1
|
Popa MV, Mîndru DE, Hizanu (Dumitrache) M, Gurzu IL, Anton-Păduraru DT, Ștreangă V, Gurzu B, Guțu C, Elkan EM, Duceac LD. Stress Factors for the Paediatric and Adult Palliative Care Multidisciplinary Team and Workplace Wellbeing Solutions. Healthcare (Basel) 2024; 12:868. [PMID: 38727425 PMCID: PMC11083451 DOI: 10.3390/healthcare12090868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 04/17/2024] [Accepted: 04/18/2024] [Indexed: 05/13/2024] Open
Abstract
BACKGROUND Palliative care is a challenging specialty, especially when it comes to caring for children with serious life-limiting conditions and supporting their families. Workers face significant challenges and experience major impacts on their wellbeing. We conducted a qualitative study to understand the sources of stress in the palliative care team, their work expectations, and how they can cope with the demands. METHODS We used an online questionnaire about the causes of stress, the impact of the COVID-19 pandemic and the ways in which support is needed in the workplace. RESULTS Of the 56 palliative care professionals who participated in the survey, 57.1% considered the main causes of stress to be high workload, difficult emotional burdens (55.4%) affecting their outlook on life (61.2%), the death of patients (46.4%), and communication with patients' families (26.8%). The COVID-19 pandemic increased stress levels for the majority of respondents (89.3%). The need for specialised training (53.6%), support groups, psychological counselling and adapted organisational policies was highlighted. CONCLUSIONS The study demonstrates the importance of understanding the needs of both paediatric and adult palliative care staff in order to provide optimal care and support their balance in this demanding area of the healthcare system.
Collapse
Affiliation(s)
- Maria Valentina Popa
- Faculty of Medicine and Pharmacy, Doctoral School of Biomedical Sciences, “Dunărea de Jos” University of Galați, 47 Domnească Street, RO-800008 Galați, Romania; (M.V.P.); (M.H.)
| | - Dana Elena Mîndru
- Department of Pediatrics, Faculty of Medicine, “Gr. T. Popa” University of Medicine and Pharmacy, RO-700115 Iasi, Romania; (D.T.A.-P.); (V.Ș.)
| | - Mihaela Hizanu (Dumitrache)
- Faculty of Medicine and Pharmacy, Doctoral School of Biomedical Sciences, “Dunărea de Jos” University of Galați, 47 Domnească Street, RO-800008 Galați, Romania; (M.V.P.); (M.H.)
| | - Irina Luciana Gurzu
- Department of Preventive Medicine and Interdisciplinarity, Discipline of Occupational Health, “Gr. T. Popa” University of Medicine and Pharmacy, RO-700115 Iasi, Romania;
| | - Dana Teodora Anton-Păduraru
- Department of Pediatrics, Faculty of Medicine, “Gr. T. Popa” University of Medicine and Pharmacy, RO-700115 Iasi, Romania; (D.T.A.-P.); (V.Ș.)
| | - Violeta Ștreangă
- Department of Pediatrics, Faculty of Medicine, “Gr. T. Popa” University of Medicine and Pharmacy, RO-700115 Iasi, Romania; (D.T.A.-P.); (V.Ș.)
| | - Bogdan Gurzu
- Department of Morfofunctional Sciences, Faculty of Medicine, “Gr. T. Popa” University of Medicine and Pharmacy, RO-700115 Iasi, Romania;
| | - Cristian Guțu
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ”Dunărea de Jos” University of Galați, 47 Domnească Street, RO-800008 Galați, Romania;
| | - Eva Maria Elkan
- Department of Morfofunctional Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University of Galați, 47 Domnească Street, RO-800008 Galați, Romania;
| | - Letiția Doina Duceac
- Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University of Galați, 47 Domnească Street, RO-800008 Galați, Romania;
| |
Collapse
|
2
|
Hooker C, Karageorge A, Scott KM, Lim R, Nash L. Grace Under Pressure: a mixed methods impact assessment of a verbatim theatre intervention to improve healthcare workplace culture. BMC Health Serv Res 2024; 24:474. [PMID: 38627758 PMCID: PMC11022423 DOI: 10.1186/s12913-024-10961-w] [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: 10/23/2023] [Accepted: 04/07/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Healthcare workplace mistreatment has been documented globally. Poor workplace behaviour, ranging from incivility to bullying and harassment, is common in healthcare, and contributes significantly to adverse events in healthcare, poor mental health among healthcare workers, and to attrition in the healthcare workforce, particularly in junior years. Poor workplace behaviour is often normalised, and is difficult to address. Verbatim theatre, a form of research informed theatre in which plays are created from informants' exact words only, is particularly suited to facilitating workplace culture change by raising awareness about issues that are difficult to discuss. The objective of this study was to assess the impact of the verbatim theatre play 'Grace Under Pressure' on workplace culture in NSW hospitals. METHODS The intervention was conducted in 13 hospitals from 8 Local Health Districts (LHDs) in NSW, Australia, in October and November 2019, with aggregated impact across all sites measured by a bespoke survey ('Pam McLean Centre (PMC) survey') at the conclusion of the intervention. This study was conducted in 3 Local Health Districts (one urban, one regional, one remote), with data collection conducted in November-December 2019 and December 2020. The study design was a mixed methods assessment of the play's impact using (1) validated baseline measures of psychosocial risk, analysed descriptively, (2) overall findings from the PMC survey above, analysed descriptively, (3) interviews conducted within a month of the intervention, analysed thematically and (4) interviews conducted one year later, analysed thematically. RESULTS Half (51.5%) of the respondents (n = 149) to the baseline survey had scores indicating high risk of job strain and depressive symptoms. Of 478 respondents to the PMC survey (response rate 57%), 93% found the play important, 92% recommended others see the play, 89% considered that it stimulated thinking about workplace behaviour, and 85% that it made discussing these issues easier. Thematic analysis of interviews within one month (n = 21) showed that the play raised awareness about poor workplace behaviour and motivated behaviour change. Interviews conducted one year later (n = 6) attributed improved workplace culture to the intervention due to improved awareness, discussion and capacity to respond to challenging issues. CONCLUSIONS Verbatim theatre is effective in raising awareness about difficult workplace behaviour in ways that motivate behaviour change, and hence can be effective in catalysing real improvements in healthcare workplace culture. Creative approaches are recommended for addressing similarly complex challenges in healthcare workforce retention.
Collapse
Affiliation(s)
- Claire Hooker
- Sydney Health Ethics, School of Public Health, University of Sydney, Camperdown, NSW, 2006, Australia.
| | - Aspasia Karageorge
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, 2006, Australia
| | - Karen M Scott
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, 2006, Australia
- The Pam McLean Centre, Faculty of Medicine and Health, The University of Sydney, St Leonards, NSW, 2064, Australia
| | - Renee Lim
- The Pam McLean Centre, Faculty of Medicine and Health, The University of Sydney, St Leonards, NSW, 2064, Australia
| | - Louise Nash
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, 2006, Australia
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, 2006, Australia
| |
Collapse
|
3
|
Hoopsick RA, Las S, Sun R. Differential effects of healthcare worker burnout on psychotropic medication use and misuse by occupational level. Soc Psychiatry Psychiatr Epidemiol 2024; 59:669-679. [PMID: 37272959 PMCID: PMC10240107 DOI: 10.1007/s00127-023-02496-y] [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: 08/26/2022] [Accepted: 05/24/2023] [Indexed: 06/06/2023]
Abstract
PURPOSE Burnout has been well examined among physicians and other high-wage, high-autonomy healthcare positions. However, lower-wage healthcare workers with less workplace autonomy (e.g., medical assistants, nurses' aides) represent a substantial proportion of the workforce, but remain understudied. We aimed to examine the effects of burnout on psychotropic medication use and misuse and whether these effects differed by occupational level. METHODS In March 2022, we collected data from a diverse sample of US healthcare workers (N = 200) and examined the cross-sectional relationship between burnout and changes in prescribed psychotropic medication (i.e., starting, stopping, and/or having a change in the dose/frequency) during the COVID-19 pandemic. We also separately examined the relationship between burnout and psychotropic medication misuse (i.e., without a prescription, in greater amounts, more often, longer than prescribed, and/or for a reason other than prescribed). We stratified models by occupational level (prescribers/healthcare administrators vs. other healthcare workers). RESULTS Greater burnout was associated with higher odds of changes in prescribed psychotropic medication among prescribers/healthcare administrators (aOR = 1.23, 95% CI 1.01, 1.48), but not among other healthcare workers (aOR = 1.04, 95% CI 0.98, 1.10). Greater burnout was not associated with psychotropic medication misuse among prescribers/healthcare administrators (aOR = 0.96, 95% CI 0.82, 1.12) but was associated with increased odds of psychotropic medication misuse among other healthcare workers (aOR = 1.07, 95% CI 1.01, 1.14). CONCLUSIONS Potential disparities in help-seeking and healthcare access might manifest in non-medical use of prescription drugs among some healthcare workers, which has implications for worker safety and well-being.
Collapse
Affiliation(s)
- Rachel A Hoopsick
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, 1206 S. Fourth St., 2017 Khan Annex, Huff Hall, Champaign, IL, 61820, USA.
| | - Sylvia Las
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, 1206 S. Fourth St., 2017 Khan Annex, Huff Hall, Champaign, IL, 61820, USA
| | - Rachel Sun
- Department of Psychology, University of Illinois Urbana-Champaign, Champaign, IL, USA
| |
Collapse
|
4
|
Blake H, Mancini H, Coyne E, Cooper J, Stanulewicz-Buckley N. Workforce wellbeing centres and their positive role for wellbeing and presenteeism in healthcare workers during the COVID-19 pandemic: secondary analysis of COVID-Well data. BMC Health Serv Res 2024; 24:302. [PMID: 38448919 PMCID: PMC10918935 DOI: 10.1186/s12913-024-10730-9] [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: 11/28/2022] [Accepted: 02/15/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND Supported wellbeing centres established during the COVID-19 pandemic provided high quality rest spaces and access to peer-to-peer psychological first aid for healthcare workers (HCWs). The centres were well accessed and valued by HCWs, but their relationship with wellbeing and job-related factors is not well established. The aim of this study was to explore the relationship between wellbeing centre use, HCWs wellbeing and job-related factors (job stressfulness, job satisfaction, presenteeism, turnover intentions). METHODS Secondary analysis of data from 819 HCWs from an acute hospital trust who completed an online survey in April-July 2020, as part of the COVID-Well study. Measures included the Warwick Edinburgh Mental Wellbeing Scale, and four single-item global measures of job stressfulness, job satisfaction, presenteeism and turnover intentions. ANCOVA models and regression analyses were conducted on these data. RESULTS HCWs who had not accessed the wellbeing centres had lower wellbeing (β = 0.12, p < .001), higher job stressfulness (β = - 0.22, p < .001), lower job satisfaction (β = 0.39, p < .001), higher presenteeism (β = - 0.22, p < .001) and were of younger age (β = 0.09, p = .002). Centre use was associated with wellbeing irrespective of job stressfulness. Those reporting presenteeism and who accessed the centre (M = 3.30, SE = 0.04) had higher wellbeing than those who accessed the centre but did not report presenteeism (M = 3.06, SE = 0.04) (F(1, 791) = 18.65, p < .001, ηp2 = 0.02). Centre use was not significantly associated with turnover intentions (B = - 0.30, p = .13; Wald = 2.26; odds = 0.74), while job stress and job satisfaction showed significant effects. CONCLUSIONS Accessing wellbeing centres was associated with higher wellbeing of HCWs, particularly for those reporting presenteeism. Therefore, the centres may have provided greatest respite and restoration for those present at work but not in optimal health. Younger workers were disproportionately affected in terms of wellbeing, and targeted support for this population is needed. Strategies to decrease presenteeism and maximise job satisfaction are urgently required. Healthcare organisations should provide rest spaces and psychological support to HCWs for the long-term, as part of a systems-wide approach to improving workforce health and wellbeing.
Collapse
Affiliation(s)
- Holly Blake
- School of Health Sciences, University of Nottingham, Nottingham, UK.
- NIHR Nottingham Biomedical Research Centre, Nottingham, UK.
| | - Helen Mancini
- Human Resources, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Emma Coyne
- Clinical Psychology Department, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Joanne Cooper
- Nursing and Midwifery, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | | |
Collapse
|
5
|
Tischendorf JS, Krecko LK, Filipiak R, Osman F, Zelenski AB. Gender influences resident physicians' perception of an employee-to-employee recognition program: a mixed methods study. BMC MEDICAL EDUCATION 2024; 24:109. [PMID: 38302913 PMCID: PMC10835820 DOI: 10.1186/s12909-024-05083-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 01/22/2024] [Indexed: 02/03/2024]
Abstract
BACKGROUND Burnout is prevalent in medical training. While some institutions have implemented employee-to-employee recognition programs to promote wellness, it is not known how such programs are perceived by resident physicians, or if the experience differs among residents of different genders. METHODS We used convergent mixed methods to characterize how residents in internal medicine (IM), pediatrics, and general surgery programs experience our employee-to-employee recognition ("Hi-5″) program. We collected Hi-5s received by residents in these programs from January 1, 2021-December 31, 2021 and coded them for recipient discipline, sex, and PGY level and sender discipline and professional role. We conducted virtual focus groups with residents in each training program. MAIN MEASURES AND APPROACH We compared Hi-5 receipt between male and female residents; overall and from individual professions. We submitted focus group transcripts to content analysis with codes generated iteratively and emergent themes identified through consensus coding. RESULTS Over a 12-month period, residents received 382 Hi-5s. There was no significant difference in receipt of Hi-5s by male and female residents. Five IM, 3 surgery, and 12 pediatric residents participated in focus groups. Residents felt Hi-5s were useful for interprofessional feedback and to mitigate burnout. Residents who identified as women shared concerns about differing expectations of professional behavior and communication based on gender, a fear of backlash when behavior does not align with gender stereotypes, and professional misidentification. CONCLUSIONS The "Hi-5" program is valuable for interprofessional feedback and promotion of well-being but is experienced differently by men and women residents. This limitation of employee-to-employee recognition should be considered when designing equitable programming to promote well-being and recognition.
Collapse
Affiliation(s)
- Jessica S Tischendorf
- Division of Infectious Disease, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Medical Foundation Centennial Building Room 5263, 1685 Highland Avenue, Madison, WI, 53705, USA.
| | - Laura K Krecko
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI, 53792, USA
| | - Rachel Filipiak
- Division of Infectious Disease, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Medical Foundation Centennial Building Room 5263, 1685 Highland Avenue, Madison, WI, 53705, USA
| | - Fauzia Osman
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, 1685 Highland Avenue, Madison, WI, 53705, USA
| | - Amy B Zelenski
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, 1685 Highland Avenue, Madison, WI, 53705, USA
| |
Collapse
|
6
|
Naidoo R, Schoeman R. Burnout in emergency department staff: The prevalence and barriers to intervention. S Afr J Psychiatr 2023; 29:2095. [PMID: 37928941 PMCID: PMC10623583 DOI: 10.4102/sajpsychiatry.v29i0.2095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 09/01/2023] [Indexed: 11/07/2023] Open
Abstract
Background Burnout impacts patient care and staff well-being. Emergency department (ED) staff are at an elevated risk for burnout. Despite an acceleration in burnout research due to the coronavirus disease 2019 (COVID-19) pandemic, there is limited data on the nature and prevalence of burnout in the South African emergency medicine setting. Aim This study determined the prevalence of burnout in ED staff (doctors, nurses and non-clinical staff) at Tygerberg Hospital and explored staff awareness and utilisation of interventions. Setting The study was conducted at Tygerberg Hospital, South Africa. Methods This cross-sectional study used the Maslach Burnout Inventory to assess burnout via a self-administered electronic survey in a convenience sample of 109 ED staff. Quantitative data were analysed with descriptive and inferential statistics. Qualitative data were analysed using thematic analysis. Results A total of 46 participants (45.10%) experienced burnout, with 73 participants (71.57%) at high risk for emotional exhaustion or depersonalisation. The prevalence of burnout in doctors was 57.89%, non-clinical staff was 25.93%, and nursing staff was 50.00%. Burnout was higher in doctors and nursing staff compared to non-clinical staff, with high emotional exhaustion and depersonalisation found in interns and specialist professional nurses. The level of intervention awareness was 41.8% and the level of intervention utilisation was 8.82%. Thematic analysis identified awareness, accessibility and reactive utilisation as barriers to utilisation with opportunities to reduce burnout and enhance resilience. Conclusion Coordinated health system and organisational efforts are required to optimise intervention strategies to reduce burnout. Contribution Guidance on the design and planning of intervention strategies considering at risk groups, intervention-related factors, and non-clinical staff.
Collapse
Affiliation(s)
- Reshen Naidoo
- Faculty of Economics and Management Sciences, Stellenbosch Business School, Cape Town, South Africa
| | - Renata Schoeman
- Faculty of Economics and Management Sciences, Stellenbosch Business School, Cape Town, South Africa
| |
Collapse
|
7
|
Bailey JG, Wong M, Bailey K, Banfield JC, Barry G, Munro A, Kirkland S, Leiter M. Pandemic-related factors predicting physician burnout beyond established organizational factors: cross-sectional results from the COPING survey. PSYCHOL HEALTH MED 2023; 28:2353-2367. [PMID: 34649468 DOI: 10.1080/13548506.2021.1990366] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 10/04/2021] [Indexed: 10/24/2022]
Abstract
The COVID-19 pandemic has increased physician burnout beyond high baseline levels. We aimed to determine whether pandemic-related factors contribute to physician burnout beyond known organizational factors. This was a cross-sectional survey of Canadian physicians using a convenience sample. Eligible participants included any physician currently holding a license to practice in Canada. Responses were gathered from May 13 to 12 June 2020. Risk factors measured included the newly developed Pandemic Experiences and Perceptions Scale (PEPS) subscales, contact with virus, pandemic preparation, and provincial caseload. The primary outcome was the Maslach Burnout Inventory (MBI). The primary outcome was completed by 309 respondents. Latent profile analysis found 107 (34.6%) respondents were burned out. In multivariate analysis, exhaustion was independently associated with PEPS adequacy, risk perception, and worklife subscales (adjusted R2 = 0.236, P < 0.001). Cynicism was associated with exhaustion, and PEPS worklife (adjusted R2 = 0.543, P < 0.001). Efficacy was associated with cynicism, PEPS worklife, and active cases (adjusted R2 = 0.152, P < 0.001). Structural equation modelling showed statistically significant direct paths between PEPS areas of worklife and all MBI subscales. Contact with virus, preparation, and PEPS risk perception added to the prediction of MBI exhaustion. Among a sample of Canadian physicians during the COVID-19 pandemic, adequacy of resources, risk perception, and quality of worklife were associated with burnout indices. To mitigate physician burnout organizations should work to improve working conditions, ensure adequate resources, and foster perceived control of risk of transmission.Trial Registration: NCT04379063.
Collapse
Affiliation(s)
- Jonathan G Bailey
- Department of Anesthesiology, Pain Management & Perioperative Medicine, Dalhousie University, Halifax, NS, Canada
| | - Michael Wong
- Department of Anesthesiology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Kristen Bailey
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Jillian C Banfield
- Department of Anesthesiology, Pain Management & Perioperative Medicine, Dalhousie University, Halifax, NS, Canada
| | - Garrett Barry
- Department of Anesthesiology, Pain Management & Perioperative Medicine, Dalhousie University, Halifax, NS, Canada
| | - Allana Munro
- Department of Anesthesiology, Pain Management & Perioperative Medicine, Dalhousie University, Halifax, NS, Canada
| | - Susan Kirkland
- Department of Community Health & Epidemiology, Dalhousie University, Halifax, NS, Canada
| | - Michael Leiter
- Centre for Organizational Research & Development, Acadia University, Wolfville, NS, Canada
| |
Collapse
|
8
|
Deshur MA, Ben-Isvy N, Wang C, Minhaj M, Greenberg S. A Quality Improvement Study Designed to Optimize Scheduling Geographic/Site Preferences Among Anesthesia Professionals Utilizing Decision Support Tool Assistance. J Med Syst 2023; 47:51. [PMID: 37097379 PMCID: PMC10126544 DOI: 10.1007/s10916-023-01946-z] [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: 09/05/2022] [Accepted: 03/29/2023] [Indexed: 04/26/2023]
Abstract
This is a quality improvement pilot study comparing percentages of anesthesia professionals receiving their first choice of workplace location both pre-, and post-implementation of an electronic decision support tool for anesthesia-in-charge schedulers. The study evaluates anesthesia professionals who use the electronic decision support tool and scheduling system at four hospitals and two surgical centers within NorthShore University HealthSystem. The subjects in the study are those anesthesia professionals that work at NorthShore University HealthSystem and are subject to being placed in their desired location by anesthesia schedulers who use the electronic decision support tool. The primary author developed the current software system enabling the electronic decision support tool implementation into clinical practice. All anesthesia-in-charge schedulers were educated during a three-week time period via administrative discussions and demonstrations on how to effectively operate the tool in real time. The total numbers and percentage of 1st choice of location selection by anesthesia professionals were summarized each week using interrupted time series Poisson regression. Slope before intervention, slope after intervention, level change, and slope change were all measured over 14-week pre- and post- implementation periods. The level of change (difference in percentage of anesthesia professionals who received their first choice) was statistically (P<0.0001) and clinically significant when comparing the historical cohorts of 2020 and 2021 to the 2022 intervention group weeks. Therefore, the implementation of an electronic decision support scheduling tool resulted in a statistically significant increase in those anesthesia professionals receiving their first-choice workplace location. This study provides the basis for further investigating whether this specific tool may improve anesthesia professional satisfaction within their work-life balance by enhancing workplace geographic/site choice.
Collapse
Affiliation(s)
- Mark A. Deshur
- NorthShore University HealthSystem, 2650 Ridge Ave., Evanston, IL 60201 USA
- Pritzker School of Medicine, University of Chicago, 5841 S. Maryland Ave, Chicago, IL 60637 USA
| | - Noah Ben-Isvy
- NorthShore University HealthSystem, 2650 Ridge Ave., Evanston, IL 60201 USA
- University of Illinois Urbana-Champaign, Champaign, IL USA
| | - Chi Wang
- NorthShore University HealthSystem, 2650 Ridge Ave., Evanston, IL 60201 USA
| | - Mohammed Minhaj
- NorthShore University HealthSystem, 2650 Ridge Ave., Evanston, IL 60201 USA
- Pritzker School of Medicine, University of Chicago, 5841 S. Maryland Ave, Chicago, IL 60637 USA
| | - Steven Greenberg
- NorthShore University HealthSystem, 2650 Ridge Ave., Evanston, IL 60201 USA
- Pritzker School of Medicine, University of Chicago, 5841 S. Maryland Ave, Chicago, IL 60637 USA
| |
Collapse
|
9
|
Hurtado DA, Greenspan SA, Valenzuela S, McGinnis W, Everson T, Lenhart A. Promise and Perils of Leader-Employee Check-ins in Reducing Emotional Exhaustion in Primary Care Clinics: Quasi-Experimental and Qualitative Evidence. Mayo Clin Proc 2023:S0025-6196(22)00708-X. [PMID: 37024355 DOI: 10.1016/j.mayocp.2022.12.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 11/29/2022] [Accepted: 12/01/2022] [Indexed: 04/08/2023]
Abstract
OBJECTIVE To analyze the role of short (<30 minutes) and frequent (quarterly) check-ins between clinic leaders and employees in reducing emotional exhaustion. METHODS Three interrelated studies were conducted: a 3-year repeated cross-sectional survey at 10 primary care clinics (n=505; we compared emotional exhaustion, perceived stress, and values alignment among employees of a clinic where check-ins were conducted vs 9 control clinics); interviews with leaders and employees (n=10) regarding the check-ins process and experiences; and interviews with leaders and employees (n=10) after replicating the check-ins at a new clinic. RESULTS Outcomes were similar at baseline. After a year, emotional exhaustion was lower at the check-ins compared with control clinics (standardized mean difference, d, -0.71 [P<.05]). After 2 years, emotional exhaustion remained lower at the check-ins clinic, but this difference was not significant. The check-ins were associated with an increment in values alignment (2018 vs 2017, d=0.59 [P<.05]; 2019 vs 2017, d=0.76 [P<.05]). There were no differences for perceived job stress. Interviews indicated that work-life challenges were discussed in the check-ins. However, employees need confidentiality and to feel safe to do so. The replication suggested that the check-ins are feasible to implement even amid turbulent times. CONCLUSION Periodic check-ins wherein leaders acknowledge and address work-life stressors might be a practical tactic to reduce emotional exhaustion in primary care clinics.
Collapse
Affiliation(s)
- David A Hurtado
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland; OHSU-PSU School of Public Health, Portland, OR.
| | - Samuel A Greenspan
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland
| | - Steele Valenzuela
- Department of Family Medicine, Oregon Health & Science University, Portland
| | - Wendy McGinnis
- Department of Internal Medicine and Geriatrics, Oregon Health & Science University, Portland
| | - Teresa Everson
- Department of Family Medicine, Oregon Health & Science University, Portland; OHSU-PSU School of Public Health, Portland, OR; Multnomah County Health Department, Portland, OR
| | - Abigail Lenhart
- Department of Internal Medicine and Geriatrics, Oregon Health & Science University, Portland
| |
Collapse
|
10
|
Bardhan R, Byrd T. Psychosocial Work Stress and Occupational Stressors in Emergency Medical Services. Healthcare (Basel) 2023; 11:healthcare11070976. [PMID: 37046903 PMCID: PMC10093884 DOI: 10.3390/healthcare11070976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 03/13/2023] [Accepted: 03/22/2023] [Indexed: 03/31/2023] Open
Abstract
Emergency medical service (EMS) professionals often experience work stress, which escalated during COVID-19. High job demand in the EMS profession may lead to progressive decline in physical and mental health. We investigated the prevalence of psychosocial job stress in the three levels of EMS: basic, advanced, and paramedic, before and during the COVID-19 pandemic. EMS professionals (n = 36) were recruited from EMS agencies following the Institutional Review Board approval. Participants took surveys on demographics, personal characteristics, chronic diseases, and work schedules. Job stress indicators, namely the effort–reward ratio (ERR) and overcommitment (OC), were evaluated from survey questionnaires using the effort–reward imbalance model. Associations of job stress indicators with age, sex, body mass index, and working conditions were measured by logistic regression. Psychosocial work stress was prevalent with effort reward ratio > 1 in 83% of participants and overcommitment scores > 13 in 89% of participants. Age, body mass index, and work hours showed strong associations with ERR and OC scores. The investigation findings suggested that a psychosocial work environment is prevalent among EMS, as revealed by high ERR, OC, and their correlation with sleep apnea in rotating shift employees. Appropriate interventions may be helpful in reducing psychosocial work stress in EMS professionals.
Collapse
|
11
|
Mavragani A, Davey Z, Srikesavan C, Hart L, Butcher D, Cipriani A. Implementation of a Web-Based Resilience Enhancement Training for Nurses: Pilot Randomized Controlled Trial. J Med Internet Res 2023; 25:e43771. [PMID: 36787181 PMCID: PMC9975925 DOI: 10.2196/43771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 12/22/2022] [Accepted: 01/12/2023] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND Global workforce challenges faced by health care providers are linked to low levels of job satisfaction, recruitment, retention, and well-being, with detrimental impacts on patient care outcomes. Resilience-building programs can provide support for staff who endure highly stressful environments, enhance resilience, and support recruitment and retention, with web-based formats being key to increasing accessibility. OBJECTIVE We aimed to examine participants' engagement with a newly developed Resilience Enhancement Online Training for Nurses (REsOluTioN), explore its acceptability, and compare levels of resilience and psychological well-being in nurses who completed REsOluTioN with those who did not. METHODS We carried out a pilot randomized trial (1:1), conducted at a single site (mental health and community trust in South England) between August 2021 and May 2022. Local research ethics approvals were obtained. Nurses were invited to participate and were randomly assigned to a waitlist group or REsOluTioN group. Training lasted for 4 weeks, consisting of prereading, web-based facilitated sessions, and mentorship support. We evaluated trial engagement, acceptability of training, and pre-post changes in resilience, measured by the Brief Resilience Scale, and psychological well-being, measured by the Warwick Edinburgh Mental Wellbeing Scale. Qualitative participant feedback was collected. Consolidated Standards of Reporting Trials 2010 extension guidelines for reporting pilot and feasibility trials were used. RESULTS Of 108 participants recruited, 93 completed the study. Participants' mean age was 44 (SD 10.85) years. Most participants were female (n=95, 88.8%), White (n=95, 88.8%), and worked in community settings (n=91, 85.0%). Sixteen facilitated and 150 mentoring sessions took place. Most REsOluTioN program participants reported the sessions helped improve their resilience (n=24, 72.8%), self-confidence (n=24, 72.7%), ability to provide good patient care (n=25, 75.8%), relationships with colleagues (n=24, 72.7%), and communication skills (n=25, 75.8%). No statistically significant differences between training and control groups and time on well-being (F1,91=1.44, P=.23, partial η2=0.02) and resilience scores (F1,91=0.33, P=.57, partial η2=0.004) were revealed; however, there were positive trends toward improvement in both. Nurse participants engaged with the REsOluTioN program and found it acceptable. Most found web-based training and mentoring useful and enjoyed learning, reflection, networking, and participatory sessions. CONCLUSIONS The REsOluTioN program was acceptable, engaging, perceived as useful, and nurses were keen for it to be implemented to optimize resilience, psychological health, communication, and workplace environments. The study has evidenced that it is acceptable to implement web-based resilience programs with similar design features within busy health care settings, indicating a need for similar programs to be carefully evaluated. Mentorship support may also be a key in optimizing resilience. Trial limitations include small sample size and reduced statistical power; a multicenter randomized controlled trial could test effectiveness of the training on a larger scale. TRIAL REGISTRATION ClinicalTrials.gov NCT05074563; https://clinicaltrials.gov/ct2/show/NCT05074563. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/37015.
Collapse
Affiliation(s)
| | - Zoe Davey
- Oxford Institute for Nursing, Midwifery and Allied Health Research, Oxford Brookes University, Oxford, United Kingdom
| | - Cynthia Srikesavan
- Oxford Institute for Nursing, Midwifery and Allied Health Research, Oxford Brookes University, Oxford, United Kingdom
| | - Liam Hart
- Research and Development, Oxford Health NHS Foundation Trust, Oxford, United Kingdom
| | - Dan Butcher
- Oxford Institute for Nursing, Midwifery and Allied Health Research, Oxford Brookes University, Oxford, United Kingdom
| | - Andrea Cipriani
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| |
Collapse
|
12
|
Henshall C, Ostinelli E, Harvey J, Davey Z, Aghanenu B, Cipriani A, Attenburrow MJ. Examining the Effectiveness of Web-Based Interventions to Enhance Resilience in Health Care Professionals: Systematic Review. JMIR MEDICAL EDUCATION 2022; 8:e34230. [PMID: 36066962 PMCID: PMC9490530 DOI: 10.2196/34230] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 07/12/2022] [Accepted: 07/31/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Internationally, the impact of continued exposure to workplace environmental and psychological stressors on health care professionals' mental health is associated with increased depression, substance misuse, sleep disorders, and posttraumatic stress. This can lead to staff burnout, poor quality health care, and reduced patient safety outcomes. Strategies to improve the psychological health and well-being of health care staff have been highlighted as a critical priority worldwide. The concept of resilience for health care professionals as a tool for negotiating workplace adversity has gained increasing prominence. OBJECTIVE This systematic review aims to examine the effectiveness of web-based interventions to enhance resilience in health care professionals. METHODS We searched the PubMed, CINAHL, PsycINFO, and Ovid SP databases for relevant records published after 1990 until July 2021. We included studies that focused on internet-delivered interventions aiming at enhancing resilience. Study quality was assessed with the Risk of Bias 2 tool for randomized controlled trial designs and Joanna Briggs Institute critical appraisal tool for other study designs. The protocol was registered on PROSPERO (International Prospective Register of Systematic Reviews; CRD42021253190). PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed. RESULTS A total of 8 studies, conducted between 2014 and 2020 and involving 1573 health care workers, were included in the review. In total, 4 randomized controlled trial designs and 4 pre- and postdesign studies were conducted across a range of international settings and health care disciplines. All of these studies aimed to evaluate the impact of web-based interventions on resilience or related symptoms in health care professionals involved in patient-facing care. Interventions included various web-based formats and therapeutic approaches over variable time frames. One randomized controlled trial directly measured resilience, whereas the remaining 3 used proxy measures to measure psychological concepts linked to resilience. Three pretest and posttest studies directly measured resilience, whereas the fourth study used a proxy resilience measure. Owing to the heterogeneity of outcome measures and intervention designs, meta-analysis was not possible, and qualitative data synthesis was undertaken. All studies found that resilience or proxy resilience levels were enhanced in health care workers following the implementation of web-based interventions. The overall risk of bias of all 8 studies was low. CONCLUSIONS The findings indicate that web-based interventions designed to enhance resilience may be effective in clinical practice settings and have the potential to provide support to frontline staff experiencing prolonged workplace stress across a range of health care professional groups. However, the heterogeneity of included studies means that findings should be interpreted with caution; more web-based interventions need rigorous testing to further develop the evidence base. TRIAL REGISTRATION PROSPERO CRD42021253190; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=253190.
Collapse
Affiliation(s)
- Catherine Henshall
- Oxford School of Nursing and Midwifery, Oxford Brookes University, Oxford, United Kingdom
- Warneford Hospital, Oxford Health National Health Service Foundation Trust, Oxford, United Kingdom
- Oxford Precision Psychiatry Lab, National Institute for Health Research Oxford Health Biomedical Research Centre, University of Oxford, Oxford, United Kingdom
- Oxford Institute for Nursing, Midwifery and Allied Health Research, Oxford Brookes University, Oxford, United Kingdom
| | - Edoardo Ostinelli
- Warneford Hospital, Oxford Health National Health Service Foundation Trust, Oxford, United Kingdom
- Oxford Precision Psychiatry Lab, National Institute for Health Research Oxford Health Biomedical Research Centre, University of Oxford, Oxford, United Kingdom
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Jade Harvey
- Warneford Hospital, Oxford Health National Health Service Foundation Trust, Oxford, United Kingdom
| | - Zoe Davey
- Oxford Institute for Nursing, Midwifery and Allied Health Research, Oxford Brookes University, Oxford, United Kingdom
| | - Bemigho Aghanenu
- Oxford School of Nursing and Midwifery, Oxford Brookes University, Oxford, United Kingdom
| | - Andrea Cipriani
- Warneford Hospital, Oxford Health National Health Service Foundation Trust, Oxford, United Kingdom
- Oxford Precision Psychiatry Lab, National Institute for Health Research Oxford Health Biomedical Research Centre, University of Oxford, Oxford, United Kingdom
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Mary-Jane Attenburrow
- Warneford Hospital, Oxford Health National Health Service Foundation Trust, Oxford, United Kingdom
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| |
Collapse
|
13
|
Srikesavan C, Davey Z, Cipriani A, Henshall C. Resilience Enhancement Online Training for Nurses (REsOluTioN): Protocol for a Pilot Randomized Controlled Trial. JMIR Res Protoc 2022; 11:e37015. [PMID: 35862692 PMCID: PMC9359309 DOI: 10.2196/37015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 07/14/2022] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Globally, nurses are facing increased pressure to provide high-quality complex patient care within environments with scarce resources in terms of staffing, infrastructure, or financial reward. The strain and demand on the psychological health and well-being of nurses during COVID-19 has been substantial, with many experiencing burnout; as such, interventions to enhance resilience within the workplace are required. A face-to-face resilience enhancement training program for nurses that was effective in improving resilience levels was translated into a 4-week online training program, Resilience Enhancement Online Training for Nurses (REsOluTioN), to enable greater accessibility for nurses. OBJECTIVE This study aims to compare levels of resilience, psychological health, and well-being in nurses before and after the online resilience training compared to a wait list control group. It will also explore participants' engagement with the trial and their acceptability of the online training. METHODS This is a two-arm, parallel, randomized controlled trial with a 6-week follow-up period. Up to 100 registered nonagency nurses working at a National Health Service hospital trust in South England will be recruited. Four cohorts will run, and participants will be randomized into a wait list control group or to REsOluTioN. Pre- and postonline surveys will collect study outcome measure data. In the REsOluTioN arm, data will be collected on the perceived usefulness of the online training via an online survey. Institutional and health research authority approvals have been obtained. RESULTS REsOluTioN will aim to empower nurses to maintain and enhance their resilience while working under challenging clinical conditions. The online training will be interactive with input from mentors, health care leaders, and peers to promote engagement and enhanced communication, and will create a forum where nurses can express their views and concerns, without hierarchical infrastructures inhibiting them. This can increase self-knowledge and learning around workplace resilience coping strategies and provide a safe space to validate feelings through mentorship and peer support. Findings will be reported in accordance with the CONSORT (Consolidated Standards of Reporting Trials) guidelines. The trial is now finished and was conducted between August 2021 and May 2022. CONCLUSIONS The REsOluTioN trial will enable preliminary data to be gathered to indicate the online training's effectiveness in enhancing nurses' resilience in the workplace, with the potential for larger scale follow-up studies to identify its value to nurses working across a range of health care settings. TRIAL REGISTRATION ClinicalTrials.gov NCT05074563; https://clinicaltrials.gov/ct2/show/NCT05074563. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/37015.
Collapse
Affiliation(s)
- Cynthia Srikesavan
- Oxford School of Nursing and Midwifery, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, United Kingdom
| | - Zoe Davey
- Oxford School of Nursing and Midwifery, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, United Kingdom
| | - Andrea Cipriani
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Catherine Henshall
- Oxford School of Nursing and Midwifery, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, United Kingdom
| |
Collapse
|
14
|
ReSEARCH Your Passion. JOURNAL OF INFUSION NURSING 2021; 44:196-197. [PMID: 34197348 DOI: 10.1097/nan.0000000000000432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|