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Akram F, Webb AE, Pidcock M, Farrar MA, Kasparian NA. Clinician Perceptions of Family-Centered Care in Pediatric and Congenital Heart Settings. JAMA Netw Open 2024; 7:e2422104. [PMID: 39008299 PMCID: PMC11250268 DOI: 10.1001/jamanetworkopen.2024.22104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 05/14/2024] [Indexed: 07/16/2024] Open
Abstract
Importance Family-centered care recognizes families as central to child health and well-being and prioritizes clinician collaboration with families to ensure optimal pediatric care and outcomes. Clinician interpersonal sensitivity and communication skills are key to this approach. Objective To examine perceptions of and factors associated with family-centered care among clinicians working in pediatric and congenital heart care. Design, Setting, and Participants In this cross-sectional study, participants from diverse clinical disciplines (pediatric cardiology, cardiothoracic surgery, nursing, anesthesia, neonatology, intensive care, psychology, and others), completed an online survey between June 2020 and February 2021. Participants included physicians, surgeons, nurses, and allied and mental health professionals at an Australian quaternary pediatric hospital network. Statistical analysis was performed from August 2022 to June 2023. Main Outcomes and Measures Family-centered care across 4 domains (showing interpersonal sensitivity, treating people respectfully, providing general information, and communicating specific information) was measured using the validated Measure of Processes of Care for Service Providers. Clinician burnout (emotional exhaustion, depersonalization, and personal accomplishment), confidence responding to families' psychosocial needs, and psychological, clinical role, and sociodemographic factors were also assessed. Informed by theory, hierarchical linear regression was used to identify factors associated with family-centered care. Results There were 212 clinicians (177 women [84.3%]; 153 nurses [72.2%], 32 physicians [15.1%], 22 allied and mental health professionals [10.4%], 5 surgeons [2.3%]; 170 [80.2%] aged 20-49 years) who participated (55% response rate). Of the 4 family-centered care domains, scores for treating people respectfully were highest and associated with greater clinician confidence responding to families' psychosocial needs (effect size [β], 0.59 [95% CI, 0.46 to 0.72]; P < .001), lower depersonalization (β, 0.04 [95% CI, -0.07 to -0.01]; P = .02), and a greater sense of personal accomplishment at work (β, 0.02 [95% CI, 0.01 to 0.04]; P = 0.04). Greater interpersonal sensitivity was associated with greater confidence responding to families' psychosocial needs (β, 0.80 [95% CI, 0.62 to 0.97]; P < .001), a greater sense of personal accomplishment at work (β, 0.03 [95% CI, 0.01 to 0.05]; P = .04), and lower use of approach-based coping, such as problem-solving (β, 0.37 [95% CI, -0.71 to -0.02]; P = .04). Conclusions and Relevance In this cross-sectional study, burnout and confidence responding to families' psychosocial needs were associated with clinicians' perceptions of family-centered care. These findings suggest that targeted interventions to address these factors may benefit clinicians and also potentially strengthen the practice of family-centered care in pediatric and congenital heart settings.
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Affiliation(s)
- Farah Akram
- Heart Centre for Children, The Sydney Children’s Hospitals Network, Sydney, Australia
- Discipline of Paediatrics and Child Health, School of Clinical Medicine, UNSW Medicine and Health, UNSW Sydney, Sydney, Australia
| | - Annabel E. Webb
- Discipline of Child and Adolescent Health, Faculty of Health and Medicine, The University of Sydney, Sydney, Australia
- School of Mathematical and Physical Sciences, Faculty of Science and Engineering, Macquarie University, Sydney, Australia
| | - Madeleine Pidcock
- Heart Centre for Children, The Sydney Children’s Hospitals Network, Sydney, Australia
- Discipline of Paediatrics and Child Health, School of Clinical Medicine, UNSW Medicine and Health, UNSW Sydney, Sydney, Australia
| | - Michelle A. Farrar
- Discipline of Paediatrics and Child Health, School of Clinical Medicine, UNSW Medicine and Health, UNSW Sydney, Sydney, Australia
| | - Nadine A. Kasparian
- Heart and Mind Wellbeing Center, Heart Institute and the Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
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Hanc V, Žvelc G, Bajec B. Development and validation of the Workplace Relational Needs Satisfaction Scale (W-RNSS). Front Psychol 2024; 15:1419765. [PMID: 38993340 PMCID: PMC11236724 DOI: 10.3389/fpsyg.2024.1419765] [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: 04/18/2024] [Accepted: 06/13/2024] [Indexed: 07/13/2024] Open
Abstract
While inadequate relationships in the workplace pose a significant psychosocial risk, quality interpersonal relationships can contribute to positive effects and prevent negative outcomes. Erskine's model of relational needs, not yet studied in the work environment, can provide a more detailed understanding of the needs employees experience in their workplace relationships. We adapted the general Relational Needs Satisfaction Scale (RNSS) for coworker relationships and examined the factor structure of relational needs in the workplace and their connections to various work aspects. The sample comprised 273 participants, including both employees and students, in a workplace setting with coworkers. The results show that the Workplace Relational Needs Satisfaction Scale (W-RNSS) is a valid and reliable instrument (α = 0.93 for the total scale and 0.77 < α < 0.89 for the subscales) for measuring relational needs in coworker relationships. A bi-factor model was the most suitable for describing the data (χ 2/df = 1.94, CFI = 0.95, TLI = 0.94, NNFI = 0.94, RMSEA = 0.06, SRMR = 0.04, AIC = 13289.27, BIC = 13506.29), confirming the previously supported 5-factor structure and the general factor. Satisfaction of relational needs was associated with higher work satisfaction, increased work engagement, greater motivation and lower burnout, underscoring the importance of quality interpersonal relationships among employees. W-RNSS shows potential for researching connections with other work aspects and practical applications in prevention and intervention strategies.
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Affiliation(s)
- Veronika Hanc
- Department of Psychology, Faculty of Arts, University of Ljubljana, Ljubljana, Slovenia
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Qureshi N, Huilgol SS, Timmins G, Meredith LS, Gidengil CA. Misaligned Supports: Differences in Reported Health Care Worker Well-being Supports Provided and Needed During the COVID-19 Pandemic. Am J Health Promot 2024:8901171241255764. [PMID: 38907369 DOI: 10.1177/08901171241255764] [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: 06/24/2024]
Abstract
PURPOSE To describe the well-being supports provided to health care workers (HCWs) during the COVID-19 pandemic in health centers and hospitals. DESIGN Cross-sectional qualitative interviews before and after implementation of a peer-based support intervention. SETTING Purposively sampled hospitals and health centers across the US. PARTICIPANTS 28 site leaders and 56 HCWs sampled from 16 hospitals and 12 health centers. METHOD Site leaders and HCWs were asked to describe supports available to HCWs during the COVID-19 pandemic. Thematic and content coding and analysis of interview responses were conducted using Dedoose. RESULTS Both site leaders and HCWs identified a range of support resources available. Communication resources were the most frequently cited in both groups. Health care workers reported bi-directional communication, while one-way communication was emphasized by site leaders. Hospitals highlighted counseling support, particularly Employee Assistance Programs (EAP), while health centers prioritized community support. Wellness activities were more prevalent in hospital settings, while health centers offered specific workplace-provided training for HCWs. Health care workers encountered barriers when accessing support, including limited time, fear of stigma, and disruptions to their existing support networks attributable to the pandemic. CONCLUSION While there are resources for HCWs, the available supports may not align with their needs and barriers to access may limit the effectiveness of these supports. Continued engagement between leaders and HCWs could help better align resources with needs.
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Affiliation(s)
- Nabeel Qureshi
- RAND Corporation, Santa Monica, CA, USA
- Pardee RAND Graduate School, Santa Monica,CA, USA
| | | | - George Timmins
- RAND Corporation, Santa Monica, CA, USA
- Pardee RAND Graduate School, Santa Monica,CA, USA
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Escudero-Guirado C, Fernández-Rodríguez L, Nájera-Sánchez JJ. Incorporating gendered analysis and flexibility in heavy work investment studies: a systematic literature review. Front Psychol 2024; 15:1401201. [PMID: 38962219 PMCID: PMC11220130 DOI: 10.3389/fpsyg.2024.1401201] [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: 03/14/2024] [Accepted: 06/04/2024] [Indexed: 07/05/2024] Open
Abstract
Introduction Significant impacts of heavy work investment on employee well-being and organizational performance have prompted its increasing importance as a research topic. The findings about good or evil of these repercussions are nonetheless inconclusive. The intersection of Heavy Work Investment construct with gender has not been explicitly addressed by previous literature review and research. Besides, the relevance of flexibility for women, as one of the key factors for successful work-family balance management, still remains to be analyzed. Methods A literature review on Heavy Work Investment was conducted using the SPAR-4-SLR protocol, wherein 83 articles were selected from a pool of 208 previously identified works. Bibliometric and content analysis techniques were employed, including co-word analysis, to evaluate research production, impact, and trends in the gender perspective within Heavy Work Investment. Results As a result, a strategic diagram illustrates thematic topics, providing a clear understanding of the field's structure and evolution. Six thematic groups were identified, around work-family conflict as the central theme. Discussion The explicit consideration of a gender perspective in literature involves nuanced differences regarding the conclusions of studies with a broader focus. First, the emerging prominence of studies on China and Japan becomes clear with gender as the specific focus of the review, aiming to clarify the experiences women face in more traditional societies with a more decisive division of roles. Second, there is a shift in interest regarding the analysis of Job Demands and Job Resources. Despite the apparent decline in interest in the former, the focus in gender literature clearly shifts toward the side of Job Resources, showing potential for the future. It could be understood that in a context of talent war and employee retention efforts, priority is given to better understanding of facilitating individual and organizational factors for work-life balance, especially for women. Future research areas are identified, including gender differences in organizational support and the impact of flexible work on the work-life balance, providing valuable insights for academia, practitioners, and organizations. The need for more comprehensive cross-cultural and gender research is also made clear.
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Affiliation(s)
- Carmen Escudero-Guirado
- Facultad de Ciencias Económicas y Empresariales, Universidad Pontificia Comillas, Madrid, Spain
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Desai K, O’Malley P, Van Culin E. Impact of heartfulness meditation practice compared to the gratitude practices on wellbeing and work engagement among healthcare professionals: Randomized trial. PLoS One 2024; 19:e0304093. [PMID: 38848338 PMCID: PMC11161083 DOI: 10.1371/journal.pone.0304093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 04/26/2024] [Indexed: 06/09/2024] Open
Abstract
OBJECTIVE To investigate whether Heartfulness meditation practice, compared to Gratitude practice, leads to measurable changes in mental wellbeing among healthcare providers across the US. METHOD Participants were randomly assigned to one of the following 6-week interventions: the trainer-guided virtual Heartfulness meditation program or the podcast-based self-guided gratitude practice group. The Professional Quality of Life Scale-5 (ProQOL-5) was used to determine Compassion Satisfaction (CS) and risk for Burnout (BO) and secondary traumatic stress (STS). The Utrecht Work Engagement Scale (UWES) was used to assess vigor, dedication, and absorption at work. Outcomes were collected at baseline and the end of the study period. Qualitative questions regarding the experience of learning and practicing were also offered at the end of the six weeks. RESULTS The majority of participants were nurses (50%), followed by allied healthcare professionals (37%) and physicians (13%) (N = 83). There was a general trend towards increases in CS in the Heartfulness group compared to the gratitude group. However, this was not statistically significant. Strong evidence suggests there was a significant improvement in BO for the Heartfulness group between Week 0 and Week 6 (p = 0.002), as well as STS (p = 0.0004) and vigor (p = 0.0392). Qualitative data analysis revealed that the subjects in the Heartfulness arm reported improved sleep and decreased reactivity to stress. Subjects in the gratitude arm reported improved mood and favorable results using gratitude practices at home with family members. CONCLUSION In our study, Heartfulness meditation practice was associated with a significant improvement in burnout and vigor at work, with a trend towards compassion satisfaction after six weeks compared with gratitude practices. Qualitative analysis indicates the benefits of both Heartfulness and Gratitude practices. Further randomized trials with a larger sample size are needed to explore these science-based practices for the wellbeing of healthcare workers.
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Affiliation(s)
- Kunal Desai
- Department of Internal Medicine, Boonshoft School of Medicine, Wright State University, Dayton, Ohio, United States of America
| | - Patricia O’Malley
- Nurse Scientist- Premier Health Nursing Research, Miami Valley Hospital, Dayton, Ohio, United States of America
| | - Emily Van Culin
- Premier Health Learning Institute, Dayton, Ohio, United States of America
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Schimpf MG, Gershengoren L, Moschenross D, Winston H, Simpson SA. Consultation-Liaison Case Conference: Assessment and Management of a Physician With Thoughts of Suicide. J Acad Consult Liaison Psychiatry 2024:S2667-2960(24)00062-4. [PMID: 38844207 DOI: 10.1016/j.jaclp.2024.05.006] [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: 01/31/2024] [Revised: 05/19/2024] [Accepted: 05/31/2024] [Indexed: 06/27/2024]
Abstract
We present the case of a physician who engages with a peer response team and discloses suicidal ideation while himself seeing patients in the hospital. Top experts in consultation-liaison psychiatry provide guidance for this clinical case based on their experience and a review of the available literature. Key teaching topics include a general approach to suicide risk assessment, peer response programs for healthcare workers, and ethical and clinical considerations in treating colleagues. Consultation-liaison psychiatrists should be familiar with suicide risk management, take a pro-active approach to addressing modifiable risk factors, and keep in mind unique challenges of treating colleagues referred for care.
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Affiliation(s)
| | | | - Darcy Moschenross
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Helena Winston
- Department of Behavioral Health Services, Denver Health, Denver, CO
| | - Scott A Simpson
- Department of Behavioral Health Services, Denver Health, Denver, CO; Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO.
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Little S, Newsome Wicks M. Supporting Nursing Student and Nursing Workforce Wellness Through Academic-Practice Partnerships. J Nurs Educ 2024; 63:347-348. [PMID: 38900265 DOI: 10.3928/01484834-20240513-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2024]
Affiliation(s)
- Sharon Little
- University of Tennessee Health, Science Center, College of Nursing
| | - Mona Newsome Wicks
- Department of Health Promotion and Disease Prevention, The University of Tennessee Health, Science Center, Assistant Editor, Journal of Nursing Education
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Shreedar P, Pangalangan JML, Puma JE, Farewell CV. Relationship Between Chronic Health Conditions and Occupational Burnout in the Early Care and Education Workforce. J Occup Environ Med 2024; 66:e238-e244. [PMID: 38527185 DOI: 10.1097/jom.0000000000003102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
OBJECTIVE The early care and education (ECE) workforce experiences high rates of poor mental and physical health outcomes, which impact staff well-being and burnout. This study aimed to assess the relationship between chronic health conditions and occupational burnout in ECE Head Start staff working in low-resourced locations. METHODS This study administered an 89-item cross-sectional survey to 332 ECE staff employed in 42 Head Start centers in the United States. Staff self-reported on the following 10 chronic health conditions: arthritis, asthma, cancer, depression, diabetes, heart disease, high blood pressure, insomnia, lung disease, and musculoskeletal disorders. RESULTS We found that multimorbidity of chronic conditions significantly predicted overall burnout ( B = 2.39, P < 0.01), particularly related to emotional exhaustion ( B = 2.04, P < 0.01). CONCLUSIONS Workplace interventions targeting emotional exhaustion related to chronic health conditions are recommended to effectively address occupational burnout among ECE staff.
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Affiliation(s)
- Priyanka Shreedar
- From the Rocky Mountain Prevention Research Center, Colorado School of Public Health, University of Colorado Anschutz, Aurora, Colorado
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Starkoff BE, Nickerson BS. Emergence of imaging technology beyond the clinical setting: Utilization of mobile health tools for at-home testing. Nutr Clin Pract 2024; 39:518-529. [PMID: 38591753 DOI: 10.1002/ncp.11151] [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: 12/19/2023] [Revised: 03/18/2024] [Accepted: 03/21/2024] [Indexed: 04/10/2024] Open
Abstract
Body composition assessment plays a pivotal role in understanding health, disease risk, and treatment efficacy. This narrative review explores two primary aspects: imaging techniques, namely ultrasound (US) and dual-energy x-ray absorptiometry (DXA), and the emergence of artificial intelligence (AI) and mobile health apps in telehealth for body composition. Although US is valuable for assessing subcutaneous fat and muscle thickness, DXA accurately quantifies bone mineral content, fat mass, and lean mass. Despite their effectiveness, accessibility and cost remain barriers to widespread adoption. The integration of AI-powered image analysis may help explain tissue differentiation, whereas mobile health apps offer real-time metabolic monitoring and personalized feedback. New apps such as MeThreeSixty and Made Health and Fitness offer the advantages of clinic-based imaging techniques from the comfort of home. These innovations hold the potential for individualizing strategies and interventions, optimizing clinical outcomes, and empowering informed decision-making for both healthcare professionals and patients/clients. Navigating the intricacies of these emerging tools, critically assessing their validity and reliability, and ensuring inclusivity across diverse populations and conditions will be crucial in harnessing their full potential. By integrating advancements in body composition assessment, healthcare can move beyond the limitations of traditional methods and deliver truly personalized, data-driven care to optimize well-being.
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Affiliation(s)
- Brooke E Starkoff
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, Ohio, USA
| | - Brett S Nickerson
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, Ohio, USA
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Mohammadnejad F, Freeman S, Klassen-Ross T, Hemingway D, Banner D. Use of Antivibration Technology to Reduce Demands for In-Home Nursing Care and Support in Rural Settings for Persons with Essential Tremors: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:714. [PMID: 38928960 PMCID: PMC11203956 DOI: 10.3390/ijerph21060714] [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: 02/27/2024] [Revised: 05/26/2024] [Accepted: 05/27/2024] [Indexed: 06/28/2024]
Abstract
INTRODUCTION With the increased integration of technologies in the healthcare sector, it is important to understand the benefits emerging technologies may play to reduce demands on the health care system. The Steadiwear antivibration glove shows promise for enhancing the independence in functional abilities for persons with essential tremors and for alleviating the need for support from the health care system. The objective of this study was to examine Registered Nurses' (RN) perceptions of the potential for the Steadiwear antivibration glove to reduce the need for in-person support from community healthcare workers. METHODS Eleven RNs, experienced in providing care in rural communities, participated in a semi-structured interview sharing their perspectives towards use of the Steadiwear antivibration glove in community practice settings. Thematic analysis guided by Braun and Clarke was undertaken. RESULTS Nurses described the value of this technology to reduce client needs for support for activities of daily living (e.g., dressing, feeding) and independent activities of daily living (e.g., banking, transportation). CONCLUSIONS Enhanced access to this technology may reduce the need for nursing and personal care support from the health system. Therefore the Steadiwear antivibration glove also shows potential to delay and/or prevent the need for more intensive support and mitigate the need for transition to a long-term care facility.
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Affiliation(s)
- Fatemeh Mohammadnejad
- School of Health Sciences, University of Northern British Columbia, Prince George, BC V2N 4Z9, Canada; (F.M.); (T.K.-R.)
| | - Shannon Freeman
- School of Nursing, University of Northern British Columbia, Prince George, BC V2N 4Z9, Canada;
| | - Tammy Klassen-Ross
- School of Health Sciences, University of Northern British Columbia, Prince George, BC V2N 4Z9, Canada; (F.M.); (T.K.-R.)
| | - Dawn Hemingway
- School of Social Work, University of Northern British Columbia, Prince George, BC V2N4Z9, Canada;
| | - Davina Banner
- School of Nursing, University of Northern British Columbia, Prince George, BC V2N 4Z9, Canada;
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Bunescu MG, Gheorman V, Marcu IR, Lungulescu CV, Dinescu VC. Tackling Shift Work: Cardiovascular Health in the Auto Industry. Healthcare (Basel) 2024; 12:1097. [PMID: 38891172 PMCID: PMC11171793 DOI: 10.3390/healthcare12111097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 05/21/2024] [Accepted: 05/25/2024] [Indexed: 06/21/2024] Open
Abstract
Shift work, particularly in the auto industry, presents significant health challenges, notably in how it impacts cardiovascular health due to irregular work schedules and associated sleep disruptions. This prospective study evaluated 4683 workers from a single Romanian automotive enterprise to investigate the relationship between fixed shift work schedules and cardiovascular health outcomes. Our analysis focused on fixed-shift workers, excluding those on rotating shifts to reduce variability and enhance the clarity of the findings. The findings reveal that night shift workers are at a heightened risk of cardiovascular diseases (CVDs) compared to their day shift counterparts. Night shift workers demonstrated a higher CVD incidence (4.3%) compared to day shift workers (2.6%), with an odds ratio (OR) of 1.68 (95% CI: 1.08 to 2.62, p = 0.021). This association remained significant after adjusting for potential confounders, with an adjusted OR of 1.74 (95% CI: 1.09 to 2.75, p = 0.019). Male night shift workers exhibited a significantly higher CVD incidence (4.5%) compared to male day shift workers (3.0%), with an OR of 1.75 (95% CI: 1.07 to 2.89, p = 0.026). Female night shift workers also showed a higher CVD incidence (3.4%) compared to female day shift workers (1.3%), although this was not statistically significant. These findings underscore the urgent need for targeted interventions and effective strategies to mitigate these risks and promote the cardiovascular health and overall well-being of shift workers in the auto industry. This research contributes to a deeper understanding of how non-traditional work schedules affect health and provides a basis for implementing protective measures in occupational settings.
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Affiliation(s)
- Marius Gabriel Bunescu
- Occupational Medicine Department, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Petru Rares 2 Street, 200349 Craiova, Romania;
| | - Veronica Gheorman
- Department 3 Medical Semiology, University of Medicine and Pharmacy of Craiova, Petru Rares 2 Street, 200349 Craiova, Romania
| | - Iulia Rahela Marcu
- Department of Physical and Rehabilitation Medicine, University of Medicine and Pharmacy of Craiova, Petru Rares 2 Street, 200349 Craiova, Romania;
| | - Cristian Virgil Lungulescu
- Oncology Department, University of Medicine and Pharmacy of Craiova, Petru Rares 2 Street, 200349 Craiova, Romania;
| | - Venera Cristina Dinescu
- Department of Health Promotion and Occupational Medicine, University of Medicine and Pharmacy of Craiova, Petru Rares 2 Street, 200349 Craiova, Romania;
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Budisavljevic A, Dedic Plavetic N, Klaric K, Kelemenic-Drazin R, Letica-Crepulja M. The Impact of Newly Diagnosed Early Breast Cancer on Psychological Resilience, Distress Levels, and the Perception of Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:677. [PMID: 38928924 PMCID: PMC11203282 DOI: 10.3390/ijerph21060677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 05/05/2024] [Accepted: 05/22/2024] [Indexed: 06/28/2024]
Abstract
Confronting a breast cancer diagnosis, along with complex and challenging treatment procedures, is an extremely stressful experience. Psychological resilience is the ability to maintain or restore normal functioning while facing adversity. We aimed to explore the impact of an early breast cancer diagnosis on psychological resilience, distress, and perception of health. A cross-sectional study was conducted, including 50 patients newly diagnosed with early breast cancer and 67 healthy women with screening mammograms graded 1 or 2 using a Breast Imaging Reporting and Data System. The levels of distress, perception of health, and psychological resilience were assessed using the depression, anxiety, and stress scale, the SF 36-Item Health Survey 1.0, and the Connor-Davidson RISC-25 scale. Differences between variables were examined using the t-test and chi-square test for interval and categorial variables. The surveys were conducted within four weeks of a breast cancer diagnosis. Patients with breast cancer reported a deterioration of their health relative to the previous year and significantly higher levels of psychological resilience, while there was no significant difference between the groups in levels of stress, anxiety, or depression. The process of diagnosis with early breast cancer may activate psychological dynamic processes which are involved in the effective adaptation to acute stress, leading to higher resilience levels in breast cancer patients compared to healthy controls.
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Affiliation(s)
- Anuska Budisavljevic
- Department of Medical Oncology and Hematology, General Hospital Pula, 52100 Pula, Croatia
| | - Natalija Dedic Plavetic
- Department of Oncology, University Hospital Centre Zagreb, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia;
| | - Kristina Klaric
- Department of Radiology, General Hospital Pula, 52100 Pula, Croatia;
| | - Renata Kelemenic-Drazin
- Department of Hematology, Oncology and Clinical Immunology, General Hospital Varazdin, 42000 Varazdin, Croatia;
| | - Marina Letica-Crepulja
- Department of Psychiatry and Psychological Medicine, Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia;
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Bambi S, Lucchini A. Nurses' Well-Being: An Amazing Recipe, But What Ingredients Remain Missing? Dimens Crit Care Nurs 2024; 43:107-110. [PMID: 38564452 DOI: 10.1097/dcc.0000000000000635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Abstract
The term "system well-being" can move forward a new vision, meaning the result coming from the addition of the well-being of persons belonging to different institutions and organizations, which are all parts of the "health care system." Beginning with this "new definition," with the aim of analyzing the multifaceted issues related to nurses' well-being, we could use the "classical nursing metaparadigm" composed of 4 concepts: "health," "nursing," "environment," and "person." We briefly describe this conceptual map and provide some focused suggestions for further reflection on topics such as physical and psychological well-being, economic gain and career opportunities, work climate, burnout, low job satisfaction, moral distress, compassion fatigue, and a joyful work environment. This view may help organizations to focus on interventions to prevent or eliminate stress, which may be more proactive and effective than interventions to manage stress. Moreover, it offers a multidimensional map to analyze the different aspects influencing the well-being issue, keeping in mind that a concrete solution can be obtained only if all the components of health care systems and society do their part. Some solutions proposed by authors and organizations to increase nurses' well-being are mindfulness based, such as meditation, yoga, acupuncture, gratitude, journaling, choirs, coaching, workload reduction, job crafting, and peer networks. Other reflections on work organization, expected professional behaviors, nurses' retention, and education should be added to the discussion on this multidimensional issue.
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Affiliation(s)
- Stefano Bambi
- General Adult and Pediatric Intensive Care Unit, Fondazione IRCCS San Gerardo dei Tintori, Monza
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Luehring MC, Romani PW, Ariefdjohan M. Preliminary evaluation of behavior technician burnout when working with boarded and traditional psychiatric inpatients diagnosed with developmental disabilities. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2024; 37:e12461. [PMID: 38564318 DOI: 10.1111/jcap.12461] [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: 11/21/2023] [Revised: 02/22/2024] [Accepted: 03/23/2024] [Indexed: 04/04/2024]
Abstract
PROBLEM The COVID-19 pandemic has led to a youth mental health crisis, with research demonstrating an increased prevalence of depression, anxiety, and disruptive behavior in youth compared to pre-pandemic years. Consequently, the insurgence of emergency psychiatric evaluations has increased the demands for extended inpatient stay (or patient boarding) at various licensed treatment facilities. Questions remain about the extent of burnout being experienced by behavior technicians who are caring for these patients. METHODS The Shirom-Melamed Burnout Measure was used to evaluate symptoms of burnout of behavior technicians practicing at a specialized psychiatric inpatient unit. Comparisons were made for instances of caring for boarded (meeting criteria for discharge but unable to be discharged due to disposition) and traditional patients (short-term treatment). FINDINGS Behavior technicians caring for boarded patients reported significantly higher scores in overall stress, physical exhaustion, cognitive fatigue, and emotional exhaustion than those managing patients getting traditional care. CONCLUSIONS Extensive burnout can have adverse impacts at both the personal level (staff well-being, individual staff-patient interactions) and clinic level (daily operations and service, general quality of care). Efforts need to be made to address this issue to prevent staff turnover.
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Affiliation(s)
- Mathew C Luehring
- Department of Psychiatry, Child and Adolescent Mental Health Division, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Pediatric Mental Health Institute, Children's Hospital Colorado, Aurora, Colorado, USA
| | - Patrick W Romani
- Department of Psychiatry, Child and Adolescent Mental Health Division, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Pediatric Mental Health Institute, Children's Hospital Colorado, Aurora, Colorado, USA
| | - Merlin Ariefdjohan
- Department of Psychiatry, Child and Adolescent Mental Health Division, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
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15
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Asgari E, Kaur J, Nuredini G, Balloch J, Taylor AM, Sebire N, Robinson R, Peters C, Sridharan S, Pimenta D. Impact of Electronic Health Record Use on Cognitive Load and Burnout Among Clinicians: Narrative Review. JMIR Med Inform 2024; 12:e55499. [PMID: 38607672 PMCID: PMC11053390 DOI: 10.2196/55499] [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: 12/14/2023] [Revised: 02/15/2024] [Accepted: 03/11/2024] [Indexed: 04/13/2024] Open
Abstract
The cognitive load theory suggests that completing a task relies on the interplay between sensory input, working memory, and long-term memory. Cognitive overload occurs when the working memory's limited capacity is exceeded due to excessive information processing. In health care, clinicians face increasing cognitive load as the complexity of patient care has risen, leading to potential burnout. Electronic health records (EHRs) have become a common feature in modern health care, offering improved access to data and the ability to provide better patient care. They have been added to the electronic ecosystem alongside emails and other resources, such as guidelines and literature searches. Concerns have arisen in recent years that despite many benefits, the use of EHRs may lead to cognitive overload, which can impact the performance and well-being of clinicians. We aimed to review the impact of EHR use on cognitive load and how it correlates with physician burnout. Additionally, we wanted to identify potential strategies recommended in the literature that could be implemented to decrease the cognitive burden associated with the use of EHRs, with the goal of reducing clinician burnout. Using a comprehensive literature review on the topic, we have explored the link between EHR use, cognitive load, and burnout among health care professionals. We have also noted key factors that can help reduce EHR-related cognitive load, which may help reduce clinician burnout. The research findings suggest that inadequate efforts to present large amounts of clinical data to users in a manner that allows the user to control the cognitive burden in the EHR and the complexity of the user interfaces, thus adding more "work" to tasks, can lead to cognitive overload and burnout; this calls for strategies to mitigate these effects. Several factors, such as the presentation of information in the EHR, the specialty, the health care setting, and the time spent completing documentation and navigating systems, can contribute to this excess cognitive load and result in burnout. Potential strategies to mitigate this might include improving user interfaces, streamlining information, and reducing documentation burden requirements for clinicians. New technologies may facilitate these strategies. The review highlights the importance of addressing cognitive overload as one of the unintended consequences of EHR adoption and potential strategies for mitigation, identifying gaps in the current literature that require further exploration.
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Affiliation(s)
- Elham Asgari
- Guy's and St Thomas' NHS Trust, London, United Kingdom
- Tortus AI, London, United Kingdom
| | - Japsimar Kaur
- Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | | | | | | | - Neil Sebire
- Great Ormond Street Hospital, London, United Kingdom
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16
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Dye ME, Runyan P, Scott TA, Dietrich MS, Hatch LD, France D, Alrifai MW. Small Patients but a Heavy Lift: Workload and Burnout of Advanced Practice Providers and Physicians in a Level IV Neonatal Intensive Care Unit. J Perinat Neonatal Nurs 2024; 38:192-200. [PMID: 38758274 PMCID: PMC11104510 DOI: 10.1097/jpn.0000000000000804] [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] [Indexed: 05/18/2024]
Abstract
OBJECTIVE This study explored the association between workload and the level of burnout reported by clinicians in our neonatal intensive care unit (NICU). A qualitative analysis was used to identify specific factors that contributed to workload and modulated clinician workload in the NICU. STUDY DESIGN We conducted a study utilizing postshift surveys to explore workload of 42 NICU advanced practice providers and physicians over a 6-month period. We used multinomial logistic regression models to determine associations between workload and burnout. We used a descriptive qualitative design with an inductive thematic analysis to analyze qualitative data. RESULTS Clinicians reported feelings of burnout on nearly half of their shifts (44%), and higher levels of workload during a shift were associated with report of a burnout symptom. Our study identified 7 themes related to workload in the NICU. Two themes focused on contributors to workload, 3 themes focused on modulators of workload, and the final 2 themes represented mixed experiences of clinicians' workload. CONCLUSION We found an association between burnout and increased workload. Clinicians in our study described common contributors to workload and actions to reduce workload. Decreasing workload and burnout along with improving clinician well-being requires a multifaceted approach on unit and systems levels.
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Affiliation(s)
- M. Eva Dye
- Monroe Carell Jr. Children’s Hospital at Vanderbilt, Nashville, TN
- Department of Pediatrics, Division of Neonatology, Vanderbilt University Medical Center, Nashville, TN
| | - Patti Runyan
- Monroe Carell Jr. Children’s Hospital at Vanderbilt, Nashville, TN
| | - Theresa A. Scott
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN
| | - Mary S. Dietrich
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN
- School of Nursing, Vanderbilt University, Nashville, TN
| | - L Dupree Hatch
- Monroe Carell Jr. Children’s Hospital at Vanderbilt, Nashville, TN
- Department of Pediatrics, Division of Neonatology, Vanderbilt University Medical Center, Nashville, TN
- Center for Child Health Policy, Vanderbilt University Medical Center, Nashville, TN
| | - Daniel France
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN
- Center for Research and Innovation in Systems Safety, Vanderbilt University Medical Center, Nashville, TN
| | - Mhd Wael Alrifai
- Monroe Carell Jr. Children’s Hospital at Vanderbilt, Nashville, TN
- Department of Pediatrics, Division of Neonatology, Vanderbilt University Medical Center, Nashville, TN
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN
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17
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Marcatto F, Patriarca E, Bramuzzo D, Lucci E, Filon FL. Investigating the role of organizational stress in nurses' psychosomatic complaints: Evidence from a study in northeastern Italy. AIMS Public Health 2024; 11:420-431. [PMID: 39027390 PMCID: PMC11252574 DOI: 10.3934/publichealth.2024021] [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: 03/01/2024] [Revised: 03/10/2024] [Accepted: 03/12/2024] [Indexed: 07/20/2024] Open
Abstract
Background Nursing is pivotal to healthcare delivery but is often associated with high levels of organizational stress. In this cross-sectional study, we aimed to investigate the associations between exposure to organizational stressors, measured using the Health and Safety Executive Management Standards Indicator Tool, and psychosomatic complaints among nurses in a medium-sized city hospital in northeastern Italy. Methods A total of 215 nurses participated in the study, completing self-report questionnaires assessing organizational stressors and the prevalence of psychosomatic complaints experienced over the preceding six months. Results Significant associations were observed between various organizational stressors and psychosomatic complaints among nurses. Specifically, the Relationships factor emerged as a significant predictor of palpitations, irritability, anxiety, physical and mental tiredness, and headache. Additionally, Demands and Managers' support were identified as significant predictors of specific psychosomatic complaints. Conclusion This study highlights the critical role of addressing organizational stressors, particularly those related to interpersonal relationships, in promoting nurse well-being and optimizing patient care delivery. Despite its strengths, including the use of a well-established measurement tool and a comprehensive assessment of psychosomatic complaints, limitations such as the cross-sectional design and self-report measures warrant consideration. By prioritizing supportive work environments and implementing targeted interventions, healthcare organizations can cultivate a culture of well-being among nurses, ultimately enhancing the quality and safety of healthcare delivery.
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Affiliation(s)
| | - Emilia Patriarca
- Clinical Unit of Occupational Medicine, University of Trieste, Trieste, Italy
| | - Davide Bramuzzo
- Clinical Unit of Occupational Medicine, University of Trieste, Trieste, Italy
| | - Emanuela Lucci
- Clinical Unit of Occupational Medicine, University of Trieste, Trieste, Italy
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18
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Xu Z, Zhao B, Zhang Z, Wang X, Jiang Y, Zhang M, Li P. Prevalence and associated factors of secondary traumatic stress in emergency nurses: a systematic review and meta-analysis. Eur J Psychotraumatol 2024; 15:2321761. [PMID: 38426665 PMCID: PMC10911249 DOI: 10.1080/20008066.2024.2321761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 02/09/2024] [Indexed: 03/02/2024] Open
Abstract
Background: Nurses in emergency departments are at a high risk of experiencing secondary traumatic stress because of their frequent exposure to trauma patients and high-stress environments.Objective: This systematic review and meta-analysis aimed to determine the overall prevalence of secondary traumatic stress among emergency nurses and to identify the contributing factors.Method: We conducted a systematic search for cross-sectional studies in databases such as PubMed, Web of Science, Embase, CINAHL, Wanfang Database, and China National Knowledge Internet up to October 21, 2023. The Joanna Briggs Institute's appraisal checklists for prevalence and analytical cross-sectional studies were used for quality assessment. Heterogeneity among studies was assessed using Cochrane's Q test and the I2 statistic. A random effects model was applied to estimate the pooled prevalence of secondary traumatic stress, and subgroup analyses were performed to explore sources of heterogeneity. Descriptive analysis summarized the associated factors.Results: Out of 345 articles retrieved, 14 met the inclusion criteria, with 11 reporting secondary traumatic stress prevalence. The pooled prevalence of secondary traumatic stress among emergency nurses was 65% (95% CI: 58%-73%). Subgroup analyses indicated the highest prevalence in Asia (74%, 95% CI: 72%-77%), followed by North America (59%, 95% CI: 49%-72%) and Europe (53%, 95% CI: 29%-95%). Nine studies identified associated factors, including personal, work-related, and social factors. In the subgroup of divided by recruitment period, emergency department nurses in the COVID-19 outbreak period had a higher prevalence of secondary traumatic stress (70%, 95% CI: 62%-78%).Conclusions: Secondary traumatic stress prevalence is notably high among emergency department nurses, with significant regional variations and period differences. The factors affecting secondary traumatic stress also varied across studies. Future research should focus on improving research designs and sample sizes to pinpoint risk factors and develop prevention strategies.Registration: PROSPERO CRD42022301167.
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Affiliation(s)
- Zhiyong Xu
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China
- Department of Emergency, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China
- Department of Nursing, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China
- Nursing Theory & Practice Innovation Research Center, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China
| | - Bingnan Zhao
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China
| | - Zhen Zhang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China
- Department of Emergency, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China
- Department of Nursing, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China
- Nursing Theory & Practice Innovation Research Center, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China
| | - Xuan Wang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China
| | - Yifan Jiang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China
| | - Min Zhang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China
- Department of Emergency, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China
- Department of Nursing, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China
- Nursing Theory & Practice Innovation Research Center, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China
| | - Ping Li
- Department of Emergency, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China
- Department of Nursing, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China
- Nursing Theory & Practice Innovation Research Center, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China
- Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Jinan, People’s Republic of China
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19
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Jackson JL, Kuriyama A, Muramatsu K. A Model of Burnout Among Healthcare Professionals. J Gen Intern Med 2024; 39:373-376. [PMID: 37946016 PMCID: PMC10897092 DOI: 10.1007/s11606-023-08514-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 10/24/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND Burnout is common and can lead to worse outcomes for both healthcare workers and patients. Our study purpose was to assess the structural relationship among factors that protect against or worsen burnout. DATA SOURCES AND STUDY SETTING We surveyed healthcare professionals in 15 different Japanese intensive care units during the 3rd wave of the COVID-19 pandemic (March 2021). Surveys assessed burnout (Mini Z 2.0), resilience (Brief Resilience Scale), depressive (PHQ-9) and anxiety (GAD-7) symptoms, job and work environment characteristics, and personal experience with COVID. We explored survey domains with principal component factor analysis and modeled our results using structural equation modeling. PRINCIPAL FINDINGS Among 936 ICU professionals, 24.3% met criteria for burnout. Our model suggested that resilience (β = - 0.26, 95% CI - 0.32 to - 0.20), teamwork (β = - 0.23, 95% CI - 0.30 to - 0.16), and feeling safe (β = - 0.11, 95% CI - 0.18 to - 0.04) reduced burnout. Depression (β = - 0.32, 95% CI - 0.41 to - 0.23) and anxiety (β = - 0.20, 95% CI - 0.29 to - 0.10) both decreased resilience as did COVID fear (β = 0.08, 95% CI - 0.14 to - 0.02). In addition to directly reducing resilience, anxiety also indirectly reduced resilience by increasing COVID fear (0.23, 95% CI 0.17 to 0.23), which decreased resilience (β - 0.08, 95% CI - 0.14 to - 0.02). CONCLUSIONS Burnout is common among Japanese ICU professionals. Resilience, teamwork, and safety are all correlated with reduced burnout. Those who had depression or anxiety or COVID fear had higher degrees of burnout, an effect that appears to be mediated by reduced resilience. These are potential targets for interventions to reduce burnout.
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Affiliation(s)
| | - Akira Kuriyama
- Emergency and Critical Care Medicine, Kurashiki Central Hospital, Okayama, Japan.
| | - Kumiko Muramatsu
- Department of Clinical Psychology, Graduate School of Niigata Seiryo University, Niigata, Japan
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20
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Moons P. Pandemic-induced stress leading to nurse attrition: the fourth COVID-19 wave in full action. Eur J Cardiovasc Nurs 2024; 23:e1-e3. [PMID: 37534773 DOI: 10.1093/eurjcn/zvad074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 07/31/2023] [Accepted: 08/01/2023] [Indexed: 08/04/2023]
Affiliation(s)
- Philip Moons
- KU Leuven Department of Public Health and Primary Care, KU Leuven-University of Leuven, Kapucijnenvoer 35 PB7001, 3000 Leuven, Belgium
- Institute of Health and Care Sciences, University of Gothenburg, Arvid Wallgrens backe 1, 413 46 Gothenburg, Sweden
- Department of Paediatrics and Child Health, University of Cape Town, Klipfontein Rd, Rondebosch, 7700 Cape Town, South Africa
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21
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Kwon KT. Reply: SARS-CoV-2 Infection Control and Burnout Prevention Among Healthcare Workers Require Individual and Public Action. Infect Chemother 2023; 55:517-518. [PMID: 38183397 PMCID: PMC10771941 DOI: 10.3947/ic.2023.0113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 12/02/2023] [Indexed: 01/08/2024] Open
Affiliation(s)
- Ki Tae Kwon
- Division of Infectious Diseases, Department of Internal Medicine, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Korea.
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22
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Valdes-Elizondo GD, Álvarez-Maldonado P, Ocampo-Ocampo MA, Hernández-Ríos G, Réding-Bernal A, Hernández-Solís A. Burnout symptoms among physicians and nurses before, during and after COVID-19 care. Rev Lat Am Enfermagem 2023; 31:e4046. [PMID: 37937599 PMCID: PMC10631294 DOI: 10.1590/1518-8345.6820.4046] [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: 04/25/2023] [Accepted: 08/13/2023] [Indexed: 11/09/2023] Open
Abstract
OBJECTIVE this study evaluated burnout symptoms among physicians and nurses before, during and after COVID-19 care. METHOD a cross-sectional comparative study in the Pulmonary Care unit of a tertiary-level public hospital. The Maslach Burnout Inventory was used. RESULTS 280 surveys were distributed across three periods: before (n=80), during (n=105) and after (n=95) COVID-19 care; 172 surveys were returned. The response rates were 57.5%, 64.8% and 61.1%, respectively. The prevalence of severe burnout was 30.4%, 63.2% and 34.5% before, during and after COVID-19 care (p<0.001). Emotional exhaustion (p<0.001) and depersonalization (p=0.002) symptoms were more prevalent among nurses than among physicians. Severe burnout was more prevalent in women, nurses and night shift staff. CONCLUSION the high prevalence of burnout doubled in the first peak of hospital admissions and returned to pre-pandemic levels one month after COVID-19 care ended. Burnout varied by gender, shift and occupation, with nurses among the most vulnerable groups. Focus on early assessment and mitigation strategies are required to support nurses not only during crisis but permanently.
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Affiliation(s)
| | - Pablo Álvarez-Maldonado
- Hospital General de México, Servicio de Neumología, Ciudad de México, México
- Becario del Sistema Nacional de Investigadores, CONACYT, México
| | | | | | - Arturo Réding-Bernal
- Hospital General de México, Servicio de Neumología, Ciudad de México, México
- Becario del Sistema Nacional de Investigadores, CONACYT, México
| | - Alejandro Hernández-Solís
- Hospital General de México, Servicio de Neumología, Ciudad de México, México
- Becario del Sistema Nacional de Investigadores, CONACYT, México
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23
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Yun JY, Myung SJ, Kim KS. Associations among the workplace violence, burnout, depressive symptoms, suicidality, and turnover intention in training physicians: a network analysis of nationwide survey. Sci Rep 2023; 13:16804. [PMID: 37798353 PMCID: PMC10556140 DOI: 10.1038/s41598-023-44119-1] [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: 12/16/2022] [Accepted: 10/04/2023] [Indexed: 10/07/2023] Open
Abstract
Depression and anxiety are the most common mental disorders among physicians, who have a greater risk of suicide than those in other professional occupations. Relationships among a demanding workload, workplace violence, burnout, and intention to turnover have also been reported. The current study examined the principal components and propagating patterns of mental health and working environment interactions in training physicians. A total of 1981 training physicians completed online self-report questionnaires during September-October (midpoint of the training year) 2020. Regularized partial correlations in a mixed graphical model (MGM) and joint probability distributions (directed acyclic graph; DAG) were estimated for four subtypes of workplace violence (verbal abuse/physical violence perpetrated by clients/hospital staff), three burnout subdomains (Maslach Burnout Inventory), thoughts about quitting, and nine depressive symptoms, including suicidality, comprising the DSM-5 diagnostic criteria for major depressive disorder (assessed using the Patient Health Questionnaire-9). Thoughts of death/self-harm showed directional dependencies on the joint probability distributions of psychomotor agitation/retardation, concentration difficulty, self-reproach, and sadness in the DAG. In the MGM, a partial correlation with psychomotor agitation/retardation (r = 0.196) accounted for 56.5% of the variance in thoughts of death/self-harm. Partial correlations with concentration difficulties (r = 0.294), self-reproach (r = 0.257), changes in appetite (r = 0.184), and worker-on-worker physical violence (r = 0.240) in the MGM accounted for 54.4% of the variance in psychomotor agitation/retardation. Thoughts about quitting were partially correlated with and dependent upon the joint probability distributions of emotional exhaustion (r = 0.222), fatigue (r = 0.142), anhedonia (r = 0.178), and sadness (r = 0.237). In contrast, worker-on-worker (r = 0.417) and client-on-physician (r = 0.167) verbal abuse had regularized partial correlations with directional dependencies on thoughts about quitting. Organization-level interventions aiming to reduce the worker-on-worker violence and individual-level approaches of clinical screening program and psychiatric counseling clinic are required. Follow-up studies to verify the effectiveness of these interventions for training physicians are needed.
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Affiliation(s)
- Je-Yeon Yun
- Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
- Yeongeon Student Support Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sun Jung Myung
- Office of Medical Education, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
| | - Kyung Sik Kim
- Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
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24
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Lucy CA, Wojtaszek J, LaLonde L, Bruni TP, Ham HL, Sunde E, Lancaster B, Maragakis A. Pediatrician Burnout Before and After the COVID-19 Pandemic. J Prim Care Community Health 2023; 14:21501319231194148. [PMID: 37599442 PMCID: PMC10441537 DOI: 10.1177/21501319231194148] [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: 06/12/2023] [Revised: 07/10/2023] [Accepted: 07/26/2023] [Indexed: 08/22/2023] Open
Abstract
OBJECTIVE During the surge of the COVID-19 pandemic, burnout among physicians increased significantly. In the spring of 2023, the COVID national emergency was terminated in the U.S. To investigate whether provider burnout rates have returned to pre-pandemic levels, the current study compared dimensions of burnout among pediatricians pre- and post-pandemic. METHOD As part of 2 separate behavioral health trainings held at a Midwest academic health center in 2019 and virtually in 2023, data on burnout was collected from 52 pediatricians pre-pandemic and 38 pediatricians post-pandemic. Participants completed an online survey during the trainings and responded to items reflecting 3 dimensions of burnout: emotional exhaustion, depersonalization, and personal accomplishment. RESULTS There were no statistically significant differences in pre- and post-pandemic burnout amongst pediatricians in terms of total scores, number of pediatricians who met the clinical cutoff for each dimension, number of cutoffs met, or number of providers reporting elevated burnout on at least 1 dimension (p > .05 for all comparisons). Participants were 1.77 times more likely to meet the cutoff for emotional exhaustion post-pandemic than pre-pandemic. Over half of providers met this cutoff post-pandemic, compared to only 35% pre-pandemic. CONCLUSIONS While post-pandemic rates of burnout among pediatricians appear to be statistically similar to pre-pandemic levels, there appear to be clinically significant differences in emotional exhaustion between groups. With 63% of the post-pandemic group meeting the cutoff score for at least 1 dimension, it is imperative for the healthcare system to consider ways to mitigate burnout.
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Affiliation(s)
| | | | - Leah LaLonde
- Oregon Health Sciences University, Portland, OR, USA
| | | | | | - Eleah Sunde
- Eastern Michigan University, Ypsilanti, MI, USA
- Michigan Medicine, Ann Arbor, MI, USA
| | | | - Alexandros Maragakis
- Eastern Michigan University, Ypsilanti, MI, USA
- Deree College, The American College of Greece, Athens, Greece
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