Burnout level and job satisfaction in Chinese pediatrics residents: A web-based cross-sectional study

The Relationship between Burnout and Sense of School Belonging among the Resident Physicians in the Standardization Training in China

BACKGROUND

As an important part in medical training in graduate school, 33-month medical residency training could be a stressful period inducing burnout (i.e. emotional exhaustion, depersonalization, and low personal accomplishment). Despite that existing literature has found that sense of belonging may have merits for residents' well-being, it has remained unclear how sense of school belonging affects burnout and the potential moderators. To address this question, a cross-sectional survey has been conducted among the residents of the physicians standardized residency training program in China.

METHODS

Seven hundred (N = 700) resident physicians from different majors (i.e. clinical medicine, clinical Stomatology, and Chinese medicine) and grades have participated in the survey. Resident's sense of school belonging was assessed with the psychological sense of school membership scale (PSSM, mean = 45.12, SD = 11.14). Burnout was measured by the 22-item Maslach Burnout Inventory (MBI-HSS, mean = 65.80, SD = 15.89), including three subscales of emotional exhaustion, depersonalization, and personal accomplishment.

RESULTS

The results showed that over 80% of the residents reported moderate or high level of emotional exhaustion and reduced personal accomplishment during residency training. Meanwhile, higher level of sense of school belonging was associated with lower overall burnout (B = -0.722, p < 0.001), less emotional exhaustion, reduced depersonalization, and higher personal accomplishment. In particular, the benefits of sense of belonging seem more pronounced among female and those at earlier stage of residency. No interaction effect was found between sense of belonging and major, while those from Chinese medicine reported lower scores in overall burnout and the three dimensions.

CONCLUSIONS

Burnout was a prevalent issue among the resident physicians, and our findings confirmed the protective effects of sense of school belonging against burnout. Therefore, support service should be developed to cultivate resident's sense of school belonging and social connections, particularly for female and those at earlier stage of residency.

Nurse managers' burnout and organizational support: The serial mediating role of leadership and resilience

AIMS

To investigate the relationship between organizational support and nurse managers' burnout and the serial multiple mediating effects of leadership and resilience.

BACKGROUND

Nurse managers are at a high risk of burnout, especially during the COVID-19 pandemic. However, no research has been done to examine the associations between nurse managers' organizational support, leadership, resilience and burnout.

METHODS

This cross-sectional study recruited 458 nurse managers from 13 tertiary public hospitals in Jiangsu, China. They completed the Survey of Perceived Organizational Support, the Clinical Leadership Survey, the Resilience Scale and the Maslach Burnout Inventor-Human Service Survey. The serial mediating effect of individual leadership and resilience was estimated using the structural equation modelling method via Mplus 7.0.

RESULTS

There were direct and indirect effects of organizational support on burnout, controlling for work variables. Leadership and resilience serially mediate the association between organizational support and burnout (β = -.051, 95% confidence interval: -0.093 to -0.020).

CONCLUSIONS

Among nurse managers, organizational support may be sequentially associated with improved leadership first and then resilience, which in turn is related to decreased burnout.

IMPLICATIONS FOR NURSING MANAGEMENT

We recommend that hospital administrators incorporate leadership, resilience and burnout assessment in the routine psychological screening of nurse managers and creatively apply the organizational interventions to decrease nurse managers' burnout.

Psychometric properties of the Spanish version of the Copenhagen Burnout Inventory in Mexican medical residents

BACKGROUND

Studies on the psychometric properties of the Copenhagen Burnout Inventory (CBI) in medical residents are scarce despite their susceptibility to burnout. Moreover, none of these studies were conducted in Spanish.

AIM OF THE STUDY

To analyze the psychometric properties of the Spanish version of the CBI among Mexican medical residents.

METHODS

This cross-sectional study was conducted online on medical residents from a public medical institution (n = 525). The English version of the CBI (19 items organized into three domains: personal-related burnout, work-related burnout, and patient-related burnout) was translated into Spanish and again into English. Content, convergent, discriminant, and concurrent validity were assessed, along with reliability.

RESULTS

The CBI Spanish version showed acceptable content, convergent and concurrent validity. Exploratory factor analysis showed two factors, but confirmatory factor analysis showed three factors with adequate fit (Root Mean Square Error of Approximation = 0.08, Comparative Fit Index = 0.95, Tucker-Lewis Index = 0.94, and Standardized Root Mean Square Residual = 0.04). There was no good discrimination between personal-related and work-related burnout. Cronbach's alpha coefficients for the personal-related, work-related, and patient-related burnout domains were 0.94, 0.95, and 0.93, respectively.

CONCLUSIONS

The Spanish version of the CBI in Mexican medical residents is reliable, and it meets adequate content, convergent and concurrent validity. The construct validity was not consistent. This should not diminish the importance of the CBI.

Association between sleep disturbance and mental health of healthcare workers: A systematic review and meta-analysis

OBJECTIVES

Sleep disturbance and mental health are challenges for healthcare workers (HCWs). Especially during the COVID-19 pandemic, they experienced more severe sleep and mental health problems. However, the association between sleep disturbance and the mental health of HCWs is still controversial. This study aimed to systematically review the relationship by conducting a systematic review and meta-analysis.

METHOD

Two researchers retrieved the literature from Web of Science, PubMed, EMBASE, CINAHL, Psyclnfo, and Cochrane Library from the establishment of the databases until November 20, 2021. We used the New Castle-Ottawa Scale (NOS) and Agency for Healthcare Research and Quality (AHRQ) to evaluate the risk of bias in prospective research and cross-sectional research, respectively. The major exposure was HCWs' sleep disturbance, and the major outcome was mental health. The correlation coefficients (r), regression coefficients (β) and odds ratios (OR) of the included studies were integrated.

RESULT

Fifty-nine studies were included for qualitative analysis, of which 30 studies could be combined and entered into quantitative analysis. There were 23 studies during the COVID-19 pandemic among the 59 included studies. The results of the meta-analysis showed that the correlation coefficient between sleep disturbance and mental health was 0.43 (95% CI: 0.39-0.47). HCWs with sleep disturbance had a 3.74 (95% CI: 2.76-5.07) times higher risk of mental health problems than those without sleep disturbance. The correlation coefficient during the COVID-19 epidemic was 0.45 (95% CI: 0.37-0.53), while it was 0.40 (95% CI: 0.36-0.44) during the non-epidemic period. Subgroup analysis compared the OR results in epidemic and non-epidemic periods of COVID-19, which were 4.48 (95% CI: 2.75-5.07) and 3.74 (95% CI: 2.74-7.32), respectively.

CONCLUSION

Sleep disturbance and mental health problems were positively correlated among HCWs. Particularly in the COVID-19 pandemic, more attention should be given to this issue.

Prevalence of burnout among university students in low- and middle-income countries: A systematic review and meta-analysis

BACKGROUND

Burnout is common among university students and may adversely affect academic performance. Little is known about the true burden of this preventable malady among university students in low-and-middle-income countries (LMICs).

OBJECTIVES

This study aimed to systematically estimate the prevalence of burnout among university students in LMICs.

METHODS

We searched PubMed, Google Scholar, CINAHL, Web of Science, African Journals Online, and Embase from the inception of each database until February 2021. Original studies were included. No study design or language restrictions were applied. A random-effects meta-analysis was performed using STATA version 16.0. Heterogeneity and publication bias were assessed using Q-statistics and funnel plots, respectively.

RESULTS

Fifty-five unique articles, including a total of 27,940 (Female: 16,215, 58.0%) university students from 24 LMICs were included. The Maslach Burnout Inventory (MBI) was used in 43 studies (78.2%). The pooled prevalence of burnout was 12.1% (95% Confidence Interval (CI) 11.9-12.3; I2 = 99.7%, Q = 21,464.1, p = < 0.001). The pooled prevalence of emotional exhaustion (feelings of energy depletion), cynicism (negativism), and reduced professional efficacy were, 27.8% (95% CI 27.4-28.3; I2 = 98.17%. p = <0.001), 32.6 (95% CI: 32.0-33.1; I2: 99.5%; p = < 0.001), and 29.9% (95% CI: 28.8-30.9; I2: 98.1%; p = < 0.001), respectively.

CONCLUSION

Nearly one-third of university students in LMICs experience burnout. More studies are needed to understand the causes of burnout in this key population. There is a need to validate freely available tools for use in these countries.

Influencing Factors of Outpatients' Satisfaction in China a Cross-Sectional Study of 16 Public Tertiary Hospitals

PURPOSE

This study aimed to analyze the status of patient satisfaction in outpatients of tertiary hospitals and the factors affecting patient satisfaction, in order to provide a scientific basis for improving patient satisfaction.

METHODS

A total of 6480 surveys of outpatients were conducted by a cross-sectional study in 16 tertiary hospitals in the Zhejiang province of China. The main contents of the survey were the basic characteristics of patients. Statistical description, single-factor analysis and binary logistic regression analysis were used to screen influencing factors.

RESULTS

Results of this study showed that the total satisfaction score of outpatients was 87.13±13.47, and higher scored factors in the survey factors were nursing level, the convenience of registration and convenience of appointment diagnosis and treatment. The factors with lower scores were treatment effect, environmental sanitation and comfort and other staffs' attitudes. Hospital managers should pay attention to the improvement of treatment level, environmental sanitation and comfort and other staffs' attitudes.

CONCLUSION

In the process of serving outpatients, doctors should pay more attention to patients who are male, 31-45 years old or over 60 years old, permanent residents, from public institutions, possessed postgraduate education, without medical insurance, and who visiting paediatrics and Chinese medicine hospitals.

Risk and protective factors for burnout among physicians from standardized residency training programs in Shanghai: a cross-sectional study

Background

High burnout has been reported in physician populations. Although the standardized residency training (SRT) in China includes components that might put residents at a higher risk for burnout, the burnout of Chinese medical residents is unknown. This study aimed to evaluate the prevalence of burnout and the associated risk and protective factors for medical residents in the SRT program in Shanghai, China.

Methods

This study was a prospective cross-sectional design. A random sampling strategy was used to recruit 330 resident physicians from four SRT sites in Shanghai, and 318 completed questionnaires were returned. Respondents completed a self-made questionnaire including demographic and work characteristics, four burnout and wellness-specific surveys. Bivariate analyses and hierarchical multiple regression models were used to analyze factors associated with three sub-scales of burn out separately.

Results

The overall burnout rate was 71.4%. Low level rate of personal accomplishment (PA) was extremely high at 69.5%. Night shift experience, high occupational stress, and low social support were significant predictors, which explained 49.1% variance of emotional exhaustion (EE) (F = 26.528, P < 0.01). Factors that significantly predicted depersonalization (DP) included male gender, senior residents, night shift experience, high occupational stress, and low psychological empathy, which explained 51.5% variance totally (F = 29.004, P < 0.01). Senior residents, high income, low occupational stress, and high empathy were also significant predictors of decreased personal achievement (PA), which explained 18.4% variance totally (F = 12.897, P < 0.01).

Conclusions

There was a high burnout rate among SRT residents in Shanghai. Occupational stress and several work-related factors were significant and strong risk factors for burnout, while empathy and social support were mild protective factors. Decreased work-related demands and increased access to resources could assist residents in reducing their work stress and improving their well-being.