Reciprocal influences between burnout and effectiveness in professional care for elders

Professional wellbeing and turnover intention among child therapists: a comparison between therapists trained and untrained in Trauma-Focused Cognitive Behavioral Therapy

Background

Poor professional wellbeing and job turnover is challenging for child mental health clinics and despite an increasing interest in implementing evidence-based practices (EBPs) in mental health services, little is known about if and how using EBPs may influence therapists’ professional wellbeing and turnover intention. To investigate this, we compare the average level of compassion satisfaction, burnout, secondary traumatic stress, and turnover intention between therapists trained in an EBP (Trauma-Focused Cognitive Behavioral Therapy – TF-CBT) and untrained therapists. We also explore the prevalence of and the associations between these personal and organizational outcomes.

Method

In this cross-sectional study, the data is collected from a national sample of 373 therapists 5 years after an implementation program began (i.e., in the sustainment phase). The variables were measured by the Professional Quality of Life and the Turnover Intention Scales. The Evidence-Based Practice Attitude Scale was also used to measure therapists’ attitudes toward EBPs.

Results

Over 70% of the respondents reported medium to high levels of burnout, secondary traumatic stress symptoms, and compassion satisfaction, whereas one-third of the respondents reported a high level of intention to leave their job in the current or near future. Higher ratings on burnout and secondary traumatic stress were significantly associated with lower compassion satisfaction and higher turnover intention. Finally, we found significantly lower degree of burnout and turnover intention along with higher compassion satisfaction among TF-CBT therapists (n = 96), compared to other therapists who were not trained in TF-CBT (n = 231). These differences could not be explained by between-group differences in age, job tenure, educational background, or therapists’ attitudes towards EBPs. However, mean differences in ratings on secondary traumatic stress symptoms were not statistically significant.

Conclusion

Although the prevalence findings are in general alarming, the present study provides the first empirical evidence for a potential positive effect of being trained in TF-CBT on therapists’ wellbeing and turnover intention. We discuss these findings in the light of self-efficacy theory and the job demands-resources model.

Prevalence of Burnout Syndrome and Job Satisfaction in Music Therapists in Spain: A Cross-Sectional, Descriptive Study

Background: Burnout syndrome and job satisfaction are topics of increasing interest due to their relevance in people’s health and well-being. Besides, they are considered very relevant in the fields of social and health care studies. Objective: The objective of this study was to analyse the professional profile of music therapists in Spain and the prevalence of burnout syndrome and job satisfaction among them. Methods: This was an observational, descriptive, cross-sectional study, carried out using an ad-hoc online questionnaire, the Maslach Scale and the general satisfaction scale on a sample of employed Spanish music therapists with more than two years of working experience in Spain. Results: Eighty questionnaires were analysed. The majority of the participants were between 30–39 years old (38.8%) and were women (85%). They combined their profession with other occupations (76.3%), mostly in care roles with a fix term contract and were self-employed (40%). The prevalence of burnout syndrome was 3.8% (p < 0.001) and the predisposition or tendency to develop this condition was over 57.5% (p < 0.001). The highest levels of burnout syndrome were found in professionals with trainee contracts (p = 0.001), in those who were providing training (p = 0.021), who attended 6 to 10 patients per week (p = 0.001), who were usually working with a therapist colleague (p = 0.046) and those who did not take prescribed psychotropic drugs (p = 0.034). The highest level of job satisfaction was observed in music therapists working in the field of disability (p = 0.010) and mental health (p = 0.022) and with seniority in their job position. The lowest level of job satisfaction was seen in music therapists with trainee contracts (p = 0.041), with less working hours per week (p = 0.016), working in the field of education (p = 0.006) and in those who did not feel valued by their colleagues (p < 0.001) or by the director of the centre where they worked (p < 0.001). Conclusions: Based on the results of this study, Spanish music therapists show a low prevalence of burnout syndrome but a moderate-high predisposition to develop it. Music therapists with burnout syndrome are those who work longer hours and perform their job in palliative care setting. In general, music therapists have a high level of both intrinsic and extrinsic job satisfaction. The lowest level of job satisfaction was found in music therapists with trainee contracts and the highest in music therapists with senior positions.

Impact of anti-immigrant rhetoric and policies on frontline health and social service providers in Southeast Michigan, U.S.A

Rising hostility towards immigrants characterised the 2016 Presidential election in the United States (US) and subsequent policy priorities by the new presidential administration. The political shift towards aggressive policies targeting undocumented immigrants is far-reaching and extends into other communities that convive con-or coexist with-immigrant communities. Our study aims to examine the rippling effects of these anti-immigrant policies and rhetoric on health and social service providers in Southeast Michigan who predominantly serve Latino immigrants. Between April and August 2018, we conducted in-depth individual interviews in two Federally Qualified Health Centers and a non-profit social service agency at a county health department. We interviewed 28 frontline health and social service providers. After coding and thematic analyses, we found that staff members' experiences in supporting immigrant clients was congruent with definitions of secondary trauma stress and compassion fatigue, whereby exposure to clients' trauma combined with job burden subsequently impacted the mental health of providers. Major themes included: (a) frontline staff experienced a mental and emotional burden in providing services to immigrant clients given the restrictive anti-immigrant context; and (b) this burden was exacerbated by the increased difficulties in providing these services to their clients. Staff described psychological and emotional distress stemming from exposure to clients' immigration-related trauma and increased mental health needs. This distress was exacerbated by an increased demand to meet clients' needs, which involved explaining or translating documents into English, assisting with legal paperwork, referring clients to mental health resources, addressing increased transportation barriers, and reestablishing trust with the community. Our findings add qualitative data on the mental health implications for frontline providers who support Latino immigrant clients impacted by immigration and highlights the need for further research and resources that address the workplace-related stress generated by heightened immigration enforcement.

Caring in community nursing practice: Inductive content analysis reveals an inter-dynamic system between patients and nurses

AIMS AND OBJECTIVES

To examine the understanding of caring in the practice of community nursing from the perspectives of patients and nurses.

BACKGROUND

An increasing population of patients with chronic disease has produced a need for humanistic caring in communities. As a result, caring has become a core value of community nursing professionals. However, community nurses meet many difficulties in trying to practice person-centred care with their clients. Furthermore, most community nurses-especially in China-lack systematic education and training about caring because the practical meaning of caring in community practice is unknown.

DESIGN

The qualitative study described herein employed inductive content analysis.

METHODS

Eleven community patients with chronic disease and fifteen community nurses who were nominated as a caring nurse from different community clinics in Beijing, China, participated in thirty-one interviews during January to August in 2018. Nine documents from the interviewed nurses were collected. Both interview data and documents were analysed using strategies of inductive content analysis. The COREQ checklist was used.

RESULTS

Patients and their corresponding nurses described a wide range of caring experiences that were generalised into 28 concepts. Caring emerged as an inter-dynamic system that comprised the foundation and quality of a caring relationship, the caring philosophy and behaviours of interactions, and positive feedback from caring interactions. A relationship-based framework of caring in community nursing practice was constructed.

CONCLUSIONS

Identifying this systematic concept of caring provides insights that are applicable to the creation of targeted management, education and practice interventions to ultimately enhance the quality of community health care-in China or elsewhere.

RELEVANCE TO CLINICAL PRACTICE

The systematic understanding of caring in community nursing practice will inform nurses in community health clinics, their educators and their managers on how to provide care to community patients and how to develop caring competence for community nurses.

Burnout and perceived social support: The mediating role of secondary traumatization in nurses vs. physicians

AIMS

The study aimed to examine differences between paediatric nurses and physicians regarding burnout syndrome, secondary traumatic stress (STS) and perceived social support (PSS).

BACKGROUND

Paediatric nurses and physicians encounter cumulative effects of treating sick and injured children and helping their families, in situations that might promote burnout and STS.

DESIGN

Cross-sectional design.

METHOD

Nurses (n = 158) and physicians (N = 76) completed self-report questionnaires on STS, PSS and burnout.

RESULTS

Nurses and physicians had similar rates of STS and burnout but showed significant differences in PSS. Furthermore, STS mediated the association between PSS and burnout for both groups; however, the effect was stronger for nurses in comparison to physicians.

CONCLUSION

Paediatric nurses and physicians would benefit from participating in interventions geared towards reducing STS, thus minimizing burnout. Moreover, advocating social support within the organization is needed to bolster the ability for coping with sources of stress.

IMPACT STATEMENT

Nurses' and physicians' involvement in the physical, physiological and mental needs of their paediatric patients might lead to burnout and secondary traumatic stress (STS). However, research on social support in the context of burnout and STS among nurses and physicians is scant. Secondary traumatic stress and burnout were similar for nurses and physicians, though perceived social support (PSS) was higher for nurses. Secondary traumatic stress plays a mediating role in the association between PSS and burnout among nurses and physicians. However, the mediation effect was stronger for nurses. Policy makers would be wise to advocate institutional stress management interventions to reduce secondary traumatic and to reinforce organizational support for nurses and physicians.

Educator Burnout and Compassion Fatigue: A Pilot Study

Sixty-four Canadian educators from Southwestern Ontario took part in a 2-hr voluntary workshop about the emotional labor and consequences that may be experienced by educators. A focus on both burnout and teacher compassion fatigue (CF), an underresearched area with respect to Canadian educators, was taken. The current study hypothesized that this professional development would positively influence educators’ knowledge, skills, and awareness regarding burnout, CF, and self-care; furthermore, it was predicted there would be a positive correlation between burnout and CF. Results supported the efficacy of professional development and partial support was detected for the relationship between burnout and CF. Implications and future research are discussed.