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Fond G, Smith L, Tran B, Lucas G, Nguyen TT, Yon DK, Boyer L. Unmasking the triad of burnout, absenteeism, and poor sleep among healthcare workers during the third wave of COVID-19 pandemics. Results from the national AMADEUS study. J Affect Disord 2024; 355:247-253. [PMID: 38554883 DOI: 10.1016/j.jad.2024.03.157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 03/25/2024] [Accepted: 03/26/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND Burnout and absenteeism are prevalent among healthcare workers, reflecting prolonged work-related stress and dissatisfaction with their job. Identifying poor sleep as a contributing factor can assist in developing targeted interventions. This study explored the relationship between burnout, absenteeism, and sleep among healthcare workers. METHODS A nationwide online cross-sectional study was conducted among healthcare professionals in France during the third wave of COVID-19, from May 2021 to June 2021. Recruitment strategies included outreach through social and professional networks and email invitations. Burnout was assessed using the Maslach Burnout Inventory, absenteeism through self-reported days absent in the preceding 12 months, and sleep quality using the Pittsburgh Sleep Quality Index. The association between burnout, absenteeism, and poor sleep was analyzed using multivariate logistic regression, accounting for individual and professional variables. The study also explored various sleep dimension abnormalities. RESULTS Of 10,087 healthcare workers, 55.2 % reported burnout, 20.5 % absenteeism, and 64.8 % poor sleep. Burnout and absenteeism were more frequent in individuals with poor sleep compared to those with good sleep (74.2 % vs. 25.8 % and 75.6 % vs. 24.4 %, respectively). The multivariate analyses confirmed the associations between burnout, absenteeism, and poor sleep (Adjusted Odds Ratio [aOR] = 2.15, 95 % CI [1.97-2.35], p < 0.001; and aOR = 1.49, 95 % CI [1.32-1.67], p < 0.001, respectively). INTERPRETATION The study highlighted the intricate relationship between burnout, absenteeism, and poor sleep among healthcare professionals, informing workforce management and policy decisions to foster a supportive work environment and enhance their well-being.
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Affiliation(s)
- Guillaume Fond
- Aix-Marseille University, CEReSS-Health Service Research and Quality of Life Center, 27, boulevard Jean -Moulin, 13005 Marseille, France; Fondation FondaMental, Créteil, France
| | - Lee Smith
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Bach Tran
- Aix-Marseille University, CEReSS-Health Service Research and Quality of Life Center, 27, boulevard Jean -Moulin, 13005 Marseille, France; Institute of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Viet Nam
| | - Guillaume Lucas
- Aix-Marseille University, CEReSS-Health Service Research and Quality of Life Center, 27, boulevard Jean -Moulin, 13005 Marseille, France
| | - Tham Thi Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang, 550000, Vietnam; Faculty of Medicine, Duy Tan University, Da Nang, 550000, Vietnam
| | - Dong Keon Yon
- Department of Pediatrics, Kyung Hee University College of Medicine, Seoul, Republic of Korea; Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Republic of Korea
| | - Laurent Boyer
- Aix-Marseille University, CEReSS-Health Service Research and Quality of Life Center, 27, boulevard Jean -Moulin, 13005 Marseille, France; Fondation FondaMental, Créteil, France.
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De Beer LT, Christensen M, Sørengaard TA, Innstrand ST, Schaufeli WB. The psychometric properties of the Burnout Assessment Tool in Norway: A thorough investigation into construct-relevant multidimensionality. Scand J Psychol 2024; 65:479-489. [PMID: 38146078 DOI: 10.1111/sjop.12996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 11/15/2023] [Accepted: 12/07/2023] [Indexed: 12/27/2023]
Abstract
OBJECTIVE The World Health Organization recognizes burnout as an occupational issue. Nevertheless, accurately identifying employee burnout remains a challenging task. To complicate matters, current measures of burnout have demonstrated limitations, prompting the development of the Burnout Assessment Tool (BAT). Given these circumstances, conducting an in-depth examination of the BAT's construct-relevant multidimensionality is crucial. METHOD This study focuses on both the original 23-item BAT and the short 12-item version, using modern factor analytic methods to investigate reliability, validity, and measurement invariance in a representative sample from Norway (n = 493; 49.54% women). RESULTS Our findings revealed that the bifactor exploratory structural equation modeling solution (burnout global factor and four specific burnout component factors) best explained the data for both BAT versions. All factors demonstrated adequate omega coefficients, with the global factor showing exceptional strength. Both BAT versions correlated highly with each other and with another burnout measure, suggesting convergent validity. Furthermore, both BAT versions achieved full (strict) measurement invariance based on gender. Finally, our results showed that burnout acts as a mediator in our proposed job demands-resources model as preliminary evidence of predictive validity. CONCLUSIONS The study validates the Burnout Assessment Tool in the Norwegian context. The study supports the reliability, validity, and unbiased nature of the tool across genders. The findings also reinforce the importance of job demands and resources, along with burnout as a key mediator, in understanding workplace dynamics in accordance with job demands-resources theory.
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Affiliation(s)
- Leon T De Beer
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
- WorkWell Research Unit, North-West University, Potchefstroom, South Africa
| | - Marit Christensen
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Torhild A Sørengaard
- Department of Leadership and Organizational Behaviour, BI Norwegian Business School, Trondheim, Norway
| | - Siw T Innstrand
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Wilmar B Schaufeli
- Department of Psychology, Utrecht University, Utrecht, the Netherlands
- Research Unit Occupational & Organizational Psychology and Professional Learning, KU Leuven, Leuven, Belgium
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Baek SU, Yoon JH, Won JU. Association between high emotional demand at work, burnout symptoms, and sleep disturbance among Korean workers: a cross-sectional mediation analysis. Sci Rep 2023; 13:16688. [PMID: 37794088 PMCID: PMC10550909 DOI: 10.1038/s41598-023-43451-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 09/24/2023] [Indexed: 10/06/2023] Open
Abstract
We explored the mediating role of burnout on the association between EDW and sleep disturbances. Our study included 18,744 Korean workers. Respondents were grouped into four levels (none, low, moderate, and high) based on their exposure to two EDW factors: handling angry clients (HAC) and hiding emotion (HE). Mediation models were used to estimate odds ratios (OR) at a 95% confidence interval (CI). Compared to those not exposed, low, moderate, and high HAC increased odds of sleep disturbance by 1.52 (95% CI 1.30-1.78), 3.20 (95% CI 2.57-3.98), and 3.28 (95% CI 2.77-3.88) times, respectively. The indirect effect via burnout accounted for 29.9%, 24.1%, and 23.6% of the total effect, respectively, with estimates of 1.13 (95% CI 1.11-1.16), 1.32 (95% CI 1.26-1.39), and 1.32 (95% CI 1.27-1.37). Low, moderate, and high HE increased the odds of sleep disturbance by 1.45 (95% CI 0.93-2.28), 2.38 (95% CI 1.57-3.61), and 3.14 (95% CI 2.08-4.71) times, respectively. The indirect effect via burnout accounted for 10.5%, 29.7%, and 33.1% of the total effect, with estimates of 1.04 (95% CI 0.98-1.10), 1.29 (95% CI 1.22-1.37), and 1.46 (95% CI 1.38-1.55), respectively. Effective policies are required to protect the psychological wellbeing of workers who frequently engage in interpersonal tasks.
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Affiliation(s)
- Seong-Uk Baek
- Department of Occupational and Environmental Medicine, Severance Hospital, Yonsei University College of Medicine, 50-1, Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, Korea
- Graduate School, Yonsei University College of Medicine, Seoul, Korea
| | - Jin-Ha Yoon
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, Korea
- Department of Public Health, Graduate School of Yonsei University, Seoul, Korea
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jong-Uk Won
- Department of Occupational and Environmental Medicine, Severance Hospital, Yonsei University College of Medicine, 50-1, Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea.
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, Korea.
- Department of Public Health, Graduate School of Yonsei University, Seoul, Korea.
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Johnson T, Gurubhagavatula I. Assessment of Vigilance and Fatigue. Sleep Med Clin 2023; 18:349-359. [PMID: 37532374 DOI: 10.1016/j.jsmc.2023.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2023]
Abstract
This article summarizes the definitions of vigilance, fatigue, and sleepiness, as well as tools used in their assessment. Consideration is given to the strengths and limitations of the different subjective and objective tools. Future directions for research are also discussed, as well as the public health importance of continued investigation in this subject.
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Affiliation(s)
- Tyler Johnson
- Division of Sleep Medicine, Perelman School of Medicine, University of Pennsylvania, 3624 Market Street, Suite 205, Philadelphia, PA 19104, USA.
| | - Indira Gurubhagavatula
- Division of Sleep Medicine, Perelman School of Medicine, University of Pennsylvania, 3624 Market Street, Suite 205, Philadelphia, PA 19104, USA; Crescenz VA Medical Center, Philadelphia, PA, USA.
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Cheng H, Liu G, Yang J, Wang Q, Yang H. Shift work disorder, mental health and burnout among nurses: A cross-sectional study. Nurs Open 2023; 10:2611-2620. [PMID: 36539975 PMCID: PMC10006599 DOI: 10.1002/nop2.1521] [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: 01/22/2021] [Revised: 10/12/2022] [Accepted: 11/20/2022] [Indexed: 12/24/2022] Open
Abstract
AIM The aim of the study was to examine the relationships among nurses' shift work disorder, mental health and burnout to inform efforts to alleviate shift work disorder. DESIGN This cross-sectional study was conducted in China using a web-based platform for questionnaire. METHODS The study was comprised of a convenience sample of 1,268 Registered Nurses from 21 public hospitals in mainland China from June 2019-July 2019. Participants completed a web-based survey designed to collect demographic and other self-reported data. An independent sample t test and Pearson correlation were performed to analyse the relationship between shift work disorder, mental health and burnout. RESULTS The vast majority (98.2%) of the participants were women between the ages of 20-59 years. The participants exhibited a higher incidence of mental health problems (58.1%) and burnout (65.5%) and those with shift work disorder exhibited a higher risk of mental health problems and burnout than those who did not have shift work disorder. Our research demonstrated that shift work disorder, combined with other variables, accounted for 40.5% of the variance in mental health (R2 = .405, adjusted R2 = .401, F = 107.214, p < .001) and 36.5% in burnout (R2 = .365, adjusted R2 = .361, F = 90.323, p < .001). Moreover, burnout negatively regulated the relationship between shift work disorder and mental health. CONCLUSION High-risk nurses with shift work disorder were at a much higher risk of mental health problems and burnout.
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Affiliation(s)
- Hui Cheng
- Nursing College of Shanxi Medical University, Taiyuan, China
| | - Guangbi Liu
- Department of Nursing, The People's Hospital of Bishan District, Chongqing, China
| | - Junyi Yang
- Department of Nursing, The People's Hospital of Bishan District, Chongqing, China
| | - Qiaohong Wang
- Nursing College of Shanxi Medical University, Taiyuan, China
| | - Hui Yang
- Nursing College of Shanxi Medical University, Taiyuan, China
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Schmickler JM, Blaschke S, Robbins R, Mess F. Determinants of Sleep Quality: A Cross-Sectional Study in University Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2019. [PMID: 36767422 PMCID: PMC9915447 DOI: 10.3390/ijerph20032019] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/18/2023] [Accepted: 01/20/2023] [Indexed: 06/18/2023]
Abstract
When entering the university setting, poor sleep quality is reportedly prevalent among students and has been linked to a range of adverse health outcomes, including reduced academic performance. Moreover, determinants of sleep quality are not yet fully understood. This study was designed to (1) assess the prevalence of poor sleep quality and (2) identify determinants of sleep quality in German university students. In total, 1,684 undergraduate and graduate students (50.6% female, mean age 22.87 ± 3.15 years) from multiple academic disciplines completed a cross-sectional online survey assessing socio-demographic, health, and study-related indicators and sleep quality using the Pittsburgh Sleep Quality Index (PSQI). In our sample, 820 (48.7%) met the PSQI cut-off score (>5) for poor sleep quality. Multiple regression analysis showed that older age, being a business student, lower subjective social status, poorer self-rated health, stress, exhaustion, and poor academic performance significantly predicted poor sleep quality. Our findings document a high prevalence of poor sleep quality among university students and suggest that business students, especially, might be exposed to a greater risk for poor sleep quality. Furthermore, the results of this study are valuable for academic staff to develop tailored interventions to promote healthy sleep-in university students.
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Affiliation(s)
| | - Simon Blaschke
- Department of Sport and Health Sciences, Technical University of Munich, 80992 Munich, Germany
| | - Rebecca Robbins
- Division of Sleep Medicine, Harvard Medical School, Boston, MA 02115, USA
| | - Filip Mess
- Department of Sport and Health Sciences, Technical University of Munich, 80992 Munich, Germany
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Khosla S, Beam E, Berneking M, Cheung J, Epstein LJ, Meyer BJ, Ramar K, So JY, Sullivan SS, Wolfe LF, Gurubhagavatula I. The COVID-19 pandemic and sleep medicine: a look back and a look ahead. J Clin Sleep Med 2022; 18:2045-2050. [PMID: 35621129 PMCID: PMC9340605 DOI: 10.5664/jcsm.10102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 05/26/2022] [Indexed: 11/13/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic is a reminder that global infectious disease outbreaks are not new and they have the potential to cause catastrophic morbidity and mortality, disrupt health care delivery, demand critical decision making in the absence of scientific certainty, interrupt trainee education, inflict economic damage, and cause a spike in demand for health care services that exceeds societal capacity. In this article, we look back at how the sleep medicine community adapted to challenges imposed by the COVID-19 pandemic. To mitigate viral transmission perhaps the single most effective and efficient adaptation was the rapid adoption of telemedicine. Many additional strategies were taken up virtually overnight, including more home sleep apnea testing, reconsideration of potential risks of positive airway pressure therapy, a reduction or cessation of laboratory services, and deployment of workers to provide frontline care to infected patients. During some periods, critical shortages in essential personal protective equipment, respiratory assist devices, and even oxygen added to logistical challenges, which were exacerbated by persistent financial threats and insufficient staffing. Through ongoing innovation, resiliency, and adaptability, breakthroughs were made in assigning staff responsibilities and designing workflows, using clinical spaces, obtaining legislative support, and achieving professional society collaboration and guidance so that the missions of providing health care, teaching, and academic pursuits could continue. Here we summarize what we have learned through these critical months and highlight key adaptations that deserve to be embraced as we move forward. CITATION Khosla S, Beam E, Berneking M, et al. The COVID-19 pandemic and sleep medicine: a look back and a look ahead. J Clin Sleep Med. 2022;18(8):2045-2050.
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Affiliation(s)
- Seema Khosla
- North Dakota Center for Sleep, Fargo, North Dakota
| | - Elena Beam
- Department of Internal Medicine, Division of Infectious Disease, Mayo Clinic, Rochester, Minnesota
| | | | - Joseph Cheung
- Division of Pulmonary and Sleep Medicine, Mayo Clinic, Jacksonville, Florida
| | - Lawrence J. Epstein
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts
| | - Brittany J. Meyer
- ProHealth Care Sleep Center, Delafield, Wisconsin
- Sweet Dreams Sleep Services, Gering, Nebraska
| | - Kannan Ramar
- Division of Pulmonary and Critical Care Medicine, Center for Sleep Medicine, Mayo Clinic, Rochester, Minnesota
| | - Jennifer Y. So
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Maryland School of Medicine, Baltimore, Maryland
| | - Shannon S. Sullivan
- Division of Pulmonary, Asthma, and Sleep Medicine, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California
| | - Lisa F. Wolfe
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Indira Gurubhagavatula
- Division of Sleep Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- Corporal Michael Crescenz VA Medical Center, Philadelphia, Pennsylvania
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Sullivan SS, Gurubhagavatula I. Re: Sørengaard TA, Saksvik-Lehouillier I. Associations between burnout symptoms and sleep among workers during the COVID-19 pandemic. Sleep Med. 2022 Feb;90:199-203. Sleep Med 2022; 98:167. [PMID: 35490151 PMCID: PMC8990526 DOI: 10.1016/j.sleep.2022.03.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 03/27/2022] [Accepted: 03/28/2022] [Indexed: 11/24/2022]
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Duong-Quy S, Tran-Duc S, Hoang-Chau-Bao D, Bui-Diem K, Vu-Tran-Thien Q, Nguyen-Nhu V. Tiredness, depression, and sleep disorders in frontline healthcare workers during COVID-19 pandemic in Vietnam: A field hospital study. Front Psychiatry 2022; 13:984658. [PMID: 36325524 PMCID: PMC9618589 DOI: 10.3389/fpsyt.2022.984658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Accepted: 09/26/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The COVID-19 outbreak witnessed in the autumn of 2021 led to unprecedented changes in healthcare systems in some emerging countries. Many field-hospitals, temporary sites of care for COVID-19 patients, were built around the country and followed by the healthcare workers who were mobilized. This study aimed to measure sleep disorders, depression, and fatigue in volunteers working at field hospitals during the COVID-19 outbreak. METHODS This was a cross-sectional study. The self-report questionnaire was used for each study subject. Sleep characters, including STOP's elements were questioned. Healthcare workers' burnout was detected by using Pichot's questionnaire. RESULTS One hundred front-line healthcare workers (FHWs), predominantly last year and graduated medical students, were included in the study (86% female subjects). The mean sleep-time of FHWs before, while working, and during the isolation period after working at COVID-19 field hospitals were: 7.78 ± 1.48, 5.71 ± 1.40, and 8.78 ± 2.31 h per day, respectively. Burnout was not a crucial issue for these volunteer subjects. The mean scores of Pichot's Fatigue Scale and Pichot's Depression Scale, measured after 4 weeks working at field hospitals, were 4.18 ± 5.42 and 2.54 ± 3.36, respectively. Thirteen participants were suspected of depression. The fatigue scores decreased significantly in the group who claimed short sleep latency. The factor that increased the depression score was "anxious feeling" (p = 0.001). Other significant factors were "short sleep latency," "observed sleep apnea," "tiredness, daily sleepiness" and "snoring." CONCLUSION Appropriate work schedule, better sleep conditions, and mental health support could be helpful for FHWs. The mandatory 2 weeks of isolation after working in field hospitals provided opportunity for FHWs' recovery.
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Affiliation(s)
- Sy Duong-Quy
- Sleep Lab Center, Lam Dong Medical College and Bio-Medical Research Center, Dalat, Vietnam.,Sleep Lab Unit, Outpatient Department, Pham Ngoc Thach Medical University, Ho Chi Minh City, Vietnam.,Immuno-Allergology Division, Hershey Medical Center, Penn State Medical College, Hershey, PA, United States.,Department of Respiratory Functional Exploration, University Medical Center, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
| | - Si Tran-Duc
- Sleep Lab Unit, Outpatient Department, Pham Ngoc Thach Medical University, Ho Chi Minh City, Vietnam
| | - Dinh Hoang-Chau-Bao
- Sleep Lab Unit, Outpatient Department, Pham Ngoc Thach Medical University, Ho Chi Minh City, Vietnam
| | - Khue Bui-Diem
- Department of Physiology-Pathophysiology-Immunology, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
| | - Quan Vu-Tran-Thien
- Department of Respiratory Functional Exploration, University Medical Center, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam.,Department of Physiology-Pathophysiology-Immunology, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
| | - Vinh Nguyen-Nhu
- Department of Respiratory Functional Exploration, University Medical Center, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
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