Work stress and attentional difficulties: An initial study on burnout and cognitive failures

Whether academics' job performance makes a difference to burnout and the effect of psychological counselling-comparison of four types of performers

Treating burnout as an independent variable while performance is the dependent variable, earlier studies revealed that job burnout experienced by academics adversely affects how well they perform. Whether performance may contribute to the emergence of burnout is yet to be analyzed-it is an issue investigated in this paper. Readjusting the nature of the variables, this quantitative study adopted group regression and it discovered that the performance of academics instead regulates their burnout without making performance a consequence of burnout-a new dynamic that challenges the earlier assumption. Following this earlier belief, counselling strategy to boost the employees' psyche was deemed to be the main post-measurement tool to deal with the burnout crisis. With respect to both tenets (current and earlier), psychological counselling was treated as a moderating variable to check whether it is important enough in removing the burnout felt by employees so that they subsequently could function better. It is further discovered that although psychological counselling removes employees' burnout to some extent, it failed to transform them into better-functioning people. This study suggests a pre-measurement counselling strategy will ensure academics are competently engaged since ensuring competency is a fundamental aspect of eliminating a job burnout crisis. The sustained competency of employees will eventually prevent burnout and may halt the transmission of a burnout crisis at large-it adds to this study's theoretical contribution to the topic.

Impact mechanism of social-related social media use on the job performance of caregivers of older adults

This study investigated the impact mechanism of social-related social media use on the job performance of caregivers of older adults through mental health and analyzed gender differences. A total of 358 valid questionnaires were collected and analyzed using SPSS and Smart PLS. The results showed that mental health plays an important role in the relationship between social-related social media use and job performance. Such social media use can improve psychological well-being and reduce psychological distress by promoting relaxation experience. Psychological well-being has a significant positive impact on job performance. In addition, significant differences exist in the impact path of social-related social media use on psychological distress among different gender groups. The findings of this study can assist nursing homes in assessing the use of social media within their organizations and provide methodological references for enhancing the job performance of caregivers of older adults.

Job burnout, cognitive functioning, and Brain-derived neurotrophic factor expression among hospital Mexican nurses

AIM

To analyze the relationship between burnout syndrome, cognitive functions, and sBDNF (Serum Brain-derived Neurotrophic Factor) in Mexican nurses.

METHOD

A descriptive cross-sectional design was used. This study target staff nurses working in hospitals in Guanajuato, México. Demographic and working condition data were collected via questionnaire. The Maslach Burnout Inventory (MBI) was used to evaluate burnout. A blood sample were collected and processed by ELISA technique to measure sBDNF. Finally, the General Cognitive Assessment (CAB) of the Cognifit© neuropsychological battery was used to evaluated cognitive functions.

RESULTS

Findings showed that there are sociodemographic characteristics and working conditions associated with burnout syndrome among nurses. Furthermore, the data demonstrated a significant decrease in sBDNF levels in burnout nurses and a negative correlation between BDNF levels and burnout syndrome. Additionally, these burnout nurse also revealed significant cognitive impairment in reasoning, memory, and attention as well as total scores of CAB. Interestingly, we found a positive correlation between sBDNF levels and the cognitive deficits in burnout nurse.

CONCLUSION

Reduced BDNF levels could be a biological indicator or part of the pathological process of burnout, which could affect cognitive abilities. Reduced cognitive function in nurses has relevant implications and emphasizes the need for specialized preventive strategies because nurses make clinical decisions concerning their patients, whose situations are constantly changing.

The effects of work on cognitive functions: a systematic review

Introduction

Cognitive functions play a crucial role in individual's life since they represent the mental abilities necessary to perform any activity. During working life, having healthy cognitive functioning is essential for the proper performance of work, but it is especially crucial for preserving cognitive abilities and thus ensuring healthy cognitive aging after retirement. The aim of this paper was to systematically review the scientific literature related to the effects of work on cognitive functions to assess which work-related factors most adversely affect them.

Method

We queried the PubMed and Scopus electronic databases, in February 2023, according to the PRISMA guidelines (PROSPERO ID number = CRD42023439172), and articles were included if they met all the inclusion criteria and survived a quality assessment. From an initial pool of 61,781 papers, we retained a final sample of 64 articles, which were divided into 5 categories based on work-related factors: shift work (n = 39), sedentary work (n = 7), occupational stress (n = 12), prolonged working hours (n = 3), and expertise (n = 3).

Results

The results showed that shift work, occupational stress, and, probably, prolonged working hours have detrimental effects on cognitive functioning; instead, results related to sedentary work and expertise on cognitive functions are inconclusive and extremely miscellaneous.

Discussion

Therefore, workplace health and well-being promotion should consider reducing or rescheduling night shift, the creation of less demanding and more resourceful work environments and the use of micro-breaks to preserve workers' cognitive functioning both before and after retirement.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023439172, identifier CRD42023439172.

Paying attention to attention: a program evaluation of faculty-delivered mindfulness-based attention training to optimize wellness and professionalism in medical students

BACKGROUND

As physician distress rises, medical schools must provide programs to counter such distress at the earliest stages of training. Mindfulness training (MT) is one intervention that can alleviate stress during medical school. However, framing MT around wellness alone misses the opportunity to connect core cognitive and psychological capacities strengthened by MT to professional goals and skill acquisition inherent to successful medical training. Here, we highlight how the attentional components of MT align with students' goals of becoming attending physicians while promoting academic, psychological, and interpersonal flourishing. MT courses that focus on strengthening attentional capacities can intuitively link academic and professional development with wellness, appealing to a wide array of students.

METHODS

We iteratively recontextualized an existing short-form mindfulness training program for high-stress pre-professionals, known as Mindfulness Based Attention Training (MBAT), to the medical school context (MBAT-Rx). MBAT-Rx was offered by physician trainers to first-year medical students at Warren Alpert Medical School of Brown University as a tool for improving study habits and focus in addition to the development of both self-care and patient care strategies. MBAT-Rx consists of weekly, two-hour sessions over four weeks, with 10-15 min of daily mindfulness practice between sessions. At the end of the four weeks, students submitted voluntary program evaluation responses detailing their experience of the program.

RESULTS

Optional program evaluation responses (n = 67) highlight that students found the program to be useful for their academic success and ability to pay attention, their interpersonal relationships, and their psychological health. By framing MT as an opportunity to boost core attentional capacities and connecting this to professional and academic goals in addition to wellness, MBAT-Rx appealed to a wide variety of students.

CONCLUSIONS

Our ongoing work suggests that framing MT as both a professional development and wellness promotion tool, taught by physicians themselves, and structured around students' time demands, may be a successful model for medical schools looking to increase the impact of their mindfulness offerings. Such programs are needed to equip medical students to navigate the demands of a challenging healthcare training landscape.

Attention Deficits in Healthcare Workers with Non-Clinical Burnout: An Exploratory Investigation

Burnout syndrome is characterized by exhaustion, cynicism, and reduced effectiveness. Workers with high burnout scores who continue their professional activities are identified as experiencing non-clinical burnout (NCB), which includes early stages where burnout symptoms (BNS) are present but not yet severe enough to necessitate work leave. This study aimed to investigate the impact of BNS on attention performance among healthcare workers (HCWs) at a COVID-19 reference hospital during the pandemic. The Maslach Burnout Inventory (MBI) was applied to assess the three burnout dimensions. The Continuous Visual Attention Test (CVAT) evaluated four different attention subdomains. Participants were divided into two groups based on their scores on the MBI: controls and NCB. Thirteen controls were matched with 13 NCB subjects based on age, sex, and HCW category. This sample (n = 26, 65% male) consisted of 11 physicians and 15 nursing professionals with a mean age of 35.3 years (standard deviation = 5.47). NCB subjects had higher impulsivity than controls. There were not any significant group differences in the other attention subdomains. We found significant correlations between impulsivity and all burnout dimensions: higher absolute scores in BNS are associated with higher impulsivity. We concluded that NCB leads to executive attention deficits.

The Health Narratives Research Group (HeNReG): A self-direction process offered to help decrease burnout in public health nurse practitioners

Founded in accordance with 19th century sex roles and public health concerns, nursing evolved as other-directed, dependent on physician-focused diagnosis, prescription decisions, and public health advancements. The result of this other direction is that public health nurse practitioners have endured significant workplace stress resulting in burnout, especially during COVID-19. To help decrease their burnout, nurses require development of self-direction. The Health Narratives Research Group (HeNReG) has the potential to reduce burnout in nurse practitioners by encouraging the development of self-direction. The HeNReG process is presented through historically analyzed documents regarding reducing burnout in health researchers by developing self-direction including: (1) three years of archived year-end feedback results provided by participants, (2) archived participant responses to specific HeNReG-related writing prompts, and (3) a comparison of HeNReG results with the outcomes of resilience programs. The conclusion-the HeNReG offers an effective option for reducing burnout in health researchers that has the potential to decrease nurse practitioner burnout in a way that resilience programs do not. Tailoring the HeNReG process to public health nurses is discussed, inviting future research for reducing burnout in public health nurses.

Effects of Prior Robot Experience, Speed, and Proximity on Psychosocial Reactions to a Soft Growing Robot

OCCUPATIONAL APPLICATIONSAfter viewing video vignettes of human interactions with a novel soft growing robot, we found that participants reported fewer perceived safety hazards, less anxiety and fear about robots, reduced social hesitancy about human-robot collaboration (HRC), and lower technology-induced fears of job insecurity. Unlike prior research with traditional rigid manipulators, we found that the manipulated proximity of the human-robot interactions was unrelated to any of these outcomes, suggesting closer interactions may be possible without adverse psychological resistance. On the other hand, fear of robots, perceived hazards, technology-induced job insecurity, and robot anxiety were all significantly lower when human-robot interactions were slower. Interestingly, participants with more extensive prior robot experience displayed preferences for faster HRC interactions. Many occupations are ripe for automation within the next two decades, yet technical and psychological barriers to adoption remain. Our research suggests that novel soft growing flexible robots may be a fruitful area for future advancements.

The Cognitive Function at Work Questionnaire (CFWQ): A new scale for measuring cognitive complaints in occupational population

Cognitive functioning is a relevant work and health related topic, however, validated methods to assess subjective cognitive complaints (SCC) at work are lacking. We introduce the Cognitive Function at Work Questionnaire (CFWQ) for measuring SCC in occupational settings. 1-year follow-up data of 418 employees from a Finnish public media service company was analyzed. Participants completed web-based CFWQ, cognitive tests and a broad set of questionnaires for evaluating depression, anxiety, insomnia, daytime sleepiness, burnout, stress, mental job burden, work ability, cognitive errors, and perceived health. The factor analysis yielded a model with the CFWQ subdomains: Memory, Language, Executive Function, Speed of Processing, Cognitive Control and Name Memory. The internal consistency (Cronbach's alpha = .87) and the test-retest constancy (ICC = .84) reflected good reliability. Correlation between the CFWQ and cognitive errors at work ranged from .25 to .64 indicating adequate concurrent validity. Employees with depression, insomnia and burnout symptoms had higher (p < .001) CFWQ scores than participants without these symptoms. Depression and burnout symptom severity as well as accumulation of mood, sleep, and psychosocial stressors were associated with higher CFWQ scores (p < .001 in all). The CFWQ appears psychometrically sound measure for the assessment of SCC in occupational population.

Altered neural processes underlying executive function in occupational burnout-Basis for a novel EEG biomarker

Introduction

As burnout has become a global pandemic, there is a call for improved understanding and detection of alterations in brain functions related to it. We have previously reported challenges in executive functions (EFs) in daily life, especially in metacognition, in subjects with occupational burnout, along with alterations in cardiac physiology. In the current study, we focused on the impact of burnout on brain physiology during a task requiring EF.

Methods

Fifty-four volunteers filled in inventories of burnout, depression, and EF in daily life (BBI-15, BDI, and BRIEF-A). Based on the BBI-15 score, subjects were divided into burnout and non-burnout groups. Subjects performed a Go/NoGo test (Executive RT test) engaging several EFs, while their EEG was recorded. The inventory scores, cognitive performance scores, and event-related potential (N2, P3) amplitudes, latencies, and interpeak latencies (IPLs) were compared between the groups.

Results

There were significant differences in the BDI and BRIEF-A scores between the groups, with more symptoms of depression and challenges in daily life in the burnout group. There were no differences in objective performance measures in the EF task between the groups. However, centroparietal P3 amplitude was larger, and while there were no differences in N2 or P3 latencies, N2-P3 IPL was longer in the Go condition in the burnout than in non-burnout group. Both ERP measures correlated significantly with burnout symptoms. A regression model from centroparietal P3 amplitude and N2-P3 IPL predicted significantly both the BBI-15 score and the BRIEF-A metacognition index.

Discussion

We conclude that burnout is linked with challenges in EF in daily life and alterations in the underlying neural processes. While cognitive performance in the task was equal, electrophysiological measures differed between the groups. Prolonged N2-P3 IPL points toward slowed transition from one cognitive process to another. Increased P3 amplitude, on the other hand, reflects increased allocation of neural processing resources. This may be a compensatory mechanism, allowing for equal performance with controls. These electrophysiological measures, obtained during the EF task, show promise as brain physiology-based biomarkers of burnout, contributing to its improved and objective detection. In addition, these results indicate occupational burnout is linked with objective alterations in brain physiology.

Revisiting the link between the sustained attention to response task (SART) and daily-life cognitive failures

In this study, we examined the relationship betweenerrors of commissionon theSustained Attention to Response Task(SART)andscores on the Cognitive Failures Questionnaire (CFQ). The goal was to assess theecological validity of the SARTin a sample of people scoring high on fatigue complaints.SART errors of commission were positively associated with CFQ scores and this finding remained after controlling for fatigue level, age, and SART reaction times.Thus, our results generally supported the ecological validity of the SART. However, when examining subsamples separately, we found the association between SART and CFQ only in our subsample of employees, not in our subsample of university students. The three subscales of the CFQ showed the same pattern of findings. Our results imply that, when using the SART to draw conclusions about everyday life, it is crucial to consider the characteristics of one's sample and control for relevant confounding variables.

Neuroticism, perfectionism, and emotion suppression in burnout: Implications for cognitive functioning

This study aimed to investigate the relationship between burnout and cognitive functions, particularly memory, attention, and executive functions, which have been found to be negatively affected in most studies. However, the results are not consistent across studies, and there is often a discrepancy between self-reported cognitive function and objective assessment. Two possible explanations for this discrepancy are the heterogeneous profiles of individuals in burnout and their personality traits. The study administered neuropsychological tests and questionnaires to 29 participants with clinical burnout to assess their cognitive functions and the impact of perfectionism, neuroticism, and emotion suppression on subjective and objective cognitive scores. The main findings showed little or no deterioration in memory or executive functions, despite patients reporting severely impaired executive function. The study found that neuroticism and perfectionism were related to poorer self-reported executive function, while emotion suppression was related to better self-reported executive function. No relationship was found between personality traits and neuropsychological test scores, indicating a discrepancy between self-perception and objective evaluation.

Remote, Disconnected, or Detached? Examining the Effects of Psychological Disconnectedness and Cynicism on Employee Performance, Wellbeing, and Work-Family Interface

Owing to the COVID-19 pandemic, organizations worldwide have implemented remote working arrangements that have blurred the work-family boundaries and brought to the forefront employees' sense of disconnectedness from their workplace (i.e., organizational disconnectedness) as a concern for multiple organizational outcomes. Cynicism, a job burnout subdimension, refers to a negative and excessively detached response to relational overload at work. While both workplace disconnectedness and cynicism involve a toxic sense of detachment, they refer to different psychological mechanisms. The present study aims to examine how employee workplace disconnectedness differs from their cynicism, and how both constructs differentially exert their detrimental effects on employee performance, work-family interface, and wellbeing. Using anonymous survey data collected online in 2021 and 2022 from a sample of in-person and flexible workers nested within organizations, conceptual distinctiveness between workplace disconnectedness and cynicism was supported. Measurement invariance across the two groups was supported, and subsequent structural invariance analyses suggested a similar pattern of results for flexible and in-person workers. Specifically, compared to disconnectedness, cynicism exerted higher negative effects on mental health and higher positive effects on cognitive failures and family-to-work conflict. Conversely, compared to cynicism, disconnectedness exerted higher negative effects on performance and work-to-family conflict. That is, feeling indifferent toward others particularly affects mental health and errors, while feeling excluded especially hampers productivity and family life. Theoretical and practical (e.g., inclusive leadership, support groups) implications of these results are discussed in light of the globally rising rates of hybrid work arrangements and related costs for employee wellbeing and productivity.

A quantitative analysis of the relationship between affective state and personality ratings in inpatient depression (RAPID)

BACKGROUND

The relationship between major depressive disorder (MDD) and personality disorders is complex, with implications for diagnosis and treatment. We sought to explore the relationship between these disorders quantitatively in an inpatient setting.

METHODS

We conducted a structured observational study exploring symptoms of depression and selected neurocognitive functions over the span of an inpatient admission in those with depression and personality disorders. Sixty inpatients presenting with symptoms of depression completed ratings of mood and neurocognitive function. Diagnosis was confirmed by structured clinical interview (SCID-5-RV) at discharge and used to allocate patients to one of the two groups for analysis: those with MDD-only and those with a personality disorder (with or without MDD).

RESULTS

On admission, observer-based ratings of depression were significantly higher in the MDD-only group while subjective ratings were higher in the personality disorder group. Depression rating scores lessened in both groups during the admission, but at discharge, the personality disorder group continued to report higher subjective ratings. The personality disorder group also rated themselves as more cognitively impaired than the MDD-only group and unlike the MDD-only group, they did not report subjective improvements in cognitive function over the course of admission. Objective assessment of cognitive function demonstrated improvements in both groups.

CONCLUSIONS

In this study, the presence of a personality disorder was associated with greater subjective severity of depressive symptomatology and selected neurocognitive functioning, despite similar or lower objective severity in comparison with those with MDD. This finding has implications for understanding the patient journey through health care settings.

Job burnout is associated with poorer hand-washing behaviors among restaurant kitchen chefs: evidence from Jiangsu Province, China

Inadequate hand-washing among chefs is a major contributor to outbreaks of foodborne illnesses originating in restaurants. Previous studies have found that mental health influences hygiene behaviors among food handlers, who have a high rate of job burnout. However, it is still unclear whether job burnout leads to restaurant kitchen chefs' poor hand washing behaviors (HWBs). In this study, we interviewed 453 restaurant kitchen chefs in Jiangsu Province, China regarding job burnout and HWBs during the summer (July-August) of 2020. The aims were to investigate job burnout (an individual internal motivation factor), identify determinants of job burnout, and examine the association between job burnout and HWBs. Variance analysis, post hoc multiple comparisons, linear regression models, and structural equation modeling were used to analyze the response data. This study revealed that chef age and the scale of the restaurant were significantly and negatively associated with reduced professional efficacy. Combined cuisine and pastry chefs had a more positive perception of their own professional efficacy than the other kitchen chefs, whereas the incidence of exhaustion was significantly higher in pastry chefs than in cuisine chefs and kitchen hands. Reduced professional efficacy was significantly and negatively associated with HWBs for all chefs. To improve the level of hand hygiene among chefs, measures should be taken to enhance chefs' professional efficacy. Furthermore, close attention should be paid to chefs in small-scale restaurants, younger chefs, cuisine chefs, pastry chefs, and kitchen hands.

Smartphone use and daily cognitive failures: A critical examination using a daily diary approach with objective smartphone measures

While smartphones have brought many benefits and conveniences to users, there is continuing debate regarding their potential negative consequences on everyday cognition such as daily cognitive failures. A few cross-sectional studies have found positive associations between smartphone use and cognitive failures. However, several research gaps remain, such as the use of cross-sectional designs, confounds related to stable individual differences, the lack of validity in self-report measures of smartphone use, memory biases in retrospective self-reports, and the lack of differentiation between smartphone checking and smartphone screen time. To simultaneously address the aforementioned shortcomings, the current study examined the within-person associations between various objective indicators of smartphone use and daily cognitive failures using a 7-day daily diary study. Multilevel modelling revealed that smartphone checking, but not total smartphone screen time, predicted a greater occurrence of daily cognitive failures at the within-person level. Surprisingly, we also found negative within-person associations between smartphone screen time for social- and tools-related applications and daily cognitive failures, suggesting that some types of smartphone use may temporarily benefit one's cognitive functioning. This finding demonstrates the importance of studying the specific functions of smartphone use and their differential cognitive consequences, as well as highlights the complex relations between smartphone use and cognition.

Stress-Related Exhaustion, Polygenic Cognitive Potential, and Cognitive Test Performance - A General Population Study

Background

We investigated whether stress-related exhaustion (chronic or short-term, and co-occurring with depression or not) is related to cognitive performance and whether polygenic cognitive potential modifies these associations.

Methods

The participants were from the Young Finns Study (N = 541-1273). Stress-related exhaustion was assessed using the Maastricht Questionnaire, depressive symptoms with the Beck Depression Inventory, and cognitive performance with subtests of the Cambridge Neuropsychological Test Automated Battery, measuring visuospatial learning, reaction time, sustained attention, and executive function. Cognitive performance and depression were assessed in 2011, and exhaustion in 2001, 2007, and 2011. A polygenic score for cognitive potential was calculated based on a GWAS on intelligence.

Results

High stress-related exhaustion, especially chronic, was associated with slower reaction time. Only clinical levels of depression were related to slower reaction time. Polygenic cognitive potential did not modify these associations. There were no differences in cognitive performance between individuals with co-occurring exhaustion and depression vs. those with only either condition.

Conclusion

Stress-related exhaustion, especially if chronic, seems to relate to slower reactions. Co-occurring exhaustion and depression may not have additive effects on cognitive performance. High polygenic cognitive potential may not protect from or predispose to harmful effects of exhaustion or depression on reaction time.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10608-023-10354-z.

Occupational Burnout Is Linked with Inefficient Executive Functioning, Elevated Average Heart Rate, and Decreased Physical Activity in Daily Life - Initial Evidence from Teaching Professionals

Burnout is becoming a global pandemic jeopardizing brain health, with a huge impact on quality of life, available workforce, and the economy. Knowledge of the impact of burnout on cognition, physiology, and physical activity (PA) in daily life allows for an improved understanding of the health consequences and everyday ramifications of burnout. Twenty-eight volunteers participated in a three-day recording of daily physiology and PA, including heart rate (HR) and daily steps, with a wearable device. They filled in questionnaires screening for burnout (BBI-15), depression (BDI), and executive functions (EFs) in daily life (BRIEF-A). The subjects with burnout had more challenges in EFs, higher average HRs and lower numbers of steps in daily life than those without it. The BBI-15 scores correlated positively with the BDI scores and BRIEF-A indices and negatively with the awake HR variability (HRV) and daily steps. The metacognition index correlated negatively with the HRV. In conclusion, burnout is linked with compromised EFs along with alterations in cardiac physiology and PA in daily life. Such alterations may be easily detected with wearable devices, opening possibilities for novel biomarkers of burnout and other neuropsychiatric disorders. We suggest that physical activity and heart and brain health are intimately intertwined and that burnout interacts with each of them bidirectionally.

Modeling cause-and-effect relationships among variables affecting work stress based on fuzzy DEMATEL method

Purpose

Several variables can affect work stress. This study aims to model the cause-and-effect relationships among different variables that can predict work stress based on one of the most important fuzzy multicriteria decision-making methods used to investigate the cause-and-effect relationships among variables.

Design/methodology/approach

This study was conducted in 2020, including 17 experts in safety management, occupational health and work psychology, based on the fuzzy decision-making trial and evaluation laboratory method as a robust approach to identify the cause-and-effect relationships among different variables.

Findings

Shift work, lack of job satisfaction, mental health, mental overload, fatigue, job security, sleep disorders, environmental discomfort, work pressure, job knowledge (this could mean expertise/level of qualifications/familiarity with the job), work complexity and role conflict were found to be the most significant variables affecting work stress. Moreover, the cause-and-effect model of relationships among variables showed that shift work and lack of job satisfaction are root causes, and mental health, fatigue, mental workload, sleep disorder and environmental discomfort are direct causes.

Originality/value

Although the results of this study demonstrate that work stress can be influenced by 12 different variables, the modeling results show that some variables, such as shift work and lack of job satisfaction, can directly or indirectly impact other variables and thus result in work stress.

The Link between Job Demands, Burnout, and the Self-Undermining of Healthcare Employees during the COVID-19 Pandemic: An Underestimated Threat?

Previous studies have shown an association between job demands and burnout in medical staff during the pandemic. However, these studies have ignored the possibility of loss cycle occurrence during the crisis. In order to address this gap, the aim of this study was to test the mediating role of burnout in the positive relationship between job demands and the self-undermining of healthcare employees during the COVID-19 pandemic. Self-undermining represents the set of behaviors that generate obstacles and diminish performance (e.g., careless mistakes, generating interpersonal conflicts, poor communication), and it has been suggested that this variable could explain the loss cycle between demands and burnout (the phenomenon in which demands increase burnout, which in turn leads to even greater demands). A total of 523 healthcare workers from two Romanian hospitals (e.g., physicians, nurses, stretcher-bearers) completed a self-report questionnaire during the COVID-19 outbreak that included three job demands, burnout, and self-undermining. Burnout mediated the positive relationship between two demands (work–family conflict; lack of equipment and supplies) and self-undermining. These results may provide a preliminary indication for the existence of loss cycles, supporting the assumptions of the job demands-resources theory. Moreover, the results highlight the risk of loss cycle occurrences for healthcare employees during outbreaks.

Neural activation during emotional interference corresponds to emotion dysregulation in stressed teachers

Teacher stress and burnout has been associated with low job satisfaction, reduced emotional wellbeing, and poor student learning outcomes. Prolonged stress is associated with emotion dysregulation and has thus become a focus of stress interventions. This study examines emotional interference effects in a group of teachers suffering from high stress and to explore how individual differences in cognitive control, emotion dysregulation, and emotion recognition related to patterns of neural activation. Forty-nine teachers suffering moderate-high stress participated in an emotional counting Stroop task while their brain activity was imaged using functional magnetic resonance imaging. Participants viewed general or teacher specific words of either negative or neutral valence and were required to count the number of words on screen. Behavioural and neuroimaging results suggest that teachers are able to control emotional responses to negative stimuli, as no evidence of emotional interference was detected. However, patterns of neural activation revealed early shared engagement of regions involved in cognitive reappraisal during negative task conditions and unique late engagement of the hippocampus only while counting teacher-specific negative words. Further, we identified that greater emotion dysregulation was associated with increased activation of regions involved in cognitive control processes during neutral word trials. Teachers who showed slower emotion recognition performance were also found to have greater activation in regions associated with visual and word processing, specifically during the teacher specific negative word condition of the task. Future research should explore emotion regulation strategy use in teachers and utilise temporally sensitive neuroimaging techniques to further understand these findings.

A new tool to evaluate burnout: the Italian version of the BAT for Italian healthcare workers

BACKGROUND

Healthcare workers (HCWs) represents one of the highest-risk population to develop burnout symptoms. Recently, a new tool has been designed to measure several dimensions that capture an exhaustive expression of burnout symptoms by six dimensions (i.e., exhaustion; mental distance; cognitive impairment; emotional impairment; psychological distress; psychosomatic complaints).

METHODS

The current study aims to adapt the Burnout Assessment Tool (BAT) to an Italian Healthcare workers' sample confirming the original second-order factorial structure. Furthermore, we expected to find good indexes of reliability and validity tests. Participants were 697 Italian Health Care Workers (Female = 68.44%; mean age = 36.47; SD = 11.20). Data were collected by self-report questionnaires submitted by the snowball method.

RESULTS

Findings show a good fit of the BAT's structure, confirming the hypothesized second-order factorial model. Furthermore, good reliability has been established with the study's measures.

CONCLUSIONS

The BAT for HCWs is eligible as a new tool to evaluate burnout in the at-risk HCWs as a multi-facet constellation of symptoms.

When fear about health hurts performance: COVID-19 and its impact on employee’s work

This study utilized terror management and conservation of resources theory to fulfill its aim of investigating the effects of fear of contamination of COVID-19 on performance of employees in the banking sector of Pakistan. A survey was conducted to collect data in two waves from 206 bank employees in Punjab region. SPSS was used for data analysis. The results demonstrated that such fear leads to emotional exhaustion which in turn negatively affects employee’s work performance. However, the perceptions of better precautionary measures taken by the organization against the spread of the disease moderated the said relationship and weakened the strength of fear on performance through emotional exhaustion. Amid the widespread fear, panic and detrimental effects of COVID-19 on organizations and economies of the worlds, this research has implications for policy makers by showing the importance of organizational measures taken and displayed to employees in decreasing the negative effects of extensive fear and uncertainty prevailing due to the pandemic.

Late Effects of Cancer Treatment, Job Resources, and Burnout Complaints Among Employees With a Breast Cancer Diagnosis 2–10 Years Ago: A Longitudinal Study

Purpose

The aim of this study was to investigate the effect of possible late effects of cancer treatment (physical complaints, fatigue, and cognitive complaints) and of two job resources (autonomy and supportive leadership style) on future burnout complaints, among employees living 2–10 years beyond breast cancer diagnosis.

Methods

Data at T1 (baseline questionnaire) and at T2 (9 months later) were collected in 2018 and 2019 (N = 287). These data were part of a longitudinal study among Dutch speaking workers with a cancer diagnosis 2–10 years ago. All complaints and job resources were self-reported. Longitudinal multivariate regression analyses were executed, controlling for years since diagnosis, living with cancer (recurrence or metastasis), and other chronic or severe diseases. Mediation by baseline burnout complaints was considered.

Results

A higher level of fatigue and cognitive complaints at baseline (T1) resulted in higher future burnout complaints (at T2), with partial mediation by baseline burnout complaints. No effect of physical complaints at T1 was observed. Higher levels of autonomy or a supportive leadership style resulted in lower burnout complaints, with full mediation by baseline burnout complaints. Buffering was observed by autonomy in the relationship of cognitive complaints with future burnout complaints. No moderation was observed by supportive leadership.

Conclusion

The level of burnout complaints among employees 2–10 years beyond breast cancer diagnosis may be an effect of fatigue or cognitive complaints, and awareness of this effect is necessary. Interventions to stimulate supportive leadership and autonomy are advisable, the latter especially in the case of cognitive complaints.

The Mediator Role of Feelings of Guilt in the Process of Burnout and Psychosomatic Disorders: A Cross-Cultural Study

Burnout was recently declared by WHO as an “occupational phenomenon” in the International Classification of Diseases 11th revision (ICD-11), recognizing burnout as a serious health issue. Earlier studies have shown that feelings of guilt appear to be involved in the burnout process. However, the exact nature of the relationships among burnout, guilt and psychosomatic disorders remains unclear. The purpose of this study was to investigate the mediator role of feelings of guilt in the relationship between burnout and psychosomatic disorders, and perform a cross-cultural validation of the multi-dimensional model by Gil-Monte in two samples of teachers (Portuguese vs. Spanish). The study sample was composed of 1,266 teachers, 1,062 from Spain, and 204 from Portugal. Burnout was measured by the Spanish Burnout Inventory. Hypotheses were tested together in a path model. The results obtained provide empirical evidence for the mediator role of guilt in the relationship between the Burnout syndrome and psychosomatic disorders in the sample of teachers from Spain and Portugal, and they contribute to the empirical validation of the model by Gil-Monte. The results indicate that guilt should be incorporated as a symptom of burnout in order to identify individuals affected by burnout and profiles or types of burnout to differentiate it from other pathologies like depression.

Emotional Labor and Burnout among Teachers: A Systematic Review

A significant amount of emotional labor takes place during teaching. Teaching is a multitasking profession that consists of both cognitive and emotional components, with teachers engaging in emotional labor on a daily basis as an instrumental part of achieving teaching goals and positive learning outcomes. The purpose of the present review was to explore the relationship between emotional labor and burnout in school settings. The review focused specifically on teachers from elementary and high schools, between January 2006 and August 2021, and 21 studies fit the inclusion criteria. Overall, the review of the literature supports the significant associations between burnout and emotional labor with the majority of results pointing to the consistent relationship between surface acting and burnout. However, the results regarding the association of deep acting and naturally felt emotions with burnout were mixed. There is considerable scope for improvement in our study of emotional labor in terms of the study designs we employ, the variables we study and our appreciation of the historical and cultural factors that moderate and mediate the relationship between emotional labor and burnout.

The drivers and effects of burnout within an information technology work context: a job demands-resources framework

Purpose

The purpose of this empirical study is to explore the drivers and effects of a multidimensional conceptualization of burnout for information technology (IT) personnel using the job demands-resources framework.

Design/methodology/approach

Using survey data from 247 IT professionals, the authors analyzed our model using partial least squares structural equation modeling (PLS-SEM), a composite-based method.

Findings

The authors find that job demands and job resources differently influence the dimensions of burnout, and the burnout dimensions influenced turnover intention (leave the organization) and turnaway intention (leave the field) except for cynicism, which did not affect turnover intention. The authors’ findings suggest that managers and human resource professionals may want to look beyond managing work exhaustion and consider focusing on the professional efficacy dimension of burnout to keep their IT professionals from leaving the organization and the IT industry.

Originality/value

This study highlights the need for researchers in the information systems field to rethink using exhaustion as a proxy for the burnout construct as focusing on work exhaustion does not tell the full story for IT professionals. Additionally, the findings indicate that job-related burnout affects not only IT professional's turnover intention but also turnaway intention. Last, psychosocial mentoring did not directly influence any of the burnout components but indirectly influenced all three components.

The relationship between the subjective experience of real-world cognitive failures and objective target-detection performance in visual search

Visual search is a common occurrence in everyday life, such as searching for the location of keys, identifying a friend in a crowd, or scanning an upcoming intersection for hazards while driving. Visual search is also used in professional contexts, such as medical diagnostic imaging and airport baggage screening. These contexts are often characterised by low-prevalence or rare targets. Here we tested whether individual differences in the detection of targets in visual search could be predicted from variables derived from the rich informational source of participants' subjective experience of their cognitive and attentional function in everyday life. We tested this in both low-prevalence (Experiment 1) and high-prevalence (Experiment 2) visual search conditions. In both experiments, participants completed a visual search with arrays containing multiple photorealistic objects, and their task was to detect the presence of a gun. Following this, they completed the Cognitive Failures Questionnaire (CFQ) and the Attentional Control Scale (ACS). In Experiment 1, the target was present on 2% of trials, while in Experiment 2, it was present on 50%. In both experiments, participants' scores on the False Triggering component of the CFQ were negatively associated with accuracy on target-present trials, while participants' scores on the Forgetfulness component of the CFQ were positively associated with target-present accuracy. These results show that objective performance in visual search can be predicted from subjective experiences of cognitive function. They also highlight that the CFQ is not monolithic. Instead, the CFQ subfactors can have qualitatively different relationships with performance. Theoretical and practical implications are discussed.

Sustained Attention and Working Memory Predict the Number of Days on Health-Related Benefits in the Year Following Occupational Rehabilitation

Purpose The objective of this study was to investigate the association between cognitive and emotional functioning and the number of days on health-related benefits such as sick leave, work assessment allowance and disability pension. We investigated whether cognitive and emotional functioning at the start of rehabilitation and the change from the start to the end of rehabilitation predicted the number of days on health-related benefits in the year after occupational rehabilitation. Methods A sample of 317 individuals (age 19-67 years), mainly diagnosed with a musculoskeletal or mental and behavioural ICD-10 disorder, participated. The sample was stratified depending on the benefit status in the year before rehabilitation. Those receiving health-related benefits for the full year comprised the work assessment allowance and disability pension (WAA) group and those receiving benefits for less than a year comprised the sick leave (SL) group. The participants were administered cognitive and emotional computerised tests and work and health questionnaires at the beginning and end of rehabilitation. The cumulative number of days on health-related benefits during 12 months after rehabilitation was the primary outcome variable and age, gender, educational level, subjective health complaints, anxiety, and depression were controlled for in multiple regression analyses. Results The WAA group (n = 179) was significantly impaired at baseline compared to the SL group (n = 135) in focused attention and executive function, and they also scored worse on work and health related variables. Higher baseline scores and change scores from the start to the end of rehabilitation, for sustained attention, were associated with fewer number of health-related benefit days in the WAA group, while higher baseline scores for working memory were associated with fewer number of health-related benefit days in the SL group. Conclusions New knowledge about attention and memory and return to work in individuals with different benefit status may pave the way for more targeted programme interventions. Rehabilitation programmes could benefit from designing interventions that respectively improve sustain attention and working memory related to working life in individuals on sick leave or work assessment allowance and disability pension.

The effects of acute and chronic stress on choice consistency

Important decisions are often made under some degree of stress. It is now well-established that acute stress affects preferences and priorities in our decisions. However, it is hard to make a general case on the net impact of stress on decision-making quality in a normative sense as evidence for or against a direct effect of stress on decision-making quality is sparse. Here, we used the revealed preference framework of choice consistency to investigate decision-making quality without the assumption of an objectively correct choice. Specifically, we tested whether acute stress influences choice consistency in a time dependent fashion. A sample of 144 participants solved a food choice task before, immediately after and in the aftermath of the Trier Social Stress Test (TSST) or a matched control procedure. We confirmed the effectiveness of our stress manipulation via an array of subjective and physiological stress measures. Using Bayesian statistics, we found strong evidence against an effect of acute stress on choice consistency. However, we found exploratory evidence for a negative association of self-reported chronic stress and choice consistency. We discuss our results in the context of previous findings of stress effects on choice consistency and preference changes.

Auditory deviance detection and involuntary attention allocation in occupational burnout-A follow-up study

Here, we investigated the central auditory processing and attentional control associated with both recovery and prolongation of occupational burnout. We recorded the event-related brain potentials N1, P2, mismatch negativity (MMN) and P3a to nine changes in speech sounds and to three rarely presented emotional (happy, angry and sad) utterances from individuals with burnout (N = 16) and their matched controls (N = 12). After the 5 years follow-up, one control had acquired burnout, half (N = 8) of the burnout group had recovered, and the other half (prolonged burnout) still had burnout. The processing of acoustical changes in speech sounds was mainly intact. Prolongation of the burnout was associated with a decrease in MMN amplitude and an increase in P3a amplitude for the happy stimulus. The results suggest that, in the absence of interventions, burnout is a persistent condition, associated with alterations of attentional control, that may be amplified with the prolongation of the condition.

Evaluating the mental health and well-being of Canadian healthcare workers during the COVID-19 outbreak

During the COVID-19 pandemic, healthcare systems have been under extreme levels of stress due to increases in patient distress and patient deaths. While additional research and public health funding initiatives can alleviate these systemic issues, it is also important to consider the ongoing mental health and well-being of professionals working in healthcare. By surveying healthcare workers working in Canada during the COVID-19 pandemic, we found that there was an elevated level of depressive symptomatology in that population. We also found that when employees were provided with accurate and timely information about the pandemic, and additional protective measures in the workplace, they were less likely to report negative effects on well-being. We recommend that healthcare employers take these steps, as well as providing targeted mental health interventions, in order to maintain the mental health of their employees, which in turn will provide better healthcare at the population level.

Are Individuals Always Aware of Their Trauma-Related Intrusive Thoughts? A Study of Meta-Awareness

Individuals are not always aware of their mental content. We tested whether lack of awareness occurs in those who have experienced trauma, with and without posttraumatic stress disorder (PTSD). We also examined the role of proposed cognitive mechanisms (working memory and inhibition) in explaining unnoticed intrusions. Individuals with PTSD (n = 44), and varying levels of symptoms (high posttraumatic stress [PTS]: n = 24; low PTS: n = 37) reported on intrusive thoughts throughout a reading task. Intermittently, participants responded to probes about whether their thoughts were trauma related. Participants were "caught" engaging in unreported trauma-related thoughts (unnoticed intrusions) for between 24 and 27% of the probes in the PTSD and high PTS groups, compared with 15% of occasions in the low PTS group. For trauma-related intrusions only, participants lacked meta-awareness for almost 40% of probes in the PTSD group, which was significantly less than that observed in the other groups (∼60%). Contrary to predictions, working memory and response inhibition did not predict unnoticed intrusions. The results suggest that individuals who have experienced significant trauma can lack awareness about the frequency of their trauma-related thoughts. Further research is warranted to identify the mechanisms underpinning the occurrence of unnoticed intrusions.

Work Environment and Elderly Abuse in Nursing Homes: The Mediating Role of Burnout

The present study focuses on elderly abuse committed by nurses and nurses' aides in nursing homes. Elderly abuse includes neglect and abusive behaviors deleterious to the health and welfare of the elderly. The study aimed at a better understanding of neglect and abusive behaviors by considering caregiver burnout and the work context of these professionals. To achieve this goal, direct effects of job demands (workload and emotional demands) and organizational resources (quality of relationships with colleagues and with the supervisor) on elderly abuse were analyzed. Moreover, the mediating role of caregiver burnout was explored by suggesting that job demands and lack of organizational resources were related to neglect and abusive behaviors through burnout. The study was conducted among 481 nurses and health care assistants from different French nursing homes. Correlations, multiple regressions, and mediation analyses were performed. Results globally confirmed our hypotheses. Emotional demands and poor quality relationships with colleagues and the team supervisor were the most predictive variables for caregiver burnout, neglect, and abusive behaviors toward the elderly. Moreover, the results contributed to the literature by highlighting the mediating effect of burnout and give rise to potential implications in preventing elderly abuse in nursing homes.

The changing demographics of the orthotist/prosthetist workforce in Australia: 2007, 2012 and 2019

BACKGROUND

Previous Australian workforce analyses revealed a small orthotist/prosthetist workforce with a low number of practitioners per 100,000 Australians. In recent years, initiatives were implemented to increase relative workforce size, including a government-led change in immigration policy to facilitate entry of experienced internationally trained orthotist/prosthetists into the Australian workforce. Given these changes, this project aimed to compare demographics of the orthotist/prosthetist workforce in Australia and each state/territory between 2007, 2012 and 2019.

METHODS

This quasi-experiment analysed data from the Australian Orthotic Prosthetic Association (AOPA) database of certified orthotist/prosthetists, to compare changes in the absolute number of practitioners and the number of practitioners per 100,000 population, as well as practitioner age, gender and service location (i.e., metropolitan, regional/remote) across three time points, with a breakdown by each Australian state and territory.

RESULTS

Between 2007 and 2019, the number of orthotist/prosthetists per 100,000 population increased 90%. Average age reduced significantly between 2007 (41.5 years) and 2019 (35 years) (p = 0.001). While the proportion of female practitioners increased significantly between 2007 (30%) and 2019 (49%), and between 2012 (38%) and 2019 (49%) (p < 0.05); only 22% of the female workforce is over 40 years of age. The proportion of practitioners servicing a regional/remote location did not change over time (range 13-14%).

CONCLUSIONS

Between 2007 and 2019, the national orthotist/prosthetist workforce increased at a rate that exceeded Australia's population growth, became younger, and more female. However, the number of practitioners per 100,000 population remains below international recommendations; particularly in states outside of Victoria and Tasmania, and in regional/remote areas. In addition, low numbers of mid-late career female practitioners suggest challenges to retention of this particular cohort. These data can help inform workforce initiatives to retain a younger and more female workforce, and improve access to orthotic/prosthetic services.

Cognitive Predictors of Precautionary Behavior During the COVID-19 Pandemic

The attempts to mitigate the unprecedented health, economic, and social disruptions caused by the COVID-19 pandemic are largely dependent on establishing compliance to behavioral guidelines and rules that reduce the risk of infection. Here, by conducting an online survey that tested participants' knowledge about the disease and measured demographic, attitudinal, and cognitive variables, we identify predictors of self-reported social distancing and hygiene behavior. To investigate the cognitive processes underlying health-prevention behavior in the pandemic, we co-opted the dual-process model of thinking to measure participants' propensities for automatic and intuitive thinking vs. controlled and reflective thinking. Self-reports of 17 precautionary behaviors, including regular hand washing, social distancing, and wearing a face mask, served as a dependent measure. The results of hierarchical regressions showed that age, risk-taking propensity, and concern about the pandemic predicted adoption of precautionary behavior. Variance in cognitive processes also predicted precautionary behavior: participants with higher scores for controlled thinking (measured with the Cognitive Reflection Test) reported less adherence to specific guidelines, as did respondents with a poor understanding of the infection and transmission mechanism of the COVID-19 virus. The predictive power of this model was comparable to an approach (Theory of Planned Behavior) based on attitudes to health behavior. Given these results, we propose the inclusion of measures of cognitive reflection and mental model variables in predictive models of compliance, and future studies of precautionary behavior to establish how cognitive variables are linked with people's information processing and social norms.

The association between nurses' burnout and objective care quality indicators: a cross-sectional survey in long-term care wards

Background

Worldwide, rather few studies have examined the association between burnout and care quality using objectively measured quality indicators, with most of the studies have relied on perceived quality outcomes. This study aimed to examine the association between staff nurses’ burnout and selected objective quality metrics in long-term care wards in Japan.

Methods

This is a secondary analysis of a cross-sectional survey. Nurse managers and staff nurses working at randomly selected hospitals with long-term care wards—the equivalent of skilled nursing homes in Western countries— completed self-administered, anonymous questionnaires. The questionnaires collected data regarding care quality indicators, staff nurses’ burnout, and other confounders (e.g., ward size, participants’ years of experience, and patients’ conditions). All statistical analyses were conducted at the ward level. A multivariate regression analysis was used to examine associations between burnout and outcome indicators.

Results

Data from 196 wards in 196 hospitals (196 nurse managers and 2473 staff nurses) across Japan were analyzed. Multivariate regression analysis showed that higher emotional exhaustion was associated with higher rates of pneumonia and pressure ulcers (p-value = .036 and .032, respectively), and that reduced personal accomplishment was associated with higher rates of tube feeding (p-value = .018). A larger ward size was also associated with low rates of pneumonia (regression coefficient = −.001, p-value = .019).

Conclusions

Staff nurses’ burnout is a significant determinant of care quality in long-term care wards, implying that organizations that implement burnout reducing strategies may see greater benefits in patient outcomes. A large ward size was significantly associated with better care outcomes—specifically, low rates of pneumonia. Future research needs to determine feasible quality improvement measures in small-scale long-term care facilities, and to provide more comprehensive insights on ward-level variables that influence care quality in long-term care settings.

Burnout and Cognitive Performance

The aim of this study was to investigate the relationship between burnout and cognitive functioning. The associations of depression, anxiety and family support with burnout and cognitive functioning were also examined both independently and as potential moderators of the burnout–cognitive functioning relationship. Seven different cognitive tasks were administered to employees of the general working population and five cognitive domains were assessed; i.e., executive functions, working memory, memory (episodic, visuospatial, prospective), attention/speed of processing and visuospatial abilities. Burnout, depression, anxiety and family support were assessed with the Maslach Burnout Inventory-General Survey, the Hospital Anxiety and Depression Scale and the Family Support Scale respectively. In congruence with the first and fourth (partially) Hypotheses, burnout and perceived family support are significantly associated with some aspects of cognitive functioning. Moreover, in line with the third Hypothesis, perceived family support is inversely related to burnout. However, in contrast to the second and fourth Hypotheses, depression, anxiety and perceived family support do not moderate the burnout–cognitive functioning relationship. Additional results reveal positive associations between burnout depression and anxiety. Overall findings suggest that cognitive deficits, depression and anxiety appear to be common in burnout while they underpin the role of perceived family support in both mental health and cognitive functioning. Implications for practice are discussed.

The effect of job stress management training on observance of professional ethics by nurses

The present study was conducted to investigate the effect of job stress management training on observance of professional ethics by nurses. This quasi-experimental study was performed on 50 clinical nurses in Shiraz, Iran. Data collection tools included a questionnaire. The research intervention consisted of six two-hour sessions of stress management training. SPSS 21 were used to analyze the data. Data analysis showed that before intervention, the level of professional ethics of 64% of nurses was relatively good, but after intervention, the level of professional ethics of the majority of nurses (94%) was at the desired level. The results showed that the levels of professional ethics after job stress management training has increased significantly compared to before. The results showed that stress management training has led to improving the level of professional ethics of nurses.

Factors associated with self-reported burnout level in allied healthcare professionals in a tertiary hospital in Singapore

BACKGROUND

Burnout has adverse implications in healthcare settings, compromising patient care. Allied health professionals (AHPs) are defined as individuals who work collaboratively to deliver routine and essential healthcare services, excluding physicians and nurses. There is a lack of studies on burnout among AHPs in Singapore. This study explored factors associated with a self-reported burnout level and barriers to seeking psychological help among AHPs in Singapore.

METHODS

We conducted a cross-sectional study in a sample of AHPs in a tertiary hospital from October to December 2019. We emailed a four-component survey to 1127 eligible participants. The survey comprised four components: (1) sociodemographic characteristics, (2) Maslach Burnout Inventory (MBI-HSS), (3) Areas of Worklife Survey, and (4) Perceived Barriers to Psychological Treatment (PBPT). We performed a multiple logistic regression analysis to identify factors associated with burnout. Adjusted odds ratios (AORs) and associated 95% confidence intervals (CIs) were computed.

RESULTS

In total, 328 participants completed the questionnaire. The self-reported burnout level (emotional exhaustion>27 and/or depersonalization>10) was 67.4%. The majority of the respondents were female (83.9%), Singaporean (73.5%), aged 40 years and below (84.2%), and Chinese ethnicity (79.9%). In the multiple logistic regression model, high burnout level was negatively associated with being in the age groups of 31 to 40 (AOR 0.39, 95% CI 0.16-0.93) and 40 years and older (AOR 0.30, 95% CI 0.10-0.87) and a low self-reported workload (AOR 0.35, 95% CI 0.23-0.52). High burnout level was positively associated with a work experience of three to five years (AOR 5.27, 95% CI 1.44-20.93) and more than five years (AOR 4.24; 95% CI 1.16-16.79. One hundred and ninety participants completed the PBPT component. The most frequently cited barriers to seeking psychological help by participants with burnout (n = 130) were 'negative evaluation of therapy' and 'time constraints.'

CONCLUSIONS

This study shows a high self-reported burnout level and identifies its associated factors among AHPs in a tertiary hospital. The findings revealed the urgency of addressing burnout in AHPs and the need for effective interventions to reduce burnout. Concurrently, proper consideration of the barriers to seeking help is warranted to improve AHPs' mental well-being.

Exhaustion disorder and altered brain activity in frontal cortex detected with fNIRS

Patients with stress-related Exhaustion Disorder (ED) have problems with memory and executive function. These problems have been associated with deviant activity in prefrontal cortex (PFC). We investigated cognitive performance and functional activity in the PFC during prolonged mental activity in patients with ED (n = 20, 16 women) with a mean duration since diagnosis of 46 ± 23 months in comparison to healthy individuals (n = 20, 12 women). A block of six neuropsychological tests was performed in a sequence that was repeated once. The brain imaging technique, functional near infrared spectroscopy (fNIRS) was used for all tests. There were no differences between the groups in terms of changes over time, i.e. difference between first and second test block. In the Stroop-Simon test, the controls showedhigher functional activity in the frontal cortex. In the left ventrolateral PFC, we observed an increased activity in controls in the incongruent compared to the congruent trials, whereas no changes were detected in the ED patient group. During processing speed tasks, only ED patients showed higher functional activity in right dorsolateral PFC. The ED patients reported lower subjective energy level and they also performed less well on a mental control task compared to healthy individuals. In conclusion, ED patients showed altered functional activity compared to controls, indicating that ED patients process information differently in the prefrontal cortex, but the functional activity did not change during the 2½ hr procedure, as revealed by the test-retest design. Lay summary In this paper we show that patient with exhaustion disorder have a reduced functional activity in the prefrontal cortex. This functional activity was not affected by 2.5 hours mental activity.

Multisensory, Nature-Inspired Recharge Rooms Yield Short-Term Reductions in Perceived Stress Among Frontline Healthcare Workers

We are currently facing global healthcare crisis that has placed unprecedented stress on healthcare workers as a result of the coronavirus disease 2019 (COVID-19). It is imperative that we develop novel tools to assist healthcare workers in dealing with the significant additional stress and trauma that has arisen as a result of the pandemic. Based in research on the effects of immersive environments on mood, a neuroscience research laboratory was rapidly repurposed using commercially available technologies and materials to create a nature-inspired relaxation space. Frontline healthcare workers were invited to book 15-min experiences in the Recharge Room before, during or after their shifts, where they were exposed to the immersive, multisensory experience 496 Recharge Room users (out of a total of 562) completed a short survey about their experience during an unselected, consecutive 14-day period. Average self-reported stress levels prior to entering the Recharge Room were 4.58/6 (±1.1). After a single 15-min experience in the Recharge Room, the average user-reported stress level was significantly reduced 1.85/6 (±1.2; p < 0.001; paired t-test). Net Promoter Score for the experience was 99.3%. Recharge Rooms such as those described here produce significant short-term reductions in perceived stress, and users find them highly enjoyable. These rooms may be of general utility in high-stress healthcare environments.

Stress Regulation of Sustained Attention and the Cholinergic Attention System

BACKGROUND

Stress exacerbates symptoms of schizophrenia and attention-deficit/hyperactivity disorder, which are characterized by impairments in sustained attention. Yet how stress regulates attention remains largely unexplored. We investigated whether a 6-day variable stressor altered sustained attention and the cholinergic attention system in male and female rats.

METHODS

Sustained attention was tested with the sustained attention task. Successful performance on the sustained attention task relies on the release of acetylcholine (ACh) into the cortex from cholinergic neurons in the nucleus basalis of Meynert (NBM). Thus, we evaluated whether variable stress (VS) altered the morphology of these neurons with a novel approach using a Cre-dependent virus in genetically modified ChAT::Cre rats, a species used for this manipulation only. Next, electrochemical recordings measured cortical ACh following VS. Finally, we used RNA sequencing to identify VS-induced transcriptional changes in the NBM.

RESULTS

VS impaired attentional performance in the sustained attention task and increased the dendritic complexity of NBM cholinergic neurons in both sexes. NBM cholinergic neurons are mainly under inhibitory control, so this morphological change could increase inhibition on these neurons, reducing downstream ACh release to impair attention. Indeed, VS decreased ACh release in the prefrontal cortex of male rats. Quantification of global transcriptional changes revealed that although VS induced many sex-specific changes in gene expression, it increased several signaling molecules in both sexes.

CONCLUSIONS

These studies suggest that VS impairs attention by inducing molecular and morphological changes in the NBM. Identifying mechanisms by which stress regulates attention may guide the development of novel treatments for psychiatric disorders with attention deficits.

Job Demands-Resources theory and self-regulation: new explanations and remedies for job burnout

Background: High job demands and low job resources may cause job strain and eventually result in burnout. However, previous research has generally ignored the roles of time and self-regulation. Objectives: This theoretical article synthesizes the literature to propose a multilevel model that delineates how acute job strain translates into enduring and severe job burnout. Methods: We integrate self-regulation perspectives in job demands-resources (JD-R) theory to propose that short-term job strain and eventually enduring burnout is the result of consistently high job demands and low job resources - combined with failed self-regulation. Results: The model shows that when employees are confronted with increased job strain, they are more likely to use maladaptive self-regulation strategies, such as coping inflexibility and self-undermining. In addition, when job strain increases, employees are less likely to use adaptive self-regulation strategies, such as job stress recovery and job crafting. It follows that when the job becomes more stressful, stable resources become more important. Organizational resources such as human resource practices and healthy leadership may help employees to regulate their short-term fatigue and avoid enduring burnout. Furthermore, key personal resources like emotional intelligence and proactive personality may help employees to recognize and regulate their fatigue in an effective way. Conclusion: The proposed model of burnout expands JD-R theory and offers important practical implications for the prevention and reduction of burnout.

Self-reported cognitive difficulties and cognitive functioning in relation to emotional exhaustion: Evidence from two studies

Individuals with burnout often report having difficulties with concentration and memory in everyday life. However, empirical evidence on cognitive decline using performance-based measures is limited and often obtained on small clinical samples. The aim of the present two studies was to investigate cognitive correlates of emotional exhaustion on otherwise healthy populations at different life stages with varying degrees of burnout. A total of 201 graduate and undergraduate students participated in Study 1, and a heterogeneous sample (N = 203) of working individuals took part in Study 2. Cognitive performance was assessed by self-reported cognitive difficulties and three performance-based cognitive tests of sustained attention, inhibition of irrelevant information, and inhibition of prepotent responses. Controlling for gender, age, and depression symptoms, multiple regression analyses in Study 1 indicated a positive relationship between emotional exhaustion and self-reported cognitive difficulties but no correlation with the performance-based cognitive measures. A similar pattern of results emerged in Study 2. However, we found tentative evidence for cognitive impairment on the sustained attention measure. The results of these two studies partially support previous findings and extend the literature on cognitive aspects of burnout.