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Dil S, Çam M. The mediator role of mindfulness in the relationship between the listening skills and anger management skills of emergency health care professionals. Int Emerg Nurs 2024; 75:101475. [PMID: 38896916 DOI: 10.1016/j.ienj.2024.101475] [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: 01/31/2024] [Revised: 05/04/2024] [Accepted: 05/31/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND Effective communication plays a crucial role in establishing strong relationships and providing essential support in clinical situations. This study was conducted to investigate the mediator role of mindfulness in the relationship between the listening skills and anger management skills of healthcare professionals working in the emergency department (ED). METHOD This was a cross-sectional study, which was conducted with 230 emergency department healthcare professionals (EHCPs) working in adult EDs in Turkey. Sociodemographic Characteristics Data Collection Form, Mindful Attention Awareness Scale (MAAS), Listening Skills Assessment Scale (LSAS), and Anger Management Scale (AMS) were used for data collection. Descriptive statistics included frequency and percentage; t test and ANOVA test were used for statistical analyses, as was "Process Macro 3.5 Model 4", which was used to study the effect of mediator variables. RESULTS The participants had a mean MAAS score of 57.71 ± 12.38, a mean LSAS score of 45.36 ± 6.23, and a mean AMS score of 17.93 ± 3.39. There were significant positive correlations between LSAS and MAAS (r = 0.197, p < 0.001), between AMS and MAAS (r = 0.233p < 0.001), and between AMS and LSAS r = 0.24p < 0.001). In addition, the process model analysis results supported that MAAS had a partial mediator role in the correlation between LSAS and AMS, and that its indirect effects were predicted by LSAS and AMS. It was determined that 5.75 % of total change on AMS was predicted by LSAS (F = 13.918; p < 0.001). CONCLUSION The results of this study indicate that as the mindfulness level of EHCPs increases, their listening and anger management skills increased. Therefore, reinforcing mindfulness by integrating mindfulness interventions into in-service training and applying strategies that promote EHCPs' listening skills and anger management skills would make it possible to provide quality health care with employees who are more efficient in conflict management and enjoy a higher level of satisfaction.
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Affiliation(s)
- Satı Dil
- Çankırı Karatekin Universtiy, Department: Faculty of Health Sciences, Çankırı, Turkey.
| | - Mehtap Çam
- T.C Ankara Bilkent City Hospital, Ankara, Turkey
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Hines-Stellisch K, Gawlik KS, Teall AM, Tucker S. Implementation of Coaching to Address Burnout in Emergency Clinicians. J Emerg Nurs 2024:S0099-1767(24)00167-3. [PMID: 39046399 DOI: 10.1016/j.jen.2024.06.007] [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: 11/11/2023] [Revised: 06/19/2024] [Accepted: 06/19/2024] [Indexed: 07/25/2024]
Abstract
BACKGROUND Factors including sleep disturbances, shift work, secondary traumatization, and workplace violence make emergency nurses uniquely susceptible to burnout. A recent study cited nearly half of emergency registered nurses (49.3%) experienced moderate to severe burnout. There is an urgent need for evidence-based solutions to address burnout and turnover in emergency nurses. The objective of this quality improvement project was to determine the effectiveness of a wellness coaching program for reducing burnout and turnover in emergency nurses and advanced practice providers. METHODS Baseline assessments of burnout and turnover intention were measured at the beginning of the coaching program and measured again upon completion of the coaching program. INTERVENTION Eight registered nurses and 2 advanced practice providers from an emergency department in a west coast community hospital completed 6 to 8 weeks of wellness coaching led by a board-certified nurse coach. The wellness coaching program was an evidence-based, modular curriculum in which participants chose the number and length of sessions. RESULTS An average of 6 hours of individualized, 1-on-1 wellness coaching was completed over 7.5 weeks. The project resulted in a large reduction in emotional exhaustion and turnover intention, no effect on depersonalization, and a small reduction in lack of personal achievement (Cohen's d = 0.79, 1.53, -0.18, and -0.35). Ninety percent of clinicians agreed or strongly agreed that coaching helped improve their burnout and said they would consider it again in the future. CONCLUSION This quality improvement project demonstrates wellness coaching was an evidence-based solution for improving burnout and turnover in emergency nurses. More investigation is needed to determine duration of reduction of these outcomes.
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Affiliation(s)
| | | | - Alice M Teall
- The Ohio State University College of Nursing, Columbus, OH
| | - Sharon Tucker
- Helene Fuld Health National Trust Institute for EBP in Nursing and Healthcare, The Ohio State University College of Nursing, Columbus, OH
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3
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Weigl M, Lifschitz M, Dodt C. Key factors for sustainable working conditions in emergency departments: an EUSEM-initiated, Europe-wide consensus survey. Eur J Emerg Med 2024:00063110-990000000-00139. [PMID: 39012362 DOI: 10.1097/mej.0000000000001159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/17/2024]
Abstract
BACKGROUND AND IMPORTANCE Modern emergency medicine (EM) is a complex, demanding, and occasionally stressful field of work. Working conditions, provider well-being, and associated health and performance outcomes are key factors influencing the establishment of a sustainable emergency department (ED) working environment. OBJECTIVES This multinational European Delphi survey aimed to identify unequivocal major factors for good and poor ED working conditions and their possible effects on health care provider well-being. DESIGN/SETTING AND PARTICIPANTS A total of 18 experts from six European countries (Belgium, Finland, Germany, Italy, Romania, and the UK) covering three different hospital sizes (small, medium, and large) in their respective countries participated in the two-round Delphi survey. All panelists held leadership roles in EM. OUTCOME MEASURES AND ANALYSIS The first step involved conducting an extensive literature search on ED working conditions. The second step involved the first Delphi round, which consisted of structured interviews with the panelists. The survey was designed to obtain information concerning important working conditions, comments regarding work-life factors identified from the literature, and ratings of their importance. Interviews were transcribed and analyzed following a standardized protocol. In the second Delphi round, experts rated the relevance of items consolidated from the first Delphi round (classified into ED work system factors, provider health outcomes, and ED work-life intervention approaches). RESULTS A nearly unequivocal consensus was obtained in four ED work condition categories, including positive (e.g. job challenges, personal motivation, and case complexities) and negative (e.g. overcrowding, workflow interruptions/multitasking, medical errors) ED work conditions. The highly relevant adverse personal health events identified included physical fatigue, exhaustion, and burnout. Concerning intervention practices, the panelists offered a wide spectrum of opportunities with less consensus. CONCLUSION Work system conditions exert positive and negative effects on the work life of ED providers across Europe. Although most European countries have varying health care systems, the expert-based survey results presented herein strongly suggest that improvement strategies should focus on system-related external stressors common in various countries. Our findings lay the scientific groundwork for future intervention studies at the local and systemic levels to improve ED provider work life.
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Affiliation(s)
- Matthias Weigl
- Institute for Patient Safety, University Hospital Bonn, Bonn, Germany
- Institute and Clinic for Occupational, Social and Environmental Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | - Michael Lifschitz
- Institute and Clinic for Occupational, Social and Environmental Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | - Christoph Dodt
- Acute and Emergency Care Clinic; München Klinik Bogenhausen, Munich, Germany
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Tunks Leach K, Demant D, Simpson P, Lewis J, Levett-Jones T. Chaplaincy and spiritual care in Australian ambulance services: an exploratory cross-sectional study. J Health Care Chaplain 2024; 30:202-225. [PMID: 38574262 DOI: 10.1080/08854726.2024.2323371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Abstract
Ambulance staff wellbeing programs aim to support the bio-psycho-social and sometimes spiritual needs of paramedics. While evidence demonstrates strong connections between spirituality and/or religion to wellbeing outcomes, little is known about spiritual care in ambulance services or its impact. The aim of this study was to investigate paramedics' perspectives on the role and value of Australian ambulance chaplains. A cross-sectional online study of registered paramedics in Australia was conducted between November and December 2022. Analysis of the 150 responses identified that paramedics viewed the chaplain's role as one built on professional caring relationships that provided proactive and reactive care in paramedic workplaces. Chaplains were perceived to promote wellbeing by incorporating emotional, psychological, social and spiritual care, and assisting paramedics to access additional support. Perceived religiousness of chaplains and organisational factors were barriers to paramedics accessing chaplains, while pre-existing relationships and shared experiences positively influenced paramedics decision to seek chaplain support.
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Affiliation(s)
- Katie Tunks Leach
- Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Daniel Demant
- Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
- Faculty of Health, Queensland University of Technology, Brisbane, OLD, Australia
| | - Paul Simpson
- School of Health Sciences, Western Sydney University, Sydney, NSW, Australia
| | | | - Tracy Levett-Jones
- Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
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Aust B, Leduc C, Cresswell-Smith J, O'Brien C, Rugulies R, Leduc M, Dhalaigh DN, Dushaj A, Fanaj N, Guinart D, Maxwell M, Reich H, Ross V, Sadath A, Schnitzspahn K, Tóth MD, van Audenhove C, van Weeghel J, Wahlbeck K, Arensman E, Greiner BA. The effects of different types of organisational workplace mental health interventions on mental health and wellbeing in healthcare workers: a systematic review. Int Arch Occup Environ Health 2024; 97:485-522. [PMID: 38695906 PMCID: PMC11130054 DOI: 10.1007/s00420-024-02065-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: 12/20/2023] [Accepted: 04/02/2024] [Indexed: 05/28/2024]
Abstract
OBJECTIVE To determine if and which types of organisational interventions conducted in small and medium size enterprises (SMEs) in healthcare are effective on mental health and wellbeing. METHODS Following PRISMA guidelines, we searched six scientific databases, assessed the methodological quality of eligible studies using QATQS and grouped them into six organisational intervention types for narrative synthesis. Only controlled studies with at least one follow-up were eligible. RESULTS We identified 22 studies (23 articles) mainly conducted in hospitals with 16 studies rated of strong or moderate methodological quality. More than two thirds (68%) of the studies reported improvements in at least one primary outcome (mental wellbeing, burnout, stress, symptoms of depression or anxiety), most consistently in burnout with eleven out of thirteen studies. We found a strong level of evidence for the intervention type "Job and task modifications" and a moderate level of evidence for the types "Flexible work and scheduling" and "Changes in the physical work environment". For all other types, the level of evidence was insufficient. We found no studies conducted with an independent SME, however five studies with SMEs attached to a larger organisational structure. The effectiveness of workplace mental health interventions in these SMEs was mixed. CONCLUSION Organisational interventions in healthcare workers can be effective in improving mental health, especially in reducing burnout. Intervention types where the change in the work environment constitutes the intervention had the highest level of evidence. More research is needed for SMEs and for healthcare workers other than hospital-based physicians and nurses.
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Affiliation(s)
- Birgit Aust
- National Research Centre for the Working Environment, Copenhagen, Denmark.
| | - Caleb Leduc
- School of Public Health, University College Cork, Cork, Ireland
| | | | - Clíodhna O'Brien
- National Suicide Research Foundation, University College Cork, Cork, Ireland
| | - Reiner Rugulies
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Mallorie Leduc
- National Suicide Research Foundation, University College Cork, Cork, Ireland
| | | | - Arilda Dushaj
- Community Centre for Health and Wellbeing, Tirana, Albania
| | - Naim Fanaj
- Per Mendje Te Shendoshe (PMSH), Prizren, Kosovo
- Alma Mater Europaea Campus Rezonanca, Pristina, Kosovo
| | - Daniel Guinart
- CIBERSAM, Hospital del Mar Research Institute, Barcelona, Spain
- Institut de Salut Mental, Hospital del Mar, Barcelona, Spain
- The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, USA
| | - Margaret Maxwell
- Nursing, Midwifery and Allied Health Professionals Research Unit, University of Stirling, Stirling, Scotland
| | - Hanna Reich
- German Foundation for Depression and Suicide Prevention, Leipzig, Germany
- Depression Research Centre of the German Depression Foundation, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| | - Victoria Ross
- Australian Institute for Suicide Research and Prevention, WHO Collaborating Centre for Research and Training in Suicide Prevention, School of Applied Psychology, Griffith University, Brisbane, Australia
| | - Anvar Sadath
- National Suicide Research Foundation, University College Cork, Cork, Ireland
| | | | - Mónika Ditta Tóth
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
| | - Chantal van Audenhove
- KU Leuven, Louvain, Belgium
- Center for Care Research and Consultancy, LUCAS, Louvain, Belgium
| | - Jaap van Weeghel
- Tranzo Scientific Center for Care and Wellbeing, Tilburg University, Tilburg, The Netherlands
| | | | - Ella Arensman
- School of Public Health, University College Cork, Cork, Ireland
- National Suicide Research Foundation, University College Cork, Cork, Ireland
- Australian Institute for Suicide Research and Prevention, WHO Collaborating Centre for Research and Training in Suicide Prevention, School of Applied Psychology, Griffith University, Brisbane, Australia
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Paterson C, Leduc C, Maxwell M, Aust B, Strachan H, O'Connor A, Tsantila F, Cresswell-Smith J, Purebl G, Winter L, Fanaj N, Doukani A, Hogg B, Corcoran P, D'Alessandro L, Mathieu S, Hegerl U, Arensman E, Greiner BA. Barriers and facilitators to implementing workplace interventions to promote mental health: qualitative evidence synthesis. Syst Rev 2024; 13:152. [PMID: 38849924 PMCID: PMC11157821 DOI: 10.1186/s13643-024-02569-2] [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: 11/08/2023] [Accepted: 05/17/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND Despite growing interest in workplace mental health interventions, evidence of their effectiveness is mixed. Implementation science offers a valuable lens to investigate the factors influencing successful implementation. However, evidence synthesis is lacking, especially for small-to-medium-sized enterprises (SMEs) and for specific work sectors. The objectives of this review are to establish the scope of research with explicit analysis of implementation aspects of workplace mental health interventions and to identify barriers and facilitators to implementation in general and within SMEs and selected sectors. METHODS A systematic scoping review and meta-synthesis of mixed methods process evaluation research from 11 databases, with the evaluation of methodological quality (MMAT) and confidence in findings (CERQual), was conducted. We selected information-rich studies and synthesised them using domains within the Nielsen and Randall implementation framework: context, intervention activities, implementation; and mental models. RESULTS We included 43 studies published between 2009 and 2022, of which 22 were rated as information-rich to be analysed for barriers and facilitators. Most studies were conducted in healthcare. Facilitators reflecting 'high confidence' included: relevant and tailored content, continuous and pro-active leadership buy-in and support, internal or external change agents/champions, assistance from managers and peers, resources, and senior-level experience and awareness of mental health issues. Healthcare sector-specific facilitators included: easy accessibility with time provided, fostering relationships, clear communication, and perceptions of the intervention. Stigma and confidentiality issues were reported as barriers overall. Due to the small number of studies within SMEs reported findings did not reach 'high confidence'. A lack of studies in construction and Information and Communication Technology meant separate analyses were not possible. CONCLUSIONS There is dependable evidence of key factors for the implementation of workplace mental health interventions which should be used to improve implementation. However, there is a lack of studies in SMEs and in a larger variety of sectors. SYSTEMATIC REVIEW REGISTRATION Research Registry ( reviewregistry897 ).
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Affiliation(s)
- Charlotte Paterson
- Nursing, Midwifery and Allied Health Professional Research Unit, University of Stirling, Pathfoot Building, Stirling, FK9 4LA, Scotland, UK
| | - Caleb Leduc
- School of Public Health, University College Cork, Western Gateway Building, Cork, Ireland
- National Suicide Research Foundation, Western Gateway Building, Cork, Ireland
| | - Margaret Maxwell
- Nursing, Midwifery and Allied Health Professional Research Unit, University of Stirling, Pathfoot Building, Stirling, FK9 4LA, Scotland, UK.
| | - Birgit Aust
- National Research Centre for the Working Environment, Lersø Parkallé 105, Copenhagen, 2100, Denmark
| | - Heather Strachan
- Nursing, Midwifery and Allied Health Professional Research Unit, University of Stirling, Pathfoot Building, Stirling, FK9 4LA, Scotland, UK
| | | | - Fotini Tsantila
- LUCAS, Centre for Care Research and Consultancy, KU Leuven, Louvain, 3000, Belgium
| | - Johanna Cresswell-Smith
- Finnish Institute for Health and Welfare (THL) Equality Unit-Mental Health Team, Helsinki, Finland
| | - Gyorgy Purebl
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
| | - Lars Winter
- Phrenos Center of Expertise for Severe Mental Illnesses, Utrecht, the Netherlands
| | - Naim Fanaj
- Mental Health Center Prizren, Prizren, Kosovo
- Almae Mater Europaea Campus College Rezonanca, Prishtina, Kosovo
| | - Asmae Doukani
- Centre for Global Mental Health, Department of Population Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Bridget Hogg
- Centre Fòrum Research Unit, Institute of Mental Health, Hospital del Mar Barcelona, Barcelona, SpainHospital del Mar Research Institute, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto Carlos III, Madrid, Spain
| | - Paul Corcoran
- School of Public Health, University College Cork, Western Gateway Building, Cork, Ireland
- National Suicide Research Foundation, Western Gateway Building, Cork, Ireland
| | - Luigia D'Alessandro
- International Association for Suicide Prevention (IASP), 5221 Wisconsin Avenue NW, Washington, DC, 20015, USA
| | - Sharna Mathieu
- Australian Institute for Suicide Research and Prevention, World Health Organization Collaborating Centre for Research and Training in Suicide Prevention, Brisbane, Australia
- School of Applied Psychology, Griffith University, Mt. Gravatt Campus, Brisbane, QLD, 4122, Australia
| | - Ulrich Hegerl
- European Alliance Against Depression E.V., Leipzig, 04109, Germany
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt Am Main, 60528, Germany
| | - Ella Arensman
- School of Public Health, University College Cork, Western Gateway Building, Cork, Ireland
- National Suicide Research Foundation, Western Gateway Building, Cork, Ireland
- Australian Institute for Suicide Research and Prevention, School of Applied Psychology, Griffith University, Brisbane, Australia
| | - Birgit A Greiner
- School of Public Health, University College Cork, Western Gateway Building, Cork, Ireland
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Hetherington D, Wilson NJ, Dixon K, Murphy G. Emergency department Nurses' narratives of burnout: Changing roles and boundaries. Int Emerg Nurs 2024; 74:101439. [PMID: 38581856 DOI: 10.1016/j.ienj.2024.101439] [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: 09/10/2023] [Revised: 02/29/2024] [Accepted: 03/10/2024] [Indexed: 04/08/2024]
Abstract
PURPOSE Emergency department nurses work in rapidly changing environments, which can contribute to occupational stress. Emergency department nurses utilise diverse strategies to mediate the impact of stress on their daily lives. There is a paucity of qualitative research which explores emergency department nurses' experiences and perspectives of burnout. This study aimed to explore emergency department nurses' experiences of burnout. Further, the study considered how emergency nurses conceptualised burnout and the strategies they used to manage the professional and personal effects of burnout. PROCEDURES The COREQ research guidelines were used throughout the study from the design stage through to dissemination. Narrative inquiry was used as the underpinning theoretical framework. The researcher met individually with eight emergency department nurses from NSW hospitals to undertake a face-to-face semi-structured interview. An inductive approach was used to establish major themes within the narrative. FINDINGS Two major themes were established: experiencing conflicting emotions and trying to establish a personal sense of control. Emergency nurses felt passionate about their professional roles, yet encountered difficulties due to management structures, time constraints and a sense of underappreciation. The misalignment between their expectations and the reality of emergency department nursing, resulted in experiences of burnout such as dissatisfaction and frustrations at work. Consequently, these nurses adopted diverse strategies within both their professional and personal domains. PRINCIPAL CONCLUSIONS The conclusions of this study are transferable to a variety of acute health services. Health service management have a role to promote a positive workplace culture for nurses, which advocates for home life balance. This will support nurses to construct clear boundaries between professional identity and their personal lives.
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Affiliation(s)
- Debbie Hetherington
- Master of Research (MRes), School of Nursing and Midwifery, Western Sydney University, Australia.
| | - Nathan J Wilson
- School of Nursing and Midwifery, Western Sydney University, Australia.
| | - Kathleen Dixon
- School of Nursing and Midwifery, Western Sydney University, Australia.
| | - Gillian Murphy
- School of Nursing and Midwifery, Western Sydney University, Australia.
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Ong NY, Teo FJJ, Ee JZY, Yau CE, Thumboo J, Tan HK, Ng QX. Effectiveness of mindfulness-based interventions on the well-being of healthcare workers: a systematic review and meta-analysis. Gen Psychiatr 2024; 37:e101115. [PMID: 38737894 PMCID: PMC11086195 DOI: 10.1136/gpsych-2023-101115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 03/07/2024] [Indexed: 05/14/2024] Open
Abstract
Background Growing evidence attests to the efficacy of mindfulness-based interventions (MBIs), but their effectiveness for healthcare workers remains uncertain. Aims To evaluate the evidence for MBIs in improving healthcare workers' psychological well-being. Methods A systematic literature search was conducted on Medline, Embase, Cumulative Index for Nursing and Allied Health Literature, PsycINFO and Cochrane Central Register of Controlled Trials up to 31 August 2022 using the keywords 'healthcare worker', 'doctor', 'nurse', 'allied health', 'mindfulness', 'wellness', 'workshop' and 'program'. Randomised controlled trials with a defined MBI focusing on healthcare workers and quantitative outcome measures related to subjective or psychological well-being were eligible for inclusion. R V.4.0.3 was used for data analysis, with the standardised mean difference as the primary outcome, employing DerSimonian and Laird's random effects model. Grading of Recommendations, Assessment, Development and Evaluation framework was used to evaluate the quality of evidence. Cochrane's Risk of Bias 2 tool was used to assess the risk of bias in the included studies. Results A total of 27 studies with 2506 participants were included, mostly from the USA, involving various healthcare professions. MBIs such as stress reduction programmes, apps, meditation and training showed small to large effects on anxiety, burnout, stress, depression, psychological distress and job strain outcomes of the participants. Positive effects were also seen in self-compassion, empathy, mindfulness and well-being. However, long-term outcomes (1 month or longer postintervention) varied, and the effects were not consistently sustained. Conclusions MBIs offer short-term benefits in reducing stress-related symptoms in healthcare workers. The review also highlights limitations such as intervention heterogeneity, reduced power in specific subgroup analyses and variable study quality. PROSPERO registration number CRD42022353340.
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Affiliation(s)
- Natasha Yixuan Ong
- NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Finn Jing Jie Teo
- NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Jane Zi Ying Ee
- NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Chun En Yau
- NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Julian Thumboo
- NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Health Services Research Unit, Singapore General Hospital, Singapore
- SingHealth Duke-NUS Medicine Academic Clinical Programme, Duke-NUS Medical School, Singapore
| | - Hiang Khoon Tan
- Singhealth Duke-NUS Global Health Institute, Singapore
- Duke Global Health Institute, Duke University, Durham, North Carolina, USA
- Division of Surgery and Surgical Oncology, Singapore General Hospital, Singapore
| | - Qin Xiang Ng
- Health Services Research Unit, Singapore General Hospital, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
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Mäkinen M, Jaakonsalo E, Saarivainio R, Koskiniemi J, Renholm M. The effects of mindfulness training for emergency department and intermediate care unit nurses. Appl Nurs Res 2024; 76:151770. [PMID: 38641379 DOI: 10.1016/j.apnr.2024.151770] [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: 02/17/2023] [Revised: 08/31/2023] [Accepted: 02/18/2024] [Indexed: 04/21/2024]
Abstract
AIM The aim of this study was to determine the effects of mindfulness and self-compassion skills on the experienced stress and work satisfaction of emergency department (ED) and intermediate care unit employees. METHODS All ED and intermediate care unit employees in the study hospital were invited to participate in an introductory lecture about mindfulness, compassion, and the intervention in January 2020. After the lecture, it was possible to enroll in training. This training was postponed due to Covid-19 and started in October 2020. RESULTS The most important findings of this study are that instructor-led mindfulness training, and the regular use of a smartphone mindfulness application can significantly reduce stress and burnout and promote mindfulness and well-being of ED and intermediate care unit personnel. CONCLUSIONS This study shows that compact mindfulness training via innovative digital technology has a positive effect in reducing ED and intermediate care unit employees stress and burnout, while improving mindfulness and well-being, and this is consistent with the wider literature. KEY FINDINGS The regular practice of smartphone-guided mindfulness can reduce stress and burnout, as well as promote mindfulness and well-being among ED and intermediate care unit employees.
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Affiliation(s)
- Marja Mäkinen
- Department of Emergency Medicine and Services, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
| | | | - Reetta Saarivainio
- Department of Emergency Medicine and Services, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Jarkko Koskiniemi
- Department of Emergency Medicine and Services, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Marja Renholm
- Management of the Joint Authority, Nursing Management, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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10
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Testa L, Richardson L, Cheek C, Hensel T, Austin E, Safi M, Ransolin N, Carrigan A, Long J, Hutchinson K, Goirand M, Bierbaum M, Bleckly F, Hibbert P, Churruca K, Clay-Williams R. Strategies to improve care for older adults who present to the emergency department: a systematic review. BMC Health Serv Res 2024; 24:178. [PMID: 38331778 PMCID: PMC10851482 DOI: 10.1186/s12913-024-10576-1] [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: 10/30/2023] [Accepted: 01/08/2024] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND The aim of this systematic review was to examine the relationship between strategies to improve care delivery for older adults in ED and evaluation measures of patient outcomes, patient experience, staff experience, and system performance. METHODS A systematic review of English language studies published since inception to December 2022, available from CINAHL, Embase, Medline, and Scopus was conducted. Studies were reviewed by pairs of independent reviewers and included if they met the following criteria: participant mean age of ≥ 65 years; ED setting or directly influenced provision of care in the ED; reported on improvement interventions and strategies; reported patient outcomes, patient experience, staff experience, or system performance. The methodological quality of the studies was assessed by pairs of independent reviewers using The Joanna Briggs Institute critical appraisal tools. Data were synthesised using a hermeneutic approach. RESULTS Seventy-six studies were included in the review, incorporating strategies for comprehensive assessment and multi-faceted care (n = 32), targeted care such as management of falls risk, functional decline, or pain management (n = 27), medication safety (n = 5), and trauma care (n = 12). We found a misalignment between comprehensive care delivered in ED for older adults and ED performance measures oriented to rapid assessment and referral. Eight (10.4%) studies reported patient experience and five (6.5%) reported staff experience. CONCLUSION It is crucial that future strategies to improve care delivery in ED align the needs of older adults with the purpose of the ED system to ensure sustainable improvement effort and critical functioning of the ED as an interdependent component of the health system. Staff and patient input at the design stage may advance prioritisation of higher-impact interventions aligned with the pace of change and illuminate experience measures. More consistent reporting of interventions would inform important contextual factors and allow for replication.
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Affiliation(s)
- Luke Testa
- Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, North Ryde, 2109, Australia
| | - Lieke Richardson
- Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, North Ryde, 2109, Australia
| | - Colleen Cheek
- Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, North Ryde, 2109, Australia.
| | - Theresa Hensel
- Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, North Ryde, 2109, Australia
- Institute of Medical Sociology, Health Services Research, and Rehabilitation Science (IMVR), University of Cologne, Cologne, Germany
| | - Elizabeth Austin
- Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, North Ryde, 2109, Australia
| | - Mariam Safi
- Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, North Ryde, 2109, Australia
- Internal Medicine Research Unit, University Hospital of Southern Denmark, Aabenraa, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Natália Ransolin
- Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, North Ryde, 2109, Australia
- Universidade Federal Do Rio Grande Do Sul, Porto Alegre, RS, Brasil
| | - Ann Carrigan
- Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, North Ryde, 2109, Australia
| | - Janet Long
- Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, North Ryde, 2109, Australia
| | - Karen Hutchinson
- Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, North Ryde, 2109, Australia
| | - Magali Goirand
- Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, North Ryde, 2109, Australia
| | - Mia Bierbaum
- Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, North Ryde, 2109, Australia
- Allied Health and Human Performance, IIMPACT in Health, University of South Australia, Adelaide, 5001, Australia
| | - Felicity Bleckly
- Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, North Ryde, 2109, Australia
| | - Peter Hibbert
- Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, North Ryde, 2109, Australia
- Allied Health and Human Performance, IIMPACT in Health, University of South Australia, Adelaide, 5001, Australia
| | - Kate Churruca
- Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, North Ryde, 2109, Australia
| | - Robyn Clay-Williams
- Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, North Ryde, 2109, Australia
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Kheirkhah H, Hartfeld NMS, Widdifield J, Kulhawy-Wibe S, Roberts J, Yacyshyn EA, Lee JJY, Jilkine K, Jerome D, Kwok TSH, Burt J, Barber CEH. An Overview of Reviews to Inform Organization-Level Interventions to Address Burnout in Rheumatologists. J Rheumatol 2023; 50:1488-1502. [PMID: 37527857 DOI: 10.3899/jrheum.2023-0437] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2023] [Indexed: 08/03/2023]
Abstract
OBJECTIVE To identify organization-directed strategies that could be implemented to prevent burnout among rheumatologists. METHODS A search of English language articles published 2011 or later was conducted on Cochrane Database of Systematic Reviews, Embase, Medline, and PsycInfo on January 25, 2022. Included reviews had ≥ 1 primary studies with ≥ 10% of participants who were physicians, recorded burnout as an outcome, and described an organization-directed intervention to prevent burnout. Overlap of primary studies across reviews was assessed. The final review inclusion was determined by study quality, minimization of overlap, and maximization of intervention breadth. The A Measurement Tool to Assess Systematic Reviews (AMSTAR) 2 tool was used for quality assessment. Included studies and interventions were assessed by rheumatologists for their applicability to rheumatology. RESULTS A total of 17 reviews, including 15 systematic reviews, 1 realist review, and 1 umbrella review were included. AMSTAR 2 quality ratings classified 5 systematic reviews as low quality, 1 as moderate, and 9 as critically low. There was significant heterogeneity between and within reviews. Six conducted a metaanalysis and 11 provided a qualitative summary of findings. The following intervention types were identified as having possible applicability to rheumatology: physician workflow and organizational strategies; peer support and formal communication training; leadership support; and addressing stress, mental health, and mindfulness. Across interventions, mindfulness had the highest quality of evidence to support its effectiveness. CONCLUSION Although the quality of evidence for interventions to prevent burnout in physicians is low, promising strategies such as mindfulness have been identified.
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Affiliation(s)
- Hengameh Kheirkhah
- H. Kheirkhah, MD, N.M.S. Hartfeld, MSc, MC, S. Kulhawy-Wibe, MD, MSc, Cumming School of Medicine, University of Calgary, Calgary, Alberta
| | - Nicole M S Hartfeld
- H. Kheirkhah, MD, N.M.S. Hartfeld, MSc, MC, S. Kulhawy-Wibe, MD, MSc, Cumming School of Medicine, University of Calgary, Calgary, Alberta
| | - Jessica Widdifield
- J. Widdifield, PhD, Sunnybrook Research Institute, University of Toronto, ICES, Toronto, Ontario
| | - Stephanie Kulhawy-Wibe
- H. Kheirkhah, MD, N.M.S. Hartfeld, MSc, MC, S. Kulhawy-Wibe, MD, MSc, Cumming School of Medicine, University of Calgary, Calgary, Alberta
| | - Janet Roberts
- J. Roberts, MD, Division of Rheumatology, Department of Medicine, Dalhousie University, Halifax, Nova Scotia
| | - Elaine A Yacyshyn
- E.A. Yacyshyn, MD, MScHQ, Division of Rheumatology, Department of Medicine, University of Alberta, Edmonton, Alberta
| | - Jennifer J Y Lee
- J.J.Y. Lee, MD, MSc, Division of Rheumatology, Department of Pediatrics, University of Toronto, Toronto, Ontario
| | - Konstantin Jilkine
- K. Jilkine, MD, Section of Rheumatology, Department of Medicine, University of Manitoba, Winnipeg, Manitoba
| | - Dana Jerome
- D. Jerome, MD, MEd, T.S.H. Kwok, MD, MSc, Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Ontario
| | - Timothy S H Kwok
- D. Jerome, MD, MEd, T.S.H. Kwok, MD, MSc, Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Ontario
| | - Jennifer Burt
- J. Burt, PT, ACPAC-trained ERP, Rheumatology Services, Eastern Health, St. John's, Newfoundland and Labrador
| | - Claire E H Barber
- C.E.H. Barber, MD, PhD, Cumming School of Medicine, University of Calgary, Calgary, Alberta, and Arthritis Research Canada, Vancouver, British Columbia, Canada.
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12
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Mithen LM, Weaver N, Walker FR, Inder KJ. Feasibility of biomarkers to measure stress, burnout and fatigue in emergency nurses: a cross-sectional study. BMJ Open 2023; 13:e072668. [PMID: 37643845 PMCID: PMC10465916 DOI: 10.1136/bmjopen-2023-072668] [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: 02/10/2023] [Accepted: 08/16/2023] [Indexed: 08/31/2023] Open
Abstract
INTRODUCTION Retaining nurses in the workforce is an urgent concern in healthcare. Emergency nurses report high levels of stress and burnout, however, there is no gold standard of how to measure these responses. This study aims to measure stress, burnout, and fatigue in emergency nurses using biomarkers and psychometric instruments. Biomarkers will be used to better understand nurses' levels of stress and burnout and to assess the feasibility of using biomarkers as a viable stress measurement tool in a real-world setting. METHODS AND ANALYSIS A two stage cross-sectional design to measure stress, burnout and fatigue in emergency nurses while they work is proposed. All registered and enrolled nurses working in the emergency department from four hospitals in Australia will be invited to participate. Validated psychometric tools will be used in stage 1 to measure depression, anxiety, acute stress, chronic stress, burnout and fatigue. Biomarkers comprising hair cortisol, saliva alpha amylase and heart rate variability will be collected as an objective measure of stress and burnout in stage 2 over one working shift per participant. Written consent will be sought for stage 2 where nurses will provide one hair sample, wear a heart rate sensor and be asked to collect their saliva at three different time points of one shift. Data analysis will measure the domains of acute stress, chronic stress and burnout and explore relationships and correlation between psychometric measures and biomarkers. ETHICS AND DISSEMINATION Ethics approval obtained from the Human Research Ethics Committee of the Hunter New England Local Health District (approval number: HREC/2020/ETH01684) and University of Newcastle HREC (H-2022-0169). Results will be reported in peer-reviewed publications using the Strengthening the Reporting of Observational Studies in Epidemiology guidelines. Public dissemination will occur by presenting at conferences and to the participating local health district.
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Affiliation(s)
- Lucinda M Mithen
- School of Nursing & Midwifery, The University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, HMRI, New Lambton, New South Wales, Australia
| | - Natasha Weaver
- Hunter Medical Research Institute, HMRI, New Lambton, New South Wales, Australia
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Frederick R Walker
- Hunter Medical Research Institute, HMRI, New Lambton, New South Wales, Australia
- School of Biomedical Sciences, The University of Newcastle, Callaghan, New South Wales, Australia
- Priority Research Centre for Stroke and Brain Injury, The University of Newcastle, Callaghan, New South Wales, Australia
- Centre for Advanced Training Systems, The University of Newcastle, Newcastle, New South Wales, Australia
| | - Kerry J Inder
- School of Nursing & Midwifery, The University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, HMRI, New Lambton, New South Wales, Australia
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13
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Wang Q, Wang F, Zhang S, Liu C, Feng Y, Chen J. Effects of a mindfulness-based interventions on stress, burnout in nurses: a systematic review and meta-analysis. Front Psychiatry 2023; 14:1218340. [PMID: 37599884 PMCID: PMC10434780 DOI: 10.3389/fpsyt.2023.1218340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 07/17/2023] [Indexed: 08/22/2023] Open
Abstract
Background Stress in the healthcare environment causes negative effects in nurses such as burnout, anxiety, and depression. The COVID-19 pandemic has resulted in increased pressure on medical staff globally, highlighting the potential benefits of mindfulness-based interventions in reducing nurses' stress levels. Despite numerous studies exploring the effect of mindfulness-based training on nurses, the results remain inconclusive. Objective To systematically evaluate the impact of mindfulness training on nurse's performance and increase the certainty of existing evidence. Methods This study searched various databases, including EBSCO, Embase, Web of Science, PubMed, ProQuest, Scopus, Cochrane Online Library, Wanfang, SinoMed, CNKI, and VIP, for randomized controlled trials on the impact of mindfulness-based interventions for nurses up until 02 December 2022. Two investigators independently screened and extracted data from the articles, while also assessing the risk of bias. The data was analyzed using RevMan 5.4 software. Results This review identified 15 studies out of the 2,171 records retrieved, consisting of a total of 1,165 participants who were randomized. Post-intervention analysis provided very-low certainty evidence of moderate effectiveness of mindfulness-based training in reducing stress [standardized mean difference (SMD) = -0.81; 95% confidence interval (CI) = -1.11 to -0.52], with no significant effect on anxiety (SMD = -0.30; 95% CI = -0.72 to 0.13) or depression (SMD = -0.24; 95% CI = -0.55 to 0.07). However, the training was effective in reducing burnout, as demonstrated by the lower scores for emotional exhaustion (SMD = -4.27; 95% CI = -5.94 to -2.59) and depersonalization (SMD = -2.89; 95% CI = -4.24 to -1.54) and higher scores for personal accomplishment (SMD = 2.81; 95% CI = 0.12 to 5.50). There was a sustained improvement in stress levels in the short-term (≤3 months), with delayed benefits for burnout. However, only two studies were available for later follow-ups, and there was no significant evidence of long-term effects. Conclusion Mindfulness-based training may be a viable intervention for improving the psychological wellbeing of nurses, including reducing stress, burnout. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023387081.
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Affiliation(s)
- Qi Wang
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Fang Wang
- Guang’an Hospital of Traditional Chinese Medicine, Guang’an, Sichuan, China
| | - Shurong Zhang
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Chaofan Liu
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Yue Feng
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Junzhu Chen
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
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Hăisan A, Hogaș S, Măirean C, Punei MO, Volovăț SR, Hogaș M, Kantor C, Cimpoeșu D. Compassion fatigue and compassion satisfaction among Romanian emergency medicine personnel. Front Med (Lausanne) 2023; 10:1189294. [PMID: 37554501 PMCID: PMC10406243 DOI: 10.3389/fmed.2023.1189294] [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: 03/18/2023] [Accepted: 07/10/2023] [Indexed: 08/10/2023] Open
Abstract
Background Contemporary scientific literature has emphasized two specific aspects of healthcare professionals: compassion satisfaction and compassion fatigue. In the context of the COVID-19 pandemic, which has placed significant strain on health systems and healthcare workers, the Russian-Ukrainian crisis appears to have a magnifying effect, particularly on mental health. Methods The aim of the present study was to investigate the relationship between threat perception, daily worries, and professional quality of life in a sample of Emergency Medicine Personnel during two major events mentioned above. The sample included 372 participants (56.7% nurses and 43.3% physicians) from emergency units in five county hospitals in the Eastern region of Romania. Results The study revealed that threats related to the pandemic were positively linked to secondary traumatic stress, and daily worries were positively linked to both secondary traumatic stress and burnout. Threats generated by the war did not manifest a direct relation with any of the indicators of professional quality of life, but daily worries generated by war positively predicted both secondary traumatic stress and burnout. Conclusion Both the pandemic, which involved cumulative exposure, and the war, which involved a lower and more distant level of exposure, had the potential to generate worries and predict a low quality of life. However, our results did not reveal any association between threats, worries, and compassion satisfaction. As a result, this positive indicator of quality of life remained stable despite the presence of threats and worries.
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Affiliation(s)
- Anca Hăisan
- Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, Iași, Romania
| | - Simona Hogaș
- Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, Iași, Romania
| | - Cornelia Măirean
- Faculty of Psychology and Educational Sciences, Alexandru Ioan Cuza University, Iași, Romania
| | - Mirabela-Olivia Punei
- Faculty of Psychology and Educational Sciences, Alexandru Ioan Cuza University, Iași, Romania
| | | | - Mihai Hogaș
- Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, Iași, Romania
| | - Cristina Kantor
- Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, Iași, Romania
| | - Diana Cimpoeșu
- Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, Iași, Romania
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15
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Peng K, Jiang J, Jiang N, An R, Zheng J, Yan S. Self-rated health and its related influencing factors among emergency department physicians: a national cross-sectional study. Front Public Health 2023; 11:1147403. [PMID: 37521980 PMCID: PMC10372430 DOI: 10.3389/fpubh.2023.1147403] [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: 01/24/2023] [Accepted: 04/10/2023] [Indexed: 08/01/2023] Open
Abstract
Background Protecting and improving the personal health of healthcare workers is critical to improving the efficiency and quality of care. To effectively meet the needs of the emergency service system, emergency physicians need to be in a good state of health. However, due to the special characteristics of work in the emergency department, emergency physicians have to face various psychosocial pressures, which may bring them physical and mental distress. Therefore, this study aims to explore the emergency physicians' self-rated health status and its related factors, to provide an empirical study for the improvement of emergency physicians' self-rated health status. Method A cross-sectional survey of emergency physicians was conducted in China between July and August 2018. The questionnaires contained items on demographic characteristics, behavioral lifestyle and job-related factors, as well as self-rated health. The generalized ordinal logistic model was used to identify related factors of emergency physicians' self-rated health status. Results Only 14.4% of Chinese emergency physicians considered themselves in good health status. Results showed that emergency physicians who never exercised (β = 0.76, p < 0.001) and exercised <2 times per week (β = 0.34, p < 0.001) were more likely to report poor health status. In addition, emergency physicians with good sleep quality (β = -3.84, p < 0.001), fewer night work shifts (β = -0.47, p < 0.001), less frequency of visiting patients (β = -0.33, p < 0.001), never suffered the workplace violence (β = -0.47, p < 0.001) and never perceived effort-reward imbalance (β = -0.68, p < 0.001) were more likely to report good self-rated health. Conclusion Chinese emergency physicians' self-rated health status was not optimistic. Self-rated health is associated with multiple domains of work-related factors and personal lifestyle. Feasible measures should be taken to improve the working environment of emergency physicians, develop acceptable shift schedules for employees, monitor and maintain the health status of emergency department physicians.
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Affiliation(s)
- Ke Peng
- Department of Finance, Southampton Business School, University of Southampton, Southampton, United Kingdom
| | - Jingjing Jiang
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Nan Jiang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Rongrong An
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jianwei Zheng
- Department of Biliary-Pancreatic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shijiao Yan
- School of Public Health, Hainan Medical University, Haikou, Hainan, China
- Key Laboratory of Emergency and Trauma of Ministry of Education, Hainan Medical University, Haikou, China
- Department of Emergency Medicine, Hunan Provincial Key Laboratory of Emergency and Critical Care Metabolomics, Hunan Provincial Institute of Emergency Medicine, Hunan Provincial People's Hospital/The First Affiliated Hospital, Hunan Normal University, Changsha, China
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16
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Cohen C, Pignata S, Bezak E, Tie M, Childs J. Workplace interventions to improve well-being and reduce burnout for nurses, physicians and allied healthcare professionals: a systematic review. BMJ Open 2023; 13:e071203. [PMID: 37385740 PMCID: PMC10314589 DOI: 10.1136/bmjopen-2022-071203] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 05/23/2023] [Indexed: 07/01/2023] Open
Abstract
There is a growing need for interventions to improve well-being in healthcare workers, particularly since the onset of COVID-19. OBJECTIVES To synthesise evidence since 2015 on the impact of interventions designed to address well-being and burnout in physicians, nurses and allied healthcare professionals. DESIGN Systematic literature review. DATA SOURCES Medline, Embase, Emcare, CINAHL, PsycInfo and Google Scholar were searched in May-October 2022. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Studies that primarily investigated burnout and/or well-being and reported quantifiable preintervention and postintervention outcomes using validated well-being measures were included. DATA EXTRACTION AND SYNTHESIS Full-text articles in English were independently screened and quality assessed by two researchers using the Medical Education Research Study Quality Instrument. Results were synthesised and presented in both quantitative and narrative formats. Meta-analysis was not possible due to variations in study designs and outcomes. RESULTS A total of 1663 articles were screened for eligibility, with 33 meeting inclusion criterium. Thirty studies used individually focused interventions, while three were organisationally focused. Thirty-one studies used secondary level interventions (managed stress in individuals) and two were primary level (eliminated stress causes). Mindfulness-based practices were adopted in 20 studies; the remainder used meditation, yoga and acupuncture. Other interventions promoted a positive mindset (gratitude journaling, choirs, coaching) while organisational interventions centred on workload reduction, job crafting and peer networks. Effective outcomes were reported in 29 studies, with significant improvements in well-being, work engagement, quality of life and resilience, and reductions in burnout, perceived stress, anxiety and depression. CONCLUSION The review found that interventions benefitted healthcare workers by increasing well-being, engagement and resilience, and reducing burnout. It is noted that the outcomes of numerous studies were impacted by design limitations that is, no control/waitlist control, and/or no post intervention follow-up. Suggestions are made for future research.
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Affiliation(s)
- Catherine Cohen
- Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Silvia Pignata
- STEM, University of South Australia, Adelaide, South Australia, Australia
| | - Eva Bezak
- Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Mark Tie
- Australian Radiology Clinics, Adelaide, South Australia, Australia
| | - Jessie Childs
- Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
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Calatayud E, Lozano-Berges G, Peralta-Marrupe P, Latorre E, Gomez-Soria I. Job demands may determine cognitive and physical aging after retirement. J Appl Gerontol 2022; 41:2435-2446. [PMID: 35959648 DOI: 10.1177/07334648221120080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
During adulthood, we spend most of our time and efforts at work. However, the impact of employment in aging is poorly explored. Our study addressed how job demands can affect aging after retirement. We have developed a descriptive observational study carried out in 367 older adults with a mean age of 73.9 years (66.5% women and 33.5% men), measuring cognition and functional status. Our results demonstrate that older adults who had high mental demands in their jobs, show better scores in cognition. However, they show poor functional development of basic and instrumental activities of daily life (p< .05). In contrast, former workers who had high physical demands, display lower scores in cognition and lower functional performance in instrumental activities (p< .05). Work life activities contribute to cognitive and physical decline after retirement. Therefore, healthy aging should include interventions that consider the job influence on the age impairment.
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Affiliation(s)
- Estela Calatayud
- Department of Physiatry and Nursing, Faculty of Health Sciences, 16765Universidad de Zaragoza, Zaragoza, Spain.,Institute of Health Research of Aragón (IIS Aragón), Zaragoza, Spain
| | - Gabriel Lozano-Berges
- Department of Physiatry and Nursing, Faculty of Health and Sport Sciences, 16765Universidad de Zaragoza, Zaragoza, Spain.,Growth, Exercise, Nutrition and Development (GENUD) Research Group, 16765Universidad de Zaragoza, Zaragoza, Spain
| | - Patricia Peralta-Marrupe
- Department of Physiatry and Nursing, Faculty of Health Sciences, 16765Universidad de Zaragoza, Zaragoza, Spain
| | - Eva Latorre
- Institute of Health Research of Aragón (IIS Aragón), Zaragoza, Spain.,Department of Biochemistry and Molecular and Cell Biology, Faculty of Sciences, 16765Universidad de Zaragoza, Zaragoza, Spain
| | - Isabel Gomez-Soria
- Department of Physiatry and Nursing, Faculty of Health Sciences, 16765Universidad de Zaragoza, Zaragoza, Spain.,Institute of Health Research of Aragón (IIS Aragón), Zaragoza, Spain
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18
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TAŞ F, AŞCI Ö, DEMİRGÖZ BAL M. Compassion Fatigue and Satisfaction in Nurses and Midwives during the COVID-19 Pandemic in Turkey. CLINICAL AND EXPERIMENTAL HEALTH SCIENCES 2022. [DOI: 10.33808/clinexphealthsci.998790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objective: To examine the levels of compassion fatigue and compassion satisfaction of nurses and midwives during the COVID-19 pandemic and the influencing factors.
Methods: This descriptive study was carried out with the participation of Turkish midwives and nurses. In the study using the convenience sampling method, data were collected online using an online questionnaire. The questionnaire, created through the Google form, was shared between May and June 2021 in the midwife and nurse groups (Facebook, Instagram, WhatsApp) on electronic platforms. Compassion fatigue (CF) and compassion satisfaction (CS) consisting of the burnout (BO) and secondary traumatic stress (STS) subcomponents were assessed by the Professional Quality of Life scale. The study was completed with 402 nurses and midwives from various units. Descriptive statistics, and the Mann-Whitney U and Kruskal-Wallis tests were used in the analysis of the data.
Results: Among the participants, the rate of dissatisfaction with the clinic worked was 24.6% and the turnover intention rate was 70.6%. During the pandemic period, 75.6% of the participants reported that they were exposed to verbal violence, 7.7% to physical violence, and 74.4% to mobbing behaviors. Low CS was found in 24.9% of the participants, a high level of BO in 27.1%, and high STS in 32.8%.
Conclusion: Violence and mobbing against nurses and midwives should be prevented in order to increase the professional quality of life.
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Affiliation(s)
- Ferdane TAŞ
- NIGDE UNIVERSITY, NIGDE ZUBEYDE HANIM HEALTH ACADEMY
| | - Özlem AŞCI
- NIGDE UNIVERSITY, NIGDE ZUBEYDE HANIM HEALTH ACADEMY
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19
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Martin SD, Urban RW, Johnson AH, Magner D, Wilson JE, Zhang Y. Health-related behaviors, self-rated health, and predictors of stress and well-being in nursing students. J Prof Nurs 2022; 38:45-53. [PMID: 35042589 DOI: 10.1016/j.profnurs.2021.11.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 11/15/2021] [Accepted: 11/19/2021] [Indexed: 01/07/2023]
Abstract
BACKGROUND Nursing students are at increased risk for the consequences of stress on wellbeing. Little is known about nursing students' health promoting behaviors and how these relate to health, stress, and well-being. PURPOSE The purpose was to describe perceived stress and measures of well-being (self-compassion, happiness, and life satisfaction) along with self-reported health promoting behaviors and health status in order to identify factors that could affect stress and well-being in nursing students. METHODS A multi-site team employed cross-sectional research methods to explore well-being, stress, and potential physical and emotional health-relevant factors in undergraduate nursing students. Baccalaureate Nursing students from three nursing programs in North Texas participated in a web-based survey. Undergraduate students (n = 417) reported being junior or senior level in a traditional (74.1%) or an alternative nursing training program (on-line, fast-track, or weekend nursing program; 24.9%) in the fall of 2019. Recruitment fliers went to a total of 2264 potential participants via university e-mail. Consenting students completed online surveys collecting demographic and health related factors as well as measures of well-being and stress. RESULTS More than half (56.6%) of students reported worsening health since starting nursing school. Exercise and meditation were related to higher measures of well-being and lower stress, but this relationship diminished in the multivariate model when considering individual demographic and health related factors. Our multivariate model suggests that self-rated health status remains a main potential predictor of reduced stress and improved well-being. CONCLUSIONS Self-reported health factors are related to wellbeing in nursing students. Targeted interventions to improve well-being among nursing students may be necessary and would fit with national recommendations for nursing education programs. Resiliency skills training with mindfulness practices may help nursing students reduce stress, improve overall well-being, and equip students to avoid burnout and stress-related illness once in the workforce.
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Affiliation(s)
- Shirley D Martin
- Department of Professional Nursing Practice, Texas Health Resources, United States of America.
| | - Regina W Urban
- College of Nursing and Health Innovations, University of Texas at Arlington, United States of America
| | - Ann H Johnson
- Department of Nursing, Harris College of Nursing and Health Sciences, Texas Christian University, United States of America
| | - Dionne Magner
- Houston J. and Florence A. Doswell College of Nursing, Texas Woman's University, United States of America
| | - Jennifer E Wilson
- Houston J. and Florence A. Doswell College of Nursing, Texas Woman's University, United States of America
| | - Yan Zhang
- Harris College of Nursing and Health Sciences, Texas Christian University, United States of America
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20
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Salvado M, Marques DL, Pires IM, Silva NM. Mindfulness-Based Interventions to Reduce Burnout in Primary Healthcare Professionals: A Systematic Review and Meta-Analysis. Healthcare (Basel) 2021; 9:healthcare9101342. [PMID: 34683022 PMCID: PMC8544467 DOI: 10.3390/healthcare9101342] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 10/05/2021] [Accepted: 10/06/2021] [Indexed: 01/23/2023] Open
Abstract
Mindfulness-based interventions (MBIs) are reported by experimental studies as practical approaches to reduce burnout in primary healthcare professionals (PHCP). However, to date, no research has synthesized the evidence to determine the overall effects of MBIs for reducing burnout in PHCP. We conducted a systematic review and meta-analysis to analyze the effects of MBIs to reduce burnout in PHCP. We searched articles in the PubMed/MEDLINE, Web of Science, Cochrane, and Scopus databases from inception to September 2021 using MeSH terms: "mindfulness", "burnout", and "primary healthcare". Two reviewers extracted the data and assessed the risk of bias. We used a random-effects meta-analysis to calculate the standardized mean differences (SMD) and mean differences (MD) with 95% confidence intervals (CI) of emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA) domains of burnout. Of 61 records, ten were included (n = 417). Overall, the studies were rated as having a high risk of bias and limited quality evidence. MBIs significantly reduced EE (SMD = -0.54, 95%CI: -0.72 to -0.36; MD = -5.89, 95%CI: -7.72 to -4.05), DP (SMD = -0.34, 95%CI: -0.52 to -0.17; MD = -1.96, 95%CI: -2.96 to -0.95), and significantly increased PA (SMD = 0.34, 95%CI: 0.17 to 0.52; MD = 2.05, 95%CI: 1.04 to 3.06). Although further high-quality research is needed, our findings support the implementation of MBIs for reducing burnout in PHCP.
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Affiliation(s)
- Mafalda Salvado
- Centro de Saúde Dr. Gorjão Henriques, Unidade de Saúde Familiar Cidade do Lis, 2410-272 Leiria, Portugal;
- Correspondence:
| | - Diogo Luís Marques
- Department of Sport Sciences, University of Beira Interior, 6201-001 Covilhã, Portugal;
| | - Ivan Miguel Pires
- Instituto de Telecomunicações, Universidade da Beira Interior, 6200-001 Covilhã, Portugal;
- Escola de Ciências e Tecnologias, University of Trás-os-Montes e Alto Douro, Quinta de Prados, 5001-801 Vila Real, Portugal
| | - Nádia Mendes Silva
- Centro de Saúde Dr. Gorjão Henriques, Unidade de Saúde Familiar Cidade do Lis, 2410-272 Leiria, Portugal;
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21
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Xu HG, Eley R, Kynoch K, Tuckett A. Effects of mobile mindfulness on emergency department work stress: A randomised controlled trial. Emerg Med Australas 2021; 34:176-185. [PMID: 34378320 DOI: 10.1111/1742-6723.13836] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 07/13/2021] [Accepted: 07/13/2021] [Indexed: 12/30/2022]
Abstract
OBJECTIVE High-occupational stress among ED staff has a detrimental impact on both staff wellness and patient care. The objective of the study is to determine whether 4 weeks of smartphone app-guided mindfulness practice reduces stress levels of ED staff. METHODS This two-arm randomised controlled trial was conducted in two Australian EDs in 2019-2020. Eligible participants were randomly assigned (1:1) to either an App group or a Wait to Treat group to practice daily 10 min app-guided mindfulness for 4 weeks. Online surveys were collected for both groups at three time periods: before (T1), immediately after (T2) and 3 months after cessation (T3). Then the Wait to Treat group received the same intervention, followed by surveys immediately after the intervention (T4) and 3 months later (T5). Primary outcome was measured using the Perceived Stress Scale. Secondary outcomes were measured using the Maslach Burnout Inventory (three subscales: emotional exhaustion, depersonalisation and personal accomplishment), Mindfulness Attention Awareness Scale and Warwick-Edinburgh Mental Well-being Scale. Both intention-to-treat and per-protocol analysis were performed. Repeated measurement data were analysed by the linear mixed model. RESULTS Of 148 enrolled participants 98 completed all the surveys, but only half (48%) reported continuous use of the app. Based on the results of the intention-to-treat analysis, there was a statistically significant improvement of perceived stress levels (F = 15.70, P < 0.001), all three components of burnout (emotional exhaustion [F = 14.22, P < 0.001], depersonalisation [F = 3.62, P = 0.030], personal accomplishment [F = 7.51, P < 0.001]), mindfulness (F = 8.83, P < 0.001) and wellbeing levels (F = 10.71, P < 0.001) from pre-intervention to 3 months later with small effect sizes. CONCLUSION Results of the present study demonstrate that brief mindfulness training via innovative digital technology had a small positive effect in improving emergency staff stress, burnout, mindfulness and wellbeing.
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Affiliation(s)
- Hui Grace Xu
- School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Queensland, Australia.,Emergency Department, Queen Elizabeth Jubilee II Hospital, Brisbane, Queensland, Australia
| | - Robert Eley
- Emergency Department, Princess Alexandra Hospital, Brisbane, Queensland, Australia.,Southside Clinical Unit, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Kathryn Kynoch
- Clinical Governance Unit and the Queensland Centre for Evidence Based Nursing and Midwifery: a Joanna Briggs Institute Centre of Excellence, Mater Health, Brisbane, Queensland, Australia
| | - Anthony Tuckett
- School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Queensland, Australia.,Curtin School of Nursing, Curtin University, Perth, Western Australia, Australia
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22
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Gualano MR, Sinigaglia T, Lo Moro G, Rousset S, Cremona A, Bert F, Siliquini R. The Burden of Burnout among Healthcare Professionals of Intensive Care Units and Emergency Departments during the COVID-19 Pandemic: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18158172. [PMID: 34360465 PMCID: PMC8346023 DOI: 10.3390/ijerph18158172] [Citation(s) in RCA: 113] [Impact Index Per Article: 37.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 07/27/2021] [Accepted: 07/31/2021] [Indexed: 12/18/2022]
Abstract
The primary aim was to evaluate the burnout prevalence among healthcare workers (HCWs) in intensive care units (ICUs) and emergency departments (EDs) during the COVID-19 pandemic. The secondary aim was to identify factors associated with burnout in this population. A systematic review was conducted following PRISMA guidelines by searching PubMed, Embase, PsychINFO, and Scopus from 1 January to 24 November 2020. Studies with information about burnout prevalence/level during the pandemic regarding ICU/ED HCWs were eligible. A total of 927 records were identified. The selection resulted in 11 studies. Most studies were conducted in April/May 2020. Samples ranged from 15 to 12,596 participants. The prevalence of overall burnout ranged from 49.3% to 58%. Nurses seemed to be at higher risk. Both socio-demographic and work-related features were associated with burnout. Many pandemic-related variables were associated with burnout, e.g., shortage in resources, worry regarding COVID-19, and stigma. This review highlighted a substantial burnout prevalence among ICU/ED HCWs. However, this population has presented a high burnout prevalence for a long time, and there is not sufficient evidence to understand if such prevalence is currently increased. It also outlined modifiable factors and the need to improve emergency preparedness both from an individual and structural level.
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23
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Xu HG, Tuckett A, Kynoch K, Eley R. A mobile mindfulness intervention for emergency department staff to improve stress and wellbeing: A qualitative study. Int Emerg Nurs 2021; 58:101039. [PMID: 34333332 DOI: 10.1016/j.ienj.2021.101039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 05/24/2021] [Accepted: 06/05/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Occupational stress and burnout in emergency departments (ED) are prominent issues requiring effective solutions. In other health settings use of a smartphone mindfulness app have been shown to be a cost-effective strategy for stress management. AIM To understand ED staff's experiences of practicing mindfulness using a smartphone app. METHOD A qualitative study was undertaken with 24 ED staff at two Australian EDs who had used a mindfulness app for 4 weeks. Semi-structured, one-to-one interviews were conducted between late 2019 and early 2020. Interviews were audio recorded and transcribed. Descriptive description was utilised in content analysis. RESULTS Four main themes were identified: individuality in use of the app, perceived benefits and impacts on life, perceived barriers and enablers to use. Participants reported that mindfulness practice had numerous benefits including better stress and anxiety management, as well as improved general wellbeing. The main barriers to mindfulness practice were poor time management for mindfulness and lack of motivation. Reported enablers included a strong desire for promoting wellbeing and the ability to embed practice into existing routine. CONCLUSION Practicing mindfulness with a smartphone app is a useful strategy to promote ED staff wellness and manage stress. Healthcare organisations should consider the implementation of a mindfulness app for staff.
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Affiliation(s)
- Hui Grace Xu
- School of Nursing, Midwifery and Social Work, University of Queensland, Brisbane, Australia; Emergency Department, Queen Elizabeth II Jubilee Hospital, Brisbane, Australia.
| | - Anthony Tuckett
- School of Nursing, Midwifery and Social Work, University of Queensland, Brisbane, Australia; Curtin School of Nursing, Faculty of Health Sciences, Curtin University, Australia
| | - Kathryn Kynoch
- Evidence in Practice Unit and Queensland Centre for Evidence Based Nursing and Midwifery, A Joanna Briggs Institute Centre of Excellence, Mater Misericordiae Ltd, Brisbane, Australia
| | - Robert Eley
- Southside Clinical Unit, Faculty of Medicine, University of Queensland, Brisbane, Australia; Emergency Department, Princess Alexandra Hospital, Brisbane, Australia
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24
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Tian M, Yang H, Yin X, Wu Y, Zhang G, Lv C, Mu K, Gong Y. Evaluating effort-reward imbalance among nurses in emergency departments: a cross-sectional study in China. BMC Psychiatry 2021; 21:353. [PMID: 34261458 PMCID: PMC8278678 DOI: 10.1186/s12888-021-03344-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 06/08/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Effort-reward imbalance is an adverse psychological response to working conditions that has several negative effects on nurses. However, there is little research on effort-reward imbalance and its influencing factors among nurses in emergency departments. This study aimed to understand the current situation of effort-reward imbalance and explore its influencing factors among emergency department nurses in China. METHODS From July to August 2018, a structured online questionnaire survey was conducted among emergency department nurses in China. Data were collected from emergency department nurses employed in hospitals providing pre-hospital care in China. The questionnaire consisted of sociodemographic characteristics, work-related factors and effort-reward imbalance. A descriptive analysis and a binary logistic regression were conducted to explore the effort-reward imbalance and its influencing factors among emergency department nurses. RESULTS The study involved 17,582 emergency department nurses; notably, the prevalence of effort-reward imbalance was 59.66%. The participating nurses who were males, aged 25 to 34 years, whose educational level was a bachelor degree or above, who had a junior or above title, who had longer years of service, and who had suffered verbal or physical violence in the past year had a higher risk of effort-reward imbalance. Furthermore, the nurses with a high monthly income, who believed that the number of nurses met the department's demand had a lower risk of effort-reward imbalance. CONCLUSIONS Effort-reward imbalance was prevalent among emergency department nurses in China. Measures such as adjusting the night shift frequency, increasing the number of nurses, raising salaries and reducing workplace violence should be considered to reduce the level of effort-reward imbalance.
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Affiliation(s)
- Mengge Tian
- grid.33199.310000 0004 0368 7223Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P. R. China
| | - Heping Yang
- grid.507061.50000 0004 1791 5792Wuchang University of Technology, Wuhan, P. R. China
| | - Xiaoxv Yin
- grid.33199.310000 0004 0368 7223Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P. R. China
| | - Yafei Wu
- grid.33199.310000 0004 0368 7223Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P. R. China
| | - Guopeng Zhang
- grid.33199.310000 0004 0368 7223Department of Nuclear medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P. R. China
| | - Chuanzhu Lv
- grid.443397.e0000 0004 0368 7493Department of Emergency, The Frist Affiliated Hospital of Hainan Medical University, Haikou, China ,grid.443397.e0000 0004 0368 7493Emergency and Trauma College, Hainan Medical University, Haikou, Hainan China ,grid.443397.e0000 0004 0368 7493Key Laboratory of Emergency and Trauma of Ministry of Education, Hainan Medical University, Haikou, Hainan China
| | - Ketao Mu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P. R. China.
| | - Yanhong Gong
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P. R. China.
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25
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Treating Pediatric and Geriatric Patients at Risk of Suicide in General Emergency Departments: Perspectives From Emergency Department Clinical Leaders. Ann Emerg Med 2021; 78:628-636. [PMID: 34218952 DOI: 10.1016/j.annemergmed.2021.04.025] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 04/01/2021] [Accepted: 04/16/2021] [Indexed: 11/22/2022]
Abstract
STUDY OBJECTIVE We explored emergency department clinical leaders' views on providing emergency mental health services to pediatric and geriatric patients with suicidal ideation and suicide attempts. METHODS We conducted semistructured interviews with a total of 34 nursing directors, medical directors, and behavioral health managers at 17 general hospital EDs across the United States, using purposive sampling to ensure variation among hospitals. Interviews were audio-recorded, transcribed verbatim, and coded and analyzed using Atlas.ti and a directed content analysis approach. RESULTS Respondents from across a range of ED types expressed concerns regarding the capacity of their EDs to meet mental health needs of children and older adults. They experienced emotional distress over the increasing number of pediatric patients presenting to EDs with suicidal ideation/suicide attempt and described EDs as inappropriate environments for young patients with suicidal ideation/suicide attempt. Similarly, leaders expressed feeling ill-equipped to diagnose and treat geriatric patients with suicidal ideation/suicide attempt, who often had medical comorbidities that complicated treatment planning. Respondents noted that pediatric and geriatric patients frequently boarded in the ED. Some felt compelled to use creative solutions to provide safe spaces for pediatric and geriatric patients. Respondents voiced frustration over the lack of outpatient and inpatient mental health services for these patients. CONCLUSION Clinical leaders in EDs across the nation expressed distress at feeling they were not adequately equipped to meet the needs of pediatric and geriatric patients with suicidal ideation/suicide attempt. Future innovations to provide ED care for children and older adults with suicidal ideation/suicide attempt might include training for ED teams, access to specialist mental health clinicians through telehealth, and adaptations of physical spaces.
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