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Swancott L, Armstrong N, Roland D, Walters HL, Kirk K. Emergency department workforces' experiences and perceptions of well-being from an international perspective: a scoping review. BMJ Open 2024; 14:e087485. [PMID: 38986554 PMCID: PMC11288155 DOI: 10.1136/bmjopen-2024-087485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Accepted: 06/03/2024] [Indexed: 07/12/2024] Open
Abstract
OBJECTIVES To identify and present the available evidence regarding workforce well-being in the emergency department. DESIGN Scoping review. SETTING The emergency department (ED). DATA SOURCES CINAHL, MEDLINE, APA PsycINFO and Web of Science were searched with no publication time parameters. The reference lists of articles selected for full-text review were also screened for additional papers. ELIGIBILITY CRITERIA FOR STUDY SELECTION All peer-reviewed, empirical papers were included if: (1) participants included staff-based full-time in the ED, (2) ED workforce well-being was a key component of the research, (3) English language was available and (4) the main focus was not burnout or other mental illness-related variables. RESULTS The search identified 6109 papers and 34 papers were included in the review. Most papers used a quantitative or mixed methods survey design, with very limited evidence using in-depth qualitative methods to explore ED workforce well-being. Interventions accounted for 41% of reviewed studies. Findings highlighted pressing issues with ED workforce well-being, contributed to by a range of interpersonal, organisational and individual challenges (eg, high workloads, lack of support). However, the limited evidence base, tenuous conceptualisations and links to well-being in existing literature mean that the findings were neither consistent nor conclusive. CONCLUSIONS This scoping review highlights the need for more high-quality research to be conducted, particularly using qualitative methods and the development of a working definition of ED workforce well-being.
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Affiliation(s)
- Lucy Swancott
- Population Health Sciences, University of Leicester, Leicester, UK
| | | | - Damian Roland
- Population Health Sciences, University of Leicester, Leicester, UK
- Emergency Department, Paediatric Emergency Medicine Leicester Academic (PEMLA) Group, Leicester, UK
| | - Helen L Walters
- Population Health Sciences, University of Leicester, Leicester, UK
| | - Kate Kirk
- Population Health Sciences, University of Leicester, Leicester, UK
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de Vargas D, Volpato RJ, Dos Santos LC, Pereira CF, de Oliveira SR, da Silva RR, Maciel MED, Fernandes IL, de Oliveira Santana K, Aguilar TF. Prevalence of psychological and mental health symptoms among nursing professionals during the COVID-19 pandemic in the Americas: Systematic review and meta-analysis. Int J Ment Health Nurs 2024; 33:582-599. [PMID: 38151828 DOI: 10.1111/inm.13274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 11/14/2023] [Accepted: 11/29/2023] [Indexed: 12/29/2023]
Abstract
To assess the prevalence of mental health symptoms in nursing professionals during the COVID-19 pandemic on the American continent. A systematic review and meta-analysis of observational studies that estimated the prevalence of mental health symptoms in nursing professionals during the COVID-19 pandemic was performed through bibliographic database searches. A three-level meta-analysis model was used with the inverse variance method, tau was estimated via restricted maximum likelihood and logistic transformation, and heterogeneity was presented as tau2 and I2. Of the 7467 studies obtained, 62 were included in the meta-analysis, which involved 52 270 nursing professionals. The overall prevalence for at least one mental health symptom was 56.3% (50.4%, 62.1%; I2 = 98.6%, p < 0.001). Eight mental health symptoms were found; among them, the most prevalent were burnout (52.1%, 37.1%, 88.8%; I2 = 98.5%, p < 0.001) and fear (52.1%, 30.1%, 73.3%; I2 = 98.1%, p < 0.001). The prevalence of mental health symptoms in nursing professionals during the COVID-19 pandemic on the American continent was high, and strategies should be developed and implemented by managers and government agencies to promote the well-being, physical and mental health of nursing professionals. Studies like this one are necessary to highlight the need for efforts in the implementation of promotion and prevention actions to be developed by health organisations, managers and leaders with a view to improving the quality of life of nursing workers.
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Affiliation(s)
| | | | | | | | | | | | - Marjorie Ester Dias Maciel
- Nucleon of Addiction Nursing Research, School of Nursing (NEPEEA), University of São Paulo, São Paulo, Brazil
| | | | | | - Thiago Faustino Aguilar
- Nucleon of Addiction Nursing Research, School of Nursing (NEPEEA), University of São Paulo, São Paulo, Brazil
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Bütün A, Yeşil Y. A Cross-Sectional Study of Emergency Care Services During the COVID-19 Pandemic: A Multicenter Study of Healthcare Staff Perspectives. Cureus 2024; 16:e61475. [PMID: 38952588 PMCID: PMC11215561 DOI: 10.7759/cureus.61475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2024] [Indexed: 07/03/2024] Open
Abstract
INTRODUCTION The coronavirus disease 2019 (COVID-19) pandemic has significantly impacted various aspects of healthcare services, including emergency care services. Healthcare staff face mental issues and physical exertion when caring for patients potentially infected with COVID-19. Understanding the experiences and perspectives of emergency department (ED) healthcare staff during the COVID-19 pandemic is essential to inform evidence-based interventions and strategies to mitigate the impact on emergency care services. This study aims to investigate the experiences of ED healthcare staff regarding emergency care services during the COVID-19 pandemic, thus providing valuable insights into the challenges faced. MATERIALS AND METHODS This study utilized a cross-sectional study design. Data were collected from 256 ED healthcare staff working in nine different hospitals located in Turkey between November 15, 2021, and December 30, 2021. Data were analyzed using descriptive statistics. RESULTS A total of 256 participants were included in the study. Of the participants, 58.6% were nurses, 19.5% were ED doctors, and 21.9% were emergency medical technicians. In addition, 67.2% of the participants were infected with COVID-19, and almost all of them (94.1%) were psychologically affected by the pandemic process. It was found that 85.2% of ED healthcare staff felt excluded by society due to being healthcare staff and 71.9% had to be separated from their families. Nurses were separated from their families at the highest rate (78%) during this period. CONCLUSION More than half of the ED healthcare staff had problems accessing protective equipment and were separated from their families during the pandemic due to the risk of COVID-19 transmission. Although the number of ED visits decreased because of restrictions at the beginning of the pandemic, ED visits increased again with the abolition of restrictions.
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Affiliation(s)
- Ahmet Bütün
- Department of Nursing, Faculty of Health Sciences, Mardin Artuklu University, Mardin, TUR
| | - Yeşim Yeşil
- Department of Midwifery, Faculty of Health Sciences, Mardin Artuklu University, Mardin, TUR
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Wang X, Shao J, Weng A, Lian J, Wen F, Fang Q, Hu Y. Nurses' Personality Traits and Perceived Work Environments During Public Health Emergencies: Implications for Nursing Workforce Planning. Risk Manag Healthc Policy 2024; 17:1199-1209. [PMID: 38737419 PMCID: PMC11088948 DOI: 10.2147/rmhp.s458235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 05/02/2024] [Indexed: 05/14/2024] Open
Abstract
Background The nursing workforce faces substantial challenges, particularly in the aftermath of the COVID-19 era. Developing an effective strategy for workforce maintenance and the strategic deployment of nurses is crucial. Purpose This study aimed to explore and categorize nurses' personality traits, with a focus on analyzing differences in their perceptions of the nursing work environment. Participants and Methods Between January 2023 and February 2023, a multi-center cross-sectional study was carried out involving nurses from 12 tertiary hospitals actively engaged in frontline COVID-19 response duties. Through cluster sampling, surveys were distributed among eligible nursing staff, comprising a general information questionnaire, the Chinese Big Five Personality Questionnaire-Short Form, subjective evaluations of emergency nursing management, and the Chinese Nursing Work Environment Scale for Public Health Emergencies. Various statistical analyses, such as descriptive analysis, cluster analysis, non-parametric tests, and general linear model analysis, were employed to investigate the correlation between personality types and the perception of nursing work environments. Results The analysis encompassed 1059 valid questionnaires, reflecting the experiences of frontline nurses. The majority of these nurses possessed 1-5 years of experience, held junior professional titles, volunteered for their roles, and served as attending nurses. Categorization based on personality traits revealed three groups: resilient (35.60%), ordinary (16.15%), and distressed (48.25%) types. Significantly distinct perceptions of nursing work environments emerged among these categories, with resilient and ordinary types expressing notably higher satisfaction compared to the distressed group (H value = 256.487, p < 0.001). Conclusion This study illustrates the connection between nurses' perceived working environment and their personality traits. Nursing managers should factor in nurses' personality traits when choosing and deploying frontline responders during public health emergencies. Prioritizing resilient-type nurses and crafting a supportive work environment that aligns with nurses' characteristics is indispensable for an effective emergency response.
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Affiliation(s)
- Xiyi Wang
- School of Nursing, Shanghai Jiao Tong University, Shanghai, 200025, People’s Republic of China
| | - Jing Shao
- Institute of Nursing Research and Department of Nursing of Fourth Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, People’s Republic of China
| | - Aozhou Weng
- School of Nursing, Shanghai Jiao Tong University, Shanghai, 200025, People’s Republic of China
| | - Jiaqi Lian
- School of Nursing, Shanghai Jiao Tong University, Shanghai, 200025, People’s Republic of China
| | - Fule Wen
- School of Nursing, Shanghai Jiao Tong University, Shanghai, 200025, People’s Republic of China
| | - Qiong Fang
- School of Nursing, Shanghai Jiao Tong University, Shanghai, 200025, People’s Republic of China
| | - Yun Hu
- School of Nursing, Shanghai Jiao Tong University, Shanghai, 200025, People’s Republic of China
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5
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Schwartz M, Berkowitz J, McCann-Pineo M. Understanding the Role of Empathy and Gender on EMS Clinician Occupational Stress and Mental Health Outcomes. PREHOSP EMERG CARE 2024; 28:635-645. [PMID: 38359401 DOI: 10.1080/10903127.2024.2319139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 02/08/2024] [Indexed: 02/17/2024]
Abstract
BACKGROUND Emergency Medical Service (EMS) clinicians experience high levels of occupational stress due to long hours, short staffing, and patient deaths, among other factors. While gender has been partially examined, little is known regarding the role of empathy on occupational stress and mental health (MH) outcomes among EMS clinicians. Therefore, the current study examines the moderating role of empathy and, separately, gender on associations between occupational stress and mental health. METHODS A cross-sectional examination of EMS clinician occupational and personal wellbeing was conducted via an anonymous, electronic survey. Information on clinician demographics, and validated measures of occupational stress, burnout, and MH outcomes were collected. Empathy was assessed using the Toronto Empathy Scale (TEQ). Descriptive/bivariate statistics were conducted for variables of interest. Separate multivariable regression models evaluated associations between occupational stress and mental health outcomes. Empathy and gender were examined as potential moderators using interactions. RESULTS A total of 568 EMS clinicians completed the survey. High levels of mental health difficulties were reported (34.0% anxiety, 29.2% depression, 48.6% burnout). Increased occupational stress was associated with increased anxiety (OR =1.08, 95% CI 1.05-1.10), depression (OR = 1.09, 95% CI 1.06-1.10), and burnout (OR = 1.10, 95% CI 1.07-1.12). No moderation analyses were significant. Greater resilience was associated with lower depression, anxiety, and burnout. CONCLUSION EMS clinicians, much like other first responders, experience considerable occupational stress, of which is associated with mental health difficulties and burnout. Findings underscore the need for intervention programs aimed at reducing the impact of occupational stress and the promotion of resilience. Continuing to understand the full scope of EMS mental health, including the role of resilience, is imperative, particularly in light of future public emergencies.
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Affiliation(s)
| | - Jonathan Berkowitz
- Northwell, New Hyde Park, New York, USA
- Department of Emergency Medicine, Northshore University Hospital, Manhasset, New York, USA
- Department of Emergency Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
| | - Molly McCann-Pineo
- Northwell, New Hyde Park, New York, USA
- Department of Emergency Medicine, Northshore University Hospital, Manhasset, New York, USA
- Department of Emergency Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
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Barrett JW, Eastley KB, Herbland A, Owen P, Naeem S, Mortimer C, King J, Foster T, Rees N, Rosser A, Black S, Bell F, Fothergill R, Mellett-Smith A, Jackson M, McClelland G, Gowens P, Spaight R, Igbodo S, Brown M, Williams J. The COVID-19 ambulance response assessment (CARA) study: a national survey of ambulance service healthcare professionals' preparedness and response to the COVID-19 pandemic. Br Paramed J 2024; 8:10-20. [PMID: 38445107 PMCID: PMC10910287 DOI: 10.29045/14784726.2024.3.8.4.10] [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: 03/07/2024] Open
Abstract
Background The COVID-19 pandemic placed significant demand on the NHS, including ambulance services, but it is unclear how this affected ambulance service staff and paramedics in other clinical settings (e.g. urgent and primary care, armed services, prisons). This study aimed to measure the self-perceived preparedness and impact of the first wave of the pandemic on paramedics' psychological stress and perceived ability to deliver care. Methods Ambulance clinicians and paramedics working in other healthcare settings were invited to participate in a three-phase sequential online survey during the acceleration (April 2020), peak (May 2020) and deceleration (September/October 2020) phases of the first wave of COVID-19 in the United Kingdom. Recruitment used social media, Trust internal bulletins and the College of Paramedics' communication channels, employing a convenience sampling strategy. Data were collected using purposively developed open- and closed-ended questions and the validated general health questionnaire-12 (GHQ-12). Data were analysed using multi-level linear and logistic regression models. Results Phase 1 recruited 3717 participants, reducing to 2709 (73%) by phase 2 and 2159 (58%) by phase 3. Participants were mostly male (58%, n = 2148) and registered paramedics (n = 1992, 54%). Mean (standard deviation) GHQ-12 scores were 16.5 (5.2) during phase 1, reducing to 15.2 (6.7) by phase 3. A total of 84% of participants (n = 3112) had a GHQ-12 score ≥ 12 during the first phase, indicating psychological distress. Participants that had higher GHQ-12 scores were feeling unprepared for the pandemic, and reported a lack of confidence in using personal protective equipment and managing cardiac arrests in confirmed or suspected COVID-19 patients. Conclusions Most participants reported psychological distress, the reasons for which are multi-factorial. Ambulance managers need to be aware of the risks to staff mental health and take action to mitigate these, to support staff in the delivery of unscheduled, emergency and urgent care under these additional pressures.
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Affiliation(s)
- Jack William Barrett
- South East Coast Ambulance Service NHS Foundation Trust ORCID iD: https://orcid.org/0000-0002-0040-537X
| | | | - Anthony Herbland
- University of Hertfordshire ORCID iD: https://orcid.org/0000-0001-6182-4191
| | - Peter Owen
- South East Coast Ambulance Service NHS Foundation Trust
| | - Salman Naeem
- Barts Health NHS Trust ORCID iD: https://orcid.org/0000-0002-0153-1669
| | - Craig Mortimer
- South East Coast Ambulance Service NHS Foundation Trust ORCID iD: https://orcid.org/0000-0001-6989-2244
| | - James King
- University of Hertfordshire ORCID iD: https://orcid.org/0000-0001-9259-0957
| | - Theresa Foster
- East of England Ambulance Service NHS Trust ORCID iD: https://orcid.org/0000-0002-6395-0885
| | - Nigel Rees
- Welsh Ambulance Services NHS Trust ORCID iD: https://orcid.org/0000-0001-8799-5335
| | - Andy Rosser
- West Midlands Ambulance Service University NHS Foundation Trust ORCID iD: https://orcid.org/0000-0002-5477-4269
| | - Sarah Black
- South Western Ambulance Service NHS Foundation Trust ORCID iD: https://orcid.org/0000-0001-6678-7502
| | - Fiona Bell
- Yorkshire Ambulance Service NHS Trust ORCID iD: https://orcid.org/0000-0003-4503-1903
| | - Rachael Fothergill
- London Ambulance Service NHS Trust ORCID iD: https://orcid.org/0000-0003-1341-6200
| | - Adam Mellett-Smith
- London Ambulance Service NHS Trust ORCID iD: https://orcid.org/0000-0002-6157-8979
| | | | - Graham McClelland
- North East Ambulance Service NHS Foundation Trust ORCID iD: https://orcid.org/0000-0002-4502-5821
| | - Paul Gowens
- Scottish Ambulance Service ORCID iD: https://orcid.org/0000-0002-9311-3885
| | - Robert Spaight
- East Midlands Ambulance Service NHS Trust ORCID iD: https://orcid.org/0000-0003-4361-5876
| | - Sandra Igbodo
- North West Ambulance Service NHS Trust ORCID iD: https://orcid.org/0009-0001-8290-0912
| | - Martina Brown
- South Central Ambulance Service NHS Foundation Trust ORCID iD: https://orcid.org/0000-0003-3083-8958
| | - Julia Williams
- South East Coast Ambulance Service NHS Foundation Trust; University of Hertfordshire; College of Paramedics ORCID iD: https://orcid.org/0000-0003-0796-5465
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Akinleye D, Wu M, Efferen LS, McCauley S, Allen A, Bennett H, Snitkoff LS, Cleary LM, Bliss K, Martiniano R, Wang S, McNutt LA, Osinaga A. Newly Acquired Burnout During the Coronavirus Disease 2019 (COVID-19) Pandemic: A Retrospective Cohort Study on the Experiences of New York State Primary Care Clinicians. J Community Health 2024; 49:34-45. [PMID: 37382837 DOI: 10.1007/s10900-023-01247-z] [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] [Accepted: 06/10/2023] [Indexed: 06/30/2023]
Abstract
The well-being of primary care clinicians represents an area of increasing interest amid concerns that the COVID-19 pandemic may have exacerbated already high prevalence rates of clinician burnout. This retrospective cohort study was designed to identify demographic, clinical, and work-specific factors that may have contributed to newly acquired burnout after the onset of the COVID-19 pandemic. An anonymous web-based questionnaire distributed in August 2020 to New York State (NYS) primary care clinicians, via email outreach and newsletters, produced 1,499 NYS primary care clinician survey respondents. Burnout assessment was measured pre-pandemic and early in the pandemic using a validated single-item question with a 5-point scale ranging from (1) enjoy work to (5) completely burned out. Demographic and work factors were assessed via the self-reporting questionnaire. Thirty percent of 1,499 survey respondents reported newly acquired burnout during the early pandemic period. This was more often reported by clinicians who were women, were younger than 56 years old, had adult dependents, practiced in New York City, had dual roles (patient care and administration), and were employees. Lack of control in the workplace prior to the pandemic was predictive of burnout early in the pandemic, while work control changes experienced following the pandemic were associated with newly acquired burnout. Low response rate and potential recall bias represent limitations. These findings demonstrate that reporting of burnout increased among primary care clinicians during the pandemic, partially due to varied and numerous work environment and systemic factors.
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Affiliation(s)
- Dean Akinleye
- Bureau of Clinical Research and Evaluation, Office of Quality and Patient Safety, New York State Department of Health, Empire State Plaza, Corning Tower, Room 1955, Albany, NY, 12237, USA.
| | - Meng Wu
- Bureau of Clinical Research and Evaluation, Office of Quality and Patient Safety, New York State Department of Health, Empire State Plaza, Corning Tower, Room 1955, Albany, NY, 12237, USA
| | - Linda S Efferen
- Office of Quality and Patient Safety, New York State Department of Health, ESP Corning Tower, Room 2019, Albany, NY, 12237, USA
| | - Susan McCauley
- Office of Quality and Patient Safety, New York State Department of Health, ESP Corning Tower, Room 2019, Albany, NY, 12237, USA
| | - Amanda Allen
- Communications, New York Chapter of the American College of Physicians, PO Box 38237, Albany, NY, 12203, USA
| | - Heather Bennett
- Diversity Equity and Inclusion Task Force, New York Chapter of the American College of Physicians, PO Box 38237, Albany, NY, 12203, USA
| | - Louis S Snitkoff
- Albany Medical College, New York Chapter of the American College of Physicians, PO Box 38237, Albany, NY, 12203, USA
| | - Lynn M Cleary
- Upstate Medical University, 750 East Adams Street, Syracuse, NY, 13210, USA
| | - Kate Bliss
- Office of Health Insurance Programs, New York State Department of Health, ESP Corning Tower, Room, Albany, NY, 12237, USA
| | - Robert Martiniano
- Center for Health Workforce Studies, University at Albany School of Public Health, 1 University Plaza, Pl #220, Rensselaer, NY, 12144, USA
| | - Shen Wang
- Center for Health Workforce Studies, University at Albany School of Public Health, 1 University Plaza, Pl #220, Rensselaer, NY, 12144, USA
| | - Louise-Ann McNutt
- Institute for Health and the Environment, University at Albany, State University of New York, 5 University Place, Room A217, Rensselaer, NY, 12144, USA
| | - Alda Osinaga
- Office of Quality and Patient Safety, New York State Department of Health, ESP Corning Tower, Room 2019, Albany, NY, 12237, USA
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Turnbach E, Coates L, Vanek FD, Cotter E, Pogue CA, Clark RRS, Aiken LH. Emergency Nurses' Well-Being in Magnet Hospitals and Recommendations for Improvements in Work Environments: A Multicenter Cross-Sectional Observational Study. J Emerg Nurs 2024; 50:153-160. [PMID: 37498276 PMCID: PMC10811286 DOI: 10.1016/j.jen.2023.06.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 06/16/2023] [Accepted: 06/25/2023] [Indexed: 07/28/2023]
Abstract
INTRODUCTION This study aimed to determine the well-being outcomes and quality of work environment among emergency nurses compared with inpatient nurses working in Magnet hospitals and identify recommendations in emergency department work environments that hold promise for enhancing emergency nurses' well-being. METHODS This is a cross-sectional analysis of multicenter survey data collected in 2021 from 11,743 nurses practicing in 60 United States Magnet hospitals. Nurses report on burnout, job dissatisfaction, intent to leave, work environment, and recommendations to improve well-being. RESULTS Emergency nurses are significantly more likely to report high burnout (P = .04), job dissatisfaction (P < .001), and intent to leave (P < .001) than inpatient nurses working in the same Magnet hospitals. Emergency nurses are significantly more likely to report insufficient staffing (P = .001), an unfavorable work environment (P < .001), and lack confidence that management will act to resolve problems in patient care (P < .001) but did report significantly better working relationships with physicians (P < .001) than their inpatient counterparts. The 2 greatest recommendations to improve well-being included improving nurse staffing (91.4%) and the ability to take uninterrupted breaks (86.7%); the lowest-ranked recommendations were employing more advanced practice providers (25.9%) and appointing a wellness champion (21.2%). DISCUSSION High burnout and other adverse nurse outcomes are common among emergency nurses in Magnet hospitals. Modifiable features of ED work environments including inadequate nurse staffing, inability of nurses to take uninterrupted breaks, and lack of responsiveness of management to persistent problems in patient care warrant high priority attention by Magnet hospital leaders.
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Pelli J, Nordquist H. Learning Lessons for Future Preparedness: Exploring Work Well-Being-Related Leadership Challenges among Paramedics during the Early Stage of the COVID-19 Pandemic-A Qualitative Study. NURSING REPORTS 2023; 13:1721-1730. [PMID: 38133118 PMCID: PMC10745729 DOI: 10.3390/nursrep13040142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 11/29/2023] [Accepted: 12/06/2023] [Indexed: 12/23/2023] Open
Abstract
The beginning of the COVID-19 pandemic majorly impacted the population and public services. In Finland, a state of emergency was declared to ensure the security of healthcare resources, and prehospital emergency medical service (EMS) organizations faced emergency conditions for the first time. This study explores the leadership challenges related to well-being experienced during the early phase of the pandemic. This qualitative study utilized reflective essay material written between August and November 2020 by experienced advanced-level paramedics (n = 30) who participated actively in EMS fieldwork at the beginning of the pandemic. The material (32,621 words) was analyzed with inductive content analysis. The work well-being-related leadership challenges experienced by paramedics during the early phase of the pandemic were divided into four upper categories: inadequate guidance, workplace reorganization, atmosphere mismanagement, and insufficient resources to cope. These upper categories were comprised of 17 subcategories. Several actions can be taken to enhance personnel well-being and prepare for similar challenges. Guidance and support should be clear and timely. Visible leadership should be emphasized and enhanced with modern communication. Efforts should be made to strengthen the work atmosphere to support those on the front lines of healthcare. This study was not registered on a publicly accessible registry.
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Affiliation(s)
- Jukka Pelli
- Faculty of Information Technology and Communication Sciences, Tampere University, Kalevantie 4, 33100 Tampere, Finland
| | - Hilla Nordquist
- Department of Health Care and Emergency Care, South-Eastern Finland University of Applied Sciences, Pääskysentie 1, 48220 Kotka, Finland
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10
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Jacobs BB. An alternate explanation for the 2023 Match: Emergency medicine physicians endure repeated workplace moral distress and our students are watching. Acad Emerg Med 2023; 30:1176-1178. [PMID: 37285078 DOI: 10.1111/acem.14761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 05/28/2023] [Accepted: 06/03/2023] [Indexed: 06/08/2023]
Affiliation(s)
- Breanne B Jacobs
- The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
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11
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Cho E, Lee KH, Kang B, Jang J, Shin J, Eltaybani S, Yamamoto-Mitani N, Kim MJ. Perceived Work Environment, Educational Status, Staffing Levels, and Work Outcomes in Long-Term Care Settings During COVID-19. J Am Med Dir Assoc 2023; 24:1600-1605. [PMID: 37696496 DOI: 10.1016/j.jamda.2023.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 08/06/2023] [Accepted: 08/07/2023] [Indexed: 09/13/2023]
Abstract
OBJECTIVES Coronavirus disease (COVID-19) has severely affected older residents in long-term care (LTC) settings. However, care workers' perceptions of their work environment and potential impact on their work outcomes during the pandemic is not well known. This study examined associations between care staff's perceived work environment, educational status, and facility staffing levels and work outcomes of care staff in LTC settings during the COVID-19 pandemic. DESIGN This study employed a cross-sectional, observational, correlational design. SETTING AND PARTICIPANTS A total of 207 care staff were conveniently recruited from 30 LTC settings in South Korea. METHODS The perceived work environment, educational status of care staff, and facility staffing levels (ie, beds-to-registered nurse [RN] and beds-to-nursing assistant [NA] or care worker ratios), as well as their work outcomes (ie, general and COVID-19 specific outcomes) were collected using questionnaires. Multivariable binary logistic regressions were conducted, controlling for the characteristics of care staff (ie, age, sex, occupation, and career length) and facilities (ie, location, bed size, ownership, and residents' disease and care profiles). RESULTS Approximately 45% of the participants were either NAs or care workers, and 38% were RNs. More than half (53.14%) perceived their work environment to be good. LTC staff who perceived their work environment to be poor were more likely to be dissatisfied with their work [odds ratio (OR) 20.88), experience high burnout (OR 8.63), intend to leave the facility within a year (OR 5.00), and experience increased overtime work (OR 3.58) and work-life imbalance (OR 1.93) due to COVID-19. CONCLUSIONS AND IMPLICATIONS LTC work environments should be improved and government-led initiatives for ensuring such improvements should be implemented to enable a better response to future public health crises and maintain the quality of care for and safety of residents in LTC settings.
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Affiliation(s)
- Eunhee Cho
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, South Korea
| | - Kyung Hee Lee
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, South Korea
| | - Bada Kang
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, South Korea
| | - Jiyoon Jang
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, South Korea
| | - Jinhee Shin
- Woosuk University College of Nursing, Wanju-Gun, Jeollabuk-do, South Korea
| | - Sameh Eltaybani
- Department of Gerontological Home Care and Long-term Care Nursing, University of Tokyo, Tokyo, Japan
| | - Noriko Yamamoto-Mitani
- Department of Gerontological Home Care and Long-term Care Nursing, University of Tokyo, Tokyo, Japan
| | - Min Jung Kim
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, South Korea.
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Buchbinder M, Jenkins T, Staley J, Berlinger N, Buchbinder L, Goldberg L. Multidimensional stressors and protective factors shaping physicians' work environments and work-related well-being in two large US cities during COVID-19. Am J Ind Med 2023; 66:854-865. [PMID: 37488786 PMCID: PMC10793871 DOI: 10.1002/ajim.23520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 06/29/2023] [Accepted: 07/13/2023] [Indexed: 07/26/2023]
Abstract
INTRODUCTION Clinician burnout and poor work-related well-being reached a critical inflection point during the COVID-19 pandemic. This article applies a novel conceptual model informed by the Total Worker Health® approach to identify and describe multilevel stressors and protective factors that affected frontline physicians' work environments and work-related well-being. METHODS We conducted a qualitative study of hospital-based physicians from multiple hospital types in Los Angeles and Miami who cared for COVID-19 patients. Semistructured interviews lasting 60-90 min were conducted over Zoom. Interview transcripts were thematically coded using Dedoose qualitative software. RESULTS The final sample of 66 physicians worked in 20 hospitals. Stressors in the social, political, and economic environment included dealing with the politicization of COVID-19, including vaccine hesitancy; state and federal governmental COVID-19 policies and messaging; and shifting CDC guidance. Employment and labor pattern stressors included the national nursing shortage, different policies for paid time off, furloughs, reduced pay, and layoffs. Organizational-level stressors included institutional policies, staffing constraints and high patient volume (i.e., increased number of cases and longer lengths of stay), and perceived poor leadership. At the individual worker level, stressors included concerns about viral transmission to family, strained personal relationships, and work-life fit, particularly for those with young children. Respondents identified promising protective factors at multiple levels, including responsive state leadership, job security, concrete opportunities to provide input into institutional policy, strong leadership and communication, and feeling cared for by one's institution. CONCLUSION Findings support a multi-level strategy that acknowledges internal organizational and external factors shaping clinicians' work-related well-being, consistent with the Total Worker Health® approach.
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Affiliation(s)
- Mara Buchbinder
- Department of Social Medicine and Center for Bioethics, School of Medicine, UNC-Chapel Hill
| | | | - John Staley
- Department of Environmental Sciences and Engineering and NC Occupational Safety and Health Education and Research Center, Gillings School of Public Health, UNC-Chapel Hill
| | | | - Liza Buchbinder
- Center for Social Medicine and Humanities and Semel Institute, UCLA
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Galanis P, Moisoglou I, Katsiroumpa A, Vraka I, Siskou O, Konstantakopoulou O, Meimeti E, Kaitelidou D. Increased Job Burnout and Reduced Job Satisfaction for Nurses Compared to Other Healthcare Workers after the COVID-19 Pandemic. NURSING REPORTS 2023; 13:1090-1100. [PMID: 37606463 PMCID: PMC10443294 DOI: 10.3390/nursrep13030095] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 08/06/2023] [Accepted: 08/12/2023] [Indexed: 08/23/2023] Open
Abstract
Nurses experience high levels of job burnout and low levels of job satisfaction, while the COVID-19 pandemic has deteriorated working conditions. In this context, our aim was to compare levels of job burnout and job satisfaction among nurses and other healthcare workers (HCWs) after the COVID-19 pandemic. Moreover, we investigated the influence of demographics and job characteristics on burnout and satisfaction. We conducted a cross-sectional study with 1760 HCWs during June 2023. We used the single-item burnout measure and the "Job Satisfaction Survey". In our sample, 91.1% of nurses experienced high levels of burnout, while the respective percentage for the other HCWs was 79.9%. Nurses' satisfaction was lower than other HCWs. In particular, 61.0% of nurses experienced low levels of satisfaction, while the respective percentage for the other HCWs was 38.8%. Multivariable analysis identified that nurses, HCWs with an MSc/PhD diploma, shift workers, and those who considered their workplace as understaffed had higher burnout score and lower satisfaction score. Our results showed that the nursing profession was an independent factor of burnout and satisfaction. Several other demographic and job characteristics affected burnout and satisfaction. Policy makers, organizations, and managers should adopt appropriate interventions to improve work conditions.
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Affiliation(s)
- Petros Galanis
- Clinical Epidemiology Laboratory, Faculty of Nursing, National and Kapodistrian University of Athens, P.C. 11527 Athens, Greece;
| | - Ioannis Moisoglou
- Faculty of Nursing, University of Thessaly, P.C. 41500 Larissa, Greece;
| | - Aglaia Katsiroumpa
- Clinical Epidemiology Laboratory, Faculty of Nursing, National and Kapodistrian University of Athens, P.C. 11527 Athens, Greece;
| | - Irene Vraka
- Department of Radiology, P. & A. Kyriakou Children’s Hospital, P.C. 11527 Athens, Greece;
| | - Olga Siskou
- Department of Tourism Studies, University of Piraeus, P.C. 18534 Piraeus, Greece;
| | - Olympia Konstantakopoulou
- Center for Health Services Management and Evaluation, Faculty of Nursing, National and Kapodistrian University of Athens, P.C. 11527 Athens, Greece; (O.K.); (D.K.)
| | - Evangelia Meimeti
- 3rd Regional Health Authority of Macedonia, P.C. 54623 Thessaloniki, Greece;
| | - Daphne Kaitelidou
- Center for Health Services Management and Evaluation, Faculty of Nursing, National and Kapodistrian University of Athens, P.C. 11527 Athens, Greece; (O.K.); (D.K.)
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14
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Zhao L, Huang H, Liu P, Xu L, Deng W, Tian F, Tan L. Risk perception in the era of COVID-19 and related factors among nurses: A cross-sectional study. Nurs Open 2023; 10:5659-5669. [PMID: 37209017 PMCID: PMC10333908 DOI: 10.1002/nop2.1811] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 04/14/2023] [Accepted: 04/30/2023] [Indexed: 05/21/2023] Open
Abstract
AIM Our study aimed at investigating the risk perception of nurses and related factors in the era of COVID-19 period. DESIGN Cross-sectional study. METHODS Four hundred and forty-two participants completed an online questionnaire relating to their risk perception on public health emergencies. Data were collected between 25 November 2020 and 1 December 2020. Kruskal-Wallis test, Mann-Whitney U test and Ordinal logistic regression analysis were used to examine factors impacting on risk perception. RESULTS 65.2% of nurses' risk perception of COVID-19 was the moderate level even below the moderate level in the postperiod of COVID-19. Kruskal-Wallis test results indicated significant differences in gender, age, education status, working years, professional title, postlevel, COVID-19 contact experience, marital status and health status (p < 0.05). Ordinal logistic regression showed that gender, education status, professional title, work department, COVID-19 contact experience, character, health status and nursing work environment are associated with risk perception (p < 0.05). No Patient or Public Contribution.
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Affiliation(s)
- Lishuang Zhao
- Department of NursingThe Second Affiliated Hospital of Soochow UniversitySuzhouChina
- School of NursingSoochow UniversitySuzhouChina
| | - Hui Huang
- Department of NursingThe Second Affiliated Hospital of Soochow UniversitySuzhouChina
| | - Pengcheng Liu
- Department of NursingThe Second Affiliated Hospital of Soochow UniversitySuzhouChina
| | - Lanying Xu
- Department of NursingThe Second Affiliated Hospital of Soochow UniversitySuzhouChina
| | - Wei Deng
- Department of NursingThe Second Affiliated Hospital of Soochow UniversitySuzhouChina
| | - Fengmei Tian
- Department of NursingThe Second Affiliated Hospital of Soochow UniversitySuzhouChina
| | - Liping Tan
- Department of NursingThe Second Affiliated Hospital of Soochow UniversitySuzhouChina
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15
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Dabney BW, Linton M, July J, Miles M. RN-to-BSN student reports of work experiences, academic performance, and program progression during the COVID-19 pandemic. Nurs Outlook 2023; 71:102019. [PMID: 37480601 DOI: 10.1016/j.outlook.2023.102019] [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] [Received: 03/30/2023] [Revised: 06/08/2023] [Accepted: 06/26/2023] [Indexed: 07/24/2023]
Abstract
BACKGROUND Individuals who were RN to BSN students during the COVID-19 pandemic had the unique experience of being both undergraduate students and nurses during a time of exceptional stress for the healthcare system. PURPOSE The aim of this study was to explore student perceptions of their work experiences during the COVID-19 pandemic and how working as a nurse during this time affected their academic performance and progression through their RN to BSN program. METHODS This qualitative study was conducted using Braun and Clark's six-step thematic analysis process. CONCLUSION Students reported experiencing both challenges and adaptability in their RN to BSN program performance and progression during the pandemic. DISCUSSION Nurse educators and nurse managers can help RN to BSN nursing students during times marked by heavy workloads and increased stress by ascertaining their needs, being flexible, and providing self-care support.
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Affiliation(s)
| | - Mary Linton
- School of Nursing, University of Michigan Flint, Flint, MI
| | - Jori July
- School of Nursing, University of Michigan Flint, Flint, MI
| | - Mary Miles
- School of Nursing, University of Michigan Flint, Flint, MI
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Kiliç M, Uslukiliç G, Yaman S. The effect of the hospital working environment on the work limitation of the employees in Turkey: a multivariable analysis. BMC Health Serv Res 2023; 23:365. [PMID: 37055755 PMCID: PMC10103452 DOI: 10.1186/s12913-023-09356-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 03/30/2023] [Indexed: 04/15/2023] Open
Abstract
BACKGROUND The aim of this study is to examine the effects of working environment and demographic variables on the level of work limitation in a university hospital. METHODS The study is cross-sectional and was conducted in 2022 among employees of a university hospital. 254 people voluntarily participated in the study. Data were collected by applying the sociodemographic data form, the Work Limitation Questionnaire (WLQ), and the Work Environment Scale (WES). Institutional permission and ethical approval were obtained for the study. In the analysis of the data, t-test, ANOVA, and linear regression (LR) were used. RESULTS The WLQ score average of hospital staff was low. According to LR analysis, the factors affecting the level of work limitation of hospital staff; worsening perception of health status, being a doctor, decreased income level, increased working time in the institution, and age reduction. It was determined that 32.8% of the change in the WLQ score was related to these factors. While in the univariate tests, the mean of work limitation was found to be significant by getting occupational health safety training, having health problems due to the work done, and taking leave due to work accidents, in the multivariable LR analysis, these factors were insignificant. CONCLUSIONS As the working environment gets worse, the level of work limitation increases. It is recommended that hospital managers make the working environment better and safer, and make arrangements and programs to increase personnel satisfaction.
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Affiliation(s)
- Mahmut Kiliç
- Faculty of Medicine Department of Public Health, Yozgat Bozok University, Yozgat, Turkey
| | - Güllü Uslukiliç
- Health Practice and Research Center Hospital, Yozgat Bozok University, Yozgat, Turkey
| | - Sevda Yaman
- Akdagmadeni Health School, Yozgat Bozok University, Yozgat, Turkey.
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Molina-Oliva M, Martín-Sánchez R, Pastor-Benito E, Soto-Cámara R, Cárdaba-García RM, Thuissard IJ, Fernández-Domínguez JJ, Matellán-Hernández MP, Navalpotro-Pascual S, Morales-Sánchez A. Influence of Previous Mental State on Psychological Outcomes of Spanish Out-of-Hospital Professionals during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3574. [PMID: 36834266 PMCID: PMC9962449 DOI: 10.3390/ijerph20043574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/14/2023] [Accepted: 02/15/2023] [Indexed: 06/18/2023]
Abstract
This study aimed to describe factors relating to the psychological distress of healthcare workers (HCWs) in Spanish out-of-hospital emergency medical services (EMS), according to the previous or non-use of psychotropic drugs or psychotherapy. A multicentre, cross-sectional descriptive study was designed. The study population were all physicians, nurses, and emergency medical technicians (EMTs) working in any Spanish out-of-hospital EMS between February and April 2021. The main outcomes were the levels of stress, anxiety, depression, and self-efficacy, assessed by DASS-21 and G-SES. Differences in levels of stress, anxiety, depression, and self-efficacy, according to sex, age, previous use of psychotropic drug or psychotherapy, work experience, professional category, type of work, and modification of working conditions were measured using the Student's t-test for independent samples, one-way ANOVA, Pearson's correlation, or 2-factor analysis of covariance. A total of 1636 HCWs were included, of whom one in three had severe mental disorders because of the pandemic. The interaction of the previous or non-use of psychotropic drugs or psychotherapy with the rest of the factors considered did not modify the levels of stress, anxiety, depression, and self-efficacy. However, HCWs with a history of psychotropic drug or psychotherapy use had a more intense negative emotional response and lower self-efficacy, regardless of their sex, professional category, type of work, or change in the working conditions. These HCWs are considered particularly vulnerable to the development or recurrence of new disorders or other comorbidities; therefore, the implementation of monitoring and follow-up strategies should be a priority.
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Affiliation(s)
- María Molina-Oliva
- Emergency Medical Service of Castilla y León–Sacyl, 47007 Valladolid, Spain
- Red de Investigación de Emergencias Prehospitalarias (RINVEMER), Sociedad Española de Urgencias y Emergencias (SEMES), 28020 Madrid, Spain
| | - Rafael Martín-Sánchez
- Emergency Medical Service of Castilla y León–Sacyl, 47007 Valladolid, Spain
- Red de Investigación de Emergencias Prehospitalarias (RINVEMER), Sociedad Española de Urgencias y Emergencias (SEMES), 28020 Madrid, Spain
- Department of Nursing, Faculty of Nursing, University of Valladolid, 47005 Valladolid, Spain
| | - Elena Pastor-Benito
- Red de Investigación de Emergencias Prehospitalarias (RINVEMER), Sociedad Española de Urgencias y Emergencias (SEMES), 28020 Madrid, Spain
- Emergency Medical Service of Madrid–SUMMA 112, 28045 Madrid, Spain
| | - Raúl Soto-Cámara
- Emergency Medical Service of Castilla y León–Sacyl, 47007 Valladolid, Spain
- Red de Investigación de Emergencias Prehospitalarias (RINVEMER), Sociedad Española de Urgencias y Emergencias (SEMES), 28020 Madrid, Spain
- Department of Health Sciences, University of Burgos, 09001 Burgos, Spain
| | - Rosa M. Cárdaba-García
- Emergency Medical Service of Castilla y León–Sacyl, 47007 Valladolid, Spain
- Red de Investigación de Emergencias Prehospitalarias (RINVEMER), Sociedad Española de Urgencias y Emergencias (SEMES), 28020 Madrid, Spain
- Department of Nursing, Faculty of Nursing, University of Valladolid, 47005 Valladolid, Spain
| | - Israel John Thuissard
- Red de Investigación de Emergencias Prehospitalarias (RINVEMER), Sociedad Española de Urgencias y Emergencias (SEMES), 28020 Madrid, Spain
- Department of Medicine, Faculty of Biomedical and Health Sciences, European University of Madrid, 28670 Madrid, Spain
| | - Juan José Fernández-Domínguez
- Red de Investigación de Emergencias Prehospitalarias (RINVEMER), Sociedad Española de Urgencias y Emergencias (SEMES), 28020 Madrid, Spain
- Emergency Medical Service of Madrid–SUMMA 112, 28045 Madrid, Spain
- Department of Medicine, Faculty of Biomedical and Health Sciences, European University of Madrid, 28670 Madrid, Spain
- Emergency Service, HLA Moncloa University Hospital, 28080 Madrid, Spain
| | - María Paz Matellán-Hernández
- Emergency Medical Service of Castilla y León–Sacyl, 47007 Valladolid, Spain
- Red de Investigación de Emergencias Prehospitalarias (RINVEMER), Sociedad Española de Urgencias y Emergencias (SEMES), 28020 Madrid, Spain
| | - Susana Navalpotro-Pascual
- Red de Investigación de Emergencias Prehospitalarias (RINVEMER), Sociedad Española de Urgencias y Emergencias (SEMES), 28020 Madrid, Spain
- Emergency Medical Service of Madrid–SUMMA 112, 28045 Madrid, Spain
- Department of Nursing, Faculty of Medicine, Autonomous University of Madrid, 2029 Madrid, Spain
| | - Almudena Morales-Sánchez
- Emergency Medical Service of Castilla y León–Sacyl, 47007 Valladolid, Spain
- Red de Investigación de Emergencias Prehospitalarias (RINVEMER), Sociedad Española de Urgencias y Emergencias (SEMES), 28020 Madrid, Spain
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Escher C, Nagy E, Creutzfeldt J, Dahl O, Ruiz M, Ericson M, Osika W, Meurling L. Fear of making a mistake: a prominent cause of stress for COVID-19 ICU staff-a mixed-methods study. BMJ Open Qual 2023; 12:e002009. [PMID: 36697055 PMCID: PMC9884924 DOI: 10.1136/bmjoq-2022-002009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 01/12/2023] [Indexed: 01/26/2023] Open
Abstract
INTRODUCTION The COVID-19 pandemic has had a profound effect on many domains of healthcare. Even in high-income countries such as Sweden, the number of patients has vastly outnumbered the resources in affected areas, in particular during the first wave. Staff caring for patients with COVID-19 in intensive care units (ICUs) faced a very challenging situation that continued for months. This study aimed to describe burnout, safety climate and causes of stress among staff working in COVID-19 ICUs. METHOD A survey was distributed to all staff working in ICUs treating patients with COVID-19 in five Swedish hospitals during 2020 and 2021. The numbers of respondents were 104 and 603, respectively. Prepandemic data including 172 respondents from 2018 served as baseline. RESULTS Staff exhaustion increased during the pandemic, but disengagement decreased compared with prepandemic levels (p<0.001). Background factors such as profession and work experience had no significant impact, but women scored higher in exhaustion. Total workload and working during both the first and second waves correlated positively to exhaustion, as did being regular ICU staff compared with temporary staff. Teamwork and safety climate remained unchanged compared with prepandemic levels.Respondents reported 'making a mistake' as the most stressful of the predefined stressors. Qualitative analysis of open-ended questions identified 'lack of knowledge and large responsibility', 'workload and work environment', 'uncertainty', 'ethical stress' and 'organization and teamwork' as major causes of stress. CONCLUSION Despite large workloads, disengagement at work was low in our sample, even compared with prepandemic levels. High levels of exhaustion were reported by the ICU staff who carried the largest workload. Multiple significant causes of stress were identified, with fear of making a mistake the most significant stressor.
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Affiliation(s)
- Cecilia Escher
- Clinical Sciences, Intervention and Technology (CLINTEC), Karolinska Institute, Stockholm, Sweden
- Department of Anesthesia and Intensive Care, Norrtälje Hospital, Stockholm, Sweden
- Center for Advanced Medical Simulation and Training (CAMST), Karolinska University Hospital, Stockholm, Sweden
| | - Elisabeth Nagy
- Clinical Sciences, Intervention and Technology (CLINTEC), Karolinska Institute, Stockholm, Sweden
- Center for Advanced Medical Simulation and Training (CAMST), Karolinska University Hospital, Stockholm, Sweden
- Department of Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden
| | - Johan Creutzfeldt
- Clinical Sciences, Intervention and Technology (CLINTEC), Karolinska Institute, Stockholm, Sweden
- Center for Advanced Medical Simulation and Training (CAMST), Karolinska University Hospital, Stockholm, Sweden
- Department of Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden
| | - Oili Dahl
- Department of Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden
- Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
| | - Mini Ruiz
- Clinical Sciences, Intervention and Technology (CLINTEC), Karolinska Institute, Stockholm, Sweden
| | - Mats Ericson
- Division of Ergonomics, Royal Institute of Technology, Stockholm, Sweden
| | - Walter Osika
- Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
| | - Lisbet Meurling
- Clinical Sciences, Intervention and Technology (CLINTEC), Karolinska Institute, Stockholm, Sweden
- Center for Advanced Medical Simulation and Training (CAMST), Karolinska University Hospital, Stockholm, Sweden
- Department of Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden
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Cezar-Vaz MR, Xavier DM, Bonow CA, Vaz JC, Cardoso LS, Sant’Anna CF, da Costa VZ, Nery CHC, Loureiro HMAM. Occupational Well-Being of Multidisciplinary PHC Teams: Barriers/Facilitators and Negotiations to Improve Working Conditions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15943. [PMID: 36498016 PMCID: PMC9737019 DOI: 10.3390/ijerph192315943] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/04/2022] [Accepted: 11/24/2022] [Indexed: 06/17/2023]
Abstract
Well-being at work is one of the factors determining healthy work conditions and is perceived by workers as a positive psychological state. In this study, the concept of well-being at work was used together with occupational functionality (i.e., current health state, current work environment, and barriers/facilitators to implementing well-being at work), occupational risk perception, and proactivity/negotiations held by workers to improve working conditions. In this context, the objectives were to identify the socio-demographic and occupational characteristics independently associated with levels of well-being at work of the multidisciplinary PHC health team; detect barriers or facilitators resulting from the attitudes of colleagues, community members, and managers that influence the well-being at work of the multidisciplinary health team; and identify with whom and what reasons led health workers to become proactive and negotiate improved working conditions. This cross-sectional study addressed 338 health workers from the multidisciplinary teams of PHC outpatient services in the extreme south of Brazil. Multivariate linear regression models were adopted to analyze data. The results show various independent associations with levels of well-being at work. Nursing workers (technicians and nurses) more frequently expressed job commitment and job satisfaction. Difficulties in solving problems and performing work routines, and co-workers' attitudes directly influence the well-being of the PHC team members. Risk perception (physical and chemical) also influences well-being. Negotiations in which PHC managers engaged to improve working conditions appeared as a significant predictor of job commitment, job satisfaction, and job involvement. The results reveal that well-being at work is an important indicator of the potential of workers' proactivity in negotiating improved working conditions.
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Affiliation(s)
| | | | - Clarice Alves Bonow
- Faculty of Nursing, Federal University of Pelotas, Pelotas 96010-610, Brazil
| | | | | | | | | | - Carlos Henrique Cardona Nery
- Institute of Human and Information Sciences—ICHI, Federal University of Rio Grande—Santa Vitória do Palmar Campus, Santa Vitória do Palmar 96230-000, Brazil
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Joshi S, Khan M, Jelen MB, Pandit AS. Current Attitudes Toward Neuroanatomy: A Comparative Cross-Sectional Survey of Neurosurgeons from the United Kingdom and Worldwide. World Neurosurg 2022; 166:e607-e623. [PMID: 35868505 DOI: 10.1016/j.wneu.2022.07.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 07/12/2022] [Accepted: 07/13/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVE How attitudes toward neuroanatomy and preferences of studying resources vary among neurosurgeons is unknown. The impact of the coronavirus disease 2019 (COVID-19) pandemic on anatomy learning habits is also yet to be elucidated. In this study, we explore these objectives, to guide the development of future neurosurgeon-tailored anatomy education and resources. METHODS This was a 2-stage, cross-sectional study design comprising a local pilot survey followed by a structured 17-item questionnaire, distributed to both neurosurgical trainees and consultants. Grade and nationality differences in sentiment agreement were statistically compared. RESULTS A total of 365 responses were received from 32 countries (overall response rate, 23.2%). Neuroanatomy is highly regarded among most neurosurgeons and takes a central role in their professional identity. Yet, 69% of neurosurgeons wanted to spend more time learning. Common study prompts included perceived operative complexity, lack of familiarity and teaching. Financial barriers and motivation were obstacles limiting neuroanatomy learning, more so among trainee neurosurgeons, with personal commitment barriers significantly varying with geographic location. Surgical relevance, accessibility, and image quality were important factors when selecting anatomy resources, with cost and up-to-datedness being important for juniors. The COVID-19 pandemic saw a shift toward virtual resources, particularly affecting United Kingdom-based trainees. CONCLUSIONS Although neuroanatomy is well regarded, barriers exist that impede further neuroanatomy learning. Neurosurgical training programs should tailor anatomy education according to the seniority and background of their residents. Furthermore, resources that are surgically relevant and accessible and are of high image quality are more likely to be better used.
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Affiliation(s)
- Shivani Joshi
- University College London Medical School, University College London, London, United Kingdom
| | - Mehdi Khan
- University College London Medical School, University College London, London, United Kingdom
| | - Maria B Jelen
- Department of Psychology and Language Sciences, University College London, London, United Kingdom
| | - Anand S Pandit
- Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, United Kingdom.
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