Influence of years of experience and age on hospital workforce compassion satisfaction, anxiety, depression, stress, and burnout during pandemic: Implications for retention

Changes in attitudes towards telemedicine in acute burn care following the Covid-19 pandemic

BACKGROUND

Telemedical referrals after burn injury had been shown to be advantageous over telephone referrals for multiple reasons, however there were several key barriers towards complete implementation. The Covid-19 pandemic facilitated the adoption of telemedicine to ensure the safety of both clinicians and patients. Due to the circumstances, it was unclear whether the pre-pandemic barriers still existed despite the complete implementation of telemedicine. This study aims to evaluate clinicians' views about the barriers towards implementation of a specific telemedicine system for burns referrals, and their changing attitudes following the pandemic, to identify key domains for improvement in current and future telemedicine systems.

METHODS

A questionnaire was created to evaluate the attitudes of referring clinicians towards telemedicine, following literature searches and administration of a pilot questionnaire. This was administered via telephone to staff working in EDs and MIUs which referred to the South-West United Kingdom Burns Network using the Medical Data Solutions and Services (MDSAS) system, in both 2019 and 2022. A statistical analysis was performed to compare the attitudes of clinicians towards telemedicine both pre- and post-pandemic.

RESULTS

100 respondents completed the survey in 2019 and 70 in 2022, with similar demographics of respondents. Out of the twelve barriers identified, the lack of reliable Wi-Fi and need to duplicate notes were identified as the main obstacles to implementation in both time periods. In both years, the single greatest barrier reported was poor access to reliable Wi-Fi (p = 0.944). Miscommunication between clinicians using the system, inadequate numbers of devices and financial constraints were identified less frequently as barriers in 2022 than 2019 (p = 0.005, p = 0.047 and p < 0.001 respectively). However, significantly more respondents reported time pressures when waiting for a response to their telemedicine referral in 2022 (p = 0.022).

CONCLUSION

Overall, clinicians displayed a positive attitude towards the MDSAS system for acute burns, with clinicians identifying fewer concerns with the system following the Covid-19 pandemic. However, concerns over the time pressures that this telemedicine system places on the referring clinician and existing Wi-Fi infrastructure persist. Further streamlining of the system and investment in internet access is recommended, with continued input from all stakeholders.

Ambivalent identification mediates the relationship between organizational justice and stress

The present study aims to examine the relationship between organizational justice and employee stress through the lenses of social identity theory and the ambivalent identification process. The research hypotheses assume that employees working in organizational environments with low levels of justice could experience more stress, and this relationship is also mediated by ambivalent identification. In other words, the mediating mechanism of this relation posited that low levels of organizational justice were associated with high levels of ambivalent identification, which in turn increased levels of work-related stress. Across a field study in several organizations from healthcare sectors, results confirmed that employees treated with less fairness experienced high ambivalence toward their organization, which increased their perception of stress, i.e., work-related burnout, client-related burnout, physical symptoms, and interpersonal strain at work. Furthermore, results supported only a full mediation model, in which the direct relationship between organizational justice and stress was not significant. The present results make an important contribution to the research literature on justice: the inclusion of the mediator variable, namely, ambivalent identification, drops the expected direct effect of organizational justice on stress, suggesting a call for action in adopting the social identity perspective in addition to organizational justice models, and specifically introducing the study of a detrimental form of identification, such as ambivalent identification. Limitations and practical implications of the study were discussed.