1
|
Kinsella EA, Smith KS, Chrestensen A. "I seemed calmer, clearer, and better able to react to challenging situations": phenomenological reflections on learning about mindfulness in health professions education. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2024:10.1007/s10459-024-10363-x. [PMID: 39249619 DOI: 10.1007/s10459-024-10363-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 08/05/2024] [Indexed: 09/10/2024]
Abstract
It is widely acknowledged that healthcare practitioner well-being is under threat, as many factors like excessive workloads, perceived lack of organizational support, the rapid introduction of new technologies, repercussions of the COVID-19 pandemic, and other factors have transformed the health care workplace. Distress, anxiety and burnout are on the rise, and are particularly concerning for health professions' students who must navigate challenging academic and clinical demands, in addition to personal responsibilities. While not a panacea for the systemic issues at play, 'mindfulness practices' have shown some promise in supporting students to navigate stressful environments. Yet despite calls for more phenomenological studies, little is known about health professions students' lived experiences of learning about and using mindfulness in higher education contexts. The objective of this hermeneutic phenomenological study was to inquire into the first-hand lived experiences of health professions students by examining their written reflections on learning about and using mindfulness in a higher education context. The study reports on themes identified in an analysis of students' phenomenological reflections written during and following a mindfulness elective course offered at a Canadian University. The analysis revealed four predominant themes: (a) reframing perceptions, (b)'being' while 'doing', (c) witnessing the struggle, and (d) compassion for self and others. In a time when health professionals are increasingly under strain, and systemic reform is needed but slow to take shape, the findings of this study reveal potential affordances of mindfulness for helping students to navigate the myriad of challenges they face. The findings are unique in their in-depth exploration of students' reflections on the experience of learning about and engaging in 'mindfulness practices' in a higher education context. The findings contribute first-hand perspectives to the evolving field of mindfulness education research and generate new conversations about mindfulness education in the health professions curriculum.
Collapse
Affiliation(s)
- Elizabeth Anne Kinsella
- Institute of Health Sciences Education, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada.
| | - Kirsten Sarah Smith
- Azireli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Allison Chrestensen
- Institute of Health Sciences Education, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| |
Collapse
|
2
|
Lodha S, Luzum N, Washabaugh C, Allen A, Stinnett S, Woodard C, Fekrat S. Evaluating the Impact of Gender and Race on Otolaryngology Resident Experiences Across the United States. Otolaryngol Head Neck Surg 2024. [PMID: 39224039 DOI: 10.1002/ohn.966] [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: 06/22/2024] [Revised: 08/01/2024] [Accepted: 08/18/2024] [Indexed: 09/04/2024]
Abstract
OBJECTIVE Otolaryngology residents often encounter work-related stress and challenges during training. Sociodemographic factors influence experiences during residency; however, the impact of race and gender on otolaryngology trainee well-being during residency remains understudied. STUDY DESIGN Online survey. SETTING US residency programs. METHODS An anonymous online survey consisting of 59 multiple-choice questions was sent to 104 directors of Accreditation Council for Graduate Medical Education otolaryngology residency programs to distribute to residents. Respondents were queried regarding demographics and experiences with bias. Residents self-identified gender and race. Black, Hispanic/Latinx, Middle Eastern/North African, and multiracial residents were categorized as underrepresented minorities (URM). RESULTS Sixty-one US otolaryngology residents responded to the survey, the majority of whom were women (60.7%) and white (62%). Many residents endorsed a belief that receipt of research and training opportunities was negatively impacted by bias due to race (29.5%) or gender (45.9%). More women (27%) than men (13%) reported maximal burnout, and fewer men (17.4%) than women (40.5%) expressed low confidence in ability to independently care for patients. More male (47.8%) and white (31.6%) residents strongly agreed they were thriving. 94.6% of women and 33.3% of URM residents reported being mistaken for a nonphysician, compared to 0% of white male respondents. CONCLUSION Otolaryngology residents perceived differential treatment based on race and gender, with women and URM residents experiencing greater exclusion and bias, as well as increased misidentification and decreased ability to thrive. Future work includes increasing sample size for generalizability and developing interventions that uphold equity in residency training environments.
Collapse
Affiliation(s)
- Shweta Lodha
- Department of Head & Neck Surgery and Communication Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Nathan Luzum
- Department of Head & Neck Surgery and Communication Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Claire Washabaugh
- Department of Head & Neck Surgery and Communication Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Ariana Allen
- Department of Head & Neck Surgery and Communication Sciences, Duke University School of Medicine, Durham, North Carolina, USA
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina, USA
| | - Sandra Stinnett
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina, USA
| | - Charles Woodard
- Department of Head & Neck Surgery and Communication Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Sharon Fekrat
- Department of Head & Neck Surgery and Communication Sciences, Duke University School of Medicine, Durham, North Carolina, USA
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina, USA
| |
Collapse
|
3
|
Casagrande Y, Newton K, Strum E, Unger JB. Health Care Workers' Reflections, Experiences, and Sequela throughout the COVID-19 Pandemic. J Occup Environ Med 2024; 66:e430-e434. [PMID: 39016288 DOI: 10.1097/jom.0000000000003176] [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: 07/18/2024]
Abstract
OBJECTIVE Health care workers (HCW) experienced significant stress during the COVID-19 pandemic. This qualitative study describes how they contextualized the experience several years later. METHODS In August 2023, 1832 HCW at an academic medical center completed a confidential electronic survey; 443 of them responded to an open-ended question about their experiences during the pandemic. The statements were analyzed qualitatively, using a grounded theory approach to allow themes to emerge from the data. RESULTS Common themes included fear/anxiety (22%), burnout (15%), protecting family from risk (11%), lack of employer support (11%), fear of illness (8%), increased appreciation for life (8%), and exposure to death/illness (5%). CONCLUSION HCW experienced substantial stress during the pandemic. Mental health services and structural changes in the health care system are needed to protect HCW during future public health emergencies.
Collapse
Affiliation(s)
- Yolee Casagrande
- From the Department of Nursing, Keck Medical Center of University of Southern California; Department of Emergency Medicine, Los Angeles County General Medical Center (K.N.); Keck Medicine of the University of Southern California, Los Angeles, California (K.N.); Department of Anesthesiology, Keck Medicine of the University of Southern California, Los Angeles, California (E.S.); and Department of Population and Public Health Sciences, Keck Medicine of the University of Southern California, Los Angeles, California (J.B.U.)
| | | | | | | |
Collapse
|
4
|
Liu H, Fei C, Zhang X, Yang L, Ji X, Zeng Q, Liu J, Song J, Yan Z. What we learned from the infection control and what we need in the future: A quantitative and qualitative study on hospital infection prevention and control practitioners (HIPCPs) in Tianjin, China. Am J Infect Control 2024; 52:1073-1083. [PMID: 38740285 DOI: 10.1016/j.ajic.2024.05.004] [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: 01/10/2024] [Revised: 05/03/2024] [Accepted: 05/08/2024] [Indexed: 05/16/2024]
Abstract
BACKGROUND In December 2022, the epidemic prevention and control policy was upgraded, and China entered a different stage of epidemic control. This study aims to identify implications for better infection control and health care supply during the epidemic. METHODS A longitudinal quantitative and qualitative study was performed based on 2 comprehensive questionnaire surveys among 497 hospital infection prevention and control practitioners (HIPCPs) before and during the epidemic peak in Tianjin, China. RESULTS The workload (8.2 hours vs 10.14 hours, P = 0) and self-reported mental health problems (23.5% vs 61.8%, P < .05) among the HIPCPs increased significantly in the peak period. Ward reconstruction and resource coordination were the most needed jobs in hospital infection control, and rapidly increased medical waste during the epidemic needs to be considered in advance. Community support for health care personnel and their families, maintaining full PPE to reduce simultaneous infection of medical staff, and clinical training of infectious diseases for medical staff, especially doctors, in advance are the most important things we learned. CONCLUSION Although it has been 4 years since the first outbreak of coronavirus disease 2019, more improvements should be made to prepare for the next epidemic of potential diseases.
Collapse
Affiliation(s)
- He Liu
- Department of Disinfection and Nosocomial Infection Control, Tianjin Centers for Disease Control and Prevention, Tianjin, China.
| | - Chunnan Fei
- Department of Disinfection and Nosocomial Infection Control, Tianjin Centers for Disease Control and Prevention, Tianjin, China
| | - Xiaojuan Zhang
- Department of Disinfection and Nosocomial Infection Control, Tianjin Centers for Disease Control and Prevention, Tianjin, China
| | - Lei Yang
- Department of Medicine, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Xueyue Ji
- Department of Disinfection and Nosocomial Infection Control, Tianjin Centers for Disease Control and Prevention, Tianjin, China
| | - Qili Zeng
- Department of Disinfection, Hubei Centers for Disease Control and Prevention, Hubei, China
| | - Jun Liu
- Department of Disinfection and Nosocomial Infection Control, Tianjin Centers for Disease Control and Prevention, Tianjin, China
| | - Jia Song
- Department of Disinfection and Nosocomial Infection Control, Tianjin Centers for Disease Control and Prevention, Tianjin, China
| | - Zheng Yan
- Department of Disinfection and Nosocomial Infection Control, Tianjin Centers for Disease Control and Prevention, Tianjin, China
| |
Collapse
|
5
|
Merrigan JJ, Klatt M, Quatman-Yates C, Emerson A, Kronenberg J, Orr M, Caputo J, Daniel K, Summers R, Mulugeta Y, Steinberg B, Hagen JA. Incorporating biofeedback into the Mindfulness in Motion Intervention for health care professionals: Impact on sleep and stress. Explore (NY) 2024; 20:103022. [PMID: 38981179 DOI: 10.1016/j.explore.2024.103022] [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: 09/12/2023] [Revised: 06/16/2024] [Accepted: 06/22/2024] [Indexed: 07/11/2024]
Abstract
CONTEXT Health care providers (HCP) experience high stress and burnout rates. Mindfulness Based Interventions (MBI) with biofeedback may help improve resiliency but require further research. DESIGN AND STUDY PARTICIPANTS Aims were to evaluate changes in sleep patterns, nocturnal physiology, stress, mood disturbances, and perceived experience with biofeedback during the Mindfulness in Motion (MIM) intervention. Data from 66 HCP were included after removing those below 75 % compliance with wearable sensors and wellness surveys. Participants were enrolled in MIM, including eight weekly one-hour virtually delivered synchronous group meetings and ∼10 min of mindfulness home practice at least 3 times per week using a mobile application. Participants wore wearable sensors to monitor sleep and nocturnal physiology and completed short daily stress and mood disturbances. RESULTS According to mixed effect models, no sleep nor physiological metrics changed across MIM (p > 0.05). More time was spent in bed after MIM sessions (8.33±1.03 h) compared to night before (8.05±0.93 h; p = 0.040). Heart rate variability was lower nights after MIM (33.00±15.59 ms) compared to nights before (34.50±17.04 ms; p = 0.004) but was not clinically meaningful (effect= 0.033). Significant reductions were noted in perceived stress at weeks 3 through 8 compared to Baseline and lower Total Mood Disturbance at weeks 3, 5, 6, and 8 compared to Baseline (p < 0.001). CONCLUSIONS Participating in the MIM with mobile applications and wearable sensors reduced perceived stress and mood disturbances but did not induce physiological changes. Additional research is warranted to further evaluate objective physiological outcomes while controlling for confounding variables (e.g., alcohol, medications).
Collapse
Affiliation(s)
- Justin J Merrigan
- Human Performance Collaborative, Office of Research, The Ohio State University, Columbus, OH, USA.
| | - Maryanna Klatt
- Center for Integrative Health, Department of Family and Community Medicine, College of Medicine, Columbus, OH, USA; Gabbe Health and Wellbeing, The Ohio State University Wexner Medical Center, The Ohio State University, Columbus, OH, USA.
| | - Catherine Quatman-Yates
- School of Health and Rehabilitation Sciences, Division of Physical Therapy, The Ohio State University, Columbus, OH, USA.
| | - Angela Emerson
- Human Performance Collaborative, Office of Research, The Ohio State University, Columbus, OH, USA
| | - Jamie Kronenberg
- Human Performance Collaborative, Office of Research, The Ohio State University, Columbus, OH, USA
| | - Morgan Orr
- Human Performance Collaborative, Office of Research, The Ohio State University, Columbus, OH, USA
| | - Jacqueline Caputo
- Center for Integrative Health, Department of Family and Community Medicine, College of Medicine, Columbus, OH, USA
| | - Kayla Daniel
- Center for Integrative Health, Department of Family and Community Medicine, College of Medicine, Columbus, OH, USA
| | - Riley Summers
- School of Health and Rehabilitation Sciences, Division of Physical Therapy, The Ohio State University, Columbus, OH, USA
| | - Yulia Mulugeta
- Center for Integrative Health, Department of Family and Community Medicine, College of Medicine, Columbus, OH, USA
| | - Beth Steinberg
- Center for Integrative Health, Department of Family and Community Medicine, College of Medicine, Columbus, OH, USA; Gabbe Health and Wellbeing, The Ohio State University Wexner Medical Center, The Ohio State University, Columbus, OH, USA
| | - Joshua A Hagen
- Human Performance Collaborative, Office of Research, The Ohio State University, Columbus, OH, USA; Department of Integrated Systems Engineering, The Ohio State University, Columbus, OH, USA.
| |
Collapse
|
6
|
Granat L, Andersson S, Åberg D, Hadziabdic E, Sandgren A. Evaluation of the Swedish Self-Efficacy in Palliative Care Scale and exploration of nurses' and physicians' self-efficacy in Swedish hospitals: A cross-sectional study. Scand J Caring Sci 2024; 38:568-578. [PMID: 38454579 DOI: 10.1111/scs.13244] [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: 06/26/2023] [Revised: 12/19/2023] [Accepted: 02/04/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND Previous research found that healthcare professionals had low preparedness for palliative care. Thus, it is necessary to explore healthcare professionals' self-efficacy. The Swedish Self-Efficacy in Palliative Care Scale (SEPC-SE) evaluates readiness in communication, patient management and multidisciplinary teamwork; however, it should be tested on a larger population. Furthermore, the constructs of the SEPC-SE should be compared to that of the original SEPC. AIM This study aimed to evaluate the consensus between the construct validity and reliability of the SEPC and the translated and adapted SEPC-SE. Furthermore, it aimed to describe and compare the self-efficacy of nurses and physicians in hospitals and explore the associated factors. METHODS The nurses (n = 288) and physicians (n = 104) completed the SEPC-SE. Factor analysis with Cronbach's alpha evaluated validity and reliability, and an analysis using the Mann-Whitney U test compared self-efficacy and multiple linear regression-associated factors. RESULTS The SEPC-SE revealed three factors with high reliability. Education or experience in specialised palliative care was minor, especially for nurses. Self-efficacy was highest in patient management (nurses, median [md] = 74.57, physicians md = 81.71, p = 0.010) and communication (nurses md = 69.88, physicians md = 77.00, p = 0.141) and lowest in multidisciplinary teamwork (nurses md = 52.44, physicians md = 62.88, p = 0.001). The strongest associations with self-efficacy were education at work and advanced homecare experiences. In addition, there were significant associations between years in the profession, male sex, physicians and university education. CONCLUSION The SEPC-SE is valid and reliable for measuring self-efficacy. Nurses had lower self-efficacy than physicians. Physicians were associated with higher self-efficacy and had more education and experience in palliative care settings, which may explain their levels of self-efficacy.
Collapse
Affiliation(s)
- Lisa Granat
- Department of Health and Caring Sciences, Center for Collaborative Palliative Care, Linnaeus University, Växjö, Sweden
| | - Sofia Andersson
- Department of Health and Caring Sciences, Center for Collaborative Palliative Care, Linnaeus University, Växjö, Sweden
- Department of Nursing, Umeå University, Umeå, Sweden
| | | | - Emina Hadziabdic
- Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden
| | - Anna Sandgren
- Department of Health and Caring Sciences, Center for Collaborative Palliative Care, Linnaeus University, Växjö, Sweden
| |
Collapse
|
7
|
Campaz-Landazabal D, Vargas I, Sánchez E, Cots F, Plaja P, Perez-Castejón JM, Sánchez-Hidalgo A, Vázquez ML. Has cross-level clinical coordination changed in the context of the pandemic? The case of the Catalan health system. BMC Health Serv Res 2024; 24:959. [PMID: 39164709 PMCID: PMC11337784 DOI: 10.1186/s12913-024-11445-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 08/14/2024] [Indexed: 08/22/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic triggered numerous changes in health services organisation, whose effects on clinical coordination are unknown. The aim is to analyse changes in the experience and perception of cross-level clinical coordination and related factors of primary (PC) and secondary care (SC) doctors in the Catalan health system between 2017 and 2022. METHODS Comparison of two cross-sectional studies based on online surveys by means of the self-administration of the COORDENA-CAT (2017) and COORDENA-TICs (2022) questionnaires to PC and SC doctors. Final sample n = 3308 in 2017 and n = 2277 in 2022. OUTCOME VARIABLES experience of cross-level information and clinical management coordination and perception of cross-level clinical coordination in the healthcare area and related factors. Stratification variables: level of care and year. Adjusting variables: sex, years of experience, type of specialty, type of hospital, type of management of PC/SC. Descriptive bivariate and multivariate analysis using Poisson regressions models to detect changes between years in total and by levels of care. RESULTS Compared with 2017, while cross-level clinical information coordination remained relatively high, with a slight improvement, doctors of both care levels reported a worse experience of cross-level clinical management coordination, particularly of care consistency (repetition of test) and accessibility to PC and, of general perception, which was worse in SC doctors. There was also a worsening in organisational (institutional support, set objectives, time available for coordination), attitudinal (job satisfaction) and interactional factors (knowledge between doctors). The use of ICT-based coordination mechanisms such as shared electronic medical records and electronic consultations between PC and SC increased, while the participation in virtual joint clinical conferences was limited. CONCLUSIONS Results show a slight improvement in clinical information but also less expected setbacks in some dimensions of clinical management coordination and in the perception of clinical coordination, suggesting that the increased use of some ICT-based coordination mechanisms did not counteract the effect of the worsened organisational, interactional, and attitudinal factors during the pandemic. Strategies are needed to facilitate direct communication, to improve conditions for the effective use of mechanisms and policies to protect healthcare professionals and services in order to better cope with new crises.
Collapse
Affiliation(s)
- Daniela Campaz-Landazabal
- Health Policy and Health Services Research Group, Health Policy Research Unit, Consortium for Health Care and Social Services of Catalonia, Barcelona, 08022, Spain
| | - Ingrid Vargas
- Health Policy and Health Services Research Group, Health Policy Research Unit, Consortium for Health Care and Social Services of Catalonia, Barcelona, 08022, Spain.
| | - Elvira Sánchez
- Serveis de Salut Integrats Baix Empordà - Hospital de Palamós. Unitat d'Inf. Assistencial, Palamós, 17230, Spain
| | | | - Pere Plaja
- Fundació Salut Empordà, Figueres, 17600, Spain
| | | | | | - María Luisa Vázquez
- Health Policy and Health Services Research Group, Health Policy Research Unit, Consortium for Health Care and Social Services of Catalonia, Barcelona, 08022, Spain
| |
Collapse
|
8
|
D'Souza GC, Kraschnewski JL, Francis E, Heilbrunn E, Kong L, Lehman E, Osevala N, Urso J, Chamberlain L, Suda KM, McNeil L, Calo WA. Implementation of COVID-19 infection control best practices in nursing homes amid the pandemic. BMC Health Serv Res 2024; 24:941. [PMID: 39154191 PMCID: PMC11329985 DOI: 10.1186/s12913-024-11407-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 08/06/2024] [Indexed: 08/19/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic has claimed around 170,000 lives among nursing home residents and staff in the United States through April 2023. In a cluster randomized controlled trial (RCT) with 136 nursing homes, we delivered training to improve COVID-19 infection control best practices. We sought to assess the implementation of infection control practices in participating nursing homes. METHODS Concurrent with the delivery of the RCT (January-November 2021), we surveyed nursing home administrators (NHAs, n = 38) at baseline and 6-month follow-up. Using validated items from the Centers for Disease Control and Prevention (CDC), the surveys inquired about 80 infection control best-practice activities (yes/no). The survey also asked seven scales corresponding to inner setting factors that may have impacted implementation. We assessed changes in infection control practices and inner setting factors between baseline and 6-month follow-up. RESULTS Overall, the implementation of 11 best practices changed over time. NHAs reported an increase in the availability of informational materials for residents and families (84% vs. 100%, p = 0.031), the use of alcohol-based hand sanitizer over soap (76% vs. 97%, p = 0.008), and the development of contingency plans for increased postmortem care (53% vs. 82%, p = 0.013). The implementation of four best-practice visitation policies and three communal restrictions decreased between baseline and 6-month follow-up (all p < 0.05). Regarding inner setting factors, only culture stress (perceived strain, stress, and role overload) increased between surveys (mean scores: 3.14 vs. 3.58, p = 0.004). CONCLUSION This study was among the first to report changes in implementing COVID-19 infection control best practices in nursing homes amid the pandemic. Culture stress was an important inner setting factor that may have impacted implementation activities. TRIAL REGISTRATION NCT04499391 DATE OF REGISTRATION: August 3rd, 2020.
Collapse
Affiliation(s)
- Gail C D'Souza
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, United States of America
| | - Jennifer L Kraschnewski
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, United States of America.
- Department of Medicine, Penn State College of Medicine, 90 Hope Drive, Mail Code A145, Hershey, PA, 17033, United States of America.
| | - Erica Francis
- Department of Medicine, Penn State College of Medicine, 90 Hope Drive, Mail Code A145, Hershey, PA, 17033, United States of America
| | - Emily Heilbrunn
- Department of Medicine, Penn State College of Medicine, 90 Hope Drive, Mail Code A145, Hershey, PA, 17033, United States of America
| | - Lan Kong
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, United States of America
| | - Erik Lehman
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, United States of America
| | - Nicole Osevala
- Department of Medicine, Penn State College of Medicine, 90 Hope Drive, Mail Code A145, Hershey, PA, 17033, United States of America
| | - Jennifer Urso
- Guardian Healthcare Pharmacy Services, Brockway, PA, United States of America
| | - Linda Chamberlain
- Pennsylvania Department of Health, Division of Home Health, Harrisburg, PA, United States of America
| | - Kim M Suda
- Helion, A division of Highmark Health, Harrisburg, PA, United States of America
| | - Laura McNeil
- Helion, A division of Highmark Health, Harrisburg, PA, United States of America
| | - William A Calo
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, United States of America
| |
Collapse
|
9
|
Yang L, Li Z, Lei Y, Liu J, Zhang R, Lei W, Anita AR. Research hotspots and trends in healthcare workers' resilience: A bibliometric and visualized analysis. Heliyon 2024; 10:e35107. [PMID: 39170181 PMCID: PMC11336405 DOI: 10.1016/j.heliyon.2024.e35107] [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: 12/16/2023] [Revised: 07/10/2024] [Accepted: 07/23/2024] [Indexed: 08/23/2024] Open
Abstract
Background The resilience of healthcare workers has gained increasing attention, yet comprehensive studies focusing on recent trends and developments are scarce. We conducted an extensive bibliometric analysis from inception to 2023 to address this gap. Methods Publications on healthcare workers' resilience were extracted from the Web of Science Core Collection database. Bibliometric analysis was conducted with CiteSpace, VOSviewer, and Scimago Graphica, focusing on annual publications, country/region, institution, journal, author, keyword analysis, and reference co-citation analysis related to resilience in healthcare workers. Results The analysis included 750 documents, revealing a general upward trend in publications across 67 countries/regions, 1,251 institutions, and 3,166 authors. The USA and China emerged as the top contributors, with 192 and 168 publications, respectively. Based on keyword analysis and reference co-citation analysis, the focus areas include the Resilience Scale, the impact of the COVID-19 pandemic on HCWs and their resilience, and nurse resilience. Conclusion This study highlights the growing interest in healthcare workers' resilience by using bibliometric and visualization techniques for effective analysis. This paper will enhance scholars' understanding of the dynamic evolution of healthcare workers' resilience and identify emerging research topics.
Collapse
Affiliation(s)
- Luhuan Yang
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Zifeng Li
- Department of Traditional Chinese Medicine, The First College of Clinical Medical Science, Three Gorges University/Yichang Central People's Hospital, Yichang City, Hubei Province, China
| | - Yunhong Lei
- Philippine Women's University School of Nursing, Manila, Philippines
| | - Jinglan Liu
- Department of Emergency and Critical Care Medicine, The First College of Clinical Medical Science, Three Gorges University/Yichang Central People's Hospital, Yichang, Hubei Province, China
| | - Rong Zhang
- Department of Emergency and Critical Care Medicine, The First College of Clinical Medical Science, Three Gorges University/Yichang Central People's Hospital, Yichang, Hubei Province, China
| | - Wei Lei
- The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi, China
| | - Abd Rahman Anita
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| |
Collapse
|
10
|
Kranke D, Kranke B, Der-Martirosian C. We Cannot Have Next Year If We Do Not Take Care of Today. HEALTH & SOCIAL WORK 2024; 49:209-210. [PMID: 38822671 DOI: 10.1093/hsw/hlae016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 12/07/2023] [Accepted: 12/29/2023] [Indexed: 06/03/2024]
Affiliation(s)
- Derrick Kranke
- Veterans Emergency Management Evaluation Center U.S. Department of Veterans Affairs North Hills, CA, USA
| | - Bridget Kranke
- Veterans Emergency Management Evaluation Center U.S. Department of Veterans Affairs North Hills, CA, USA
| | - Claudia Der-Martirosian
- Veterans Emergency Management Evaluation Center U.S. Department of Veterans Affairs North Hills, CA, USA
| |
Collapse
|
11
|
Abdus S, Selden TM. Racial and Ethnic Disparities in Attendance to Well-Child Visit Recommendations during COVID-19. Acad Pediatr 2024; 24:922-929. [PMID: 38614214 DOI: 10.1016/j.acap.2024.04.003] [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: 08/14/2023] [Revised: 03/25/2024] [Accepted: 04/05/2024] [Indexed: 04/15/2024]
Abstract
OBJECTIVE To measure the impact of the COVID-19 pandemic on racial and ethnic disparities in attendance to well-child visit recommendations. METHODS We used the nationally representative Medical Expenditure Panel Survey (MEPS) to compare pre-pandemic (2018-2019) and pandemic (2020 and 2021) ratios of well-child visits to age-based recommendations, presenting both unadjusted and adjusted attendance disparities over time. We also used the 1996-2021 MEPS to place the pandemic changes in an historical context. RESULTS Average attendance decreased from 66.6% in 2018-2019 (95% confidence interval [CI]: 64.1, 69.1) to 58.6% in 2020 (95% CI: 55.5, 61.6), rebounding to 65.1% in 2021 (95% CI: 61.5, 68.7). The unadjusted disparity in attendance between White non-Hispanic and Black non-Hispanic children widened from 9.6 percentage points in 2018-2019 (95% CI: 2.8, 16.4) to 24.8 percentage points in 2020 (95% CI: 17.5, 32.2) and 21.4 percentage points in 2021 (95% CI: 11.2, 31.5). The unadjusted disparity in attendance between White non-Hispanic and Hispanic children widened from 14.8 percentage points in 2018-2019 (95% CI: 9.7, 19.8) to 26.3 percentage points in 2020 (95% CI: 19.9, 32.7) and 24.9 percentage points in 2021 (95% CI: 17.5, 32.3). Changes in disparities were large even when we controlled for health status, demographic and socioeconomic characteristics, health insurance, and state of residence. Magnitudes of the racial and ethnic attendance disparities during the pandemic's first two years were unprecedented since 1996. CONCLUSIONS Widening attendance disparities during the pandemic highlight the need to build a more equitable health care system for all children.
Collapse
Affiliation(s)
- Salam Abdus
- Division of Research and Modeling, Center for Financing, Access and Cost Trends, Agency for Healthcare Research and Quality, Department of Health and Human Services, Rockville, Md.
| | - Thomas M Selden
- Division of Research and Modeling, Center for Financing, Access and Cost Trends, Agency for Healthcare Research and Quality, Department of Health and Human Services, Rockville, Md
| |
Collapse
|
12
|
Kelly TD, de Venecia BT, Pang PS, Turner JS, Reed KD, Pettit KE. Bereavement scheduling policy for emergency medicine residents: A descriptive pilot study. AEM EDUCATION AND TRAINING 2024; 8:e11009. [PMID: 38993542 PMCID: PMC11234136 DOI: 10.1002/aet2.11009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 06/06/2024] [Accepted: 06/12/2024] [Indexed: 07/13/2024]
Abstract
Background The Accreditation Council for Graduate Medical Education has tasked residency programs to prioritize resident wellness, reduce trainee stress, and prevent burnout. Grief and bereavement can significantly impact residents' wellness during difficult clinical training schedules. There are no best practices on how to support residents during this time. Methods In a split academic county emergency medicine (EM) residency, this pilot study documents a resident-driven change to scheduling practices for bereavement leave. An advisory group of residents, chief residents, and program directors informally polled peer institutions to develop bereavement leave guidelines. Considerations were made to balance resident wellness, education, and patient care in developing a bereavement scheduling policy. Results The bereavement policy was adopted in January 2023, aiming to "support the resident during a difficult time and reduce concerns around shift coverage" following the death of a family member without impacting sick call. The number of covered days depended on the relationship of the resident to the deceased. Residents covering bereavement days for their peers were financially compensated. During the first 7 months following implementation, five residents utilized the policy. These residents noted this to be the most positive impact on the residency during the past year. Based on resident feedback, the scope was expanded to include grave medical illness of a family member as an implementation criterion. Conclusions This article outlines the creation, implementation, and benefits of a bereavement scheduling policy within an EM residency. Describing this approach will provide guidance for other residencies to adopt similar wellness-focused strategies.
Collapse
Affiliation(s)
| | - Bryce T. de Venecia
- Indiana University School of MedicineIndianapolisIndianaUSA
- Present address:
Rush University Medical CenterChicagoIllinoisUSA
| | - Peter S. Pang
- Indiana University School of MedicineIndianapolisIndianaUSA
| | | | - Kyra D. Reed
- Indiana University School of MedicineIndianapolisIndianaUSA
| | | |
Collapse
|
13
|
Manzella A, Ecker BL, Eskander MF, Grandhi MS, In H, Kravchenko T, Langan RC, Kennedy T, Alexander HR, Beninato T, Pitt HA. Operative trends for pancreatic and hepatic malignancies during the COVID-19 pandemic. Surgery 2024; 176:364-370. [PMID: 38582733 DOI: 10.1016/j.surg.2024.02.023] [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: 01/17/2024] [Accepted: 02/25/2024] [Indexed: 04/08/2024]
Abstract
BACKGROUND The COVID-19 pandemic disrupted routine health care, including many elective and non-cancer operations in the United States. Most hepato-pancreato-biliary malignancy patients require outpatient imaging, tissue sampling, and staging, and many undergo neoadjuvant therapy before operative intervention. The aims of this study were to evaluate the effect of the COVID-19 pandemic on hepato-pancreato-biliary oncologic operations and to determine whether trends in neoadjuvant therapy were altered by the pandemic. METHODS Adult patients in the United States undergoing oncologic operations for pancreatic, primary and secondary hepatic malignancies, with or without neoadjuvant therapy, were extracted from the Vizient Clinical Data Base. Control chart analysis was used to plot trends over time and to determine whether changes were statistically significant. Wilcoxon rank-sum tests also compared monthly operative volume from pre-pandemic (12 month) and pandemic (28 months) periods. RESULTS A total of 36,553 patients were identified over 40 months. Mean monthly pancreatic oncologic operations were unaffected by the pandemic (P = .257). Operations for pancreatic oncologic operations with prior neoadjuvant therapy increased throughout the pandemic (P = .002). Oncologic operations for primary and secondary hepatic malignancies were significantly reduced for 4 and 2 months, respectively, at the beginning of the pandemic but returned to their pre-pandemic baseline within 4 months (P = .169 and P = .598). CONCLUSION Pancreatic operation volumes for cancer did not change, but pancreatic operations after neoadjuvant therapy continued to increase during the pandemic. Operations for hepatic malignancy were transiently disrupted but quickly normalized. These observations suggest that surgery for hepato-pancreato-biliary malignancies was prioritized during the pandemic.
Collapse
Affiliation(s)
- Alexander Manzella
- Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ; Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Brett L Ecker
- Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ; Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Mariam F Eskander
- Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ; Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Miral S Grandhi
- Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ; Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Haejin In
- Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ; Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Timothy Kravchenko
- Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ; Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Russell C Langan
- Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ; Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Timothy Kennedy
- Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ; Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - H Richard Alexander
- Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ; Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Toni Beninato
- Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ; Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Henry A Pitt
- Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ; Rutgers Cancer Institute of New Jersey, New Brunswick, NJ.
| |
Collapse
|
14
|
Sos T, Melton B. A Qualitative Analysis of a Mindfulness-Based Stress Management Program to Reduce Stress and Burnout for Health Care Staff. Holist Nurs Pract 2024:00004650-990000000-00024. [PMID: 39042718 DOI: 10.1097/hnp.0000000000000662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2024]
Abstract
Occupational stress in the work setting can lead to burnout. Health care workers are at a higher risk of experiencing stress and burnout. Mindfulness has gained momentum as a coping mechanism for stress and feelings of burnout, although it is unknown which mindfulness practices are the most effective for reducing feelings of occupational stress. The purpose of the qualitative portion of this mixed-methods study was to explore health care staff's perceptions of the characteristics of mindfulness interventions that were effective in reducing their stress and feelings of burnout. Health care staff consisting of nurses, State Tested Nursing Aides, housekeeping staff, culinary staff, activities staff, social workers, and chaplain staff (N = 48) in a senior care and rehabilitation setting in a Midwestern city were invited to attend a semi-structured focus group, post-intervention. Thematic analysis was used to identify 3 main themes: ease of use promotes effective implementation, positive impact of mindfulness on self and others, and home- and work-related factors affect implementation. Overall, participants perceived benefit from various mindfulness practices for reducing their feelings of stress and burnout in the workplace. Guidance, ease of use of the mindfulness practice, and addressing barriers such as time and location can help with implementation.
Collapse
Affiliation(s)
- Tammy Sos
- Author Affiliations: Exercise Science, Cleveland State University, Cleveland, OH (Drs Sos and Melton); and Health and Human Performance Department, Concordia University Chicago, River Forest, Illinois (Dr Melton)
| | | |
Collapse
|
15
|
Lieberman AF, Ghosh Ippen C. Engaging the child-parent relationship to treat early trauma: The challenge and promise of scaling with fidelity. J Trauma Stress 2024. [PMID: 39018350 DOI: 10.1002/jts.23077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 05/27/2024] [Accepted: 05/28/2024] [Indexed: 07/19/2024]
Abstract
There is an urgent imperative to scale up access to effective, family-focused mental health services for trauma-exposed infants, toddlers, and preschoolers, who represent the most vulnerable and most underserved sector of the clinical child population. This article describes the process of scaling child-parent psychotherapy, an evidence-based treatment currently used in 39 U.S. states and six countries, as an example of the promise and challenge of large-scale implementation of relationship-based treatments.
Collapse
Affiliation(s)
- Alicia F Lieberman
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, California, USA
| | - Chandra Ghosh Ippen
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, California, USA
| |
Collapse
|
16
|
Kranke D, Kranke B, Milligan S, Dobalian A. Introducing Trauma Trigger Fatigue as an Underlying Factor of Social Work Burnout. SOCIAL WORK 2024:swae034. [PMID: 39013117 DOI: 10.1093/sw/swae034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 03/26/2024] [Accepted: 04/07/2024] [Indexed: 07/18/2024]
Affiliation(s)
- Derrick Kranke
- Veterans Emergency Management Evaluation Center (VEMEC), U.S. Department of Veterans Affairs (VA), 16111 Plummer Street, North Hills, CA 91343, USA
| | | | - Sharon Milligan
- Grace Longwell Coyle associate professor, Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, USA
| | | |
Collapse
|
17
|
Sullivan EE, Stephenson AL, DePuccio MJ, Anderson B, Auxier B, Henderson J, Linzer M. Workplace factors related to health care leader well-being in rural settings. J Rural Health 2024. [PMID: 38956817 DOI: 10.1111/jrh.12863] [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: 03/13/2024] [Revised: 05/13/2024] [Accepted: 06/16/2024] [Indexed: 07/04/2024]
Abstract
PURPOSE To examine which workplace factors contribute to health care leader well-being in rural settings. METHODS Working with two rurally focused organizations, we administered a Rural Leader Burnout survey to executive leaders. The survey contained 25 questions; 24 were closed-item multiple choice and 1 open-ended question. The survey was based on the Mini Z 10 item burnout survey with 5 additional items for leaders. Logistic regression and qualitative content analysis determined factors associated with job satisfaction, burnout, and intent to leave (ITL). FINDINGS There were 288 respondents (response rate 22%). Of 272 with complete data, 61.4% were women and 51.8% had worked > 10 years. About 81% reported job satisfaction, 40.2% were burned out, and 49.8% intended to leave their administrative roles within 2 years. Factors statistically associated with satisfaction were work control (OR = 3.0), values alignment with leadership (OR = 2.1), and trust in organization (OR = 2.0). Work control (OR = 0.3), trust in organization (OR = 0.4), and stress (OR = 4.1) were associated with burnout. Trust in organization (OR = 0.5), feeling valued (OR = 0.6), and stress (OR = 1.8) associated with ITL. Qualitative data revealed three themes relevant to rural leaders: (1) industry challenges, (2) daily operational issues, and (3) difficult relationships. CONCLUSIONS These exploratory analyses demonstrate practical ways to improve work conditions to mitigate burnout and turnover in rural leaders. Promoting thriving in leaders would be an important step in maintaining the rural health care workforce.
Collapse
Affiliation(s)
- Erin E Sullivan
- Department of Healthcare Administration, Sawyer Business School, Suffolk University, Boston, Massachusetts, USA
| | - Amber L Stephenson
- Healthcare Management, David D. Reh School of Business, Clarkson University, Potsdam, New York, USA
| | - Matthew J DePuccio
- Department of Health Systems Management, College of Health Sciences, Rush University, Chicago, Illinois, USA
| | | | - Bill Auxier
- Center for Rural Health Leadership, Kansas City, Missouri, USA
| | - John Henderson
- Texas Organization of Rural and Community Hospitals, Austin, Texas, USA
| | - Mark Linzer
- Department of Medicine, Hennepin Healthcare, Minneapolis, Minnesota, USA
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA
| |
Collapse
|
18
|
de Lisser R, Lauderdale J, Dietrich MS, Ramanujam R, Stolldorf DP. The Social Ecology of Burnout: A framework for research on nurse practitioner burnout. Nurs Outlook 2024; 72:102188. [PMID: 38788272 DOI: 10.1016/j.outlook.2024.102188] [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: 10/06/2023] [Revised: 03/08/2024] [Accepted: 04/27/2024] [Indexed: 05/26/2024]
Abstract
BACKGROUND The U.S. health system is burdened by rising costs, workforce shortages, and unremitting burnout. Well-being interventions have emerged in response, yet data suggest that the work environment is the problem. Nurse practitioner (NP) burnout is associated with structural and relational factors in the work environment, practice autonomy, and hierarchical leadership. PURPOSE We explore the unique social, cultural, and political environment in which NPs work through the lens of social ecology and present the Social Ecology of Burnout (SEB) framework. METHODS We review current burnout frameworks in the context of the NP practice environment and discuss the SEB, specifically exploring psychological safety and its influence on burnout. FINDINGS Psychological safety, work environment, and policy are presented within the SEB and solutions which empower NPs are considered. DISCUSSION Our framework can serve as a guide for future nursing research, practice, and policy.
Collapse
Affiliation(s)
- Rosalind de Lisser
- School of Nursing, Vanderbilt University, Nashville, TN; Department of Community Health Systems, School of Nursing, University of California San Francisco, San Francisco, CA.
| | | | - Mary S Dietrich
- School of Nursing, Vanderbilt University, Nashville, TN; Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN
| | - Rangaraj Ramanujam
- Center for Health Care Programs, Owen Graduate School of Management, Vanderbilt University, Nashville, TN
| | | |
Collapse
|
19
|
Çivilidağ A, Durmaz Ş, Uslu B. The Effect of Coronavirus (COVID-19) on Job Satisfaction, Work Stress and Burnout of Healthcare Workers: A Systematic Review and Meta-Analysis. IRANIAN JOURNAL OF PUBLIC HEALTH 2024; 53:1482-1495. [PMID: 39086423 PMCID: PMC11287602 DOI: 10.18502/ijph.v53i7.16043] [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: 08/24/2023] [Accepted: 11/15/2023] [Indexed: 08/02/2024]
Abstract
Background We aimed to examine the job satisfaction (JS), work stress (WS) and burnout (B) levels of healthcare workers (HCWs), who are at the forefront of the fight against the coronavirus (COVID-19) epidemic process, which negatively affects the whole world, by meta-analysis. Methods Articles, theses and papers in the literature before the COVID-19 (2014-2019) and during COVID-19 (2020-2022) were systematically reviewed. The sample size of 54 studies conducted from 13 countries was 49.139. Data analysis was performed with the Comprehensive Meta-analysis (CMA) 3.0 Version program. Results According to the random effect model analysis result, a negative, significant and low-level relationship was found between WS and JS, before and during COVID-19. There was a negative, significant and medium level relationship between JS and B. It was found positive, significant and high-level relationship between WS and B. Human development level (HDL) has a moderating effect on WS and B. In addition, sample size has moderating effect on WS and JS. Conclusion During the prolonged COVID-19 pandemic, HCWs have experienced more burnout due to strict isolation, working conditions requiring overtime, fatigue, insomnia and concerns about virus transmission. Intense work tempo, inadequate health equipment, patient deaths, and low wages are the factors that decrease JS and increase WS and B. It is recommended to improve working conditions globally and provide financial support and mental health protection for HCWs.
Collapse
Affiliation(s)
- Aydın Çivilidağ
- Department of Psychology, Akdeniz University, Antalya, Türkiye
| | - Şerife Durmaz
- Department of Labour Economics and Industrial Relations, Akdeniz University, Antalya, Türkiye
| | - Berk Uslu
- Akdeniz University Institute of Social Sciences, Akdeniz University, Antalya, Türkiye
| |
Collapse
|
20
|
Zerden LDS. Social Work and Burnout: Everything, Everywhere, All at Once. SOCIAL WORK 2024; 69:217-219. [PMID: 38745383 DOI: 10.1093/sw/swae021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/23/2024] [Indexed: 05/16/2024]
|
21
|
Shenoy ES, Banach DB, Batshon LJ, Branch-Elliman W, Dumyati G, Haessler S, Hsu VP, Jump RLP, Malani AN, Mathew TA, Murthy RK, Pergam SA, Seeger MW, Weber DJ. SHEA position statement on pandemic preparedness for policymakers: the role of healthcare epidemiologists in communicating during infectious diseases outbreaks. Infect Control Hosp Epidemiol 2024:1-5. [PMID: 38836649 DOI: 10.1017/ice.2024.63] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2024]
Affiliation(s)
- Erica S Shenoy
- Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Mass General Brigham, Boston, MA, USA
| | - David B Banach
- School of Medicine, University of Connecticut, Farmington, CT, USA
- Public Health, Yale School, New Haven, CT, USA
| | | | - Westyn Branch-Elliman
- Veterans Affairs Boston Healthcare System, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Ghinwa Dumyati
- University of Rochester Medical Center, Rochester, NY, USA
- Center for Community Health, Rochester, NY, USA
| | - Sarah Haessler
- Baystate Medical Center, Springfield, MA, USA
- University of Massachusetts Chan Medical School - Baystate, Springfield, MA, USA
| | - Vincent P Hsu
- AdventHealth, Altamonte Springs, FL, USA
- School of Medicine, Loma Linda University, Loma Linda, CA, USA
| | - Robin L P Jump
- Geriatric Research Education and Clinical Center (GRECC) at the Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA, USA
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | | | - Trini A Mathew
- HealthTAMCycle3, PLLC, Troy, MI, USA
- Corewell Health, Taylor, MI, USA
- School of Medicine, Wayne State University, Detroit, and Oakland University William Beaumont, Rochester, MI, USA
| | - Rekha K Murthy
- Cedars-Sinai, Los Angeles, CA, USA
- David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Steven A Pergam
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- University of Washington, Seattle, WA, USA
- Seattle Cancer Care Alliance, Seattle, WA, USA
| | | | | |
Collapse
|
22
|
Stillman M, Sullivan EE, Prasad K, Sinsky C, Deubel J, Jin JO, Brown R, Nankivil N, Linzer M. Understanding what leaders can do to facilitate healthcare workers' feeling valued: improving our knowledge of the strongest burnout mitigator. BMJ LEADER 2024:leader-2023-000921. [PMID: 38649265 DOI: 10.1136/leader-2023-000921] [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: 10/05/2023] [Accepted: 03/21/2024] [Indexed: 04/25/2024]
Abstract
AIM Feeling valued is a striking mitigator of burnout yet how to facilitate healthcare workers (HCWs) feeling valued has not been adequately studied. This study discovered factors relating to HCWs feeling valued so leaders can mitigate burnout and retain their workforce. METHOD The Coping with COVID-19 survey, initiated in March 2020 by the American Medical Association, was distributed to 208 US healthcare organisations. Of the respondents, 37 685 physicians, advanced practice clinicians, nurses, and other clinical staff answered questions that assessed burnout, intent to leave and whether they felt valued.Quantitative analysis looked at odds of burnout and intent to leave among the highest versus lowest feeling valued (FV) groups. Open-ended comments provided by 5559 respondents with high or low sense of FV were analysed to understand aspects of work life that contributed to FV. RESULTS Of 37 685 respondents, 45% felt valued; HCWs who felt highly valued had 8.3 times lower odds of burnout and 10.2 lower odds of intent to leave than those who did not feel valued at all. Qualitative data identified six themes associated with FV: (1) physical safety, (2) compensation and pandemic-related finances, (3) transparent and frequent communication, (4) effective teamwork, (5) empathetic and respectful leaders, and (6) organisational support. CONCLUSION This US study demonstrates that FV correlates with burnout and intent to leave, yet only 45% of HCWs feel valued. Six themes link to interventions leaders can follow to facilitate HCWs FV and potentially reduce burnout and increase retention for a challenged healthcare workforce.
Collapse
Affiliation(s)
- Martin Stillman
- Department of Medicine, Hennepin Healthcare System, Minneapolis, Minnesota, USA
- Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Erin E Sullivan
- Sawyer School of Business, Suffolk University, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Kriti Prasad
- Department of Medicine, Boston Medical Center, Boston, Massachusetts, USA
| | | | - Jordyn Deubel
- Sawyer School of Business, Suffolk University, Boston, Massachusetts, USA
| | - Jill O Jin
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Roger Brown
- School of Nursing, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | | | - Mark Linzer
- Department of Medicine, Hennepin Healthcare System, Minneapolis, Minnesota, USA
- Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| |
Collapse
|
23
|
Loudet CI, Jorro Barón F, Reina R, Arias López MDP, Alegría SL, Barrios CDV, Buffa R, Cabana ML, Cunto ER, Fernández Nievas S, García MA, Gibbons L, Izzo G, Llanos MN, Meregalli C, Joaquín Mira J, Ratto ME, Rivet ML, Roberti J, Silvestri AM, Tévez A, Uranga LJ, Zakalik G, Rodríguez V, García-Elorrio E. Quality improvement collaborative for improving patient care delivery in Argentine public health sector intensive care units. BMJ Open Qual 2024; 13:e002618. [PMID: 38830729 PMCID: PMC11149125 DOI: 10.1136/bmjoq-2023-002618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 05/13/2024] [Indexed: 06/05/2024] Open
Abstract
BACKGROUND The demand for healthcare services during the COVID-19 pandemic was excessive for less-resourced settings, with intensive care units (ICUs) taking the heaviest toll. OBJECTIVE The aim was to achieve adequate personal protective equipment (PPE) use in 90% of patient encounters, to reach 90% compliance with objectives of patient flow (OPF) and to provide emotional support tools to 90% of healthcare workers (HCWs). METHODS We conducted a quasi-experimental study with an interrupted time-series design in 14 ICUs in Argentina. We randomly selected adult critically ill patients admitted from July 2020 to July 2021 and active HCWs in the same period. We implemented a quality improvement collaborative (QIC) with a baseline phase (BP) and an intervention phase (IP). The QIC included learning sessions, periods of action and improvement cycles (plan-do-study-act) virtually coached by experts via platform web-based activities. The main study outcomes encompassed the following elements: proper utilisation of PPE, compliance with nine specific OPF using daily goal sheets through direct observations and utilisation of a web-based tool for tracking emotional well-being among HCWs. RESULTS We collected 7341 observations of PPE use (977 in BP and 6364 in IP) with an improvement in adequate use from 58.4% to 71.9% (RR 1.2, 95% CI 1.17 to 1.29, p<0.001). We observed 7428 patient encounters to evaluate compliance with 9 OPF (879 in BP and 6549 in IP) with an improvement in compliance from 53.9% to 67% (RR 1.24, 95% CI 1.17 to 1.32, p<0.001). The results showed that HCWs did not use the support tool for self-mental health evaluation as much as expected. CONCLUSION A QIC was effective in improving healthcare processes and adequate PPE use, even in the context of a pandemic, indicating the possibility of expanding QIC networks nationwide to improve overall healthcare delivery. The limited reception of emotional support tools requires further analyses.
Collapse
Affiliation(s)
- Cecilia Inés Loudet
- Sociedad Argentina de Terapia Intensiva, Ciudad Autónoma de Buenos Aires, Argentina
- Hospital Interzonal General de Agudos General San Martín, La Plata, Buenos Aires, Argentina
| | - Facundo Jorro Barón
- Instituto de Efectividad Clínica y Sanitaria, Ciudad Autónoma de Buenos Aires, Argentina
| | - Rosa Reina
- Sociedad Argentina de Terapia Intensiva, Ciudad Autónoma de Buenos Aires, Argentina
| | | | | | | | | | | | - Eleonora Roxana Cunto
- Hospital de Infecciosas Dr Francisco Javier Muñiz, Ciudad Autónoma de Buenos Aires, Argentina
| | - Simón Fernández Nievas
- Instituto de Efectividad Clínica y Sanitaria, Ciudad Autónoma de Buenos Aires, Argentina
| | | | - Luz Gibbons
- Instituto de Efectividad Clínica y Sanitaria, Ciudad Autónoma de Buenos Aires, Argentina
| | - Gabriela Izzo
- Hospital Simplemente Evita, González Catán, Buenos Aires, Argentina
| | | | - Claudia Meregalli
- Sociedad Argentina de Terapia Intensiva, Ciudad Autónoma de Buenos Aires, Argentina
| | - José Joaquín Mira
- Departamento de Salud Alicante-Sant Joan, Sant Joan d'Alacant, Spain
| | - María Elena Ratto
- Sociedad Argentina de Terapia Intensiva, Ciudad Autónoma de Buenos Aires, Argentina
| | - Mariano Luis Rivet
- Hospital General de Agudos Bernardino Rivadavia, Ciudad Autónoma de Buenos Aires, Argentina
| | - Javier Roberti
- Instituto de Efectividad Clínica y Sanitaria, Ciudad Autónoma de Buenos Aires, Argentina
- CIESP/CONICET, Buenos Aires, Argentina
| | | | - Analía Tévez
- Hospital Balestrini, La Matanza, Buenos Aires, Argentina
| | | | | | - Viviana Rodríguez
- Instituto de Efectividad Clínica y Sanitaria, Ciudad Autónoma de Buenos Aires, Argentina
| | | |
Collapse
|
24
|
de Vargas D, Volpato RJ, Dos Santos LC, Pereira CF, de Oliveira SR, da Silva RR, Maciel MED, Fernandes IL, de Oliveira Santana K, Aguilar TF. Prevalence of psychological and mental health symptoms among nursing professionals during the COVID-19 pandemic in the Americas: Systematic review and meta-analysis. Int J Ment Health Nurs 2024; 33:582-599. [PMID: 38151828 DOI: 10.1111/inm.13274] [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: 04/26/2023] [Revised: 11/14/2023] [Accepted: 11/29/2023] [Indexed: 12/29/2023]
Abstract
To assess the prevalence of mental health symptoms in nursing professionals during the COVID-19 pandemic on the American continent. A systematic review and meta-analysis of observational studies that estimated the prevalence of mental health symptoms in nursing professionals during the COVID-19 pandemic was performed through bibliographic database searches. A three-level meta-analysis model was used with the inverse variance method, tau was estimated via restricted maximum likelihood and logistic transformation, and heterogeneity was presented as tau2 and I2. Of the 7467 studies obtained, 62 were included in the meta-analysis, which involved 52 270 nursing professionals. The overall prevalence for at least one mental health symptom was 56.3% (50.4%, 62.1%; I2 = 98.6%, p < 0.001). Eight mental health symptoms were found; among them, the most prevalent were burnout (52.1%, 37.1%, 88.8%; I2 = 98.5%, p < 0.001) and fear (52.1%, 30.1%, 73.3%; I2 = 98.1%, p < 0.001). The prevalence of mental health symptoms in nursing professionals during the COVID-19 pandemic on the American continent was high, and strategies should be developed and implemented by managers and government agencies to promote the well-being, physical and mental health of nursing professionals. Studies like this one are necessary to highlight the need for efforts in the implementation of promotion and prevention actions to be developed by health organisations, managers and leaders with a view to improving the quality of life of nursing workers.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Marjorie Ester Dias Maciel
- Nucleon of Addiction Nursing Research, School of Nursing (NEPEEA), University of São Paulo, São Paulo, Brazil
| | | | | | - Thiago Faustino Aguilar
- Nucleon of Addiction Nursing Research, School of Nursing (NEPEEA), University of São Paulo, São Paulo, Brazil
| |
Collapse
|
25
|
Amos TB, Griffin C, Schaffzin JK, Ankrum A, Scaggs Huang F. Adherence to Personal Protective Equipment practices during the COVID-19 pandemic: A pilot study. Infect Prev Pract 2024; 6:100369. [PMID: 38812717 PMCID: PMC11134548 DOI: 10.1016/j.infpip.2024.100369] [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: 12/14/2023] [Accepted: 04/17/2024] [Indexed: 05/31/2024] Open
Abstract
A direct observational pilot project of healthcare personnel (HCP) was conducted to validate a tool that measures personal protective equipment (PPE) adherence at a large pediatric institution. Overall unit PPE adherence for all moments ranged from 50-61%. Masking was the most adhered to PPE moment (100%); hand hygiene prior to donning PPE had the lowest adherence (13%). Using data from this standardized tool, researchers can evolve PPE standards to maximize their adherence, effectiveness, and ease of utilization.
Collapse
Affiliation(s)
- Taryn B. Amos
- Department of Psychology, Old Dominion University, Norfolk, USA
| | - Cameron Griffin
- Infection Prevention & Control Program, Cincinnati Children's Hospital, Cincinnati, USA
| | - Joshua K. Schaffzin
- Division of Infectious Diseases, Cincinnati Children's Hospital, Cincinnati, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, USA
| | - Andrea Ankrum
- Infection Prevention & Control Program, Cincinnati Children's Hospital, Cincinnati, USA
| | - Felicia Scaggs Huang
- Division of Infectious Diseases, Cincinnati Children's Hospital, Cincinnati, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, USA
| |
Collapse
|
26
|
Aafjes-Van Doorn K, Békés V, Luo X, Hopwood CJ. Therapists' perception of the working alliance, real relationship and therapeutic presence in in-person therapy versus tele-therapy. Psychother Res 2024; 34:574-588. [PMID: 37011405 DOI: 10.1080/10503307.2023.2193299] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 03/14/2023] [Indexed: 04/05/2023] Open
Abstract
Objective: Although teletherapy is increasingly common, very little is known about its impact on therapeutic relationships. We aimed to examine differences between therapists' experiences of teletherapy and in-person therapy post-pandemic with regard to three variables pertinent to the therapeutic relationship: working alliance, real relationship, and therapeutic presence. METHODS In a sample of 826 practicing therapists, we examined these relationship variables, as well as potential moderators of these perceived differences including professional and patient characteristics and covid-related variables. RESULTS Therapists reported feeling significantly less present in teletherapy and their perceptions of the real relationship were somewhat impacted, but there were no average effects on their perceived quality of the working alliance. Perceived differences in the real relationship did not persist with clinical experience controlled. The relative reduction in therapeutic presence in teletherapy was driven by the ratings of process-oriented therapists and therapists conducting mostly individual therapy. Evidence for moderation by covid-related issues was also found, with larger perceived differences in the working alliance reported by therapists who used teletherapy because it was mandated and/or not by choice. CONCLUSION Our findings might have important implications for generating awareness around the therapists' lowered sense of presence in teletherapy compared to in-person teletherapy.
Collapse
Affiliation(s)
| | - Vera Békés
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA
| | - Xiaochen Luo
- Department of Counseling Psychology, Santa Clara University, Santa Clara, CA, USA
| | | |
Collapse
|
27
|
Richards S, Wang T, Abel ED, Linzer M, Romberger D. Sustainable. Am J Med 2024; 137:552-558. [PMID: 38492767 DOI: 10.1016/j.amjmed.2024.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 03/01/2024] [Indexed: 03/18/2024]
Affiliation(s)
- Sarah Richards
- Department of Medicine, University of Nebraska Medical Center, Omaha
| | | | | | - Mark Linzer
- Department of Medicine, Hennepin Healthcare and University of Minnesota, Minneapolis.
| | - Debra Romberger
- Department of Medicine, University of Nebraska Medical Center, Omaha
| |
Collapse
|
28
|
Hochman L, Silberman N, Jung MK, Greco JL. Clinical Site Visits: Perspectives of Clinical Instructors and Site Coordinators of Clinical Education. JOURNAL, PHYSICAL THERAPY EDUCATION 2024; 38:150-160. [PMID: 38758179 DOI: 10.1097/jte.0000000000000314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 08/21/2023] [Indexed: 05/18/2024]
Abstract
INTRODUCTION Site visits (SVs) are a common component of clinical education. The purpose of this paper was to explore clinicians' perspectives regarding SVs, including methods of communication used and their effectiveness, purposes of SVs, and the level of interaction between the stakeholders. REVIEW OF THE LITERATURE Several communication methods are used to conduct SVs, with varying levels of "richness" and effectiveness. Previous studies have explored the perceptions of physical therapist (PT) students and Directors of Clinical Education regarding communication methods used during SVs, as well as reporting the purposes, effectiveness, and logistics. SUBJECTS Clinicians, including clinical instructors (CIs) and Site Coordinators of Clinical Education, from across the United States, representing various geographical locations and settings were invited to participate. METHODS An electronic survey was distributed to participants using information from 2 PT education programs and the Physical Therapist Clinical Performance Instrument database. RESULTS A total of 273 responses were included in the analysis. Clinicians ranked in-person visits as their first choice of communication for future SVs (n = 157, 59.9%) and indicated that in-person communication was "very effective" (n = 143, 52.4%) when compared with videoconferencing (n = 55, 20.1%) and telephone (n = 49, 17.9%). Clinicians ranked verifying the competency level of the student and verifying site resources during the SV as "extremely important" or "important" (n = 257, 94.2% and n = 250, 91.5%, respectively). Answering CI's questions and providing support to the CI were also identified as "extremely important" or "important" (n = 262, 96% and n = 244, 89.4%, respectively). Analysis of open-ended responses revealed 5 themes: Communication is important, flexibility allows best fit for a situation, on-site visits offer a more complete picture, real-time dialog is preferred, and email can lead to misinterpretation. DISCUSSION AND CONCLUSION Communication is a key component of the clinical-academic relationship. Although clinicians prefer in-person communication, flexibility is necessary when planning and conducting SVs. Future research recommendations include gathering student and clinician perceptions regarding faculty involvement in SVs, as well as gathering faculty perspectives regarding their participation in SVs. In addition, the impact of the pandemic on the future of SVs warrants further exploration.
Collapse
Affiliation(s)
- Lori Hochman
- Lori Hochman is an assistant professor in the Department of Physical Therapy at the New York Institute of Technology, Northern Boulevard, Wisser Library, Old Westbury, NY 11568 . Please address all correspondence to Lori Hochman
- Nicki Silberman is an associate professor in the Department of Physical Therapy at the Hunter College
- Min-Kyung Jung is a biostatistician in the College of Osteopathic Medicine at the New York Institute of Technology
- Jamie L. Greco is an assistant professor in the Doctor of Physical Therapy Division at the Duke University School of Medicine
| | - Nicki Silberman
- Lori Hochman is an assistant professor in the Department of Physical Therapy at the New York Institute of Technology, Northern Boulevard, Wisser Library, Old Westbury, NY 11568 . Please address all correspondence to Lori Hochman
- Nicki Silberman is an associate professor in the Department of Physical Therapy at the Hunter College
- Min-Kyung Jung is a biostatistician in the College of Osteopathic Medicine at the New York Institute of Technology
- Jamie L. Greco is an assistant professor in the Doctor of Physical Therapy Division at the Duke University School of Medicine
| | - Min-Kyung Jung
- Lori Hochman is an assistant professor in the Department of Physical Therapy at the New York Institute of Technology, Northern Boulevard, Wisser Library, Old Westbury, NY 11568 . Please address all correspondence to Lori Hochman
- Nicki Silberman is an associate professor in the Department of Physical Therapy at the Hunter College
- Min-Kyung Jung is a biostatistician in the College of Osteopathic Medicine at the New York Institute of Technology
- Jamie L. Greco is an assistant professor in the Doctor of Physical Therapy Division at the Duke University School of Medicine
| | - Jamie L Greco
- Lori Hochman is an assistant professor in the Department of Physical Therapy at the New York Institute of Technology, Northern Boulevard, Wisser Library, Old Westbury, NY 11568 . Please address all correspondence to Lori Hochman
- Nicki Silberman is an associate professor in the Department of Physical Therapy at the Hunter College
- Min-Kyung Jung is a biostatistician in the College of Osteopathic Medicine at the New York Institute of Technology
- Jamie L. Greco is an assistant professor in the Doctor of Physical Therapy Division at the Duke University School of Medicine
| |
Collapse
|
29
|
Dahiya P, Riano NS, Dilley JW, Olfson M, Cournos F, Mangurian C, Arnold EA. Care challenges and silver linings in HIV and behavioral health service delivery for individuals living with HIV and severe mental illness during the COVID-19 pandemic: a qualitative study. BMC Health Serv Res 2024; 24:690. [PMID: 38822307 PMCID: PMC11143645 DOI: 10.1186/s12913-024-11146-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 05/24/2024] [Indexed: 06/02/2024] Open
Abstract
BACKGROUND There has been a longstanding effort to integrate behavioral health and HIV care for people with comorbid HIV and behavioral health needs, including those with severe mental illness (SMI). As this population frequents both behavioral health and HIV care settings, they were likely to experience new obstacles to the quality and availability of care during the COVID-19 pandemic. This study aims to describe how clinics for HIV services or behavioral healthcare-as well as co-located sites providing both-sought to rapidly shift protocols to maintain a standard of patient care for people with comorbid HIV and SMI while adapting to the unprecedented circumstances of the pandemic. METHODS We interviewed HIV and behavioral healthcare providers, clinic leaders, and support service agencies that served clients impacted by both HIV and SMI. Seventeen key informants across three settings (HIV care settings, behavioral health care settings, and integrated or co-located care settings) were interviewed in 2022. Interviews focused on changes in clinical services, protocols, and care provision strategies during and at the onset of the COVID-19 pandemic. Interviews were transcribed and coded using thematic analysis. RESULTS Commonly endorsed themes included both positive and negative changes in care and care provision during the pandemic. Negative impacts of the pandemic included the loss of physical space, exacerbated mental health needs and disengagement in HIV care, patient barriers to telehealth and the digital divide, and increased healthcare workforce burnout. Positive changes included improved healthcare delivery and care engagement through telehealth, new opportunities to provide a wide range of social services, paradoxical increases in engagement in HIV care for certain patients, and broad institution of workforce wellness practices. CONCLUSIONS Though COVID-19 presented several complex barriers to care for providers serving patients with comorbid HIV and SMI, the increased flexibility afforded by telehealth and a greater focus on collaborative approaches to patient care may benefit this patient population in the future. Additionally, the focus on workforce wellness may serve to increase retention and avoid burnout among providers. The strategies and lessons learned through adapting to COVID-19 may be invaluable moving forward as healthcare systems respond to future pandemics.
Collapse
Affiliation(s)
- Priya Dahiya
- Department of Psychiatry & Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, School of Medicine, 675 18th St, San Francisco, CA, 94143, USA
| | - Nicholas S Riano
- Department of Psychiatry & Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, School of Medicine, 675 18th St, San Francisco, CA, 94143, USA
- Department of Psychological Science, School of Social Ecology, University of California Irvine. 4220 Social and Behavioral Sciences Gateway, Irvine, CA, 92697, USA
| | - James W Dilley
- Department of Psychiatry & Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, School of Medicine, 675 18th St, San Francisco, CA, 94143, USA
| | - Mark Olfson
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY, 10032, USA
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, 630 West 168th St, New York, NY, 10032, USA
| | - Francine Cournos
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, 630 West 168th St, New York, NY, 10032, USA
| | - Christina Mangurian
- Department of Psychiatry & Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, School of Medicine, 675 18th St, San Francisco, CA, 94143, USA
- Department of Epidemiology & Biostatistics, University of California San Francisco, School of Medicine, 550 16th Street, Second Floor, San Francisco, CA, 94158, USA
- Center for Vulnerable Populations, Zuckerberg San Francisco General Hospital, 2789 25th Street, Suite 350, San Francisco, CA, 94110, USA
| | - Emily A Arnold
- Center for AIDS Prevention Studies, University of California San Francisco, 550 16th Street, 3rd Floor, Box 0886, San Francisco, CA, 94143, USA.
| |
Collapse
|
30
|
Jeong S, Pyo H, Park W, Han Y. The Prediction of Stress in Radiation Therapy: Integrating Artificial Intelligence with Biological Signals. Cancers (Basel) 2024; 16:1964. [PMID: 38893087 PMCID: PMC11171009 DOI: 10.3390/cancers16111964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 05/17/2024] [Accepted: 05/20/2024] [Indexed: 06/21/2024] Open
Abstract
This study aimed to predict stress in patients using artificial intelligence (AI) from biological signals and verify the effect of stress on respiratory irregularity. We measured 123 cases in 41 patients and calculated stress scores with seven stress-related features derived from heart-rate variability. The distribution and trends of stress scores across the treatment period were analyzed. Before-treatment information was used to predict the stress features during treatment. AI models included both non-pretrained (decision tree, random forest, support vector machine, long short-term memory (LSTM), and transformer) and pretrained (ChatGPT) models. Performance was evaluated using 10-fold cross-validation, exact match ratio, accuracy, recall, precision, and F1 score. Respiratory irregularities were calculated in phase and amplitude and analyzed for correlation with stress score. Over 90% of the patients experienced stress during radiation therapy. LSTM and prompt engineering GPT4.0 had the highest accuracy (feature classification, LSTM: 0.703, GPT4.0: 0.659; stress classification, LSTM: 0.846, GPT4.0: 0.769). A 10% increase in stress score was associated with a 0.286 higher phase irregularity (p < 0.025). Our research pioneers the use of AI and biological signals for stress prediction in patients undergoing radiation therapy, potentially identifying those needing psychological support and suggesting methods to improve radiotherapy effectiveness through stress management.
Collapse
Affiliation(s)
- Sangwoon Jeong
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul 06355, Republic of Korea;
| | - Hongryull Pyo
- Department of Radiation Oncology, Samsung Medical Center, Seoul 06355, Republic of Korea; (H.P.); (W.P.)
- School of Medicine, Sungkyunkwan University, Seoul 06355, Republic of Korea
| | - Won Park
- Department of Radiation Oncology, Samsung Medical Center, Seoul 06355, Republic of Korea; (H.P.); (W.P.)
- School of Medicine, Sungkyunkwan University, Seoul 06355, Republic of Korea
| | - Youngyih Han
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul 06355, Republic of Korea;
- Department of Radiation Oncology, Samsung Medical Center, Seoul 06355, Republic of Korea; (H.P.); (W.P.)
- School of Medicine, Sungkyunkwan University, Seoul 06355, Republic of Korea
| |
Collapse
|
31
|
Ng IKS. What an aspiring medical student should know about medicine. Postgrad Med J 2024; 100:437-439. [PMID: 37812830 DOI: 10.1093/postmj/qgad089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 09/02/2023] [Accepted: 09/13/2023] [Indexed: 10/11/2023]
Affiliation(s)
- Isaac K S Ng
- Department of Medicine, National University Hospital, Singapore
| |
Collapse
|
32
|
Linzer M, Mallick S, Shah P, Becker A, Nankivil N, Poplau S, Patel SK, Nosal C, Sinsky CA, Goelz E, Stillman M, Alexandrou M, Sullivan EE, Brown R. Resident worklife and wellness through the late phase of the pandemic: a mixed methods national survey study. BMC MEDICAL EDUCATION 2024; 24:484. [PMID: 38698362 PMCID: PMC11064291 DOI: 10.1186/s12909-024-05480-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 04/26/2024] [Indexed: 05/05/2024]
Abstract
BACKGROUND System contributors to resident burnout and well-being have been under-studied. We sought to determine factors associated with resident burnout and identify at risk groups. METHODS We performed a US national survey between July 15 2022 and April 21, 2023 of residents in 36 specialties in 14 institutions, using the validated Mini ReZ survey with three 5 item subscales: 1) supportive workplace, 2) work pace/electronic medical record (EMR) stress, and 3) residency-specific factors (sleep, peer support, recognition by program, interruptions and staff relationships). Multilevel regressions and thematic analysis of 497 comments determined factors related to burnout. RESULTS Of 1118 respondents (approximate median response rate 32%), 48% were female, 57% White, 21% Asian, 6% LatinX and 4% Black, with 25% PGY 1 s, 25% PGY 2 s, and 22% PGY 3 s. Programs included internal medicine (15.1%) and family medicine (11.3%) among 36 specialties. Burnout (found in 42%) was higher in females (51% vs 30% in males, p = 0.001) and PGY 2's (48% vs 35% in PGY-1 s, p = 0.029). Challenges included chaotic environments (41%) and sleep impairment (32%); favorable aspects included teamwork (94%), peer support (93%), staff support (87%) and program recognition (68%). Worklife subscales were consistently lower in females while PGY-2's reported the least supportive work environments. Worklife challenges relating to burnout included sleep impairment (adjusted Odds Ratio (aOR) 2.82 (95% CIs 1.94, 4.19), absolute risk difference (ARD) in burnout 15.9%), poor work control (aOR 2.25 (1.42, 3.58), ARD 12.2%) and chaos (aOR 1.73 (1.22, 2.47), ARD 7.9%); program recognition was related to lower burnout (aOR 0.520 (0.356, 0.760), ARD 9.3%). These variables explained 55% of burnout variance. Qualitative data confirmed sleep impairment, lack of schedule control, excess EMR and patient volume as stressors. CONCLUSIONS These data provide a nomenclature and systematic method for addressing well-being during residency. Work conditions for females and PGY 2's may merit attention first.
Collapse
Affiliation(s)
- Mark Linzer
- Institute for Professional Worklife, Hennepin Healthcare, 701 Park Avenue, Minneapolis, MN, 55415, USA.
| | - Sanjoyita Mallick
- Department of Medicine, Hennepin Healthcare, 701 Park Avenue, Minneapolis, MN, 55415, USA
| | - Purva Shah
- American Medical Association, 330 N. Wabash Avenue, Chicago, IL, 60611, USA
| | - Anne Becker
- Department of Medicine, Hennepin Healthcare, 701 Park Avenue, Minneapolis, MN, 55415, USA
| | - Nancy Nankivil
- American Medical Association, 330 N. Wabash Avenue, Chicago, IL, 60611, USA
| | - Sara Poplau
- Institute for Professional Worklife, Hennepin Healthcare, 701 Park Avenue, Minneapolis, MN, 55415, USA
| | - Shivani K Patel
- American Medical Association, 330 N. Wabash Avenue, Chicago, IL, 60611, USA
| | - Caitlin Nosal
- American Medical Association, 330 N. Wabash Avenue, Chicago, IL, 60611, USA
| | - Christine A Sinsky
- American Medical Association, 330 N. Wabash Avenue, Chicago, IL, 60611, USA
| | - Elizabeth Goelz
- Institute for Professional Worklife, Hennepin Healthcare, 701 Park Avenue, Minneapolis, MN, 55415, USA
| | - Martin Stillman
- Institute for Professional Worklife, Hennepin Healthcare, 701 Park Avenue, Minneapolis, MN, 55415, USA
| | | | - Erin E Sullivan
- Sawyer School of Business, Harvard Medical School and Suffolk University, 73 Tremont St, Boston, MA, 02108, USA
| | - Roger Brown
- School of Nursing, University of Wisconsin, 701 Highland Avenue, Madison, WI, 53705, USA
| |
Collapse
|
33
|
Lindsay J, Cropley S, Benton A, Thompson M, Clary K. The COVID-19 Lived Experience Through the Eyes of Nursing and Social Work Students. Creat Nurs 2024; 30:145-153. [PMID: 38629129 DOI: 10.1177/10784535241247093] [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] [Indexed: 05/12/2024]
Abstract
Purpose: The purpose of this study was to explore the lived experiences of nursing and social work students who were taking courses during the COVID-19 pandemic. Focus group discussions gave students a chance to express the pandemic's effects on their education and life. Methods: A hermeneutic phenomenological approach using Van Manen's Four Lifeworld Existentials guided this study. Using an open-ended format, interviews were conducted in 6 small groups ranging from 2 to 9 individuals, in person or via Zoom. The study was conducted from May to August 2022 in a university setting with 23 participants. Results: Ten existential themes emerged: Being Behind, Groundhog Day, Trying to Keep Up, Loss of Community, Fear of COVID, Being Alone, What is Self-Care?, Is This Career Right for Me?, What is Healthy?, and Access to Counseling. Conclusions: Participants indicated that the COVID-19 pandemic negatively impacted educational delivery, limiting learning opportunities and increasing feelings of isolation, stress, and anxiety. Implications for Education and the Future Workforce: Projected health-care workforce shortages may be exacerbated by students departing from the health-care professions as a result of increased burnout. Resilience training while in school is necessary to help promote coping, self-care strategies, and retention in the health-care professions.
Collapse
Affiliation(s)
- Judith Lindsay
- St. David's School of Nursing, Texas State University, USA
| | - Stacey Cropley
- St. David's School of Nursing, Texas State University, USA
| | - Amy Benton
- School of Social Work, Texas State University, USA
| | | | - Kelly Clary
- School of Social Work, Texas State University, USA
| |
Collapse
|
34
|
2024 Alzheimer's disease facts and figures. Alzheimers Dement 2024; 20:3708-3821. [PMID: 38689398 PMCID: PMC11095490 DOI: 10.1002/alz.13809] [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] [Indexed: 05/02/2024]
Abstract
This article describes the public health impact of Alzheimer's disease (AD), including prevalence and incidence, mortality and morbidity, use and costs of care and the ramifications of AD for family caregivers, the dementia workforce and society. The Special Report discusses the larger health care system for older adults with cognitive issues, focusing on the role of caregivers and non-physician health care professionals. An estimated 6.9 million Americans age 65 and older are living with Alzheimer's dementia today. This number could grow to 13.8 million by 2060, barring the development of medical breakthroughs to prevent or cure AD. Official AD death certificates recorded 119,399 deaths from AD in 2021. In 2020 and 2021, when COVID-19 entered the ranks of the top ten causes of death, Alzheimer's was the seventh-leading cause of death in the United States. Official counts for more recent years are still being compiled. Alzheimer's remains the fifth-leading cause of death among Americans age 65 and older. Between 2000 and 2021, deaths from stroke, heart disease and HIV decreased, whereas reported deaths from AD increased more than 140%. More than 11 million family members and other unpaid caregivers provided an estimated 18.4 billion hours of care to people with Alzheimer's or other dementias in 2023. These figures reflect a decline in the number of caregivers compared with a decade earlier, as well as an increase in the amount of care provided by each remaining caregiver. Unpaid dementia caregiving was valued at $346.6 billion in 2023. Its costs, however, extend to unpaid caregivers' increased risk for emotional distress and negative mental and physical health outcomes. Members of the paid health care and broader community-based workforce are involved in diagnosing, treating and caring for people with dementia. However, the United States faces growing shortages across different segments of the dementia care workforce due to a combination of factors, including the absolute increase in the number of people living with dementia. Therefore, targeted programs and care delivery models will be needed to attract, better train and effectively deploy health care and community-based workers to provide dementia care. Average per-person Medicare payments for services to beneficiaries age 65 and older with AD or other dementias are almost three times as great as payments for beneficiaries without these conditions, and Medicaid payments are more than 22 times as great. Total payments in 2024 for health care, long-term care and hospice services for people age 65 and older with dementia are estimated to be $360 billion. The Special Report investigates how caregivers of older adults with cognitive issues interact with the health care system and examines the role non-physician health care professionals play in facilitating clinical care and access to community-based services and supports. It includes surveys of caregivers and health care workers, focusing on their experiences, challenges, awareness and perceptions of dementia care navigation.
Collapse
|
35
|
Haider A, Sullivan J, Lawrence E, Russell JC, Paul J, Greenbaum A. General Surgery Resident Participation in a Mandatory Wellness Program: Six Years Later. J Surg Res 2024; 297:83-87. [PMID: 38460453 DOI: 10.1016/j.jss.2024.02.005] [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: 03/02/2023] [Revised: 01/10/2024] [Accepted: 02/05/2024] [Indexed: 03/11/2024]
Abstract
INTRODUCTION Following the approval of a resident-created physician wellness program in 2016, an initial survey demonstrated majority support for the implementation of a mandatory curriculum. The purpose of this study is to survey surgical residents about the wellness curriculum six years after implementation and re-evaluate preference for mandatory participation. METHODS In 2016, the CORE7 Wellness Program didactic sessions were integrated into the general surgery resident education curriculum. A comparison between 2016 and 2022 resident survey results was done to examine overall approval and resident experience. RESULTS A total of 25 general surgery residents responded to the 2022 survey which equaled to a response rate of 67.5% compared to a response rate of 87.1% in 2016. Similar to the results in 2016, there was unanimous support (100%, n = 25) in favor of the ongoing development of a general surgery wellness program. The majority of residents (88% versus 85.2% in 2016) preferred quarterly "wellness half-days" remain a mandatory component of the program. In 2016, most of the residents (50%) stated that the reason for mandatory preference for wellness half-days was ease of explanation to faculty. In 2022, the reason changed to a combination of reasons with most residents (59%) selecting ease of explanation to attendings, feeling too guilty otherwise to leave the shift, and forcing the resident to think about self-care. Complaints about taking a wellness half-day from other team members increased from 29% in 2016 to 48% in 2022. CONCLUSIONS Six years after implementation, there is unanimous support for the mandatory components of a general surgery residency wellness curriculum. Increased perceived complaints from faculty and staff about resident wellness present an opportunity for improvement.
Collapse
Affiliation(s)
- Aleezay Haider
- Department of Surgery, University of New Mexico Health Sciences Center, Albuquerque, New Mexico
| | - Jessica Sullivan
- Department of Surgery, University of New Mexico Health Sciences Center, Albuquerque, New Mexico
| | - Elizabeth Lawrence
- Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico
| | - John C Russell
- Department of Surgery, University of New Mexico Health Sciences Center, Albuquerque, New Mexico
| | - Jasmeet Paul
- Department of Surgery, University of New Mexico Health Sciences Center, Albuquerque, New Mexico
| | - Alissa Greenbaum
- Department of Surgery, University of New Mexico Health Sciences Center, Albuquerque, New Mexico.
| |
Collapse
|
36
|
Pillado E, Li RD, Chia MC, Eng JS, DiLosa K, Grafmuller L, Conway A, Escobar GA, Shaw P, Sheahan MG, Bilimoria KY, Hu YY, Coleman DM. Reported pain at work is a risk factor for vascular surgery trainee burnout. J Vasc Surg 2024; 79:1217-1223. [PMID: 38215953 DOI: 10.1016/j.jvs.2024.01.003] [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: 10/30/2023] [Revised: 12/30/2023] [Accepted: 01/04/2024] [Indexed: 01/14/2024]
Abstract
BACKGROUND Work-related pain is a known risk factor for vascular surgeon burnout. It risks early attrition from our workforce and is a recognized threat to the specialty. Our study aimed to understand whether work-related pain similarly contributed to vascular surgery trainee well-being. METHODS A confidential, voluntary survey was administered after the 2022 Vascular Surgery In-Service Examination to trainees in all Accreditation Council for Graduate Medical Education-accredited vascular surgery programs. Burnout was measured by a modified, abbreviated Maslach Burnout Inventory; pain after a full day of work was measured using a 10-point Likert scale and then dichotomized as "no to mild pain" (0-2) vs "moderate to severe pain" (3-9). Univariable analyses and multivariable regression assessed associations of pain with well-being indicators (eg, burnout, thoughts of attrition, and thoughts of career change). Pain management strategies were included as additional covariables in our study. RESULTS We included 527 trainees who completed the survey (82.2% response rate); 38% reported moderate to severe pain after a full day of work, of whom 73.6% reported using ergonomic adjustments and 67.0% used over-the-counter medications. Significantly more women reported moderate to severe pain than men (44.3% vs 34.5%; P < .01). After adjusting for gender, training level, race/ethnicity, mistreatment, and dissatisfaction with operative autonomy, moderate-to-severe pain (odds ratio, 2.52; 95% confidence interval, 1.48-4.26) and using physiotherapy as pain management (odds ratio, 3.06; 95% confidence interval, 1.02-9.14) were risk factors for burnout. Moderate to severe pain was not a risk factor for thoughts of attrition or career change after adjustment. CONCLUSIONS Physical pain is prevalent among vascular surgery trainees and represents a risk factor for trainee burnout. Programs should consider mitigating this occupational hazard by offering ergonomic education and adjuncts, such as posture awareness and microbreaks during surgery, early and throughout training.
Collapse
Affiliation(s)
- Eric Pillado
- Northwestern Quality Improvement, Research, & Education in Surgery (NQUIRES) Department of Surgery, Northwestern University, Chicago, IL
| | - Ruojia Debbie Li
- Northwestern Quality Improvement, Research, & Education in Surgery (NQUIRES) Department of Surgery, Northwestern University, Chicago, IL
| | - Matthew C Chia
- Northwestern Quality Improvement, Research, & Education in Surgery (NQUIRES) Department of Surgery, Northwestern University, Chicago, IL
| | - Joshua S Eng
- Surgical Outcomes and Quality Improvement Center (SOQIC), Department of Surgery, Indiana University, Indianapolis, IN
| | - Kathryn DiLosa
- Division of Vascular Surgery, Department of Surgery, University of California, Davis, Sacramento, CA
| | - Leanne Grafmuller
- Division of Vascular Surgery, Department of Surgery, University of Rochester, Rochester, NY
| | - Allan Conway
- Division of Vascular Surgery Lenox Hill Hospital, Department of Surgery, Northwell Health, New York, NY
| | - Guillermo A Escobar
- Division of Vascular Surgery, Department of Surgery, Emory University, Atlanta, GA
| | - Palma Shaw
- Division of Vascular Surgery, Upstate Medical University, Syracuse, NY
| | - Malachi G Sheahan
- Division of Vascular and Endovascular Surgery, Louisiana State University Health Sciences Center, New Orleans, LA
| | - Karl Y Bilimoria
- Surgical Outcomes and Quality Improvement Center (SOQIC), Department of Surgery, Indiana University, Indianapolis, IN
| | - Yue-Yung Hu
- Surgical Outcomes and Quality Improvement Center (SOQIC), Department of Surgery, Indiana University, Indianapolis, IN
| | - Dawn M Coleman
- Division of Vascular and Endovascular Surgery, Department of Surgery, Duke University, Durham, NC.
| |
Collapse
|
37
|
Dye ME, Runyan P, Scott TA, Dietrich MS, Hatch LD, France D, Alrifai MW. Small Patients but a Heavy Lift: Workload and Burnout of Advanced Practice Providers and Physicians in a Level IV Neonatal Intensive Care Unit. J Perinat Neonatal Nurs 2024; 38:192-200. [PMID: 38758274 PMCID: PMC11104510 DOI: 10.1097/jpn.0000000000000804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
OBJECTIVE This study explored the association between workload and the level of burnout reported by clinicians in our neonatal intensive care unit (NICU). A qualitative analysis was used to identify specific factors that contributed to workload and modulated clinician workload in the NICU. STUDY DESIGN We conducted a study utilizing postshift surveys to explore workload of 42 NICU advanced practice providers and physicians over a 6-month period. We used multinomial logistic regression models to determine associations between workload and burnout. We used a descriptive qualitative design with an inductive thematic analysis to analyze qualitative data. RESULTS Clinicians reported feelings of burnout on nearly half of their shifts (44%), and higher levels of workload during a shift were associated with report of a burnout symptom. Our study identified 7 themes related to workload in the NICU. Two themes focused on contributors to workload, 3 themes focused on modulators of workload, and the final 2 themes represented mixed experiences of clinicians' workload. CONCLUSION We found an association between burnout and increased workload. Clinicians in our study described common contributors to workload and actions to reduce workload. Decreasing workload and burnout along with improving clinician well-being requires a multifaceted approach on unit and systems levels.
Collapse
Affiliation(s)
- M. Eva Dye
- Monroe Carell Jr. Children’s Hospital at Vanderbilt, Nashville, TN
- Department of Pediatrics, Division of Neonatology, Vanderbilt University Medical Center, Nashville, TN
| | - Patti Runyan
- Monroe Carell Jr. Children’s Hospital at Vanderbilt, Nashville, TN
| | - Theresa A. Scott
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN
| | - Mary S. Dietrich
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN
- School of Nursing, Vanderbilt University, Nashville, TN
| | - L Dupree Hatch
- Monroe Carell Jr. Children’s Hospital at Vanderbilt, Nashville, TN
- Department of Pediatrics, Division of Neonatology, Vanderbilt University Medical Center, Nashville, TN
- Center for Child Health Policy, Vanderbilt University Medical Center, Nashville, TN
| | - Daniel France
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN
- Center for Research and Innovation in Systems Safety, Vanderbilt University Medical Center, Nashville, TN
| | - Mhd Wael Alrifai
- Monroe Carell Jr. Children’s Hospital at Vanderbilt, Nashville, TN
- Department of Pediatrics, Division of Neonatology, Vanderbilt University Medical Center, Nashville, TN
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN
| |
Collapse
|
38
|
Porter-O'Grady T, Malloch K, Scott K. Renewing the Nursing Culture: Sustaining the Professional Community of Practice Through the Role of the Preceptor. Nurs Adm Q 2024; 48:87-96. [PMID: 38564719 DOI: 10.1097/naq.0000000000000639] [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: 04/04/2024]
Abstract
Culture is the driving frame within which all human action takes form. This article explores the elements and characteristics of culture and applies them to the nursing professional community of practice. As it drills down to the work in the cultural context, it argues for the central role of the preceptor in evidencing the influence of culture. For onboarding nurses and the nursing community, the preceptor becomes the carrier of culture, demonstrating the impact of culture in a way that exhibits its influence and impact on nursing practice and patient care.
Collapse
Affiliation(s)
- Tim Porter-O'Grady
- Author Affiliations: Senior Partner, Tim Porter-O'Grady Associates, Atlanta, Georgia (Dr Porter-O'Grady); Consultant, The Ohio State University, College of Nursing, Columbus, Ohio (Dr Malloch); and Partner, L3 Fusion, LLC. Phoenix, Arizona (Dr Scott)
| | | | | |
Collapse
|
39
|
Sirait SRA, Sinaga BYM, Tarigan AP, Wahyuni AS. Factors associated with cognitive impairment and the quality-of-life among COVID-19 survivors working as healthcare workers. NARRA J 2024; 4:e658. [PMID: 38798859 PMCID: PMC11125409 DOI: 10.52225/narra.v4i1.658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 03/18/2024] [Indexed: 05/29/2024]
Abstract
Prolonged physical and mental health changes, known as post-COVID conditions (PCC), could impair the quality-of-life (QoL) of healthcare workers. The aim of this study was to identify factors that contribute to cognitive impairments and QoL among COVID-19 survivors working as healthcare workers. This cross-sectional study involved healthcare workers at Prof. Dr. Chairuddin P. Lubis Universitas Sumatera Utara Hospital, Medan, Indonesia. The Montreal Cognitive Assessment (MoCA) was used to assess the cognitive function, while the World Health Organization Quality-of-Life Brief Version (WHOQOL-BREF) questionnaire was used to evaluate the QoL. Factors associated with cognitive and QoL status were examined using Mann-Whitney and Chi-squared tests. A total of 100 COVID-19 survivors were included in the study, most of whom were female (74%), aged ≤35 years (95%), and were doctors (62%). Only 22% of the participants had a normal BMI, 93% had a history of mild COVID-19, and 54% had one comorbidity. The Overall MoCA score averaged 24.18±2.86, indicating mild cognitive impairment among the groups. The distribution of MoCA scores had similar patterns with no significant differences based on age, gender, comorbidities, BMI, COVID-19 severity, and frequency of COVID-19 infection. Interestingly, the number of vaccine doses received by the participants had a statistically significant associated with MoCA scores of which those receiving more than two doses had higher cognitive scores than those with only two doses (p=0.008). Based on categorized MoCA scores (normal vs cognitive impairment), none assessed factors were not significantly associated with cognitive outcomes. The WHOQOL-BREF scores ranged from 62.5 to 95.5, with a mean±SD of 83.67±7.03. None of the assessed factors were associated with WHOQOL-BREF scores among COVID-19 survivors. These findings highlight the need for further study to explore the protective role of vaccination frequency in cognitive impairment and the factors underlying the resilience in QoL among survivors.
Collapse
Affiliation(s)
- Sondang RA. Sirait
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Bintang YM. Sinaga
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
- Department of Pulmonology and Respiratory Medicine, Prof. Dr. Chairuddin P Lubis Universitas Sumatera Utara Hospital, Medan, Indonesia
| | - Amira P. Tarigan
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
- Department of Pulmonology and Respiratory Medicine, Prof. Dr. Chairuddin P Lubis Universitas Sumatera Utara Hospital, Medan, Indonesia
| | - Arlinda S. Wahyuni
- Department of Community Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| |
Collapse
|
40
|
Childs TM, Iachini AL, Reitmeier M, Browne T, DeHart D, Bengel A, Haynesworth M. Exploring Social Work Practitioners' Perspectives on the Contributors to Burnout since the COVID-19 Pandemic. SOCIAL WORK 2024; 69:142-150. [PMID: 38366254 DOI: 10.1093/sw/swae005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 10/30/2023] [Accepted: 11/09/2023] [Indexed: 02/18/2024]
Abstract
Burnout has a historic and disproportionate impact on social workers and is one important contributor to the ongoing health and behavioral health workforce crisis in the United States. Little is known, however, about social workers' experiences of burnout and their perceptions of factors that contribute to burnout since the COVID-19 pandemic. This study sought to explore this by answering the following research questions: (a) To what extent are social workers in South Carolina experiencing burnout? and (b) What do South Carolina social workers view as the top reasons for burnout in their professional role? Seventy social work practitioners and leaders from South Carolina completed an online survey during Fall 2022 that included the Copenhagen Burnout Inventory and an open-ended question focused on identifying their perceptions of the top three reasons for burnout in the profession. Findings suggest that social workers in this study are experiencing moderate levels of burnout since the COVID-19 pandemic and report primarily organizational (83 percent) contributors to burnout. They also identified individual (36 percent), systemic (29 percent), and interpersonal (27 percent) contributors to burnout. Implications are discussed related to policy and practice responses to prevent and address burnout among social workers.
Collapse
Affiliation(s)
- Tasha M Childs
- PhD, LMSW, is assistant professor, School of Social Work, University of Missouri-Columbia, 701 Fifth Street, 726 Clark Hall, Columbia, MO 65203, USA
| | - Aidyn L Iachini
- PhD, LSW, is professor and associate dean for research and faculty, College of Social Work, University of South Carolina, Columbia, SC, USA
| | - Melissa Reitmeier
- PhD, LMSW, is director of field education and clinical professor, College of Social Work, University of South Carolina, Columbia, SC, USA
| | - Teri Browne
- PhD, LMSW, is dean and professor, College of Social Work, University of South Carolina, Columbia, SC, USA
| | - Dana DeHart
- PhD, is professor emerita, College of Social Work, University of South Carolina, Columbia, SC, USA
| | - Ala Bengel
- MSW, is HOPE-WWR project coordinator, College of Social Work, University of South Carolina, Columbia, SC, USA
| | - My'Ashia Haynesworth
- is an MSW candidate, College of Social Work, University of South Carolina, Columbia, SC, USA
| |
Collapse
|
41
|
Kranke DA, Barmaksezian N, Milligan S, Der-Martirosian C. Countering Burnout Associated with Teleworking in This Postpandemic Era. SOCIAL WORK 2024; 69:197-200. [PMID: 38366922 DOI: 10.1093/sw/swae012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 10/04/2023] [Accepted: 10/10/2023] [Indexed: 02/19/2024]
Affiliation(s)
- Derrick Alan Kranke
- PhD, is health science specialist, Veterans Emergency Management Evaluation Center (VEMEC), U.S. Department of Veterans Affairs (VA), 16111 Plummer Street, North Hills, CA 91343, USA
| | | | - Sharon Milligan
- PhD, MSW, MPH, is Grace Longwell Coyle Associate Professor, Jack, Joseph, and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, USA
| | | |
Collapse
|
42
|
Lin SC, Donney JF, Lebrun-Harris LA. Lessons Learned From Adolescent COVID-19 Vaccine Administration in Medically Underserved Communities. Public Health Rep 2024; 139:241-251. [PMID: 38240272 PMCID: PMC10851897 DOI: 10.1177/00333549231218723] [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] [Indexed: 02/09/2024] Open
Abstract
OBJECTIVES In May 2021, the Health Resources and Services Administration Health Center COVID-19 Vaccine Program (HCCVP) began supporting the national adolescent vaccination rollout for a safe return to in-person learning for children and adolescents from medically underserved communities. To understand the initial implementation of adolescent vaccinations, we estimated the number of vaccines administered through the HCCVP at the national and state level to adolescents aged 12-17 years, and we examined challenges and solutions in vaccine deployment. METHODS We analyzed data on vaccine administration, challenges, and solutions from the Health Center COVID-19 Survey during May 14-August 27, 2021, and we analyzed data on patients served from the 2019 Uniform Data System. National adolescent COVID-19 vaccination and population data came from CDC's COVID Data Tracker and the US Census Bureau's 2019 Current Population Survey. RESULTS HCCVP health centers administered >485 000 COVID-19 vaccine doses to adolescents during the study period, with variations across states. Health centers in 13 states and territories (Arizona, California, Colorado, Connecticut, Delaware, Maine, Massachusetts, Missouri, Nebraska, Nevada, Oregon, Virginia, and Puerto Rico) vaccinated more adolescents than their share of prepandemic adolescent patients. The most frequently reported challenges in vaccine administration were vaccine confidence and staffing availability. CONCLUSIONS This assessment of the initial months of COVID-19 vaccine administration among adolescent health center patients suggests rapid response by health centers in several states, reaching beyond their adolescent patient population to support state-level pandemic response. Future research could examine processes to optimize strategic activation of health centers in public health emergency responses.
Collapse
Affiliation(s)
- Sue C. Lin
- Office of Quality Improvement, Bureau of Primary Health Care, Health Resources and Services Administration, US Department of Health and Human Services, Rockville, MD, USA
| | - Julie Fife Donney
- Office of Epidemiology and Research, Maternal and Child Health Bureau, Health Resources and Services Administration, US Department of Health and Human Services, Rockville, MD, USA
| | - Lydie A. Lebrun-Harris
- Office of Epidemiology and Research, Maternal and Child Health Bureau, Health Resources and Services Administration, US Department of Health and Human Services, Rockville, MD, USA
| |
Collapse
|
43
|
Doğan A, Ertuğrul B, Akin K. Examination of workload perception, burnout, and perceived organizational support in emergency healthcare professionals: A structural equation model. Nurs Health Sci 2024; 26:e13092. [PMID: 38369305 DOI: 10.1111/nhs.13092] [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: 02/25/2023] [Revised: 12/19/2023] [Accepted: 01/20/2024] [Indexed: 02/20/2024]
Abstract
Job stress is one of the important factors affecting employee behavior. One of the most important factors in reducing burnout caused by stress is organizational support. In this context, the aim of this study is to identify the moderating role of perceived organizational support in the effect of workload perception on burnout within the emergency healthcare professionals' universe. The data for this study were collected from 703 health professionals working in emergency health services in three major cities of Turkey. The relationships and the model of the study is analyzed by the Structural Equation Model technique. The results indicate that perceived workload is a factor that causes employee burnout, and perceived organizational support is a factor that reduces employee burnout. This study contributes to researchers and health managers by revealing the importance of workload planning and organizational activities that support employees to reduce burnout in health workers.
Collapse
Affiliation(s)
- Aysun Doğan
- Vocational School of Health Services, Program of Operating Room Services, Baskent University, Ankara, Turkey
| | - Bekir Ertuğrul
- Vocational School of Health Services, Program of First and Emergency Aid, Baskent University, Ankara, Turkey
| | - Kutay Akin
- Faculty of Economics and Administrative Science, Technology and Knowledge Management, Başkent University, Ankara, Turkey
| |
Collapse
|
44
|
Vasudev K, Vasudev E, Lee C, Neumann AA, Regner A, Simpson PM, Dasgupta M, Fletcher KE. Influence of the COVID-19 Pandemic on Health-Care Career Interests Among High School Students. J Adolesc Health 2024; 74:621-624. [PMID: 38069934 DOI: 10.1016/j.jadohealth.2023.10.022] [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: 08/02/2023] [Revised: 10/05/2023] [Accepted: 10/12/2023] [Indexed: 02/05/2024]
Abstract
PURPOSE This study investigates the influence of the COVID-19 pandemic on high school students' interest in health-care careers. METHODS A voluntary web-based survey, approved by the Medical College of Wisconsin's Institutional Review Board, was administered across eight high schools in Milwaukee and its suburbs in Wisconsin. The survey collected students' demographic details, opinions on the health-care system's pandemic response, and their interest in health-care careers before and after the pandemic. RESULTS Out of 2,949 respondents, 29.9% were already contemplating a health-care career before the pandemic, with 27.7% indicating increased interest thereafter. Students not previously interested in health-care careers registered an 11.5% increase in interest due to the pandemic. Notably, the pandemic significantly boosted health-care career interest among females and freshmen. DISCUSSION The COVID-19 pandemic has distinctly influenced high school students' interest in health-care careers, notably among females and freshmen. This finding has implications for addressing projected health-care professional shortages.
Collapse
Affiliation(s)
- Krish Vasudev
- Upper School Division, University School of Milwaukee, Milwaukee, Wisconsin.
| | - Eshaan Vasudev
- Upper School Division, University School of Milwaukee, Milwaukee, Wisconsin
| | - Chloe Lee
- Brookfield Central High School, Brookfield, Wisconsin
| | | | | | - Pippa M Simpson
- Division of Quantitative Health Sciences, Department of Pediatrics, Medical College of Wisconsin, Translational & Biomedical Research Center, Children's Research Institute, Milwaukee, Wisconsin
| | - Mahua Dasgupta
- Division of Quantitative Health Sciences, Department of Pediatrics, Medical College of Wisconsin, Translational & Biomedical Research Center, Children's Research Institute, Milwaukee, Wisconsin
| | - Kathlyn E Fletcher
- Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| |
Collapse
|
45
|
Antar M, Ullerich H, Zaruchas A, Meier T, Diller R, Pannewick U, Dhayat SA. Long-Term Quality of Life after COVID-19 Infection: Cross-Sectional Study of Health Care Workers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:235. [PMID: 38397724 PMCID: PMC10887886 DOI: 10.3390/ijerph21020235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 02/01/2024] [Accepted: 02/11/2024] [Indexed: 02/25/2024]
Abstract
(1) Background: Post-COVID syndrome is defined as symptoms that occur simultaneously with or after a COVID-19 infection, last for 12 weeks, and are not due to another diagnosis. Limited data are available on people's long-term quality of life following a COVID-19 infection. The aim of this cross-sectional study was to investigate the long-term quality of life after COVID-19 among employees of a hospital in Germany and to identify risk factors. (2) Methods: A monocentric, cross-sectional study was conducted using the validated and digitized WHOQOL-BREF questionnaire via Netigate® between 10/2022 and 02/2023. Data on the quality of life and global health status were collected in the following four domains: physical health, mental health, social relationships, and the environment. (3) Results: The response rate was 73.8 % (923/1250). Furthermore, 63.4 % of the hospital staff respondents reported at least one persistent symptom after a COVID-19 infection, leading to significant differences in quality of life. Pre-existing conditions, persistent symptoms, and disabilities after a COVID-19 infection as well as a high BMI, no partnership, and a low educational level were found to significantly contribute to a low long-term quality of life. (4) Conclusions: Obesity, a lack of partnership, and a low level of education were independent risk factors for a lower quality of life post-COVID-19 infection in this cohort of hospital staff. Further multicenter studies are required to validate the incidence and their suitability as independent risk factors for post-COVID syndrome.
Collapse
Affiliation(s)
- Moussa Antar
- Department of Internal Medicine, Gastroenterology, and Pneumology, Brüderkrankenhaus St. Josef Paderborn, Husener Straße 46, 33098 Paderborn, Germany; (M.A.); (A.Z.); (U.P.)
| | - Hansjoerg Ullerich
- Department of Medicine, Gastroenterology, and Infectiology, University Hospital Muenster, Albert-Schweitzer-Campus 1 (A14), 48149 Muenster, Germany;
| | - Andreas Zaruchas
- Department of Internal Medicine, Gastroenterology, and Pneumology, Brüderkrankenhaus St. Josef Paderborn, Husener Straße 46, 33098 Paderborn, Germany; (M.A.); (A.Z.); (U.P.)
| | - Torsten Meier
- Department of Anaesthesiology, Operative Intensive Care Medicine, and Pain Therapy, Brüderkrankenhaus St. Josef Paderborn, Husener Straße 46, 33098 Paderborn, Germany;
| | - Ricarda Diller
- Department of General and Visceral Surgery, Brüderkrankenhaus St. Josef Paderborn, Husener Straße 46, 33098 Paderborn, Germany;
| | - Ulrich Pannewick
- Department of Internal Medicine, Gastroenterology, and Pneumology, Brüderkrankenhaus St. Josef Paderborn, Husener Straße 46, 33098 Paderborn, Germany; (M.A.); (A.Z.); (U.P.)
| | - Sameer A. Dhayat
- Department of General and Visceral Surgery, Brüderkrankenhaus St. Josef Paderborn, Husener Straße 46, 33098 Paderborn, Germany;
| |
Collapse
|
46
|
Schaffler Y, Probst T, Pieh C, Haid B, Humer E. Prevalence of mental health symptoms and potential risk factors among Austrian psychotherapists. Sci Rep 2024; 14:3888. [PMID: 38366010 PMCID: PMC10873375 DOI: 10.1038/s41598-024-54372-7] [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: 08/18/2023] [Accepted: 02/12/2024] [Indexed: 02/18/2024] Open
Abstract
This research focused on the intricacies of mental health within the psychotherapist community, a domain currently understudied. A recent study suggests a better overall mental health profile for Austrian psychotherapists compared to the general population. However, a substantial proportion of psychotherapists still exhibited scores beyond the cut-off for clinically significant mental disorders, potentially undermining the efficacy of patient outcomes. A cross-sectional study was conducted between April to June 2023, enrolling a cohort of 502 Austrian psychotherapists (79.7% female; mean age: 53.4 ± 9.26 years). The analysis leveraged indicators for symptoms of depression (PHQ-2), anxiety (GAD-2), insomnia (ISI-2), stress (PSS-4), and overall well-being (WHO-5). Key correlations were revealed using multivariable logistic regressions incorporating sociodemographic, work-related, and health behavior variables. Mental health symptoms in psychotherapists were associated with lower income, lesser physical activity, employment in outpatient facilities, less experience in the field, and a smaller patient load. Notably, physical activity emerged as a significant protective component, underscoring regular exercise as a vital self-care routine for psychotherapists. Adequate income also presented as a crucial contributor to mental health stability. These findings augment our understanding of the complex dynamics influencing psychotherapists' mental health, potentially enhancing their well-being and optimizing professional output.
Collapse
Affiliation(s)
- Yvonne Schaffler
- Department of Psychosomatic Medicine and Psychotherapy, University for Continuing Education Krems, Krems, Austria
| | - Thomas Probst
- Division of Psychotherapy, Department of Psychology, Paris Lodron University Salzburg, Salzburg, Austria
| | - Christoph Pieh
- Department of Psychosomatic Medicine and Psychotherapy, University for Continuing Education Krems, Krems, Austria
| | - Barbara Haid
- Austrian Federal Association for Psychotherapy, Vienna, Austria
| | - Elke Humer
- Department of Psychosomatic Medicine and Psychotherapy, University for Continuing Education Krems, Krems, Austria.
- Faculty of Psychotherapy Science, Sigmund Freud University Vienna, Vienna, Austria.
| |
Collapse
|
47
|
Musker M, Othman S. Effective interventions to reduce burnout in nurses: A meta-analysis. Complement Ther Clin Pract 2024; 54:101827. [PMID: 38181650 DOI: 10.1016/j.ctcp.2023.101827] [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: 08/24/2023] [Revised: 11/29/2023] [Accepted: 12/29/2023] [Indexed: 01/07/2024]
Abstract
BACKGROUND To examine the effectiveness of interventions to ameliorate burnout, secondary traumatic stress, and emotional exhaustion in nurses and midwives. The systematic review was completed with all available studies that reported data on the effect of interventions that targeted burnout using the outcome measures of the Professional Quality of Life scale (ProQOL), or the Maslach Burnout Inventory (MBI). METHODS We used a systematic review methodology, which included a meta-analysis. A total of 2103 articles resulted from the systematic search; 688 were removed as duplicates, and 1415 articles were reviewed by the title and abstract, of which 255 were eligible for full-text screening. Only 66 met the inclusion criteria and were included in the analysis. The final meta-analysis consisted of 33 reports divided into 12 studies for ProQOL and 21 studies for the MBI. RESULTS The results provide an overall effect in studies using the ProQOL measurement was Z = 2.07 (P = 0.04) and a positive improvement mean difference of 9.32. The overall effect in studies using MBI was Z = 3.13 (P = 0.002) and a positive improvement mean difference of 6.58. CONCLUSIONS Whilst most studies indicated a positive difference, the most effective interventions included clinical supervision or activities that addressed the personal physical and mental well-being of nurses. Less effective interventions were managerial interventions or ones that used a strictly educational approach.
Collapse
Affiliation(s)
- Mike Musker
- UniSA, Clinical & Health Sciences, Mental Health and Suicide Prevention Research and Education Group, University of South Australia, Adelaide, SA, 5000, Australia.
| | - Shwikar Othman
- Wardliparingga Aboriginal Health Equity, Population Health, South Australian Health and Medical Research Institute (SAHMRI), North Terrace, Adelaide, SA, 5000, Australia; Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, North Terrace, Adelaide, SA, 5000, Australia.
| |
Collapse
|
48
|
Hansel TC, Saltzman LY, Melton PA. Work Environment and Health Care Workforce Well-Being: Mental Health and Burnout in Medically Underserved Communities Prone to Disaster. Am J Public Health 2024; 114:156-161. [PMID: 38354340 PMCID: PMC10916726 DOI: 10.2105/ajph.2023.307478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2023] [Indexed: 02/16/2024]
Abstract
Health care workers (n = 71) completed an online survey or participated in one of five focus groups. Clinical cutoff scores revealed concerning levels of depression (16%), anxiety, and burnout (49%). Qualitative responses (n = 172) yielded two themes: work environment and well-being. Addressing burnout requires an ecological systems mindset, which accounts for complex stressors present in individual providers' lives (large-scale disasters and personal stressors), agency-level factors (scheduling and workload), and larger social and contextual administrative factors (allocating time for self-care through scheduling and billing codes). (Am J Public Health. 2024;114(S2):S156-S161. https://doi.org/10.2105/AJPH.2023.307478).
Collapse
Affiliation(s)
- Tonya Cross Hansel
- Tonya Cross Hansel, Leia Y. Saltzman, and Pamela A. Melton are with the School of Social Work, Tulane University, New Orleans, LA
| | - Leia Y Saltzman
- Tonya Cross Hansel, Leia Y. Saltzman, and Pamela A. Melton are with the School of Social Work, Tulane University, New Orleans, LA
| | - Pamela A Melton
- Tonya Cross Hansel, Leia Y. Saltzman, and Pamela A. Melton are with the School of Social Work, Tulane University, New Orleans, LA
| |
Collapse
|
49
|
Schuster RC, Wachter K, McRae K, McDaniel A, Davis OI, Nizigiyimana J, Johnson-Agbakwu CE. "If You Don't Have the Heart to Help, You Cannot Do This Job": The Multidimensional Wellbeing of Community Health Workers Serving Refugees During the COVID-19 Pandemic. QUALITATIVE HEALTH RESEARCH 2024; 34:183-194. [PMID: 37950593 DOI: 10.1177/10497323231209836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
Community health workers are members of two groups whose short- and long-term health has been uniquely shaped by the COVID-19 pandemic: health workers and the oft-marginalized populations that they serve. Yet, their wellbeing, particularly of those serving resettled refugees, before and during the pandemic has been largely overlooked. Drawing from a holistic conceptualization of wellness, this study examined the effects of the COVID-19 pandemic on a group of cultural health navigators (CHNs), who serve resettled refugees. We conducted semi-structured individual interviews with CHNs at a southwestern U.S. hospital system between July and August 2020, a critical time in the pandemic. Our analysis produced four themes that encapsulate the effects of the pandemic on CHN wellbeing: (1) "You fear for your life": Chronic risk of COVID-19 exposure takes a toll on physical, emotional, and environmental wellbeing; (2) "It is stressful because it is completely new": Uncertainty diminishes occupational, financial, and emotional wellbeing; (3) "If you don't have the heart to help, you cannot do this job": CHNs remain committed while facing challenges to their occupational wellbeing on multiple fronts; and (4) "Now, you cannot release your stress": Loss of and shifts in outlets integral to social and spiritual wellbeing. The findings deepen empirical understanding of how the pandemic affected the holistic wellbeing of CHNs, as they continued to serve their communities in a time of crisis. We discuss the implications for addressing the multidimensionality of community health worker wellbeing in research, policy, and practice.
Collapse
Affiliation(s)
- Roseanne C Schuster
- School of Human Evolution and Social Change, Arizona State University, Tempe, AZ, USA
- Office of Refugee Health, Southwest Interdisciplinary Research Center, Arizona State University, Phoenix, AZ, USA
| | - Karin Wachter
- Office of Refugee Health, Southwest Interdisciplinary Research Center, Arizona State University, Phoenix, AZ, USA
- School of Social Work, Arizona State University, Phoenix, AZ, USA
| | - Kenna McRae
- School of Human Evolution and Social Change, Arizona State University, Tempe, AZ, USA
- Department of Bioengineering, Schools of Engineering and Medicine, Stanford University, Stanford, CA, USA
| | - Anne McDaniel
- School of Human Evolution and Social Change, Arizona State University, Tempe, AZ, USA
| | - Olga I Davis
- Office of Refugee Health, Southwest Interdisciplinary Research Center, Arizona State University, Phoenix, AZ, USA
- Hugh Downs School of Human Communication, Arizona State University, Tempe, AZ, USA
- Barrett, The Honors College, Arizona State University, Phoenix, AZ, USA
| | - Jeanne Nizigiyimana
- Office of Refugee Health, Southwest Interdisciplinary Research Center, Arizona State University, Phoenix, AZ, USA
- Center for Refugee and Global Health, Valleywise Health, Phoenix, AZ, USA
| | - Crista E Johnson-Agbakwu
- Office of Refugee Health, Southwest Interdisciplinary Research Center, Arizona State University, Phoenix, AZ, USA
- Department of Obstetrics & Gynecology, UMass Memorial Health, Worcester, MA, USA
- Population and Quantitative Health Sciences, UMass Chan Medical School, Worcester, MA, USA
| |
Collapse
|
50
|
Hyte M, Clark C, Pandey R, Redden D, Roderick M, Brock K. How COVID-19 impacted CAUTI and CLABSI rates in Alabama. Am J Infect Control 2024; 52:147-151. [PMID: 37263421 PMCID: PMC10226899 DOI: 10.1016/j.ajic.2023.05.014] [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: 03/20/2023] [Revised: 05/24/2023] [Accepted: 05/25/2023] [Indexed: 06/03/2023]
Abstract
BACKGROUND The study objective was to quantify infection rate trends for central line-associated bloodstream infections (CLABSIs) and catheter-associated urinary tract infections (CAUTIs) in 89 Alabama hospitals from 2015 to 2021 to analyze how the COVID-19 pandemic impacted health care delivery. METHODS Retrospective analysis of CLABSI and CAUTI rates, from 89 Alabama hospitals via data from the Alabama Department of Public Health from 2015 to 2021. RESULTS Based on our modeling strategies, there was a statistically significant decrease in rates of CAUTIs from 2015 to 2019 at an estimated rate of 7% per year (P = 0.0167) and CLABSIs from 2015 to 2018 at an estimated rate of 13% per year (P < .001) in these hospitals. In 2020, the CAUTI and CLABSI rates began increasing at a modeled rate of 29% per year (P = .001) and 35% per year (P < .001) respectively. DISCUSSION A review of potential causes for the elevated rate of health care-associated infections illustrated that certain practices may have contributed to increased CAUTI and CLABSI rates. Utilizing staff from noncritical care areas with less experience in health care-associated infection prevention, batching of tasks to conserve personal protective equipment, and a nationwide mental health crisis could have affected infection prevention bundle compliance. CONCLUSIONS An increase in CAUTIs and CLABSIs was observed during the pandemic, likely due to the large volume of patients requiring advanced medical care and subsequent depleted resources.
Collapse
Affiliation(s)
- Melanie Hyte
- Edward Via College of Osteopathic Medicine-Auburn Campus, Auburn, AL.
| | - Cassidy Clark
- Edward Via College of Osteopathic Medicine-Auburn Campus, Auburn, AL
| | - Rishika Pandey
- Edward Via College of Osteopathic Medicine-Auburn Campus, Auburn, AL
| | - David Redden
- Edward Via College of Osteopathic Medicine-Auburn Campus, Auburn, AL
| | | | - Kenny Brock
- Edward Via College of Osteopathic Medicine-Auburn Campus, Auburn, AL
| |
Collapse
|