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Mu H, Deng Y, Li Y, Xie Q, Na J, Mao C, Geng Y, Sun W, Yan L, Pan G. Cross-sectional study of the association between burnout and work overload and work-life imbalance among medical personnel in Liaoning, China: role of specialty. BMJ Open 2024; 14:e079304. [PMID: 38834323 PMCID: PMC11163827 DOI: 10.1136/bmjopen-2023-079304] [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: 08/28/2023] [Accepted: 04/09/2024] [Indexed: 06/06/2024] Open
Abstract
OBJECTIVES Burnout is common among medical personnel in China and may be related to excessive and persistent work-related stressors by different specialties. The aims of this study were to assess the prevalence of burnout, work overload and work-life imbalance according to different specialties and to explore the effect of specialty, work overload and work-life imbalance on burnout among medical personnel. DESIGN A cross-sectional study. SETTING This study was conducted in 1 tertiary general public hospital, 2 secondary general hospitals and 10 community health service stations in Liaoning, China. PARTICIPANTS A total of 3299 medical personnel participated in the study. METHODS We used the 15-item Chinese version of the Maslach Burnout Inventory General Survey (MBI-GS) to measure burnout. Multivariable logistic regression models were used to explore the association between medical specialty, work overload, work-life imbalance and burnout. RESULTS 3299 medical personnel were included in this study. The prevalence of burnout, severe burnout, work overload and work-life imbalance were 88.7%, 13.6%, 23.4% and 23.2%, respectively. Compared with medical personnel in internal medicine, working in obstetrics and gynaecology (OR=0.61, 95% CI 0.38, 0.99) and management (OR=0.45, 95% CI 0.28, 0.72) was significantly associated with burnout, and working in ICU (Intensive Care Unit)(OR=2.48, 95% CI 1.07, 5.73), surgery (OR=1.66, 95% CI 1.18, 2.35) and paediatrics (OR=0.24, 95% CI 0.07, 0.81) was significantly associated with severe burnout. Work overload and work-life imbalance were associated with higher ORs for burnout (OR=1.64, 95% CI 1.16, 2.32; OR=2.79, 95% CI 1.84, 4.24) and severe burnout (OR=4.33, 95% CI 3.43, 5.46; OR=3.35, 95% CI 2.64, 4.24). CONCLUSIONS Burnout, work overload and work-life imbalance were prevalent among Chinese medical personnel but varied considerably by clinical specialty. Burnout may be reduced by decreasing work overload and promoting work-life balance across different specialties.
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Affiliation(s)
- Huijuan Mu
- Institute of Preventive Medicine, China Medical University, Shenyang, Liaoning Province, China
- Institute of Chronic Diseases, Liaoning Provincial Center for Disease Control and Prevention, Shenyang, China
| | - Yan Deng
- Research Center for Universal Health, School of Public Health, China Medical University, Shenyang, China
| | - Yanxia Li
- Institute of Preventive Medicine, China Medical University, Shenyang, Liaoning Province, China
- Institute of Chronic Diseases, Liaoning Provincial Center for Disease Control and Prevention, Shenyang, China
| | - Qiong Xie
- Research Center for Universal Health, School of Public Health, China Medical University, Shenyang, China
| | - Jun Na
- Institute of Preventive Medicine, China Medical University, Shenyang, Liaoning Province, China
- Institute of Chronic Diseases, Liaoning Provincial Center for Disease Control and Prevention, Shenyang, China
| | - Chunying Mao
- Research Center for Universal Health, School of Public Health, China Medical University, Shenyang, China
| | - Yihang Geng
- Research Center for Universal Health, School of Public Health, China Medical University, Shenyang, China
| | - Wei Sun
- Research Center for Universal Health, School of Public Health, China Medical University, Shenyang, China
| | - Lingjun Yan
- Research Center for Universal Health, School of Public Health, China Medical University, Shenyang, China
| | - Guowei Pan
- Research Center for Universal Health, School of Public Health, China Medical University, Shenyang, China
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Halperin O, Idilbi N, Robes D, Biderman SN, Malka-Zeevi H, Green G. Predicting post-traumatic stress disorder: The complex relationship between burnout, intentions to leave and emotional support among health care professionals. Nurs Outlook 2024; 72:102134. [PMID: 38301290 DOI: 10.1016/j.outlook.2024.102134] [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: 10/11/2023] [Revised: 01/01/2024] [Accepted: 01/10/2024] [Indexed: 02/03/2024]
Abstract
BACKGROUND Health care professionals working in delivery rooms often encounter stressful situations. Understanding their challenges and the support they receive is essential for improving their well-being and consequently patient care. PURPOSE Examining the relationship between burnout, intentions to leave, post-traumatic stress disorder (PTSD) symptoms, and complex PTSD among health care professionals, and identifying their predictors. METHODS A mixed methods design, including a survey among 196 midwives and gynecologists assessing burnout, intentions to leave, exposure to negative work experiences and PTSD, as well as 15 semi-structured interviews. DISCUSSION Most participants experienced multiple difficult events in the delivery room, reporting insufficient emotional support. Burnout and lack of emotional support were significant predictors of PTSD symptoms. Participants expressed a need for emotional support to cope with complex situations. CONCLUSION Burnout among midwives must be addressed through prevention and intervention programs. Emotional support is essential in mitigating PTSD symptoms among midwives and gynecologists, enhancing their resilience and well-being.
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Affiliation(s)
- Ofra Halperin
- Nursing Department, Max Stern Academic College of Emek-Yezreel, Emek-Yezreel, Israel.
| | - Nasra Idilbi
- Nursing Department, Max Stern Academic College of Emek-Yezreel, Emek-Yezreel, Israel; Galilee Medical Center, Nahariya, Israel
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Zhou J, Hu T, Xue S, Dong Z, Tang W. The association of childhood trauma with suicidality in adult psychiatric patients: The mediating role of NSSI and the moderating role of self-esteem. J Clin Psychol 2024; 80:664-677. [PMID: 38265412 DOI: 10.1002/jclp.23646] [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: 01/03/2024] [Accepted: 01/10/2024] [Indexed: 01/25/2024]
Abstract
BACKGROUND The contribution of specific childhood trauma subtypes to suicidal thoughts and the associated mechanisms remains unclear, particularly in psychiatric patients. METHODS Face-to-face interviews were conducted with 449 psychiatric patients aged 18-73. Childhood trauma, self-esteem, nonsuicidal self-injury (NSSI), and suicidality were assessed retrospectively. Regression and moderated mediation model were employed to examine these relationships. RESULTS Emotional and sexual abuse were independently associated with suicidality. Female patients reported higher levels of emotional and sexual abuse, lower self-esteem, and a heightened risk of suicide. Self-esteem moderated the links between childhood trauma and NSSI, as well as between NSSI and suicidality. NSSI served as a mediator between childhood trauma and suicidality. CONCLUSIONS Suicide prevention in mentally ill patients should involve targeted programs addressing specific childhood trauma. Additionally, psychological interventions to enhance self-esteem and assist individuals engaging in NSSI behavior are crucial.
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Affiliation(s)
- Jing Zhou
- Department of Psychosomatic Medicine, Leshan People's Hospital, Leshan, Sichuan, China
- Department of Psychiatry, Mental Health Centre, West China Hospital, Sichuan University, Chengdu, China
| | - Tao Hu
- School of Education and Psychology, Chengdu Normal University, Chengdu, China
- Business School, Sichuan University, Chengdu, China
| | - Shuang Xue
- Department of Sociology and Psychology, School of Public Administration, Sichuan University, Chengdu, China
| | - Zaiquan Dong
- Department of Psychiatry, Mental Health Centre, West China Hospital, Sichuan University, Chengdu, China
| | - Wanjie Tang
- Department of Psychiatry, Mental Health Centre, West China Hospital, Sichuan University, Chengdu, China
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Zhang J, Yang X, Zhang X, Liu Y, Liu M, Fang Y, Liu M, Wu M. Mediating effects of social support and presenteeism on turnover intention and post-traumatic stress disorder among Chinese nurses in the post-pandemic era: a cross-sectional study. Front Public Health 2024; 12:1323126. [PMID: 38420027 PMCID: PMC10899410 DOI: 10.3389/fpubh.2024.1323126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 01/30/2024] [Indexed: 03/02/2024] Open
Abstract
Background The shift in national policies for epidemic prevention and control in the post-pandemic era is undoubtedly a challenge for health care professionals. Nurses, as an important part of the health care professional population, have an even greater impact on their mental health and occupational safety. This may expose nurses to post-traumatic stress disorder (PTSD) and presenteeism, and ultimately lead to their turnover. Objective This study aimed to investigate the relationship between turnover intention and post-traumatic stress disorder among Chinese nurses during post-pandemic era, and the mediating role of social support and presenteeism. Methods In this study, a multicentre cross-sectional survey was conducted in April 2023 among nursing staff in several tertiary general hospitals in northern China, with online data collection using the Turnover intention Scale (PTSD), the Impact of Events Scale (IES), the Social Support Scale (SSS), and the Stanford presenteeism Scale (STAS) and the relationship between variables was analyzed using hierarchical multivariate regression, and Structural Equation Modeling (SEM) was used to analyze the relationship between post-traumatic stress disorder and the Turnover intention from the pathway between. Results Data were collected from 2,513 nurses who met the inclusion criteria, in which general information such as age, department, specific department, Professional title, history of alcohol consumption, form of employment, Years of working, and Average working hours per day were statistically significant with the difference in the turnover intention. The results of the study showed a 32% high turnover intention among nurses in the post-pandemic era, which was lower than the turnover intention during the pandemic. The results of hierarchical multiple regression analysis showed that post-traumatic stress disorder, social support, and presenteeism were significant predictors of turnover intention. The total effect of post-traumatic stress disorder on turnover intention to work was 0.472 [bias modified 95% confidence interval (0.415-0.483), p < 0.001]. Social support and attendance played a partially intermediate role in post-traumatic stress disorder and propensity to leave (an indirect effect of 26% of the total effect). Conclusion Turnover intention and post-traumatic stress disorder levels are high and social support plays an important role in the tendency to leave the job and post-traumatic stress disorder, healthcare institution can be achieved by strengthening social support for nurses in the post-epidemic era and preventing the occurrence of presenteeism.
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Affiliation(s)
- Jingshuo Zhang
- School of Nursing, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Xin Yang
- School of Nursing, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Xiaoman Zhang
- School of Nursing, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Yuping Liu
- The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Mengshi Liu
- School of Nursing, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Yu Fang
- School of Nursing, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Mengjie Liu
- School of Nursing, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Min Wu
- School of Nursing, Xuzhou Medical University, Xuzhou, Jiangsu, China
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Katz C, Jacobson M, Priolo Filho SR, Goldfarb D, Liu J, Zibetti MR, Varela N, Attrash Najjar A, Bérubé A, Collin-Vézina D, Maguire-Jack K, Massarweh N, Munir A, Tiwari A, Wekerle C. Examining resilience among child protection professionals during COVID-19: A global comparison across 57 countries. CHILD ABUSE & NEGLECT 2024:106659. [PMID: 38326165 DOI: 10.1016/j.chiabu.2024.106659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 12/03/2023] [Accepted: 01/18/2024] [Indexed: 02/09/2024]
Abstract
BACKGROUND The COVID-19 pandemic led to numerous challenges for child protection professionals (CPPs). However, limited research has investigated the interwoven concepts of coping, resilience, and mental distress among CPPs during COVID-19 on a global scale. OBJECTIVES This study aimed to explore CPPs' practice, resilience, and mental distress during COVID-19, the relationship between their resilience and mental distress, the global stability of the Multi-System Model of Resilience (MSMR), and how CPPs' resilience varied according to the Human Development Index (HDI). METHODS Data were collected from 420 CPPs in 57 countries across five continents between July and September 2021. Participants completed an online questionnaire on demographics, resilience, mental distress, coping, and perceptions of child protection during the pandemic in their native languages. The analyses compared the countries grouped according to HDI using means comparisons, correlations, and multiple linear regressions. A two-path analysis was also performed to identify variables associated with behavioral resilience engagement and mental distress. RESULTS The findings indicated that CPPs' perceptions of COVID-19's impact on child maltreatment varied in correlation with their country's HDI. There were also significant HDI-based differences regarding the perceived opportunity to engage in resilient behavior and its helpfulness. Years of professional experience, internal resilience, and external resilience were shown to be significant predictors of mental distress among CPPs during the pandemic, and resilience mediated how years of experience predicted mental distress. CONCLUSIONS This study emphasized the importance of experience and internal resilience for CPPs' psychological well-being. It also provides empirical evidence to support the MSMR theory on a global scale. Additionally, it demonstrates how the perceived changes in child maltreatment during COVID-19 may be associated with regional HDI. Lastly, the opportunities CPPs had to engage in resilient behavior and how much this helped them was associated with regional HDI, but not in the way originally predicted. Study results also hold implications for how practice and policy may be altered to help CPPs cope better during times of crisis and generally.
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Affiliation(s)
- Carmit Katz
- Bob Shapell School of Social Work, Tel Aviv University, Ramat Aviv, 69978, Israel.
| | - Ma'ayan Jacobson
- Haruv Institute, The Hebrew University of Jerusalem, Mount Scopus, Jerusalem, Israel.
| | - Sidnei R Priolo Filho
- Laboratório de Pesquisa, Prevenção e Intervenção em Psicologia Forense, Universidade Tuiuti do Paraná, Curitiba, Brazil.
| | | | - Jenny Liu
- Schulich School of Medicine and Dentistry, Western University, London, Canada.
| | | | | | - Afnan Attrash Najjar
- Bob Shapell School of Social Work, Tel Aviv University, Ramat Aviv, 69978, Israel.
| | - Annie Bérubé
- The Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Canada.
| | - Delphine Collin-Vézina
- The Centre for Research on Children and Families, McGill University, Suite 106, Wilson Hall, 3506 University Street, Montreal, Quebec H3A 2A7, Canada.
| | - Kathryn Maguire-Jack
- School of Social Work, University of Michigan, 1080 S. University Ave., Ann Arbor, MI 48109, USA.
| | | | - Akhtar Munir
- Department of Social Work, Kohat University of Science and Technology, Kohat, Pakistan.
| | - Ashwini Tiwari
- Augusta University, CJ2300 1120 15th Street, Augusta, GA 30912; USA.
| | - Christine Wekerle
- The Offord Centre for Child Studies, McMaster University, 1280 Main St. W. - MIP 201A, Hamilton, ON L8S 4K1, Canada.
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Rigas N, Kyritsis Z, Dagla M, Soldatou A, Orovou E, Tzitiridou-Chatzopoulou M, Eskitzis P, Antoniou E. Post-Traumatic Stress Disorder Symptoms among Pediatric Healthcare Workers. NURSING REPORTS 2024; 14:115-127. [PMID: 38251188 PMCID: PMC10801477 DOI: 10.3390/nursrep14010010] [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: 09/22/2023] [Revised: 12/30/2023] [Accepted: 01/04/2024] [Indexed: 01/23/2024] Open
Abstract
Post-traumatic stress disorder symptoms related to work in pediatric departments aremajor public health problems, as they directly affect health organizations, healthcare workers, and, due to the poor quality of care, the patients as well. The post-traumatic symptoms that a healthcare worker may experience are related to intrusion, avoidance, negative changes in cognition and mood, and changes in arousal and reactivity. The aim of the present investigation was to identify risk factors that contribute to the development of PTSD in pediatric healthcare workers, in order to implement necessary workplace measures. A sample of four hundred and forty-five pediatric workers at seven Greek public hospitals consented to participate in the survey. Socio-demographic data and a post-traumatic checklist (5th edition) were used to diagnose post-traumatic stress disorder. According to the results, risk factors for the development of post-traumatic symptoms include medical or nursing errors, threats to a child's life, and incidents of workplace bullying. More specifically, 25.2% of the participants had a provisional PTSD diagnosis, 72.8%of the sample experienced an incident involving a medical or nursing error in their workplace related to the treatment or care of a child, 56% experienced an incident involving a child's death or a threat to a child's life due to a serious illness or injury, and 55.5% experienced an incident of workplace bullying. In addition, it was found that having a university-level education, master's, or PhD, working in a circular shift, being assigned to a department by management rather than the worker, and dissatisfaction with salary were associated with post-traumatic stress disorder. The high rates of PTSD symptoms among participants highlight the need for prevention and management measures to protect and support the mental health of workers in pediatric departments. We propose frequent evaluations of the mental health of employees, more time for rest, incentives for professional development, utilization of their specializations and specialties, support from mental health specialists when symptoms are diagnosed, and the option for employees to change departments if they wish or if they show symptoms of mental trauma.
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Affiliation(s)
- Nikolaos Rigas
- Department of Midwifery, University of West Attica, 12243 Athens, Greece; (M.D.); (E.A.)
| | - Zacharias Kyritsis
- Department of Mathematics, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Maria Dagla
- Department of Midwifery, University of West Attica, 12243 Athens, Greece; (M.D.); (E.A.)
| | - Alexandra Soldatou
- Faculty of Medicine, National and Kapodistrian University of Athens, 15772 Athens, Greece;
| | - Eirini Orovou
- Department of Midwifery, University of Western Macedonia, 50200 Ptolemaida, Greece; (E.O.); (M.T.-C.); (P.E.)
| | | | - Panagiotis Eskitzis
- Department of Midwifery, University of Western Macedonia, 50200 Ptolemaida, Greece; (E.O.); (M.T.-C.); (P.E.)
| | - Evangelia Antoniou
- Department of Midwifery, University of West Attica, 12243 Athens, Greece; (M.D.); (E.A.)
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Xiong NN, Fan TT, Liu Q, Fritzsche K, Leonhart R, Stein B, Waller C, Müller MM. Burnout, emotional distress and sleep quality among Chinese psychiatric healthcare workers during the COVID-19 pandemic: a follow-up study. Front Public Health 2023; 11:1272074. [PMID: 38179557 PMCID: PMC10764523 DOI: 10.3389/fpubh.2023.1272074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 12/08/2023] [Indexed: 01/06/2024] Open
Abstract
Background Different from the very early stages of the COVID-19 pandemic, burnout and chronic mental health problems among health care workers (HCWs) has become a challenge. Research is lacking on the relationship between burnout, stress, emotional distress and sleep quality. Methods The Chinese center has been involved in the Cope-Corona project since the second survey (T2). Named after the project, a total of three cross-sectional surveys were distributed: T2 (February 16-20, 2021), T3 (May 10-14, 2022), and T4 (December 20-24, 2022). Burnout, depression, anxiety, sleep quality, workplace factors and individual resources were measured. Using the T4 data, we conducted structural equation model (SEM) to examine the mediating role of burnout in predicting emotional distress and sleep quality. Results 96, 124, and 270 HCWs were enrolled at T2, T3, and T4, respectively. In line with the epidemic trends, the level of perceived COVID-19 related risks was significantly higher at T4, while the feeling of health and safety decreased significantly. At T4, the percentages of participants with clinically significant levels of depression and anxiety symptoms were 18.9% (51/270) and 9.3% (25/270), respectively, while 30.4% (82/270) of them reported poor or very poor sleep quality. According to the SEM, individual resources and workplace factors mainly had an indirect effect in predicting depression and anxiety via burnout. However, neither burnout nor stress was a mediator or predictor of sleep quality. Instead, individual resources, positive workplace factors, and younger age had a direct effect in predicting good sleep quality. Conclusion Measures designed to enhance workplace factors and individual resources should be implemented to improve psychosomatic wellbeing of HCWs.
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Affiliation(s)
- Na-na Xiong
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Centre for Mental Disorders (Peking University Sixth Hospital), Peking University Sixth Hospital, Peking University Institute of Mental Health, Peking University, Beijing, China
| | - Teng-teng Fan
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Centre for Mental Disorders (Peking University Sixth Hospital), Peking University Sixth Hospital, Peking University Institute of Mental Health, Peking University, Beijing, China
| | - Qi Liu
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Centre for Mental Disorders (Peking University Sixth Hospital), Peking University Sixth Hospital, Peking University Institute of Mental Health, Peking University, Beijing, China
| | - Kurt Fritzsche
- Department of Psychosomatic Medicine and Psychotherapy, Faculty of Medicine, Center for Mental Health, Medical Centre - University of Freiburg, Freiburg, Germany
| | - Rainer Leonhart
- Department for Social Psychology and Methodology, Institute of Psychology, University of Freiburg, Freiburg, Germany
| | - Barbara Stein
- Department of Psychosomatic Medicine and Psychotherapy, Nuremberg General Hospital, Paracelsus Medical University, Nuremberg, Germany
| | - Christiane Waller
- Department of Psychosomatic Medicine and Psychotherapy, Nuremberg General Hospital, Paracelsus Medical University, Nuremberg, Germany
| | - Markus M. Müller
- Department of Psychosomatic Medicine and Psychotherapy, Nuremberg General Hospital, Paracelsus Medical University, Nuremberg, Germany
- Social and Organizational Psychology, Catholic University of Eichstätt-Ingolstadt, Eichstätt, Germany
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Ruta MV, Alexescu T, Todea DA, Motoc NS, Necrelescu OL, Campean AU, Toma C, Crisan CA, Man MA. COVID-19 "Nightmare": Perceived Stress, Emotional Distress, and Burnout Syndrome among Medical Staff after One Year of the COVID-19 Pandemic. J Pers Med 2023; 13:1640. [PMID: 38138867 PMCID: PMC10744827 DOI: 10.3390/jpm13121640] [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: 08/26/2023] [Revised: 11/12/2023] [Accepted: 11/15/2023] [Indexed: 12/24/2023] Open
Abstract
(1) After one year of treating patients with SARS-CoV-2 infection, physical exhaustion is added to emotional stress and burnout syndrome. (2) By applying specific questionnaires, we evaluated healthcare workers who handled patients infected with SARS-CoV-2in terms of disease perception, perceived stress, emotional distress, and burnout syndrome after one year of the COVID-19 pandemic and compared them with staff who did not handle infected patients. (3) A total of 165 persons were evaluated, with 79 working in the COVID-19 department and 86 working in the non-COVID-19 department. No statistically significant differences were found in the perceived stress scores, emotional distress (functional or dysfunctional), and disease perception among the COVID-19 and non-COVID-19 groups. Also, we did not find any differences between the COVID-19 and non-COVID-19 departments concerning their total Maslach scores-50 in the COVID-19 department and 51 in the non-COVID-19 department, p = 0480-so a moderate level of burnout in the two groups. The only statistical difference was in the Maslach depersonalization scores, which were higher among COVID-19 workers (p = 0.024). (4) In our center, there was no statistically significant difference in perceived stress or emotional distress. The level of burnout syndrome seems to be the same among the two groups, regardless if they worked withCOVID-19-infected patients or not.
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Affiliation(s)
- Maria Victoria Ruta
- “Leon Daniello” Clinical Hospital of Pulmonology, 400012 Cluj-Napoca, Romania; (M.V.R.); (O.L.N.)
| | - Teodora Alexescu
- Department of Internal Medicine, Faculty of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania;
| | - Doina Adina Todea
- Department of Medical Sciences—Pulmonology, Faculty of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (D.A.T.); (M.A.M.)
| | - Nicoleta Stefania Motoc
- Department of Medical Sciences—Pulmonology, Faculty of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (D.A.T.); (M.A.M.)
| | - Octavia Luiza Necrelescu
- “Leon Daniello” Clinical Hospital of Pulmonology, 400012 Cluj-Napoca, Romania; (M.V.R.); (O.L.N.)
| | - Andrada Urda Campean
- Department of Biostatistics, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania;
| | - Claudia Toma
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania;
| | - Catalina Angela Crisan
- Department of Neurosciences, Discipline Psychiatry and Pediatric Psychiatry—Pulmonology, Faculty of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania;
| | - Milena Adina Man
- Department of Medical Sciences—Pulmonology, Faculty of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (D.A.T.); (M.A.M.)
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Xia J, Zhu L, Huang H, Fan P, Zhou M, Cai XL, He H. Relationships between childhood trauma and mental health during the COVID-19 pandemic: a network analysis. Front Psychiatry 2023; 14:1251473. [PMID: 37743981 PMCID: PMC10515217 DOI: 10.3389/fpsyt.2023.1251473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 08/17/2023] [Indexed: 09/26/2023] Open
Abstract
Background Childhood trauma has been found to have an important impact on mental health. However, little is known regarding the intercorrelations between childhood trauma and mental health during the COVID-19 pandemic. This study aimed to investigate such complex interplay between childhood trauma, depression, anxiety, post-traumatic stress level during the COVID-19 pandemic, and fear of COVID-19 using network analysis. Methods A total of 1,247 college students were recruited and were asked to complete a series of questionnaires, including the Childhood Trauma Questionnaire, Patient Health Questionnaire, Generalized Anxiety Disorder Scale, Post-traumatic Stress Checklist-Civilian version, and Fear of COVID-19 Scale. The Gaussian graphical model with the scores of the questionnaires as nodes was estimated. The partial correlations between nodes were calculated as edges. Moreover, network comparison tests were conducted to compare the network patterns between participants with high levels of childhood trauma and low levels of childhood trauma. Results Childhood trauma was found to be connected to depression, anxiety, and post-traumatic stress level. The node of childhood trauma exhibited the strongest strength and the highest expected influence in the network. Participants with high levels of childhood trauma and participants with low levels of childhood trauma showed comparable network structure and global strength. Conclusion Our findings revealed a complex network pattern between childhood trauma and different mental health problems, indicating that childhood trauma might be a risk factor for mental health during the COVID-19 pandemic.
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Affiliation(s)
- Jinjin Xia
- Department of Neurology, Changxing People’s Hospital of Zhejiang Province, Huzhou, China
- Department of Neurology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Lin Zhu
- Institute of Brain Science and Department of Physiology, School of Basic Medical Sciences, Hangzhou Normal University, Hangzhou, China
| | - Huayun Huang
- Department of Neurology, Changxing People’s Hospital of Zhejiang Province, Huzhou, China
| | - Pengfei Fan
- Department of Neurology, Changxing People’s Hospital of Zhejiang Province, Huzhou, China
| | - Meifeng Zhou
- Department of Neurology, Changxing People’s Hospital of Zhejiang Province, Huzhou, China
| | - Xin-lu Cai
- Institute of Brain Science and Department of Physiology, School of Basic Medical Sciences, Hangzhou Normal University, Hangzhou, China
- Zhejiang Philosophy and Social Science Laboratory for Research in Early Development and Childcare, Hangzhou Normal University, Hangzhou, China
- Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, China
| | - Hui He
- Department of Neurology, Changxing People’s Hospital of Zhejiang Province, Huzhou, China
- Department of Neurology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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10
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Dong Y, Zhu Q, Chang R, Wang R, Cai Y, Huang H. Association between work stress and mental health in Chinese public health workers during the COVID-19 epidemic: mediating role of social support and self-efficacy. Front Public Health 2023; 11:1236645. [PMID: 37575107 PMCID: PMC10415911 DOI: 10.3389/fpubh.2023.1236645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 07/05/2023] [Indexed: 08/15/2023] Open
Abstract
Background Little is known about the mediating mechanisms underlying the association between work stress and mental health, especially among primary public health workers (PHWs). We aimed to evaluated the association between work stress and mental health among PHWs, and explore the mediating roles of social support and self-efficacy. Methods A large-scale cross-sectional survey was conducted among 3,809 PHWs from all 249 community health centers in 16 administrative districts throughout Shanghai, China. Pearson correlation and hierarchical linear regression were used to explore the associations among work stress, social support, self-efficacy and mental health. Structural equation modeling (SEM) was conducted to examine the mediation effects. Results The prevalence of depression and anxiety symptoms among primary PHWs was 67.3 and 55.5%, respectively. There is a significant positive direct effect of work stress on mental health (β = 0.325, p < 0.001). Social support and self-efficacy partially mediated the relationship between work stress and mental health, respectively. Meanwhile, the chained mediating effects of social support and self-efficacy also buffered the predictive effects of work stress on anxiety and depression symptoms (β = 0.372, p < 0.001). Conclusion Work stress has significant direct and indirect effects on mental health among primary PHWs. Enhancing social support and self-efficacy may be effective psychological interventions to mitigate the effects of work-related stress on mental health. These findings highlight the severity of mental health problems among primary public health workers and provide new evidence for early prevention and effective intervention strategies.
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Affiliation(s)
- Yinqiao Dong
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qianqian Zhu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ruijie Chang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Rongxi Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yong Cai
- Hongqiao International Institute of Medicine, Tongren Hospital, Shanghai Jiao Tong Univeristy School of Medicine, Shanghai, China
| | - Hong Huang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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11
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Deltour V, Poujol AL, Laurent A. Post-traumatic stress disorder among ICU healthcare professionals before and after the Covid-19 health crisis: a narrative review. Ann Intensive Care 2023; 13:66. [PMID: 37477706 PMCID: PMC10361923 DOI: 10.1186/s13613-023-01145-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 05/31/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND The ICU (intensive care unit) involves potentially traumatic work for the professionals who work there. This narrative review seeks to identify the prevalence of post-traumatic stress disorder (PTSD) among ICU professionals; how PTSD has been assessed; the risk factors associated with PTSD; and the psychological support proposed. METHODS Three databases and editorial portals were used to identify full-text articles published in English between 2009 and 2022 using the PRISMA method. RESULTS Among the 914 articles obtained, 19 studies met our inclusion criteria. These were undertaken primarily during the Covid-19 period (n = 12) and focused on nurses and assistant nurses (n = 10); nurses and physicians (n = 8); or physicians only (n = 1). The presence of mild to severe PTSD among professionals ranged from 3.3 to 24% before the pandemic, to 16-73.3% after the pandemic. PTSD in ICU professionals seems specific with particularly intense intrusion symptoms. ICU professionals are confronted risk factors for PTSD: confrontation with death, unpredictability and uncertainty of care, and insecurity related to the crisis COVID-19. The studies show that improved communication, feeling protected and supported within the service, and having sufficient human and material resources seem to protect healthcare professionals from PTSD. However, they also reveal that ICU professionals find it difficult to ask for help. CONCLUSION ICU professionals are particularly at risk of developing PTSD, especially since the Covid-19 health crisis. There seems to be an urgent need to develop prevention and support policies for professionals.
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Affiliation(s)
- Victoire Deltour
- Psychology Laboratory: Relational Dynamics and Identity Processes (Psy-DREPI), University of Bourgogne Franche-Comté, AAFE pole, Esplanade Erasme, 21078, Dijon, France
- VCR Team, School of Practitioner Psychologists, Catholic University of Paris, 7403, Paris, EA, France
| | - Anne-Laure Poujol
- Multidisciplinary Intensive Care Unit, Department of Anesthesiology and Critical Care, La Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, Sorbonne University, Paris, France
- VCR Team, School of Practitioner Psychologists, Catholic University of Paris, 7403, Paris, EA, France
| | - Alexandra Laurent
- Psychology Laboratory: Relational Dynamics and Identity Processes (Psy-DREPI), University of Bourgogne Franche-Comté, AAFE pole, Esplanade Erasme, 21078, Dijon, France.
- Department of Anaesthesiology and Critical Care Medicine, Dijon University Medical Centre, Dijon, France.
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12
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Giusti EM, Veronesi G, Callegari C, Borchini R, Castelnuovo G, Gianfagna F, Iacoviello L, Ferrario MM. Pre-pandemic burnout and its changes during the COVID-19 outbreak as predictors of mental health of healthcare workers: A lesson to be learned. Psychiatry Res 2023; 326:115305. [PMID: 37331071 PMCID: PMC10261975 DOI: 10.1016/j.psychres.2023.115305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 06/08/2023] [Accepted: 06/11/2023] [Indexed: 06/20/2023]
Abstract
The aim of this study was to identify how previously existing burnout and its changes during the pandemic contributed to PTSD symptoms and psychological distress in a cohort of 388 healthcare workers (HCWs). Each HCW was surveyed in Sep 2019 (before COVID-19) and again in Dec 2020-Jan 2021 (during the pandemic) to assess burnout (MBI); and in the second wave only to assess PTSD (PCL-5-SF), psychological distress (GHQ-12) and resilience (CD-RISC-10). Changes in emotional exhaustion (EE) and depersonalisation (DEP) were stronger in HCWs with lower EE and DEP baseline values. HCWs with higher baseline poor personal accomplishment (PPA) improved more than those with lower baseline values. In multivariable-adjusted models, pre-pandemic EE and its changes were equally associated to both outcomes: standardised-βs of 0.52 and 0.54 for PTSD, respectively; and 0.55 and 0.53 for psychological distress. Changes in DEP were associated with PTSD only (0.10). Changes in PPA had a higher association with psychological distress (0.29) than pre-pandemic PPA (0.13). Resilience was associated with lower psychological distress (-0.25). Preventive actions aimed at reducing EE, e.g., addressing organisational dysfunctions, are needed to mitigate the impact of future crises, whereas improving personal accomplishment levels is a key target to protect HCWs from mental health disorders during a pandemic.
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Affiliation(s)
- Emanuele Maria Giusti
- EPIMED Research Center, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Giovanni Veronesi
- EPIMED Research Center, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Camilla Callegari
- Division of Psychiatry, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | | | - Gianluca Castelnuovo
- Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy; Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, Verbania, Italy
| | - Francesco Gianfagna
- EPIMED Research Center, Department of Medicine and Surgery, University of Insubria, Varese, Italy; Mediterranea Cardiocentro, Napoli, Italy
| | - Licia Iacoviello
- EPIMED Research Center, Department of Medicine and Surgery, University of Insubria, Varese, Italy; Department of Epidemiology and Prevention, IRCCS Neuromed, Pozzilli, Italy
| | - Marco Mario Ferrario
- EPIMED Research Center, Department of Medicine and Surgery, University of Insubria, Varese, Italy.
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COVID-19-Related Burnout and Intention of Fully Vaccinated Individuals to Get a Booster Dose: The Mediating Role of Resilience. Vaccines (Basel) 2022; 11:vaccines11010062. [PMID: 36679907 PMCID: PMC9860670 DOI: 10.3390/vaccines11010062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 12/23/2022] [Accepted: 12/24/2022] [Indexed: 12/29/2022] Open
Abstract
Because an annual COVID-19 booster vaccine appears to be required to control the pandemic, identifying the factors that influence individuals' decision to receive a booster dose is critical. Thus, our goal was to quantify the influence of COVID-19-related burnout on vaccination intention and to investigate the role of resilience in mediating the link between burnout and intention. We conducted a cross-sectional study with a convenience sample during October 2022. We used the COVID-19 burnout scale and the Brief Resilience Scale. The study sample included 1256 people who had received their primary COVID-19 vaccination. Among the participants, 34.1% reported being very likely to be vaccinated with a booster dose. COVID-19-related burnout was found to be inversely connected with vaccination intention. Moreover, our results suggested that resilience not only had a positive direct effect on vaccination intention but also mediated the relationship between burnout and vaccination intention. Although our study had limitations, such as a convenience sample and information bias, we demonstrate the critical role of resilience in reducing the impact of COVID-19-related burnout on the vaccination intention. Policymakers should develop and implement initiatives to address the issues of COVID-19-related burnout and enhance booster adoption by strengthening psychosocial resources such as resilience.
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