Burnout in ICU doctors and nurses in mainland China-A national cross-sectional study

Depicting occupational trauma concepts impacting nurse well-being during the COVID-19 pandemic

PURPOSE

The purpose of this concept delineation was to differentiate similar concepts impacting nurse well-being during the COVID-19 pandemic, including: compassion fatigue, burnout, moral injury, secondary traumatic stress, and second victim.

METHODS

A total of 63 articles were reviewed for concept delineation. Morse's (1995) approach to concept delineation was utilized to analyse the articles.

RESULTS

Concepts were described interchangeably but were found to present themselves in a sequence. A nurse may experience moral injury, leading to a second victim experience, synonymous with secondary traumatic stress, then compassion fatigue and/or burnout that can be acute or chronic in nature. An Occupational Trauma Conceptual Model was created to depict how these concepts interact based on concept delineation findings.

CONCLUSION

Nurses are experiencing long-lasting occupational trauma and future intervention research should centre on optimizing nurse well-being to ensure the sustainability of nursing profession.

Effects of compassion satisfaction and compassion fatigue on posttraumatic growth of psychiatric nurses: A cross-sectional study

AIMS

This study aimed to explore the effects of compassion satisfaction and compassion fatigue on the posttraumatic growth of psychiatric nurses.

BACKGROUND

Psychiatric nurses' prolonged and repeated exposure to trauma and complex situations in the work environment can lead to negative emotions such as compassion fatigue, but they also experience positive consequences such as posttraumatic growth, and the relationship between compassion fatigue and posttraumatic growth is not unclear.

METHODS

A total of 336 nurses from psychiatry departments of seven tertiary hospitals in Sichuan Province, China, were administered an online questionnaire. Participants were recruited through convenience sampling. The posttraumatic growth level was measured with the Simplified Chinese version of the Posttraumatic Growth Inventory. The Professional Quality of Life Scale-Chinese version was used to assess compassion satisfaction, burnout and secondary traumatic stress. T-test and one-way variance analysis, Pearson correlation analysis and hierarchical linear regression were used for data analysis. A STROBE checklist was used to guide the reporting of the research.

RESULTS

Psychiatric nurses' posttraumatic growth is at a low level, influenced by demographic and occupational factors, whereas compassion satisfaction, burnout and secondary traumatic stress are at a moderate level. Hierarchical regression analysis suggested that compassion satisfaction and secondary traumatic stress had a positive impact on posttraumatic growth, whereas burnout had a negative impact on posttraumatic growth.

CONCLUSIONS

Findings suggest that nursing managers should attach importance to the mental health of psychiatric nurses, improve compassion satisfaction, alleviate burnout and promote posttraumatic growth.

Development of burnout and moral distress in intensive care nurses: An integrative literature review

AIMS

To describe, through an integrative literature review, the factors contributing to the development of burnout and moral distress in nursing professionals working in intensive care units and to identify the assessment tools used most frequently to assess burnout and moral distress.

METHODS

An integrative literature review was carried out. PubMed, CINAHL, PsycINFO, SciELO, Dialnet, Web of Science, Scopus, and Cochrane databases were reviewed from January 2012 to February 2023. Additionally, snowball sampling was used. The results were analysed by using integrative synthesis, as proposed by Whittemore et al., the Critical Appraisal Skills Programme for literature reviews, the Strengthening the Reporting of Observational Studies in Epidemiology guidelines for quantitative observational studies, and the Joanna Briggs Institute checklist for qualitative research were used to evaluate evidence quality.

RESULTS

Forty-one articles were selected for review: 36 were cross-sectional descriptive articles, and five were literature reviews. The articles were grouped into five-factor categories: 1) personal factors, 2) organisational factors, 3) labour relations factors, 4) end-of-life care factors, and 5) factors related to coronavirus disease 2019 (COVID-19). The Maslach Burnout Inventory-Human Services Survey and the Moral Distress Survey-Revised instruments were the most commonly used to measure burnout and moral distress.

CONCLUSIONS

This review highlights the multiple personal, organisational, relational, situational, and end-of-life factors promoting burnout and moral distress among critical care nurses. Interventions in these areas are necessary to achieve nurses' job satisfaction and retention while improving nurses' quality of care.

Calcium and vitamin D supplements and burnout of anesthesiologists: National cross-sectional study from China

OBJECTIVE

Job burnout among anesthesiologists has been consistently high. This study evaluated the association of calcium and vitamin D supplementation with burnout among Chinese anesthesiologists.

METHOD

A cross-sectional online survey was conducted during April and May 2023. Burnout was evaluated using the Maslach Burnout Inventory, which assesses emotional exhaustion, depersonalization, and low personal accomplishment. Data on calcium and vitamin D supplementations were self-reported. Sociodemographic information and medical history were also assessed. Binary and ordinal logistic regression were used to evaluate the risk of burnout and burnout levels, respectively. The relative excess risk due to interaction and the attributable proportion due to interaction were examined to determine the synergistic effects of calcium and vitamin D supplementations on burnout risk.

RESULTS

Among the 4222 invited anesthesiologists, 3766 submitted eligible questionnaires. Approximately 49.8% met the criteria for general burnout. Among anesthesiologists with burnout, 58.4% experienced emotional exhaustion, 35.8% depersonalization, and 61.2% low personal accomplishment. Anesthesiologists receiving calcium supplementation had a decreased risk of emotional exhaustion (OR = .83, 95% CI = .70-.99). Supplementation of vitamin D with or without calcium was not associated with overall burnout and any of its dimensions. No additive interaction of calcium and vitamin D on burnout was observed.

CONCLUSIONS

Job burnout among anesthesiologists is of concern in China. Burnout is negatively associated with calcium supplementation but not with vitamin D. Further research is warranted to confirm the mechanism and causal relationship.

Prevalence and factors associated with job burnout among nurses in China: A cross-sectional study

AIM

Many people see nursing as a high-pressure, high-risk profession. Therefore, job burnout among nursing staff has become an important topic of study and has received widespread attention worldwide. This research intended to evaluate the frequency of and variables related with work burnout among nurses in public hospitals in China.

DESIGN

Using a multistage random sample procedure, a cross-sectional survey was carried out in the eastern, central and western areas of China.

METHODS

The Maslach Inventory-Human Service Survey and demographic information made up the two sections of the questionnaire. Of the 5250 questionnaires sent, 4865 were deemed legitimate, yielding an effective response rate of 92.67%. A linear regression analysis was performed to investigate the variables linked to nursing work burnout.

RESULTS

Among the 4865 nurses, women accounted for 97.4% of the survey respondents, most of whom were aged 26-35 years. Results showed that the total scores of emotional exhaustion (EE), depersonalization (DP) and reduced personal accomplishment (PA) were 20.02 ± 12.04, 4.78 ± 5.54 and 34.42 ± 10.32 respectively. 50.7% of subjects obtained high or moderated scores on EE, 32.8% of subjects obtained high or moderated scores on DP and 80.4% of subjects obtained low or moderated scores on PA. Age, department, position, post-establishment, work shift type in recent months, overtime times in recent months and night shift frequency in recent months were negatively correlated with EE, and child status, monthly income, working days per week and sleep quality in recent 1 month were positively correlated with it (F = 141.827, P < 0.01, R2 = 0.243). Age, gender, department, post-establishment, overtime hours in recent months and night shift frequency in recent months were negatively correlated with DP, and child status and sleep quality in the last 1 month were positively correlated with it (F = 78.794, p < 0.01, R2 = 0.115). Child status, years of nursing work and sleep quality in the last 1 month were negatively correlated with PA, whereas age, position, work shift type in recent months and night shift frequency in recent months were positively correlated with it (F = 67.981, p < 0.01, R2 = 0.089).

How does strength use relate to burnout among Chinese healthcare professionals? Exploring the mediating roles of beliefs about stress and basic psychological needs satisfaction

BACKGROUND

The prevalence of burnout among healthcare workers remains chronically high. Former studies have indicated that strength use is a promising approach to reduce burnout. However, relatively little is known about the psychological mechanisms underlying the ability of strength use to reduce burnout, especially among healthcare workers.

AIM

This study sought to examine the link between strength use and burnout in Chinese healthcare workers, and to explore the mediating roles of beliefs about stress and basic psychological needs satisfaction in that relationship.

METHODS

This study was conducted in two time periods, from September to October 2020 and from February to September 2022. A total of 812 healthcare workers completed a multi-section questionnaire.

RESULTS

Strength use was negatively associated with burnout and negative stress beliefs, and positively associated with positive stress beliefs, control beliefs, and basic psychological needs satisfaction. Moreover, negative stress beliefs, control beliefs, and basic psychological needs satisfaction fully mediated the relationship between strength use and burnout. Furthermore, effect contrasts revealed that the mediating effect of basic psychological needs satisfaction was stronger than that of negative stress beliefs and control beliefs.

CONCLUSION

Our findings revealed that negative stress beliefs, control beliefs, and basic psychological needs satisfaction act as mediators in the association of strength use with burnout. Furthermore, basic psychological needs satisfaction plays a more important mediating role than negative stress beliefs and control beliefs in the strength use-burnout relationship.

Association Between Physical Activity and the Risk of Burnout in Health Care Workers: Systematic Review

BACKGROUND

Burnout is a multidimensional psychological syndrome that arises from chronic workplace stress. Health care workers (HCWs), who operate in physically and emotionally exhausting work contexts, constitute a vulnerable group. This, coupled with its subsequent impact on patients and public economic resources, makes burnout a significant public health concern. Various self-care practices have been suggested to have a positive effect on burnout among HCWs. Of these, physical activity stands out for its ability to combine psychological, physiological, and biochemical mechanisms. In fact, it promotes psychological detachment from work and increases self-efficacy by inhibiting neurotransmitters and neuromodulators, increasing endorphin levels, enhancing mitochondrial function, and attenuating the hypothalamic pituitary-adrenal axis response to stress.

OBJECTIVE

Our objective was to conduct a systematic review of the evidence on the association between physical activity and burnout among HCWs.

METHODS

We considered HCWs, physical activity, and burnout, framing them as population, exposure, and outcome, respectively. We searched APA PsycArticles, MEDLINE, and Scopus until July 2022. We extracted relevant data on study design, methods to measure exposure and outcome, and statistical approaches.

RESULTS

Our analysis encompassed 21 independent studies. Although 10% (2/21) of the studies explicitly focused on physical activity, the remaining investigations were exploratory in nature and examined various predictors, including physical activity. The most commonly used questionnaire was the Maslach Burnout Inventory. Owing to the heterogeneity in definitions and cutoffs used, the reported prevalence of burnout varied widely, ranging from 7% to 83%. Heterogeneity was also observed in the measurement tools used to assess physical activity, with objective measures rarely used. In total, 14% (3/21) of the studies used structured questionnaires to assess different types of exercise, whereas most studies (18/21, 86%) only recorded the attainment of a benchmark or reported the frequency, intensity, or duration of exercise. The reported prevalence of physically active HCWs ranged from 44% to 87%. The analyses, through a variety of inferential approaches, indicated that physical activity is often associated with a reduced risk of burnout, particularly in the domains of emotional exhaustion and depersonalization. Furthermore, we compiled and classified a list of factors associated with burnout.

CONCLUSIONS

Our comprehensive overview of studies investigating the association between physical activity and burnout in HCWs revealed significant heterogeneity in definitions, measurements, and analyses adopted in the literature. To address this issue, it is crucial to adopt a clear definition of physical activity and make thoughtful choices regarding measurement tools and methodologies for data analysis. Our considerations regarding the measurement of burnout and the comprehensive list of associated factors have the potential to improve future studies aimed at informing decision-makers, thus laying the foundation for more effective management measures to address burnout.

Glucose management in critically ill adults: A qualitative study from the experiences of health care providers

Aims and objective

To explain the components and elements of glucose management in critically ill adult patients from the healthcare providers' experiences.

Background

Critically ill adults are highly susceptible to stress-induced hyperglycaemia due to glucose metabolic disorders. Healthcare workers play a key role in the glycaemic management of critically ill patients. However, there is a lack of qualitative studies on the content and elements of glycaemic management and healthcare workers' perceptions about glycaemic management in China.

Design

Qualitative study that followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines.

Methods

Individual semi-structured interviews were conducted from January to April 2022. Fifteen physicians and nurses were recruited from ten hospitals in mainland China. Data were analysed using inductive thematic analysis.

Results

Glucose management in critically ill adult patients from their experiences included two parts: the inner ring (practice behaviours) and the external space (methods and drivers). The practice behaviours of glucose management include five elements, while the methods and drivers of glucose management focus on three elements. The content covered under each element was identified.

Conclusion

This study developed a glycaemic management model for critically ill adult patients, clarified its elements based on the perceptions of healthcare providers and elaborated on the methods and drivers covered under each element to provide a reference for physicians and nurses to develop a comprehensive glycaemic management guideline for critically ill adult patients.

Relevance to clinical practice

Our study proposed a glucose management practice model for critically ill adult patients, and the elements and components included in this model can provide a reference for physicians and nurses when performing glucose management in critically ill patients.

The prevalence of burnout among pulmonologists or respiratory therapists pre- and post-COVID-19: a systematic review and meta-analysis

OBJECTIVES

The coronavirus disease-19 (COVID-19) increased the already heavy workload in the pulmonary and respiratory departments, which therefore possibly increased the prevalence of burnout among pulmonologists or respiratory therapists. We aimed to compare the differences in burnout among pulmonologists or respiratory therapists pre- and post-COVID-19 by doing a systematic review with meta-analysis.

METHODS

We searched pulmonologist, or pulmonary, or respiratory, and burnout up to 29 January 2023 in six databases. We included studies investigating pulmonologists or respiratory therapists and reporting the prevalence of burnout among them. The risk of bias was assessed by a tool for prevalence studies. The overall prevalence of burnout was pooled.

RESULTS

A total of 2859 records were identified and 16 studies were included in the final analysis. The included studies reported 3610 responding individuals and 2336 burnouts. The pooled prevalence of burnout was 61.7% (95% confidence interval (CI), 48.6-73.2%; I² = 96.3%). The pooled prevalence of burnout during COVID-19 was significantly higher than it was prior to the outbreak (68.4% vs. 41.6%, p = .01). The result of the meta-regression revealed that COVID-19 coverage was significantly associated with the prevalence of burnout (p = .04).

CONCLUSIONS

Burnout was widely prevalent among pulmonologists or respiratory therapists and increasingly perceived during COVID-19. Therefore, interventions were needed to reduce burnout in this specialty.KEY MESSASGESThe coronavirus disease-19 increased the already heavy workload in the pulmonary and respiratory departments.Burnout was widely prevalent among pulmonologists or respiratory therapists and increasingly perceived during COVID-19.

Medical staff's emotional exhaustion and its relationship with patient safety dimensions

PURPOSE

Medical staff's emotional exhaustion increases cynical attitudes and behaviors about work and patients and leads medical staff to become detached from work. This may decrease patients' trust and satisfaction and even endanger patients' lives. There is a need to examine the critical factors affecting the medical staff's emotional exhaustion by investigating its relationship with the patient-safety dimensions based on the safety attitudes questionnaire (SAQ).

DESIGN/METHODOLOGY/APPROACH

A case study is conducted from the viewpoints of physicians and nurses to examine the relationship between emotional exhaustion and six dimensions of the SAQ from 2016 to 2020 from a regional teaching hospital in Taiwan. Linear regression with forward selection is employed. Six dimensions of the SAQ are the independent variables, whereas emotional exhaustion is the dependent variable for each year.

FINDINGS

Stress recognition is the most important variable to influence emotional exhaustion negatively, while job satisfaction is the second important variable to affect emotional exhaustion positively from 2016 to 2020. On the contrary, working conditions do not influence emotional exhaustion in this hospital from medical staff's viewpoints.

ORIGINALITY/VALUE

This study uses longitudinal data to find that both stress recognition and job satisfaction consistently influence emotional exhaustion negatively and positively, respectively, in this five-year period. The third dimension to impact emotional exhaustion varies from time to time. Thus, the findings from a cross-sectional study might be limited. The authors' findings show that reducing stress recognition and enhancing job satisfaction can lead to the improvement of emotional exhaustion from medical staff's viewpoints, which should be monitored by hospital management.

Burnout symptoms among physicians and nurses before, during and after COVID-19 care

OBJECTIVE

this study evaluated burnout symptoms among physicians and nurses before, during and after COVID-19 care.

METHOD

a cross-sectional comparative study in the Pulmonary Care unit of a tertiary-level public hospital. The Maslach Burnout Inventory was used.

RESULTS

280 surveys were distributed across three periods: before (n=80), during (n=105) and after (n=95) COVID-19 care; 172 surveys were returned. The response rates were 57.5%, 64.8% and 61.1%, respectively. The prevalence of severe burnout was 30.4%, 63.2% and 34.5% before, during and after COVID-19 care (p<0.001). Emotional exhaustion (p<0.001) and depersonalization (p=0.002) symptoms were more prevalent among nurses than among physicians. Severe burnout was more prevalent in women, nurses and night shift staff.

CONCLUSION

the high prevalence of burnout doubled in the first peak of hospital admissions and returned to pre-pandemic levels one month after COVID-19 care ended. Burnout varied by gender, shift and occupation, with nurses among the most vulnerable groups. Focus on early assessment and mitigation strategies are required to support nurses not only during crisis but permanently.

Factors Associated with Burnout in Medical Staff: A Look Back at the Role of the COVID-19 Pandemic

Despite the significant consequences for medical practice and public health, burnout in healthcare workers remains underestimated. Pandemic periods have increased the reactivity to stress by favoring some changes whose influence are still felt.

PURPOSE

This study aims to identify opportune factors during pandemic periods that predispose medical personnel to burnout and the differences between medical staff which worked with COVID-19 patients and those who did not work with COVID-19 patients.

MATERIAL AND METHODS

This is a prospective study on 199 subjects, medical staff and auxiliary staff from national health units, COVID-19 and non-COVID-19, who answered questions using the Google Forms platform about the level of stress related to the workplace and the changes produced there. All statistical analyses were conducted using IBM SPSS Statistics (Version 28).

RESULTS

The limited equipment and disinfectant solutions from the lack of medical resources category, the fear of contracting or transmitting the infection from the fears in relation to the COVID-19 pandemic category and the lack of personal and system-level experience in combating the infection due to the lack of information on and experience with COVID-19 were the most predisposing factors for burnout. No significant differences were recorded between those on the front line and the other healthcare representatives.

CONCLUSIONS

The results of this study identify the stressors generated in the pandemic context with prognostic value in the development of burnout among medical personnel. At the same time, our data draw attention to the cynicism or false-optimism stage of burnout, which can mask a real decline.

Nurse burnout before and during the COVID-19 pandemic: a systematic comparative review

Introduction

This review aimed to compare available evidence examining burnout using the Maslach Burnout Inventory (MBI) in nurses before and during the COVID-19 pandemic. The specific objective was to compare nurse burnout scores in terms of emotional exhaustion, depersonalization, and personal accomplishment.

Methods

A comprehensive search was conducted for studies on nurses' burnout using the MBI published between 1994 and 2022. In total, 19 studies conducted prior to the pandemic and 16 studies conducted during the pandemic were included and compared using the criteria from the Joanna Briggs Institute Critical Appraisal Tool.

Results

Surprisingly, the results indicated that nurses' burnout scores did not differ significantly before (N = 59,111) and during (N = 18,629) the pandemic. The difference observed was qualitative rather than quantitative.

Discussion

The outbreak of the COVID-19 pandemic exacerbated an already critical situation, and while COVID-19 may serve as an additional triggering factor for staff mental illness, it cannot solely explain the observed burnout levels. These findings underscore the need for long-term clinical and preventive psychological interventions, suggesting that psychological resources should not be limited to emergencies but extended to address the ongoing challenges faced by nurses.

Systematic review registration

https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=399628, identifier: CRD42023399628.

Influence of psychological capital on core competency for new nurses

BACKGROUND

The development of core competency is crucial for the success of new nurses, enabling them to deliver high-quality care. Psychological capital (PsyCap), encompassing self-efficacy, optimism, hope, and resilience, significantly influences individuals' abilities and achievements across various professions. However, limited research has specifically examined the impact of PsyCap on the core competency of new nurses. This study aims to bridge this gap by investigating the relationship between PsyCap and core competency development in new nurses, providing valuable strategic insights for improving PsyCap and promoting core competence acquisition.

METHODS

142 new nurses were chosen for the investigation using a convenient cluster sampling method. The questionnaire included components on socio-demographic characteristics, the Competency Inventory for Registered Nurses (CIRN), and the PsyCap Questionnaire-24 (PCQ-24). The t-test, One-Way ANOVA, Pearson correlation analysis and hierarchical multiple regression were used for statistical analysis.

RESULT

The number of valid questionnaires was 138, and the effective return rate was 97.2%. The overall mean score for core competencies was 171.01 (SD 25.34), and the PsyCap score was 104.76(SD 13.71). The PsyCap of new nurses was highly correlated with core competency, with a correlation coefficient of r = 0.7, p < 0.01. Self-efficacy of PsyCap is a significant independent predictor of core competency (adjust R2 = 0.49).

CONCLUSION

Self-efficacy in PsyCap is an important predictor of new nurses' core competency. Nursing managers should pay sufficient attention to the cultivation and development of new nurses' PsyCap, with particular emphasis on enhancing self-efficacy to improve their core competency.

Relationship between burnout levels of nurses and their circadian preference, sleep quality, and personality traits

Occupational stress and burnout are widely encountered among many healthcare professionals, including nurses and doctors, as well as among members of other professions. For example, nurses, who have disrupted circadian rhythms, are seen to have sleep problems. In addition, their personality traits are also considered to be related with burnout. This study aimed to identify nurses' circadian preference and personality traits along with their effects on sleep quality and their relationship with burnout. In this study, 211 nurses (40 male, 171 female) using the correlational model from quantitative research methods was used since the variables of morningness/eveningness, personality trait, sleep quality, and burnout were aimed to be investigated at once, without intervention, within the predictivity context of the relationship among them. When the scores obtained from the burnout scale were examined, it was observed that the emotional exhaustion and personal accomplishment subdimensions were so close to the median value and mean, while depersonalization was quite low compared to these sub-dimensions. The participants' sleep quality was seen to be at the lowest step of the poor sleep quality class. When the scores obtained from the MESSI scale are examined, it is seen that the scores obtained from the morning affect dimension are above the median value, and the highest average according to the Five-Factor Personality Traits Scale is obtained in the subdimensions of agreeableness and conscientiousness. Female gender, constantly work at night, having a high number of weekly working hours increased burnout level. Additionally Evening chronotype, poor sleep quality, neuroticism, agreeableness, extroversion and conscientiousness personality traits were found to be associated with burnout in this study. In the study, being of different chronotypes, having other personality traits, and varying sleep quality scores were seen to affect the sub-dimensions of burnout.

Relationship between sleep disturbance and burnout among Chinese urban teachers: Moderating roles of resilience

BACKGROUND

Sleep disturbance and burnout are prevalent among primary and secondary school teachers. Nevertheless, little is known about the relationship between sleep disturbance and burnout, and the mechanisms connecting this link. Our study aimed to explore the relationship between sleep disturbance and burnout among urban teachers, as well as to investigate this influencing mechanism further with resilience as a moderator.

METHODS

14,218 primary and secondary school teachers provided valid data. We assessed demographic information, sleep disturbance, burnout, and resilience. Multivariable logistic regression, Spearman correlation, and moderation analyses were used to evaluate the relationship between sleep disturbance and burnout and the moderating role of resilience.

RESULTS

Of the participants, the prevalence of sleep disturbance and sleep deprivation among teachers was 20.0% and 31.7%, respectively. Additionally, 58.4% of teachers reported moderate or severe burnout, and 15.3% had both sleep disturbance and burnout. Sleep disturbance was significant and positively related to burnout. Resilience was found to moderate the association between sleep disturbance and burnout.

CONCLUSIONS

These findings suggested strong associations between sleep disturbance and burnout. Interventions in improving resilience may protect teachers with sleep disturbance from burnout.

Prevalence and correlators of burnout among health professionals during different stages of the COVID-19 pandemic in China

Background

Persistently increased workload and stress occurred in health professionals (HPs) during the past 3 years as the COVID-19 pandemic continued. The current study seeks to explore the prevalence of and correlators of HPs' burnout during different stages of the pandemic.

Methods

Three repeated online studies were conducted in different stages of the COVID-19 pandemic: wave 1: after the first peak of the pandemic, wave 2: the early period of the zero-COVID policy, and wave 3: the second peak of the pandemic in China. Two dimensions of burnout, emotional exhaustion (EE) and declined personal accomplishment (DPA), were assessed using Human Services Survey for Medical Personnel (MBI-HSMP), a 9-item Patient Health Questionnaire (PHQ-9), and a 7-item Generalized Anxiety Disorder (GAD-7) to assess mental health conditions. An unconditional logistic regression model was employed to discern the correlators.

Results

There was an overall prevalence of depression (34.9%), anxiety (22.5%), EE (44.6%), and DPA (36.5%) in the participants; the highest prevalence of EE and DPA was discovered in the first wave (47.4% and 36.5%, respectively), then the second wave (44.9% and 34.0%), and the third wave had the lowest prevalence of 42.3% and 32.2%. Depressive symptoms and anxiety were persistently correlated with a higher prevalence risk of both EE and DPA. Workplace violence led to a higher prevalence risk of EE (wave 1: OR = 1.37, 95% CI: 1.16-1.63), and women (wave 1: OR = 1.19, 95% CI: 1.00-1.42; wave 3: OR =1.20, 95% CI:1.01-1.44) and those living in a central area (wave 2: OR = 1.66, 95% CI: 1.20-2.31) or west area (wave 2: OR = 1.54, 95% CI: 1.26-1.87) also had a higher prevalence risk of EE. In contrast, those over 50 years of age (wave 1: OR = 0.61, 95% CI: 0.39-0.96; wave 3: OR = 0.60, 95% CI: 0.38-0.95) and who provided care to patients with COVID-19 (wave 2: OR = 0.73, 95% CI: 0.57-0.92) had a lower risk of EE. Working in the psychiatry section (wave 1: OR = 1.38, 95% CI: 1.01-1.89) and being minorities (wave 2: OR = 1.28, 95% CI: 1.04-1.58) had a higher risk of DPA, while those over 50 years of age had a lower risk of DPA (wave 3: OR = 0.56, 95% CI: 0.36-0.88).

Conclusion

This three-wave cross-sectional study revealed that the prevalence of burnout among health professionals was at a high level persistently during the different stages of the pandemic. The results suggest that functional impairment prevention resources and programs may be inadequate and, as such, continuous monitoring of these variables could provide evidence for developing optimal strategies for saving human resources in the coming post-pandemic era.

High-level burnout in physicians and nurses working in adult ICUs: a systematic review and meta-analysis

PURPOSE

The prevalence of burnout in intensive care unit (ICU) professionals is difficult to establish due to the variety of survey instruments used, the heterogeneity of the targeted population, the design of the studies, and the differences among countries regarding ICU organization.

METHODS

We performed a systematic review and meta-analysis examining the prevalence of high-level burnout in physicians and nurses working in adult ICUs, including only studies that use the Maslach Burnout Inventory (MBI) as a tool to evaluate burnout and involving at least 3 different ICUs.

RESULTS

Twenty-five studies with a combined population of 20,723 healthcare workers from adult ICUs satisfied the inclusion criteria. Combining 18 studies including 8187 ICU physicians, 3660 of them reported a high level of burnout (prevalence 0.41, range 0.15-0.71, 95% CI [0.33; 0.5], I2 97.6%, 95% CI [96.9%; 98.1%]). The heterogeneity can be at least in part explained by the definition of burnout used and the response rate as confirmed by the multivariable metaregression done. In contrast, there was no significant difference regarding other factors such as the study period (before or during the coronavirus disease 2019 (COVID-19) pandemic), the income of the countries, or the Healthcare Access and Quality (HAQ) index. Combining 20 studies including 12,536 ICU nurses, 6232 of nurses were reporting burnout (prevalence 0.44, range 0.14-0.74, [95% CI 0.34; 0.55], I2 98.6% 95% CI [98.4%; 98.9%]). The prevalence of high-level burnout in ICU nurses for studies performed during the COVID-19 pandemic was higher than that reported for studies performed before the COVID-19 pandemic (0.61 [95% CI, 0.46; 0.75] and 0.37 [95% CI, 0.26; 0.49] respectively, p = 0.003). As for physicians, the heterogeneity is at least in part explained by the definition used for burnout using the MBI but not by the number of participants. When compared, the prevalence of high-level burnout was not different between ICU physicians and ICU nurses. However, the proportion of ICU nurses with a high level of emotional exhaustion was higher than for ICU physicians (0.42 [95% CI, 0.37; 0.48] and 0.28 [0.2; 0.39], respectively, p = 0.022).

CONCLUSION

According to this meta-analysis, the prevalence of high-level burnout is higher than 40% in all ICU professionals. However, there is a great heterogeneity in the results. To evaluate and to compare preventive and therapeutic strategies, there is the need to use a consensual definition of burnout when using the MBI instrument.

Healthy And Unhealthy Lifestyles As Factors Of Occupational Burnout In Obstetrics And Gynecology Physicians

This article investigates healthy and unhealthy lifestyles and its components (physical activity, drinking alcohol, consumption of caffeinated products, tobacco use) as factors of occupational burnout in obstetrics and gynecology physicians. Material and Methods. A total of 132 physicians and nurses from the different clinics of Irkutsk were surveyed. We used Maslach Burnout Inventory (MBI), SF-12, and Godin Leisure-Time Exercise Questionnaire. Results: Differences in healthy and unhealthy lifestyles between physicians and nurses employed in obstetrics and gynecology, with or without a high burnout, were revealed. According to the obtained results, the frequency of alcohol consumption was directly related to burnout. In study subjects engaged in low and moderate physical activity, burnout occurred briefly or rarely. The differences became more pronounced when we excluded physicians and nurses with poor physical health from consideration, because they did not exercise much. According to the results of logistic regression, the probability of burnout and reduced level of quality of life among physicians and nurses increased with a bigger family size, lower work experience, and less time spent on moderate physical activity. Conclusion: Healthy and unhealthy lifestyles can cause healthcare employee burnout. Physicians and nurses with a high burnout consumed stronger alcohol and spent less time in moderate physical activity.

Risk Factors Surrounding an Increase in Burnout and Depression Among Health Care Professionals in Taiwan During the COVID-19 Pandemic

OBJECTIVES

This study aimed to investigate the risk factors surrounding an increase in both burnout levels and depression among health care professionals in Taiwan through use of a longitudinal study design.

DESIGN

This is a 2-year observational study that took place from January 2019 to December 2020.

SETTING AND PARTICIPANTS

Data among health care professionals were extracted from the Overload Health Control System of a tertiary medical center in central Taiwan.

METHODS

Burnout was measured through use of the Chinese version of the Copenhagen Burnout Inventory (C-CBI), whereas depression was ascertained by the Taiwanese Depression Questionnaire. Each participant provided both burnout and depression measurements during a nonpandemic period (2019) as well as during the COVID pandemic era (2020). Risk factors surrounding an increase in burnout levels and depression were analyzed through a multivariate logistic regression model with adjusting confounding factors.

RESULTS

Two thousand nineteen participants completed the questionnaire over 2 consecutive years, including 132 visiting doctors, 105 resident doctors, 1371 nurses, and 411 medical technicians. After adjustments, sleeplessness, daily working hours >8, and stress due to one's workload were all found to be risk factors for an increase in depression levels, whereas sleeplessness, lack of exercise, and stress due to one's workload were all found to be risk factors for an increase in personal burnout level. Being a member of the nursing staff, a younger age, sleeplessness, and lack of exercise were all risk factors for an increase in work-related burnout levels.

CONCLUSIONS AND IMPLICATIONS

Poor sleep, lack of exercise, long working hours, and being a member of the nursing staff were risk factors regarding an increase in personal burnout, work-related burnout levels and depression among health care professionals. Leaders within the hospital should investigate the working conditions and personal habits of all medical staff regularly and systematically during the COVID-19 pandemic and take any necessary preventive measures, such as improving resilience for nursing staff, in order to best care for their employees.

The relationship between secondary traumatic stress and burnout in critical care nurses: The mediating effect of resilience

PURPOSE

To examine the mediating factor on the association of secondary traumatic stress and burnout among critical care nurses.

DESIGN

A correlational study.

METHODS

Data were collected from a convenience sampling of 147 nurses from two general hospitals who had six or more months of experience working in an intensive care unit. The collected data were analyzed through t-test, ANOVA, Scheffé test, Mann-Whitney test, Kruskal-Wallis test, Bonferroni correction, and Pearson's correlation coefficient using SPSS 25.0. The mediating effect of resilience was analyzed through the three-stage mediation effect test procedure using hierarchical regression analysis and the Sobel test.

RESULTS

Secondary traumatic stress had a statistically significant positive correlation with burnout (r = 0.45, p <.001), and a statistically significant negative correlation between burnout and resilience (r = -0.54, p <.001) was observed. Secondary traumatic stress was found to have a statistically significant effect on resilience, which was the mediating variable (β = -0.17, p =.042). Additionally, secondary traumatic stress had a statistically significant effect on burnout (β = 0.45, p <.001). The significance of the mediating effect of resilience on the relationship between secondary traumatic stress and burnout was investigated using the Sobel test, and the mediating effect of resilience was found to be statistically significant (Z = 1.98, p =.048).

CONCLUSION

Resilience was found to have a partial mediating effect in the relationship between critical care nurses' secondary traumatic stress and burnout. The study thus provides basic data on the importance of resilience in preventing burnout from secondary traumatic stress.

Does perceived organization support moderates the relationships between work frustration and burnout among intensive care unit nurses? A cross-sectional survey

BACKGROUND

Intensive care unit (ICU) nurses are at high risk of burnout and warranting attention. Existing literature found that work frustration was related to burnout, whilst perceived organization support influenced the association of work frustration with burnout. The purpose of this study was to investigate the relationship of work frustration and burnout among ICU nurses, and to examine the moderating effect of perceived organization support in their relationship.

METHODS

The cross-sectional study was conducted with a convenience sample of 479 ICU nurses from several 3 tertiary hospitals during December 2021 to May 2022. The Maslach Burnout Inventory-Human services survey (MBI-HSS), National Aeronautics and Space Administration Task Load Index (NASA-TLX) and perceived organization support Scale (POSS) were used to collect data. The PROCESS macro was performed to test the moderation effect of perceived organization support.

RESULTS

The total score of burnouts was (55.79 ± 17.20), the total score of work frustration was (7.44 ± 1.86). Burnout was positively correlated with work frustration (r = 0.301, P < 0.001) and negatively correlated with perceived organizational support (r = -0.430, P < 0.001). The moderation model analysis showed that perceived organizational support could moderate the relationship between work frustration and burnout (β = -0.111, ΔR2 = 0.011, P = 0.007).

CONCLUSIONS

The findings highlight the moderating role of perceived organizational support in the relationship between work frustration and burnout. Hence, interventions to reduce burnout among ICU nurses should consider targeting organizational support and work frustration.

Predictors of job burnout among Chinese nurses: a systematic review based on big data analysis

Job burnout is an occupational hazard induced by prolonged exposure to excessive work-related stress -a state of physical or emotional exhaustion that also involves a sense of reduced accomplishment and loss of personal identity. Knowledge jobs involve many health-promoting features, but stress and burnout may be caused by the rapid increase in the knowledge intensity of work, new job demands, and emerging new professional subcultures emphasizing the excessive commitment to work. Although there are studies on job burnout and predictors among nurses worldwide, evidence specific to Chinese nurses is lacking. The purpose of this review is to synthesize current research on predictors related to burnout affecting Chinese nurses. We searched the Chinese databases including National Knowledge Infrastructure (CNKI), WanFang, China Science and Technology Journal Database, and Chinese Biological Medical Database (CBM); and international databases including Cochrane Library, PubMed, EMBASE, and Web of Science published up to 30th August 2022. The 125 studies identified assessed a range of predictors of job burnout. The results showed good working relationships and internally controlled individuals were found to be predictive of job burnout. Moreover, numerous predictors produced contradictory data. There are still challenges with how to systematically operationalize such a complicated phenomenon to effectively prevent or reduce job burnout.

Burnout among ICU Healthcare Workers at Two Tertiary Care Hospitals in Makkah during the Hajj Season

Background

The Hajj season results in increased workload and longer shift hours for healthcare workers at the intensive care units (ICUs), which may result in burnout.

Objective

To determine the point prevalence of professional burnout and its predictors among healthcare workers at the ICUs of two tertiary care hospitals in Makkah during the Hajj season.

Methods

This cross-sectional descriptive study included all healthcare professionals working at the ICU departments of two of the largest tertiary care hospitals in the Makkah region during the 1439/2018 Hajj season. The original Maslach Burnout Inventory (MBI) questionnaire was used to measure burnout. Logistic regression models were fitted to estimate the effect size of the associated risk factors.

Results

A total of 354 participants completed the questionnaire. Moderate to severe burnout was found in each of the three subscales: emotional exhaustion, 56%; depersonalization, 82%, and impaired personal achievement, 72%. Nurses were significantly more likely to experience burnout compared with physicians (P = 0.017). Independent predictors of moderate or severe burnout were being aged ≤40 years (odds ratio [OR]: 2.1, 95% CI: 0.395-4.002; P = 0.045), female gender (OR: 2.2, 95% CI: 0.242-4.346; P = 0.037); work having a negative impact on family (OR: 3, 95% CI: 0.164-5.504; P = 0.019); unsatisfaction with salary (OR: 2.8, 95% CI: 0.28-5.056; P = 0.025); and working at the cardiac critical care unit (OR: 2.6, 95% CI: 0.440-4.467; P = 0.035).

Conclusion

This study revealed that the point prevalence of burnout is common among ICU healthcare workers during the Hajj season. These findings can be used by policymakers to devise strategies to mitigate the risks of burnout during the Hajj season.

From sense of competence to work–life and life–work enhancements of medical doctors: Sen’s capability approach

Purpose

Drawing upon the capability approach, this study aims to investigate the impact of sense of competence on work–life and life–work enhancements. It also examines the mediating roles of mindfulness and flow at work in the above relationships.

Design/methodology/approach

A sample of 254 medical doctors in various hospitals in Vietnam was surveyed to validate the measures via confirmatory factor analysis and to test the model and hypotheses using structural equation modeling.

Findings

The results demonstrate that mindfulness and flow at work fully mediate the effects of sense of competence on both work–life and life–work enhancements, but sense of competence does not have any direct effect on both.

Originality/value

To the best of the authors’ knowledge, this study is among the first to examine the roles of sense of competence, mindfulness and flow at work in work–life and life–work enhancements, adding further insight into the literature on work–life balance. It also offers evidence for the capacity approach in explaining work–life and life–work enhancements in an emerging market, Vietnam.

Status and related factors of burnout among palliative nurses in China: a cross-sectional study

Background

Burnout occurs frequently in nurses and seems more common in nurses providing palliative care. However, to our knowledge, there is a lack of understanding regarding the factors influencing burnout among palliative nurses in China.

Methods

A cross-sectional design was conducted. A total of 331 palliative nurses from 25 hospitals participated in this study. Anonymous data were collected through a self-designed social-demographic questionnaire, the Nursing Burnout Scale, the Perceived Social Support Scale, the General Self-Efficacy Scale, the Connor-Davidson Resilience Scale, and the Simplified Coping Style Questionnaire. Independent sample t tests, one-way ANOVA, Pearson correlations, and multiple linear regressions were performed to identify the related factors of the three dimensions of burnout.

Results

In the results of multiple linear regression, resilience, health condition, coping style, and pessimistic personality were common related factors; in addition, end-of-life care training, social support, and income satisfaction were statistically significantly associated with burnout. These factors could explain 38.6%, 27.8%, and 34.5% of the total variance in emotional exhaustion, depersonalization, and reduced personal accomplishment, respectively.

Conclusions

The findings of this study help policy makers and nurse managers better understand burnout among palliative nurses in China. The results highlighted the importance of implementing culture-oriented training programs, providing perceived organizational support, and building a reasonable salary system to decrease burnout among palliative nurses, increase the quality of nursing and promote the development of Chinese palliative care.

Burnout Syndrome During COVID-19 Second Wave on ICU Caregivers

Objective

The main objective of this article is to evaluate the prevalence of burnout syndrome (BOS) among the Intensive Care Unit (ICU) healthcare workers.

Methods

The COVID-impact study is a study conducted in 6 French intensive care units. Five units admitting COVID patient and one that doesn’t admit COVID patients. The survey was conducted between October 20th and November 20th, 2020, during the second wave in France. A total of 208 professionals responded (90% response rate). The Maslach Burnout Inventory scale, the Hospital Anxiety and Depression Scale and the Impact of Event Revisited Scale were used to study the psychological impact of the COVID-19 Every intensive care unit worker.

Results

The cohort includes 208 professionals, 52.4% are caregivers. Almost 20% of the respondents suffered from severe BOS. The professionals who are particularly affected by BOS are women, engaged people, nurses or reinforcement, not coming willingly to the intensive care unit and professionals with psychological disorders since COVID-19, those who are afraid of being infected, and people with anxiety, depression or post-traumatic stress disorder. Independent risk factors isolated were being engaged and being a reinforcement. Being a volunteer to come to work in ICU is protective. 19.7% of the team suffered from severe BOS during the COVID-19 pandemic in our ICU. The independent risk factors for BOS are: being engaged (OR = 3.61 (95% CI, 1.44; 9.09), don’t working in ICU when it’s not COVID-19 pandemic (reinforcement) (OR = 37.71 (95% CI, 3.13; 454.35), being a volunteer (OR = 0.10 (95% CI, 0.02; 0.46).

Conclusion

Our study demonstrates the value of assessing burnout in health care teams. Prevention could be achieved by training personnel to form a health reserve in the event of a pandemic.

Factors Associated with Burnout in Healthcare Professionals

Burnout in healthcare professionals remains an ongoing concern. There are a number of variables associated with reactivity to stress in healthcare staff. This study wants to identify risk factors which predispose healthcare professionals to burnout.

MATERIAL AND METHODS

The cross-sectional study included a group of 200 subjects, medical staff and auxiliary staff from the national health units, who gave their free consent to answer the questions regarding the level of perceived stress at work. The screening tool used was disseminated through the Google Forms platform, maintaining the anonymity of the participants.

RESULTS

Resident doctors (42%) responded predominantly, reporting the highest level of burnout, with nurses (26.5%) being the least affected (χ² = 36.73, p < 0.01). Less work experience is correlated with increased burnout (rho = 0.29, p < 0.01). Reactivity to stress was highly associated with workplace, with ambulance staff being the most vulnerable (χ² = 6.58, p < 0.05). Participants' relationship status significantly influenced the burnout rate, the unmarried, with or without a partner, being more affected (χ² = 16.14, p < 0.01). There are no significant differences between male and female gender, regarding the average level of burnout (U = 1.47; p > 0.05), nor between living in a house or apartment (U = 4.66; p > 0.05). Positive associations were identified between the level of burnout and variables such as: management pressure, administrative work, routine, regretting decisions regarding patients, harassment at work and sacrifice of personal time.

CONCLUSIONS

The results of this study identify age, profession, workplace seniority and relationship status as factors associated with burnout in medical personnel.

Prevalence Of Sleep Disorders Among Physicians And Nurses During COVID-19 Pandemic

The objective of our review was to analyze studies of prevalence sleep disorders among medical workers during COVID-19 pandemic. Material and Methods — Overall, during the analyzed period, studying domestic and foreign databases, we identified 94 publications on the development of sleep disorders among medical personnel working during COVID–19 pandemic in 2000-2021. However, only 88 of these publications complied with the objective of the review. We included 75 full-text publications in this review. Results — Physicians and nurses during COVID-19 pandemic do not have the opportunity to take therapy aimed at combating the symptoms of sleep disorders, due to the need to maintain sufficient attention and the risk of developing excessive drowsiness while on duty in a COVID -19 hospital. The latter can have a negative impact on their professional activities. Thus, this problem certainly requires professional psychotherapeutic correction. Unfortunately, not all medical institutions have such specialists. Conclusion — Based on the literature review, we found out that health care workers have a high risk of developing sleep disorders. This can include violations of the circadian rhythm, a decrease in the quality and duration of night sleep, daytime hypersomnia caused by shift work in a hospital. An additional factor affecting the frequency and severity of sleep disorders in healthcare workers (physicians and nurses) is chronic stress, the importance of which has increased during the COVID-19 pandemic. Currently, the above problem has not been completely solved and requires research in this area and the development of new programs to help medical personnel.

Associations between perceived overqualification, transformational leadership and burnout in nurses from intensive care units: a multicentre survey

AIMS

To explore whether perceived overqualification increases the risk of burnout, and whether transformational leadership negatively moderates this relationship.

BACKGROUND

Perceived overqualification might contribute to burnout and lead to poor experience of transformational leadership, and transformational leadership might be associated with burnout. However, these relationships have not yet been confirmed.

METHODS

A multicentre cross-sectional study. A total of 321 nurses from intensive care units were recruited from six tertiary hospitals. Scale of Perceived OverQualification, Transformational Leadership Questionnaire and emotional exhaustion subscale of the Maslach Burnout Inventory-General Survey were employed to collect the data. Hierarchical multiple regression and bootstrap resampling were applied to analyse the data.

RESULTS

Burnout was positively associated with perceived overqualification and negatively associated with transformational leadership (each p < 0.05). Transformational leadership significantly mediated the relationship between perceived overqualification and burnout (b = -0.6389, 95% confidence interval: -0.8706, -0.4072).

CONCLUSION

Our findings indicated that perceived overqualification and transformational leadership directly or indirectly affect burnout among nurses from intensive care units. Implications for nursing managers Personal and organizational-oriented interventions utilizing nurses' overall qualifications and implementing transformational leadership should be employed by nurse managers to alleviate burnout and promote the work performance of nurses from intensive care units.

Burnout Among Medical Staff 1 Year After the Beginning of the Major Public Health Emergency in Wuhan, China

Objectives

Wuhan is the city where coronavirus disease (COVID-19) was first reported and developed into a pandemic. However, the impact of the prolonged COVID-19 pandemic on medical staff burnout remains limited. We aimed to identify the prevalence and major determinants of burnout among medical staff 1 year after the beginning of the COVID-19 pandemic in Wuhan, China.

Materials and Methods

A total of 1,602 medical staff from three hospitals in Wuhan, China, were included from November 1–28, 2021. Chi-square tests were conducted to compare the prevalence of burnout across groups based on sociodemographic and professional characteristics. A multivariate analysis was performed using a forward stepwise logistic regression model.

Results

Approximately 37.39% of the medical staff experienced burnout 1 year after COVID-19 pandemic. Emotional exhaustion (EE) was the most common symptom of burnout, with 1,422 (88.76%) participants reporting a severe EE. Burnout was associated with insufficient social support and “neutral” or “dissatisfied” patient-physician relationships. Respondents who participated in the care of COVID-19 patients had a higher risk of burnout symptoms than those who did not participate. In particular, mental resilience was negatively associated with burnout among the medical staff.

Conclusion

Nearly two-fifths of the participants had symptoms of burnout, with reduced personal accomplishment being the predominant symptom 1 year after COVID-19. Healthcare organizations should regularly measure and monitor burnout among the medical staff. In addition, creating positive work environments and improving the mental resilience of medical staff may be effective ways to reduce burnout.

Experiences and psychosocial predictors of professional function among intensive care nurses under the shadow of Covid-19: A mixed-methods study

BACKGROUND

The outbreak of the Corona virus (COVID-19) pandemic led to a sharp rise in morbidity and hospitalizations, and a significant therapeutic burden fell on intensive care units (ICUs). Intensive care nurses reported physical and emotional stress in response to the extra workload caused by caring for critically ill COVID-19 patients. However, at the time of publication of the study, to the best of our knowledge there have been no studies that examined uncertainty, stress, or hope in the context of functioning among intensive care nurses.

AIM

To examine: (a) the challenges of operating and managing intensive care units during the COVID-19 pandemic among nurse managers in intensive care units, and (b) the relationships between uncertainty, stress, burnout, hope, and professional functioning among intensive care nurses during the COVID-19 pandemic.

DESIGN

This mixed-methods study was conducted in intensive care units (ICUs) at a large tertiary medical center in Israel, during February-May 2021.

METHODS

The data were collected in two phases. In the first phase, qualitative data were collected from focus groups attended by 15 senior managerial nurses. The second phase involved a cross-sectional study among 100 staff nurses working in 5 ICUs. The data were collected using a structured questionnaire.

RESULTS

Qualitative data analysis revealed two main themes: (a) challenges of the COVID-19 pandemic and (b) positive aspects of the COVID-19 pandemic. The nurses reported high levels of burnout, emotional stress and uncertainty, but moderate State Hope Scale scores, and moderate levels of professional functioning. There were no statistical differences in study variables by exposure to COVID-19 patients. State Hope Scale levels, uncertainty, and burnout variables contributed significantly and explained 46% of the variance of the professional functioning.

CONCLUSIONS

The intensity of the experiences and psych-social phenomena, is not affected by exposure to treatment of COVID-19 patients. The relationships between the study variables emphasize the importance of initiated and ongoing interventions to reduce uncertainty, address burnout, and strengthen hope. Improvement in these indices may lead to better ICU nurses' professional functioning and their work life well-being.

Burnout und Abhängigkeit bei ärztlichem Personal zeitlos und während der COVID-19-Pandemie am Beispiel der Chirurgie und Anästhesie

Hintergrund

Die COVID-19(„coronavirus disease 2019“)-Pandemie wirkt sich auf die psychische Gesundheit und das berufliche Verhalten von Chirurgen und Chirurginnen und Anästhesisten und Anästhesistinnen aus und scheint einen Einfluss auf die Substanzabhängigkeit zu haben.

Fragestellung

Welche Gründe gibt es für das Auftreten einer Substanzabhängigkeit und einem Burnout bei Chirurgen und Chirurginnen und Anästhesisten und Anästhesistinnen zeitlos und während der COVID-19-Pandemie und welche Verbesserungsmaßnahmen könnten im klinischen Alltag helfen?

Material und Methoden

Es wurde eine Literaturrecherche in Form einer systematischen Übersicht („systematic review“) zu Studien und Übersichtsarbeiten durchgeführt, die für das Thema relevant sind.

Ergebnisse

Im Laufe der Jahre hat sich gezeigt, dass Chirurgen bzw. Chirurginnen und Anästhesisten bzw. Anästhesistinnen aufgrund ihres direkten Zugangs zu Medikamenten in der Klinik und der arbeitsbezogenen Stressbelastung zur Drogenabhängigkeit neigen. Insbesondere Chirurgen und Chirurginnen und Anästhesisten und Anästhesistinnen schienen eine erhöhte Neigung zur Suchterkrankungen und ein erhöhtes Burnout-Risiko in der Pandemie vorzuweisen.

Schlussfolgerungen

Präventive Maßnahmen zugunsten besserer Arbeitsbedingungen in der Chirurgie und Anästhesie und eine bessere Drogenkontrolle (nicht nur wegen der Ausgabe, sondern auch wegen der richtigen Drogentests) sowie mehr Therapie- und Wiedereingliederungsprogramme unter psychiatrischer Begleitung und in Zusammenarbeit mit einem multidisziplinären Team sind sinnvoll.

A Comparative Cross-Sectional Study Assessing the Psycho-Emotional State of Intensive Care Units’ Physicians and Nurses of COVID-19 Hospitals of a Russian Metropolis

Working in intensive care units (ICUs) is stressful and potentially leads to various psycho-emotional disorders. Today, this issue represents a serious concern to the healthcare sector and affects the quality of healthcare provided. This study aimed to assess and compare the psycho-emotional state in COVID-19 and non-COVID-19 hospitals’ ICU healthcare workers (HCWs). From January to July 2021, we conducted an anonymous cross-sectional web survey of ICU physicians and nurses (N = 1259) of various hospitals in a metropolis with a population of over 10 million people. The statistical distributions of non-COVID-19 ICU HCWs showed the following results: emotional exhaustion levels (low 14.6%, average 30.8%, and high 54.6%); depersonalization levels (low 11.6%, average 16.5%, and high 71.9%); and reduced personal accomplishment levels (low 23.5%, average 40.3%, and high 36.2%). The statistical distributions of COVID-19 ICU HCWs showed the following results: emotional exhaustion levels (low 16.5%, average 31.5%, and high 52%); depersonalization levels (low 7.4%, average 9.4%, and high 83.1%); and reduced personal accomplishment levels (low 25.4%, average 45.4%, and high 29.1%). This study found a strong correlation between emotional exhaustion, aggression, and depersonalization in non-COVID-19 ICU HCWs and also found a correlation between their age, aggression, emotional exhaustion, and occupational stress.

Demographic Factors and Job Characteristics Associated With Burnout in Chinese Female Nurses During Controlled COVID-19 Period: A Cross-Sectional Study

Background: To investigate the prevalence of burnout syndrome among Chinese female nurses during the controlled coronavirus disease 2019 (COVID-19) period and explore its associated socio-demographic factors and job characteristics. Methods: With the multistage, stratified sampling method, a cross-sectional online survey was conducted from September to October 2020 in China. The survey tool included revised Maslach Burnout Inventory (MBI) with 15 items, socio-demographic and job characteristics. Univariate logistic regression analysis and multivariate factor logistic regression analysis were used to identify the risk factors for burnout of female nurses. Results: During controlled COVID-19 period in China, the overall prevalence of burnout symptoms among Chinese female nurses was 60.2% with a breakdown in severity as follows: 451 (39.8 %) mild, 163 (14.4%) moderate, and 68 (6.0%) severe burnout. Little variance was reported for burnout symptoms according to job tenure (Waldχ ² = 14.828, P < 0.05,odds ratio [OR] <1), monthly salary income (Waldχ ² = 12.460, P < 0.05, OR <1), and night shift (Waldχ ² = 3.821, P < 0.05, OR > 1). Conclusion: Burnout symptoms among Chinese female nurses were prevalent and associated with job tenure, monthly salary income, and night shift. Female nurses who were with shorter job tenure, worked at night shifts, and had lower monthly salaries tended to exhibit increasing high-level burnout than their counterparts. This study serves as an implication for administrators and policy-makers to improve the work conditions of nurses for promoting overall healthcare service quality.

Female representation in intensive care medicine: Challenges and perspectives from China

The gender gap in the practice of intensive care medicine has increasingly been recognized as a problem in recent years. Despite limited information, the available data suggest that representation of women in the physician workforce, academic positions, and leadership roles in intensive care is inadequate globally. In this article, we describe the situation of female intensive care unit (ICU) physicians from the perspective of Chinese intensivists. The proportion of female ICU physicians in China has been increasing in recent years. The biggest challenges faced by female ICU physicians include balance of work and life, difficulties in career planning, and lack of academic influence. More attention and policy support should be provided to help them play a better role in intensive care medicine.

Physician Burnout and the Electronic Health Record Leading up to and During The First Year of COVID-19: A Systematic Review (Preprint)

Background

Physician burnout was first documented in 1974, and the electronic health record (EHR) has been known to contribute to the symptoms of physician burnout. Authors pondered the extent of this effect, recognizing the increased use of telemedicine during the first year of COVID-19.

Objective

The aim of this review was to objectively analyze the literature over the last 5 years for empirical evidence of burnout incident to the EHR and to identify barriers to, facilitators to, and associated patient satisfaction with using the EHR to improve symptoms of burnout.

Methods

No human participants were involved in this review; however, 100% of participants in studies analyzed were adult physicians. We queried 4 research databases and 1 targeted journal for studies commensurate with the objective statement from January 1, 2016 through January 31, 2021 (n=25).

Results

The hours spent in documentation and workflow are responsible for the sense of loss of autonomy, lack of work-life balance, lack of control of one’s schedule, cognitive fatigue, a general loss of autonomy, and poor relationships with colleagues. Researchers have identified training, local customization of templates and workflow, and the use of scribes as strategies to alleviate the administrative burden of the EHR and decrease symptoms of burnout.

Conclusions

The solutions provided in the literature only addressed 2 of the 3 factors (workflow and documentation time) but not the third factor (usability). Practitioners and administrators should focus on the former 2 factors because they are within their sphere of control. EHR vendors should focus on empirical evidence to identify and improve the usability features with the greatest impact. Researchers should design experiments to explore solutions that address all 3 factors of the EHR that contribute to burnout.

Trial Registration

PROSPERO International Prospective Register of Systematic Reviews CRD42020201820; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=201820

International Registered Report Identifier (IRRID)

RR2-10.2196/15490

Exploring the Feelings of Nurses during Resuscitation—A Cross-Sectional Study

Cardiopulmonary resuscitation (CPR) is one of the most stressful situations in emergency medicine. Nurses involved in performing basic and advanced resuscitation procedures are therefore exposed to a certain amount of stress. The purpose of this study was to determine the stressors and the level of stress experienced by nurses during resuscitation. A cross-sectional quantitative study was done. The sample consisted of 457 nurses who worked in emergency units. First demographic data were collected, followed by a questionnaire regarding the effect of different situations that occur during and after resuscitation on nurses including Post-Code Stress Scale questionnaire. The most disturbing situations for respondents were resuscitation of young person (MV = 3.7, SD = 1.4), when they fail to establish an intravenous pathway (MV = 3.5, SD = 1.4), chaotic situation during resuscitation (MV = 3.4, SD = 1.4) and making decision about termination of resuscitation (MV = 3.1, SD = 1.5). Research has shown that nurses are exposed to a certain amount of stress during resuscitation, but most of them manage to compensate for stress effectively.

Prevalence, Risk Factors and Burnout Levels in Intensive Care Unit Nurses: A Systematic Review and Meta-Analysis

Nursing is considered to be an at-risk profession of burnout due to daily exposure to difficult situations such as death and pain care. In addition, some units such as the intensive care unit (ICU), can be stressful due to high levels of morbidity and mortality and ethical dilemmas. Burnout causes a deterioration in quality of care, increasing the risk of mortality in patients due to poor performance and errors in the healthcare environment. The aim of this study was to analyse the levels, prevalence and related factors of burnout in ICU nurses. A systematic review and meta-analysis were carried out in the Medline, Scopus and CINAHL databases. Fifteen articles were found for the systematic review and four for the meta-analysis. With a sample of n = 1986 nurses, the meta-analytic estimate prevalence for high emotional exhaustion was 31% (95% CI, 8-59%), for high depersonalization was 18% (95% CI, 8-30%), and for low personal accomplishment was 46% (95% CI, 20-74%). Within the dimensions of burnout, emotional exhaustion had a significant relationship with depression and personality factors. Both sociodemographic factors (being younger, single marital status, and having less professional experience in ICU) and working conditions (workload and working longer hours) influence the risk of burnout syndrome.

Psychological distress among healthcare providers during COVID-19 in Asia: Systematic review and meta-analysis

INTRODUCTION

COVID-19 pandemic is having a devastating effect on the mental health and wellbeing of healthcare providers (HCPs) globally. This review is aimed at determining the prevalence of depression, anxiety, stress, fear, burnout and resilience and its associated factors among HCPs in Asia during the COVID-19 pandemic.

MATERIAL AND METHODS

We performed literature search using 4 databases from Medline, Cinahl, PubMed and Scopus from inception up to March 15, 2021 and selected relevant cross-sectional studies. Publication bias was assessed using funnel plot. Random effects model was used to estimate the pooled prevalence while risk factors were reported in odds ratio (OR) with 95% CI.

RESULTS

We included 148 studies with 159,194 HCPs and the pooled prevalence for depression was 37.5% (95%CI: 33.8-41.3), anxiety 39.7(95%CI: 34.3-45.1), stress 36.4% (95%CI: 23.2-49.7), fear 71.3% (95%CI: 54.6-88.0), burnout 68.3% (95%CI: 54.0-82.5), and low resilience was 16.1% (95%CI: 12.8-19.4), respectively. The heterogeneity was high (I2>99.4%). Meta-analysis reported that both females (OR = 1.48; 95% CI = 1.30-1.68) and nurses (OR = 1.21; 95%CI = 1.02-1.45) were at increased risk of having depression and anxiety [(Female: OR = 1.66; 95% CI = 1.49-1.85), (Nurse: OR = 1.36; 95%CI = 1.16-1.58)]. Females were at increased risk of getting stress (OR = 1.59; 95%CI = 1.28-1.97).

CONCLUSION

In conclusion, one third of HCPs suffered from depression, anxiety and stress and more than two third of HCPs suffered from fear and burnout during the COVID-19 pandemic in Asia.

Assessment of patient safety culture during COVID-19: a cross-sectional study in a tertiary a-level hospital in China

Purpose

The aims of this study are to (1) evaluate physicians and nurses' perspectives on patient safety culture amid the COVID-19 pandemic and (2) integrate the emotional exhaustion of physicians and nurses into an evaluation of patient safety culture to provide insights into appropriate implications for medical care.

Design/methodology/approach

Patient safety culture was assessed with the Chinese version of the Safety Attitudes Questionnaire. Confirmatory factor analysis was conducted to validate the structure of the data (i.e. reliability and validity), and Pearson's correlation analysis was performed to identify relationships between safety-related dimensions.

Findings

Safety climate was strongly associated with working conditions and teamwork climate. In addition, working conditions was highly correlated with perceptions of management and job satisfaction, respectively. It is worth noting that the stress and emotional exhaustion of the physicians and nurses during this epidemic were high and needed attention.

Practical implications

For healthcare managers and practitioners, team-building activities, power of public opinions, IoT-focused service, and Employee Assistance Programs are important implications for inspiring the patient safety-oriented culture during the period of the COVID-19 pandemic.

Originality/value

This paper considers the role of emotional state into patient safety instrument, a much less understood but equally important dimension in the field of patient safety.

Protective and Risk Factors for Medical and Nursing Staff Suffering From Psychological Symptoms During COVID-19

Background: With the outbreak of the coronavirus disease 2019 (COVID-19) epidemic in China, the general public but also medical staff were confronted with psychological challenges, suffering from the highly infectious and unknown characteristics of COVID-19. In this study, we surveyed psychological symptoms including anxiety, depression, and sleep disorders in medical staff.

Method: A questionnaire star/WeChat link-based survey assessing the Generalized Anxiety Disorder 7-item scale, Patient Health Questionnaire-9 depression, the Insomnia Severity Index, Social Support scales in addition to lifestyle, and income level was conducted and included 8,288 medical staff from 24 provinces in China. Pearson Chi-square and Mann-Whitney U-tests were used to evaluate single risk factors and significant differences in psychological symptoms before and during the outbreak of COVID-19. Binary logistic regression analyses were conducted for the risk factors of anxiety, depression, and sleep disorder symptoms.

Results: Medical staff had a high incidence of psychological symptoms, which was more prominent during the COVID-19 epidemic. Comparatively, females, nurses, first-line department, never exercised, and low income were risk factors for psychological symptoms. Social support including objective support, subjective support, support utility, and regular sports over 3 times per week were protective and manageable elements that could protect from and manage the psychological symptoms of medical staff.

Conclusion: The susceptibility of psychological symptoms among medical staff should be of concern to policymakers and the public in the long-term, and the aggravation of mental health problems of medical staff could be eased by providing adequate social support during and after the COVID-19 outbreak.