Day group). Short- and medium-term outcomes were examined between groups. The primary endpoint was early mortality (30-day and in-hospital). Results Thirty-four patients were enrolled in the Night group, along with 68 well-matched patients in the Day group. As expected, donors in the Night group had longer cold ischemia times compared to the Day group (344 minutes vs 285 minutes; P < .01). Thirty-day mortality (3% vs 3%; P = .99), grade 3 primary graft dysfunction at 72 hours (8% vs 4%; P = .40), postoperative complications (26% vs 38%; P = .28), and hospital length of stay (15 days vs 14 days; P = .91) were similar in the 2 groups. No significant differences were noted between groups in 3-year survival (70% vs 77%; P = .30) or freedom from chronic lung allograft dysfunction (91% vs 95%; P = .75) at 3 years post-transplantation. The median follow-up was 752.5 days (interquartile range, 487-1048 days). Conclusions Lung transplant recipients with donor cross-clamp times scheduled after 1:30 am may safely have their operations delayed until 6:30 am with acceptable outcomes. Adoption of such a policy in clinically appropriate settings may lead to an alternative workflow and improved team well-being.
Collapse
Affiliation(s)
- Samuel T. Kim
- David Geffen School of Medicine, University of California, Los Angeles, Calif
- Division of Cardiac Surgery, Department of Surgery, University of California, Los Angeles, Calif
| | - Yu Xia
- Division of Cardiac Surgery, Department of Surgery, University of California, Los Angeles, Calif
| | - Peter D. Cho
- David Geffen School of Medicine, University of California, Los Angeles, Calif
| | - Jonathan K. Ho
- Division of Cardiothoracic Anesthesiology, Department of Anesthesiology and Perioperative Medicine, University of California, Los Angeles, Calif
| | - Swati Patel
- Division of Cardiothoracic Anesthesiology, Department of Anesthesiology and Perioperative Medicine, University of California, Los Angeles, Calif
| | - Christine Lee
- Division of Cardiothoracic Anesthesiology, Department of Anesthesiology and Perioperative Medicine, University of California, Los Angeles, Calif
| | - Abbas Ardehali
- Division of Cardiac Surgery, Department of Surgery, University of California, Los Angeles, Calif
| |
Collapse
|
12
|
Mul Fedele ML, López Gabeiras MDP, Simonelli G, Diez JJ, Bellone GJ, Cagliani J, Larrateguy L, Eiguchi K, Golombek DA, Cardinali DP, Pérez-Chada D, Vigo DE. "Multivariate analysis of the impact of sleep and working hours on medical errors: a MICE approach". BMC Public Health 2023; 23:2317. [PMID: 37996804 PMCID: PMC10666331 DOI: 10.1186/s12889-023-17130-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 11/01/2023] [Indexed: 11/25/2023] Open
Abstract
BACKGROUND The main objective of this study was to describe the relationship between working conditions, sleep and psycho-affective variables and medical errors. METHODS This was an observational, analytical and cross-sectional study in which 661 medical residents answered questionnaires about working conditions, sleep and psycho-affective variables. Actigraphic sleep parameters and peripheral temperature circadian rhythm were measured in a subgroup of 38 subjects. Bivariate and multivariate predictors of medical errors were assessed. RESULTS Medical residents reported working 66.2 ± 21.9 weekly hours. The longest continuous shift was of 28.4 ± 10.9 h. They reported sleeping 6.1 ± 1.6 h per day, with a sleep debt of 94 ± 129 min in workdays. A high percentage of them reported symptoms related to psycho-affective disorders. The longest continuous shift duration (OR = 1.03 [95% CI, 1.00-1.05], p = 0.01), working more than six monthly on-call shifts (OR = 1.87 [95% CI, 1.16-3.02], p = 0.01) and sleeping less than six hours per working day (OR = 1.66 [95% CI, 1.10-2.51], p = 0.02) were independently associated with self-reported medical errors. The report of medical errors was associated with an increase in the percentage of diurnal sleep (2.2% [95% CI, 0.1-4.3] vs 14.5% [95% CI, 5.9-23.0]; p = 0.01) in the actigraphic recording. CONCLUSIONS Medical residents have a high working hour load that affect their sleep opportunities, circadian rhythms and psycho-affective health, which are also related to the report of medical errors. These results highlight the importance of implementing multidimensional strategies to improve medical trainees' sleep and wellbeing, increasing in turn their own and patients' safety.
Collapse
Affiliation(s)
- Malena Lis Mul Fedele
- Chronophysiology Lab, Institute for Biomedical Research (UCA-CONICET), Buenos Aires, Argentina
| | | | - Guido Simonelli
- Centre d'études Avancées en Médecine du Sommeil, Hôpital du Sacré-Coeur de Montréal, CIUSSS du Nord de L'Île-de-Montréal, Montreal, Canada
- Department of Medicine, Faculty of Medicine, University of Montreal, Montreal, Canada
- Department of Neuroscience, Faculty of Medicine, University of Montreal, Montreal, Canada
| | - Joaquín José Diez
- Pan-American Institute of Sleep Medicine and Chronobiology, Buenos Aires, Argentina
| | - Giannina Julieta Bellone
- Pontifical Catholic University of Argentina, Buenos Aires, Argentina
- Chronobiology Lab, Department of Science and Technology, National University of Quilmes, Bernal, Argentina
| | - Joaquín Cagliani
- Anesthesiology Department, North Shore University Hospital, Manhasset, NY, USA
| | - Luis Larrateguy
- Private Center of Respiratory Medicine of Paraná, Entre Ríos, Argentina
| | | | - Diego Andrés Golombek
- Chronobiology Lab, Department of Science and Technology, National University of Quilmes, Bernal, Argentina
- Interdisciplinary Time Lab, San Andrés University, Buenos Aires, Argentina
| | | | | | - Daniel Eduardo Vigo
- Chronophysiology Lab, Institute for Biomedical Research (UCA-CONICET), Buenos Aires, Argentina.
- Katholieke Universiteit Leuven, Leuven, Belgium.
| |
Collapse
|
13
|
Lu DW. Sleep and Burnout Among Health Care Professionals-The Role of the Individual. JAMA Netw Open 2023; 6:e2341882. [PMID: 37921774 DOI: 10.1001/jamanetworkopen.2023.41882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2023] Open
Affiliation(s)
- Dave W Lu
- Department of Emergency Medicine, University of Washington School of Medicine, Seattle
| |
Collapse
|
14
|
Shechter A, Firew T, Miranda M, Fray N, Norful AA, Gonzalez A, Chang BP. Sleep Disturbance and Burnout in Emergency Department Health Care Workers. JAMA Netw Open 2023; 6:e2341910. [PMID: 37921770 PMCID: PMC10625040 DOI: 10.1001/jamanetworkopen.2023.41910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 09/22/2023] [Indexed: 11/04/2023] Open
Abstract
This cross-sectional study examines the association of sleep disturbances with burnout among emergency medicine health care workers.
Collapse
Affiliation(s)
- Ari Shechter
- Center for Behavioral Cardiovascular Health, Department of Medicine, Columbia University Irving Medical Center, New York, New York
| | - Tsion Firew
- Department of Emergency Medicine, Columbia University Irving Medical Center, New York, New York
| | - Maody Miranda
- Department of Emergency Medicine, Columbia University Irving Medical Center, New York, New York
| | - Nakesha Fray
- Center for Behavioral Cardiovascular Health, Department of Medicine, Columbia University Irving Medical Center, New York, New York
| | | | - Alvis Gonzalez
- Center for Behavioral Cardiovascular Health, Department of Medicine, Columbia University Irving Medical Center, New York, New York
| | - Bernard P. Chang
- Department of Emergency Medicine, Columbia University Irving Medical Center, New York, New York
| |
Collapse
|
15
|
Sun H, Zhang T, Wang X, Wang C, Zhang M, Song H. The occupational burnout among medical staff with high workloads after the COVID-19 and its association with anxiety and depression. Front Public Health 2023; 11:1270634. [PMID: 37954047 PMCID: PMC10639132 DOI: 10.3389/fpubh.2023.1270634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 10/12/2023] [Indexed: 11/14/2023] Open
Abstract
Objective After the end of COVID-19, medical staff were immediately faced with a high workload, leading to widespread occupational burnout. This study aims to explore the level and influencing factors of burnout among medical staff during this period, as well as its relationship with anxiety and depression. Methods The participants' levels of burnout were assessed using Maslach Burnout Inventory-Human Services Survey (MBI-HSS), and the reliability and validity of the questionnaire were evaluated through Cronbach's α and Confirmatory Factor Analysis (CFA). Independent sample t-test, chi-square test, and Pearson analysis were employed to determine the correlation between two sets of variables. Univariate and multivariate logistic regression analyses were conducted to identify significant factors influencing burnout. Finally, nomograms were used to predict the probability of burnout occurrence. Results This study collected a total of 1,550 questionnaires, and after excluding 45 questionnaires that were duplicates or incomplete, a sample of 1,505 (97.1%) participants were included in the final statistical analysis. Both Cronbach's α and the fit indices of CFA demonstrated excellent adaptability of the Chinese version of MBI-HSS in this study. The overall prevalence rates for emotional exhaustion (EE), depersonalization (DP), and diminished personal accomplishment (PA) were 52.4, 55.3, and 30.6%, respectively. Obtaining psychological support, health condition, relationship with family members, and insufficient sleep were identified as common contributing factors to burnout among medical staff. Additionally, age and promotion pressure were also associated with burnout among doctors, and exceeding legal working hours was an important factor for nurse burnout. The C-index for the nomograms predicting burnout among doctors and nurses was 0.832 and 0.843, respectively. Furthermore, burnout exhibited a significant linear correlation with anxiety and depression. Conclusion After the end of COVID-19, medical staff in high workload environments were facing severe burnout, which might lead to anxiety and depression. The occupational burnout of medical staff needed to be taken seriously and actively intervened.
Collapse
Affiliation(s)
- Hao Sun
- Department of Gastrointestinal Surgery, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, Heilongjiang, China
| | - Tengfei Zhang
- Department of Breast Surgery, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, Heilongjiang, China
| | - Xinyu Wang
- Department of Gastrointestinal Surgery, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, Heilongjiang, China
| | - Caixia Wang
- Department of Gastrointestinal Surgery, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, Heilongjiang, China
| | - Mengqiao Zhang
- Department of Gastrointestinal Surgery, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, Heilongjiang, China
| | - Hongjiang Song
- Department of Gastrointestinal Surgery, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, Heilongjiang, China
| |
Collapse
|
16
|
Chiriac VF, Moşoiu DV. Insomnia in cancer patients - A survey of health-care professionals' views and current practice in Romania. J Cancer Res Ther 2023; 19:1950-1955. [PMID: 38376302 DOI: 10.4103/jcrt.jcrt_682_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 05/03/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND Changes in the quality of sleep are reported often in cancer patients and have a major impact on general health. However, insomnia tends to be insufficiently evaluated and managed. AIM The aim of the study was to analyze the perception of clinical staff working in oncology units regarding patients' sleep disorders. Furthermore, we assessed the prevalence of insomnia in this category of professionals. MATERIALS AND METHODS The study was cross sectional and used a descriptive and correlational design. Clinical personnel working in oncology departments were invited to complete a questionnaire regarding sleep problems in patients, and optionally, the Pittsburgh sleep quality index questionnaire was administered. Correlations between age, profession, experience, and their responses were statistically analyzed. RESULTS We gathered 101 responses, with 63.4% coming from doctors. With one exception, all professionals observed changes in sleep patterns in patients, but less than a third were actively looking for these problems and only three health professionals used questionnaires. No significant differences in answers were noted based on age, profession, or experience. Regarding professionals, 45.6% of them had impaired sleep based on the Pittsburgh questionnaire results. CONCLUSION Oncology staff are aware of the existence and impact of sleep problems, but active assessment for sleep problems is low. There is a relative high prevalence of poor sleep quality among oncology staff. In order to improve the well-being of patients, the quality of sleep should be documented as part of the care plan. The existence of guidelines is desirable.
Collapse
|
17
|
Coleman JJ, Robinson CK, von Hippel W, Holmes KE, Kim J, Pearson S, Lawless RA, Hubbard AE, Cohen MJ. What Happens on Call Doesn't Stay on Call. The Effects of In-house Call on Acute Care Surgeons' Sleep and Burnout: Results of the Surgeon Performance (SuPer) Trial. Ann Surg 2023; 278:497-505. [PMID: 37389574 DOI: 10.1097/sla.0000000000005971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
OBJECTIVE We sought to quantify the effects of in-house call(IHC) on sleep patterns and burnout among acute care surgeons (ACS). BACKGROUND Many ACS take INC, which leads to disrupted sleep and high levels of stress and burnout. METHODS Physiological and survey data of 224 ACS with IHC were collected over 6 months. Participants continuously wore a physiological tracking device and responded to daily electronic surveys. Daily surveys captured work and life events as well as feelings of restfulness and burnout. The Maslach Burnout Inventory (MBI) was administered at the beginning and end of the study period. RESULTS Physiological data were recorded for 34,135 days, which includes 4389 nights of IHC. Feelings of moderate, very, or extreme burnout occurred 25.7% of days and feelings of being moderately, slightly, or not at all rested occurred 75.91% of days. Decreased amount of time since the last IHC, reduced sleep duration, being on call, and having a bad outcome all contribute to greater feelings of daily burnout ( P <0.001). Decreased time since last call also exacerbates the negative effect of IHC on burnout ( P <0.01). CONCLUSIONS ACS exhibit lower quality and reduced amount of sleep compared with an age-matched population. Furthermore, reduced sleep and decreased time since the last call led to increased feelings of daily burnout, accumulating in emotional exhaustion as measured on the MBI. A reevaluation of IHC requirements and patterns as well as identification of countermeasures to restore homeostatic wellness in ACS is essential to protect and optimize our workforce.
Collapse
Affiliation(s)
- Jamie J Coleman
- Department of Surgery, University of Louisville, Louisville, KY
| | | | | | - Kristen E Holmes
- Department of Psychology, University of Queensland, Brisbane, Queensland, Australia
| | | | - Samuel Pearson
- Business School, University of Queensland, Brisbane, Queensland, Australia
| | - Ryan A Lawless
- Department of Surgery, Orlando Regional Medical Center, Orlando, FL
| | - Alan E Hubbard
- Department of Biostatistics, University of California Berkeley, Berkeley, CA
| | | |
Collapse
|
18
|
Tai-Seale M, Baxter S, Millen M, Cheung M, Zisook S, Çelebi J, Polston G, Sun B, Gross E, Helsten T, Rosen R, Clay B, Sinsky C, Ziedonis DM, Longhurst CA, Savides TJ. Association of physician burnout with perceived EHR work stress and potentially actionable factors. J Am Med Inform Assoc 2023; 30:1665-1672. [PMID: 37475168 PMCID: PMC10531111 DOI: 10.1093/jamia/ocad136] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 04/27/2023] [Accepted: 07/07/2023] [Indexed: 07/22/2023] Open
Abstract
OBJECTIVE Physicians of all specialties experienced unprecedented stressors during the COVID-19 pandemic, exacerbating preexisting burnout. We examine burnout's association with perceived and actionable electronic health record (EHR) workload factors and personal, professional, and organizational characteristics with the goal of identifying levers that can be targeted to address burnout. MATERIALS AND METHODS Survey of physicians of all specialties in an academic health center, using a standard measure of burnout, self-reported EHR work stress, and EHR-based work assessed by the number of messages regarding prescription reauthorization and use of a staff pool to triage messages. Descriptive and multivariable regression analyses examined the relationship among burnout, perceived EHR work stress, and actionable EHR work factors. RESULTS Of 1038 eligible physicians, 627 responded (60% response rate), 49.8% reported burnout symptoms. Logistic regression analysis suggests that higher odds of burnout are associated with physicians feeling higher level of EHR stress (odds ratio [OR], 1.15; 95% confidence interval [CI], 1.07-1.25), having more prescription reauthorization messages (OR, 1.23; 95% CI, 1.04-1.47), not feeling valued (OR, 3.38; 95% CI, 1.69-7.22) or aligned in values with clinic leaders (OR, 2.81; 95% CI, 1.87-4.27), in medical practice for ≤15 years (OR, 2.57; 95% CI, 1.63-4.12), and sleeping for <6 h/night (OR, 1.73; 95% CI, 1.12-2.67). DISCUSSION Perceived EHR stress and prescription reauthorization messages are significantly associated with burnout, as are non-EHR factors such as not feeling valued or aligned in values with clinic leaders. Younger physicians need more support. CONCLUSION A multipronged approach targeting actionable levers and supporting young physicians is needed to implement sustainable improvements in physician well-being.
Collapse
Affiliation(s)
- Ming Tai-Seale
- Family Medicine, UC San Diego School of Medicine, La Jolla, California, USA
- Outcomes Analysis and Scholarship, Information Services, UC San Diego Health, La Jolla, California, USA
- Research and Learning, Population Health Services Organization, UC San Diego Health, La Jolla, California, USA
- Medicine, UC San Diego School of Medicine, La Jolla, California, USA
- UC San Diego Health, La Jolla, California, USA
| | - Sally Baxter
- Medicine, UC San Diego School of Medicine, La Jolla, California, USA
- UC San Diego Health, La Jolla, California, USA
- Ophthalmology, UC San Diego School of Medicine, La Jolla, California, USA
| | - Marlene Millen
- Medicine, UC San Diego School of Medicine, La Jolla, California, USA
- UC San Diego Health, La Jolla, California, USA
| | - Michael Cheung
- Family Medicine, UC San Diego School of Medicine, La Jolla, California, USA
| | - Sidney Zisook
- UC San Diego Health, La Jolla, California, USA
- Psychiatry, UC San Diego School of Medicine, La Jolla, California, USA
| | - Julie Çelebi
- Family Medicine, UC San Diego School of Medicine, La Jolla, California, USA
- UC San Diego Health, La Jolla, California, USA
| | - Gregory Polston
- UC San Diego Health, La Jolla, California, USA
- Anesthesiology, UC San Diego School of Medicine, La Jolla, California, USA
| | - Bryan Sun
- UC San Diego Health, La Jolla, California, USA
- Dermatology, UC San Diego School of Medicine, La Jolla, California, USA
| | - Erin Gross
- UC San Diego Health, La Jolla, California, USA
- Obstetrics and Gynecology, UC San Diego School of Medicine, La Jolla, California, USA
| | - Teresa Helsten
- Medicine, UC San Diego School of Medicine, La Jolla, California, USA
- UC San Diego Health, La Jolla, California, USA
| | - Rebecca Rosen
- Family Medicine, UC San Diego School of Medicine, La Jolla, California, USA
- UC San Diego Health, La Jolla, California, USA
| | - Brian Clay
- Medicine, UC San Diego School of Medicine, La Jolla, California, USA
- UC San Diego Health, La Jolla, California, USA
| | - Christine Sinsky
- Professional Satisfaction, American Medical Association, Chicago, Illinois, USA
| | - Douglas M Ziedonis
- Psychiatry, University of New Mexico, School of Medicine, Albuquerque, New Mexico, USA
- University of New Mexico Health Sciences and Health System, Albuquerque, New Mexico, USA
| | - Christopher A Longhurst
- Medicine, UC San Diego School of Medicine, La Jolla, California, USA
- UC San Diego Health, La Jolla, California, USA
| | - Thomas J Savides
- Medicine, UC San Diego School of Medicine, La Jolla, California, USA
- UC San Diego Health, La Jolla, California, USA
| |
Collapse
|
19
|
Sahli H, Sahli F, Saidane M, Rebhi M, Guelmami N, Trabelsi K, Jahrami H, Ammar A, Terry PC, Zghibi M. Testing the Psychometric Properties of an Arabic Version of the Brunel Mood Scale among Physical Education Students. Eur J Investig Health Psychol Educ 2023; 13:1539-1552. [PMID: 37623309 PMCID: PMC10453414 DOI: 10.3390/ejihpe13080112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 07/27/2023] [Accepted: 08/09/2023] [Indexed: 08/26/2023] Open
Abstract
In our study, we translated and tested the psychometric properties of an Arabic version of the Brunel Mood Scale (BRUMS), referred to as the Arabic Mood Scale (ARAMS), among physical education university students. A total of 681 participants completed the ARAMS in exploratory and confirmatory phases. Exploratory analyses were conducted on data from 253 students between the ages of 19 and 25 years (M = 21.14 ± 1.65 years) of whom 132 were women (52.2%) and 121 were men (47.8%). Confirmatory analyses were conducted on data from 428 students between the ages of 19 and 25 years (M = 20.93 ± 1.55 years) of whom 203 were women (52.6%) and 225 were men (47.4%). The measurement model of the ARAMS was initially evaluated using exploratory factor analysis (EFA) and was subsequently tested via confirmatory factor analysis (CFA). EFA identified a 24-item, 6-factor structure that aligned with the original BRUMS measurement model, and CFA demonstrated congruence between the two models. Internal consistency of the six subscales exceeded adequacy levels with good Cronbach's alpha and McDonald's Omega values respectively for anger (0.811; 0.812), confusion (0.830; 0.830), depression (0.858; 0.859), fatigue (0.823; 0.825), and tension (0.824; 0.825), and an acceptable value for vigor (0.749; 0.748). Findings support the factorial validity and internal consistency of the ARAMS, which appears to be a suitable measure for use in Arabic physical education contexts. Further validation studies are required before the ARAMS is used in other Arabic-language contexts.
Collapse
Affiliation(s)
- Hajer Sahli
- Research Unit, Sportive Performance and Physical Rehabilitation, High Institute of Sports and Physical Education of Kef, University of Jendouba, Kef 7100, Tunisia; (H.S.); (M.S.); (N.G.); (M.Z.)
| | - Faten Sahli
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax 3000, Tunisia;
| | - Mouna Saidane
- Research Unit, Sportive Performance and Physical Rehabilitation, High Institute of Sports and Physical Education of Kef, University of Jendouba, Kef 7100, Tunisia; (H.S.); (M.S.); (N.G.); (M.Z.)
| | - Mahmoud Rebhi
- Research Unit, Physical Activity, Sport and Health, UR18JS01, National Observatory of Sport, Tunis 1003, Tunisia; (M.R.); (K.T.)
| | - Noomen Guelmami
- Research Unit, Sportive Performance and Physical Rehabilitation, High Institute of Sports and Physical Education of Kef, University of Jendouba, Kef 7100, Tunisia; (H.S.); (M.S.); (N.G.); (M.Z.)
| | - Khaled Trabelsi
- Research Unit, Physical Activity, Sport and Health, UR18JS01, National Observatory of Sport, Tunis 1003, Tunisia; (M.R.); (K.T.)
- Research Laboratory, Education, Motricity, Sport and Health, EM2S, LR19JS01, University of Sfax, Sfax 3000, Tunisia
| | - Haitham Jahrami
- Ministry of Health, Manama 410, Bahrain;
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama 329, Bahrain
| | - Achraf Ammar
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax 3000, Tunisia;
- Department of Training and Movement Science, Institute of Sport Science, Johannes Gutenberg-University Mainz, 55128 Mainz, Germany
- Research Laboratory, Molecular Bases of Human Pathology, LR19ES13, Faculty of Medicine of Sfax, University of Sfax, Sfax 3029, Tunisia
| | - Peter C. Terry
- Centre for Health Research, University of Southern Queensland, Toowoomba, QLD 4350, Australia;
| | - Makram Zghibi
- Research Unit, Sportive Performance and Physical Rehabilitation, High Institute of Sports and Physical Education of Kef, University of Jendouba, Kef 7100, Tunisia; (H.S.); (M.S.); (N.G.); (M.Z.)
| |
Collapse
|
20
|
Chernyshev OY. Sleep Deprivation and Its Consequences. Continuum (Minneap Minn) 2023; 29:1234-1252. [PMID: 37590831 DOI: 10.1212/con.0000000000001323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/19/2023]
Abstract
OBJECTIVE This article reviews the clinical, cognitive, behavioral, and physiologic consequences of sleep deprivation in relation to general neurology practice. LATEST DEVELOPMENTS Despite being one of the most common sleep problems in modern society, the role of sleep deprivation is underrecognized and underestimated in clinical medicine and general neurology practice. The recognition, diagnosis, and management of sleep deprivation in neurologic practice have only recently received close attention. The consequences of sleep deprivation involve all aspects of general neurology practice, including individuals with neurologic disease, neurologists, communities, and health care systems. The identification and timely management of sleep deprivation symptoms may help to improve symptoms of underlying primary neurologic disorders. ESSENTIAL POINTS This article emphasizes complexities related to the identification and evaluation of sleep deprivation in general neurology practice and describes the consequences of sleep deprivation. By recognizing sleep deprivation in patients with neurologic conditions, the neurologist can provide comprehensive care and contribute to improved clinical and neurologic outcomes.
Collapse
|
21
|
Steffey MA, Griffon DJ, Risselada M, Scharf VF, Buote NJ, Zamprogno H, Winter AL. Veterinarian burnout demographics and organizational impacts: a narrative review. Front Vet Sci 2023; 10:1184526. [PMID: 37470072 PMCID: PMC10352684 DOI: 10.3389/fvets.2023.1184526] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 06/19/2023] [Indexed: 07/21/2023] Open
Abstract
Burnout is a work-related syndrome of physical and emotional exhaustion secondary to prolonged, unresolvable occupational stress. Individuals of different demographic cohorts may have disparate experiences of workplace stressors and burnout impacts. Healthcare organizations are adversely affected by burnt out workers through decreased productivity, low morale, suboptimal teamwork, and potential impacts on the quality of patient care. In this second of two companion reviews, the demographics of veterinary burnout and the impacts of burnout on affected individuals and work environments are summarized, before discussing mitigation concepts and their extrapolation for targeted strategies within the veterinary workplace and profession.
Collapse
Affiliation(s)
- Michele A. Steffey
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
| | - Dominique J. Griffon
- Western University of Health Sciences, College of Veterinary Medicine, Pomona, CA, United States
| | - Marije Risselada
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West-Lafayette, IN, United States
| | - Valery F. Scharf
- Department of Clinical Sciences, North Carolina State University College of Veterinary Medicine, Raleigh, NC, United States
| | - Nicole J. Buote
- Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, NY, United States
| | | | | |
Collapse
|
22
|
Steffey MA, Griffon DJ, Risselada M, Buote NJ, Scharf VF, Zamprogno H, Winter AL. A narrative review of the physiology and health effects of burnout associated with veterinarian-pertinent occupational stressors. Front Vet Sci 2023; 10:1184525. [PMID: 37465277 PMCID: PMC10351608 DOI: 10.3389/fvets.2023.1184525] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 06/19/2023] [Indexed: 07/20/2023] Open
Abstract
Chronic workplace stress and burnout are serious problems in veterinary medicine. Although not classified as a medical condition, burnout can affect sleep patterns and contributes to chronic low grade systemic inflammation, autonomic imbalance, hormonal imbalances and immunodeficiencies, thereby increasing the risks of physical and psychological ill health in affected individuals. Cultural misconceptions in the profession often lead to perceptions of burnout as a personal failure, ideas that healthcare professionals are somehow at lower risk for suffering, and beliefs that affected individuals can or should somehow heal themselves. However, these concepts are antiquated, harmful and incorrect, preventing the design of appropriate solutions for this serious and growing challenge to the veterinary profession. Veterinarians must first correctly identify the nature of the problem and understand its causes and impacts before rational solutions can be implemented. In this first part of two companion reviews, burnout will be defined, pathophysiology discussed, and healthcare and veterinary-relevant occupational stressors that lead to burnout identified.
Collapse
Affiliation(s)
- Michele A. Steffey
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
| | - Dominique J. Griffon
- Western University of Health Sciences, College of Veterinary Medicine, Pomona, CA, United States
| | - Marije Risselada
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West-Lafayette, IN, United States
| | - Nicole J. Buote
- Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, NY, United States
| | - Valery F. Scharf
- Department of Clinical Sciences, North Carolina State University College of Veterinary Medicine, Raleigh, NC, United States
| | | | | |
Collapse
|
23
|
Gan R, Xue J, Chen S. Mindfulness and burnout among Chinese college students: mediation through sleep quality and perceived stress. PSYCHOL HEALTH MED 2023; 28:1755-1766. [PMID: 36786805 DOI: 10.1080/13548506.2023.2177686] [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: 07/15/2022] [Accepted: 02/02/2023] [Indexed: 02/15/2023]
Abstract
College students often face challenges and obstacles which leads them vulnerable to burnout. Though numerous studies have supported an association between mindfulness and burnout, yet little is known about the potential mediating role of mindfulness exerts its effect in this link. This study aimed to explore the relationship between mindfulness and burnout among Chinese college students and investigated the sleep quality and perceived stress as two potential mediators of that relationship. A total of 536 college students (mean age = 21.93, 66.2% female) were investigated and completed the Five Facet of Mindfulness Questionnaire, Pittsburgh Sleep Quality Index, Perceived Stress Scale and Academic Burnout Scale of College Students. Path analyses were employed to examine the mediating effect. Results indicated that mindfulness had significant negative correlation with burnout (r=-.584, p < 0.001). Sleep quality and perceived stress were significant mediators of the observed relationship between mindfulness and burnout. These findings shed light upon the mediating role of sleep quality and perceived stress, and suggest that college students' mindfulness may facilitate their sleep quality and decrease perceived stress, which, in turn, may help prevent and reduce burnout.
Collapse
Affiliation(s)
- Ruochen Gan
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, ChinaShulin Chen
| | - Jiang Xue
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, ChinaShulin Chen
| | - Shulin Chen
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, ChinaShulin Chen
| |
Collapse
|
24
|
Huth K, Frankel H, Cook S, Samuels RC. Caring for a Child with Chronic Illness: Effect on Families and Siblings. Pediatr Rev 2023; 44:393-402. [PMID: 37391635 DOI: 10.1542/pir.2022-005649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/02/2023]
Affiliation(s)
- Kathleen Huth
- Boston Children's Hospital and Harvard Medical School, Boston, MA
| | - Hilary Frankel
- Children's Hospital at Montefiore and Albert Einstein College of Medicine, Bronx, NY
| | - Stacey Cook
- Boston Children's Hospital and Harvard Medical School, Boston, MA
| | - Ronald C Samuels
- Children's Hospital at Montefiore and Albert Einstein College of Medicine, Bronx, NY
| |
Collapse
|
25
|
Yang Z, Wang D, Fan Y, Ma Z, Chen X, Zhang Y, Fan F. Relationship between sleep disturbance and burnout among Chinese urban teachers: Moderating roles of resilience. Sleep Med 2023; 108:29-37. [PMID: 37311321 DOI: 10.1016/j.sleep.2023.06.002] [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: 02/05/2023] [Revised: 04/16/2023] [Accepted: 06/01/2023] [Indexed: 06/15/2023]
Abstract
BACKGROUND Sleep disturbance and burnout are prevalent among primary and secondary school teachers. Nevertheless, little is known about the relationship between sleep disturbance and burnout, and the mechanisms connecting this link. Our study aimed to explore the relationship between sleep disturbance and burnout among urban teachers, as well as to investigate this influencing mechanism further with resilience as a moderator. METHODS 14,218 primary and secondary school teachers provided valid data. We assessed demographic information, sleep disturbance, burnout, and resilience. Multivariable logistic regression, Spearman correlation, and moderation analyses were used to evaluate the relationship between sleep disturbance and burnout and the moderating role of resilience. RESULTS Of the participants, the prevalence of sleep disturbance and sleep deprivation among teachers was 20.0% and 31.7%, respectively. Additionally, 58.4% of teachers reported moderate or severe burnout, and 15.3% had both sleep disturbance and burnout. Sleep disturbance was significant and positively related to burnout. Resilience was found to moderate the association between sleep disturbance and burnout. CONCLUSIONS These findings suggested strong associations between sleep disturbance and burnout. Interventions in improving resilience may protect teachers with sleep disturbance from burnout.
Collapse
Affiliation(s)
- Zheng Yang
- School of Psychology, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China; Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, South China Normal University, Guangzhou, China
| | - Dongfang Wang
- School of Psychology, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China; Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, South China Normal University, Guangzhou, China
| | - Yunge Fan
- School of Psychology, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China; Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, South China Normal University, Guangzhou, China
| | - Zijuan Ma
- School of Psychology, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China; Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, South China Normal University, Guangzhou, China
| | - Xiaoyan Chen
- School of Psychology, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China; Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, South China Normal University, Guangzhou, China
| | - Yifan Zhang
- School of Psychology, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China; Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, South China Normal University, Guangzhou, China
| | - Fang Fan
- School of Psychology, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China; Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, South China Normal University, Guangzhou, China.
| |
Collapse
|
26
|
Chapleau RR. Genome-wide associations, polygenic risk, and Mendelian randomization reveal limited interactions between John Henryism and cynicism. World J Med Genet 2023; 11:8-20. [DOI: 10.5496/wjmg.v11.i2.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 04/28/2023] [Accepted: 05/22/2023] [Indexed: 06/02/2023] Open
Abstract
BACKGROUND John Henryism (JH) is a strategy for dealing with chronic psychological stress characterized by high levels of physical effort and work. Cynicism is a belief that people are motivated primarily by self-interest. High scores on the JH scale and cynicism measures correlate with an increased risk of cardiovascular disease. High cynicism is also a hallmark of burnout syndrome, another known risk factor for heart disease.
AIM To evaluate possible interactions between JH and cynicism hoping to clarify risk factors of burnout.
METHODS We analyzed genetic and psychological data available from the Database of Genotypes and Phenotypes for genome-wide associations with these traits. We split the total available samples and used plink to perform the association studies on the discovery set (n = 1852, 80%) and tested for replication using the validation set (n = 465). We used scikit-learn to perform supervised machine learning for developing genetic risk algorithms.
RESULTS We identified 2, 727, and 204 genetic associations for scores on the JH, cynicism and cynical distrust (CD) scales, respectively. We also found 173 associations with high cynicism, 109 with high CD, but no associations with high JH. We also produced polygenic classifiers for high cynicism using machine learning with areas under the receiver operator characteristics curve greater than 0.7.
CONCLUSION We found significant genetic components to these traits but no evidence of an interaction. Therefore, while there may be a genetic risk, JH is not likely a burnout risk factor.
Collapse
Affiliation(s)
- Richard R Chapleau
- Department of Genetics, NeuroStat Analytical Solutions, Great Falls, VA 22066, United States
| |
Collapse
|
27
|
Lwiza AF, Lugazia ER. Burnout and associated factors among healthcare workers in acute care settings at a tertiary teaching hospital in Tanzania: An analytical cross-sectional study. Health Sci Rep 2023; 6:e1256. [PMID: 37152234 PMCID: PMC10160764 DOI: 10.1002/hsr2.1256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 04/23/2023] [Accepted: 04/24/2023] [Indexed: 05/09/2023] Open
Abstract
Background and Aims Healthcare worker burnout has been linked to increased patient safety risk, low work professionalism, and low satisfaction with the care encounter. This study aimed to find the prevalence and factors associated with burnout among healthcare workers in acute care settings at a national referral hospital in Tanzania. Methods An analytical cross-sectional study was performed at a national referral hospital in Tanzania. Healthcare workers at the departments of Emergency Medicine, Intensive Care Unit, and Anesthesia at Muhimbili National Hospital were recruited from January 2021 to March 2021. A two-part questionnaire adopted from the Maslach Burnout Inventory (MBI) and MBI-Human Services Survey tool were administered to measure burnout. Categorical variables were summarized using frequencies and percentages, and variables were compared using logistic regression. Results A total of 174 healthcare workers were issued questionnaires to participate in the study. With a response rate of 78%, 135 healthcare workers were included in the study, 43.7% were from the intensive care unit; the majority were female (63.7%), and assistant nursing officers (42%). The prevalence of burnout among participants was 62%, with 90.4% of participants showing a high level of emotional exhaustion. A longer duration of a single-day shift was associated with increased burnout among work-related factors (p < 0.001). Fewer night-time sleeping hours, tobacco use, and lack of regular exercise were significantly associated with increased burnout among social-related factors (p < 0.001). Conclusion The study showed an alarmingly high prevalence of burnout among healthcare workers in the acute care setting of Muhimbili National Hospital. Personal well-being and participation in wellness programs have been associated with a reduced prevalence of burnout. The hospital should address the issue of burnout among its healthcare workers. This also calls for immediate action, necessitating further studies at the regional and national levels to ascertain the burden and causes of burnout in this setting.
Collapse
Affiliation(s)
- Alex F. Lwiza
- Department of Anesthesiology, School of MedicineMuhimbili University of Health and Allied SciencesDar es SalaamTanzania
- Department of Anesthesia and Critical CareKilimanjaro Christian Medical CentreKilimanjaroTanzania
| | - Edwin R. Lugazia
- Department of Anesthesiology, School of MedicineMuhimbili University of Health and Allied SciencesDar es SalaamTanzania
| |
Collapse
|
28
|
Bramati PS, Swan A, Urbauer DL, Rozman De Moraes A, Bruera E. Evaluation of a Daily Nine-Item "Handbook for Self-Care at Work" for Palliative Care Clinicians. J Palliat Med 2023; 26:622-626. [PMID: 36318801 PMCID: PMC10325800 DOI: 10.1089/jpm.2022.0347] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2022] [Indexed: 11/07/2022] Open
Abstract
Context: A daily nine-item "Handbook for Self-Care at Work" was created to increase the well-being and satisfaction of the staff at the department of palliative care of a tertiary oncological center in the United States. Objectives: To evaluate the perceived usefulness of and adherence to the Handbook. Design, Setting and Participants: An anonymous survey was conducted among the palliative care staff asking for the frequency of utilization and the perception of usefulness of the Handbook. Additional data collected included demographics, satisfaction with professional life, frequency of burnout, and frequency of callousness toward people. We also compared the use and perception of the Handbook before and during the COVID-19 pandemic. Results: Of 52 palliative care clinicians, 39 (75%) completed the survey. Most participants were women and were <49 years. Most respondents (59%) found the Handbook useful or very useful. Offer help, ask for help, and hydration were perceived as the most useful items. The items most frequently achieved were movement, hydration, and eat light. The least useful perceived item was nap time, which was rarely achieved. During the COVID-19 pandemic, 32 (82%) respondents found the Handbook to be as/somewhat more/much more useful, and 29 (75%) were able to adhere to the items as/somewhat more/much more often than before. Conclusion: Most respondents found the Handbook useful and were able to accomplish the items most of the days. During the COVID-19 pandemic, the staff felt that the Handbook was more useful.
Collapse
Affiliation(s)
- Patricia S. Bramati
- Department of Palliative Care, Rehabilitation, Integrative Medicine, and The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Amy Swan
- Department of Palliative Care, Rehabilitation, Integrative Medicine, and The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Diana L. Urbauer
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Aline Rozman De Moraes
- Department of Palliative Care, Rehabilitation, Integrative Medicine, and The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Eduardo Bruera
- Department of Palliative Care, Rehabilitation, Integrative Medicine, and The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| |
Collapse
|
29
|
Ruan A, Klein A, Jhita P, Hasan-Hill N, Shafer SL, Flood PD. The Effect of Night Float Rotation on Resident Sleep, Activity, and Well-Being. Anesth Analg 2023; 136:701-710. [PMID: 36342844 DOI: 10.1213/ane.0000000000006261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Night float call systems are becoming increasingly common at training programs with the goal of reducing fatigue related to sleep deprivation and sleep disturbance. Previous studies have shown that trainees obtain less sleep during the night float rotation and have decreased sleep efficiency for several days after the rotation. The impact on physical and emotional well-being has not been documented. METHODS Twenty-seven anesthesia residents were enrolled in a study using wearable sleep and activity trackers and National Institutes of Health Patient-Reported Outcome Measurement Information System (NIH PROMIS) surveys for sleep disturbance, fatigue, and positive affect to record data the week before ("baseline"), during ("night float"), and 1 week after ("recovery") their night float rotation. Each subject's data during the night float week and recovery week were compared to his or her own baseline week data using a paired, nonparametric analysis. The primary outcome variable was the change in average daily sleep hours during the night float week compared to the baseline week. Average daily rapid eye movement (REM) sleep, daily steps, and NIH PROMIS scores comparing night float and recovery weeks to baseline week were prespecified secondary outcomes. NIH PROMIS scores range from 0 to 100 with 50 as the national mean and more of the construct having a higher score. RESULTS There was no difference in average daily sleep hours between the night float and the baseline weeks (6.7 [5.9-7.8] vs 6.7 [5.5-7.7] hours, median [interquartile range]; P = .20). Residents had less REM sleep during the night float compared to the baseline weeks (1.1 [0.7-1.5] vs 1.4 [1.1-1.9] hours, P = .002). NIH PROMIS fatigue scores were higher during the night float than the baseline week (58.8 [54.6-65.1] vs 48.6 [46.0-55.1], P = .0004) and did not return to baseline during the recovery week (51.0 [48.6-58.8], P = .029 compared to baseline). Sleep disturbance was not different among the weeks. Positive affect was reduced after night float compared to baseline (39.6 [35.0-43.5] vs 44.8 [40.1-49.6], P = .0009), but returned to baseline during the recovery week (43.6 [39.6-48.2], P = .38). CONCLUSIONS The residents slept the same number of total hours during their night float week but had less REM sleep, were more fatigued, and had less positive affect. All of these resolved to baseline except fatigue, that was still greater than the baseline week. This methodology appears to robustly capture psychophysiological data that might be useful for quality initiatives.
Collapse
Affiliation(s)
- Alexandra Ruan
- From the Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Stanford, California
| | | | | | | | | | | |
Collapse
|
30
|
D'orsogna T, Halson SL, Oehmen R. Poor sleep quality during COVID-19 pandemic restrictions associated with reduced psychological wellbeing in healthcare students. Chronobiol Int 2023:1-12. [PMID: 36883343 DOI: 10.1080/07420528.2023.2186127] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
Abstract
Sleep is inexorably linked to both physiological and psychological wellbeing. Restrictions imposed to control the COVID-19 pandemic likely impacted upon daily and weekly routines, which can have a negative impact on a range of factors including sleep quality, and/or quantity and general wellbeing. The aim of this study was to investigate the effect of COVID-19 related restrictions on sleep patterns and psychological wellbeing of healthcare students. A survey was delivered to healthcare students across three faculties at a single institution. Participants completed questionnaires on the effect of COVID-19 restrictions on course delivery and clinical placements, its effect on sleep-wake times, sleep quality, sleep hygiene, psychological wellbeing, their current sleep knowledge and sleep education in their current course. Using the Pittsburgh Sleep Quality Index (PSQI), over 75% of participants were found to have poor sleep quality. Changes in sleep habits and sleep behaviours during COVID-19 restrictions were associated with poorer sleep quality, and this poor sleep quality was associated with poor psychological wellbeing, particularly, motivation, stress and fatigue. Increases in negative sleep hygiene behaviours were associated with a statistically significant increase in PSQI global score. Positive emotions were positively correlated with PSQI (r = 0.22-0.24, p < .001), negative emotions were negatively correlated with PSQI (r = -0.22 - -0.31, p < .001). Also, a self-perceived lack of sleep education was identified. This study illustrates the negative association between self-reported poor sleep behaviour and poor sleep quality during COVID-19 restrictions on university student mental health and wellbeing. Additionally, there is a self-perceived lack of sleep education with little to no time spent educating students in their current degree. Hence, appropriate sleep education may improve sleep behaviours and subsequent sleep quality, which may prove to be a protective factor against poor mental health in the face of unexpected changes to routines.
Collapse
Affiliation(s)
- Tommaso D'orsogna
- School of Medicine, University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - Shona L Halson
- School of Behavioural and Health Sciences, Australian Catholic University, Banyo, Australia
| | - Raoul Oehmen
- School of Medicine, University of Notre Dame Australia, Fremantle, Western Australia, Australia
| |
Collapse
|
31
|
Lin Y, Huang Y, Xi X. Association between lifestyle behaviors and health-related quality of life among primary health care physicians in China: A cross-sectional study. Front Public Health 2023; 11:1131031. [PMID: 36969630 PMCID: PMC10030863 DOI: 10.3389/fpubh.2023.1131031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 02/16/2023] [Indexed: 03/11/2023] Open
Abstract
BackgroundPrimary health care (PHC) serves as the gatekeeper of health system and PHC physicians take on significant obligations to provide health care services in the pursuit of Universal Health Coverage (UHC). PHC physicians' health-related quality of life (HRQoL) can have a strong impact on patients, physicians and the health care system. Lifestyle interventions are found to be effective to improve HRQoL. The purpose of this study was to evaluate the association between lifestyle behaviors and HRQoL among PHC physicians, so that lifestyle intervention can be tailored by policy makers for health promotion.MethodsA survey covering 31 provinces and administrative regions in China was conducted in 2020 using a stratified sampling strategy. Data on sociodemographic characteristics lifestyle behaviors and HRQoL were collected by a self-administered questionnaire. HRQoL was measured through EuroQol-five dimension-five level (EQ-5D-5L) instrument. A Tobit regression model was performed to evaluate the association between sociodemographic characteristics, lifestyle behaviors and HRQoL.ResultsAmong 894 PHC physicians who completed the survey, Anxiety/Depression (AD) was the dimension with the most problems reported (18.1%). Regular daily routine (β = 0.025, 95%CI 0.004 to 0.045) and good sleep quality (β = 0.049, 95% CI = 0.029 to 0.069) were protective factors for HRQoL, while smoking (β = −0.027, 95% CI = −0.079 to −0.003) and frequency of eating breakfast (β = −0.041, 95%CI = −0.079 to −0.003) were negatively associated with HRQoL. Physical activity and alcohol drinking were not significantly associated with HRQoL.ConclusionThese findings suggest that tailored interventions on daily routine, improving sleep quality, and tobacco control among PHC physicians may be effective strategies to improve their HRQoL.
Collapse
|
32
|
Czeisler MÉ, Wolkow AP, Czeisler CA, Howard ME, Rajaratnam SMW, Lane RI. Association between burnout and adherence with mask usage and additional COVID-19 prevention behaviours: findings from a large-scale, demographically representative survey of US adults. BMJ Open 2023; 13:e066226. [PMID: 36858474 PMCID: PMC9979584 DOI: 10.1136/bmjopen-2022-066226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 02/02/2023] [Indexed: 03/03/2023] Open
Abstract
OBJECTIVES Studies have found associations between occupational burnout symptoms and reduced engagement with healthy behaviours. We sought to characterise demographic, employment and sleep characteristics associated with occupational burnout symptoms, and to evaluate their relationships with adherence to COVID-19 prevention behaviours (mask usage, hand hygiene, avoiding gatherings, physical distancing, obtaining COVID-19 tests if potentially infected). METHODS During December 2020, surveys were administered cross-sectionally to 5208 US adults (response rate=65.8%). Quota sampling and survey weighting were employed to improve sample representativeness of sex, age and race and ethnicity. Among 3026 employed respondents, logistic regression models examined associations between burnout symptoms and demographic, employment and sleep characteristics. Similar models were conducted to estimate associations between burnout and non-adherence with COVID-19 prevention behaviours. RESULTS Women, younger adults, unpaid caregivers, those working more on-site versus remotely and those with insufficient or impaired sleep had higher odds of occupational burnout symptoms. Burnout symptoms were associated with less frequent mask usage (adjusted odds ratio (aOR)=1.7, 95% CI 1.3-2.1), hand hygiene (aOR=2.1, 95% CI 1.7-2.7), physical distancing (aOR=1.3, 95% CI 1.1-1.6), avoiding gatherings (aOR=1.4, 95% CI 1.1-1.7) and obtaining COVID-19 tests (aOR=1.4, 95% CI 1.1-1.8). CONCLUSIONS Disparities in occupational burnout symptoms exist by gender, age, caregiving, employment and sleep health. Employees experiencing occupational burnout symptoms might exhibit reduced adherence with COVID-19 prevention behaviours. Employers can support employee health by addressing the psychological syndrome of occupational burnout.
Collapse
Affiliation(s)
- Mark É Czeisler
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
- Institute for Breathing and Sleep, Austin Health, Melbourne, Victoria, Australia
- Francis Weld Peabody Society, Harvard Medical School, Boston, Massachusetts, USA
| | - Alexander P Wolkow
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
| | - Charles A Czeisler
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Mark E Howard
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
- Institute for Breathing and Sleep, Austin Health, Melbourne, Victoria, Australia
- Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - Shantha M W Rajaratnam
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
- Institute for Breathing and Sleep, Austin Health, Melbourne, Victoria, Australia
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Rashon I Lane
- Department of Social and Behavioral Sciences, University of California San Francisco, San Francisco, California, USA
| |
Collapse
|
33
|
Shi C, Luo JM, Xiao Y. The association of sleep quality and burnout among Chinese medical residents under standardized residency training in a tertiary hospital. Sleep Breath 2023; 27:379-386. [PMID: 35460049 PMCID: PMC9033310 DOI: 10.1007/s11325-022-02621-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 03/22/2022] [Accepted: 04/15/2022] [Indexed: 12/01/2022]
Abstract
PURPOSE To investigate the impact of sleep quality and chronotype on job burnout among medical residents under standardized residency training (SRT) in a tertiary hospital in Beijing, China. METHODS Medical residents in the Department of Internal Medicine of Peking Union Medical College Hospital were assessed by Morning and Evening Questionaire-5 (MEQ-5), Pittsburgh sleep quality index (PSQI), and Maslach Burnout Inventory-General Survey (MBI-GS). Factors associated with burnout were analyzed. RESULTS A total of 142 respondents returned completed questionnaires. Burnout was present in 85 (60%) residents. Prevalence of high emotional exhaustion, high depersonalization, and low personal accomplishment were 51%, 28%, and 18%, respectively. The global PSQI score of residents was 5.9 ± 2.4, and the self-reported sleep duration was 6.2 ± 0.8 h/day. The MEQ-5 distribution skewed towards morningness, with a median score of 14.5 [13.0, 16.3]. Poor daytime function significantly predicted emotional exhaustion and depersonalization. Chronotypes were not associated with any of the burnout components. CONCLUSION Sleep-related daytime dysfunction was strongly related to burnout. Strategies protecting the sleep of residents should be incorporated into the SRT programs for both efficiency and sustainability considerations.
Collapse
Affiliation(s)
- Chuan Shi
- Department of Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science (CAMS) and Peking Union Medical College (PUMC), Beijing, 100730, China
| | - Jin-Mei Luo
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science (CAMS) and Peking Union Medical College (PUMC), Beijing, 100730, China.
| | - Yi Xiao
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science (CAMS) and Peking Union Medical College (PUMC), Beijing, 100730, China
| |
Collapse
|
34
|
Cooper-Bribiesca D, Rascón-Martínez DM, Miguel-Puga JA, Juárez-Carreón MK, Sánchez-Hurtado LA, Colin-Martinez T, Anda-Garay JC, Espinosa-Poblano E, Jáuregui-Renaud K. Physicians' Distress Related to Moral Issues and Mental Health In-Between Two Late Waves of COVID-19 Contagions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3989. [PMID: 36901003 PMCID: PMC10002359 DOI: 10.3390/ijerph20053989] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 02/09/2023] [Accepted: 02/20/2023] [Indexed: 06/18/2023]
Abstract
In addition to the sanitary constrains implemented due to the pandemic, frontline physicians have faced increased workloads with insufficient resources, and the responsibility to make extraordinary clinical decisions. In 108 physicians who were at the forefront of care of patients with COVID-19 during the first two years of the pandemic, mental health, moral distress, and moral injury were assessed twice, in between two late waves of COVID-19 contagions, according to their adverse psychological reactions, in-hospital experience, sick leave due to COVID-19, quality of sleep, moral sensitivity, clinical empathy, resilience, and sense of coherence. Three months after the wave of contagions, the adverse emotional reactions and moral distress decreased, while moral injury persisted. Moral distress was related to clinical empathy, with influence from burnout and sick leave due to COVID-19, and moral injury was related to the sense of coherence, while recovery from moral distress was related to resilience. The results suggest that measures to prevent physician infection, as well as strengthening resilience and a sense of coherence, may be helpful to prevent persistent mental damage after exposure to a sanitary crisis.
Collapse
Affiliation(s)
- Davis Cooper-Bribiesca
- Unidad de Investigación Médica en Otoneurología, Instituto Mexicano del Seguro Social, Ciudad de México 06720, Mexico
- Departamento de Psiquiatría, Hospital de Especialidades del Centro Médico Nacional Siglo XXI del Instituto Mexicano del Seguro Social, Ciudad de México 06720, Mexico
| | - Dulce María Rascón-Martínez
- Departamento de Anestesiología, Hospital de Especialidades del Centro Médico Nacional Siglo XXI del Instituto Mexicano del Seguro Social, Ciudad de México 06720, Mexico
| | - José Adan Miguel-Puga
- Unidad de Investigación Médica en Otoneurología, Instituto Mexicano del Seguro Social, Ciudad de México 06720, Mexico
| | - María Karen Juárez-Carreón
- Departamento de Psiquiatría, Hospital de Especialidades del Centro Médico Nacional Siglo XXI del Instituto Mexicano del Seguro Social, Ciudad de México 06720, Mexico
| | - Luis Alejandro Sánchez-Hurtado
- Departamento de Terapia Intensiva, Hospital de Especialidades del Centro Médico Nacional Siglo XXI del Instituto Mexicano del Seguro Social, Ciudad de México 06720, Mexico
| | - Tania Colin-Martinez
- Departamento de Admisión Continua, Hospital de Especialidades del Centro Médico Nacional Siglo XXI del Instituto Mexicano del Seguro Social, Ciudad de México 06720, Mexico
| | - Juan Carlos Anda-Garay
- Departamento de Medicina Interna, Hospital de Especialidades del Centro Médico Nacional Siglo XXI del Instituto Mexicano del Seguro Social, Ciudad de México 06720, Mexico
| | - Eliseo Espinosa-Poblano
- Departamento de Inhaloterapia y Neumología, Hospital de Especialidades del Centro Médico Nacional Siglo XXI del Instituto Mexicano del Seguro Social, Ciudad de México 06720, Mexico
| | - Kathrine Jáuregui-Renaud
- Unidad de Investigación Médica en Otoneurología, Instituto Mexicano del Seguro Social, Ciudad de México 06720, Mexico
| |
Collapse
|
35
|
Chu WM, Ho HE, Lin YL, Li JY, Lin CF, Chen CH, Shieh GJ, Chan WC, Tsan YT. Risk Factors Surrounding an Increase in Burnout and Depression Among Health Care Professionals in Taiwan During the COVID-19 Pandemic. J Am Med Dir Assoc 2023; 24:164-170.e3. [PMID: 36592937 PMCID: PMC9747695 DOI: 10.1016/j.jamda.2022.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 11/18/2022] [Accepted: 12/06/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVES This study aimed to investigate the risk factors surrounding an increase in both burnout levels and depression among health care professionals in Taiwan through use of a longitudinal study design. DESIGN This is a 2-year observational study that took place from January 2019 to December 2020. SETTING AND PARTICIPANTS Data among health care professionals were extracted from the Overload Health Control System of a tertiary medical center in central Taiwan. METHODS Burnout was measured through use of the Chinese version of the Copenhagen Burnout Inventory (C-CBI), whereas depression was ascertained by the Taiwanese Depression Questionnaire. Each participant provided both burnout and depression measurements during a nonpandemic period (2019) as well as during the COVID pandemic era (2020). Risk factors surrounding an increase in burnout levels and depression were analyzed through a multivariate logistic regression model with adjusting confounding factors. RESULTS Two thousand nineteen participants completed the questionnaire over 2 consecutive years, including 132 visiting doctors, 105 resident doctors, 1371 nurses, and 411 medical technicians. After adjustments, sleeplessness, daily working hours >8, and stress due to one's workload were all found to be risk factors for an increase in depression levels, whereas sleeplessness, lack of exercise, and stress due to one's workload were all found to be risk factors for an increase in personal burnout level. Being a member of the nursing staff, a younger age, sleeplessness, and lack of exercise were all risk factors for an increase in work-related burnout levels. CONCLUSIONS AND IMPLICATIONS Poor sleep, lack of exercise, long working hours, and being a member of the nursing staff were risk factors regarding an increase in personal burnout, work-related burnout levels and depression among health care professionals. Leaders within the hospital should investigate the working conditions and personal habits of all medical staff regularly and systematically during the COVID-19 pandemic and take any necessary preventive measures, such as improving resilience for nursing staff, in order to best care for their employees.
Collapse
Affiliation(s)
- Wei-Min Chu
- Department of Family Medicine, Taichung Veterans General Hospital, Taichung, Taiwan,School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan,Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan,School of Medicine, Chung Shan Medical University, Taichung, Taiwan,Education and innovation Center for Geriatrics and Gerontology, National Center for Geriatrics and Gerontology, Aichi, Japan,Division of Occupational Medicine, Department of Emergency Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Hsin-En Ho
- Department of Family Medicine, Taichung Armed Force General Hospital, Taichung, Taiwan,Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan,National Defense Medical Center, Taipei, Taiwan
| | - Yu-Li Lin
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan,Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan,Division of Occupational Medicine, Department of Emergency Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Jhih-Yan Li
- Ming Crown Industry Company, Changhwa, Taiwan
| | - Cheng-Fu Lin
- Division of Occupational Medicine, Department of Emergency Medicine, Taichung Veterans General Hospital, Taichung, Taiwan,Center for Geriatrics and Gerontology, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Cing-Hua Chen
- Department of Nursing, Taichung Veterans General Hospital, Taichung, Taiwan,Department of Occupational Safety and Health Office, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Gow-Jen Shieh
- Department of Occupational Safety and Health Office, Taichung Veterans General Hospital, Taichung, Taiwan,Department of Top Hospital Administration, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Wei-Cheng Chan
- Division of Occupational Medicine, Department of Emergency Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Yu-Tse Tsan
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan; Division of Occupational Medicine, Department of Emergency Medicine, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Occupational Safety and Health Office, Taichung Veterans General Hospital, Taichung, Taiwan.
| |
Collapse
|
36
|
Abera H, Hunt M, Levin JH. Sleep Deprivation, Burnout, and Acute Care Surgery. CURRENT TRAUMA REPORTS 2023; 9:40-46. [PMID: 36721843 PMCID: PMC9880369 DOI: 10.1007/s40719-023-00253-9] [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] [Accepted: 01/03/2023] [Indexed: 01/28/2023]
Abstract
Purpose of Review To define what sleep deprivation is, how it relates to the growing problem of burnout within surgeons, and what can be done to mitigate its effects. Recent Findings There is a growing awareness that sleep deprivation, in both its acute and chronic manifestations, plays an immense role in burnout. The physical and mental manifestations of sleep deprivation are manifold, effecting nearly every physiologic system. Studies evaluating strategies at mitigating the effects of sleep deprivation are promising, including work done with napping, stimulant use, and service restructuring, but are fundamentally limited by generalizability, scale, and scope. Summary The overwhelming majority of data published on sleep deprivation is limited by size, scope, and generalizability. Within acute care surgery, there is a dearth of studies that adequately define and describe sleep deprivation as it pertains to high-performance professions. Given the growing issue of burnout amongst surgeons paired with a growing patient population that is older and more complex, strategies to combat sleep deprivation are paramount for surgeon retention and wellbeing.
Collapse
Affiliation(s)
- Hermona Abera
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN USA
| | - Maya Hunt
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN USA
| | - Jeremy H. Levin
- Division of Acute Care Surgery, Department of Surgery, Indiana University School of Medicine, 1630 N. Capitol Avenue, B258, Indianapolis, IN 46202 USA
| |
Collapse
|
37
|
Mezian K, Hrehová L. High prevalence of insomnia among physiatrists in the Czech Republic: A web-based questionnaire survey. Work 2023:WOR220050. [PMID: 36641721 DOI: 10.3233/wor-220050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Physicians who suffer from poor sleep quality are at an increased risk of mistakes and poor decision-making. We deemed it noteworthy to assess sleep quality in practicing physiatrists, previously reported to be at higher risk of physician burnout, which was documented associated with sleep deprivation. OBJECTIVE The aim was to estimate the prevalence of sleep disturbance among practicing physiatrists and evaluate the association of sleep quality with their sleep hygiene habits and depression. METHODS Of the 101 study participants (77 females) who met the inclusion criteria, the majority was between the age of 25 and 40 years (70.3% ); 62 (61.4% ) were specialists and 39 (38.6% ) were in training. In this cross-sectional study, practicing physiatrists were invited to complete an anonymous and voluntary web-based survey. The survey consisted of questions covering demographic information, nicotine and caffeine consumption, exercise habits, and three questionnaires: the Pittsburgh Sleep Quality Index (PSQI), the Beck Depression Inventory-II (BDI-II), and the Sleep Hygiene Index (SHI). RESULTS Sixty-five (64.4% ) respondents showed poor sleep quality (PSQI > 5), and 23 (22.8% ) showed at least mild symptoms of depression (BDI-II>13). The mean PSQI, SHI, BDI-II scores were 6.85±3.09, 18.18±5.35, and 8.36±7.52, respectively. Poor sleep quality was significantly positively correlated with symptoms of depression and sleep hygiene misbehavior. CONCLUSION We found that 64.4% of practicing physiatrists suffered from poor sleep quality, and 22.8% showed at least mild symptoms of depression. Considerable efforts should be directed toward sleep hygiene behavior and mental health improvement.
Collapse
Affiliation(s)
- Kamal Mezian
- Department of Rehabilitation Medicine, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Laura Hrehová
- Institute of General Practice, First Faculty of Medicine, Charles University, Prague, Czech Republic
| |
Collapse
|
38
|
Vancampfort D, Mugisha J. Associations between compassion fatigue, burnout and secondary traumatic stress with lifestyle factors in mental health nurses: A multicenter study from Uganda. Arch Psychiatr Nurs 2022; 41:221-226. [PMID: 36428053 DOI: 10.1016/j.apnu.2022.08.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 08/22/2022] [Accepted: 08/22/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE This cross-sectional study aimed (a) to explore levels of compassion satisfaction, secondary traumatic stress, and symptoms of burnout among Ugandan mental health nurses working in regional referral hospitals in Uganda during the Covid-19 pandemic, and (b) to investigate associations between compassion satisfaction, secondary traumatic stress, and symptoms of burnout and sedentary levels, physical activity (PA) levels, sleep quality, and harmful drinking. MATERIAL AND METHODS In total 108 mental health nurses from 8 regional referral hospitals across Uganda (age = 34.8 ± 10.0 years; 55.6 % female) completed the Professional Quality of Life Scale-5, (PQoLS-5), the Simple Physical Activity Questionnaire (SIMPAQ), Physical Activity Vital Sign (PAVS), Pittsburgh Sleep Quality Index (PSQI), and Alcohol Use Disorder Identification Test - Concise (AUDIT-C). Spearman Rho correlations and Mann-Whitney U tests were applied. RESULTS ProQOL-5 compassion satisfaction correlated significantly with SIMPAQ walking, PSQI and AUDIT-C, ProQOL-5 burnout with SIMPAQ exercise and PSQI and ProQOL-5 traumatic with SIMPAQ walking and PSQI. Mental health nurses meeting PA guidelines reported higher ProQOL-5 compassion satisfaction and lower ProQOL-5 burnout and traumatic stress than those who did not. Those who reported a poor sleep quality reported significantly less ProQOL-5 compassion satisfaction and higher ProQOL-5 burnout than those who did not. Those who reported harmful drinking patterns reported a significantly lower compassion satisfaction versus those who did not. DISCUSSION In mental health nurses, a lower professional quality of life is associated with an unhealthy lifestyle. The effectiveness and efficacy of resilience and self-care programs for mental health nurses focusing on unhealthy lifestyle patterns should be explored.
Collapse
Affiliation(s)
- Davy Vancampfort
- Department of Rehabilitation Sciences, Faculty of Movement and Rehabilitation Sciences, KU Leuven, Leuven, Belgium.
| | - James Mugisha
- Department of Sociology and Social Administration, Faculty of Arts and Social Sciences, Kyambogo University, Kampala, Uganda
| |
Collapse
|
39
|
Youssef D, Youssef J, Abou-Abbas L, Kawtharani M, Hassan H. Prevalence and correlates of burnout among physicians in a developing country facing multi-layered crises: a cross-sectional study. Sci Rep 2022; 12:12615. [PMID: 35871153 PMCID: PMC9308770 DOI: 10.1038/s41598-022-16095-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 07/04/2022] [Indexed: 02/07/2023] Open
Abstract
AbstractBurnout among physicians is a serious concern that cultivates its seeds during their education. This study assessed the prevalence of burnout among Lebanese physicians and explored its correlates and the combined effects of the pandemic and the economic crisis on burnout. A web-based cross-sectional study was conducted in December 2020 using a snowball sampling technique. Moderate and high levels of burnout hit 90.7% of the physicians where personal, work-related, and client-related burnout were detected among 80.4%, 75.63%, and 69.6% of them respectively. A strong association was found between the higher level of burnout and female gender, younger age, being single, having a dependent child, living with an elderly or a family member with comorbidities, and insufficient sleeping hours. Physicians’ specialties, working in a public health facility, limited years of professional experience, lack of previous experience in a pandemic, and extensive working hours were also associated with increased burnout. Furthermore, low income, working in the frontline, higher threat perception, and fear of COVID-19 were contributing to higher burnout. The combined effect of threat perception and financial hardship significantly increased burnout levels. The alarming burnout level detected among physicians urges health authorities to take prompt actions to enhance the physicians’ well-being.
Collapse
|
40
|
Shaik L, Cheema MS, Subramanian S, Kashyap R, Surani SR. Sleep and Safety among Healthcare Workers: The Effect of Obstructive Sleep Apnea and Sleep Deprivation on Safety. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58121723. [PMID: 36556925 PMCID: PMC9788062 DOI: 10.3390/medicina58121723] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 11/16/2022] [Accepted: 11/21/2022] [Indexed: 11/26/2022]
Abstract
Almost one billion people worldwide are affected by Obstructive Sleep Apnea (OSA). Affected individuals experience disordered breathing patterns during sleep, which results in fatigue, daytime drowsiness, and/or sleep deprivation. Working under the influence of these symptoms significantly impairs work productivity and leads to occupational accidents and errors. This impact is seen in healthcare workers (HCWs) who are not immune to these conditions. However, poorly controlled OSA in this subset of individuals takes a heavy toll on patient care due to the increased risk of medical errors and can also alter the mental and physical well-being of the affected HCW in various ways. OSA and safety issues have been recognized and mitigated among the airline and transport industries; however, the healthcare industry lags in addressing these concerns. This article reviews hypersomnolence and sleep disorder as key clinical features of OSA and their effect on HCW safety.
Collapse
Affiliation(s)
| | - Mustafa S. Cheema
- G9QC+GGM CMH Lahore Medical College, Abdul Rehman Rd, Sarwar Colony, Lahore 54000, Pakistan
| | | | | | - Salim R. Surani
- Department of Pulmonary, Critical Care & Sleep Medicine, Texas A&M University, College Station, TX 77843, USA
- Correspondence:
| |
Collapse
|
41
|
Ślusarz R, Cwiekala-Lewis K, Wysokiński M, Filipska-Blejder K, Fidecki W, Biercewicz M. Characteristics of Occupational Burnout among Nurses of Various Specialties and in the Time of the COVID-19 Pandemic-Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13775. [PMID: 36360655 PMCID: PMC9657093 DOI: 10.3390/ijerph192113775] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 10/19/2022] [Accepted: 10/21/2022] [Indexed: 06/16/2023]
Abstract
Occupational burnout is particularly common among nurses due to their work being associated with stress, showing understanding, compassion, and commitment, along with the simultaneous need to maintain the necessary emotional distance. The aim of this review was to assess the occurrence and characterization of burnout among nurses working within neurology, geriatric care, intensive care units and with patients infected with the novel COVID-19 virus. PRISMA guidelines were used to conduct the review. The search for literature was limited to articles meeting the inclusion criteria and published from 2017 to 2022 in PubMed, Scopus, Science Direct, Google Scholar, and Wiley. A total of 768 articles from this category have been found. Ultimately, after in-depth analysis, 20 articles were included in the study. The group of respondents ranged from 49 to 3100 participants. According to the data, the percentages of nurses suffering from burnout in the presented research ranged from 14.3% to 84.7%, with the highest value of burnout among nurses who worked in the ICU during the COVID-19 pandemic. There are certain factors among nurses that significantly affect the occurrence of burnout. These include, among others, working time, age, exposure to infection and contact with infected patients, lack of training on COVID-19 prevention, providing care to an increased number of COVID-19 patients per shift, lack of personal protective equipment, lack of support of administration, lack of pay satisfaction, intrinsic motivation and turnover intention.
Collapse
Affiliation(s)
- Robert Ślusarz
- Neurological and Neurosurgical Nursing Department, Faculty of Health Science, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-821 Bydgoszcz, Poland
| | - Klaudia Cwiekala-Lewis
- School of Nursing & Health Professions, York College of Pennsylvania, York, PA 17403-3651, USA
| | - Mariusz Wysokiński
- Department of Basic Nursing, Chair of Development in Nursing, Faculty of Health Sciences, Medical University, 20-081 Lublin, Poland
| | - Karolina Filipska-Blejder
- Neurological and Neurosurgical Nursing Department, Faculty of Health Science, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-821 Bydgoszcz, Poland
| | - Wiesław Fidecki
- Department of Basic Nursing, Chair of Development in Nursing, Faculty of Health Sciences, Medical University, 20-081 Lublin, Poland
| | - Monika Biercewicz
- Clinic of Geriatrics, Faculty of Health Science, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-094 Bydgoszcz, Poland
| |
Collapse
|
42
|
Priya A, Tharion E. Sleep and Exercise among Young Doctors in a Tertiary Care Hospital in India: A Pilot Cross-Sectional Study. J Lifestyle Med 2022; 12:164-170. [PMID: 36628182 PMCID: PMC9798884 DOI: 10.15280/jlm.2022.12.3.164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 08/03/2022] [Indexed: 12/24/2022] Open
Abstract
Background Limited information is available on the sleep and propensity for daytime sleepiness in young medical doctors of India. Methods The 2-week self-reported data surrounding sleep and exercise habits, and the Epworth sleepiness scale (ESS) score obtained from volunteering doctors of a tertiary care hospital in India, were summarized as median (Q1-Q3). Comparisons with Mann-Whitney U test and correlations with Spearman's rank correlation were done. Results Forty-seven doctors (28 [26-33] years, 16 males) reported a total sleep duration (TSD) of 6.3 (6-6.7) hours, sleep latency of 9 (5.1-15.8) minutes, and ESS score of 8 (5-10). The number of days (out of 14) when the subjective feeling of 'refreshed', 'somewhat refreshed', and 'fatigued' was experienced was respectively 6 (2-9), 5 (3-8), and 1 (0-4). Junior-level doctors experienced more days of 'fatigue' than senior-level doctors (3 [0-4.3], 0 [0-0]; p = 0.002). Doctors who did not exercise reported greater days of fatigue than those who exercised (2 [0-4.8], 0 [0-2]; p = 0.047). Conclusions The young doctors of our study slept less than the recommended amount of 7 hours by the American Academy of Sleep Medicine. Their short sleep latency and normal propensity for daytime sleepiness, though encouraging, may be an effect of insufficient sleep and mentally alerting daytime schedule respectively. Notably, we found a positive association between exercise habits and subjective restoration following sleep in our study population. The sleep requirements and sleep structure among Indians are yet to be established. Our findings add to the data on sleep in the Indian context.
Collapse
Affiliation(s)
- Ankita Priya
- Department of Physiology, All India Institute of Medical Sciences, Kalyani, West Bengal, India
| | - Elizabeth Tharion
- Department of Physiology, Christian Medical College, Vellore, Tamil Nadu, India,Corresponding author: Elizabeth Tharion, Department of Physiology, Christian Medical College, Vellore, Tamil Nadu 632002, India Tel: 91-416-228-4268, Fax: 91-416-226-2788, E-mail:
| |
Collapse
|
43
|
Abdalla RN, Ansari SA, Hurley MC, Attarian H, Fargen KM, Hirsch JA, Cantrell DR, Curl PK, Daves PR, Shaibani A. Correlation of Call Burden and Sleep Deprivation with Physician Burnout, Driving Crashes, and Medical Errors among US Neurointerventionalists. AJNR Am J Neuroradiol 2022; 43:1286-1291. [PMID: 36007952 PMCID: PMC9451637 DOI: 10.3174/ajnr.a7606] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 06/27/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND AND PURPOSE High call frequency can lead to inadequate sleep, fatigue, and burnout, resulting in detrimental effects on physicians and patients. We aimed to assess the correlation between the frequency and burden of neurointerventional surgery calls and sleep deprivation with physician burnout, physical and driving safety, and fatigue-related medical errors. MATERIALS AND METHODS We sent an online questionnaire to the members of the 2 neurointerventional surgery societies comprising 50 questions and spanning 3 main topics: 1) overnight/weekend call burden, 2) sleeping patterns, and 3) Copenhagen Burnout Inventory. RESULTS One hundred sixty-four surveys were completed. Most (54%) neurointerventional surgeons reported burnout. Call burden of ≥1 every 3 days and being in practice >10 years were independent predictors of burnout. Thirty-nine percent reported falling asleep at the wheel, 23% reported a motor vehicle crash/near-crash, and 34% reported medical errors they considered related to call/work fatigue. On multivariate logistic regression, high call burden (called-in >3 times/week) was an independent predictor of sleeping at the wheel and motor vehicle crashes. Reporting <4 hours of uninterrupted sleep was an independent predictor of motor vehicle crashes and medical errors. Most neurointerventional surgeons recommended a maximum call frequency of once every 3 days. CONCLUSIONS Call frequency and burden, number of years in practice, and sleep deprivation are associated with burnout of neurointerventional surgeons, sleeping at the wheel, motor vehicle crashes, and fatigue-related medical errors. These findings contribute to the increasing literature on physician burnout and may guide future societal recommendations related to call burden in neurointerventional surgery.
Collapse
Affiliation(s)
- R N Abdalla
- From the Departments of Radiology (R.N.A., S.A.A., D.R.C., A.S.)
- Neurological Surgery (R.N.A., S.A.A., A.S.)
- Department of Radiology (R.N.A.), Ain Shams University, Cairo, Egypt
| | - S A Ansari
- From the Departments of Radiology (R.N.A., S.A.A., D.R.C., A.S.)
- Neurology (S.A.A.)
- Neurological Surgery (R.N.A., S.A.A., A.S.)
| | - M C Hurley
- Department of Radiology (M.C.H.), University of Chicago, Chicago, Illinois
| | - H Attarian
- Sleep Medicine (H.A.), Northwestern University, Feinberg School of Medicine, Chicago, Illinois
| | - K M Fargen
- Department of Neurosurgery (K.M.F.), Wake Forest University, Winston-Salem, North Carolina
| | - J A Hirsch
- Department of Radiology (J.A.H.), Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - D R Cantrell
- From the Departments of Radiology (R.N.A., S.A.A., D.R.C., A.S.)
| | - P K Curl
- Department of Radiology (P.K.C.), University of Washington, Seattle, Washington
| | - P R Daves
- Department of Finance (P.R.D.), University of Tennessee, Knoxville, Tennessee
| | - A Shaibani
- From the Departments of Radiology (R.N.A., S.A.A., D.R.C., A.S.)
- Neurological Surgery (R.N.A., S.A.A., A.S.)
| |
Collapse
|
44
|
Shreffler J, Shreffler M, Thomas A, Huecker M. Wise Exertion: Associating Stoic Thought with Stress, Well-Being, and Life Satisfaction in Physicians. Am J Lifestyle Med 2022. [DOI: 10.1177/15598276221120785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Recognition of how physicians contemplate and approach their activities, positive or negative, may shed light into a more holistic depiction of physician well-being. The purpose of this work was to develop items to measure wise cognitive exertion, constructed with Stoic thought, and determine its association with physician stress, well-being, and life satisfaction. A survey was sent to physicians and university staff members. This pilot investigation found a relationship among focusing on a purposeful life, acknowledging locus of control, avoiding wasteful cognition, and taking (good or bad) life experiences for personal growth and superior life satisfaction, well-being and lower stress. A 13-Item Wise Exertion Scale was developed and had significant associations with stress, well-being, and life satisfaction. Each of the four factors from the 13-Item Wise Exertion Scale were significantly associated with each measure with the exception of Control Consciousness and life satisfaction. Within physicians (N = 59), the 13-Item Wise Exertion Scale was a significant predictor, after adjusting for demographics with stress, well-being, and life satisfaction. Physicians had significantly lower 13-Item Wise Exertion Scale scores compared to non-physicians (N = 126). Future inquiries are required to determine if physicians with a mindset assembled with these beliefs have superior well-being.
Collapse
Affiliation(s)
- Jacob Shreffler
- Department of Emergency Medicine, University of Louisville, Louisville, KY, USA (JS, AT, MH); and Department of Health and Sports Sciences, University of Louisville, Louisville, KY, USA (MS)
| | - Megan Shreffler
- Department of Emergency Medicine, University of Louisville, Louisville, KY, USA (JS, AT, MH); and Department of Health and Sports Sciences, University of Louisville, Louisville, KY, USA (MS)
| | - Alyssa Thomas
- Department of Emergency Medicine, University of Louisville, Louisville, KY, USA (JS, AT, MH); and Department of Health and Sports Sciences, University of Louisville, Louisville, KY, USA (MS)
| | - Martin Huecker
- Department of Emergency Medicine, University of Louisville, Louisville, KY, USA (JS, AT, MH); and Department of Health and Sports Sciences, University of Louisville, Louisville, KY, USA (MS)
| |
Collapse
|
45
|
Zarei S, Fooladvand K. Mediating effect of sleep disturbance and rumination on work-related burnout of nurses treating patients with coronavirus disease. BMC Psychol 2022; 10:197. [PMID: 35962404 PMCID: PMC9372524 DOI: 10.1186/s40359-022-00905-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 08/08/2022] [Indexed: 12/05/2022] Open
Abstract
Background COVID-19 has created significant and unprecedented psychological distress on nurses working with COVID-19 patients. Nurses dealing with such psychological distress are prone to burnout. This study examined the mediating role of sleep disturbance and rumination in the association between psychological distress and work-related burnout of nurses treating COVID-19 patients. Methods A cross-sectional study was conducted from 26th February to 16th March 2021, on a sample of 250 nurses who were actively working during the COVID-19 pandemic in five referral hospitals in Tehran, Iran. The Oldenburg Burnout Inventory, Kessler Psychological Distress Scale (K10), Pittsburgh Sleep Quality Index, and Ruminative Responses Scale were used to collect data. Data analysis was based on pearson’ correlation analysis and path analysis. Results Psychological distress has a significant effect on job burnout. When sleep disturbances were modeled as a mediator, path coefficients of psychological distress showed a significant effect on job burnout. Also, according to the findings, rumination poses a significant mediating effect on the association between psychological distress and job burnout. Conclusion This study demonstrated the importance of designing psychological interventions intended to reduce sleep disturbances and rumination when experiencing stressful events to avoid job burnout among nurses.
Collapse
Affiliation(s)
- Salman Zarei
- Psychology Department, Lorestan University, Khorramabad, Iran.
| | | |
Collapse
|
46
|
A Model of Depression in University Faculty, Staff, and Health Care Workers Using an Automated Mental Health Screening Tool. J Occup Environ Med 2022; 64:607-613. [DOI: 10.1097/jom.0000000000002538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
47
|
Membrive-Jiménez MJ, Gómez-Urquiza JL, Suleiman-Martos N, Velando-Soriano A, Ariza T, De la Fuente-Solana EI, Cañadas-De la Fuente GA. Relation between Burnout and Sleep Problems in Nurses: A Systematic Review with Meta-Analysis. Healthcare (Basel) 2022; 10:954. [PMID: 35628091 PMCID: PMC9140410 DOI: 10.3390/healthcare10050954] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 05/17/2022] [Accepted: 05/19/2022] [Indexed: 02/04/2023] Open
Abstract
Burnout can affect nurses’ sleep quality. The aim of this study was to analyze the relationship between burnout syndrome and sleep problems in nurses. A systematic review with meta-analysis was performed. PubMed, CINAHL and Scopus databases were used. Some of the inclusion criteria were quantitative studies, in which the levels of burnout and sleep disorders were investigated in a sample of nurses using validated scales. A total of 12 studies were included. Sociodemographic variables did not influence the relation between burnout and sleep problems, except for being female. The environment and workplace violence, together with psychological traits and shifts, affect the probability of developing burnout and insomnia. The meta-analysis sample was n = 1127 nurses. The effect size of the correlation between burnout and sleep disorders was r = 0.39 (95% CI 0.29−0.48) with p < 0.001, indicating that the higher the level of burnout in nurses, the greater the presence of sleep disorders. The positive correlation between burnout and sleep disorders is a problem that must be addressed to improve the health of nurses. Developing turnicity strategies, using warmer lights in hospital units during night shifts and eliminating the fixed night shift could improve nurses’ working conditions.
Collapse
Affiliation(s)
| | - José Luis Gómez-Urquiza
- Faculty of Health Sciences, Campus Universitario de Ceuta, University of Granada, 51001 Ceuta, Spain;
| | - Nora Suleiman-Martos
- Faculty of Health Sciences, University of Granada, 18071 Granada, Spain; (N.S.-M.); (G.A.C.-D.l.F.)
| | | | - Tania Ariza
- Department of Educational Psychology and Psychobiology, Faculty of Education, Universidad Internacional de La Rioja (UNIR), 26006 Logroño, Spain
| | | | | |
Collapse
|
48
|
Aljabri D, Alshatti F, Alumran A, Al-Rayes S, Alsalman D, Althumairi A, Al-Kahtani N, Aljabri M, Alsuhaibani S, Alanzi T. Sociodemographic and Occupational Factors Associated With Burnout: A Study Among Frontline Healthcare Workers During the COVID-19 Pandemic. Front Public Health 2022; 10:854687. [PMID: 35356019 PMCID: PMC8959574 DOI: 10.3389/fpubh.2022.854687] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 02/04/2022] [Indexed: 11/29/2022] Open
Abstract
Purpose To describe the prevalence of burnout among frontline healthcare workers (HCWs) during the COVID-19 pandemic and the associated sociodemographic and occupational factors. Methods A cross sectional survey study was carried out to study HCWs burnout using the 19-item Full Copenhagen Burnout Inventory (CBI) that includes personal, work, and patient-related burnout subscales. Bivariate analysis was used to test for associations and p < 0.05 was considered statistically significant. Results A total of 207 responses received; where the mean score of personal burnout was 67.23, the mean of work-related burnout was 61.38, and the mean of patient-related burnout was 54.55. Significant associations were found; where female HCWs, those working in rotating day-and-night shifts, working more than 55-h per week, and who had their shift time and hours changed during the pandemic, had higher levels of personal and work-related burnout (P < 0.05). Patient-related burnout was higher among those who were single (divorced or separated), nurses, non-Citizens, those with fewer years of experience, and who were infected by COVID-19 and have been quarantined (P < 0.05). Age was not a significant factor of burnout in any of the CBI subscales. Conclusions There is a prevalent level of burnout among frontline HCWs during the COVID-19 pandemic. Findings highlight key sociodemographic and occupational factors affecting burnout; which can help planning for psychological support strategies. Furthermore, effective administrative control is important to institute policies and mechanisms to identify, and freely report burnout symptoms among HCWs to promote their wellbeing.
Collapse
Affiliation(s)
- Duaa Aljabri
- Department of Health Information Management and Technology, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Fatimah Alshatti
- Department of Health Information Management and Technology, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Arwa Alumran
- Department of Health Information Management and Technology, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Saja Al-Rayes
- Department of Health Information Management and Technology, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Deema Alsalman
- Department of Health Information Management and Technology, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Arwa Althumairi
- Department of Health Information Management and Technology, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Nouf Al-Kahtani
- Department of Health Information Management and Technology, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Mohammad Aljabri
- General Administration of Medical Consultations, Ministry of Health, Riyadh, Saudi Arabia
| | - Shaheed Alsuhaibani
- Department of Urology, College of Medicine, King Fahd University Hospital, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Turki Alanzi
- Department of Health Information Management and Technology, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| |
Collapse
|
49
|
Mahler L, Sebo P, Favrod-Coune T, Moussa A, Cohidon C, Broers B. The prevalence of five lifestyle risk factors in primary care physicians: A cross-sectional study in Switzerland. Prev Med Rep 2022; 26:101740. [PMID: 35251911 PMCID: PMC8889261 DOI: 10.1016/j.pmedr.2022.101740] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 01/18/2022] [Accepted: 02/16/2022] [Indexed: 11/16/2022] Open
Affiliation(s)
- Liv Mahler
- Institute for Family Medicine and Paediatrics, University of Geneva, Geneva, Switzerland
- Corresponding author at: Institute for Family Medicine and Paediatrics, University of Geneva, Rue Michel-Servet, 1, 1211 Geneva 4, Switzerland.
| | - Paul Sebo
- Institute for Family Medicine and Paediatrics, University of Geneva, Geneva, Switzerland
| | | | - Amir Moussa
- Institute for Family Medicine and Paediatrics, University of Geneva, Geneva, Switzerland
| | - Christine Cohidon
- Department of Family Medicine, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Barbara Broers
- Primary Care Division, Geneva University Hospital, Geneva, Switzerland
| |
Collapse
|
50
|
Duggan NM, Hasdianda MA, Baker O, Jambaulikar G, Goldsmith AJ, Condella A, Azizoddin D, Landry AI, Boyer EW, Eyre AJ. The Effect of Noise-Masking Earbuds (SleepBuds) on Reported Sleep Quality and Tension in Health Care Shift Workers: Prospective Single-Subject Design Study. JMIR Form Res 2022; 6:e28353. [PMID: 35315781 PMCID: PMC8984824 DOI: 10.2196/28353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 08/06/2021] [Accepted: 12/14/2021] [Indexed: 11/13/2022] Open
Abstract
Background Shift work is associated with sleep disorders, which impair alertness and increase risk of chronic physical and mental health disease. In health care workers, shift work and its associated sleep loss decrease provider wellness and can compromise patient care. Pharmacological sleep aids or substances such as alcohol are often used to improve sleep with variable effects on health and well-being. Objective We tested whether use of noise-masking earbuds can improve reported sleep quality, sleepiness, and stress level in health care shift workers, and increase alertness and reaction time post night shift. Methods Emergency medicine resident physicians were recruited for a prospective, single-subject design study. Entrance surveys on current sleep habits were completed. For 14 days, participants completed daily surveys reporting sleep aid use and self-rated perceived sleepiness, tension level, and last nights’ sleep quality using an 8-point Likert scale. After overnight shifts, 3-minute psychomotor vigilance tests (PVT) measuring reaction time were completed. At the end of 14 days, participants were provided noise-masking earbuds, which they used in addition to their baseline sleep regimens as they were needed for sleep for the remainder of the study period. Daily sleep surveys, post–overnight shift PVT, and earbud use data were collected for an additional 14 days. A linear mixed effects regression model was used to assess changes in the pre- and postintervention outcomes with participants serving as their own controls. Results In total, 36 residents were recruited, of whom 26 participants who completed daily sleep surveys and used earbuds at least once during the study period were included in the final analysis. The median number of days of earbud use was 5 (IQR 2-9) days of the available 14 days. On days when residents reported earbud use, previous nights’ sleep quality increased by 0.5 points (P<.001, 95% CI 0.23-0.80), daily sleepiness decreased by 0.6 points (P<.001, 95% CI –0.90 to –0.34), and total daily tension decreased by 0.6 points (P<.001, 95% CI –0.81 to –0.32). These effects were more pronounced in participants who reported worse-than-average preintervention sleep scores. Conclusions Nonpharmacological noise-masking interventions such as earbuds may improve daily sleepiness, tension, and perceived sleep quality in health care shift workers. Larger-scale studies are needed to determine this interventions’ effect on other populations of shift workers’ post–night shift alertness, users’ long-term physical and mental health, and patient outcomes.
Collapse
Affiliation(s)
- Nicole M Duggan
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, United States
| | - M Adrian Hasdianda
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, United States
| | - Olesya Baker
- Center for Clinical Investigation, Brigham and Women's Hospital, Boston, MA, United States
| | - Guruprasad Jambaulikar
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, United States
| | - Andrew J Goldsmith
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, United States
| | - Anna Condella
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, United States
| | - Desiree Azizoddin
- Health Promotion Research Center, Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Adaira I Landry
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, United States
| | - Edward W Boyer
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, United States
| | - Andrew J Eyre
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, United States
| |
Collapse
|