1
|
Batanda I. Prevalence of burnout among healthcare professionals: a survey at fort portal regional referral hospital. NPJ MENTAL HEALTH RESEARCH 2024; 3:16. [PMID: 38710834 DOI: 10.1038/s44184-024-00061-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 02/29/2024] [Indexed: 05/08/2024]
Abstract
The work environment in most hospitals is characterised by activities that are strenuous both physically and mentally. These can result in physical and mental exhaustion, which can lead to burnout if not adequately addressed. Burnout among healthcare professionals can negatively affect their clinical decision-making, quality of communication with patients and colleagues as well as their ability to cope with work-related pressure, and ultimately affect the quality of care and patient outcomes. The inclusion of burnout in the 11th revision of the International Classification of Diseases (ICD-11) as an occupational phenomenon indicates that it is an issue of concern in the workplace for which people may need professional attention. This descriptive cross-sectional survey aimed to determine the point prevalence of burnout among healthcare professionals at Fort Portal Regional Referral Hospital and the factors contributing to burnout. The study also evaluated the linear relationship between the age of workers, their work duration at the hospital, and their burnout score, in addition to the possible impact on patient care. Participants were selected from the hospital WhatsApp group and invitations to participate were sent to their individual accounts. Burnout was assessed using the Copenhagen Burnout Inventory. Generally, burnout scores ranged from 16% to 86%, with an overall mean burnout score of 57.4%. The notable factors contributing to burnout included imbalances in duty allocation, physically strenuous work, and resource constraints. Burnout of varying levels was found to be prevalent across all carders in the hospital, although the results indicate that most healthcare professionals experience moderate burnout. Most of the factors contributing to burnout are within the scope of hospital leadership to address. The possible impact on staff performance and patients' clinical outcomes is speculative, and additional studies are required.
Collapse
Affiliation(s)
- Ian Batanda
- Fort Portal Regional Referral Hospital, Fort Portal, Uganda.
| |
Collapse
|
2
|
Kadura S, Poulakis A, Roberts DE, Arora VM, Darrow SN, Eisner L, Ibarra M, Lin J, Wang L, Pigeon WR. Sleeping with one cerebrum open: patient and staff perceptions of sleep quality and quantity on an inpatient neurology unit. J Clin Sleep Med 2024; 20:619-629. [PMID: 38063214 PMCID: PMC10985310 DOI: 10.5664/jcsm.10958] [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: 07/13/2023] [Revised: 11/30/2023] [Accepted: 11/30/2023] [Indexed: 04/04/2024]
Abstract
STUDY OBJECTIVES This study sought to investigate perceptions of sleep disruptions among patients and staff in the inpatient neurology setting. The objectives were to explore the differences between these groups regarding factors that impact sleep, identify the most significant sleep disruptions, and examine the barriers and opportunities suggested to improve inpatient sleep. METHODS A survey-based observational study was conducted on a 25-bed inpatient neurology unit at an academic medical center. Staff and patients completed the Potential Hospital Sleep Disruptions and Noises Questionnaire, and focus groups were held to gather qualitative data. Patient-reported sleep measures were collected for additional assessment. Responses were dichotomized for comparison. Regression models were used to assess associations between disruptors and patient-reported sleep measures. Qualitative thematic analyses were performed. RESULTS Forty-nine inpatient staff and 247 patients completed sleep surveys. Top primary patient diagnoses included stroke, epilepsy, autoimmune diseases, and psychogenic nonepileptic attacks. Medical interventions, environmental factors, patient-related factors, and unit workflows emerged as key themes related to sleep disruptions. Patient-reported sleep efficiency was significantly reduced when pain, anxiety, stress, temperature, and medication administration disrupted sleep. Staff perspectives highlighted medical interventions as most disruptive to sleep, while patients did not find them as disruptive as expected. CONCLUSIONS Differing perspectives on sleep disruption exist between staff and patients in the inpatient neurology setting. Medical interventions may be overstated in staff perceptions and inpatient sleep research, as pain, anxiety, and stress had the most significant impact on patient-reported sleep efficiency. CITATION Kadura S, Poulakis A, Roberts DE, et al. Sleeping with one cerebrum open: patient and staff perceptions of sleep quality and quantity on an inpatient neurology unit. J Clin Sleep Med. 2024;20(4):619-629.
Collapse
Affiliation(s)
- Sullafa Kadura
- Department of Medicine, Pulmonary Diseases and Critical Care, University of Rochester Medical Center, Rochester, New York
| | - Alexander Poulakis
- University of Rochester School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, New York
| | - Debra E. Roberts
- Department of Neurology, University of Rochester Medical Center, Rochester, New York
| | - Vineet M. Arora
- Department of Medicine, University of Chicago Medicine, Chicago, Illinois
| | - Stephanie N. Darrow
- Department of Operations Excellence, University of Rochester Medical Center, Rochester, New York
| | - Lauren Eisner
- University of Rochester School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, New York
| | - Michael Ibarra
- Department of Neurology, University of Rochester Medical Center, Rochester, New York
| | - Jennifer Lin
- University of Rochester School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, New York
| | - Lu Wang
- Department of Biostatistics, University of Rochester Medical Center, Rochester, New York
| | - Wilfred R. Pigeon
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York
| |
Collapse
|
3
|
Geier TJ, Simske N, Melin S, Trevino C, Murphy P, Schroeder ME, Brandolino A, deRoon-Cassini T, Schramm AT. Psychiatric comorbidity in emergency general surgery patients: a prospective observational study. Trauma Surg Acute Care Open 2023; 8:e001117. [PMID: 37622160 PMCID: PMC10445363 DOI: 10.1136/tsaco-2023-001117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 08/04/2023] [Indexed: 08/26/2023] Open
Abstract
Objectives Annually, approximately 27 million individuals in the United States are admitted to hospitals for emergency general surgery (EGS). Approximately 50% develop postoperative complications and 22% require unplanned readmission within 90 days, highlighting a need to understand factors impacting well-being and recovery. Psychiatric comorbidity can impact medical treatment adherence, cost, and premature mortality risk. Despite the severity of illness in EGS, there is limited research on psychiatric comorbidity in EGS patients. Thus, the purpose of the current study was to characterize EGS patient mental health and to assess its relationship with pain, social support, and healthcare utilization (ie, length of stay, readmission). Methods Adult EGS patients were screened for participation during hospitalization. Inclusion criteria included: (1) 18 years or older, (2) communicate fluently in English, and (3) assessed within 7 days of admission. Participants (n=95) completed assessment, which included a structured clinical diagnostic interview. Record review captured medical variables, including length of stay, discharge disposition, narcotic prescription, and 90-day readmission rates. Results Ninety-five patients completed the assessment, and 31.6% met criteria for at least one current psychiatric diagnosis; 21.3% with a major depressive episode, 9.6% with a substance use disorder, and 7.5% with post-traumatic stress disorder (PTSD). Lower perceived social support and greater pain severity and interference were significantly related to more severe depression and anxiety. Depression was associated with longer length of stay, and those with PTSD were more likely to be re-admitted. Conclusion The EGS patient sample exhibited psychiatric disorder rates greater than the general public, particularly regarding depression and anxiety. Screening protocols and incorporation of psychological and social interventions may assist in recovery following EGS. Level of evidence Level II, prognostic.
Collapse
Affiliation(s)
- Timothy J Geier
- Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Natasha Simske
- Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Sarah Melin
- Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Colleen Trevino
- Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Patrick Murphy
- Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | | | - Amber Brandolino
- Comprehensive Injury Center, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Terri deRoon-Cassini
- Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
- Comprehensive Injury Center, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Andrew T Schramm
- Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| |
Collapse
|
4
|
Gerges S, Hallit R, Hallit S. Stressors in hospitalized patients and their associations with mental health outcomes: testing perceived social support and spiritual well-being as moderators. BMC Psychiatry 2023; 23:323. [PMID: 37161403 PMCID: PMC10169454 DOI: 10.1186/s12888-023-04833-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 04/30/2023] [Indexed: 05/11/2023] Open
Abstract
BACKGROUND Although hospitalization can be a burdensome experience for all patients, research into the sources of this distress and potential protective factors has so far been scattered, specifically among the broad hospitalized population across all disease types and inpatient units. The present study explores the frequency and nature of the foremost experienced hassles among a sample of Lebanese hospitalized patients, tracing their correlations with depression and anxiety while also investigating positive coping (i.e., perceived social support and spiritual well-being) as potential moderator of these relationships. METHODS A total of 452 Lebanese inpatients from all medical units filled a survey composed of a list of 38 stressors experienced during hospitalization and other measures assessing depression, anxiety, perceived social support, and spiritual well-being. RESULTS Pain was the most common stressor experienced by the patients (88.9%), followed by the feeling of being overwhelmed (80.3%). When conducting a factor analysis, 18 stressors loaded on 4 distinct factors, hence yielding 4 main stressor groups (i.e., Illness Apprehension, Hopelessness/Uselessness, Social Isolation, and Spiritual Concerns). The multivariable analysis showed that increased illness apprehension (Beta = 0.69) and hopelessness (Beta = 1.37), being married (Beta = 1.17) or divorced (Beta = 1.38) compared to single, being admitted in a two-bed room compared to one-bed (Beta = 1.59), higher financial burden (Beta = 0.24), and lower socio-economic status (Beta = 1.60) were significantly associated with higher anxiety. Additionally, increased hopelessness (Beta = 0.82) and being married (Beta = 0.79) compared to single were significantly associated with higher depression. However, among patients experiencing high levels of stressors, those with high spiritual well-being and perceived social support had lower depressive/anxiety symptoms. CONCLUSION Our study characterized the principal stressors encountered during hospitalization, underscoring their associations with Lebanese inpatients' mental health. On the other hand, as perceived social support and spiritual well-being acted as negative moderators of these associations, intervention programs aimed at enhancing such adaptive coping techniques are strongly called upon to palliate the psychological distress of patients in hospital settings.
Collapse
Affiliation(s)
- Sarah Gerges
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Rabih Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
- Department of Infectious Disease, Notre Dame, Secours University Hospital Center, Street 93, Postal Code 3, Byblos, Lebanon
- Department of Infectious Disease, Bellevue Medical Center, Mansourieh, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon.
- Applied Science research Center, Applied Science private university, Amman, Jordan.
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.
| |
Collapse
|
5
|
Lepilkina TА, Beniashvili AG, Cheremin RA, Malyukova NG, Morozova MA, Bogdanov MA, Burminsky DS, Potanin SS, Rodkina SV, Rupchev GE, Eip MN. Efficacy of a Relaxation Scenario in Virtual Reality for the Comorbid Symptoms of Anxiety and Asthenia in a General Hospital Setting: A Pilot Comparative Randomized Open-Label Study. CONSORTIUM PSYCHIATRICUM 2023; 4:38-51. [PMID: 38239567 PMCID: PMC10790732 DOI: 10.17816/cp221] [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: 10/28/2022] [Accepted: 02/14/2023] [Indexed: 03/19/2023] Open
Abstract
BACKGROUND Patients in general hospitals often display concomitant signs of mental maladjustment: low mood, anxiety, apathy, asthenia, all of which can have a negative impact on the course of the underlying disease and the recovery process. One of the non-pharmacological approaches that has gained wider acceptance in medical practice in recent years is the use of procedures based on virtual reality. AIM Assess the efficacy of the new domestic, virtual reality application Flow as relates to symptoms of anxiety and asthenia in patients undergoing inpatient treatment. METHODS The study was open-label and had a comparison group; the patients were assigned to the experimental or control group using a randomization table. The patients were assessed using the Spielberger State Anxiety Inventory; the Fatigue Symptom Rating Scale; the Well-being, Activity, Mood questionnaire; the Depression Anxiety Stress Scale; and the Clinical Global Impression Scale. Physical parameters were measured before and after each virtual reality session. The obtained data were statistically processed. RESULTS The study involved 60 patients. In 40 patients, the treatment program included a course of five daily relaxation sessions in virtual reality; the control group consisted of 20 patients, who were treated in accordance with the usual practice of the institution. The addition of virtual reality sessions to the standard treatment course yielded significant advantage in terms of affective symptoms reduction in patients both after a single session and as a result of undergoing the full course, and several days after its completion. The patients in the experimental group also showed a significant decrease in blood pressure after the sessions, and this was most pronounced in individuals who initially had elevated and high blood pressure. CONCLUSION The use of relaxation program courses in the virtual reality application Flow is an effective and promising means of non-pharmacological care for non-psychiatric inpatients showing symptoms of anxiety, apathy, depressive mood, as well as hypertension.
Collapse
|
6
|
van Niekerk M, Walker J, Hobbs H, Magill N, Toynbee M, Steward B, Harriss E, Sharpe M. The Prevalence of Psychiatric Disorders in General Hospital Inpatients: A Systematic Umbrella Review. J Acad Consult Liaison Psychiatry 2022; 63:567-578. [PMID: 35491011 DOI: 10.1016/j.jaclp.2022.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 04/08/2022] [Accepted: 04/24/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND To inform the future development of consultation-liaison psychiatry services, we need accurate information on the prevalence of psychiatric disorders in the general hospital inpatient setting. Systematic reviews have summarized the literature on specific aspects of this broad topic, but there has been no high-level overview that aggregates their findings and identifies gaps in the relevant literature. OBJECTIVE We aimed to produce a comprehensive overview of the field, summarizing the research literature on the prevalence of psychiatric disorders (i.e., interview-based psychiatric diagnoses) in general hospital inpatients. We did this using a systematic umbrella review (systematic review of systematic reviews), which is the best and most efficient method for summarizing a broad area of research. METHODS We searched Ovid Medline, Ovid Embase, Ovid PsycINFO, EBSCO CINAHL, and Scopus from database inception to September 2021 for systematic reviews that provided a pooled prevalence estimate, or prevalence range, for interview-diagnosed psychiatric disorders in general hospital inpatients. Two reviewers independently assessed articles and extracted data. The review is registered with PROSPERO, number CRD42019125574. RESULTS We screened 11,728 articles and included 10 systematic reviews in our umbrella review. We were able to extract pooled prevalence estimates from these as follows: major depression 12% to 20%, any anxiety disorder 8%, generalized anxiety disorder 5%, panic disorder 3%, delirium 15%. We were only able to extract a prevalence range for dementia, which was 3% to 63%. We found no systematic reviews from which we could extract prevalence data for the other psychiatric disorders that we included in our searches, indicating important gaps. From these data, we estimated that approximately one-third of inpatients have a psychiatric disorder. CONCLUSIONS Psychiatric disorders are very common in general hospital inpatients. While the planning of consultation-liaison psychiatry services will benefit from more research on the prevalence of each of the full range of disorders encountered in the inpatient setting, our findings indicate that we already know enough to justify increased and more population-based service provision.
Collapse
Affiliation(s)
- Maike van Niekerk
- Psychological Medicine Research, University of Oxford Department of Psychiatry, Warneford Hospital, Oxford, UK
| | - Jane Walker
- Psychological Medicine Research, University of Oxford Department of Psychiatry, Warneford Hospital, Oxford, UK
| | - Harriet Hobbs
- Psychological Medicine Research, University of Oxford Department of Psychiatry, Warneford Hospital, Oxford, UK
| | - Nicholas Magill
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - Mark Toynbee
- Psychological Medicine Research, University of Oxford Department of Psychiatry, Warneford Hospital, Oxford, UK
| | - Ben Steward
- Psychological Medicine Research, University of Oxford Department of Psychiatry, Warneford Hospital, Oxford, UK
| | - Eli Harriss
- Bodleian Health Care Libraries, University of Oxford, Oxford, UK
| | - Michael Sharpe
- Psychological Medicine Research, University of Oxford Department of Psychiatry, Warneford Hospital, Oxford, UK.
| |
Collapse
|