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Zimmermann C, Strohmaier S, Herkner H, Niederkrotenthaler T, Schernhammer E. Suicide rates among physicians compared with the general population in studies from 20 countries: gender stratified systematic review and meta-analysis. BMJ 2024; 386:e078964. [PMID: 39168499 PMCID: PMC11337323 DOI: 10.1136/bmj-2023-078964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/10/2024] [Indexed: 08/23/2024]
Abstract
OBJECTIVES To estimate age standardised suicide rate ratios in male and female physicians compared with the general population, and to examine heterogeneity across study results. DESIGN Systematic review and meta-analysis. DATA SOURCES Studies published between 1960 and 31 March 2024 were retrieved from Embase, Medline, and PsycINFO. There were no language restrictions. Forward and backwards reference screening was performed for selected studies using Google Scholar. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Observational studies with directly or indirectly age standardised mortality ratios for physician deaths by suicide, or suicide rates per 100 000 person years of physicians and a reference group similar to the general population, or extractable data on physician deaths by suicide suitable for the calculation of ratios. Two independent reviewers extracted data and assessed the risk of bias using an adapted version of the Joanna Briggs Institute checklist for prevalence studies. Mean effect estimates for male and female physicians were calculated based on random effects models, with subgroup analyses for geographical region and a secondary analysis of deaths by suicide in physicians compared with other professions. RESULTS Among 39 included studies, 38 studies for male physicians and 26 for female physicians were eligible for analyses, with a total of 3303 suicides in male physicians and 587 in female physicians (observation periods 1935-2020 and 1960-2020, respectively). Across all studies, the suicide rate ratio for male physicians was 1.05 (95% confidence interval 0.90 to 1.22). For female physicians, the rate ratio was significantly higher at 1.76 (1.40 to 2.21). Heterogeneity was high for both analyses. Meta-regression revealed a significant effect of the midpoint of study observation period, indicating decreasing effect sizes over time. The suicide rate ratio for male physicians compared with other professions was 1.81 (1.55 to 2.12). CONCLUSION Standardised suicide rate ratios for male and female physicians decreased over time. However, the rates remained increased for female physicians. The findings of this meta-analysis are limited by a scarcity of studies from regions outside of Europe, the United States, and Australasia. These results call for continued efforts in research and prevention of physician deaths by suicide, particularly among female physicians and at risk subgroups. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42019118956.
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Affiliation(s)
- Claudia Zimmermann
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Susanne Strohmaier
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Harald Herkner
- Department of Emergency Medicine, Vienna General Hospital, Medical University of Vienna, Vienna, Austria
| | - Thomas Niederkrotenthaler
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Eva Schernhammer
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Vienna, Austria
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
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Gayed A, Strudwick J, Kugenthiran N, LaMontagne AD, Mackinnon A, Christensen H, Glozier N, Harvey S. Mental health training for physicians supervising resident physicians: a cluster randomised controlled trial. Med J Aust 2024. [PMID: 39148492 DOI: 10.5694/mja2.52407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 12/22/2023] [Indexed: 08/17/2024]
Abstract
OBJECTIVE To evaluate an online training program for physician supervisors with the aim of promoting a mentally healthy workplace by improving their use of both responsive and preventive mental health support strategies. STUDY DESIGN Cluster randomised, waitlist-controlled trial. SETTING, PARTICIPANTS Royal Australasian College of Physicians fellows who were supervising at least one resident physician in any of the 31 primary health networks in Australia and 20 district health boards in New Zealand (health network clusters). INTERVENTION A brief online skills-based mental health training program, comprising twelve modules grouped into three topics: common mental illnesses; helping trainees you are concerned about (responsive strategies); and minimising mental health risks at work (preventive strategies). MAIN OUTCOME MEASURES Change between baseline and the 3-month assessment in self-reported recommended supervisor behaviours; differences between intervention and control groups in recommended behaviour scores three weeks, three months, and six months after the program. RESULTS Ninety physicians from 20 health network clusters were allocated to the intervention group, 88 physicians from 22 clusters to the control group. Intervention group participants reported greater positive change in behaviour across the study period than those in the control group (mixed model repeated measures analysis, group × time interaction: P < 0.001). The mean change in self-reported supervisory behaviour score was higher for the intervention than the control group at the 3-week (mean difference in score, 1.6; 95% confidence interval [CI], 0.8-2.4), 3-month (0.9; 95% CI, 0.2-1.6), and 6-month assessments (1.9; 95% CI, 1.1-2.7). The mean change in self-reported responsive behaviour score was also greater for the intervention group at the 3-week (mean difference, 2.3; 95% CI, 1.5-3.1), 3-month (1.0; 95% CI, 0.2-1.9), and 6-month assessments (2.0; 95% CI, 1.1-2.9); differences in the mean change in preventive behaviour scores were statistically significant at the 3-week (mean difference, 1.1; 95% CI, 0.1-2.2) and 6-month assessments (1.8; 95% CI, 0.8-2.8), but not the 3-month assessment (0.8; 95% CI, -0.1 to 1.7). CONCLUSIONS Brief online mental health training for senior physicians can lead to changes in their self-reported behaviour for supporting the mental health needs of resident physicians. Whether this leads to better mental health for resident physicians should be investigated. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry, ACTRN12619001496101 (prospective).
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Affiliation(s)
| | | | | | - Anthony D LaMontagne
- Institute for Health Transformation, Deakin University, Geelong, VIC
- Melbourne School of Population and Global Health, the University of Melbourne, Melbourne, VIC
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Bailey JG, Mossenson AI, Whynot S, Nyirigira G, Gower S, Livingston P. A Mixed-Methods Cohort Study Evaluating the Impact of a One-Day Well-Being Course for Anesthesia Providers Working in Low-Resource Settings. Anesth Analg 2024; 139:375-384. [PMID: 39008977 DOI: 10.1213/ane.0000000000006870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2024]
Abstract
BACKGROUND Burnout, depression, and anxiety are increasingly recognized as common among health care providers. Risks for these conditions are exacerbated in low-resource settings by excessive workload, high disease burden, resource shortage, and stigma against mental health issues. Based on discussions and requests to learn more about burnout during the Vital Anaesthesia Simulation Training (VAST), our team developed VAST Wellbeing, a 1-day course for health care providers in low-resource settings to recognize and mitigate burnout and to promote personal and professional well-being. METHODS This mixed-methods study used quantitative pre- and postcourse surveys using validated mental health measures and qualitative semistructured interviews to explore participants' experience of VAST Wellbeing during and after the course. Quantitative outcomes included burnout and professional fulfillment as measured by the Professional Fulfillment Index and general well-being as measured by the Warwick-Edinburgh Mental Wellbeing Scale. RESULTS Twenty-six participants from 9 countries completed the study. In the immediate postcourse survey, study participants rated the course overall as "very good" (60.7%) and "excellent" (28.6%). Quantitative analysis showed no statistical differences in levels of work exhaustion, interpersonal disengagement, burnout, professional fulfillment, or general mental well-being 2 months after the course. Five themes on the impact of VAST Wellbeing were identified during qualitative analysis: (1) raising awareness, breaking taboos; (2) not feeling alone; (3) permission and capacity for personal well-being; (4) workplace empowerment; and (5) VAST Wellbeing was relevant, authentic, and needed. CONCLUSIONS Causes of burnout are complex and multidimensional. VAST Wellbeing did not change measures of burnout and fulfillment 2 months postcourse but did have a meaningful impact by raising awareness, reducing stigma, fostering connection, providing skills to prioritize personal well-being, and empowering people to seek workplace change.
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Affiliation(s)
- Jonathan G Bailey
- From the Department of Anesthesia, Pain Management and Perioperative Medicine, Dalhousie University, Halifax, Canada
| | - Adam I Mossenson
- From the Department of Anesthesia, Pain Management and Perioperative Medicine, Dalhousie University, Halifax, Canada
- St John of God Midland Public and Private Hospitals, Perth, Australia
- Curtin Medical School, Curtin University, Perth, Australia
| | - Sara Whynot
- Department of Surgery, Dalhousie University, Halifax, Canada
| | - Gaston Nyirigira
- Department of Anesthesia and Critical Care, University of Rwanda, Kigali, Rwanda
| | - Shelley Gower
- Curtin School of Nursing, Curtin University, Perth, Australia
| | - Patricia Livingston
- From the Department of Anesthesia, Pain Management and Perioperative Medicine, Dalhousie University, Halifax, Canada
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LaMontagne AD, Åberg M, Blomqvist S, Glozier N, Greiner BA, Gullestrup J, Harvey SB, Kyron MJ, Madsen IEH, Hanson LM, Maheen H, Mustard C, Niedhammer I, Rugulies R, Smith PM, Taouk Y, Waters S, Witt K, King TL. Work-related suicide: Evolving understandings of etiology & intervention. Am J Ind Med 2024; 67:679-695. [PMID: 38853462 DOI: 10.1002/ajim.23624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 05/24/2024] [Accepted: 05/28/2024] [Indexed: 06/11/2024]
Abstract
Previously published analyses of suicide case investigations suggest that work or working conditions contribute to 10%-13% of suicide deaths. Yet, the way in which work may increase suicide risk is an underdeveloped area of epidemiologic research. In this Commentary, we propose a definition of work-related suicide from an occupational health and safety perspective, and review the case investigation-based and epidemiologic evidence on work-related causes of suicide. We identified six broad categories of potential work-related causes of suicide, which are: (1) workplace chemical, physical, and psychosocial exposures; (2) exposure to trauma on the job; (3) access to means of suicide through work; (4) exposure to high-stigma work environments; (5) exposure to normative environments promoting extreme orientation to work; and (6) adverse experiences arising from work-related injury or illness. We summarise current evidence in a schema of potential work-related causes that can also be applied in workplace risk assessment and suicide case investigations. There are numerous implications of these findings for policy and practice. Various principle- and evidence-based workplace intervention strategies for suicide prevention exist, some of which have been shown to improve suicide-prevention literacy, reduce stigma, enhance helping behaviours, and in some instances maybe even reduce suicide rates. Prevailing practice in workplace suicide prevention, however, overly emphasises individual- and illness-directed interventions, with little attention directed to addressing the working conditions that may increase suicide risk. We conclude that a stronger emphasis on improving working conditions will be required for workplace suicide prevention to reach its full preventive potential.
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Affiliation(s)
- Anthony D LaMontagne
- Institute for Health Transformation & School of Health & Social Development, Deakin University, Geelong, Victoria, Australia
| | - Maria Åberg
- School of Public Health and Community Medicine, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Sandra Blomqvist
- Department of Psychology, Stress Research Institute, Stockholm University, Stockholm, Sweden
| | - Nick Glozier
- Central Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | | | - Jorgen Gullestrup
- Institute for Health Transformation & School of Health & Social Development, Deakin University, Geelong, Victoria, Australia
| | - Samuel B Harvey
- Black Dog Institute, University of New South Wales, Randwick, New South Wales, Australia
| | - Michael J Kyron
- Suicide Prevention and Resilience Research Center (SPARRC), School of Psychological Science, Perth, Western Australia, Australia
| | - Ida E H Madsen
- National Research Centre for the Working Environment, Copenhagen, Denmark
- National Institute of Public Health, Copenhagen, Denmark
| | - Linda Magnusson Hanson
- Department of Psychology, Stress Research Institute, Stockholm University, Stockholm, Sweden
| | - Humaira Maheen
- Centre for Health Policy, Melbourne School of Population Health, University of Melbourne, Melbourne, Victoria, Australia
| | | | - Isabelle Niedhammer
- Institut National de la Santé et de la Recherche Médicale (INSERM), Univ Angers, Angers, France
| | - Reiner Rugulies
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Department of Public Health, Section of Epidemiology, University of Copenhagen, Copenhagen, Denmark
| | - Peter M Smith
- Instutute for Work & Health, Toronto, Ontario, Canada
| | - Yamna Taouk
- Centre for Health Policy, Melbourne School of Population Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Sarah Waters
- School of Languages, Cultures and Societies, University of Leeds, Leeds, UK
| | - Katrina Witt
- Orygen Centre for Youth Mental Health, Parkville, Victoria, Australia
| | - Tania L King
- Centre for Health Policy, Melbourne School of Population Health, University of Melbourne, Melbourne, Victoria, Australia
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Jeanmonod D, Irick J, Munday AR, Awosika AO, Jeanmonod R. Compassion Fatigue in Emergency Medicine: Current Perspectives. Open Access Emerg Med 2024; 16:167-181. [PMID: 39045605 PMCID: PMC11264384 DOI: 10.2147/oaem.s418935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 06/11/2024] [Indexed: 07/25/2024] Open
Abstract
Compassion fatigue (CF), or loss of ability to empathize or feel compassion for others for whom one cares, is a growing concern for emergency physicians (EP). EPs, by the nature of their jobs, work under unpredictable conditions at odd hours with high levels of exposure to traumatic events. They are placed under substantial psychological, physical, and cognitive pressure, with little opportunity to recover or reflect. CF occurs when this workplace stress leads to feelings of being overwhelmed, helpless, unsupported, and unable to cope. Additionally, primary traumatic stress from threats of workplace violence and secondary traumatic stress (STS) from witnessing the suffering of others increase the likelihood of developing CF. Unchecked, this progression to CF causes reduction in quality of care to patients, reduction in patient satisfaction, increased levels of EP depression and anxiety, increased levels of EP substance use, and increased attrition from the specialty. To truly improve CF, individuals and organizations should be aware of the contributors to CF: namely, emotional exhaustion, depersonalization, primary and STS, and personal achievement. EPs should maximize their resilience to CF by using cognitive behavioral techniques and mindfulness, taking care of their physical health, seeking meaning and development within their work, developing hobbies outside of work, and creating boundaries between work and home. Organizations should actively address the known drivers of physician burnout: workload and job demands, efficiency and resources, meaning in work, culture and values, control and flexibility, work community, and work-life integration. Organizations should also provide adequate safety within facilities to reduce the threat of primary trauma and should supply adequate support and destigmatization for post-traumatic symptoms for EPs suffering from STS.
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Affiliation(s)
- Donald Jeanmonod
- Department of Emergency Medicine, St. Luke’s University Health Network, Bethlehem, PA, USA
| | - Jennifer Irick
- Department of Emergency Medicine, St. Luke’s University Health Network, Easton, PA, USA
| | - Adam R Munday
- Department of Emergency Medicine, St. Luke’s University Health Network, Bethlehem, PA, USA
| | - Afopefoluwa O Awosika
- Department of Emergency Medicine, St. Luke’s University Health Network, Easton, PA, USA
| | - Rebecca Jeanmonod
- Department of Emergency Medicine, St. Luke’s University Health Network, Bethlehem, PA, USA
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Fresán A, Robles-García R, Yoldi-Negrete M, Guízar-Sánchez D, Tovilla-Zárate CA. To the bone: Prevalence and correlates of depression and anxiety among orthopedic residents in Mexico. Int J Psychiatry Med 2024; 59:455-468. [PMID: 37653426 DOI: 10.1177/00912174231199216] [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] [Indexed: 09/02/2023]
Abstract
OBJECTIVE Examining orthopedic residents in Mexico, researchers explore the relationship between the presence of depressive or anxious symptoms and the degree of perfectionism, perceived work-related distress, and involvement in the care of patient(s) who died. METHODS This was a cross-sectional online survey of 642 orthopedic residents from October 2019 to April 2021. RESULTS Of orthopedic residents contacted, 50.6% responded rate (70.9% male, average age 29.8 years). A total of 12.5% reported significant depressive symptoms and 18.4% reported significant anxious symptoms. On a scale from 0-100, the mean score of perceived work-related distress was 51.9. One-third (33.6%) reported being involved in the care of patient(s) who had died. Higher levels of work-related distress and higher scores on perfectionism were associated with depressive and anxiety symptoms. In particular, being involved in the care of patient(s) who had died was associated with anxious symptoms (OR = 1.79; 95%CI = 1.18-2.72). CONCLUSIONS These results highlight the need for systematic monitoring of the mental health of orthopedic residents in Mexico, particularly those who report a high level of work-related distress or perfectionism or who have recently experienced the death of a patient.
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Affiliation(s)
- Ana Fresán
- Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico
| | - Rebeca Robles-García
- Centro de Investigación en Salud Mental Global, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico
| | - María Yoldi-Negrete
- Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico
| | - Diana Guízar-Sánchez
- Departamento de Fisiología de la Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico
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Aust B, Leduc C, Cresswell-Smith J, O'Brien C, Rugulies R, Leduc M, Dhalaigh DN, Dushaj A, Fanaj N, Guinart D, Maxwell M, Reich H, Ross V, Sadath A, Schnitzspahn K, Tóth MD, van Audenhove C, van Weeghel J, Wahlbeck K, Arensman E, Greiner BA. The effects of different types of organisational workplace mental health interventions on mental health and wellbeing in healthcare workers: a systematic review. Int Arch Occup Environ Health 2024; 97:485-522. [PMID: 38695906 PMCID: PMC11130054 DOI: 10.1007/s00420-024-02065-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 04/02/2024] [Indexed: 05/28/2024]
Abstract
OBJECTIVE To determine if and which types of organisational interventions conducted in small and medium size enterprises (SMEs) in healthcare are effective on mental health and wellbeing. METHODS Following PRISMA guidelines, we searched six scientific databases, assessed the methodological quality of eligible studies using QATQS and grouped them into six organisational intervention types for narrative synthesis. Only controlled studies with at least one follow-up were eligible. RESULTS We identified 22 studies (23 articles) mainly conducted in hospitals with 16 studies rated of strong or moderate methodological quality. More than two thirds (68%) of the studies reported improvements in at least one primary outcome (mental wellbeing, burnout, stress, symptoms of depression or anxiety), most consistently in burnout with eleven out of thirteen studies. We found a strong level of evidence for the intervention type "Job and task modifications" and a moderate level of evidence for the types "Flexible work and scheduling" and "Changes in the physical work environment". For all other types, the level of evidence was insufficient. We found no studies conducted with an independent SME, however five studies with SMEs attached to a larger organisational structure. The effectiveness of workplace mental health interventions in these SMEs was mixed. CONCLUSION Organisational interventions in healthcare workers can be effective in improving mental health, especially in reducing burnout. Intervention types where the change in the work environment constitutes the intervention had the highest level of evidence. More research is needed for SMEs and for healthcare workers other than hospital-based physicians and nurses.
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Affiliation(s)
- Birgit Aust
- National Research Centre for the Working Environment, Copenhagen, Denmark.
| | - Caleb Leduc
- School of Public Health, University College Cork, Cork, Ireland
| | | | - Clíodhna O'Brien
- National Suicide Research Foundation, University College Cork, Cork, Ireland
| | - Reiner Rugulies
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Mallorie Leduc
- National Suicide Research Foundation, University College Cork, Cork, Ireland
| | | | - Arilda Dushaj
- Community Centre for Health and Wellbeing, Tirana, Albania
| | - Naim Fanaj
- Per Mendje Te Shendoshe (PMSH), Prizren, Kosovo
- Alma Mater Europaea Campus Rezonanca, Pristina, Kosovo
| | - Daniel Guinart
- CIBERSAM, Hospital del Mar Research Institute, Barcelona, Spain
- Institut de Salut Mental, Hospital del Mar, Barcelona, Spain
- The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, USA
| | - Margaret Maxwell
- Nursing, Midwifery and Allied Health Professionals Research Unit, University of Stirling, Stirling, Scotland
| | - Hanna Reich
- German Foundation for Depression and Suicide Prevention, Leipzig, Germany
- Depression Research Centre of the German Depression Foundation, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| | - Victoria Ross
- Australian Institute for Suicide Research and Prevention, WHO Collaborating Centre for Research and Training in Suicide Prevention, School of Applied Psychology, Griffith University, Brisbane, Australia
| | - Anvar Sadath
- National Suicide Research Foundation, University College Cork, Cork, Ireland
| | | | - Mónika Ditta Tóth
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
| | - Chantal van Audenhove
- KU Leuven, Louvain, Belgium
- Center for Care Research and Consultancy, LUCAS, Louvain, Belgium
| | - Jaap van Weeghel
- Tranzo Scientific Center for Care and Wellbeing, Tilburg University, Tilburg, The Netherlands
| | | | - Ella Arensman
- School of Public Health, University College Cork, Cork, Ireland
- National Suicide Research Foundation, University College Cork, Cork, Ireland
- Australian Institute for Suicide Research and Prevention, WHO Collaborating Centre for Research and Training in Suicide Prevention, School of Applied Psychology, Griffith University, Brisbane, Australia
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Swenson TL, Ehsanian R, Tran RT, Petersen TR, Kennedy DJ, Roche M, Oppezzo M, Noordsy DL, Fredericson M. The Association Between Well-Being and Empathy in Medical Residents: A Cross-Sectional Survey. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2024; 30:691-697. [PMID: 38416862 PMCID: PMC11304836 DOI: 10.1089/jicm.2023.0116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/01/2024]
Abstract
Objective: To evaluate the extent to which personal well-being may be associated with empathy, while controlling for potential confounders. Settings/Location: Residency programs throughout the United States. Subjects: A total of 407 medical residents from residencies including general medicine, surgery, specialized and diagnostic medicine participated in this study. Outcome Measures: Well-being was measured using the modified existential well-being subscale of the spiritual well-being scale. Empathy was measured using the Jefferson Scale of Empathy. Results: Well-being was found to be positively correlated with empathy when adjusted for possible confounders (p < 0.001). In addition to well-being, other factors noted to be statistically significant contributors to higher empathy scores while controlling for the others included age, gender, year in residency, specialty, and work-hours (p < 0.05 for each). After controlling for these factors, a resident's year in residency was not found to be a statistically significant contributor to empathy score. Conclusions: In this study, well-being was associated with empathy in medical and surgical residents. Empathy is a fundamental component of physician competency, and its development is an essential aspect of medical training. These findings suggest that efforts to increase well-being may promote empathy among medical residents.
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Affiliation(s)
- Theodora L. Swenson
- Department of Physical Medicine and Rehabilitation, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Reza Ehsanian
- Department of Anesthesiology and Critical Care Medicine, University of New Mexico School of Medicine, Albuquerque, NM, USA
| | | | - Timothy R. Petersen
- Department of Anesthesiology and Critical Care Medicine, Department of Obstetrics and Gynecology, University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - David J. Kennedy
- Department of Physical Medicine and Rehabilitation, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Megan Roche
- Stanford University School of Medicine, Stanford, CA, USA
| | - Marily Oppezzo
- Division of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Douglas L. Noordsy
- Division of Psychiatry, Stanford University School of Medicine, Stanford, CA, USA
| | - Michael Fredericson
- Division of Physical Medicine and Rehabilitation, Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, CA, USA
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Kupis R, Domagała A. Are Polish doctors ready to start working right after graduation? The 2023 modification to physicians' postgraduate internship and possible paths forward. Health Policy 2024; 145:105083. [PMID: 38781707 DOI: 10.1016/j.healthpol.2024.105083] [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: 11/03/2023] [Revised: 05/14/2024] [Accepted: 05/15/2024] [Indexed: 05/25/2024]
Abstract
The Polish healthcare system faces many problems, among which the shortage of healthcare professionals is one of the most urgent. In less than ten years, more than twenty Higher Education Institutions (HEIs) have been allowed to add medical programmes to their offer, aiming to increase the number of doctors in Poland. Recently, the healthcare system was faced with a proposal to abolish the mandatory postgraduate internship which has been a mandatory component of medical training for years. Two main reforms were considered. The first one focused on the programme of the internship and aimed to update it. The second one recommended an abolition of the internship. The authors of this article analysed the opinions and positions of key players within the system regarding the postgraduate internship. Opinions in this regard are diverse, leading to the conclusion that additional actions would be required prior to the internship abolition. Undergraduate training has changed and currently students are taught in modern facilities, using new teaching methods. On the other hand, internship allows trainees to improve or even acquire skills they may not have obtained during their studies. The postgraduate internship is an essential part of doctors' training. However, in Poland, there is still a lack of a well-thought, long-term policy or strategy for physicians' workforce development. Our study presents a Polish perspective on common challenges in medical training and workforce policy, highlighting the clash over the growing demand for physicians and the limitations of the existing system.
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Affiliation(s)
- Robert Kupis
- Jagiellonian University Medical College, Centre of Innovative Medical Education, Department of Medical Education, Medyczna 7 Street, 30-688 Kraków, Poland.
| | - Alicja Domagała
- Jagiellonian University Medical College, Faculty of Health Sciences, Institute of Public Health, Skawińska 8 Street, 31-066 Kraków, Poland
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Lin-Siegler X, Lovett BJ, Wang K, Hadis S, DeGaetano AC, Williamson T, Duerr E, Levy EI. Under Pressure: Emotional Reactions to Stress of Neurosurgeons and Neurosurgical Trainees. World Neurosurg 2024:S1878-8750(24)00964-1. [PMID: 38857865 DOI: 10.1016/j.wneu.2024.06.016] [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: 02/25/2024] [Revised: 06/04/2024] [Accepted: 06/05/2024] [Indexed: 06/12/2024]
Abstract
OBJECTIVE Neurosurgeons demonstrate some of the highest levels of burnout among surgeons, yet little research has been done to understand the underlying stressors that neurosurgeons and trainees experience and the emotional responses to them. Our goal was to conduct a feasibility study identifying job stressors and emotional responses among neurosurgeons rather than generalize findings across the profession. METHODS Emphasizing a qualitative approach in this feasibility and descriptive study, we strategically selected a small sample of neurosurgical attendings, residents, and fellows at 2 United States academic neurosurgical departments to ensure an in-depth analysis laying the groundwork for future extensive research. Participants were asked to complete a questionnaire regarding work-related stressors and high- and low-arousal emotional responses to these stressors, as well as a standardized Depression, Anxiety, and Stress Scale. Both quantitative and qualitative analyses evaluating types of stressors and emotional responses reported were assessed based on participant training level. RESULTS Participants identified 3 main stressors: 1) administrative deficiencies; 2) delivering bad news/saving lives; and 3) work-life balance. A low frequency of negative emotional responses was reported, but those reported were mainly high-arousal emotions. Limited prior training in coping strategies was also reported. We also found that residents, fellows, and faculty surgeons reported about work stressors and coping strategies differently. CONCLUSIONS The results of our study provide an understanding of neurosurgical professionals' unique emotional landscape, emphasizing the need for reforms in administrative practices, enhanced, healthy coping strategies, and career stage-specific mental health support.
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Affiliation(s)
- Xiaodong Lin-Siegler
- Department of Human Development, Education for Persistence and Innovation Center (EPIC), Teachers College, Columbia University, New York, New York, USA
| | - Benjamin J Lovett
- Department of Health and Behavioral Studies, Education for Persistence and Innovation Center (EPIC), Teachers College, Columbia University, New York, New York, USA
| | - Keying Wang
- Department of Human Development, Education for Persistence and Innovation Center (EPIC), Teachers College, Columbia University, New York, New York, USA
| | - Syntia Hadis
- Department of Human Development, Education for Persistence and Innovation Center (EPIC), Teachers College, Columbia University, New York, New York, USA
| | - Aimee C DeGaetano
- Department of Health Science and Medicine, Eastern Virginia Medical School, Norfolk, Virginia, USA
| | - Theresa Williamson
- Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts, USA; Harvard Center for Bioethics, Harvard Medical School, Boston, Massachusetts, USA
| | - Emmy Duerr
- Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts, USA; Harvard Center for Bioethics, Harvard Medical School, Boston, Massachusetts, USA
| | - Elad I Levy
- Departments of Neurosurgery and Radiology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA; Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, New York, USA; Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, New York, USA; Jacobs Institute, Buffalo, New York, USA.
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11
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Deutsch AJ, Alvarez A, Balint S, Pappal RD, Roseen S, Sun WW, Warren J, Stanton K, Agarwal AK. #StopTheStigmaEM: Building a social media-based movement to support emergency medicine mental health. Acad Emerg Med 2024; 31:617-620. [PMID: 37897107 DOI: 10.1111/acem.14829] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 10/19/2023] [Accepted: 10/22/2023] [Indexed: 10/29/2023]
Affiliation(s)
| | - Al'ai Alvarez
- Stanford Hospital and Clinics, Stanford, California, USA
| | | | - Ryan D Pappal
- Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Stacey Roseen
- Society for Academic Emergency Medicine, Des Plaines, Illinois, USA
| | - Wendy W Sun
- Yale School of Medicine, New Haven, Connecticut, USA
| | | | - Kelsey Stanton
- The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Anish K Agarwal
- University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
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12
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von Känel R, Princip M, Holzgang SA, Giannopoulos AA, Kaufmann PA, Buechel RR, Zuccarella-Hackl C, Pazhenkottil AP. Cross-sectional study on the impact of adverse childhood experiences on coronary flow reserve in male physicians with and without occupational burnout. J Psychosom Res 2024; 181:111672. [PMID: 38636300 DOI: 10.1016/j.jpsychores.2024.111672] [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: 01/20/2024] [Revised: 04/13/2024] [Accepted: 04/13/2024] [Indexed: 04/20/2024]
Abstract
OBJECTIVE Physicians face documented challenges to their mental and physical well-being, particularly in the forms of occupational burnout and cardiovascular disease. This study examined the previously under-researched intersection of early life stressors, prolonged occupational stress, and cardiovascular health in physicians. METHODS Participants were 60 practicing male physicians, 30 with clinical burnout, defined by the Maslach Burnout Inventory, and 30 non-burnout controls. They completed the Adverse Childhood Experiences (ACE) Questionnaire asking about abuse, neglect and household dysfunctions before the age of 18, and the Perceived Stress Scale to rate thoughts and feelings about stress in the past month. Endothelium-independent (adenosine challenge) coronary flow reserve (CFR) and endothelium-dependent CFR (cold pressor test) were assessed by positron emission tomography-computed tomography. The segment stenosis score was determined by coronary computed tomography angiography. RESULTS Twenty-six (43%) participants reported at least one ACE and five (8%) reported ≥4 ACEs. A higher ACEs sum score was associated with lower endothelium-independent CFR (r partial (rp) = -0.347, p = .01) and endothelium-dependent CFR (rp = -0.278, p = .04), adjusting for age, body mass index, perceived stress and segment stenosis score. In exploratory analyses, participants with ≥4 ACEs had lower endothelium-independent CFR (rp = -0.419, p = .001) and endothelium-dependent CFR (rp = -0.278, p = .04), than those with <4 ACEs. Endothelium-dependent CFR was higher in physicians with burnout than in controls (rp = 0.277, p = .04). No significant interaction emerged between burnout and ACEs for CFR. CONCLUSION The findings suggest an independent association between ACEs and CFR in male physicians and emphasize the nuanced relationship between early life stressors, professional stress, and cardiovascular health.
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Affiliation(s)
- Roland von Känel
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
| | - Mary Princip
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Sarah A Holzgang
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Andreas A Giannopoulos
- Cardiac Imaging, Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Philipp A Kaufmann
- Cardiac Imaging, Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Ronny R Buechel
- Cardiac Imaging, Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Claudia Zuccarella-Hackl
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Aju P Pazhenkottil
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland; Cardiac Imaging, Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland; Department of Cardiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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13
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Pirnia B. Suicide among medical residents in Iran. Lancet Psychiatry 2024; 11:411. [PMID: 38760109 DOI: 10.1016/s2215-0366(24)00111-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 03/17/2024] [Accepted: 03/29/2024] [Indexed: 05/19/2024]
Affiliation(s)
- Bijan Pirnia
- Behavioral Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran 1617763141, Iran; Bijan Center for Substance Abuse Treatment, Tehran, Iran.
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14
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Khalil MA, Khalifa D, Allam RM, Abdalgeleel SA, Khalaf OO. Suicide and depressive symptoms possible correlates among a sample of Egyptian physicians: observational cross-sectional study (online survey). BMC Psychiatry 2024; 24:408. [PMID: 38816711 PMCID: PMC11137965 DOI: 10.1186/s12888-024-05825-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 05/09/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND Compared to other occupations, physicians are more susceptible to depression and suicide. Suicide among physicians in some countries reached up to 1.5- to threefold higher than the general population. However, this rate was not homogenous in all countries. Most of the Egyptian studies were related to the stressful pandemic event, but the actual prevalence of depression among physicians is still under research. To the best of the researcher's knowledge, no other study has been conducted to evaluate the risk of suicide among Egyptian physicians. AIM The study aimed to screen for depressive symptoms and suicide among Egyptian physicians and to investigate the correlates associated with suicide ideations. METHODS This cross-sectional survey included Egyptian physicians recruited online by Google Forms. Depressive symptoms were screened using the Beck Depression Scale (BDI-II), while suicidal ideas were assessed using the Suicidal Ideation Attributes Scale (SIDAS). RESULTS Six hundred sixty Egyptian physicians completed the survey following a two-week pilot study between January 10 and July 16, 2023. The average age was 39.1 years, and 71.4% were married. 49.1% were medical specialists. The median daily working hours were eight, and 27.7% of the physicians attended night shifts. 22.3% had a psychiatric illness, and 34.3% had a chronic disease. Younger and single physicians of both sexes were more prone to suicide risk (p-value = 0.019 and 0.021, respectively). Those with psychiatric or chronic medical disorders had a higher suicidal risk (p-values < 0.001 and 0.004, respectively). Physicians with fewer academic degrees and those who work longer hours or night shifts had more depressive symptoms (p-values < 0.001 and 0.009, respectively). The risk of depression and suicide is almost the same in all medical specialties. The SIDAS suicide score and the Beck depression score revealed a statistically significant association (r = 0.288, p-value < 0.001). CONCLUSION Suicide risk is higher among younger, single physicians of both sexes, as well as those with psychiatric or chronic medical disorders. More depressive symptoms are seen in physicians who have more extended hours or night shifts and who have fewer academic degrees. Almost all medical specialties carry the same risk of depression and suicide. Longitudinal research is recommended for regular follow-up of suicidal thoughts and depressive symptoms.
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Affiliation(s)
- Mohamed A Khalil
- Psychiatry Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Dalia Khalifa
- Psychiatry Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Rasha Mahmoud Allam
- Cancer Epidemiology and Biostatistics Department, National Cancer Institute, Cairo University, Egypt
| | - Shaimaa Abdalaleem Abdalgeleel
- Cancer Epidemiology and Biostatistics Department, National Cancer Institute, Cairo University, Egypt
- Department of Public Health, Faculty of Applied Medical Sciences, Al-Baha University, Al-Baha, Saudi Arabia
| | - Ola Osama Khalaf
- Psychiatry Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
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15
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Stangl FP, Heidegger I, Kraft P, Lammers RJM, Horvath M, Deger MD, Polo-Alonso E, Wenzel M, Affentranger A, Schou-Jensen K, Ali L, Keenan RA, Gallardo-Zamora L, Alva JF, Trerè D, Tsampoukas G, Hoyerup P, Cerrato C, Raison N, Brookman-May S, Vásquez JL. Challenging the Urologist of the Future: Time for a Change? Eur Urol 2024:S0302-2838(24)02393-5. [PMID: 38811312 DOI: 10.1016/j.eururo.2024.05.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 05/07/2024] [Accepted: 05/17/2024] [Indexed: 05/31/2024]
Abstract
Physicians need both medical expertise and diverse skills for effective patient care. Adaptability is also key in embracing advances in technology and new techniques. We outline six thought-provoking points to guide the new generation of urologists.
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Affiliation(s)
- Fabian P Stangl
- Department of Urology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
| | - Isabel Heidegger
- Department of Urology, Medical University of Innsbruck, Innsbruck, Austria
| | - Pia Kraft
- Department of Urology, Cantonal Hospital Winterthur, Winterthur, Switzerland
| | - Rianne J M Lammers
- Department of Urology, University Medical Center Groningen, Groningen, The Netherlands
| | - Mark Horvath
- Department of Urology, Petz Aladar University Teaching Hospital, Gyor, Hungary
| | | | | | - Mike Wenzel
- Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt, Germany
| | | | | | - Lobna Ali
- Department of Urology, Evangelical Clinic Bethel, Bielefeld, Germany
| | - Robert A Keenan
- Department of Urology, St. James's Hospital, Dublin, Ireland
| | | | | | - Domenico Trerè
- Department of Urology, University Hospital of Sassari, Sassari, Italy
| | - Georgios Tsampoukas
- Department of Urology, Homerton Healthcare NHS Foundation Trust, Homerton, UK
| | - Peter Hoyerup
- Department of Urology, Zealand University Hospital, Roskilde, Denmark
| | - Clara Cerrato
- Department of Urology, University Hospital Southampton NHS Trust, Southampton, UK
| | - Nicolas Raison
- MRC Centre for Transplantation, Guy's Hospital, King's College London, London, UK; Department of Urology, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - Sabine Brookman-May
- Department of Urology, Ludwig-Maximilians University, Munich, Germany; Research & Development, Johnson & Johnson Innovative Medicine, Spring House, PA, USA
| | - Juan Luis Vásquez
- Department of Urology, Zealand University Hospital, Roskilde, Denmark; Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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16
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Berger-Estilita J, Salvisberg D, Köselerli E, Haupt S, Meço BC. Impact of Burnout on Anaesthesiologists. Turk J Anaesthesiol Reanim 2024; 52:54-59. [PMID: 38700106 DOI: 10.4274/tjar.2024.241565] [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: 05/05/2024] Open
Abstract
Professional burnout syndrome (PBS) is an issue affecting individuals and organizations alike, characterized by emotional exhaustion and reduced effectiveness resulting from overwhelming work demands. Root causes include excessive workload, unrealistic expectations, and blurred work-life boundaries, which are often intensified by organizational culture and inadequate support systems. The consequences range from decreased productivity and creativity to high turnover rates and financial strain on organizations. Mitigating PBS requires a comprehensive approach that addresses both individual and organizational levels. Individually, stress management techniques and self-care practices are crucial for building resilience and coping with work-related stressors. Organizations play a vital role in promoting employee well-being by fostering a supportive work environment, promoting work-life balance and providing access to support systems such as counseling and mentorship programs. Leadership is key in creating a culture that values employee health and prioritizes open communication and empathy. Policy interventions can further support efforts to combat PBS by enforcing labor laws that protect employee rights, such as setting limits on working hours and ensuring access to mental health services. Additionally, incentivise organizations to prioritize employee well-being through tax incentives or certification programs can encourage proactive measures against burnout. The aim of this review is to provide a comprehensive exploration of PBS, examining its causes, consequences, and potential mitigation strategies in individuals and organizations, with a focus on anaesthesiology.
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Affiliation(s)
- Joana Berger-Estilita
- Hirslanden Medical Group Salem Spital, Institute of Anaesthesiology and Intensive Care, Bern, Switzerland
- University of Bern, Institute for Medical Education, Bern, Switzerland
- University of Porto Faculty of Medicine, Centre for Health Technology and Services Research, Porto, Portugal
| | | | - Ekin Köselerli
- Ankara University Faculty of Medicine, İbn-i Sina Hospital, Department of Anaesthesiology and Intensive Care Unit, Ankara, Turkey
| | - Stefan Haupt
- Hirslanden Medical Group Salem Spital, Institute of Anaesthesiology and Intensive Care, Bern, Switzerland
| | - Başak Ceyda Meço
- Ankara University Faculty of Medicine, İbn-i Sina Hospital, Department of Anaesthesiology and Intensive Care Unit, Ankara, Turkey
- Ankara University Brain Research Center (AÜBAUM), Ankara, Turkey
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17
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Harris SR, Amano A, Winget M, Skeff KM, Brown-Johnson CG. Trauma-Informed Healthcare Leadership? Evidence and opportunities from interviews with leaders during COVID-19. BMC Health Serv Res 2024; 24:515. [PMID: 38659009 PMCID: PMC11044408 DOI: 10.1186/s12913-024-10946-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 04/02/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND COVID-19 impacted the mental health of healthcare workers, who endured pressures as they provided care during a prolonged crisis. We aimed to explore whether and how a Trauma-Informed Care (TIC) approach was reflected in qualitative perspectives from healthcare leaders of their experience during COVID-19 (2020-2021). METHODS Semi-structured interviews with healthcare leaders from four institutions were conducted. Data analysis consisted of four stages informed by interpretative phenomenological analysis: 1) deductive coding using TIC assumptions, 2) inductive thematic analysis of coded excerpts, 3) keyword-in-context coding of full transcripts for 6 TIC principles with integration into prior inductive themes, and 4) interpretation of themes through 6 TIC principles (safety; trustworthiness and transparency; peer support; collaboration and mutuality; empowerment, voice, and choice; and awareness of cultural, historical, and gender issues). RESULTS The actions of leaders (n = 28) that were reported as successful and supportive responses to the COVID-19 pandemic or else missed opportunities reflected core principles of Trauma-Informed Care. To promote safety, leaders reported affirmative efforts to protect staff by providing appropriate physical protection, and enhanced psychological safety by providing channels for communication about emotional well-being. To promote trustworthiness and transparency, leaders listened to their staff, shared current COVID-19 information, and increased frequency of meetings to disseminate accurate information. To promote mutual support, strategies included wellness check-ins, sharing uplifting stories, affirming common goals, articulating fears, and leading by example. Examples of empowerment included: making time and adjusting modalities for flexible communication; naming challenges outside of the hospital; and functioning as a channel for complaints. Reported missed opportunities included needing more dedicated time and space for healthcare employees to process emotions, failures in leadership managing their own anxiety, and needing better support for middle managers. Awareness of the TIC principle of cultural, historical, and gender issues was largely absent. Results informed the nascent Trauma-Informed Healthcare Leadership (TIHL) framework. CONCLUSIONS We propose the Trauma-Informed Healthcare Leadership framework as a useful schema for action and analysis. This approach yields recommendations for healthcare leaders including creating designated spaces for emotional processing, and establishing consistent check-ins that reference personal and professional well-being.
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Affiliation(s)
| | - Alexis Amano
- UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Marcy Winget
- Stanford University School of Medicine, Palo Alto, CA, USA
| | - Kelley M Skeff
- Stanford University School of Medicine, Palo Alto, CA, USA
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18
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Baas MAM, Stramrood CAI, Molenaar JE, van Baar PM, Vanhommerig JW, van Pampus MG. Continuing the conversation: a cross-sectional study about the effects of work-related adverse events on the mental health of Dutch (resident) obstetrician-gynaecologists (ObGyns). BMC Psychiatry 2024; 24:286. [PMID: 38627649 PMCID: PMC11022402 DOI: 10.1186/s12888-024-05678-3] [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: 11/20/2023] [Accepted: 03/12/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Obstetrician-Gynaecologists (ObGyns) frequently face work-related adverse events such as severe obstetric complications and maternal or neonatal deaths. In 2014, the WATER-1 study showed that ObGyns are at risk of developing work-related posttraumatic stress disorder (PTSD), while many hospitals lacked a professional support system. The aim of the present study is to evaluate the current prevalence of work-related traumatic events and mental health problems among Dutch ObGyns, as well as to examine the current and desired support. METHODS In 2022, an online questionnaire was sent to all members of the Dutch Society of Obstetrics and Gynaecology (NVOG), including resident and attending ObGyns. The survey included questions about experienced work-related events, current and desired coping strategies, and three validated screening questionnaires for anxiety, depression, and PTSD (HADS, TSQ, and PCL-5). RESULTS The response rate was 18.8% and 343 questionnaires were included in the analysis. Of the respondents, 93.9% had experienced at least one work-related adverse event, 20.1% had faced a complaint from the national disciplinary board, and 49.4% had considered leaving the profession at any moment in their career. The prevalence rates of clinically relevant anxiety, depression, and psychological distress were 14.3, 4.4, and 15.7%, respectively. The prevalence of work-related PTSD was 0.9% according to DSM-IV and 1.2% according to DSM-5. More than half of the respondents (61.3%) reported the presence of a structured support protocol or approach in their department or hospital, and almost all respondents (92.6%) rated it as sufficient. CONCLUSIONS The percentages of anxiety, depression, psychological distress and PTSD are comparable to the similar study performed in 2014. Most Dutch ObGyns experience adverse events at work, which can be perceived as traumatic and, in certain cases, may lead to the development of PTSD. Structured support after adverse work-related events is now available in almost two-thirds of workplaces, and was mostly experienced as good. Despite substantial improvements in the availability and satisfaction of professional support after work-related adverse events, the prevalence rates of mental problems remain considerable, and it is imperative to sustain conversation about the mental well-being of ObGyns.
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Affiliation(s)
- Melanie A M Baas
- Department of Obstetrics and Gynaecology, OLVG, 1090 HM, Amsterdam, PO box 95500, The Netherlands
- Department of Obstetrics and Gynaecology, University Medical Center Groningen, 9700 RB, Groningen, PO box 30.001, The Netherlands
| | - Claire A I Stramrood
- Department of Obstetrics and Gynaecology, OLVG, 1090 HM, Amsterdam, PO box 95500, The Netherlands
- Beval Beter, 1000 AH, Amsterdam, PO box 345, The Netherlands
| | - Jolijn E Molenaar
- Department of Obstetrics and Gynaecology, OLVG, 1090 HM, Amsterdam, PO box 95500, The Netherlands
| | - Petra M van Baar
- Department of Obstetrics and Gynaecology, OLVG, 1090 HM, Amsterdam, PO box 95500, The Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam UMC, 1105 AZ, Amsterdam, the Netherlands
| | - Joost W Vanhommerig
- Department of Research and Epidemiology, OLVG, 1090 HM, Amsterdam, PO box 95500, The Netherlands
| | - Maria G van Pampus
- Department of Obstetrics and Gynaecology, OLVG, 1090 HM, Amsterdam, PO box 95500, The Netherlands.
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Anderson LN, Anaya YB, Gilchrist V. Supporting Our Women Colleagues. Fam Med 2024; 56:219-221. [PMID: 38748630 PMCID: PMC11189125 DOI: 10.22454/fammed.2024.754708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2024]
Abstract
Burnout is a challenge for all of us. Many of us experience burnout and know the toll it can take on our health and well-being. This editorial focuses on the experiences of women physicians and learners by highlighting the lived experience of one woman physician, briefly examining the extensive research into women physicians' practice, and identifying solutions that all genders can leverage to support women physicians and learners.
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Affiliation(s)
- LaKesha N Anderson
- Center for Health Professions Education, Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Yohualli B Anaya
- Department of Family Medicine and Community Health, School of Medicine and Public Health, University of Wisconsin, Madison, WI
| | - Valerie Gilchrist
- Department of Family Medicine and Community Health, School of Medicine and Public Health, University of Wisconsin, Madison, WI
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20
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Ng IK, Tan SM, Law LS, Tan LF, Teo DB. Spotlighting 'Medical Collegiality'. J R Coll Physicians Edinb 2024; 54:89-93. [PMID: 38160200 DOI: 10.1177/14782715231221833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024] Open
Abstract
'Collegiality' comes from the Latin term 'Collegium', which essentially refers to a community of individuals bounded by their collective pursuit of a common goal. The concept has historical roots in both organised religion and academia, with its use subsequently extended to various industrial and corporate settings including healthcare. Nowadays, 'collegiality' has become a common buzzword adopted by the medical fraternity - often deemed as having a polite and respectful demeanour, maintaining cordial work relationships and being a team player who demonstrates willingness to help others and avoid speaking ill of fellow colleagues. While it is true that workplace incivility, aggression, bullying and verbal abuse are not uncommonly reported in highly stressful healthcare settings, which are concerning phenomena that should be addressed and prevented, the concept of 'medical collegiality' is, in reality, a rich and multi-faceted concept that is not limited to behavioural attributes, but extends to larger cultural principles and organisational constructs. In this article, we herein define 'medical collegiality' as 'a collective manifestation of respect, empathy and solidarity within the medical fraternity, driven by a common pursuit of clinical excellence in patient care, demonstrated through interpersonal/work relationships and organisational culture', by referencing historical origins of 'collegiality' in organised religion and academia. We further review the concept of 'medical collegiality' through three core lenses of cultural, behavioural and structural collegiality. Finally, we discuss the importance of medical collegiality for physician mental health and well-being, and quality of clinical care.
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Affiliation(s)
- Isaac Ks Ng
- Department of Medicine, National University Hospital, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Sarah Ml Tan
- Department of Medicine, National University Hospital, Singapore
| | - Lawrence Sc Law
- Department of Medicine, National University Hospital, Singapore
| | - Li Feng Tan
- Department of Medicine, National University Hospital, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Healthy Ageing Programme, Alexandra Hospital, Singapore
| | - Desmond B Teo
- Department of Medicine, National University Hospital, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Division of Advanced Internal Medicine, Department of Medicine, National University Hospital, Singapore
- Fast and Chronic Programmes, Alexandra Hospital, Singapore
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Collins RA, Herman T, Snyder RA, Haines KL, Stey A, Arora TK, Geevarghese SK, Phillips JD, Vicente D, Griggs CL, McElroy IE, Wall AE, Hughes TM, Sen S, Valinejad J, Alban A, Swan JS, Mercaldo N, Jalali MS, Chhatwal J, Gazelle GS, Rangel E, Yang CFJ, Donelan K, Gold JA, West CP, Cunningham C. Unspoken Truths: Mental Health Among Academic Surgeons. Ann Surg 2024; 279:429-436. [PMID: 37991182 DOI: 10.1097/sla.0000000000006159] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2023]
Abstract
OBJECTIVE To characterize the current state of mental health within the surgical workforce in the United States. BACKGROUND Mental illness and suicide is a growing concern in the medical community; however, the current state is largely unknown. METHODS Cross-sectional survey of the academic surgery community assessing mental health, medical error, and suicidal ideation. The odds of suicidal ideation adjusting for sex, prior mental health diagnosis, and validated scales screening for depression, anxiety, post-traumatic stress disorder (PTSD), and alcohol use disorder were assessed. RESULTS Of 622 participating medical students, trainees, and surgeons (estimated response rate=11.4%-14.0%), 26.1% (141/539) reported a previous mental health diagnosis. In all, 15.9% (83/523) of respondents screened positive for current depression, 18.4% (98/533) for anxiety, 11.0% (56/510) for alcohol use disorder, and 17.3% (36/208) for PTSD. Medical error was associated with depression (30.7% vs. 13.3%, P <0.001), anxiety (31.6% vs. 16.2%, P =0.001), PTSD (12.8% vs. 5.6%, P =0.018), and hazardous alcohol consumption (18.7% vs. 9.7%, P =0.022). Overall, 13.2% (73/551) of respondents reported suicidal ideation in the past year and 9.6% (51/533) in the past 2 weeks. On adjusted analysis, a previous history of a mental health disorder (aOR: 1.97, 95% CI: 1.04-3.65, P =0.033) and screening positive for depression (aOR: 4.30, 95% CI: 2.21-8.29, P <0.001) or PTSD (aOR: 3.93, 95% CI: 1.61-9.44, P =0.002) were associated with increased odds of suicidal ideation over the past 12 months. CONCLUSIONS Nearly 1 in 7 respondents reported suicidal ideation in the past year. Mental illness and suicidal ideation are significant problems among the surgical workforce in the United States.
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Affiliation(s)
- Reagan A Collins
- Department of Surgery, Massachusetts General Hospital, Boston, MA
- Institute for Technology Assessment, Massachusetts General Hospital, Boston, MA
- School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX
| | - Tianna Herman
- Institute for Technology Assessment, Massachusetts General Hospital, Boston, MA
| | - Rebecca A Snyder
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - Anne Stey
- Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Tania K Arora
- Department of Surgery, Augusta University at the Medical College of Georgia, Augusta, GA
| | | | | | - Diego Vicente
- Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Cornelia L Griggs
- Department of Pediatric Surgery, Massachusetts General Hospital, Boston, MA
| | - Imani E McElroy
- Department of Surgery, Massachusetts General Hospital, Boston, MA
| | - Anji E Wall
- Department of Surgery, Baylor University Medical Center, Dallas, TX
| | - Tasha M Hughes
- Department of Surgery, University of Michigan, Ann Arbor, MI
| | - Srijan Sen
- Department of Psychiatry, University of Michigan, Ann Arbor, MI
| | - Jaber Valinejad
- Institute for Technology Assessment, Massachusetts General Hospital, Boston, MA
| | - Andres Alban
- Institute for Technology Assessment, Massachusetts General Hospital, Boston, MA
| | - J Shannon Swan
- Institute for Technology Assessment, Massachusetts General Hospital, Boston, MA
| | - Nathaniel Mercaldo
- Institute for Technology Assessment, Massachusetts General Hospital, Boston, MA
| | - Mohammad S Jalali
- Institute for Technology Assessment, Massachusetts General Hospital, Boston, MA
| | - Jagpreet Chhatwal
- Institute for Technology Assessment, Massachusetts General Hospital, Boston, MA
| | - G Scott Gazelle
- Institute for Technology Assessment, Massachusetts General Hospital, Boston, MA
| | - Erika Rangel
- Department of Surgery, Massachusetts General Hospital, Boston, MA
| | | | - Karen Donelan
- Institute for Technology Assessment, Massachusetts General Hospital, Boston, MA
| | - Jessica A Gold
- Department of Psychiatry, Washington University in St Louis, St Louis, MO
| | - Colin P West
- Department of Medicine, Mayo Clinic, Rochester, MN
| | - Carrie Cunningham
- Department of Surgery, Massachusetts General Hospital, Boston, MA
- Institute for Technology Assessment, Massachusetts General Hospital, Boston, MA
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Petrie K, Gayed A, Spittal MJ, Glozier N, Shand F, Harvey SB. Work-related factors and the risk of common mental disorder 1 year later: A prospective cohort study among junior doctors. Aust N Z J Psychiatry 2024; 58:227-237. [PMID: 37933864 DOI: 10.1177/00048674231209843] [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] [Indexed: 11/08/2023]
Abstract
OBJECTIVE This study investigated the relationship between work-related factors at baseline and the risk of common mental disorder at 12 month follow-up among a cohort of junior doctors. METHOD The data comprised the junior doctor respondents from two annual waves of the 'Medicine in Australia: Balancing Employment and Life' (MABEL) survey, a national longitudinal cohort of Australian doctors. Individual and work-related risk factors were assessed at baseline and the mental health outcome of caseness of common mental disorder (CMD) was assessed using the 6-item Kessler Psychological Distress Scale at 12-month follow-up. Unadjusted and adjusted logistic regressions were conducted to estimate the association between each baseline variable and the likelihood of CMD caseness at follow-up 1 year later. RESULTS Among 383 junior doctors, 24 (6%) had CMD 1 year later. Five work-related baseline variables were significantly associated with a higher likelihood of CMD 1 year later in adjusted models; lack of social support in work location (odds ratios (OR) = 6.11; 95% confidence intervals (CI) = [2.52, 14.81]), work-life imbalance (OR = 4.50; 95% CI = [1.31, 15.46]), poor peer support network in the workplace (OR = 2.61; 95% CI = [1.08, 6.27]), perceptions of patient expectations (OR = 2.46; 95% CI = [1.06, 5.71]) and total weekly work hours (OR 1.04; 95% CI = [1.01, 1.07]; p = 0.002)in models adjusting for gender. CONCLUSION These results identify key modifiable work-related factors that are associated with junior doctors' future mental health. Our findings suggest the need for a greater focus upon interpersonal factors and work-life balance in multi-level interventions while continuing to address workplace and system-level factors to prevent future mental disorder in junior doctors.
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Affiliation(s)
- Katherine Petrie
- Discipline of Psychiatry, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
- Black Dog Institute, University of New South Wales, Randwick, NSW, Australia
| | - Aimee Gayed
- Black Dog Institute, University of New South Wales, Randwick, NSW, Australia
| | - Matthew J Spittal
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Nicholas Glozier
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Australian Research Council (ARC) Centre of Excellence for Children and Families over the Life Course, Sydney, NSW, Australia
| | - Fiona Shand
- Black Dog Institute, University of New South Wales, Randwick, NSW, Australia
| | - Samuel B Harvey
- Black Dog Institute, University of New South Wales, Randwick, NSW, Australia
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Bhugra D, Smith AJ, Ventriglio A, Rao N, Ng R, Javed A, Chisolm MS, Malhi G, Kar A, Chumakov E, Liebrenz M. World Psychiatric Association-Asian Journal of Psychiatry Commission on the Mental Health and Wellbeing of International Medical Graduates. Asian J Psychiatr 2024; 93:103943. [PMID: 38342035 DOI: 10.1016/j.ajp.2024.103943] [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: 09/28/2023] [Revised: 01/05/2024] [Accepted: 01/31/2024] [Indexed: 02/13/2024]
Abstract
Historically, doctors have migrated for a range of personal, educational, economic, and political reasons. Likewise, medical students from many countries have moved abroad to complete their training and education and may or may not return to their country of origin. Within this context, globalisation has had a major impact on medical education and healthcare workforces, contributing to recent migration trends. Globalisation is a complex phenomenon with positive and negative outcomes. For example, lower-income countries are regularly losing doctors to higher-income areas, thereby exacerbating strains on existing services. Across various national healthcare settings, migrating International Medical Graduates (IMGs) can face socioenvironmental and psychosocial pressures, which can lead to lower mental wellbeing and undermine their contributions to clinical care. Rates of stress and burnout are generally increasing for doctors and medical students. For IMGs, stressors related to migration, acculturation, and adjustment are not dissimilar to other migrants but may carry with them specific nuances. Accordingly, this Commission will explore the history of IMG trends and the challenges faced by IMGs, proposing recommendations and solutions to support their mental health and wellbeing.
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Affiliation(s)
- Dinesh Bhugra
- Institute of Psychiatry, Psychology and Neurosciences, Kings College London, De Crespigny Park, London SE5 8AF, UK.
| | - Alexander J Smith
- Department of Forensic Psychiatry, University of Bern, Bern, Switzerland
| | | | - Nyapati Rao
- Stony Brook University Health Sciences Center School of Medicine, New York, USA
| | - Roger Ng
- World Psychiatric Association, Geneva, Switzerland
| | - Afzal Javed
- World Psychiatric Association, Geneva, Switzerland
| | | | - Gin Malhi
- School of Psychiatry, University of Sydney, Sydney, Australia
| | - Anindya Kar
- Advanced Neuropsychiatry Institute, Kolkata, India
| | - Egor Chumakov
- Department of Psychiatry & Addiction, St Petersburg State University, St Petersburg, Russia
| | - Michael Liebrenz
- Department of Forensic Psychiatry, University of Bern, Bern, Switzerland
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Habbous S, Saunders N, Chan KK, Hota S, Wang J, Messenger D, Hellsten E. SARS-CoV-2 infection among physicians over time in Ontario, Canada: a population-based retrospective cohort study. Croat Med J 2024; 65:30-42. [PMID: 38433510 PMCID: PMC10915769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 02/21/2024] [Indexed: 03/05/2024] Open
Abstract
AIM To assess this risk of SARS-CoV-2 infection among Ontario physicians by specialty and in comparison with non-physician controls during the COVID-19 pandemic. METHODS In this retrospective cohort study, the primary outcome was incident SARS-CoV-2 infection confirmed by polymerase chain reaction (PCR). Secondary outcomes were hospitalization, use of critical care, and mortality. RESULTS From March 1, 2020 to December 31, 2022, 6172/30 617 (20%) active Ontario physicians tested positive for SARS-CoV-2. Infection was less likely if physicians were older (OR 0.78 [0.76-0.81] per 10 years), rural residents (OR 0.70 [0.59-0.83]), and lived in more marginalized neighborhoods (OR 0.74 [0.62-0.89]), but more likely if they were female (OR 1.14 [1.07-1.22]), worked in long-term care settings (OR 1.16 [1.02-1.32]), had higher patient volumes (OR 2.05 [1.82-2.30] for highest vs lowest), and were pediatricians (OR 1.25 [1.09-1.44]). Compared with community-matched controls (n=29 763), physicians had a higher risk of infection during the first two waves of the pandemic (OR 1.38 [1.20-1.59]) but by wave 3 the risk was no longer significantly different (OR 0.93 [0.83-1.05]). Physicians were less likely to be hospitalized within 14 days of their first positive PCR test than non-physicians (P<0.0001), but there was no difference in the use of critical care (P=0.48) or mortality (P=0.15). CONCLUSION Physicians had higher rates of infection than community-matched controls during the first two waves of the pandemic in Ontario, but not from wave 3 onward. Physicians practicing in long-term care facilities and pediatricians were more likely to test positive for SARS-CoV-2 than other physicians.
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Affiliation(s)
- Steven Habbous
- Steven Habbous, 525 University Ave, Toronto, Ontario, Canada, M5G 2L3,
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25
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Hahn N, Brzoska P, Kiessling C. On the correlation between gratitude and resilience in medical students. GMS JOURNAL FOR MEDICAL EDUCATION 2024; 41:Doc8. [PMID: 38504862 PMCID: PMC10946207 DOI: 10.3205/zma001663] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 08/20/2023] [Accepted: 11/14/2023] [Indexed: 03/21/2024]
Abstract
Objective Medical students' health and resilience have increasingly been the subject of current research in recent years. A variety of interventions are recommended to strengthen resilience or its known or suspected influencing factors, although the literature shows that the evidence on the effectiveness of the interventions is inconsistent. The present study investigated whether gratitude is a direct protective factor for resilience in medical students or whether resilience factors (optimism, self-efficacy, social support) and stress mediate the effects of gratitude on resilience. Methods 90 medical students at Witten/Herdecke University took part in the study that determined their gratitude, resilience, optimism, self-efficacy, social support and stress levels using validated questionnaires (GQ-6, RS-25, LOT-R, SWE, F-SozU, PSS). Correlations were analyzed using Pearson correlation coefficients. In addition, a multivariate regression analysis and a path analysis were calculated to determine the direct and indirect effects of gratitude on resilience. Results Multivariate regression analysis showed that only optimism, social support and stress were significantly associated with resilience (B=0.48, 95% CI: 0.31, 0.66; B=0.23, 95% CI: 0.01, 0.44 and B=-0.02, 95% CI: -0.03, -0.001, respectively). The direct effect of gratitude on resilience was minimal and not significant in the path analysis. However, there was an indirect effect of gratitude on resilience (B=0.321; p<0.05). Mediation via the optimism variable was mainly responsible for this effect (indirect effect B=0.197; p<0.05). Conclusion This study shows that gratitude has only a minimal direct influence on resilience. However, results indicate that optimism as a mediating factor strengthens the resilience of medical students. Against this background, it may be useful to integrate interventions that promote an optimistic attitude into medical studies in order to strengthen the mental health of future doctors in the long term.
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Affiliation(s)
- Nicolai Hahn
- Witten/Herdecke University, Faculty of Health, Education of Personal and Interpersonal Competencies in Health Care, Witten, Germany
| | - Patrick Brzoska
- Witten/Herdecke University, Faculty of Health, Health Services Research, Witten, Germany
| | - Claudia Kiessling
- Witten/Herdecke University, Faculty of Health, Education of Personal and Interpersonal Competencies in Health Care, Witten, Germany
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Chou LB, Kha ST, Shapiro LM. Health Considerations for Female Orthopaedic Surgeons. J Am Acad Orthop Surg 2024; 32:e125-e133. [PMID: 37797264 DOI: 10.5435/jaaos-d-23-00221] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 09/06/2023] [Indexed: 10/07/2023] Open
Abstract
The number of female orthopaedic surgeons is increasing. They face unique health concerns, which include cancer risk, pregnancy and fertility problems, musculoskeletal issues, and mental health disorders. In 2010, a survey study showed a 2.9-fold increased prevalence of breast cancer in female orthopaedic surgeons, compared with women in the general US population. A follow-up study 13 years later showed a 3.97-fold higher prevalence of breast cancer in female orthopaedic surgeons compared with matched women in the US general population. Surveys on fertility have also reported that orthopaedic surgery is one of three surgical subspecialty fields with the highest rates of fertility difficulty. In addition, the rate of pregnancy loss in female surgeons was twice the rate compared with that of the general population. There is an increased risk of preterm delivery in female orthopaedic surgeons. Awareness, education, and preventive measures may help reduce these issues and thereby promote the recruitment, retainment, and success of female surgeons in orthopaedic surgery.
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Affiliation(s)
- Loretta B Chou
- From the Department of Orthopaedic Surgery, Stanford University School of Medicine, Redwood City (Chou, and Kha), and the Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, CA (Shapiro)
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Diaz E, Abad-Tortosa D, Ghezal M, Davin J, Lopez-Castroman J. Role of stressful life events and personality traits on the prevalence of wish to die among French physicians. Front Public Health 2024; 12:1244605. [PMID: 38322123 PMCID: PMC10844508 DOI: 10.3389/fpubh.2024.1244605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 01/04/2024] [Indexed: 02/08/2024] Open
Abstract
Background Suicide rates are higher among physicians than in the general population. We aimed to investigate the role of stressful life events (related or not to work conditions) and personality traits on wish to die, a proxy measure of suicidal ideation. Methods This cross-sectional study took place in France from March 2018 to September 2018. Physicians completed an online questionnaire. A multiple logistic regression model estimated factors associated with wish to die. Moderated moderation models were used to assess the effect of personality traits on the relationship between stressful events and wish to die. Results 1,020 physicians completed the questionnaire. Most (75%) had endorsed a work-related stressful event and one in six (15.9%) endorsed a wish to die the year before. Wish to die was associated with burnout (OR = 2.65, 95%CI = 1.82-3.88) and work-related stressful events (OR = 2.18, 95%CI = 1.24-3.85) including interpersonal conflicts, harassment and work-overload. Emotional stability was the only personality trait associated with wish to die in the logistic regression (OR = 0.69, 95%CI = 0.59-0.82). In moderation models, we observed a significant interaction involving three personality traits-emotional stability, extraversion, and agreeableness-along with gender, influencing the impact of stressful events on the wish to die. Limitations Our study is limited by the impossibility to control for risk factors associated with suicide like psychiatric comorbidities. Conclusion Work-related stressful events significantly contribute to the manifestation of a wish to die among physicians. The impact of stressful events on the wish to die is moderated by factors such as gender and personality traits, including emotional stability and extraversion. These results are overall consistent with prior studies concerning the risk of burnout and suicide among physicians.
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Affiliation(s)
- Emmanuel Diaz
- Department of Psychiatry, Nîmes University Hospital (CHU), Nîmes, France
| | - Diana Abad-Tortosa
- Department of Psychiatry, Nîmes University Hospital (CHU), Nîmes, France
| | - Maha Ghezal
- Department of Psychiatry, Nîmes University Hospital (CHU), Nîmes, France
| | - Josephine Davin
- Department of Psychiatry, Nîmes University Hospital (CHU), Nîmes, France
| | - Jorge Lopez-Castroman
- Department of Psychiatry, Nîmes University Hospital (CHU), Nîmes, France
- IGF, CNRS-INSERM, University of Montpellier, Montpellier, France
- CIBERSAM, Madrid, Spain
- Department of Signal Theory and Communication, Universidad Carlos III, Madrid, Spain
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Jaiswal S, Purpura SR, Manchanda JK, Nan J, Azeez N, Ramanathan D, Mishra J. Design and Implementation of a Brief Digital Mindfulness and Compassion Training App for Health Care Professionals: Cluster Randomized Controlled Trial. JMIR Ment Health 2024; 11:e49467. [PMID: 38252479 PMCID: PMC10845023 DOI: 10.2196/49467] [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: 05/30/2023] [Revised: 11/09/2023] [Accepted: 12/01/2023] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND Several studies show that intense work schedules make health care professionals particularly vulnerable to emotional exhaustion and burnout. OBJECTIVE In this scenario, promoting self-compassion and mindfulness may be beneficial for well-being. Notably, scalable, digital app-based methods may have the potential to enhance self-compassion and mindfulness in health care professionals. METHODS In this study, we designed and implemented a scalable, digital app-based, brief mindfulness and compassion training program called "WellMind" for health care professionals. A total of 22 adult participants completed up to 60 sessions of WellMind training, 5-10 minutes in duration each, over 3 months. Participants completed behavioral assessments measuring self-compassion and mindfulness at baseline (preintervention), 3 months (postintervention), and 6 months (follow-up). In order to control for practice effects on the repeat assessments and calculate effect sizes, we also studied a no-contact control group of 21 health care professionals who only completed the repeated assessments but were not provided any training. Additionally, we evaluated pre- and postintervention neural activity in core brain networks using electroencephalography source imaging as an objective neurophysiological training outcome. RESULTS Findings showed a post- versus preintervention increase in self-compassion (Cohen d=0.57; P=.007) and state-mindfulness (d=0.52; P=.02) only in the WellMind training group, with improvements in self-compassion sustained at follow-up (d=0.8; P=.01). Additionally, WellMind training durations correlated with the magnitude of improvement in self-compassion across human participants (ρ=0.52; P=.01). Training-related neurophysiological results revealed plasticity specific to the default mode network (DMN) that is implicated in mind-wandering and rumination, with DMN network suppression selectively observed at the postintervention time point in the WellMind group (d=-0.87; P=.03). We also found that improvement in self-compassion was directly related to the extent of DMN suppression (ρ=-0.368; P=.04). CONCLUSIONS Overall, promising behavioral and neurophysiological findings from this first study demonstrate the benefits of brief digital mindfulness and compassion training for health care professionals and compel the scale-up of the digital intervention. TRIAL REGISTRATION Trial Registration: International Standard Randomized Controlled Trial Number Registry ISRCTN94766568, https://www.isrctn.com/ISRCTN94766568.
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Affiliation(s)
- Satish Jaiswal
- Department of Psychiatry, University of California San Diego, San Diego, CA, United States
| | - Suzanna R Purpura
- Department of Psychiatry, University of California San Diego, San Diego, CA, United States
| | - James K Manchanda
- Department of Psychiatry, University of California San Diego, San Diego, CA, United States
| | - Jason Nan
- Department of Psychiatry, University of California San Diego, San Diego, CA, United States
| | - Nihal Azeez
- Department of Psychiatry, University of California San Diego, San Diego, CA, United States
| | - Dhakshin Ramanathan
- Department of Mental Health, Veterans Affairs San Diego Medical Center, San Diego, CA, United States
| | - Jyoti Mishra
- Department of Psychiatry, University of California San Diego, San Diego, CA, United States
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Rometsch C. The Role of Female Physicians in Psychosomatic Medicine: Opportunities and Challenges. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2024; 5:8-12. [PMID: 38249938 PMCID: PMC10797173 DOI: 10.1089/whr.2023.0070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/25/2023] [Indexed: 01/23/2024]
Abstract
Background Female physicians are in some cases preferred by patients due to their sex-related characteristics such as softness and empathy. Psychosomatic medicine presents a compelling working environment due to its holistic approach. Methods This brief review synthesizes the challenges encountered by female physicians in psychosomatic medicine and outlines potential strategies for overcoming these barriers. Results The presence of female role models may constitute a crucial advancement in this process. There exists a pressing demand for specialized clinical and scientific programs in psychosomatic medicine at both national and international levels. Such programs, offered by universities and ministries, as well as comprehensive training initiatives, are indispensable in fostering the next generation of females in psychosomatics. Leading journals can lend their support by publishing special issues dedicated to female physicians. Conclusion Strengthening female physicians throughout all positions in psychosomatic medicine can contribute ultimately to the improvement of patient care.
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Affiliation(s)
- Caroline Rometsch
- Department of Experimental and Clinical Medicine, University of Florence, Firenze, Italy
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Ippolito M, Noto A, Lakbar I, Chalkias A, Afshari A, Kranke P, Garcia CSR, Myatra SN, Schultz MJ, Giarratano A, Bilotta F, De Robertis E, Einav S, Cortegiani A. Peri-operative night-time work of anaesthesiologists: A qualitative study of critical issues and proposals. Eur J Anaesthesiol 2024; 41:34-42. [PMID: 37972930 DOI: 10.1097/eja.0000000000001930] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
BACKGROUND Qualitative data on the opinions of anaesthesiologists regarding the impact of peri-operative night-time working conditions on patient safety are lacking. OBJECTIVES This study aimed to achieve in-depth understanding of anaesthesiologists' perceptions regarding the impact of night-time working conditions on peri-operative patient safety and actions that may be undertaken to mitigate perceived risks. DESIGN Qualitative analysis of responses to two open-ended questions. SETTING Online platform questionnaire promoted by the European Society of Anaesthesiology and Intensive Care (ESAIC). PARTICIPANTS The survey sample consisted of an international cohort of anaesthesiologists. MAIN OUTCOME MEASURES We identified and classified recurrent themes in the responses to questions addressing perceptions regarding (Q1) peri-operative night-time working conditions, which may affect patient safety and (Q2) potential solutions. RESULTS We analysed 2112 and 2113 responses to Q1 and Q2, respectively. The most frequently reported themes in relation to Q1 were a perceived reduction in professional performance accompanied by concerns regarding the possible consequences of work with fatigue (27%), and poor working conditions at night-time (35%). The most frequently proposed solutions in response to Q2 were a reduction of working hours and avoidance of 24-h shifts (21%), an increase in human resources (14%) and performance of only urgent or emergency surgeries at night (14%). CONCLUSION Overall, the surveyed anaesthesiologists believe that workload-to-staff imbalance and excessive working hours were potential bases for increased peri-operative risk for their patients, partly because of fatigue-related medical errors during night-time work. The performance of nonemergency elective surgical cases at night and lack of facilities were among the reported issues and potential targets for improvement measures. Further studies should investigate whether countermeasures can improve patient safety as well as the quality of life of anaesthesia professionals. Regulations to improve homogeneity, safety, and quality of anaesthesia practice at night seem to be urgently needed.
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Affiliation(s)
- Mariachiara Ippolito
- From the Department of Surgical, Oncological and Oral Science (Di.Chir.On.S.), University of Palermo (MI, AG, AC), Department of Anaesthesia, Intensive Care and Emergency, Policlinico Paolo Giaccone, Palermo (MI, AG, AC), Division of Anaesthesia and Intensive Care, Department of Human Pathology of the Adult and Evolutive Age 'Gaetano Barresi', University of Messina, Policlinico 'G. Martino', Messina, Italy (AN), Anesthesiology and Intensive Care, Anesthesia and Critical Care Department B, Saint Eloi Teaching Hospital, PhyMedExp, University of Montpellier, INSERM U1046, 1, Montpellier Cedex 5, Montpellier, France (IL), Institute for Translational Medicine and Therapeutics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA (AC), Outcomes Research Consortium, Cleveland, OH, USA (AC), Department of Paediatric and Obstetric Anaesthesia, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark (AA), Institute of Clinical Medicine, University of Copenhagen (AA), Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University Hospital Würzburg, Würzburg, Germany (PK), Consorcio Hospital General Universitario de Valencia, Valencia. Methodology research Department, Universidad Europea de Valencia, Spain (CSRG), Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India (SNM), Department of Intensive Care, Amsterdam University Medical Centers, Location 'AMC', Amsterdam, The Netherlands (MJS), Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand (MJS), Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, Oxford University, Oxford, UK (MJS), Department of Anaesthesiology, Critical Care and Pain Medicine, Policlinico Umberto I Teaching Hospital, Sapienza University of Rome, Rome (FB), Division of Anaesthesia, Analgesia, and Intensive Care, Department of Medicine and surgery. University of Perugia, Italy (EDR) and General Intensive Care Unit of the Shaare Zedek Medical Centre and the Hebrew University Faculty of Medicine, Jerusalem, Israel (SE)
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Schneider RH, Travis F, Nader T. Addressing Clinician Burnout: A Unifying Systems Medicine Model with Meditation as a Heart-mind Intervention. HEART AND MIND 2024; 8:5-11. [PMID: 38298475 PMCID: PMC10830140 DOI: 10.4103/hm.hm-d-23-00013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024] Open
Affiliation(s)
- Robert H. Schneider
- College of Integrative Medicine, Maharishi International University, Fairfield, Iowa, USA
- Institute for Prevention Research, Maharishi International University, Vedic City, Iowa, USA
| | - Fred Travis
- Center for Brain, Consciousness and Cognition, Maharishi International University, Fairfield, Iowa, USA
| | - Tony Nader
- Dr. Tony Nader Institute, Maharishi International University, Fairfield, Iowa, USA
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Ng IK, Tan BC, Goo S, Al-Najjar Z. Mental health stigma in the medical profession: Where do we go from here? Clin Med (Lond) 2024; 24:100013. [PMID: 38382183 PMCID: PMC11024831 DOI: 10.1016/j.clinme.2024.100013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
Mental health conditions are highly prevalent among physicians with high rates of depression, anxiety, stress-related disorders, suicidal ideation and burnout reported among medical practitioners at all levels of training and practice. This phenomenon is in part contributed by a highly stressful clinical environment with an often suboptimal support system for doctors. Concerningly, there is hitherto a striking reluctance amongst medical trainees/practitioners to seek treatment/help for mental health-related conditions due to fear of associated stigma and negative career repercussions. In this article, we sought to raise awareness of the mental health stigma that has long been prevailing in the medical community, and review the key drivers of such stigma at the individual, community and organisational level. In general, drivers of mental health stigma in the medical profession include self-stigmatisation predisposed by physician personality and character traits, societal stereotypes about mental illness permeating through the medical community, and systemic constructs such as mandatory mental health declarations for medical licensure that perpetuate the unfortunate perception that mental illness appears synonymous with job impairment or incompetency. To destigmatise mental health issues in the medical profession, we herein propose multi-pronged strategies which can practically be implemented: 1) normalisation of mental health issues through open dialogue and sharing, 2) creating a supportive, "psychologically friendly" work environment through increased accessibility to workplace mental health support services, peer support systems, and reduction of psychiatric "name-calling" practices, and 3) reviewing systemic practices, in particular the mandatory mental health declarations for medical registration, that perpetuate mental health stigma.
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Affiliation(s)
- Isaac Ks Ng
- Internal Medicine Resident, Department of Medicine, National University of Hospital, Singapore.
| | - Bill Cornelius Tan
- Resident Medical Officer, Canberra Health Services, Canberra Hospital, Canberra, Australia
| | - Sabrina Goo
- Medical Officer, Department of Psychiatry, Changi General Hospital, Singapore
| | - Zaid Al-Najjar
- Director, NHS Practitioner Health, London, United Kingdom
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Van der Merwe LJ, Motlapema N, Matsepe T, Nchepe K, Ramachela P, Rangolo T, Kutu Z, Joubert G, Van Rooyen C. Medical registrars at the University of the Free State: Burnout, resilience and coping strategies. S Afr Fam Pract (2004) 2023; 65:e1-e7. [PMID: 38112018 PMCID: PMC10730451 DOI: 10.4102/safp.v65i1.5788] [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: 06/19/2023] [Revised: 08/17/2023] [Accepted: 09/20/2023] [Indexed: 12/20/2023] Open
Abstract
BACKGROUND Burnout among doctors has been linked with decreased quality of patient care. The coronavirus disease 2019 (COVID-19) pandemic highlighted the need to protect doctors' mental health and well-being. This study aimed to investigate burnout, resilience and coping strategies among registrars in the MMed programme of the University of the Free State (UFS) in 2020. METHODS In this quantitative, cross-sectional study, a link to an online anonymous self-administered questionnaire with socio-demographic questions, perceived stress, Copenhagen Burnout Inventory (CBI), Connor-Davidson Resilience Scale and Brief Cope was emailed to all 278 registrars. RESULTS Sixty registrars responded (response rate 21.6%). More than half (55.0%) were male and 73.3% were married. There were 28.3% second- and third-year students, respectively. Most (58.3%) had 5-10 years' work experience. The CBI personal scale had the highest median value (58.3; interquartile range [IQR]: 43.3; 70.8) with 70% scoring ≥ 50. The median score for resilience was 78 of 100 (IQR: 69; 84). There were weak negative correlations between resilience and burnout scores (r = -0.31 to r = -0.37). Planning, positive reframing and acceptance were the most frequently used adaptive coping mechanisms; self-distraction was the most frequently used maladaptive coping mechanism. There was no association between gender and burnout and resilience scores. CONCLUSION Registrars were resilient with low levels of patient- and work-related burnout, and higher personal burnout, using mostly positive coping strategies.Contribution: This study gives insight into the well-being of registrars at the UFS during COVID-19. Continuous monitoring and support for this population are essential to foster mental health and well-being.
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Affiliation(s)
- Lynette J Van der Merwe
- Division of Health Sciences Education, Faculty of Health Sciences, University of the Free State, Bloemfontein.
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Korošec D, Vrbnjak D, Štiglic G. Prevalence of mental disorders and high rates of absenteeism from work among healthcare professionals in Slovenia: a retrospective study. BMJ Open 2023; 13:e075718. [PMID: 38070887 PMCID: PMC10729225 DOI: 10.1136/bmjopen-2023-075718] [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: 05/22/2023] [Accepted: 11/15/2023] [Indexed: 12/18/2023] Open
Abstract
OBJECTIVES To investigate the prevalence of mental disorders and the higher rates of absenteeism from work among healthcare workers employed in Slovenia by analysing the prevalence of sick leave and medication prescriptions for treatment of mental health and behavioural disorders from 2015 to 2020. DESIGN Retrospective analysis of nationwide data on absenteeism and prescription of medications for treatment of mental health and behavioural disorders (anxiolytics, antipsychotics, antidepressants). SETTING National databases of the National Institute of Public Health in Slovenia. PARTICIPANTS All employed healthcare workers (35 008 in December 2020): dentists, midwives, nurses, nursing assistants, pharmacists and physicians in Slovenia from 2015 to 2020. RESULTS The most time spent on sick leave by male healthcare workers aged >50 was for 'neoplasms' (71.50 days on average), followed by 'mental health and behavioural disorders' (62.08 days on average). Female healthcare workers under 40 years old spent the most time on sick leave for 'pregnancy, childbirth, and the postpartum period (puerperium)', causing an average of 58.38 days of sick leave. From 2015 to 2020, the highest increase in prescribed medications for treatment of mental health and behavioural disorders was among nursing assistants (an increase of 38.42%), pharmacists (an increase of 29.36%) and nurses (an increase of 26.61%); since the COVID-19 pandemic, an increase of 12.36% was found among dentists, an increase of 11.51% among pharmacists and an increase of 11.36% among nurses. CONCLUSION The prescription of medications for treatment of mental health and behavioural disorders was on the rise from 2015 to 2020. The importance of employee health to individuals and society necessitates the systematisation of effective prevention programmes as well as programmes to assist those in need, especially health workers, whose work contributes significantly to maintaining public health.
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Affiliation(s)
- Darja Korošec
- Faculty of Health Sciences, University of Maribor, Maribor, Slovenia
| | - Dominika Vrbnjak
- Faculty of Health Sciences, University of Maribor, Maribor, Slovenia
| | - Gregor Štiglic
- Faculty of Health Sciences, University of Maribor, Maribor, Slovenia
- Faculty of Electrical Engineering and Computer Science, University of Maribor, Maribor, Slovenia
- University of Edinburgh, Usher Institute, Edinburgh, UK
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Gostoli S, D’Oronzo A, Malaguti C, Guolo F, Balducci C, Subach R, Lodi V, Petio C, Rafanelli C. Psychopathological Burden among Healthcare Workers during the COVID-19 Pandemic Compared to the Pre-Pandemic Period. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7153. [PMID: 38131705 PMCID: PMC10742499 DOI: 10.3390/ijerph20247153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 12/05/2023] [Indexed: 12/23/2023]
Abstract
This retrospective observational study on hospital staff requesting an "application visit" (from 2017 to 2022) at the Occupational Medicine department aimed at comparing a "pre-COVID group" (2017-2019) with a "COVID group" (2020-2022) regarding (a) sociodemographic data (i.e., age, sex, occupation, years of employment at the hospital), (b) rate and type of psychiatric diagnoses in both groups and rate of psychiatric diagnoses per subject, and (c) rate of drug/psychotherapeutic prescriptions. Two hundred and five healthcare workers (F = 73.7%; mean age = 50.7 ± 10.33) were visited. Compared with the pre-COVID group, healthcare workers evaluated during COVID-19 were significantly younger and reported fewer years of employment at the hospital. Although rates of primary psychiatric diagnoses were similar in both samples, an increased number of psychopathologies per subject and associated treatment prescriptions in the COVID group was observed. In the COVID group, 61% had one psychiatric diagnosis, and 28% had 2+ psychiatric diagnoses, compared with 83.8% and 6.7% of pre-COVID. Furthermore, 56.2%/1.9% in pre-COVID and 73%/6% in the COVID group were prescribed drugs/psychotherapy, respectively. The findings of the present study highlighted an increase in both younger workers' requests and psychiatric comorbidities during the pandemic, representing a burden on the Italian healthcare system. It is thus relevant to address the mental health challenges of healthcare workers accordingly.
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Affiliation(s)
- Sara Gostoli
- Department of Psychology “Renzo Canestrari”, University of Bologna, 40127 Bologna, Italy; (S.G.); (A.D.); (R.S.); (C.R.)
| | - Angelica D’Oronzo
- Department of Psychology “Renzo Canestrari”, University of Bologna, 40127 Bologna, Italy; (S.G.); (A.D.); (R.S.); (C.R.)
| | - Carlotta Malaguti
- Occupational Health Unit, Bologna University Hospital Authority St. Orsola Malpighi Polyclinic IRCCS, 40138 Bologna, Italy; (C.M.); (V.L.)
| | - Francesco Guolo
- Division of Cardiology, Bellaria Hospital, AUSL Bologna, 40139 Bologna, Italy;
| | - Cristian Balducci
- Department of Quality of Life Sciences, University of Bologna, 47921 Rimini, Italy;
| | - Regina Subach
- Department of Psychology “Renzo Canestrari”, University of Bologna, 40127 Bologna, Italy; (S.G.); (A.D.); (R.S.); (C.R.)
| | - Vittorio Lodi
- Occupational Health Unit, Bologna University Hospital Authority St. Orsola Malpighi Polyclinic IRCCS, 40138 Bologna, Italy; (C.M.); (V.L.)
| | - Carmine Petio
- Department of Psychiatry, Bologna University Hospital Authority St. Orsola Malpighi Polyclinic IRCCS, 40138 Bologna, Italy
| | - Chiara Rafanelli
- Department of Psychology “Renzo Canestrari”, University of Bologna, 40127 Bologna, Italy; (S.G.); (A.D.); (R.S.); (C.R.)
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Møller CM, Clausen T, Aust B, Budtz-Lilly JW, Eiberg JP. Burnout and Its Consequences among Vascular Surgeons and Trainees: A Danish National Survey. J Am Coll Surg 2023; 237:874-883. [PMID: 37694920 DOI: 10.1097/xcs.0000000000000853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
BACKGROUND Burnout among physicians has widespread negative consequences. Little is known about burnout among European vascular surgeons (VS). A previously published study found that 82% of VS and vascular surgical trainees (VST) in Denmark experience burnout symptoms. The present study aimed to investigate work- and health-related consequences of burnout. STUDY DESIGN An electronic survey was distributed to all VS/VST in Denmark in January 2020. Validated assessment tools were used to measure burnout, mental health, and psychosocial work environment aspects. RESULTS Of 104 invited VS/VST, 82% (n = 85) completed the survey. VS accounted for 72% (n = 61) of the respondents, and 40% (n = 33) were female. Statistically significant associations were found between higher levels of burnout and a range of work- and health-related outcomes, including a sense of meaning at work, workplace commitment, conflicts between work and private life, work stress, sick leave, and depressive symptoms. VS/VST using pain medication daily or weekly had significantly higher burnout scores than respondents who rarely or never use pain medication. A significant association between burnout and job satisfaction and retention was found, with respondents indicating an intention to stay within the specialty having significantly lower burnout scores than those who considered leaving within 5 years. Among those who indicated leaving the specialty, 35% (n = 13) attributed this to their current working conditions. CONCLUSIONS Burnout among VS/VST in Denmark is negatively associated with various work- and health-related outcomes. The work environment seems to play an essential role in these associations, and alterations in workplace organization may remedy this situation.
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Affiliation(s)
- Cecilie M Møller
- From the Department of Cardiothoracic and Vascular Surgery, University Hospital Aarhus, Aarhus, Denmark (Møller, Budtz-Lilly)
| | - Thomas Clausen
- From the Department of Cardiothoracic and Vascular Surgery, University Hospital Aarhus, Aarhus, Denmark (Møller, Budtz-Lilly)
| | - Birgit Aust
- From the Department of Cardiothoracic and Vascular Surgery, University Hospital Aarhus, Aarhus, Denmark (Møller, Budtz-Lilly)
| | - Jacob W Budtz-Lilly
- From the Department of Cardiothoracic and Vascular Surgery, University Hospital Aarhus, Aarhus, Denmark (Møller, Budtz-Lilly)
| | - Jonas P Eiberg
- From the Department of Cardiothoracic and Vascular Surgery, University Hospital Aarhus, Aarhus, Denmark (Møller, Budtz-Lilly)
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Ranasinghe PD, Zhou A. Women physicians and the COVID-19 pandemic: gender-based impacts and potential interventions. Ann Med 2023; 55:319-324. [PMID: 36594806 PMCID: PMC9815224 DOI: 10.1080/07853890.2022.2164046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Aim: These are extraordinary times caused by the first global pandemic in our modern era. Physicians and other frontline healthcare providers face unique challenges, for which they have had little formal preparation. This combination of challenge and deficit leads to significant negative impacts, not only on what medical practices and health care systems can deliver to the public, but also on the individual healthcare providers themselves.Methods: In this essay, we specifically address women physicians, and explore the considerable impact they bear from the COVID-19 pandemic, particularly in the contexts of response to stress, social isolation, work-life integration, and autonomy. Because the language we use is important, we think it necessary to clarify that when we refer to 'women physicians,' we are referring to physicians that self-identify as women, and we acknowledge that not all the references we cite may use the same definition.Results: We offer several potential interventions that turn the challenges women physicians are facing into opportunities to address longstanding inequity. These interventions include tackling barriers to work-life balance, addressing gender and maternal bias, and promoting women physician representation in leadership.Conclusion: The COVID-19 pandemic is likely to become a chronic part of our lives; protecting vulnerable populations, such as women physicians, through thoughtful intervention is paramount.KEY MESSAGESWomen physicians experience considerable adversity during the COVID-19 pandemic, particularly in the contexts of response to stress, social isolation, work-life integration, and autonomy.These challenges create opportunities for interventions to improve equity in medicine during the COVID-19 pandemic and in the long-term, including tackling barriers to work-life balance, addressing gender and maternal bias, and promoting women physician representation in leadership.
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Affiliation(s)
| | - Ashley Zhou
- School of Medicine, Johns Hopkins University, Baltimore, MD, USA
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38
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Göksel P, Ay R, Kılınçel O. Psychological Attitudes of Physicians in Seeking Help and Associated Factors. PSYCHIAT CLIN PSYCH 2023; 33:287-291. [PMID: 38765848 PMCID: PMC11037469 DOI: 10.5152/pcp.2023.23692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 08/18/2023] [Indexed: 05/22/2024] Open
Abstract
Background Physician suicides have been increasing in recent years, and this shows that the psychological state of physicians is a subject that needs research and intervention. We think that the factors affecting the behavior of physicians to seek medical help due to their psychiatric disorders should be addressed. Therefore, we conducted a study examining the relationship between the anxiety, depression and stress levels of physicians, their attitudes toward seeking psychological help, and the degree of self-stigma related to seeking help. Methods One hundred sixty-six physicians who accessed online platforms were included in the study, and data were collected using self-report forms. The Depression Anxiety Stress Scale, the Attitudes Toward Seeking Professional Psychological Help Scale, and the Self-Stigma in Seeking Help Scale were used as assessment instruments. Results A positive correlation was found between negative attitudes toward seeking psychological help and depression, anxiety, and stress, whereas a negative association was found between positive attitudes and depression, anxiety, and stress. A significant association was found between age and depression and anxiety scores. Conclusion Physicians with high levels of depression, anxiety, and stress are more likely to exhibit negative attitudes toward seeking psychological help, and interventions are needed to improve attitudes toward seeking help.
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Affiliation(s)
- Pelin Göksel
- Department of Psychiatry, Ondokuz Mayıs University, School of Medicine, Samsun, Turkey
| | - Rukiye Ay
- Department of Psychiatry, University of Health Sciences, Bursa Yüksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Oğuzhan Kılınçel
- Department of Psychiatry, Istanbul Gelişim University, Faculty of Health Sciences, Istanbul,Turkey
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Wu J, Qiu L, Xiong W, Shen Y, Li J, Wu J, Zhou Q. COVID-19 anxiety and related factors amid adjusted epidemic prevention policies: a cross-sectional study on patients with late-life depression in China. BMJ Open 2023; 13:e072725. [PMID: 38000824 PMCID: PMC10680000 DOI: 10.1136/bmjopen-2023-072725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 11/08/2023] [Indexed: 11/26/2023] Open
Abstract
OBJECTIVES To explore the prevalence and associated factors of COVID-19 anxiety in patients with late-life depression (LLD) during the adjustment of epidemic prevention policies in China. DESIGN Cross-sectional study. SETTING The data analysed in this study were collected from seven regions in China between November 2022 and January 2023. PARTICIPANTS A total of 1205 patients with LLD (aged 60-78 years) participated in the survey. They completed a social demographic assessment and the Chinese version of the five-point Coronavirus Anxiety Scale (CAS). PRIMARY OUTCOME MEASURES The primary outcome was the anxiety level of the participants. Patients were categorised into two groups based on their anxiety levels, one with anxiety and one without, according to CAS scores. RESULTS The prevalence of COVID-19 anxiety in depressed older adults was 47.3%. Regression analysis revealed that the average COVID-19 anxiety score was significantly higher among females (AOR: 2.177, 95% CI 1.201 to 3.947), widowed individuals (AOR: 3.015, 95% CI 1.379 to 6.591), patients residing at a distance from healthcare facilities (AOR: 3.765, 95% CI 1.906 to 7.438), and those who frequently experienced worry (AOR: 1.984, 95% CI 1.111 to 3.543). Conversely, the anxiety score was significantly lower among divorced individuals (AOR: 0.491, 95% CI 0.245 to 0.988), those aged 70 years and above (AOR: 0.117, 95% CI 0.064 to 0.213), patients without difficulty obtaining medication (AOR: 0.027, 95% CI 0.007 to 0.097), those living with family members (AOR: 0.080, 95% CI 0.022 to 0.282) or in nursing homes compared with those living alone (AOR: 0.019, 95% CI 0.004 to 0.087). CONCLUSION Women with LLD who are widowed, live far from healthcare facilities, and are prone to excessive worry are more likely to experience anxiety. It is advisable to implement appropriate preventive measures and provide psychosocial support programmes for this vulnerable group during the COVID-19 pandemic.
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Affiliation(s)
- Jianhong Wu
- Department of Pharmacy, The Affiliated Mental Health Center of Jiangnan University, Wuxi, Jiangsu, China
| | - Linghe Qiu
- Department of General Psychiatry, The Affiliated Mental Health Center of Jiangnan University, Wuxi, Jiangsu, China
| | - Wendian Xiong
- School of Life Sciences and Health Engineering, Jiangnan University, Wuxi, Jiangsu, China
| | - Yuan Shen
- Department of Pharmacy, The Affiliated Mental Health Center of Jiangnan University, Wuxi, Jiangsu, China
| | - Jun Li
- Department of Pharmacy, Nanjing First Hospital, Nangjing, Jiangsu, China
| | - Ju Wu
- Department of Pharmacy, Jiangsu Provincial Rongjun Hospital, Wuxi, Jiangsu, China
| | - Qin Zhou
- Department of Pharmacy, The Affiliated Mental Health Center of Jiangnan University, Wuxi, Jiangsu, China
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Chen WY, Lin FL. On the Asymmetric Relationship Between Physician Mental Health Disorders on Quality of Healthcare Under the COVID-19 Pandemic in Taiwan: Quantile on Quantile Regression Analyses. Risk Manag Healthc Policy 2023; 16:2291-2307. [PMID: 37953809 PMCID: PMC10638657 DOI: 10.2147/rmhp.s429516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 10/19/2023] [Indexed: 11/14/2023] Open
Abstract
Purpose When examining the nexus of physician mental health disorders and healthcare quality from the empirical perspective, mental health disorders are frequently associated with cyclical patterns corresponding to cyclic seasonality, mood swings, emission of air pollution and business cycles, the potential asymmetric effects of physician mental health disorders on healthcare quality have not received adequate attention from researchers. Therefore, the purpose of this study is to explore the asymmetric relationship between physician mental health disorders and healthcare quality during the pandemic outbreak in Taiwan. Methods Daily data for care quality indicators and physician mental health disorders were collected from the National Insurance Research Database in Taiwan, and the quantile-on-quantile regression model was applied to proceed with our analyses. Results Our results indicated that the overall aggregate effects of each quantile of physician mental health disorders on the cumulative quantiles of healthcare quality are negative (positive) for the 14-day readmission rate (preventable hospitalization rate and non-urgent ED-visit rate). Positively (negatively) cumulative effects of each quantile of physician mental health disorders were detected in the middle (low and high) quantiles of the preventable hospitalization rate. The cumulative effects of each quantile of physician mental health disorders on the high (low and middle) quantiles of the 14-day readmission rate are negative (positive), but the cumulative effects on various quantiles of the non-urgent ED-visit rate exhibit the opposite pattern. Conclusion The observed variation in the relationship between physician mental health disorders and different quantiles of healthcare quality suggests the need for tailored strategic interventions based on distinct levels of healthcare quality when addressing the higher risk of physician mental health disorders during the pandemic outbreak conditions.
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Affiliation(s)
- Wen-Yi Chen
- Department of Senior Citizen Service Management, National Taichung University of Science and Technology, Taichung City, Taiwan
| | - Feng-Li Lin
- Department of Accounting, Chaoyang University of Technology, Taichung City, Taiwan
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Cam H, Wennlöf B, Gillespie U, Franzon K, Nielsen EI, Ling M, Lindner KJ, Kempen TGH, Kälvemark Sporrong S. The complexities of communication at hospital discharge of older patients: a qualitative study of healthcare professionals' views. BMC Health Serv Res 2023; 23:1211. [PMID: 37932683 PMCID: PMC10626684 DOI: 10.1186/s12913-023-10192-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 10/20/2023] [Indexed: 11/08/2023] Open
Abstract
BACKGROUND Hospital discharge of older patients is a high-risk situation in terms of patient safety. Due to the fragmentation of the healthcare system, communication and coordination between stakeholders are required at discharge. The aim of this study was to explore communication in general and medication information transfer in particular at hospital discharge of older patients from the perspective of healthcare professionals (HCPs) across different organisations within the healthcare system. METHODS We conducted a qualitative study using focus group and individual or group interviews with HCPs (physicians, nurses and pharmacists) across different healthcare organisations in Sweden. Data were collected from September to October 2021. A semi-structured interview guide including questions on current medication communication practices, possible improvements and feedback on suggestions for alternative processes was used. The data were analysed thematically, guided by the systematic text condensation method. RESULTS In total, four focus group and three semi-structured interviews were conducted with 23 HCPs. Three main themes were identified: 1) Support systems that help and hinder describes the use of support systems in the discharge process to compensate for the fragmentation of the healthcare system and the impact of these systems on HCPs' communication; 2) Communication between two separate worlds depicts the difficulties in communication experienced by HCPs in different healthcare organisations and how they cope with them; and 3) The large number of medically complex patients disrupts the communication reveals how the highly pressurised healthcare system impacts on HCPs' communication at hospital discharge. CONCLUSIONS Communication at hospital discharge is hindered by the fragmented, highly pressurised healthcare system. HCPs are at risk of moral distress when coping with communication difficulties. Improved communication methods at hospital discharge are needed for the benefit of both patients and HCPs.
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Affiliation(s)
- Henrik Cam
- Hospital Pharmacy Department, Uppsala University Hospital, Uppsala, Sweden.
- Department of Pharmacy, Uppsala University, Uppsala, Sweden.
| | - Björn Wennlöf
- Department of Pharmacy, Uppsala University, Uppsala, Sweden
- Centre for Clinical Research, Uppsala University, Västmanland County Hospital, Västerås, Sweden
- Närvården Viksäng-Irsta, Region Västmanland, Västerås, Sweden
| | - Ulrika Gillespie
- Hospital Pharmacy Department, Uppsala University Hospital, Uppsala, Sweden
- Department of Pharmacy, Uppsala University, Uppsala, Sweden
| | - Kristin Franzon
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | | | - Mia Ling
- Department of Pharmacy, Region Västmanland, Västerås, Sweden
| | | | - Thomas Gerardus Hendrik Kempen
- Department of Pharmacy, Uppsala University, Uppsala, Sweden
- Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, the Netherlands
| | - Sofia Kälvemark Sporrong
- Department of Pharmacy, Uppsala University, Uppsala, Sweden
- Department of Pharmacy, University of Copenhagen, Copenhagen, Denmark
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McFarland DC, Lee HB. Preventing Physician Suicide-A Role for Consultation-Liaison Psychiatry? J Acad Consult Liaison Psychiatry 2023; 64:489-491. [PMID: 37890786 DOI: 10.1016/j.jaclp.2023.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/29/2023]
Affiliation(s)
- Daniel C McFarland
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY; Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY.
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Yun JY, Myung SJ, Kim KS. Associations among the workplace violence, burnout, depressive symptoms, suicidality, and turnover intention in training physicians: a network analysis of nationwide survey. Sci Rep 2023; 13:16804. [PMID: 37798353 PMCID: PMC10556140 DOI: 10.1038/s41598-023-44119-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 10/04/2023] [Indexed: 10/07/2023] Open
Abstract
Depression and anxiety are the most common mental disorders among physicians, who have a greater risk of suicide than those in other professional occupations. Relationships among a demanding workload, workplace violence, burnout, and intention to turnover have also been reported. The current study examined the principal components and propagating patterns of mental health and working environment interactions in training physicians. A total of 1981 training physicians completed online self-report questionnaires during September-October (midpoint of the training year) 2020. Regularized partial correlations in a mixed graphical model (MGM) and joint probability distributions (directed acyclic graph; DAG) were estimated for four subtypes of workplace violence (verbal abuse/physical violence perpetrated by clients/hospital staff), three burnout subdomains (Maslach Burnout Inventory), thoughts about quitting, and nine depressive symptoms, including suicidality, comprising the DSM-5 diagnostic criteria for major depressive disorder (assessed using the Patient Health Questionnaire-9). Thoughts of death/self-harm showed directional dependencies on the joint probability distributions of psychomotor agitation/retardation, concentration difficulty, self-reproach, and sadness in the DAG. In the MGM, a partial correlation with psychomotor agitation/retardation (r = 0.196) accounted for 56.5% of the variance in thoughts of death/self-harm. Partial correlations with concentration difficulties (r = 0.294), self-reproach (r = 0.257), changes in appetite (r = 0.184), and worker-on-worker physical violence (r = 0.240) in the MGM accounted for 54.4% of the variance in psychomotor agitation/retardation. Thoughts about quitting were partially correlated with and dependent upon the joint probability distributions of emotional exhaustion (r = 0.222), fatigue (r = 0.142), anhedonia (r = 0.178), and sadness (r = 0.237). In contrast, worker-on-worker (r = 0.417) and client-on-physician (r = 0.167) verbal abuse had regularized partial correlations with directional dependencies on thoughts about quitting. Organization-level interventions aiming to reduce the worker-on-worker violence and individual-level approaches of clinical screening program and psychiatric counseling clinic are required. Follow-up studies to verify the effectiveness of these interventions for training physicians are needed.
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Affiliation(s)
- Je-Yeon Yun
- Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
- Yeongeon Student Support Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sun Jung Myung
- Office of Medical Education, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
| | - Kyung Sik Kim
- Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
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Wei Y, Tang J, Zhao J, Liang J, Li Z, Bai S. Association of loneliness and social isolation with mental disorders among medical residents during the COVID-19 pandemic: A multi-center cross-sectional study. Psychiatry Res 2023; 327:115233. [PMID: 37567113 PMCID: PMC10172154 DOI: 10.1016/j.psychres.2023.115233] [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: 11/15/2022] [Revised: 04/26/2023] [Accepted: 04/29/2023] [Indexed: 08/13/2023]
Abstract
BACKGROUND Loneliness and social isolation usually increase the risk of mental disorders. However, this association among Chinese medical residents during the COVID-19 pandemic remains unclear. METHODS This study was conducted in September 2022; 1,338 medical residents from three hospitals in Northeastern China were included in the final analysis. The data were collected via online self-administered questionnaires. Adjusted odds ratios and 95% confidence intervals were determined for adjusting for potential confounders by binary logistic regression. RESULTS Among the 1,338 participants, 12.93% (173), 9.94% (133), and 9.72% (130) had experienced major depression, major anxiety, and suicidal ideation, respectively. Further, 24.40% (327) and 44.50% (596) of the total participants had experienced loneliness and social isolation. Loneliness increased the risk of major depression, major anxiety, and suicidal ideation (all p<0.001); Compared with the lowest quartile, the odds ratios of the highest quartile were 4.81, 4.63, and 5.34. The same result was obtained in relation to social isolation (all p<0.001). CONCLUSIONS The findings of this study revealed a considerable prevalence of loneliness, social isolation, and mental disorders among Chinese medical residents during the COVID-19 pandemic. Both loneliness and social isolation increased the risk of major depression, major anxiety, and suicidal ideation.
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Affiliation(s)
- Yingliang Wei
- Department of Orthopedics, Shengjing Hospital of China Medical University.
| | - Jun Tang
- Department of thoracic surgery, Shengjing hospital of China Medical University; Department of postgraduate Administration, Shengjing Hospital of China Medical University.
| | - Jianzhu Zhao
- Department of oncology, Shengjing hospital of China Medical University.
| | - Jiajian Liang
- Department of Orthopedics, Shengjing Hospital of China Medical University.
| | - Zhiyuan Li
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, China.
| | - Song Bai
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, China.
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Bitar A, Amnelius L, Kristoffersson E, Boman J. Emotional intelligence among medical students in Sweden - a questionnaire study. BMC MEDICAL EDUCATION 2023; 23:603. [PMID: 37620811 PMCID: PMC10464491 DOI: 10.1186/s12909-023-04570-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 08/05/2023] [Indexed: 08/26/2023]
Abstract
BACKGROUND Emotional intelligence (EI), the ability to understand and regulate one's and other's emotions, has been linked to academic and clinical performance and stress management, making it an essential skill to develop during medical school. Nevertheless, uncertainty remains about the impact of medical education on EI, its association with sociodemographic factors, and the potential moderating role of gender. Therefore, this study aimed to explore levels of global EI among Swedish medical students based on their completed semesters while analyzing the potential moderator role of gender and identifying potential EI differences associated with age, gender, prior education, work experience, and previous experience working in a leadership position. METHODS The participants were medical students in semesters 1, 3, 5, 7, 9, and 11 at a Swedish University. Participants answered the self-report Trait Emotional Intelligence Questionnaire - Short Form (TEIQue-SF) and demographic questions. For each participant, the mean global trait EI was calculated (range 1-7), and differences were compared based on semesters and sociodemographic factors. In addition, we investigated the relationship between semester and EI scores with gender as a moderator. RESULTS Of the 663 invited medical students, 429 (65%) responded, including 269 women (62.7%), 157 men (36.6%), and 3 identifying as others (0.7%). The participants had a mean global trait EI score of 5.33. Final-year students demonstrated significantly higher global trait EI scores than first-year students, and gender did not have a moderating effect across semesters. Furthermore, students in the age group 25-29 years showed higher EI scores compared to those in the age group 21-24 years, while there were no significant differences in EI scores for older students (≥ 30 years) compared to other age groups. Higher EI scores were also positively associated with previous work-and leadership experiences. Gender and previous education did not significantly impact EI scores. CONCLUSIONS Our findings suggest that higher EI scores are associated with semesters of medical education, age, and previous work and leadership experience. Future longitudinal studies are needed to identify factors that could improve EI among medical students to design curricular activities aimed at supporting the EI of the next generation of physicians.
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Affiliation(s)
- Aziz Bitar
- Department of Clinical Science, Professional Development, Umeå University, Umeå, 901 87, Sweden.
| | - Lava Amnelius
- Department of Clinical Science, Professional Development, Umeå University, Umeå, 901 87, Sweden
| | - Emelie Kristoffersson
- Department of Clinical Science, Professional Development, Umeå University, Umeå, 901 87, Sweden
| | - Jens Boman
- Department of Clinical Science, Professional Development, Umeå University, Umeå, 901 87, Sweden
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Kapur N. The NHS workforce plan needs a wellbeing focus. BMJ 2023; 382:1911. [PMID: 37595974 DOI: 10.1136/bmj.p1911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/20/2023]
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Hakami N, Madkhali A, Hakami F, ALshekh M, Masmali E, Hamithi D, Zogel B. Obstacles Deterring Medical Students From Pursuing a Career in the Field of Surgery in Jazan University, Saudi Arabia. Cureus 2023; 15:e43233. [PMID: 37692738 PMCID: PMC10491465 DOI: 10.7759/cureus.43233] [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: 07/16/2023] [Accepted: 08/09/2023] [Indexed: 09/12/2023] Open
Abstract
BACKGROUND Particularly in Saudi Arabia, there is a dearth of trained specialists in the field of surgery. Understanding the obstacles that discourage medical students and residents from pursuing a surgical career is essential for resolving this shortage. This study intended to investigate the characteristics that influence medical students and trainees at Jazan University, Saudi Arabia, to pursue a career in surgery. METHODOLOGY This observational study employed a descriptive, cross-sectional approach. The intended audience consisted of fourth- to sixth-year medical students and medical residents. The questionnaire gathered information on demographics, academic year, previous surgical experience, perceptions of surgery as a specialty, and variables influencing career selections. RESULTS Out of 413 participants, 74.3% were considering a surgical career, with 24.4% interested in general surgery, followed by cardiac surgery (14.3%) and pediatric surgery (12.4%). Factors influencing career decisions included potential income (82%), the possibility of part-time work (82%), and partial leave (74%). A significant proportion of participants agreed or strongly agreed that the incidence of suicide (62%) and the risk of depression (72%) are higher in surgical specialties. Female participants were more likely to agree that their chance of becoming a spouse could be affected by a surgical career (p=0.002) and that meeting role models could influence their choice of surgical specialty (p=0.015). CONCLUSION Work-life balance, long working hours, and mental health concerns are identified as variables that discourage medical students and residents from pursuing a surgical career in the study. Efforts to encourage work-life balance, minimize workload, and provide support and resources for mental health issues should help surgeons suffer less stress and burnout. Moreover, encouraging an open-minded attitude and de-stigmatizing mental health concerns in the medical field should encourage individuals to seek assistance when necessary and lower the incidence of suicide and depression. Finally, tackling gender discrimination and encouraging diversity and inclusion in surgical specialties could attract more skilled surgeons.
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Affiliation(s)
| | | | | | | | - Enas Masmali
- Faculty of Medicine, Jazan University, Jazan, SAU
| | | | - Basem Zogel
- Faculty of Medicine, Jazan University, Jazan, SAU
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Bailey CH, Gesch JD. Team Strategies and Dynamics During Resuscitation. Emerg Med Clin North Am 2023; 41:587-600. [PMID: 37391252 DOI: 10.1016/j.emc.2023.03.011] [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: 07/02/2023]
Abstract
Resuscitations are complex events that require teamwork to succeed. In addition to the technical skills involved, a host of nontechnical skills are critical for optimal medical care delivery. These skills include mental preparation; planning for tasks and roles; leadership to guide resuscitation progress; and clear, closed-loop communication. Concerns and error detection should be escalated in an established format. Debriefing after the event helps identify learning points to carry forward for the next resuscitation. Support of the team providing this intense form of care is crucial to protect the mental health and function of providers.
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Affiliation(s)
- Caitlin H Bailey
- Department of Emergency Medicine, Highland Hospital, Alameda Health System, 1411 East 31st Street, Oakland, CA 94602, USA.
| | - Julie D Gesch
- Department of Emergency Medicine, Highland Hospital, Alameda Health System, 1411 East 31st Street, Oakland, CA 94602, USA
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Al-Zahrani FA, Abdulrazak LF, Ali MM, Islam MN, Ahmed K. StackDPP: Stacking-Based Explainable Classifier for Depression Prediction and Finding the Risk Factors among Clinicians. Bioengineering (Basel) 2023; 10:858. [PMID: 37508885 PMCID: PMC10376085 DOI: 10.3390/bioengineering10070858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 07/08/2023] [Accepted: 07/13/2023] [Indexed: 07/30/2023] Open
Abstract
Mental health is a major concern for all classes of people, but especially physicians in the present world. A challenging task is to identify the significant risk factors that are responsible for depression among physicians. To address this issue, the study aimed to build a machine learning-based predictive model that will be capable of predicting depression levels and finding associated risk factors. A raw dataset was collected to conduct this study and preprocessed as necessary. Then, the dataset was divided into 10 sub-datasets to determine the best possible set of attributes to predict depression. Seven different classification algorithms, KNN, DT, LGBM, GB, RF, ETC, and StackDPP, were applied to all the sub-datasets. StackDPP is a stacking-based ensemble classifier, which is proposed in this study. It was found that StackDPP outperformed on all the datasets. The findings indicate that the StackDPP with the sub-dataset with all the attributes gained the highest accuracy (0.962581), and the top 20 attributes were enough to gain 0.96129 accuracy by StackDPP, which was close to the performance of the dataset with all the attributes. In addition, risk factors were analyzed in this study to reveal the most significant risk factors that are responsible for depression among physicians. The findings of the study indicate that the proposed model is highly capable of predicting the level of depression, along with finding the most significant risk factors. The study will enable mental health professionals and psychiatrists to decide on treatment and therapy for physicians by analyzing the depression level and finding the most significant risk factors.
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Affiliation(s)
| | | | - Md Mamun Ali
- Department of Software Engineering (SWE), Daffodil International University (DIU), Sukrabad, Dhaka 1207, Bangladesh
- Division of Biomedical Engineering, University of Saskatchewan, 57 Campus Drive, Saskatoon, SK S7N 5A9, Canada
| | - Md Nazrul Islam
- Department of Community Health & Epidemiology, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada
| | - Kawsar Ahmed
- Department of Electrical and Computer Engineering, University of Saskatchewan, 57 Campus Drive, Saskatoon, SK S7N 5A9, Canada
- Group of Biophotomatiχ, Department of Information and Communication Technology, Mawlana Bhashani Science and Technology University, Santosh, Tangail 1902, Bangladesh
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Jungmar Ridell R, Orvelius L. Quality of Life in Healthcare Workers during COVID-19-A Longitudinal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6397. [PMID: 37510629 PMCID: PMC10379197 DOI: 10.3390/ijerph20146397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 07/06/2023] [Accepted: 07/15/2023] [Indexed: 07/30/2023]
Abstract
The COVID-19 pandemic occurred in 2020, and affected people's daily life worldwide at work and at home. Healthcare workers are a professional group with heavy workloads, and during the COVID-19 pandemic, their burden increased. The literature from earlier outbreaks describes risks for affected mental health in frontline workers, and the main aim of this study is to examine healthcare workers' quality of life during the COVID-19 pandemic. In addition, we sought to assess if there was any difference in working at a pandemic ward compared to anon-pandemic ward. In this longitudinal and descriptive study, a total of 147 healthcare workers assessed their perceived health every third month over one year using the RAND-36 health survey. RAND-36 is a general instrument that consists of 36 questions and is widely used for assessing quality of life. The healthcare workers in this study showed reductions in perceived quality of life during the first six months of the COVID-19 pandemic. Healthcare workers on a pandemic ward reported a lower score in RAND-36 compared to healthcare workers on a non-pandemic ward. Registered nurses and licensed practical nurses seemed more negatively affected in their quality of life than physicians. Compared to data from the general Swedish population, healthcare workers in this study had less energy during this period.
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Affiliation(s)
- Robin Jungmar Ridell
- Department of Infectious Diseases in Östergötland and Department of Biomedical and Clinical Sciences, Linköping University, 581 83 Linköping, Sweden
| | - Lotti Orvelius
- Department of Intensive Care, Clinical and Experimental Medicine, Linköping University, 581 83 Linköping, Sweden
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