Professional interpersonal dynamics and burnout in European transplant surgeons

Assessment of the prevalence of burnout and well-being in solid organ transplant pharmacists

BACKGROUND

Solid organ transplant (SOT) pharmacist burnout and well-being has not been described.

METHODS

A survey of SOT pharmacists was distributed to transplant pharmacy organization listervs. Burnout was assessed with the full 22 item Maslach Burnout Inventory Human Services Survey for Medical Personnel (MBI-HSS-MP) and well-being was assessed with the Mayo Well-Being Index (WBI). Logistic multivariate regression was constructed to identify risk factors for a composite burnout assessment.

RESULTS

In total, 230 responses were included (estimated response rate 36.2%). Survey participants were predominantly Caucasian (80.4%), female (79.1%), married/partnered (67.4%), and were within the first 5 years of practice (32.2%) as clinical pharmacist/specialists (87%). According to the MBI-HSS-MP, 63% met criteria for burnout. Comparing the groups with or without burnout, low quality of life (40.4% vs 9.5%; p<0.001), extreme fatigue (52.1% vs 19%; p<0.001), and likelihood of leaving the job for reasons other than retirement (38.5% vs 10.7%; p<0.001) were more common. The incidence of SOT pharmacists with WBI scores ≥ 5 (decreased well-being) was 26.5%. Among clinical pharmacists, risk factors for burnout included > 10 hours per week of clinical duties outside of transplant (OR 2.669, p = 0.021) and extreme fatigue (OR 3.473, p<0.001).

CONCLUSIONS

Pharmacist burnout in SOT practice was similar to that reported in various pharmacy specialties (53-61%), which impacts clinical workforce retention and personal well-being. This article is protected by copyright. All rights reserved.

Burnout prevalence among European physicians: a systematic review and meta-analysis

PURPOSE

Our objective was to assess burnout prevalence rates among physicians practicing in Europe (regardless of their specialty) taking into account the main approaches used to define burnout with the Maslach Burnout Inventory (MBI) tool.

METHODS

A systematic review was carried out from 2006 to 2018. A keyword request was obtained using the PubMed/Medline, Web of Science and Banque de Données en Santé Publique search engine. Studies written in English measuring burnout with the MBI tool among a population of practicing European physicians were selected. Data were extracted and classified according to burnout's definition provided by the authors. Three definitions using the MBI dimensions were considered: tri-, bi- and unidimensional definition. A meta-analysis was then performed on burnout prevalence rates according to the dimensional definition of burnout.

RESULTS

From 2378 search results, we selected 56 studies including from up to 41 European countries. Depending upon the study, physicians' burnout prevalence rates ranged from 2.5% to 72.0%. The pooled prevalence rate of burnout was estimated at 7.7% [5.3-10.4%] with the tridimensional definition, 19.7% [13.5-26.3%] with the bidimensional definition and 43.2% [29.0-57.6%] with the unidimensional definition.

CONCLUSION

Burnout pooled prevalence among physicians varies from single to fivefold depending on the method employed to assess burnout with the MBI tool. Medical community should determine a standardized method to assess burnout prevalence rates to best evaluate this phenomenon.

Burnout within UK surgical specialties: a systematic review

INTRODUCTION

Burnout is of growing concern within the surgical workforce, having been shown to result in reduced job satisfaction, decreased patient satisfaction and higher rates of medical errors. Determining the extent of burnout and identifying its risk factors within UK surgical practice is essential to ensure appropriate interventions can be implemented to improve mental wellbeing.

MATERIALS

A systematic search of PubMed, Medline, Embase, PsychINFO and Cochrane databases was performed, following PRISMA guidelines. Studies published between January 2000 and October 2019 that reported prevalence data or risk factors on burnout for surgeons working within the UK and/or the Republic of Ireland were included.

FINDINGS

Ten papers met the inclusion criteria. The overall prevalence of burnout amongst surgeons in the UK was 32.0% (IQR 28.9-41.0%), with surgical trainees having the highest prevalence (59.0%) of burnout documented for any subgroup. The most common risk factors identified for burnout were younger surgeon age and lower clinical grade. Being married or living with a partner was found to be protective.

CONCLUSIONS

Burnout is highly prevalent in UK surgical specialties, mostly amongst surgical trainees. Targeted pre-emptive interventions based upon relevant risk factors for burnout should be prioritised, at both individual and institutional levels.

Extinguishing burnout: National analysis of predictors and effects of burnout in abdominal transplant surgery fellows

Burnout among surgeons has been attributed to increased workload and decreased autonomy. Although prior studies have examined burnout among transplant surgeons, no studies have evaluated burnout in abdominal transplant surgery fellows. The objective of our study was to identify predictors of burnout and understand its impact on personal and patient care during fellowship. A survey was sent to all abdominal transplant surgery fellows in an American Society of Transplant Surgeons-accredited fellowship. The response rate was 59.2% (n = 77) and 22.7% (n = 17) of fellows met criteria for burnout. Fellows with lower grit scores were more likely to exhibit burnout compared with fellows with higher scores (3.6 vs 4.0, P = .026). Those with burnout were more likely to work >100 hours per week (58.8% vs 27.6%, P = .023), have severe work-related stress (58.8% vs 22.4%, P = .010), consider quitting fellowship (94.1% vs 20.7%, P < .001), or make a medical error (35.3% vs 5.2%, P = .003). This national analysis of abdominal transplant fellows found that burnout rates are relatively low, but few fellows engage in self-care. Personal and program-related factors attribute to burnout and it has unacceptable effects on patient care. Transplant societies and fellowship programs should develop interventions to give fellows tools to prevent and combat burnout.

Evaluating the Relationship Between Burnout Levels and Compassion Fatigue, Emotional Intelligence, and Communication Skills of Organ Transplant Coordinators

AIM

The aim was to determine the effects of compassion fatigue, emotional intelligence levels, and communication skills of organ transplant coordinators on burnout.

METHODS

This descriptive correlational study included 104 organ transplant coordinators. Data were collected via a survey that consisted of demographic information, the Copenhagen Burnout Inventory, the Emotional Intelligence Scale, and the Compassion Fatigue Scale.

FINDINGS

A positive relationship was reported between burnout (mean, 39.42 [SD, 19.54]) and compassion fatigue (mean, 2.26 [SD, 0.86]) measurements of the organ transplant coordinators (r = 0.432) and a negative and significant relationship existed between burnout and emotional intelligence (mean, 3.53 [SD, 0.58]) measurements (r = -0.372). However, no correlation was found between communication skills (mean, 4.27 [SD, 0.52]) and burnout (r = -0.184; P > .05) except a negative correlation with client-related burnout measurements (r = -0.222; P < .05). As a result of the 2-step regression analysis, the regression-squared value predicted the joint effect of compassion fatigue and emotional intelligence on burnout (R² = .285).

CONCLUSIONS

Organ transplant coordinators reported moderate levels of burnout and compassion fatigue and high levels of emotional intelligence and communication skills. Compassion fatigue caused burnout, while emotional intelligence decreased. Additionally, transplant coordinators' communication skills were related to client-related burnout.

Factors associated with burnout syndrome in surgeons: a systematic review

INTRODUCTION

To date, studies have shown a high prevalence of burnout in surgeons. Various factors have been found to be associated with burnout, and it has significant consequences personally and systemically. Junior doctors are increasingly placing their own health and wellbeing as the most important factor in their decisions about training. Finding ways to reduce and prevent burnout is imperative to promote surgical specialties as attractive training pathways.

METHODS

The MEDLINE, PsychInfo and EMBASE databases were searched using the subject headings related to surgery and burnout. All full text articles that reported data related to burnout were eligible for inclusion. Articles which did not use the Maslach Burnout Inventory or included non-surgical groups were excluded; 62 articles fulfilled the criteria for inclusion.

FINDINGS

Younger age and female sex tended to be associated with higher levels of burnout. Those further in training had lower levels of burnout, while residents suffered more than their seniors. Burnout is associated with a lower personal quality of life, depression and alcohol misuse. Academic work and emotional intelligence may be protective of burnout. Certain personality types are less likely to be burnt out. Mentorship may reduce levels of burnout.

CONCLUSIONS

Workload and work environment are areas that could be looked at to reduce job demands that lead to burnout. Intervening in certain psychological factors such as emotional intelligence, resilience and mindfulness may help to reduce burnout. Promoting physical and mental health is important in alleviating burnout, and these factors likely have a complex interplay.

Grief, Stress, Trauma, and Support During the Organ Donation Process

The organ donation process is complex and stressful for the family of the potential donor and members of the multidisciplinary team who may experience grief, ethical dilemmas, vicarious trauma, or compassion fatigue. Several studies each explore the role of a specific healthcare group and the impact of inhospital processes on group members. We conducted a systematic literature search to identify such studies and a qualitative synthesis to consolidate findings and highlight features of the interaction and relationships between role players. Our results suggest that, while healthcare professionals have different roles, attitudes, and views, the experience of stressors and interdisciplinary tension is common. Nevertheless, staff are united by the goal of caring for the patient and family. We therefore propose that, while focusing on bereavement care and other aspects of the family's experience, staff can find other shared goals and develop understanding, trust, empathy, and respect for each other's positions, thereby improving functioning in the complex adaptive system that forms at this time. Education and training can equip staff to facilitate anticipatory mourning, family-led activities, and a meaningful parting from their relative, assisting families with their grief and increasing staff members' efficacy, confidence, and interdisciplinary teamwork. Knowledge of systems thinking and opportunities to share ideas and experiences will enable staff to appreciate each other's roles, while supportive mentors, self-care strategies, and meaningful feedback between role players will foster healthy adjustment and shared learning. A focus on psychosocial outcomes such as family satisfaction with the process, collaboration within the multidisciplinary team, and reduction in the role stress of healthcare professionals will contribute to family well-being as well as personal and professional growth for staff.

Patient as Gift

"Sit down," Mr. R demanded. "I've got something to say to you." I shot the medical student a querying glance as we simultaneously sunk into our chairs. He continued, "You don't know me, and I got some things to tell you." I thought I knew Mr. R, and I certainly had some idea of what he was all about. But then he called to me. In his summoning, Mr. R arrested all my preconceived ideas about him. And as the medical student and I began to understand him better, we wanted to know more. We began to engage him more deeply. In the subsequent days, caring for him somehow felt easier, akin to the care one gives a distraught friend rather than a difficult patient.

Emotional experiences of health professionals in organ procurement and transplantation. A systematic review

INTRODUCTION

The objective was to explore, discuss and synthesize the emotional experiences of health professionals during the process of organ procurement and transplantation.

METHODS

A systematic review was made in Medline, Science Direct and the Virtual Library of the Andalusian Public Health System, selecting 16 original articles for inclusion in the review, with qualitative evaluation and narrative synthesis.

RESULTS

The results revealed the main use of qualitative methodology, and 4emergent themes were identified: working in organ procurement and transplantation; the transition of professional roles; emotional experiences; and, coping strategies and emotional management. This systematic review revealed the complex and diverse character of professionals' emotional experiences as well as the importance of the interpersonal relationship.

CONCLUSIONS

Intense emotional experiences related to the sense of responsibility, the work challenge and coping strategies based on reward searching explained important contradictions and tensions about professional roles and functions, especially during the donation interview.