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Stilos K. Promoting Self-Care in Palliative Care: Through the Wisdom of My Grandmother. Creat Nurs 2024; 30:87-90. [PMID: 38291617 DOI: 10.1177/10784535241228527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
In the post COVID-19 pandemic period, targeted efforts are needed more than ever to improve frontline nurses' well-being. In the field of palliative care, there is recognition of the importance of self-care, but the concept itself remains nebulous, and proactive implementation of self-care is lacking. Reflective writing has been noted to have positive impacts on health care providers' well-being. This piece brings to light the author's interest and work in reflective writing, sharing a personal account that provides a source of happiness and an opportunity to better understand her palliative care practice. Beyond the individual level, organizations are also encouraged to invest in their nurses' overall well-being.
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Affiliation(s)
- Kalli Stilos
- Division of Palliative Care, Adjunct Clinical Faculty for Lawrence Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
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Elkudssiah Ismail N, Hui WM, Goh KW, Jimam NS, Hermansyah A, Ming LC. Resilience among Malaysian Community Pharmacists and General Medical Practitioners Using the 10-Item Connor-Davidson Resilience Scale (CD-RISC): The First National Survey. Behav Sci (Basel) 2022; 12:bs12080272. [PMID: 36004843 PMCID: PMC9405043 DOI: 10.3390/bs12080272] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 07/17/2022] [Accepted: 07/20/2022] [Indexed: 11/16/2022] Open
Abstract
With the growing importance of the healthcare sector, resilience has become a fundamental personal quality that healthcare professionals need to cultivate to cope with adverse events in daily work. Distress in the workplace cannot only impact the well-being of healthcare professionals but also negatively affect the capability to care effectively for others. This study was conducted to determine the score and level of resilience among private primary healthcare professionals and their relationships with independent variables. Sets of questionnaires on resilience based on the Connor–Davidson resilience scale-10 (CD-RISC-10) were completed by 164 general practitioners (GPs) and 87 community pharmacists (CPs). Inferential analysis was used to assess the difference, correlation, association, and predictor among dependent and independent variables. The validity and reliability of the study instrument were assessed using Modern Test Theory (MTT) and Classical Test Theory (CTT). The majority of GPs and CPs possessed the lowest resilience level. There were significant differences between CD-RISC-10 with gender, age, and years of experience in GPs as well as overall. Significant associations were found between CD-RISC-10 with all independent variables, except for the highest education level in GPs and overall. This study revealed significant correlations between independent variables with CD-RISC-10 in GPs and overall. However, there were nonsignificant differences, associations, and correlations among CPs between all independent variables and CD-RISC-10. Gender was the predictor of CD-RISC-10 in GPs, while age and years of experience were the predictors of CD-RISC-10 in GPs and overall. There was no predictor of independent variables for CPs. In multinomial logistics regression, years of experience and gender were the significant predictors of CD-RISC-10 among GPs. The CD-RISC-10 instrument had good validity and reliability. Overall, healthcare professionals showed a low level of resilience. This emphasized the need to cultivate and build resilience, as it is a desirable, important element when working in harsh and unprecedented healthcare settings.
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Affiliation(s)
- Nahlah Elkudssiah Ismail
- Malaysian Academy of Pharmacy, Puchong 47160, Malaysia
- Faculty of Pharmacy, MAHSA University, Bandar Saujana Putra, Jenjarom 42610, Malaysia
- Correspondence: (N.E.I.); (A.H.)
| | - Wong Min Hui
- Faculty of Pharmacy, MAHSA University, Bandar Saujana Putra, Jenjarom 42610, Malaysia
| | - Khang Wen Goh
- Faculty of Data Science and Information Technology, INTI International University, Nilai 71800, Malaysia
| | | | - Andi Hermansyah
- Department of Pharmacy Practice, Faculty of Pharmacy, Universitas Airlangga, Surabaya 60115, Indonesia
- Correspondence: (N.E.I.); (A.H.)
| | - Long Chiau Ming
- Pengiran Anak Puteri Rashidah Sa’adatul Bolkiah Institute of Health Sciences, Universiti Brunei Darussalam, Gadong BE 1410, Brunei or
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Antoniadou M. Estimation of Factors Affecting Burnout in Greek Dentists before and during the COVID-19 Pandemic. Dent J (Basel) 2022; 10:108. [PMID: 35735650 PMCID: PMC9221850 DOI: 10.3390/dj10060108] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 06/07/2022] [Accepted: 06/09/2022] [Indexed: 12/25/2022] Open
Abstract
This study is a comprehensive, cross-sectional survey in occupational burnout, career satisfaction, and quality of life conducted in March 2021 among dentists in the vast area of metropolitan Athens, Greece. Data were collected using a self-reported questionnaire based on the Copenhagen Questionnaire (CQ) for assessing work stress and the Maslach Burnout Inventory-Human Service Survey (MBI-HSS) for evaluating occupational burnout. Using the independent t-test, ANOVA, Pearson's correlation, and multiple linear regression, 804 valid questionnaires were analyzed. During the pandemic, personal exhaustion was affected by gender (b = 1.862, p = 0.0001), age (b = -0.598, p = 0.0001), number of children (b = -0.886, p = 0.020) and higher degree (b = -0.450, p = 0.012). Exhaustion due to working with patients was affected by gender (b = 0.662 p = 0.0001), age (b = -0.513, p = 0.0001), number of children (b = -0.701, p = 0.0001), higher degree (b = -0.207, p = 0.028) and years in practice (b = 0.408 p = 0.0001). Males were more prone to unhappiness, dissatisfaction, and professional physical and emotional exhaustion, but personal resources through higher education, beliefs, values, and hobbies can offer a preventive shield to all dental professionals. Economic management issues can also enhance dentists' satisfaction and feeling of safety in a rapidly changing environment.
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Affiliation(s)
- Maria Antoniadou
- Dental School, National and Kapodistrian University of Athens, GR-115 27 Athens, Greece
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Gamskjaer T, Werlauff U, Handberg C. Investigating job satisfaction in palliative rehabilitation: Reflections and perspectives of health professionals working with amyotrophic lateral sclerosis. J Eval Clin Pract 2022; 28:108-119. [PMID: 34269500 DOI: 10.1111/jep.13599] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 06/24/2021] [Accepted: 06/25/2021] [Indexed: 12/11/2022]
Abstract
STUDY RATIONALE Amyotrophic lateral sclerosis is a progressive neurodegenerative disease which causes impairment of the motor functions in the upper and lower limbs and bulbar muscles with a median survival time is three years from the first appearance of symptoms. There is massive psychological impact on health professionals to persons with amyotrophic lateral sclerosis, hence the work leads to multiple challenges and stressful and demanding situations with high risk of experiencing diminished personal well-being including burnout, moral distress, and compassion fatigue. AIM To investigate reflections and perspectives from health professionals working within palliative rehabilitation for elements of importance in relation to job satisfaction. METHODS AND MATERIALS The design was qualitative and based on the phenomenological-hermeneutical methodology by Paul Ricoeur's interpretation theory. Data consisted of two semi-structured focus group interviews with a total of 12 specialized health professionals: Nurses, Psychologists, Physicians, Occupational Therapists, Physiotherapists, and Social workers, working within a hospital setting of specialized palliative rehabilitation for people with amyotrophic lateral sclerosis and their families. RESULTS The analysis revealed insight into four themes: fundamental drive, working conditions, value of collegiality and work-life balance. Fundamental drive was deeply rooted in the professionals' sense of having a meaningful job. Working conditions such as self-management were important for job satisfaction as were good collegial relations. Finally, a good balance between working life and private life was considered important for job satisfaction. CONCLUSION Our study indicates that work within the field of palliative rehabilitation is experienced as enriching and beneficial under the right circumstances and in an appreciatory working environment. We found elements like autonomy, mastery, purpose, collegiality, and work-life balance to be of great importance. Our findings can help guide managements and health professionals in other palliative rehabilitation contexts to ensure satisfied employees and to optimize the quality of care.
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Affiliation(s)
- Tine Gamskjaer
- Department of Public Health, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Ulla Werlauff
- National Rehabilitation Center for Neuromuscular Diseases, Aarhus, Denmark
| | - Charlotte Handberg
- Department of Public Health, Faculty of Health, Aarhus University, Aarhus, Denmark.,National Rehabilitation Center for Neuromuscular Diseases, Aarhus, Denmark
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Stilos K(K, Ford B, Chakraborty A, Takahashi D. Spiritual Care as Part of an Interprofessional Model for Debriefing on an Oncology Unit. THE JOURNAL OF PASTORAL CARE & COUNSELING : JPCC 2021; 75:158-162. [PMID: 34763574 PMCID: PMC8592097 DOI: 10.1177/15423050211021387] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Health care clinicians who care for seriously ill and dying patients have been known to be at higher risk for burnout and moral distress. When not well supported in their workplace, clinicians may suffer additional adverse outcomes to their overall wellbeing. Self-care is one way to help mitigate these adverse outcomes. The literature has described formalized debriefing not only as a self-care strategy but an intervention to promote healthy team development. The focus of this paper will showcase how social work and spiritual care practitioners in our institution worked collaboratively to support an inpatient oncology unit to address issues related to burnout by providing staff with monthly debriefing sessions intended to enhance self-care and wellness in the workplace.
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Affiliation(s)
- Kalli (Kalliopi) Stilos
- Kalli (Kalliopi) Stilos, Department of Nursing, Faculty of Nursing, University of Toronto, Toronto, Ontario M5S, Canada.
| | - Bill Ford
- Sunnybrook Health Sciences Centre, Canada
| | - Anita Chakraborty
- Sunnybrook Health Sciences Centre, Canada; University of Toronto, Canada
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Stilos KK, Burgoyne K. Incorporating reflective writing & art therapy in my palliative care practice. Can Oncol Nurs J 2021; 31:205-212. [PMID: 34036159 PMCID: PMC8128433 DOI: 10.5737/23688076312205212] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The specialty of palliative care routinely focuses on the complex needs of patients living with incurable illness and their families’ emotional and psychosocial concerns. Healthcare professionals who work with patients with advanced illness sometimes suffer from frustration and anxiety when they return home from caring for dying patients. The psychosocial care that increases patient and family satisfaction is sometimes lost when nurses are suffering (Pendry, 2007; Freeman, 2013). Continuous exposure to such difficult situations and the accumulation of unrecognized feelings and attitudes can lead to physical and psychological challenges (Pereira et al., 2011). As such, nurses have a duty to maintain their health to the best of their ability. To encourage nurses in promoting emotional health, Freeman’s (2013) CARES tool (Comfort, Airway management, Restlessness and delirium, Emotional and spiritual support, and Self-care) was integrated into our organization’s Comfort Measures Order Set for imminently dying patients (prognosis <72 hours) (Stilos, Wynntchuk et al., 2016).
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Affiliation(s)
- Kalliopi Kalli Stilos
- Advance Practice Nurse for the In-Patient Palliative Care Consult Team Adjunct Clinical Faculty, University of Toronto's Lawrence Bloomberg Faculty of Nursing, Sunnybrook Health Science Centre, 2075 Bayview Avenue, Toronto, ON M4N 3M5 H337,
| | - Katherine Burgoyne
- Recreation Therapy & Creative Arts Therapies Department in the Veterans Centre, Sunnybrook Health Science Centre, 2075 Bayview Avenue, Toronto, ON M4N 3M5 H337,
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Stilos KK, Burgoyne K. Intégrer l’écriture réflexive et l’art-thérapie à sa pratique de soins palliatifs. Can Oncol Nurs J 2021; 31:213-220. [PMID: 34036160 PMCID: PMC8128431 DOI: 10.5737/23688076312213220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
La spécialité des soins palliatifs se concentre bien souvent sur la prise en charge des besoins complexes des patients souffrant d’une maladie incurable et des préoccupations émotionnelles et psychosociales de leur famille. Les professionnels de la santé qui travaillent avec des patients atteints d’une maladie à un stade avancé sont parfois anxieux et frustrés lorsqu’ils rentrent chez eux après s’être occupés de patients mourants. Quelquefois, lorsque les infirmières souffrent, elles ne peuvent plus assurer les soins psychosociaux qui contribuent à la satisfaction des patients et de leur famille (Pendry, 2007; Freeman, 2013). L’exposition permanente à des situations aussi difficiles et l’accumulation de sentiments et de comportements qui ne sont pas pris en compte peuvent conduire à des difficultés physiques et psychologiques (Pereira et al., 2011). C’est pourquoi les infirmières se doivent de préserver au mieux leur santé. Pour inciter les infirmières à promouvoir la santé émotionnelle, nous avons intégré l’outil CARES (Comfort, Airway management, Restlessness and delirium, Emotional and spiritual support, Self-care [confort, prise en charge des voies respiratoires, agitation et délire, soutien affectif et spirituel et autosoins]) de Freeman (2013) à l’ensemble des mesures de confort définies par notre organisme pour les patients mourants (pronostic < 72 heures) (Stilos, Wynntchuk et al., 2016).
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Affiliation(s)
- Kalliopi Kalli Stilos
- Infirmière en pratique avancée au sein de l'équipe de consultation en soins palliatifs pour les patients en ambulatoire, Faculté clinique auxiliaire, Faculté de soins infirmiers Lawrence Bloomberg de l'Université de Toronto, Centre des sciences de la santé de Sunnybrook, 2075, Bayview Avenue, Toronto (Ontario) M4N 3M5 H337,
| | - Katherine Burgoyne
- Service de récréothérapie et de thérapies par les arts créatifs au Veterans Centre, Centre des sciences de la santé de Sunnybrook 2075, Bayview Avenue, Toronto (Ontario) M4N 3M5 H337,
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Moreno-Milan B, Breitbart B, Herreros B, Dague KO, Coca Pereira MC. Psychological well-being of palliative care professionals: Who cares? Palliat Support Care 2021; 19:257-261. [PMID: 33818368 PMCID: PMC8314064 DOI: 10.1017/s1478951521000134] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Traditionally, the psychological well-being of healthcare workers has been taken for granted - it has even been considered a part of the requirements that were demanded of them. When these professionals have experienced suffering and psychological depletion, they have been held accountable for this suffering, adopting an individualistic and reductionist viewpoint focused only on the professional. This approach has become obsolete due to its proven ineffectiveness, especially from an ethics of responsibility and organization viewpoint. CONTEXT The psychological well-being of the healthcare worker (and its opposites: suffering, exhaustion, and disenchantment) is advantageous to the professional's commitment to the institution, to their work performance, and to their personal life. OBJECTIVE The objective of this paper is to reflect on the psychological suffering of the palliative care professional. METHOD We will reflect on the three levels of responsibility that influence such suffering (micro-meso-macro-ethical; worker-environment-institution). RESULTS We will propose a global strategy for the care of psychological well-being supported by scientific evidence and key references. SIGNIFICANCE OF RESULTS We conclude with some contributions on what we have learned and still have to learn on this topic.
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Affiliation(s)
- Beatriz Moreno-Milan
- Department of Palliative Care, Hospital de la Fuenfria, Cercedilla, Madrid, Spain
| | - Bill Breitbart
- Memorial Sloan-Kettering Cancer Center, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Benjamin Herreros
- Instituto de Ética Clínica Francisco Vallés, Universidad Europea de Madrid Campus de Villaviciosa de Odón, Madrid, Spain
| | | | - María Cristina Coca Pereira
- Instituto de Ética Clínica Francisco Vallés, Universidad Europea de Madrid Campus de Villaviciosa de Odón, Madrid, Spain
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Pluut H, Wonders J. Not Able to Lead a Healthy Life When You Need It the Most: Dual Role of Lifestyle Behaviors in the Association of Blurred Work-Life Boundaries With Well-Being. Front Psychol 2020; 11:607294. [PMID: 33424717 PMCID: PMC7786197 DOI: 10.3389/fpsyg.2020.607294] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 11/25/2020] [Indexed: 12/21/2022] Open
Abstract
As there is a growing trend for people to work from home, precipitated by the COVID-19 pandemic, this research examines the impact of blurred work-life boundaries on lifestyle and subjective well-being. Our cross-sectional study in the Netherlands demonstrates that heightened levels of blurred work-life boundaries predict negative changes in happiness through enhanced emotional exhaustion. In addition, the findings point to a dual role of lifestyle in this process. On the one hand, we observed that healthy overall lifestyle patterns buffered employees against the detrimental effects of blurred work-life boundaries and emotional exhaustion on happiness. On the other hand, employees who experienced increases in blurring of work-life boundaries reported a deterioration in healthy lifestyle behaviors, which in turn was related to reduced happiness. Paradoxically, it seems that those who would benefit the most from a healthy lifestyle are less able to sustain health-promoting behaviors. A case for shared responsibility between employers and employees is built as we discuss the practical implications of the current research.
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Affiliation(s)
- Helen Pluut
- Department of Business Studies, Leiden University, Leiden, Netherlands
| | - Jaap Wonders
- SMC Rijnland Fysiotherapeuten, Leiden, Netherlands
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Abstract
OBJECTIVE Healthcare professionals who work in palliative care units face stressful life events on a daily basis, most notably death. For this reason, these professionals must be equipped with the necessary protective resources to help them cope with professional and personal burnout. Despite the well-recognized importance of the construct "meaning of work," the role of this construct and its relationship with other variables is not well-understood. Our objective is to develop and evaluate a model that examines the mediating role of the meaning of work in a multidisciplinary group of palliative care professionals. Using this model, we sought to assess the relationships between meaning of work, perceived stress, personal protective factors (optimism, self-esteem, life satisfaction, personal growth, subjective vitality), and sociodemographic variables. METHOD Professionals (n = 189) from a wide range of disciplines (physicians, psychologists, nurses, social workers, nursing assistants, physical therapists, and chaplains) working in palliative care units at hospitals in Madrid and the Balearic Islands were recruited. Sociodemographic variables were collected and recorded. The following questionnaires were administered: Meaning of Work Questionnaire, Perceived Stress Questionnaire, Life Orientation Test-Revised, Satisfaction with Life Scale, Subjective Vitality Scale, Rosenberg Self-Esteem Scale, and the Personal Growth Scale. RESULT The explanatory value of the model was high, explaining 49.5% of the variance of life satisfaction, 43% of subjective vitality, and 36% of personal growth. The main findings of this study were as follow: (1) meaning of work and perceived stress were negatively correlated; (2) optimism and self-esteem mediated the effect of stress on the meaning attached to work among palliative care professionals; (3) the meaning of work mediated the effect of stress on subjective vitality, personal growth, and life satisfaction; and (4) vitality and personal growth directly influenced life satisfaction. SIGNIFICANCE OF RESULTS The proposed model showed a high explanatory value for the meaning professionals give to their work and also for perceived stress, personal protective factors, and sociodemographic variables. Our findings could have highly relevant practical implications for designing programs to promote the psychological well-being of healthcare professionals.
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Kapu AN, Borg Card E, Jackson H, Kleinpell R, Kendall J, Lupear BK, LeBar K, Dietrich MS, Araya WA, Delle J, Payne K, Ford J, Dubree M. Assessing and addressing practitioner burnout: Results from an advanced practice registered nurse health and well-being study. J Am Assoc Nurse Pract 2019; 33:38-48. [PMID: 31702604 DOI: 10.1097/jxx.0000000000000324] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 08/08/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Numerous nursing and physician studies have reported the effects of workload, environment, and life circumstances contributing to burnout. Effects may include job dissatisfaction, poor quality of life, and associated negative patient outcomes. Although assessing clinician burnout to determine effective interventions has become a topic of great importance, there are minimal studies specific to advanced practice registered nurses (APRNs). PURPOSE This single-center study was conducted to assess the prevalence and impact of APRN burnout and to recommend targeted interventions toward improvement of overall health and well-being. METHODS A cross-sectional, mixed methods design was used. The voluntary, anonymous survey examined perceptions of wellness, inclusion, social support, personal coping mechanisms, and status of burnout. RESULTS The 78-question survey was sent to 1,014 APRNs (94%) and PAs (6%), with a 43.6% response rate (n = 433); 76.4% were nurse practitioners. Participants were identified as currently experiencing burnout, formerly burned out, or never having experienced burnout. Profiles were developed, and similarities and differences between each group were compared. Of 433 respondents, 40.4% (n = 175) reported having never experienced burnout, 33.3% (n = 144) reported they had formerly experienced burnout, and 26.3% (n = 114) reported they were currently experiencing burnout. IMPLICATIONS FOR PRACTICE The results of the study identified that some APRNs report experiencing burnout at different times in their careers. Recommendations by participants to mitigate burnout included self-care, organizational promotion of health and well-being, career development, and leadership support. This study is one of the first to report on burnout among APRNs and potential interventions to build resilience; however, additional research is warranted.
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Affiliation(s)
- April N Kapu
- Advanced Practice, Vanderbilt University Medical Center and Professor of Clinical Nursing, Vanderbilt University School of Nursing, Nashville, Tennessee
| | | | - Heather Jackson
- Outpatient Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Ruth Kleinpell
- Vanderbilt University School of Nursing, Nashville, Tennessee
| | - Jim Kendall
- Work/Life Connections-EAP, Vanderbilt University School of Nursing, Nashville, Tennessee
| | - Buffy Krauser Lupear
- Office of Advanced Practice, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Kiersten LeBar
- Vanderbilt Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Mary S Dietrich
- Vanderbilt University Schools of Medicine and Nursing, Nashville, Tennessee
| | - Wendy A Araya
- Neonatal Intensive Care Practitioners, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Janelle Delle
- Trauma Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Kate Payne
- Center for Biomedical Ethics and Society, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Jaquelyn Ford
- Neurosurgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Marilyn Dubree
- Vanderbilt University Medical Center, Nashville, Tennessee
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Schwartz SP, Adair KC, Bae J, Rehder KJ, Shanafelt TD, Profit J, Sexton JB. Work-life balance behaviours cluster in work settings and relate to burnout and safety culture: a cross-sectional survey analysis. BMJ Qual Saf 2018; 28:142-150. [PMID: 30309912 PMCID: PMC6365921 DOI: 10.1136/bmjqs-2018-007933] [Citation(s) in RCA: 80] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 06/11/2018] [Accepted: 08/07/2018] [Indexed: 11/09/2022]
Abstract
Background Healthcare is approaching a tipping point as burnout and dissatisfaction with work-life integration (WLI) in healthcare workers continue to increase. A scale evaluating common behaviours as actionable examples of WLI was introduced to measure work-life balance. Objectives (1) Explore differences in WLI behaviours by role, specialty and other respondent demographics in a large healthcare system. (2) Evaluate the psychometric properties of the work-life climate scale, and the extent to which it acts like a climate, or group-level norm when used at the work setting level. (3) Explore associations between work-life climate and other healthcare climates including teamwork, safety and burnout. Methods Cross-sectional survey study completed in 2016 of US healthcare workers within a large academic healthcare system. Results 10 627 of 13 040 eligible healthcare workers across 440 work settings within seven entities of a large healthcare system (81% response rate) completed the routine safety culture survey. The overall work-life climate scale internal consistency was α=0.830. WLI varied significantly among healthcare worker role, length of time in specialty and work setting. Random effects analyses of variance for the work-life climate scale revealed significant between-work setting and within-work setting variance and intraclass correlations reflected clustering at the work setting level. T-tests of top versus bottom WLI quartile work settings revealed that positive work-life climate was associated with better teamwork and safety climates, as well as lower personal burnout and burnout climate (p<0.001). Conclusion Problems with WLI are common in healthcare workers and differ significantly based on position and time in specialty. Although typically thought of as an individual difference variable, WLI appears to operate as a climate, and is consistently associated with better safety culture norms.
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Affiliation(s)
- Stephanie P Schwartz
- Department of Pediatrics, Univerity of North Carolina at Chapel Hill Children's Hospital, Chapel Hill, North Carolina, USA
| | - Kathryn C Adair
- Patient Safety Center, Duke University Health System, Durham, North Carolina, USA
| | - Jonathan Bae
- Duke Hospital Medicine Association, Duke University, Durham, North Carolina, USA
| | - Kyle J Rehder
- Department of Pediatrics, Duke University Children's Hospital and Health Center, Durham, North Carolina, United States
| | | | - Jochen Profit
- Department of Pediatrics, Stanford University, Stanford, North Carolina, USA
| | - J Bryan Sexton
- Patient Safety Center, Duke University Health System, Durham, North Carolina, USA
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Abstract
CONTEXT The literature regarding work-life balance (WLB) is plentiful, particularly in the National Collegiate Athletic Association Division I collegiate setting due to its demanding nature as defined by work hours and travel. Despite the comprehensive understanding of factors contributing to WLB for athletic trainers (ATs) in this setting, the effect of time of year has yet to be investigated. OBJECTIVE To determine the influence sport season timing (ie, preseason, in-season, off-season) can have on perceptions and experiences of WLB for ATs. DESIGN Qualitative, case-study design. SETTING Division I collegiate practice setting. PATIENTS OR OTHER PARTICIPANTS Six ATs employed in the Division I college setting (3 women, 3 men) volunteered and completed our study over 1 year. The average age of participants was 31.0 ± 3 years, and they had 9.0 ± 3 years of experience. DATA COLLECTION AND ANALYSIS We conducted semistructured one-on-one phone interviews with each participant at 4 points during the year (August, November, February, June). All interviews were transcribed verbatim. Data were analyzed inductively, and we used peer review, multiple-analyst triangulation, and member checks for credibility. RESULTS Time of year (eg, competitive in-season), organizational demands (eg, hours and travel), and life stage (eg, roles assumed) were factors that influenced WLB for ATs in the collegiate setting. Having a positive and adaptable mind-set; having coworker, supervisor, and personal support; and engaging in personal or family time were factors that counterbalanced the inhibitors. CONCLUSIONS Our results indicate that a career as an AT in the collegiate setting can create WLB concerns; these concerns, however, seem to peak during the competitive in-season for the AT's primary coverage team. Additionally, conflict that arises for ATs seems to be stimulated by time, as work roles are often less accommodating due to the athletic atmosphere.
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Affiliation(s)
- Stephanie Mazerolle
- Department of Kinesiology, Athletic Training Program, College of Agriculture, Health, and Natural Resources, University of Connecticut, Storrs
| | - Christianne Eason
- Department of Kinesiology, Athletic Training Program, College of Agriculture, Health, and Natural Resources, University of Connecticut, Storrs
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Mazerolle SM, Eason CM. Perceptions of National Collegiate Athletic Association Division I Female Athletic Trainers on Motherhood and Work-Life Balance: Individual- and Sociocultural-Level Factors. J Athl Train 2015; 50:854-61. [PMID: 26067427 DOI: 10.4085/1062-6050-50.5.02] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT A multilevel model of work-life balance (WLB) has been established in the sports management literature to explain interactions among organizational/structural, individual, and sociocultural factors and their effects on individual responses and attitudes toward WLB. These factors influence experiences and outcomes related to WLB. OBJECTIVE To examine individual and sociocultural factors that may influence perceptions of female athletic trainers (ATs) employed in the National Collegiate Athletic Association Division I setting, particularly any sex-specific influences. DESIGN Qualitative study. SETTING National Collegiate Athletic Association Division I. PATIENTS OR OTHER PARTICIPANTS A total of 27 women (14 single with no children, 6 married with no children, 7 married with children) currently employed as full-time ATs in the Division I setting participated. DATA COLLECTION AND ANALYSIS Participants responded to a series of open-ended questions via reflective journaling. Data were examined using a general inductive approach. Trustworthiness was established by multiple-analyst triangulation, member interpretive review, and peer review. RESULTS Participants recognized that their sex played a role in assessing WLB and a long-term career as an AT. In addition, they identified various individual- and sociocultural-level factors that affected their perceptions of WLB and attitudes toward a career goal. CONCLUSIONS Our data suggested that female ATs may hold traditional sex ideologies of parenting and family roles, which may influence their potential for career longevity.
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Affiliation(s)
- Stephanie M Mazerolle
- Department of Kinesiology, Athletic Training Program, University of Connecticut, Storrs
| | - Christianne M Eason
- Department of Kinesiology, Athletic Training Program, University of Connecticut, Storrs
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Mazerolle SM, Pitney WA, Eason CM. Experiences of Work-Life Conflict for the Athletic Trainer Employed Outside the National Collegiate Athletic Association Division I Clinical Setting. J Athl Train 2015; 50:748-59. [PMID: 25879575 DOI: 10.4085/1062-6050-50.4.02] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT The intercollegiate setting receives much of the scholarly attention related to work-life conflict (WLC). However research has been focused on the National Collegiate Athletic Association Division I setting. Multiple factors can lead to WLC for the athletic trainer (AT), including hours, travel, and lack of flexibility in work schedules. OBJECTIVE To investigate the experiences of WLC among ATs working in the non-Division I collegiate setting and to identify factors that contribute to fulfillment of work-life balance in this setting. DESIGN Qualitative study. SETTING Institutions in the National Collegiate Athletic Association Divisions II and III, the National Association of Intercollegiate Athletics, and the National Junior College Athletic Association. PATIENTS OR OTHER PARTICIPANTS A total of 244 ATs (128 women, 114 men; age = 37.5 ± 13.3 years, experience = 14 ± 12 years) completed phase I. Thirteen participants (8 women, 5 men; age = 38 ± 13 years, experience = 13.1 ± 11.4 years) completed phase II. DATA COLLECTION AND ANALYSIS For phase I, participants completed a previously validated and reliable (Cronbach α > .90) Web-based survey measuring their levels of WLC and work-family conflict (WFC). This phase included 2 WFC scales defining family; scale 1 defined family as having a partner or spouse with or without children, and scale 2 defined family as those individuals, including parents, siblings, grandparents, and any other close relatives, involved in one's life. Phase II consisted of an interview. Qualitative data were evaluated using content analysis. Data source and multiple-analyst triangulation secured credibility. RESULTS The WFC scores were 26.33 ± 7.37 for scale 1 and 20.46 ± 10.14 for scale 2, indicating a moderate level of WFC for scale 1 and a low level of WFC for scale 2. Qualitative analyses revealed that organizational dimensions, such as job demands and staffing issues, can negatively affect WLC, whereas a combination of organizational and personal dimensions can positively affect WLC. CONCLUSIONS Overload continues to be a prevalent factor in negatively influencing WLC and WFC. Supervisor and peer support, personal networks, and time away from the role positively influenced work-life balance and WFC. Athletic trainers are encouraged to support one another in the workplace, especially when providing flexibility in scheduling.
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Morparia K. Work-Life Balance: Striking the Right Chords for Harmony. Front Pediatr 2015; 3:122. [PMID: 26793698 PMCID: PMC4709414 DOI: 10.3389/fped.2015.00122] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Accepted: 12/24/2015] [Indexed: 11/20/2022] Open
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Goodman A, Mazerolle SM, Pitney WA. Achieving work-life balance in the National Collegiate Athletic Association Division I setting, part II: perspectives from head athletic trainers. J Athl Train 2014; 50:89-94. [PMID: 25098746 DOI: 10.4085/1062-6050-49.3.87] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Work-life balance has been examined at the collegiate level from multiple perspectives except for the athletic trainer (AT) serving in a managerial or leadership role. OBJECTIVE To investigate challenges and strategies used in achieving work-life balance from the perspective of the head AT at a National Collegiate Athletic Association Division I university. DESIGN Qualitative study. SETTING Web-based management system. PATIENTS OR OTHER PARTICIPANTS A total of 18 head ATs (13 men, 5 women; age = 44 ± 8 years, athletic training experience = 22 ± 7 years) volunteered. DATA COLLECTION AND ANALYSIS Participants journaled their thoughts and experiences in response to a series of questions. To establish data credibility, we included multiple-analyst triangulation, stakeholder checks, and peer review. We used a general inductive approach to analyze the data. RESULTS Two higher-order themes emerged from our analysis of the data: organizational challenges and work-life balance strategies. The organizational challenges theme contained 2 lower-order themes: lack of autonomy and role demands. The work-life balance strategies theme contained 3 lower-order themes: prioritization of commitments, strategic boundary setting, and work-family integration. CONCLUSIONS Head ATs are susceptible to experiencing work-life imbalance just as ATs in nonsupervisory roles are. Although not avoidable, the causes are manageable. Head ATs are encouraged to prioritize their personal time, make efforts to spend time away from their demanding positions, and reduce the number of additional responsibilities that can impede time available to spend away from work.
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Affiliation(s)
- Ashley Goodman
- Department of Health and Exercise Science, Appalachian State University, Boone, NC
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Affiliation(s)
- Andreas Schwingshackl
- Division of Critical Care Medicine, Department of Pediatrics, University of Tennessee Health Science Center , Memphis, TN , USA
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Mazerolle SM, Gavin K. Female athletic training students' perceptions of motherhood and retention in athletic training. J Athl Train 2013; 48:678-84. [PMID: 23725461 DOI: 10.4085/1062-6050-48.3.05] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Motherhood appears to be a catalyst in job turnover for female athletic trainers, especially those employed at the National Collegiate Athletic Association Division I level. However, most researchers examining this topic have investigated the perspectives of those who are currently employed rather than those who are preparing to enter the profession. OBJECTIVE To evaluate female athletic training students' perceptions of motherhood and retention. DESIGN Qualitative study. SETTING Athletic training education program. PATIENTS OR OTHER PARTICIPANTS A total of 18 female athletic training students volunteered to participate. They were enrolled in 1 Commission on Accrediting Athletic Training Education-accredited athletic training program and represented 3 levels of academic STUDY. DATA COLLECTION AND ANALYSIS The participants responded to a series of questions related to work-life balance and retention in athletic training. Analysis of the data followed a general inductive process. Credibility was established by interpretive member checks and peer review. RESULTS The first theme, clinical setting, speaks to the belief that work-life balance and retention in athletic training require an employment setting that fosters a family-friendly atmosphere and a work schedule (including travel) that allows for time at home. The second theme, mentorship, reflects the acknowledgment that a female mentor who is successful in balancing the roles of mother and athletic trainer can serve as a role model. The final theme, work-life balance strategies, illustrates the need to have a plan in place to meet the demands of both home and work life. CONCLUSIONS A female athletic trainer who is successfully balancing her career and family responsibilities may be the most helpful factor in retention, especially for female athletic training students. Young professionals need to be educated on the importance of developing successful work-life balance strategies, which can be helpful in reducing attrition from the profession.
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Straus SE, Sackett DL. Clinician-trialist rounds: 10. Mentoring – part 4: attributes of an effective mentor. Clin Trials 2012; 9:367-9. [DOI: 10.1177/1740774512440343] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Sharon E Straus
- Dr Straus is a general internist, geriatrician, and clinical researcher at St. Michael’s Hospital, University of Toronto. She directs the Division of Geriatric Medicine at the University and is Director of the Knowledge Translation Program at the Li Ka Shing Knowledge Institute
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