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Rousseau AF, Fontana M, Georis S, Lambermont B, Cavalleri J, Pirotte M, Tronconi G, Paquay M, Misset B. Implementation of a routine post-shift debriefing program in ICU aiming at quality-of-care improvement: A primary analysis of feasibility and impacts. Intensive Crit Care Nurs 2024; 84:103752. [PMID: 38896963 DOI: 10.1016/j.iccn.2024.103752] [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: 01/09/2024] [Revised: 05/02/2024] [Accepted: 06/10/2024] [Indexed: 06/21/2024]
Abstract
OBJECTIVES This report describes the implementation of a clinical debriefing (CD) program in intensive care units (ICU) and analyses its feasibility and its impact on staff well-being. DESIGN Observational study. SETTING From April to September 2023, post-shift CDs were run once a week in 2 out of 7 units in our department, using an adapted version of the DISCOVER-PHASE tool. CD sessions were performed face-to-face with volunteer members of the multidisciplinary ICU team. MAIN OUTCOME MEASURES After 6 months, a survey assessing the satisfaction of the debriefed teams was conducted. The impact of CD on staff well-being was assessed using three validated questionnaires (Maslach Burnout Inventory, Ways of Coping Checklist, Professional Quality of Life Scale) administered in the 7 units before and after the CD period. RESULTS A total of 44 CDs were performed, lasting 15 (4-35) min. There were 6 (1-9) attendees per CD, mainly nurses (64.6%). Discussions focused mainly on basic problems related to dysfunctional material, communication and organization inside the team. The two debriefed teams were satisfied of the program and gave 9, 8 and 8 out of 10 on a visual analogical scale for the climate of confidence of the DC, their organisation, and their ability to improve working conditions and quality of care, respectively. Subscores at the three questionnaires assessing staff well-being before and after the CD period were similar, whether teams experienced CD or not. CONCLUSIONS Implementing of post-shift debriefings in our ICU was feasible and well accepted. More prolonged programs are probably needed to demonstrate benefits on staff well-being. IMPLICATIONS FOR CLINICAL PRACTICE This report offers elements that other teams can use to successfully conduct post-shift debriefings and to plan future research on longer-term programs.
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Affiliation(s)
- Anne-Françoise Rousseau
- Intensive Care Department, University Hospital of Liège, University of Liège, Belgium; Research Unit for a Life-Course Perspective on Health & Education-RUCHE, University of Liège, Liège, Belgium.
| | - Michael Fontana
- Intensive Care Department, University Hospital of Liège, University of Liège, Belgium
| | - Stéphanie Georis
- Intensive Care Department, University Hospital of Liège, University of Liège, Belgium
| | - Bernard Lambermont
- Intensive Care Department, University Hospital of Liège, University of Liège, Belgium
| | - Jonathan Cavalleri
- Intensive Care Department, University Hospital of Liège, University of Liège, Belgium
| | - Marc Pirotte
- Intensive Care Department, University Hospital of Liège, University of Liège, Belgium
| | - Gaëlle Tronconi
- Intensive Care Department, University Hospital of Liège, University of Liège, Belgium
| | - Méryl Paquay
- Centre for Medical Simulation, University of Liège, Belgium; Emergency Department, University Hospital of Liège, University of Liège, Belgium
| | - Benoit Misset
- Intensive Care Department, University Hospital of Liège, University of Liège, Belgium
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Ahya VN, De Luca D. Rebuttal From Drs Ahya and De Luca. Chest 2024; 165:1044-1045. [PMID: 38724145 DOI: 10.1016/j.chest.2024.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 01/05/2024] [Indexed: 05/25/2024] Open
Affiliation(s)
- Vivek N Ahya
- Clinical Practices of the University of Pennsylvania, Pulmonary, Allergy & Critical Care Division, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.
| | - Daniele De Luca
- Division of Pediatrics and Neonatal Critical Care, "A.Béclère" Medical Center, Paris-Saclay University Hospitals and the Physiopathology and Therapeutic Innovation Unit, Paris-Saclay University, Paris, France
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Martins P, Luzia RWS, Filho JAP, Welsh KS, Fuzikawa C, Nicolato R, Alemão MM, Gonçalves MA, Cavalheiro JC, Ávila ID, Veiga RT. Prevalence and factors associated with burnout among health professionals of a public hospital network during the COVID-19 pandemic. PLoS One 2024; 19:e0298187. [PMID: 38648225 PMCID: PMC11034648 DOI: 10.1371/journal.pone.0298187] [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: 06/26/2023] [Accepted: 01/20/2024] [Indexed: 04/25/2024] Open
Abstract
Burnout is most commonly defined as a syndrome characterized by emotional exhaustion, cynicism, and ineffectiveness, which occurs in response to chronic stressors at work. It can adversely affect health workers' physical and mental health, and the quality of care provided. The COVID-19 pandemic increased stressors and could impact burnout prevalence in this group. There is a lack of information regarding the prevalence of burnout among hospital health workers in Brazil. A newer definition of burnout has been proposed that considers three different clinical profiles: the frenetic, underchallenged and worn-out subtypes. This differentiation could lead to interventions tailored for each subtype. The present study aimed to estimate the prevalence of burnout, its subtypes, and associated factors in workers of a public hospital network in Brazil, during the pandemic. A total of 143 randomly selected participants answered an online form that included sociodemographic and occupational items, and the Burnout Clinical Subtypes Questionnaire, a summarized version. This questionnaire evaluates three burnout dimensions (overload, lack of development, neglect) that can be used to discriminate the three burnout subtypes (frenetic, underchallenged, worn-out, respectively); higher scores indicate higher burnout levels. The prevalence of burnout was high (53.85%), similar to other studies during the pandemic. The most common subtypes were 'frenetic' (34.97%), characterized by increased efforts to meet work demands, to the point of neglecting personal needs, and 'lack of development' (23.78%), characterized by a sense that work is uninteresting and does not contribute to personal development, and a perfunctory behavior towards tasks. Age was associated with burnout: workers with less than 51 years presented higher levels of burnout. These findings indicate the need for effective interventions to prevent and/or treat burnout. The assessment of burnout subtypes can allow managers to better understand the processes affecting employees, and inform actions to improve workforce health.
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Affiliation(s)
- Patricia Martins
- Department of Mental Health, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Richardson Warley Siqueira Luzia
- Statistics and Workforce Management Center at Hospital Foundation of the State of Minas Gerais (FHEMIG), Belo Horizonte, Minas Gerais, Brazil
| | - Jair Alves Pereira Filho
- Statistics and Workforce Management Center at Hospital Foundation of the State of Minas Gerais (FHEMIG), Belo Horizonte, Minas Gerais, Brazil
| | - Kelly Silva Welsh
- Ezequiel Dias Foundation (FUNED), Belo Horizonte, Minas Gerais, Brazil
| | - Cíntia Fuzikawa
- Department of Mental Health, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Rodrigo Nicolato
- Department of Mental Health, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Márcia Mascarenhas Alemão
- Department of Health Management, School of Nursing, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Márcio Augusto Gonçalves
- Department of Administrative Sciences, Faculty of Economic Sciences, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - José Carlos Cavalheiro
- Department of Letters, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Ianny Dumont Ávila
- Academic at the Faculty of Medical Sciences of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Ricardo Teixeira Veiga
- Department of Administrative Sciences, Faculty of Economic Sciences, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
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Garcia MVF. What every intensivist should know about stoicism to prevent burnout. J Crit Care 2024; 80:154454. [PMID: 37925242 DOI: 10.1016/j.jcrc.2023.154454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 01/18/2023] [Indexed: 11/06/2023]
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Mema B, Helmers A, Proulx C, Min KSK, Navne LE. Through the looking glass: qualitative study of critical care clinicians engaging in humanities. Intensive Care Med 2024; 50:427-436. [PMID: 38451286 DOI: 10.1007/s00134-024-07331-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 01/20/2024] [Indexed: 03/08/2024]
Abstract
PURPOSE Critical care medicine is facing an epidemic of burnout and consequent attrition. Interventions are needed to re-establish the medical field as a place of professional growth, resilience, and personal well-being. Humanities facilitate creation, reflection, and meaning-making, holding the promise of personal and community transformation. This study aimed to explore how clinicians engage with a humanities program, and what role and impact do the humanities play in their individual and collective journey. METHODS This is a qualitative study employing a phenomenological approach. Participants were faculty and trainees who participated in the program. Data consisted of (a) 60-h observations of humanities evenings, (b) more than 200 humanities artifacts brought by participants, and (c) 15 in-depth participant interviews. Data were analyzed inductively and reflectively by a team of researchers. RESULTS Participants were motivated to engage with the humanities curriculum because of past experiences with art, identifying a desire to re-explore their creativity to make meaning from their clinical experiences and a wish to socialize with and understand their colleagues through a different lens. The evenings facilitated self-expression, and inspired and empowered participants to create art pieces and re-engage with art in their daily lives. More importantly, they found a community where they could be vulnerable and supported, where shared experiences were discussed, emotions were validated, and relationships were deepened between colleagues. CONCLUSIONS Humanities may impact resilience and personal and community well-being by facilitating reflection and meaning-making of challenging clinical work and building bonds between colleagues.
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Affiliation(s)
- Briseida Mema
- Department of Critical Care Medicine, Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Canada.
| | - Andrew Helmers
- Department of Critical Care Medicine, Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Catherine Proulx
- Department of Critical Care Medicine, Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
- University of Toronto, Toronto, Canada
| | - Kyung-Seo Kay Min
- Rare Book School (RBS), University of Virginia, Charlottesville, USA
| | - Laura E Navne
- The Danish Center for Social Science Research, VIVE, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Alshurtan KS, Aldhaifi SY, Alshammari KA, Alodayli OM, Alqahtani KF, Aldhaifi SY. Burnout Syndrome Among Critical Care Health Providers in Saudi Arabia. J Multidiscip Healthc 2024; 17:843-854. [PMID: 38434482 PMCID: PMC10908335 DOI: 10.2147/jmdh.s452294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 02/20/2024] [Indexed: 03/05/2024] Open
Abstract
Background Burnout Syndrome constitutes a critical concern in healthcare, particularly among practitioners operating in high-stress, critical care settings. Understanding the multifaceted factors contributing to burnout in this context is pivotal for devising effective interventions and promoting the well-being of critical care professionals. Objective To investigate the prevalence, contributing factors, and potential interventions related to Burnout Syndrome among critical care health providers in Saudi Arabia. Methods A cross-sectional research design was employed, gathering data from a sample of critical care health providers, including medical practitioners. A self-administered structured electronic questionnaire was used, incorporating the Maslach Burnout Inventory (MBI) with its three subscales: emotional exhaustion, depersonalization, and personal accomplishment. The target population was male and female critical care health providers over 18 years age, most participants lies between 25 years to 34 years. Results Statistical analysis shows significant disparities in response distribution (p<0.05), highlighting the importance of understanding encounters with emotional exhaustion, personal accomplishment, and depersonalization. The Durbin-Watson statistic indicated limited autocorrelation, and collinearity tolerance values suggested nominal intercorrelations among predictors. A significant positive correlation was found between the "Depersonalization Loss of Empathy MBI" factor and the outcome variables, indicating complex relationships between emotional exhaustion, personal accomplishment, and depersonalization. Conclusion The study highlights the multifaceted nature of burnout, revealing intricate relationships between emotional exhaustion, personal accomplishment, and depersonalization. These findings collectively form an important foundation for future guidelines and interventions to enhance the well-being of healthcare professionals.
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Affiliation(s)
- Kareemah Salem Alshurtan
- Department of Internal Medicine and Adult Critical Care, College of Medicine, University of Ha’il, Ha’il, Saudi Arabia
| | - Saad Yousef Aldhaifi
- Department of Internal Medicine and Adult Critical Care, College of Medicine, University of Ha’il, Ha’il, Saudi Arabia
| | - Khalid Abdulkarim Alshammari
- Department of Internal Medicine and Adult Critical Care, College of Medicine, University of Ha’il, Ha’il, Saudi Arabia
| | - Othman Mohammed Alodayli
- Department of Internal Medicine and Adult Critical Care, College of Medicine, University of Ha’il, Ha’il, Saudi Arabia
| | - Khalid Falah Alqahtani
- Department of Internal Medicine and Adult Critical Care, College of Medicine, University of Ha’il, Ha’il, Saudi Arabia
| | - Sarah Yousef Aldhaifi
- Department of Internal Medicine and Adult Critical Care, College of Medicine, University of Ha’il, Ha’il, Saudi Arabia
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Halimi SN, Mirzaei A, Rowett D, Whitfield K, Luetsch K. Resilience and empathy in pharmacy interns: Insights from a three-year cohort study. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2023; 12:100333. [PMID: 37823011 PMCID: PMC10562191 DOI: 10.1016/j.rcsop.2023.100333] [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: 07/23/2023] [Revised: 09/15/2023] [Accepted: 09/18/2023] [Indexed: 10/13/2023] Open
Abstract
Background Resilience and empathy are important attributes for healthcare professionals to navigate challenging work environments and providing patient-centred care. Knowledge about pharmacists' levels of resilience and empathy, particularly during the early stages of their careers, is limited. Objectives To explore pharmacy interns' levels of resilience and empathy using the Connor-Davidson-Resilience-Scale-25 (CD-RISC-25) and the Kiersma-Chen-Empathy-Scale (KCES), examine potential associations with demographic characteristics and ascertain what challenges interns' resilience and which support mechanisms they identify. Methods Hard copies of the surveys were distributed to three cohorts during face-to-face intern pharmacy workshops from 2020 to 2022. Additionally, a qualitative questionnaire explored interns' experiences while completing an accredited internship program during the COVID-19 pandemic. Data were analysed using descriptive and inferential statistics, open-ended questions were analysed through qualitative and quantitative content analysis. Results Among 134 completed surveys, most respondents were female, aged 18-22, and worked in hospitals. The CD-RISC-25 mean score was 66.6 (SD 11.7) and the KCES mean was 84.3 (SD 9.23) indicative of intermediate levels of resilience and empathy. Resilience and empathy scores did not significantly differ between the three cohorts (p-value > 0.05), and both were not consistently correlated with each other (p-value > 0.05). No significant associations were found between demographic characteristics and resilience scores. However, age and pre-internship employment history showed a statistically significant association with empathy scores (p-value < 0.05), with younger age groups and those who worked part-time during undergraduate studies demonstrating higher levels of empathy. Challenges undermining interns' resilience included the COVID-19 pandemic, internship requirements, and feelings of inadequacy and inexperience. Conclusions This study showed that resilience and empathy scores among interns were at what can be regarded as intermediate levels, largely unaffected by the COVID-19 pandemic or cohort demographics. It highlights professional aspects and strategies which are professionally sustaining and may assist interns in navigating challenges to their resilience and empathy.
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Affiliation(s)
- Syafiqah Nadiah Halimi
- School of Pharmacy, The University of Queensland, 20 Cornwall Street, Woolloongabba, Queensland 4102, Australia
- Kulliyyah of Pharmacy, International Islamic University Malaysia, 25710 Kuantan, Pahang Darul Makmur, Malaysia
| | - Ardalan Mirzaei
- School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, New South Wales 2006, Australia
| | - Debra Rowett
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, South Australia 5000, Australia
| | - Karen Whitfield
- School of Pharmacy, The University of Queensland, 20 Cornwall Street, Woolloongabba, Queensland 4102, Australia
| | - Karen Luetsch
- School of Pharmacy, The University of Queensland, 20 Cornwall Street, Woolloongabba, Queensland 4102, Australia
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8
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Tremayne P, de Bourg L. Exploring nurses' well-being and strategies to support self-care. Nurs Stand 2023; 38:e12206. [PMID: 37842764 DOI: 10.7748/ns.2023.e12206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2023] [Indexed: 10/17/2023]
Abstract
Nurses experience a range of challenges in their practice that can adversely affect their well-being, for example work-related stress and workforce issues. These challenges may have been intensified by various factors, such as the coronavirus disease 2019 (COVID-19) pandemic and shift working. This article considers the concept of well-being and explores nurses' well-being in the context of ongoing stressors and workforce issues. It also examines some of the effects of shift work on nurses' well-being and how these could be mitigated. The authors outline a range of self-care practices that nurses could engage in and consider how they may be supported in this by their line managers and healthcare organisations.
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Affiliation(s)
- Penny Tremayne
- Leicester School of Nursing and Midwifery, De Montfort University, Leicester, England
| | - Lorna de Bourg
- Leicester School of Nursing and Midwifery, De Montfort University, Leicester, England
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Haruna J, Uemura S, Taguchi Y, Muranaka S, Niiyama S, Inamura H, Sawamoto K, Mizuno H, Narimatsu E. Influence of work and family environment on burnout among emergency medical technicians. Clin Exp Emerg Med 2023; 10:287-295. [PMID: 36796782 PMCID: PMC10579723 DOI: 10.15441/ceem.22.389] [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: 10/23/2022] [Revised: 01/09/2023] [Accepted: 01/31/2023] [Indexed: 02/18/2023] Open
Abstract
OBJECTIVE Burnout among emergency medical technicians is a serious problem affecting delivery of quality emergency medical services. Although the repetitive nature of the job and lower education level requirements for technicians have been reported as risk factors, little is known about the influence of burden of responsibility, degree of supervisor support, and home environment on burnout among emergency medical technicians. This study aimed to test the hypothesis that burden of responsibility, degree of supervisor support, and home environment increase burnout probability. METHODS A web-based survey was conducted among emergency medical technicians in Hokkaido, Japan from July 26, 2021 to September 13, 2021. A total of 21 facilities were randomly selected from 42 fire stations. Prevalence of burnout was measured using the Maslach Burnout-Human Services Survey Inventory (MBI-HSS). Burden of responsibility was measured using a visual analog scale. Occupational background was also measured. Supervisor support was measured using the Brief Job Stress Questionnaire (BJSQ). Family-work negative spillover was measured using the Japanese version of Survey Work-Home Interaction-NijmeGen (SWING). The cutoff value for burnout syndrome was defined as emotional exhaustion≥27 and/or depersonalization≥10. RESULTS A total of 700 survey respondents were included, and 27 surveys with missing data were excluded. The suspected burnout frequency was 25.6%. Covariates were adjusted using multilevel logistic regression model analysis. Low supervisor support (odds ratio, 1.421; 95% confidence interval, 1.136-1.406; P<0.001) and high family-work negative spillover (odds ratio, 1.264; 95% confidence interval, 1.285-1.571; P<0.001) were independent factors associated with higher probability of burnout. CONCLUSION This study indicated that focusing on improvement of supervisor support for emergency medical technicians and creating supportive home environments may assist in reducing burnout frequency.
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Affiliation(s)
- Junpei Haruna
- Department of Emergency Medical Services, Life Flight and Disaster Medicine, Sapporo Medical University, Sapporo, Japan
- Department of Intensive Care Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Shuji Uemura
- Department of Emergency Medical Services, Life Flight and Disaster Medicine, Sapporo Medical University, Sapporo, Japan
- Department of Emergency Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Yukiko Taguchi
- Department of Emergency Medical Services, Life Flight and Disaster Medicine, Sapporo Medical University, Sapporo, Japan
- Department of Nursing, Sapporo Medical University School of Health Sciences, Sapporo, Japan
| | - Saori Muranaka
- Department of Emergency Medical Services, Life Flight and Disaster Medicine, Sapporo Medical University, Sapporo, Japan
- Department of Advanced Critical Care and Emergency Center, Sapporo Medical University Hospital, Sapporo, Japan
| | - Sachi Niiyama
- Department of Emergency Medical Services, Life Flight and Disaster Medicine, Sapporo Medical University, Sapporo, Japan
- Department of Advanced Critical Care and Emergency Center, Sapporo Medical University Hospital, Sapporo, Japan
| | - Hirotoshi Inamura
- Department of Emergency Medical Services, Life Flight and Disaster Medicine, Sapporo Medical University, Sapporo, Japan
- Department of Hospital Pharmacy, Sapporo Medical University Hospital, Sapporo, Japan
| | - Keigo Sawamoto
- Department of Emergency Medical Services, Life Flight and Disaster Medicine, Sapporo Medical University, Sapporo, Japan
- Department of Emergency Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Hirotoshi Mizuno
- Department of Emergency Medical Services, Life Flight and Disaster Medicine, Sapporo Medical University, Sapporo, Japan
- Department of Emergency Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Eichi Narimatsu
- Department of Emergency Medical Services, Life Flight and Disaster Medicine, Sapporo Medical University, Sapporo, Japan
- Department of Emergency Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
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Wong A, Berenbrok LA, Snader L, Soh YH, Kumar VK, Javed MA, Bates DW, Sorce LR, Kane-Gill SL. Facilitators and Barriers to Interacting With Clinical Decision Support in the ICU: A Mixed-Methods Approach. Crit Care Explor 2023; 5:e0967. [PMID: 37644969 PMCID: PMC10461946 DOI: 10.1097/cce.0000000000000967] [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] [Indexed: 08/31/2023] Open
Abstract
OBJECTIVES Clinical decision support systems (CDSSs) are used in various aspects of healthcare to improve clinical decision-making, including in the ICU. However, there is growing evidence that CDSS are not used to their full potential, often resulting in alert fatigue which has been associated with patient harm. Clinicians in the ICU may be more vulnerable to desensitization of alerts than clinicians in less urgent parts of the hospital. We evaluated facilitators and barriers to appropriate CDSS interaction and provide methods to improve currently available CDSS in the ICU. DESIGN Sequential explanatory mixed-methods study design, using the BEhavior and Acceptance fRamework. SETTING International survey study. PATIENT/SUBJECTS Clinicians (pharmacists, physicians) identified via survey, with recent experience with clinical decision support. INTERVENTIONS An initial survey was developed to evaluate clinician perspectives on their interactions with CDSS. A subsequent in-depth interview was developed to further evaluate clinician (pharmacist, physician) beliefs and behaviors about CDSS. These interviews were then qualitatively analyzed to determine themes of facilitators and barriers with CDSS interactions. MEASUREMENTS AND MAIN RESULTS A total of 48 respondents completed the initial survey (estimated response rate 15.5%). The majority believed that responding to CDSS alerts was part of their job (75%) but felt they experienced alert fatigue (56.5%). In the qualitative analysis, a total of five facilitators (patient safety, ease of response, specificity, prioritization, and feedback) and four barriers (excess quantity, work environment, difficulty in response, and irrelevance) were identified from the in-depth interviews. CONCLUSIONS In this mixed-methods survey, we identified areas that institutions should focus on to improve appropriate clinician interactions with CDSS, specific to the ICU. Tailoring of CDSS to the ICU may lead to improvement in CDSS and subsequent improved patient safety outcomes.
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Affiliation(s)
- Adrian Wong
- Beth Israel Deaconess Medical Center, Department of Pharmacy, Boston, MA
| | | | - Lauren Snader
- University of Pittsburgh, School of Pharmacy, Pittsburgh, PA
| | - Yu Hyeon Soh
- University of Pittsburgh, School of Pharmacy, Pittsburgh, PA
| | | | | | - David W Bates
- Brigham and Women's Hospital, Division of General Internal Medicine and Primary Care, Boston, MA
- Harvard Medical School, School of Medicine, Boston, MA
| | - Lauren R Sorce
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
- Northwestern University Feinberg School of Medicine, Division of Pediatric Critical Care, Chicago, IL
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Nehme M, Vieux L, Kaiser L, Chappuis F, Chenaud C, Guessous I. The longitudinal study of subjective wellbeing and absenteeism of healthcare workers considering post-COVID condition and the COVID-19 pandemic toll. Sci Rep 2023; 13:10759. [PMID: 37402726 PMCID: PMC10319731 DOI: 10.1038/s41598-023-37568-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 06/23/2023] [Indexed: 07/06/2023] Open
Abstract
Experts have warned against the pandemic burden on healthcare workers early on, however little is known about the evolution of this burden with time, in addition to the long-term effects of post-COVID symptoms in healthcare workers. Staff at the Geneva University Hospitals in Switzerland had an online follow-up in July and December 2021, on their physical and mental health, quality of life and functional capacity using validated scales. Descriptive analyses compared the prevalence of symptoms, functional impairment and quality of life in SARS-CoV-2 positive and negative individuals at baseline and at follow-up. Out of the initial n = 3,083 participants that answered at baseline in July 2021, n = 900 (mean age of 46.4 years, 70.1% women) completed the follow-up in December 2021. With time, more individuals reported fatigue (+ 9.4%), headache (+ 9.0%), insomnia (+ 2.3%), cognitive impairment (+ 1.4%), stress/burnout (+ 8.8%), pain (+ 8.3%), digestive symptoms (+ 3.6%), dyspnea (+ 1.0%), and cough (+ 7.7%) compared to baseline, with a differentially larger increase in symptoms in the SARS-CoV-2 negative group. Individuals had more functional impairment (12.7% at baseline and 23.9% at follow-up), with more absenteeism and worsening quality of life. Healthcare workers are potentially suffering from long term consequences of the pandemic burden, calling for urgent action and solutions.
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Affiliation(s)
- Mayssam Nehme
- Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland.
| | - Laure Vieux
- Division of Occupational Medicine, Geneva University Hospital, Geneva, Switzerland
| | - Laurent Kaiser
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland
- Geneva Center for Emerging Viral Diseases, Geneva University Hospitals, Geneva, Switzerland
- Division of Laboratory Medicine, Laboratory of Virology, Geneva University Hospitals, Geneva, Switzerland
| | - François Chappuis
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division of Tropical and Humanitarian Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Catherine Chenaud
- Division of Occupational Medicine, Geneva University Hospital, Geneva, Switzerland
| | - Idris Guessous
- Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
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12
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Sikora A. Critical Care Pharmacists: A Focus on Horizons. Crit Care Clin 2023; 39:503-527. [PMID: 37230553 DOI: 10.1016/j.ccc.2023.01.006] [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: 05/27/2023]
Abstract
Critical care pharmacy has evolved rapidly over the last 50 years to keep pace with the rapid technological and knowledge advances that have characterized critical care medicine. The modern-day critical care pharmacist is a highly trained individual well suited for the interprofessional team-based care that critical illness necessitates. Critical care pharmacists improve patient-centered outcomes and reduce health care costs through three domains: direct patient care, indirect patient care, and professional service. Optimizing workload of critical care pharmacists, similar to the professions of medicine and nursing, is a key next step for using evidence-based medicine to improve patient-centered outcomes.
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Affiliation(s)
- Andrea Sikora
- Department of Clinical and Administrative Pharmacy, University of Georgia College of Pharmacy, 120 15th Street, HM-118, Augusta, GA 30912, USA; Department of Pharmacy, Augusta University Medical Center, Augusta, GA, USA.
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13
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Bahrami Nejad Joneghani R, Bahrami Nejad Joneghani R, Dustmohammadloo H, Bouzari P, Ebrahimi P, Fekete-Farkas M. Self-Compassion, Work Engagement and Job Performance among Intensive Care Nurses during COVID-19 Pandemic: The Mediation Role of Mental Health and the Moderating Role of Gender. Healthcare (Basel) 2023; 11:1884. [PMID: 37444718 DOI: 10.3390/healthcare11131884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 06/24/2023] [Accepted: 06/27/2023] [Indexed: 07/15/2023] Open
Abstract
(1) Background: The COVID-19 pandemic has highlighted attention on the importance of certain variables in predicting job performance. Among these, mental health is one of the main variables affected by this pandemic. It can have an important mediating role in predicting job performance by individual, occupational, and organizational variables, especially in the nursing community. However, there is little information about its mediation role among the predictors of job performance. This cross-sectional study aimed to examine the role of mental health as a mediating factor in the influence of self-compassion and work engagement on ICU nurses' job performance during the COVID-19 pandemic, as well as the moderating effect of gender on all model relations. A survey of 424 ICU nurses (men 193 and women 231) was undertaken in three Coronavirus hospitals in Isfahan, Iran. (2) Method: Questionnaires were distributed and collected among the statistical sample, and the data from the questionnaires were analyzed using AMOS24 software (version 24). The research model was evaluated in two stages (the main model and the two sub-models in two gender groups). (3) Result: The analysis revealed that work engagement (β = 0.42, p < 0.001), mental health (β = 0.54, p < 0.001) and job performance (β = 0.51, p < 0.001) were discovered to be positively related to self-compassion. Work engagement is positively associated with mental health (β = 0.16, p < 0.01) and job performance (β = 0.21, p < 0.001), and mental health is linked positively to job performance (β = 0.23, p < 0.001). Furthermore, the effects of self-compassion and work engagement on job performance are mediated by mental health. According to the findings, gender moderates the link between self-compassion and work engagement, work engagement and job performance, and self-compassion and job performance. (4) Conclusion: Mental health has a mediating role in the effect of self-compassion and work engagement on ICU nurses' job performance. Gender also acted as a moderator in some relationships. Males are dominant in all of these relationships as compared to females.
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Affiliation(s)
| | | | - Hakimeh Dustmohammadloo
- California Language Academy, Jalan Ampang, Kuala Lampur City Center, Kuala Lampur 50450, Malaysia
| | - Parisa Bouzari
- Department of Agricultural Logistics, Trade and Marketing, Institute of Agricultural and Food Economics, Hungarian University of Agriculture and Life Sciences (MATE), Páter Károly Street 1, H-2100 Gödöllő, Hungary
| | - Pejman Ebrahimi
- Doctoral School of Economic and Regional Sciences, Hungarian University of Agriculture and Life Sciences (MATE), H-2100 Gödöllő, Hungary
| | - Mária Fekete-Farkas
- Institute of Agricultural and Food Economics, Hungarian University of Agriculture and Life Sciences (MATE), Páter Károly Street 1, H-2100 Gödöllő, Hungary
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14
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Kruser JM, Viglianti EM, Mylvaganam R, Krolikowski KA, Khorzad R, Detsky ME, Wiegmann DA, Wunderink RG, Holl JL. Mapping the process of ICU care delivery to improve treatment decisions in acute respiratory failure. IISE TRANSACTIONS ON HEALTHCARE SYSTEMS ENGINEERING 2023; 14:32-41. [PMID: 38646086 PMCID: PMC11025699 DOI: 10.1080/24725579.2023.2188319] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
Evidence suggests system-level norms and care processes influence individual patients' medical decisions, including end-of-life decisions for patients with critical illnesses like acute respiratory failure. Yet, little is known about how these processes unfold over the course of a patient's critical illness in the intensive care unit (ICU). Our objective was to map current-state ICU care delivery processes for patients with acute respiratory failure and to identify opportunities to improve the process. We conducted a process mapping study at two academic medical centers, using focus groups and semi-structured interviews. The 70 participants represented 17 distinct roles in ICU care, including interprofessional medical ICU and palliative care clinicians, surrogate decision makers, and patient survivors. Participants refined and endorsed a process map of current-state care delivery for all patients admitted to the ICU with acute respiratory failure requiring mechanical ventilation. The process contains four critical periods for active deliberation about the use of life-sustaining treatments. However, active deliberation steps are inconsistently performed and frequently disrupted, leading to prolongation of life-sustaining treatment by default, without consideration of patients' individual goals and priorities. Interventions to standardize active deliberation in the ICU may improve treatment decisions for ICU patients with acute respiratory failure.
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Affiliation(s)
- Jacqueline M Kruser
- Department of Medicine, Division of Allergy, Pulmonary, and Critical Care, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States of America
| | - Elizabeth M Viglianti
- Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Ruben Mylvaganam
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
| | - Kristyn A Krolikowski
- Center for Health Services and Outcomes Research, Institute for Public Health and Medicine, Chicago, IL, United States
| | - Rebeca Khorzad
- Arvin LLC Healthcare Quality Improvement, Lake Forest, Illinois, United States of America
| | - Michael E Detsky
- Department of Medicine, Sinai Health System, Toronto, Canada
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Canada
| | - Douglas A Wiegmann
- Department of Industrial and Systems Engineering, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Richard G Wunderink
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
| | - Jane L Holl
- Biological Sciences Division, University of Chicago, Chicago, Illinois, United States of America
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15
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Papazian L, Hraiech S, Loundou A, Herridge MS, Boyer L. High-level burnout in physicians and nurses working in adult ICUs: a systematic review and meta-analysis. Intensive Care Med 2023; 49:387-400. [PMID: 36971792 PMCID: PMC10041519 DOI: 10.1007/s00134-023-07025-8] [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: 01/03/2023] [Accepted: 03/01/2023] [Indexed: 03/29/2023]
Abstract
PURPOSE The prevalence of burnout in intensive care unit (ICU) professionals is difficult to establish due to the variety of survey instruments used, the heterogeneity of the targeted population, the design of the studies, and the differences among countries regarding ICU organization. METHODS We performed a systematic review and meta-analysis examining the prevalence of high-level burnout in physicians and nurses working in adult ICUs, including only studies that use the Maslach Burnout Inventory (MBI) as a tool to evaluate burnout and involving at least 3 different ICUs. RESULTS Twenty-five studies with a combined population of 20,723 healthcare workers from adult ICUs satisfied the inclusion criteria. Combining 18 studies including 8187 ICU physicians, 3660 of them reported a high level of burnout (prevalence 0.41, range 0.15-0.71, 95% CI [0.33; 0.5], I2 97.6%, 95% CI [96.9%; 98.1%]). The heterogeneity can be at least in part explained by the definition of burnout used and the response rate as confirmed by the multivariable metaregression done. In contrast, there was no significant difference regarding other factors such as the study period (before or during the coronavirus disease 2019 (COVID-19) pandemic), the income of the countries, or the Healthcare Access and Quality (HAQ) index. Combining 20 studies including 12,536 ICU nurses, 6232 of nurses were reporting burnout (prevalence 0.44, range 0.14-0.74, [95% CI 0.34; 0.55], I2 98.6% 95% CI [98.4%; 98.9%]). The prevalence of high-level burnout in ICU nurses for studies performed during the COVID-19 pandemic was higher than that reported for studies performed before the COVID-19 pandemic (0.61 [95% CI, 0.46; 0.75] and 0.37 [95% CI, 0.26; 0.49] respectively, p = 0.003). As for physicians, the heterogeneity is at least in part explained by the definition used for burnout using the MBI but not by the number of participants. When compared, the prevalence of high-level burnout was not different between ICU physicians and ICU nurses. However, the proportion of ICU nurses with a high level of emotional exhaustion was higher than for ICU physicians (0.42 [95% CI, 0.37; 0.48] and 0.28 [0.2; 0.39], respectively, p = 0.022). CONCLUSION According to this meta-analysis, the prevalence of high-level burnout is higher than 40% in all ICU professionals. However, there is a great heterogeneity in the results. To evaluate and to compare preventive and therapeutic strategies, there is the need to use a consensual definition of burnout when using the MBI instrument.
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Affiliation(s)
- Laurent Papazian
- Centre Hospitalier de Bastia, 20600, Bastia, Corsica, France.
- Aix-Marseille Université, Faculté de médecine, Centre d'Etudes et de Recherches sur les Services de Santé et qualité de vie EA 3279, 13005, Marseille, France.
- Intensive Care Unit, Bastia General Hospital, Chemin de Falconaja, 20600, Bastia, Corsica, France.
| | - Sami Hraiech
- Aix-Marseille Université, Faculté de médecine, Centre d'Etudes et de Recherches sur les Services de Santé et qualité de vie EA 3279, 13005, Marseille, France
- Assistance Publique-Hôpitaux de Marseille, Hôpital Nord, Médecine Intensive Réanimation, 13015, Marseille, France
| | - Anderson Loundou
- CEReSS-Health Service Research and Quality of Life Center, Aix-Marseille University, 27 Boulevard Jean Moulin, 13005, Marseille, France
| | - Margaret S Herridge
- Critical Care and Respiratory Medicine, 22 Toronto General Research Institute, Institute of Medical Sciences, and Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Laurent Boyer
- CEReSS-Health Service Research and Quality of Life Center, Aix-Marseille University, 27 Boulevard Jean Moulin, 13005, Marseille, France
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16
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Green J, Berdahl CT, Ye X, Wertheimer JC. The impact of positive reinforcement on teamwork climate, resiliency, and burnout during the COVID-19 pandemic: The TEAM-ICU (Transforming Employee Attitudes via Messaging strengthens Interconnection, Communication, and Unity) pilot study. J Health Psychol 2023; 28:267-278. [PMID: 35723168 PMCID: PMC9982400 DOI: 10.1177/13591053221103640] [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] [Indexed: 11/16/2022] Open
Abstract
Burnout is an internationally recognized occupational phenomenon that negatively impacts the healthcare workforce and its recipients. The aim of this pilot study was to test whether positive reinforcement and integrating a language of support among co-workers can enhance resiliency, facilitate psychological wellness, and encourage hope. This embedded mixed methods prospective, behavioral, interventional study evaluated the effects of positive feedback on wellness among intensive care unit clinicians during the COVID-19 pandemic in a single center, quaternary care medical center. The deliberate positive feedback paradigm has the potential to augment resiliency and improve attitudes toward a teamwork climate. The routine use of deliberate positivity may represent a scalable, low-cost initiative to enhance wellness in a healthcare organization.
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Affiliation(s)
| | | | - Xin Ye
- Cedars-Sinai Medical Center, USA
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17
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Halimi SN, Rowett D, Whitfield K, Luetsch K. How early career pharmacists understand resilience - A qualitative study of experiences, challenges and strategies. Res Social Adm Pharm 2023; 19:486-494. [PMID: 36344335 DOI: 10.1016/j.sapharm.2022.10.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 10/26/2022] [Accepted: 10/26/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Resilience assists healthcare professionals in negotiating challenges, remaining positive when experiencing adversity, and in constructively dealing with difficult work situations and environments. There is increasing research about how early career healthcare professionals, understand and maintain resilience but little is known about support early career pharmacists may need and value. AIMS To explore early career pharmacists' understanding of resilience, their strategies to enhance and maintain resilience as healthcare professionals and to identify resilience-fostering programmes they perceive could be implemented to support them. METHODS Three focus groups and 12 semi-structured interviews with a total of 15 hospital pharmacists and 10 community pharmacists (both less than 3 years post-registration) were conducted. An inductive thematic analysis of transcripts was performed to identify main themes and subthemes. RESULTS Pharmacists understood resilience as the capability to adapt to and learn from challenges and setbacks, which they can build through experience and exposure. Resilience in the workplace was challenged by their working environment and workload, which could lead to ego depletion, the transition from intern to registered pharmacist and working during the COVID-19 pandemic, which both added pressure and uncertainty to their role. Professional resilience was supported on individual, social and organisational levels and through self-care strategies. Pharmacists perceived mentorship and sharing experiences, experiential placements and constructive but challenging role play as potentially beneficial in building resilience during undergraduate studies and internship. DISCUSSION Pharmacists defined resilience constructively and identified challenges testing but also strategies supporting their resilience in the workplace. Workplaces can support pharmacists by monitoring workload and workplace relationships, creating opportunities for peer and mentor support and by allowing pharmacists to implement their personal, individualised resilience maintaining strategies. Early career pharmacists' experiences and insights would be valuable when considering the design and implementation of resilience-fostering programmes.
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Affiliation(s)
- Syafiqah Nadiah Halimi
- Kulliyyah of Pharmacy, International Islamic University Malaysia, 25710, Kuantan, Pahang Darul Makmur, Malaysia; School of Pharmacy, The University of Queensland, 20 Cornwall Street, Woolloongabba, Queensland, 4102, Australia.
| | - Debra Rowett
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, South Australia, 5000, Australia.
| | - Karen Whitfield
- School of Pharmacy, The University of Queensland, 20 Cornwall Street, Woolloongabba, Queensland, 4102, Australia.
| | - Karen Luetsch
- School of Pharmacy, The University of Queensland, 20 Cornwall Street, Woolloongabba, Queensland, 4102, Australia.
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18
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Yıldız E. Psychopathological Factors Associated With Burnout in Intensive Care Nurses: A Cross-Sectional Study. J Am Psychiatr Nurses Assoc 2023; 29:122-135. [PMID: 33719680 DOI: 10.1177/1078390321999725] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Although previous studies have separately revealed that parameters such as anxiety, depression, and secondary traumatic stress (STS) are associated with burnout, there is still a limited understanding of the relationship between anxiety, depression, and STS and burnout in intensive care unit (ICU) nurses. AIMS To investigate the relationship between levels of burnout, anxiety, depression, and STS in ICU nurses. METHODS A cross-sectional study was conducted with ICU nurses (N = 164) from a university hospital in eastern Turkey. The participants completed the anxiety, depression, STS, and burnout scales along with the descriptive characteristics form. The data were analyzed using descriptive statistics, correlation, and logistic regression analysis. RESULTS The mean scores for STS, anxiety, depression, and burnout were 40.60 ± 13.77, 17.14 ± 12.90, 13.28 ± 9.75 and 41.39 ± 14.87, respectively. The results showed that, in the ICU nurses, anxiety, depression, and STS components explained 61% of emotional exhaustion, 38% of depersonalization, and 13% of personal accomplishment. CONCLUSIONS While the present findings supported the paradigm that burnout in ICU nurses is associated with STS, anxiety, and depression, they also revealed some details about the psychopathological factors associated with burnout. These details were as follows: (1) individuals who resorted to avoidance as a component of STS on a high level were more likely to experience emotional exhaustion and depersonalization, (2) individuals with severe depressive symptoms were more likely to experience a decrease in their personal accomplishment, and (3) individuals with anxiety symptoms were more likely to experience both emotional exhaustion and personal accomplishment.
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Affiliation(s)
- Erman Yıldız
- Erman Yıldız, PhD, RN, Inonu University, Malatya, Turkey
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19
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Klick JC, Syed M, Leong R, Miranda H, Cotter EK. Health and Well-Being of Intensive Care Unit Physicians: How to Ensure the Longevity of a Critical Specialty. Anesthesiol Clin 2023; 41:303-316. [PMID: 36872006 PMCID: PMC9985495 DOI: 10.1016/j.anclin.2022.10.009] [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: 03/07/2023]
Abstract
A second epidemic of burnout, fatigue, anxiety, and moral distress has emerged concurrently with the coronavirus disease 2019 (COVID-19) pandemic, and critical care physicians are especially affected. This article reviews the history of burnout in health care workers, presents the signs and symptoms, discusses the specific impact of the COVID-19 pandemic on intensive care unit caregivers, and attempts to identify potential strategies to combat the Great Resignation disproportionately affecting health care workers. The article also focuses on how the specialty can amplify the voices and highlight the leadership potential of underrepresented minorities, physicians with disabilities, and the aging physician population.
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Affiliation(s)
- John C Klick
- Department of Anesthesiology, University of Vermont Medical Center, University of Vermont Larner College of Medicine, 111 Colchester Avenue, Burlington, VT 05401, USA
| | - Madiha Syed
- Department of Intensive Care & Resuscitation, Anesthesiology Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, Mail Code G58, Cleveland, OH 44195, USA
| | - Ron Leong
- Thomas Jefferson University Hospital, Sidney Kimmel Medial College, 111 South 11th Street, Gibbon Building, Suite 8130, Philadelphia, PA 19107, USA
| | - Haley Miranda
- Department of Anesthesiology, Pain and Perioperative Medicine, University of Kansas Medical Center, 3901 Rainbow Boulevard, MS 1034, Kansas City, KS 66160, USA
| | - Elizabeth K Cotter
- Department of Anesthesiology, Pain and Perioperative Medicine, University of Kansas Medical Center, 3901 Rainbow Boulevard, MS 1034, Kansas City, KS 66160, USA.
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20
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Dahm P, Kink R, Stroud M, Dhar A. A Multicenter Survey of Pediatric-Neonatal Transport Teams in the United States to Assess the Impact of the Coronavirus Disease 2019 Pandemic on Staffing. Air Med J 2023; 42:196-200. [PMID: 37150574 PMCID: PMC9972252 DOI: 10.1016/j.amj.2023.01.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 01/26/2023] [Accepted: 01/29/2023] [Indexed: 03/06/2023]
Abstract
Objective The coronavirus disease 2019 pandemic has resulted in unprecedented burnout in frontline health care providers. However, the impact of the pandemic on interfacility pediatric and neonatal transport team members has not been studied. The current study uses a survey design to document the impact of the pandemic on pediatric and neonatal transport team members with a focus on staffing and resilience promotion strategies. Methods Data for this study came from a short cross-sectional survey distributed to members of the American Academy of Pediatrics Section on Transport Medicine. Results Sixty-six teams responded (around 45%). Forty-one respondents (62%) reported vacancies on their transport teams, with 35 (53.8%) reporting more vacancies during the pandemic. Forty percent of highly trained registered nurses and respiratory therapists from specialty teams left their positions for those with better compensation during the pandemic. Forty-two percent of respondents were not trained to recognize burnout, stress, or compassion fatigue. Conclusion Our study shows that half of the respondents had more vacancies during the pandemic than in previous years and reported difficulty in filling those positions. We were unable to link the vacancies to the pandemic and burnout because hospitalizations and transports in the pediatric facilities decreased during the pandemic; however, we do report that coronavirus disease 2019 exposure before the vaccine was a source of stress for team members. There are opportunities to improve the identification of burnout and to foster resilience and boost retention of this highly skilled niche workforce.
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Affiliation(s)
- Paul Dahm
- Children's Memorial Hermann Hospital, The University of Texas Health Science Center at Houston, Houston, TX
| | - Rudy Kink
- Le Bonheur Children's Hospital, University of Tennessee Health Sciences, Memphis, TN
| | - Michael Stroud
- Arkansas Children's Hospital, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Archana Dhar
- Children's Health Children's Medical Center of Dallas, UT Southwestern Medical School, Dallas, TX,Address for correspondence: Archana Dhar, MD, Children's Health Children's Medical Center of Dallas, UT Southwestern Medical School, 1935 Medical District Drive, Dallas, TX 75235
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21
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Gannon WD, Trindade AJ, Stokes JW, Casey JD, Benson C, Patel YJ, Pugh ME, Semler MW, Bacchetta M, Rice TW. Extracorporeal Membrane Oxygenation Selection by Multidisciplinary Consensus: The ECMO Council. ASAIO J 2023; 69:167-173. [PMID: 35544441 DOI: 10.1097/mat.0000000000001757] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) has increased the demand for extracorporeal membrane oxygenation (ECMO) and introduced distinct challenges to patient selection for ECMO. Standardized processes for patient selection amidst resource limitations are lacking, and data on ECMO consults are underreported. We retrospectively reviewed consecutive adult ECMO consults for acute respiratory failure received at a single academic medical center from April 1, 2020, to February 28, 2021, and evaluated the implementation of a multidisciplinary selection committee (ECMO Council) and standardized framework for patient selection for ECMO. During the 334-day period, there were 202 total ECMO consults; 174 (86.1%) included a diagnosis of COVID-19. Among all consults, 157 (77.7%) were declined and 41 (20.3%) resulted in the initiation of ECMO. Frequent reasons for decline included the presence of multiple relative contraindications (n = 33), age greater than 60 years (n = 32), and resource limitations (n = 27). The ECMO Council deliberated on every case in which an absolute contraindication was not present (n = 96) via an electronic teleconference platform. Utilizing multidisciplinary consensus together with a standardized process for patient selection in ECMO is feasible during a pandemic and may be reliably exercised over time. Whether such an approach is feasible at other centers remains unknown.
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Affiliation(s)
- Whitney D Gannon
- From the Department of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Anil J Trindade
- From the Department of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - John W Stokes
- Department of Thoracic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Jonathan D Casey
- From the Department of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Clayne Benson
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Yatrik J Patel
- Department of Thoracic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Meredith E Pugh
- From the Department of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Matthew W Semler
- From the Department of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Matthew Bacchetta
- Department of Thoracic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.,Department of Cardiac Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.,Department of Biomedical Engineering, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Todd W Rice
- From the Department of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
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22
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McPeake J, Kentish-Barnes N, Banse E, Anderson L, Cuzco C, Azoulay E, Quasim T, Castro P, Puxty K. Clinician perceptions of the impact of ICU family visiting restrictions during the COVID-19 pandemic: an international investigation. Crit Care 2023; 27:33. [PMID: 36681838 PMCID: PMC9862209 DOI: 10.1186/s13054-023-04318-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 01/11/2023] [Indexed: 01/22/2023] Open
Abstract
PURPOSE To guarantee the safety of the public, clinicians and patients during the COVID-19 pandemic, hospital visits were severely restricted internationally. There are limited data on the precise impact of these visiting restrictions on Intensive Care Unit clinicians. Our objectives therefore were to explore the impact of family visitation restrictions on clinicians and care delivery and describe innovation alongside areas for potential improvement. METHODS A qualitative approach using focus groups was employed. We recruited members of the multi-disciplinary team from Spain, France and the UK. Framework analysis was used to synthesize and interpret data. RESULTS In total, 28 staff from multiple international sites contributed to data across six focus groups: 12 from the UK, 9 from France and 7 from Spain. In relation to the key aims, we derived four themes: the emergence of new technologies, relationships and rapport establishment, communication challenges and end-of-life care provision. Across each theme, the overarching concepts of clinician emotional exhaustion and emotional distress emerged alongside the negative impact on job satisfaction. CONCLUSION The impact of COVID-19 family visitation restrictions is far reaching. Future research should examine the wider impact of family presence in the ICU.
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Affiliation(s)
- Joanne McPeake
- The Healthcare Improvement Studies Institute, University of Cambridge, Cambridge, UK
| | - Nancy Kentish-Barnes
- AP-HP Nord, Saint Louis Hospital, Medical Intensive Care, Famiréa Research Group, Paris, France
| | - Emilie Banse
- Psychological Sciences Research Institute, Université Catholique de Louvain, Louvain-La-Neuve, Belgium
| | - Lynne Anderson
- Department of Anaesthetics, Golden Jubilee National Hospital, Glasgow, UK
| | - Cecilia Cuzco
- Medical Lntensive Care Unit, Hospital Clínic of Barcelona, Institut d’Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
- Department of Fundamental Care and Medical-Surgical Nursing, Nursing School of Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Elie Azoulay
- AP-HP Nord, Saint Louis Hospital, Medical Intensive Care, Famiréa Research Group, Paris, France
| | - Tara Quasim
- Intensive Care Unit, Glasgow Royal Infirmary, Glasgow, UK
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK
| | - Pedro Castro
- Medical Lntensive Care Unit, Hospital Clínic of Barcelona, Institut d’Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Kathryn Puxty
- Intensive Care Unit, Glasgow Royal Infirmary, Glasgow, UK
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK
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23
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Crawford AM, Shiferaw AA, Ntambwe P, Milan AO, Khalid K, Rubio R, Nizeyimana F, Ariza F, Mohammed AD, Baker T, Banguti PR, Madzimbamuto F. Global critical care: a call to action. Crit Care 2023; 27:28. [PMID: 36670506 PMCID: PMC9854162 DOI: 10.1186/s13054-022-04296-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 12/28/2022] [Indexed: 01/22/2023] Open
Abstract
Critical care is underprioritized. A global call to action is needed to increase equitable access to care and the quality of care provided to critically ill patients. Current challenges to effective critical care in resource-constrained settings are many. Estimates of the burden of critical illness are extrapolated from common etiologies, but the true burden remains ill-defined. Measuring the burden of critical illness is epidemiologically challenging but is thought to be increasing. Resources, infrastructure, and training are inadequate. Millions die unnecessarily due to critical illness. Solutions start with the implementation of first-step, patient care fundamentals known as Essential Emergency and Critical Care. Such essential care stands to decrease critical-illness mortality, augment pandemic preparedness, decrease postoperative mortality, and decrease the need for advanced level care. The entire healthcare workforce must be trained in these fundamentals. Additionally, physician and nurse specialists trained in critical care are needed and must be retained as leaders of critical care initiatives, researchers, and teachers. Context-specific research is mandatory to ensure care is appropriate for the patient populations served, not just duplicated from high-resourced settings. Governments must increase healthcare spending and invest in capacity to treat critically ill patients. Advocacy at all levels is needed to achieve universal health coverage for critically ill patients.
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Affiliation(s)
- Ana Maria Crawford
- grid.168010.e0000000419368956Anesthesiology and Critical Care, Stanford University, 300 Pasteur Drive, Stanford, CA USA
| | - Ananya Abate Shiferaw
- grid.7123.70000 0001 1250 5688College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Papytcho Ntambwe
- grid.79746.3b0000 0004 0588 4220Anaesthesia and Critical Care, Livingstone University Teaching Hospital, Livingstone, Zambia
| | - Alexei Ortiz Milan
- Critical Care Medicine Physician, Sir Ketumile Masire Teaching Hospital, Notwane and Mabutho Road, Plot 4775, Private Bag UB 001, Gaborone, Botswana
| | - Karima Khalid
- grid.25867.3e0000 0001 1481 7466Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Rodrigo Rubio
- Departamento de Anestesia, Hospital ABC, Vasco de Quiroga 154, Cuajimalpa, 05348 Ciudad de Mexico, Mexico
| | - Francoise Nizeyimana
- grid.418074.e0000 0004 0647 8603Consultant Anesthesiology and Critical Care, Head of Department CHUK, Kigali, Rwanda
| | - Fredy Ariza
- grid.477264.4Anesthesia and Perioperative Medicine, Fundación Valle del Lili, ICESI/UNIVALLE Universities, Cali, Colombia
| | - Alhassan Datti Mohammed
- grid.413710.00000 0004 1795 3115Department of Anaesthesiology and Intensive Care, Bayero University, Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Tim Baker
- grid.25867.3e0000 0001 1481 7466Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania ,grid.4714.60000 0004 1937 0626Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden ,grid.4868.20000 0001 2171 1133Queen Mary University of London, London, UK
| | - Paulin Ruhato Banguti
- grid.10818.300000 0004 0620 2260Anesthesiology and Critical Care, University of Rwanda, Kigali, Rwanda
| | - Farai Madzimbamuto
- grid.7621.20000 0004 0635 5486Anaesthesiology and Critical Care, University of Botswana School of Medicine, Notwane and Mabutho Road, Plot 4775, Private Bag UB 001, Gaborone, Botswana
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Meneguin S, Ignácio I, Pollo CF, Honório HM, Patini MSG, de Oliveira C. Burnout and quality of life in nursing staff during the COVID-19 pandemic. BMC Nurs 2023; 22:14. [PMID: 36635750 PMCID: PMC9834673 DOI: 10.1186/s12912-022-01168-7] [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: 07/13/2022] [Accepted: 12/29/2022] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE To investigate the association between burnout and quality of life among nursing staff at intensive care units during the new coronavirus pandemic and identify the influence of sociodemographic variables. METHODS A cross-sectional study was conducted with 109 nursing staff members at intensive care units of a public hospital in Brazil. Data collection involved the administration of a sociodemographic questionnaire as well as the WHOQOL-Bref and Oldenburg Burnout Inventory. RESULTS The participants presented a high state of burnout and a low score in the physical domain of the quality-of-life instrument. Men (p = 0.037), income (p = 0.011) and burnout (p < 0.001) independently influenced quality-of-life (p < 0.01). Age, being a nursing technician and working at two hospitals exerted an influence on burnout status (p < 0.05). A negative association was found between quality of life and burnout (p < 0.01). CONCLUSION Our findings showed that burnout due to occupational circumstances affected negatively the quality of life perceptions of nursing staff working at intensive care units during the COVID-19 pandemic.
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Affiliation(s)
- Silmara Meneguin
- grid.410543.70000 0001 2188 478XDepartment of Nursing, Botucatu Medical School, Paulista State University, São Paulo, Brazil
| | - Isabelle Ignácio
- grid.410543.70000 0001 2188 478XDepartment of Nursing, Botucatu Medical School, Paulista State University, São Paulo, Brazil
| | - Camila Fernandes Pollo
- grid.410543.70000 0001 2188 478XDepartment of Nursing, Botucatu Medical School, Paulista State University, São Paulo, Brazil
| | | | - Mayara Salles Gasparini Patini
- grid.410543.70000 0001 2188 478XDepartment of Nursing, Botucatu Medical School, Paulista State University, São Paulo, Brazil
| | - Cesar de Oliveira
- grid.83440.3b0000000121901201Department of Epidemiology & Public health, University College London, London, UK
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Alhenaidi A, Al-Haqan A, Kelendar H, Al-Bader B, Alkandari O, Al-Zuabi H. The Association of Professional Burnout and Turnover Intentions Among Intensive Care Units Physicians: A Cross-Sectional Study. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2023; 60:469580231206253. [PMID: 37877580 PMCID: PMC10605698 DOI: 10.1177/00469580231206253] [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: 06/06/2023] [Revised: 09/18/2023] [Accepted: 09/21/2023] [Indexed: 10/26/2023]
Abstract
Intensive Care Units (ICU) workers work in highly stressful conditions that make them prone to professional burnout, which can lead to high turnover rates. This study explores professional burnout levels among ICU workers in Kuwait general governmental hospitals (GGHs), their turnover intentions, and the correlation factors. A cross-sectional self-administered survey study was conducted. Professional burnout level was measured using the Copenhagen Burnout Inventory (CBI), while turnover intention was measured using the Turnover Intention Scale (TIS-6). Data were analyzed using STATA software, and descriptive, correlative, and comparative analyses were performed. Eighty-nine ICU physicians filled out the questionnaire. Most of the participants were males, married, non-Kuwaiti nationals, with 10 to 20 years of experience, and the mean age of respondents was 39.2. The total professional burnout score was high was 54.7 (17.6). There were high total average scores for the personal and work-related domains. Participants who were younger than 35 years of age and graduated before 5 to 10 years had higher levels of professional burnout compared to other groups. More than half of the sample expressed their intention to leave their current job as an ICU physician. However, no association was found between turnover intentions and levels of burnout. High levels of professional burnout of turnover intentions were seen among ICU physicians in Kuwait. Policies should be adopted to reduce and mitigate professional burnout among ICU physicians and increase their retention. Future research should further investigate professional burnout among ICU staff, the associated factors, and its relation to their turnover intention.
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Affiliation(s)
- Abdulaziz Alhenaidi
- Directorate of Planning and Monitoring, Ministry of Health, Kuwait
- General Practice and Primary Care, School of Health and Wellbeing, University of Glasgow, Scotland
| | - Asmaa Al-Haqan
- Department of Pharmacy Practice, College of Pharmacy, Kuwait University, Kuwait
| | - Hisham Kelendar
- Directorate of Planning and Monitoring, Ministry of Health, Kuwait
| | | | | | - Homoud Al-Zuabi
- Directorate of Non-Communicable Diseases Control and Prevention, Ministry of Health, Kuwait
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Elliott R, Crowe L, Pollock W, Hammond NE. The impact of the COVID-19 pandemic on critical care healthcare professionals' work practices and wellbeing: A qualitative study. Aust Crit Care 2023; 36:44-51. [PMID: 36371294 PMCID: PMC9550671 DOI: 10.1016/j.aucc.2022.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 09/26/2022] [Accepted: 10/02/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Burnout and other psychological comorbidities were evident prior to the COVID-19 pandemic for critical care healthcare professionals (HCPs) who have been at the forefront of the health response. Current research suggests an escalation or worsening of these impacts as a result of the COVID-19 pandemic. OBJECTIVES The objective of this study was to undertake an in-depth exploration of the impact of the evolving COVID-19 pandemic on the wellbeing of HCPs working in critical care. METHODS This was a qualitative study using online focus groups (n = 5) with critical care HCPs (n = 31, 7 medical doctors and 24 nurses) in 2021: one with United Kingdom-based participants (n = 11) and four with Australia-based participants (n = 20). Thematic analysis of qualitative data from focus groups was performed using Gibbs framework. FINDINGS Five themes were synthesised: transformation of anxiety and fear throughout the pandemic, the burden of responsibility, moral distress, COVID-19 intruding into all aspects of life, and strategies and factors that sustained wellbeing during the pandemic. Moral distress was a dominant feature, and intrusiveness of the pandemic into all aspects of life was a novel finding. CONCLUSIONS The COVID-19 pandemic has adversely impacted critical care HCPs and their work experience and wellbeing. The intrusiveness of the pandemic into all aspects of life was a novel finding. Moral distress was a predominate feature of their experience. Leaders of healthcare organisations should ensure that interventions to improve and maintain the wellbeing of HCPs are implemented.
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Affiliation(s)
- Rosalind Elliott
- Malcolm Fisher Department of Intensive Care, Royal North Shore Hospital and Centre for Nursing and Midwifery Research, Northern Sydney Local Health District, Pacific Highway, St Leonards NSW 2065 Australia; Faculty of Health, University of Technology, Ultimo NSW 2007 Australia.
| | - Liz Crowe
- School of Medicine, Brisbane, The University of Queensland, 20 Weightman Street, Herston QLD 4006 Australia; Queensland Children's Hospital, 501 Stanley Street, South Brisbane, QLD 4101 Australia.
| | - Wendy Pollock
- Faculty of Medicine, Nursing and Health Sciences, Monash University, 35 Rainforest Walk, Clayton, VIC 3800, Australia; Department of Nursing, Midwifery and Health, Northumbria University, Benton, Newcastle-upon-Tyne, NE7 7XA, UK.
| | - Naomi E Hammond
- Malcolm Fisher Department of Intensive Care, Royal North Shore Hospital and Centre for Nursing and Midwifery Research, Northern Sydney Local Health District, Pacific Highway, St Leonards NSW 2065 Australia; Critical Care Division, The George Institute for Global Health and University of NSW, Level 5, 1 King Street, Newtown NSW 2042 Australia.
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Lovell T, Mitchell M, Powell M, Cummins B, Tonge A, Metcalf E, Ownsworth T, O'Neill K, Morris L, Ranse K. Fostering positive emotions, psychological well-being, and productive relationships in the intensive care unit: A before-and-after study. Aust Crit Care 2023; 36:28-34. [PMID: 36114097 DOI: 10.1016/j.aucc.2022.08.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 07/25/2022] [Accepted: 08/04/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Intensive care units (ICUs) are emotionally demanding workplaces. Exposure to stress can negatively impact ICU staff members' emotional resilience, health, and capacity to provide care. Despite recognition of the benefits of promoting "healthy workplaces", there are limited interventional studies aimed at improving the well-being of ICU staff. AIM The aim of this study was to assess the effectiveness of a multifaceted intervention for improving well-being of staff working in a tertiary ICU. METHODS A before-and-after interventional study was conducted over a 2-year period, between 2019 and 2021. Interventions included social activities, fitness, nutrition, and emotional support. An electronic version of the PERMA-Profiler questionnaire was used to assess the well-being of a convenience sample of ICU staff before (n = 96) and after (n = 137) the intervention. Ten focus groups (each involving 12-18 nurses) were held to explore nurses' perceptions of the intervention's effectiveness. RESULTS After the intervention, a significantly greater proportion of participants described their work week as draining (32% vs 19%, χ2 = 4.4 df + 1, P = 0.03) and at least a bit harder than normal (38% vs 22%, χ2 = 6.4 df + 1, p = 0.01) compared to baseline surveys. However, well-being scores after the intervention (mean = 6.95, standard deviation = 1.28) were not statistically different (p = 0.68) from baseline scores (mean = 7.02, standard deviation = 1.29). Analysis of focus groups data revealed three key categories: boosting morale and fostering togetherness, supporting staff, and barriers to well-being. CONCLUSIONS After the intervention, there was a preserved level of well-being from baseline despite a statistically significant increase in staff reporting the work week as draining and at least a little bit harder than normal. These findings must be considered in light of the COVID-19 pandemic, which started after baseline data collection and continues to impact the community, including staff workload and pressures in intensive care. The study findings may inform strategies for improving ICU staff members' well-being.
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Affiliation(s)
- Tania Lovell
- Intensive Care Unit, Princess Alexandra Hospital, Metro South Hospital Health Service, Queensland, Australia.
| | - Marion Mitchell
- Intensive Care Unit, Princess Alexandra Hospital, Metro South Hospital Health Service, Queensland, Australia; School of Nursing & Midwifery, Griffith University, Queensland, Australia; Patient Centred Health Services, Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Madeleine Powell
- School of Population Health, University of New South Wales, NSW, Australia; National Drug and Alcohol Research Centre, University of New South Wales, NSW, Australia
| | - Braddon Cummins
- Intensive Care Unit, Princess Alexandra Hospital, Metro South Hospital Health Service, Queensland, Australia
| | - Angela Tonge
- Intensive Care Unit, Princess Alexandra Hospital, Metro South Hospital Health Service, Queensland, Australia
| | - Emma Metcalf
- Intensive Care Unit, Princess Alexandra Hospital, Metro South Hospital Health Service, Queensland, Australia
| | - Tamara Ownsworth
- School of Applied Psychology and The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Queensland, Australia
| | - Kylie O'Neill
- Intensive Care Unit, Princess Alexandra Hospital, Metro South Hospital Health Service, Queensland, Australia
| | - Lynne Morris
- Intensive Care Unit, Princess Alexandra Hospital, Metro South Hospital Health Service, Queensland, Australia
| | - Kristen Ranse
- Intensive Care Unit, Princess Alexandra Hospital, Metro South Hospital Health Service, Queensland, Australia; School of Nursing & Midwifery, Griffith University, Queensland, Australia; Patient Centred Health Services, Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
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Rugaan A, Aisa T, Alkhatib KH, Baky MA, Al Tatar F, Ramadan I, Elmorsy S, Hussein A. Burnout among ICU Healthcare Workers at Two Tertiary Care Hospitals in Makkah during the Hajj Season. SAUDI JOURNAL OF MEDICINE & MEDICAL SCIENCES 2023; 11:54-59. [PMID: 36909006 PMCID: PMC9997863 DOI: 10.4103/sjmms.sjmms_199_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 11/08/2022] [Accepted: 12/11/2022] [Indexed: 01/05/2023]
Abstract
Background The Hajj season results in increased workload and longer shift hours for healthcare workers at the intensive care units (ICUs), which may result in burnout. Objective To determine the point prevalence of professional burnout and its predictors among healthcare workers at the ICUs of two tertiary care hospitals in Makkah during the Hajj season. Methods This cross-sectional descriptive study included all healthcare professionals working at the ICU departments of two of the largest tertiary care hospitals in the Makkah region during the 1439/2018 Hajj season. The original Maslach Burnout Inventory (MBI) questionnaire was used to measure burnout. Logistic regression models were fitted to estimate the effect size of the associated risk factors. Results A total of 354 participants completed the questionnaire. Moderate to severe burnout was found in each of the three subscales: emotional exhaustion, 56%; depersonalization, 82%, and impaired personal achievement, 72%. Nurses were significantly more likely to experience burnout compared with physicians (P = 0.017). Independent predictors of moderate or severe burnout were being aged ≤40 years (odds ratio [OR]: 2.1, 95% CI: 0.395-4.002; P = 0.045), female gender (OR: 2.2, 95% CI: 0.242-4.346; P = 0.037); work having a negative impact on family (OR: 3, 95% CI: 0.164-5.504; P = 0.019); unsatisfaction with salary (OR: 2.8, 95% CI: 0.28-5.056; P = 0.025); and working at the cardiac critical care unit (OR: 2.6, 95% CI: 0.440-4.467; P = 0.035). Conclusion This study revealed that the point prevalence of burnout is common among ICU healthcare workers during the Hajj season. These findings can be used by policymakers to devise strategies to mitigate the risks of burnout during the Hajj season.
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Affiliation(s)
- Asia Rugaan
- Department of Adult Critical Care Medicine, King Abdullah Medical City, Makkah, Saudi Arabia
| | - Tharwat Aisa
- Department of Adult Critical Care Medicine, King Abdullah Medical City, Makkah, Saudi Arabia
| | - Kasim H Alkhatib
- Department of Adult Critical Care Medicine, Al Noor Specialist Hospital, Makkah, Saudi Arabia
| | - Moamen Abdel Baky
- Department of Adult Critical Care Medicine, King Abdullah Medical City, Makkah, Saudi Arabia
| | - Faisal Al Tatar
- Department of Adult Critical Care Medicine, King Abdullah Medical City, Makkah, Saudi Arabia
| | - Ibrahim Ramadan
- Department of Adult Critical Care Medicine, King Abdullah Medical City, Makkah, Saudi Arabia
| | - Soha Elmorsy
- Department of Adult Critical Care Medicine, King Abdullah Medical City, Makkah, Saudi Arabia
| | - Adel Hussein
- Department of Adult Critical Care Medicine, King Abdullah Medical City, Makkah, Saudi Arabia
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Gebczynska-Janowicz A, Janowicz R, Targowski W, Cudnik R, Paszko K, Zielinska-Dabkowska KM. Evaluation of Medical Staff Satisfaction for Workplace Architecture in Temporary COVID-19 Hospital: A Case Study in Gdańsk, Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:639. [PMID: 36612960 PMCID: PMC9819390 DOI: 10.3390/ijerph20010639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/23/2022] [Accepted: 12/27/2022] [Indexed: 06/17/2023]
Abstract
This article analyses the architecture that was used in the temporary AmberExpo hospital in Gdańsk, Poland which was installed during the COVID-19 pandemic. The construction of this type of facility is often based on experimental approaches, aimed at caring for patients suffering from an infectious disease in emergency conditions. In order to assess the level of employee satisfaction with the architectural and technical elements used in the first period of the hospital's activity, medical staff were asked to fill out a questionnaire. The analysis of the survey's results indicated that the majority of employees expressed satisfaction with the architectural and technical elements, with the design of the spatial layout of the individual medical zones receiving the most positive feedback. However, frequently selected drawbacks in the design included the lack of natural daylight, the artificial light that was used and the acoustics of the facility. This detailed examination of the satisfaction and feedback from medical employees working in this type of emergency facility enables the development of solutions that in the future will allow for the improved adaptive reuse and implementation of such structures, with enhanced time and economic efficiency, and most importantly, the ability to provide a safer workplace.
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Affiliation(s)
| | - Rafal Janowicz
- Faculty of Architecture, Gdańsk University of Technology, 80-233 Gdansk, Poland
| | - Wojciech Targowski
- Faculty of Architecture, Gdańsk University of Technology, 80-233 Gdansk, Poland
| | - Rafal Cudnik
- Copernicus Podmiot Leczniczy Sp. z o. o., 80-803 Gdansk, Poland
| | - Krystyna Paszko
- Institute of Nursing and Midwifery, Medical University of Gdańsk, 80-210 Gdansk, Poland
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Coronavirus disease 2019 aftermath: psychological trauma in ICU healthcare workers. Curr Opin Crit Care 2022; 28:686-694. [PMID: 36302198 DOI: 10.1097/mcc.0000000000000994] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
PURPOSE OF REVIEW We aim to describe the extent of psychological trauma and moral distress in healthcare workers (HCW) working in the intensive care unit (ICU) during the coronavirus disease 2019 (COVID-19) pandemic. Specifically, we review reports on prevalence of mental health symptoms, highlight vulnerable populations and summarize modifiable risk factors associated with mental health symptoms in ICU HCW. RECENT FINDINGS The pandemic has resulted in a multitude of closely intertwined professional and personal challenges for ICU HCW. High rates of posttraumatic stress disorder (14-47%), burnout (45-85%), anxiety (31-60%), and depression (16-65%) have been reported, and these mental health symptoms are often interrelated. Most studies suggest that nurses and female HCW are at highest risk for developing mental health symptoms. The main personal concerns associated with reporting mental health symptoms among ICU HCW were worries about transmitting COVID-19 to their families, worries about their own health, witnessing colleagues contract the disease, and experiencing stigma from their communities. Major modifiable work-related risk factors were experiencing poor communication from supervisors, perceived lack of support from administrative leadership, and concerns about insufficient access to personal protective equipment, inability to rest, witnessing hasty end-of-life decisions, and restriction of family visitation policies. SUMMARY The COVID-19 pandemic has severely impacted ICU HCW worldwide. The psychological trauma, manifesting as posttraumatic stress disorder, burnout, anxiety, and depression, is substantial and concerning. Urgent action by lawmakers and healthcare administrators is required to protect ICU HCW and sustain a healthy workforce.
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Sawyer AT, Pepe J, Robinson PS, Bailey AK, Sun J. Employment Status of Nurses After a Psychoeducational Group Intervention: A Matched Case-Control Study. J Nurs Adm 2022; 52:620-624. [PMID: 36301871 DOI: 10.1097/nna.0000000000001219] [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: 11/27/2022]
Abstract
OBJECTIVE This matched case-control study compared the long-term employment status of direct care nurses based on participation in a psychoeducational group intervention and calculated the estimated cost savings. BACKGROUND Chronic stress, in addition to lack of support and low autonomy, can lead to burnout among nurses. Burnout is a common reason for job dissatisfaction and turnover. Interventions combining education with therapeutic processing and peer support may lead to healing and growth in nurses already experiencing the effects of chronic stress and burnout. The COVID-19 pandemic also contributed to stress among nurses. METHODS Fifty-four direct care nurses who participated in the intervention were paired with 54 direct care nurses who did not participate, matched on the following variables: age, gender, race, work setting, and campus. RESULTS This study found a higher percentage of direct care nurses who participated in the intervention remained employed compared with the matched control subjects who did not participate. CONCLUSION At a relatively low cost compared with the cost of turnover by each nurse, the psychoeducational group intervention may provide an opportunity to improve retention among nurses.
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Affiliation(s)
- Amanda T Sawyer
- Author Affiliations: Research Scientist (Dr Sawyer and Ms Bailey), Senior Manager of Nursing, Population Health, and Academic Research (Dr Pepe), Scientific Director of Nursing, Population Health, and Academic Research (Dr Robinson), Health Economics Scientist (Dr Sun), AdventHealth Research Institute, Orlando, Florida
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Toscano F, Tommasi F, Giusino D. Burnout in Intensive Care Nurses during the COVID-19 Pandemic: A Scoping Review on Its Prevalence and Risk and Protective Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12914. [PMID: 36232211 PMCID: PMC9564773 DOI: 10.3390/ijerph191912914] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 10/04/2022] [Accepted: 10/05/2022] [Indexed: 05/27/2023]
Abstract
BACKGROUND The COVID-19 pandemic has strained hospitals and healthcare workers engaged in combating the virus with limited knowledge and resources. Intensive care unit (ICU) nurses are among the healthcare workers most affected by the pandemic and are at risk for developing burnout syndrome. OBJECTIVE The present study aims to explore burnout symptoms prevalence among ICU nurses and to identify the individual, organizational, and contextual risk, and protective factors of burnout in ICU nurses during the COVID-19 pandemic. METHODS A scoping review was conducted by searching PubMed, Scopus, and Web of Science. Only papers with empirical data and referred to ICU nurses were included. A total of 350 initial results were yielded, and 40 full texts were screened. Twelve papers constituted the final sample in the analysis. RESULTS High levels of symptoms of burnout (emotional exhaustion, depersonalization, and reduced personal accomplishment) were registered among ICU nurses during the COVID-19 pandemic. Increased workload, lack of equipment, social stigma, and fear of contagion emerged as key risk factors. Social support from leaders and colleagues, professional recognition, use of personal protective tools, and witnessing patients' successful recovery emerged as major protective factors. CONCLUSIONS The results may inform the development of timely actions to counter burnout in ICU nurses during this COVID-19 pandemic and in a post-COVID-19 scenario.
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Affiliation(s)
| | - Francesco Tommasi
- Department of Human Sciences, University of Verona, 37129 Verona, Italy
| | - Davide Giusino
- Department of Psychology, University of Bologna, 40127 Bologna, Italy
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Moss M, Edelblute A, Sinn H, Torres K, Forster J, Adams T, Morgan C, Henry M, Reed K. The Effect of Creative Arts Therapy on Psychological Distress in Health Care Professionals. Am J Med 2022; 135:1255-1262.e5. [PMID: 35576997 DOI: 10.1016/j.amjmed.2022.04.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 04/26/2022] [Accepted: 04/28/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Work-related psychological distress is common among health care professionals. We determined whether 4 creative arts therapy (CAT) programs were acceptable, feasible, and improved psychological distress and job turnover intention in health care professionals with burnout symptoms. METHODS Health care professionals were enrolled during the coronavirus disease (COVID-19) pandemic from September 2020 until July 2021. Participants attended in-person weekly 90-minute group session for 12 consecutive weeks. Intervention and control subjects completed surveys before the beginning and after the end of their cohort. The study outcomes were session attendance (feasibility), program satisfaction (acceptability), and change in symptoms of anxiety, depression, burnout, posttraumatic stress disorder (PTSD), and job turnover intention. RESULTS We randomized 165 participants into 4 CAT interventions and 1 common control group across 3 sequential cohorts. Thirty-five randomized participants dropped out before the start of the cohort, and 16 were replaced from a waiting list. Therefore, the cohort consisted of 146 participants. On average, participants were 35 years old, white (85%), and female (92%). Overall, 52% were nurses, 10% were doctors, and 16% were behavioral health specialists. Participants attended a median of 9.5 [8-11] sessions. Program satisfaction was high with a median Client Satisfaction Questionnaire (CSQ-8) score of 31 [17-32] out of a possible score of 32. Participants randomized to the intervention had improvements in anxiety (P < .0001) and depression scores (P = .0007), total posttraumatic stress disorder score (P =.0002), burnout scores (P = .001, .003, .008), and turnover intention (P = .001). CONCLUSIONS A CAT program is feasible, acceptable, and may reduce psychological distress and turnover intention for health care professionals.
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Affiliation(s)
- Marc Moss
- Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado School of Medicine, Aurora, CO.
| | - Anthony Edelblute
- Ponzio Creative Arts Therapy Program, Children's Hospital Colorado, Aurora, CO
| | - Hillary Sinn
- Ponzio Creative Arts Therapy Program, Children's Hospital Colorado, Aurora, CO
| | - Kristen Torres
- Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado School of Medicine, Aurora, CO
| | - Jeri Forster
- Department of Physical Medicine and Rehabilitation, University of Colorado School of Medicine, Aurora, CO
| | - Tisha Adams
- Ponzio Creative Arts Therapy Program, Children's Hospital Colorado, Aurora, CO
| | | | | | - Katherine Reed
- Ponzio Creative Arts Therapy Program, Children's Hospital Colorado, Aurora, CO
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Adnan NBB, Dafny HA, Baldwin C, Jakimowitz S, Chalmers D, Aroury AMA, Chamberlain D. What are the solutions for well-being and burn-out for healthcare professionals? An umbrella realist review of learnings of individual-focused interventions for critical care. BMJ Open 2022; 12:e060973. [PMID: 36691206 PMCID: PMC9462087 DOI: 10.1136/bmjopen-2022-060973] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 08/18/2022] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVE To determine what, how, for whom and under what conditions individual-focused interventions are effective to improve well-being and decrease burn-out among critical care healthcare professionals. DESIGN This study is an umbrella review that used the realist approach, using Realist and Meta-narrative Evidence Synthesis: Evolving Standards guidelines. PsycINFO, Web of Science, CINAHL, MEDLINE, Scopus, ClinicalTrials.gov and ISRCTN databases were searched for published and unpublished systematic reviews and meta-analyses literature between 2016 and 2020. The team appraised and extracted data and identified relationships between content, mechanism and outcomes (CMOs). Theory prepositions were developed using CMOs and were used to refine the existing programme. RESULTS A total of 81 interventions from 17 reviews were mapped, including mindfulness interventions, cognitive-behavioural therapy, self-care and coping strategies. The revised programme theory determined that contextual factors such as ethnicity, workload, and work schedules play a crucial role in determining the effectiveness of interventions. Mechanisms including the interventions' interests, acceptance, and receptivity are also influential in determining engagement and adherence to the intervention. Findings suggest that the solution for burn-out is complex. However, it offers an optimistic view of tailoring and customising one or a combination of interventions, integrating structured education and components of emotional intelligence. Self-care, social support, awareness or mindfulness and self-efficacy are prime components to improve emotional intelligence and resilience for critical care healthcare professionals to improve well-being and decrease burn-out experience. CONCLUSIONS These findings provide realistic and reliable reporting of outcomes to better support implementation within the 'real world'. Future research such as seeking validation using expert opinions can provide further in depth understanding of hidden contextual factors, mechanisms and their interactions to provide a greater depth of knowledge ready for application with the critical care population.
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Affiliation(s)
- Nurul Bahirah Binte Adnan
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
- Flinders University Caring Futures Institute, Bedford Park, South Australia, Australia
| | - Hila Ariela Dafny
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
- Flinders University Caring Futures Institute, Bedford Park, South Australia, Australia
| | - Claire Baldwin
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
- Flinders University Caring Futures Institute, Bedford Park, South Australia, Australia
| | - Samantha Jakimowitz
- School of Nursing and Midwifery, University of Technology Sydney, Sydney, New South Wales, Australia
| | | | - Ammar Moh'd Ahmad Aroury
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
- Flinders University Caring Futures Institute, Bedford Park, South Australia, Australia
| | - Diane Chamberlain
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
- Flinders University Caring Futures Institute, Bedford Park, South Australia, Australia
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Urso C, Laserna A, Feng L, Agnite A, Jawe N, Magoun C, Layton LS, Nates JL, Gutierrez C. Mindfulness as an Antidote to Burnout for Nursing and Support Staff in an Oncological Intensive Care Unit: A Pilot Study. Holist Nurs Pract 2022; 36:E38-E47. [PMID: 35981118 PMCID: PMC9395129 DOI: 10.1097/hnp.0000000000000544] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
We set out to implement a pilot mindfulness-based intervention (MBI) to alleviate burnout, stress, anxiety, and depression in nursing and support staff of an oncological intensive care unit. We created an 8-week personalized yoga therapy MBI for nurses and patient care technicians in an oncological intensive care unit. Validated self-report scale tools were used to measure burnout, stress, anxiety, and depression in the intervention and control groups (Institutional Quality Improvement Registry no. 296, 2018). Changes in scores from baseline to postintervention were evaluated between groups. Forty-five staff, 21 in the control group and 24 in the intervention group, participated. Both groups at baseline had low prevalence of stress, anxiety, and depression (13% vs 36.8%, P = .11; 21.7% vs 52.6%, P = .17; 17.4% vs 26.3%, P = .48; respectively). Low rates of high emotional exhaustion, depersonalization, and low professional efficacy were observed for both groups (41.7% vs 35.0%, P = .65; 20.8% vs 15%, P = .71; 58.3% vs 50.0%, P = .58, respectively). Post-MBI, prevalence of depression, anxiety, stress, emotional exhaustion, and depersonalization remained low and similar between both groups. Notwithstanding, professional efficacy scores significantly improved in a between-group comparison (0.063 vs -0.25; P = .0336). We observed that burnout, stress, anxiety, and depression were remarkably low in our study relative to the literature. Implementation of the MBI faced many obstacles and had low compliance during participation. This presumably influenced results and should be addressed prior to any future intervention. Despite this, professional efficacy improved significantly. TRIAL REGISTRATION Approved by MD Anderson Cancer Center Quality Improvement Registry (no. 296, 2018).
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Affiliation(s)
- Catherine Urso
- Departments of Critical Care and Palliative, Rehabilitation & Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston (Ms Urso); Division of Anesthesiology and Critical Care, Department of Critical Care, The University of Texas MD Anderson Cancer Center, Houston (Drs Laserna, Nates, and Gutierrez); Department of Statistics, The University of Texas MD Anderson Cancer Center, Houston (Mr Feng); Limitless Yoga Project, Houston, Texas (Ms Agnite); Clinical Quality Improvement Department of Critical Care, The University of Texas MD Anderson Cancer Center, Houston (Ms Jawe); Surgical and Medical Intensive Care Units, Department of Critical Care, The University of Texas MD Anderson Cancer Center, Houston (Mss Magoun and Layton); and Surgical and Medical Intensive Care Units, and Division of Anesthesiology and Critical Care, Department of Critical Care, The University of Texas MD Anderson Cancer Center, Houston (Dr Nates)
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Buchbinder M, Jenkins T. Burnout in Critical Care: Time for Moving Upstream. Ann Am Thorac Soc 2022; 19:1443-1445. [PMID: 35482779 PMCID: PMC10765947 DOI: 10.1513/annalsats.202202-111ip] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 04/28/2022] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Tania Jenkins
- Department of Sociology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Secunda KE, Kruser JM. Patient-Centered and Family-Centered Care in the Intensive Care Unit. Clin Chest Med 2022; 43:539-550. [PMID: 36116821 PMCID: PMC9885766 DOI: 10.1016/j.ccm.2022.05.008] [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] [Indexed: 02/01/2023]
Abstract
Patient-centered and family-centered care (PFCC) is widely recognized as integral to high-quality health-care delivery. The highly technical nature of critical care puts patients and families at risk of dehumanization and renders the delivery of PFCC in the intensive care unit (ICU) challenging. In this article, we discuss the history and terminology of PFCC, describe interventions to promote PFCC, highlight limitations to the current model, and offer future directions to optimize PFCC in the ICU.
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Affiliation(s)
- Katharine E Secunda
- Department of Medicine, Division of Pulmonary and Critical Care, University of Pennsylvania
| | - Jacqueline M Kruser
- Department of Medicine, Division of Allergy, Pulmonary, and Critical Care, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI 53792, USA.
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Lovell LMP, Atherley AE, Watson HR, King RD. An exploration of burnout and resilience among emergency physicians at three teaching hospitals in the English-speaking Caribbean: A cross-sectional survey. LANCET REGIONAL HEALTH. AMERICAS 2022; 15:100357. [PMID: 36778072 PMCID: PMC9903692 DOI: 10.1016/j.lana.2022.100357] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
Background Burnout is common among doctors working in emergency departments. It has significant consequences and is multifactorial. Self-care and resilience tendencies may contribute to being burnt out, or not. This study explores burnout and resilience amongst physicians working in Caribbean emergency departments. Methods Data were collected from 111 participants using the Maslach Burnout Inventory (MBI) and the Resilience Scale-14 (RS14) as measures of burnout and resilience, respectively. Questions collected data on participant demographics and characteristics related to self-care. The associations between demographic characteristics and total burnout and resilience scales were explored. Findings Among participants, 88.6% had medium to high range emotional exhaustion, 82.8% exhibited medium to high range depersonalization, and 19.6% had low to medium range personal accomplishment. Participants in Barbados had higher emotional exhaustion and depersonalization scores (p=0.009), and those in a postgraduate programme had higher depersonalization scores (p=0.047). The mean RS-14 score was 81.1 out of a maximum of 98.0 with a standard deviation of 13.1 and a range of 26 to 98. Depression correlated with high emotional exhaustion scores (p=0.004) and low resilience scores (p<0.0001). Emotional exhaustion scores increased among participants using alcohol daily (p=0.01), using recreational drugs (p=0.021) and sleeping aids (p=0.028). Interpretation High burnout, despite high resilience, is present in this sample of physicians working in emergency departments of teaching hospitals in the Caribbean. Although resilience scores were high, those with lower resilience tendencies had poorer self-care habits. Funding No external funding.
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Affiliation(s)
- Lynn-Marie P. Lovell
- Emergency Medicine, Queen Elizabeth Hospital; Faculty of Medical Sciences, University of the West Indies, Cave Hill Campus, Barbados,Corresponding author at: Dr. Lynn-Marie Lovell Queen Elizabeth Hospital, Barbados.
| | - Anique E.N. Atherley
- Academy of Teaching and Learning, Academic Learning Environment, Ross University School of Medicine, Barbados
| | - Harold R. Watson
- Emergency Medicine, Queen Elizabeth Hospital; Faculty of Medical Sciences, University of the West Indies, Cave Hill Campus, Barbados
| | - Reginald DaC. King
- Emergency Medicine, Queen Elizabeth Hospital; Faculty of Medical Sciences, University of the West Indies, Cave Hill Campus, Barbados
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Vranas KC, Golden SE, Nugent S, Valley TS, Schutz A, Duggal A, Seitz KP, Chang SY, Slatore CG, Sullivan DR, Hough CL, Mathews KS. The Influence of the COVID-19 Pandemic on Intensivists' Well-Being: A Qualitative Study. Chest 2022; 162:331-345. [PMID: 35568205 PMCID: PMC9093195 DOI: 10.1016/j.chest.2022.05.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 04/05/2022] [Accepted: 05/04/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has strained health care systems and has resulted in widespread critical care staffing shortages, negatively impacting the quality of care delivered. RESEARCH QUESTION How have hospitals' emergency responses to the pandemic influenced the well-being of frontline intensivists, and do any potential strategies exist to improve their well-being and to help preserve the critical care workforce? STUDY DESIGN AND METHODS We conducted semistructured interviews of intensivists at clusters of tertiary and community hospitals located in six regions across the United States between August and November 2020 using the "four S" framework of acute surge planning (ie, space, staff, stuff, and system) to organize the interview guide. We then used inductive thematic analysis to identify themes describing the influence of hospitals' emergency responses on intensivists' well-being. RESULTS Thirty-three intensivists from seven tertiary and six community hospitals participated. Intensivists reported experiencing substantial moral distress, particularly because of restricted visitor policies and their perceived negative impacts on patients, families, and staff. Intensivists also frequently reported burnout symptoms as a result of their experiences with patient death, exhaustion over the pandemic's duration, and perceived lack of support from colleagues and hospitals. We identified several potentially modifiable factors perceived to improve morale, including the proactive provision of mental health resources, establishment of formal backup schedules for physicians, and clear actions demonstrating that clinicians are valued by their institutions. INTERPRETATION Restrictive visitation policies contributed to moral distress as reported by intensivists, highlighting the need to reconsider the risks and benefits of these policies. We also identified several interventions as perceived by intensivists that may help to mitigate moral distress and to improve burnout as part of efforts to preserve the critical care workforce.
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Affiliation(s)
- Kelly C Vranas
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Oregon Health and Science University, Portland, OR; Division of Pulmonary and Critical Care, Oregon Health and Science University, Portland, OR; Palliative and Advanced Illness Research (PAIR) Center, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
| | - Sara E Golden
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Oregon Health and Science University, Portland, OR
| | - Shannon Nugent
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Oregon Health and Science University, Portland, OR; Department of Psychiatry, Oregon Health and Science University, Portland, OR
| | - Thomas S Valley
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI; Center for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor, MI
| | - Amanda Schutz
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI
| | - Abhijit Duggal
- Department of Critical Care, Respiratory Institute, Cleveland Clinic, Cleveland, OH; Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH
| | - Kevin P Seitz
- Division of Pulmonary, Allergy, and Critical Care Medicine, Vanderbilt University, Nashville, TN
| | - Steven Y Chang
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, David Geffen School of Medicine at UCLA, Ronald Reagan-UCLA Medical Center, Los Angeles, CA
| | - Christopher G Slatore
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Oregon Health and Science University, Portland, OR; Division of Pulmonary and Critical Care, Oregon Health and Science University, Portland, OR
| | - Donald R Sullivan
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Oregon Health and Science University, Portland, OR; Division of Pulmonary and Critical Care, Oregon Health and Science University, Portland, OR; Knight Cancer Institute, Oregon Health and Science University, Portland, OR
| | - Catherine L Hough
- Division of Pulmonary and Critical Care, Oregon Health and Science University, Portland, OR
| | - Kusum S Mathews
- Division of Pulmonary, Critical Care, & Sleep Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY; Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
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González-Valero G, Gómez-Carmona CD, Bastida-Castillo A, Corral-Pernía JA, Zurita-Ortega F, Melguizo-Ibáñez E. Could the complying with WHO physical activity recommendations improve stress, burnout syndrome, and resilience? A cross-sectional study with physical education teachers. SPORT SCIENCES FOR HEALTH 2022. [DOI: 10.1007/s11332-022-00981-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Abstract
Purpose
Teachers are exposed to inherent psychosocial risks in the workplace such as chronic stress, psychological distress, exhaustion, and burnout syndrome. To compare the values in psychosocial variables based on compliance with the recommendations for physical activity by the World Health Organization (WHO) and the type of physical activity performed.
Methods
The study had a non-experimental and comparative design, with measurements in a single group. The sample was composed of 415 physical education teachers from Spain, with an age range of 21–53 years (28.78 ± 6.15) and a heterogeneous distribution of gender (69.4% male; 30.6% women). The Perceived Stress Scale, the Maslach Burnout Inventory, the Connor–Davidson Resilience Scale, and an Ad-Hoc questionnaire were used to record the sociodemographic aspects and physical-sports practice.
Results
Most of the teachers complied with the recommendations for physical activity practice (n = 335; 80.7%). Physical activity was associated with lower signs of burnout and a greater ability to overcome. Although, teachers who did not comply with WHO recommendations, showed greater stress and emotional exhaustion. In conclusion, enough practice of physical activity based on WHO was shown as a preventive factor of stress and signs of burnout.
Conclusions
The findings suggest that perform physical activity based on the WHO recommendations helps for work stress prevention and burnout syndrome in teachers, as well as to overcome work adversities.
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Iqbal SA, Abubakar IR. Hospital Outdoor Spaces as Respite Areas for Healthcare Staff During the COVID-19 Pandemic. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2022; 15:343-353. [PMID: 35831995 DOI: 10.1177/19375867221111530] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The COVID-19 pandemic has created considerable implications for healthcare staff around the globe. During the pandemic, the frontline healthcare workers experience intense anxiety, stress, burnout, and psychological breakdown, with severe implications on their mental and physical well-being. In addition to these implications, anxiety and stress can hinder their productivity and ability to perform their duties efficiently. The literature indicates that hospital gardens and contact with nature can help alleviate psychological distress among hospital staff. However, few studies investigated the role of outdoor spaces as areas for respite and work breaks in healthcare facilities during the pandemic. The present opinion paper highlights the challenges of job stress and psychological distress health workers face during the pandemic. This article also underscores the role of hospital outdoor spaces and garden facilities in coping with the challenges. While other measures to reduce stress among hospital staff and ensure their health and safety are important, hospital administrators and relevant government agencies should also emphasize the provision of gardens and open spaces in healthcare facilities. These spaces can act as potential areas for respite for hospital staff to help them cope with the stress and anxiety accumulated through working under crises.
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Affiliation(s)
- Saad Arslan Iqbal
- Department of Educational Policy Studies, Faculty of Education, University of Alberta, Edmonton, Canada
| | - Ismaila Rimi Abubakar
- College of Architecture and Planning, Imam Abdulrahman Bin Faisal University (Formerly, University of Dammam), Dammam, Saudi Arabia
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Ghatak T, Singh RK, Kumar A, Patnaik R, Sanjeev OP, Verma A, Kumar S. The Impact of COVID-19 on the Clinical Practices, Working Environment, and Social Life of Intensivists in Non-COVID ICU. Indian J Crit Care Med 2022; 26:816-824. [PMID: 36864855 PMCID: PMC9973188 DOI: 10.5005/jp-journals-10071-24245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose Enlightening the changes in the usual clinical practices, working environment, and social life of Intensivists working in noncoronavirus disease intensive care units (non-COVID ICU) during the COVID pandemic. Materials and methods Observational cross-sectional study for Indian intensivists working in non-COVID ICUs conducted between July and September 2021. A 16-question online survey consisting of the work and social profile of the participating intensivists, changes in the usual clinical practices, working environment, and impact on their social life was administered. For the last three sections, intensivists were asked to compare pandemic times to prepandemic times (pre-mid-March 2020). Results The number of invasive interventions performed by intensivists working in the private sector with lesser clinical experience (<12 years) were significantly less as compared to the government sector (p = 0.07) and clinically experienced (p = 0.07). Intensivists without comorbidities performed significantly lesser number of patient examinations (p = 0.03). The cooperation from healthcare workers (HCWs) decreased significantly with lesser experienced intensivists (p = 0.05). Leaves were significantly reduced in case of private sector intensivists (p = 0.06). Lesser experienced intensivists (p = 0.06) and intensivists working in the private sector (p = 0.06) spent significantly lesser time with family. Conclusion Coronavirus disease-2019 (COVID-19) affected the non-COVID ICUs as well. Young and private sector intensivists were affected due to less leaves and family time. HCWs need proper training for better cooperation during the pandemic time. How to cite this article Ghatak T, Singh RK, Kumar A, Patnaik R, Sanjeev OP, Verma A, et al. The Impact of COVID-19 on the Clinical Practices, Working Environment, and Social Life of Intensivists in Non-COVID ICU. Indian J Crit Care Med 2022;26(7):816-824.
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Affiliation(s)
- Tanmoy Ghatak
- Department of Emergency Medicine, SGPGIMS, Lucknow, Uttar Pradesh, India,Tanmoy Ghatak, Department of Emergency Medicine, SGPGIMS, Lucknow, Uttar pradesh, India, Phone: +91 05222771956, e-mail:
| | - Ratender K Singh
- Department of Emergency Medicine, SGPGIMS, Lucknow, Uttar Pradesh, India
| | - Anup Kumar
- Department of Biostatistics and Health Informatics, SGPGIMS, Lucknow, Uttar Pradesh, India
| | - Rupali Patnaik
- Department of Critical Care Medicine, IMS and SUM Hospital, Bhubaneswar, Odisha, India
| | - Om P Sanjeev
- Department of Emergency Medicine, SGPGIMS, Lucknow, Uttar Pradesh, India
| | - Alka Verma
- Department of Emergency Medicine, SGPGIMS, Lucknow, Uttar Pradesh, India
| | - Sachin Kumar
- Department of Biostatistics and Health Informatics, SGPGIMS, Lucknow, Uttar Pradesh, India
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McPeake J, Iwashyna TJ, Salluh JI. Learning Systems as a Path to Improve ICU Staff Wellbeing. Chest 2022; 162:30-32. [PMID: 35809933 PMCID: PMC9257198 DOI: 10.1016/j.chest.2022.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 03/14/2022] [Indexed: 11/05/2022] Open
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Aram SA, Saalidong BM, Opoku EO, Sam Hayford I. Perceived risk of contracting COVID-19 among healthcare workers in Ghana: A cross-sectional study. Health Sci Rep 2022; 5:e653. [PMID: 35702514 PMCID: PMC9178411 DOI: 10.1002/hsr2.653] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 04/15/2022] [Accepted: 04/18/2022] [Indexed: 12/24/2022] Open
Abstract
Background and Aims The COVID-19 pandemic has stretched many healthcare systems, and it is having detrimental impacts on healthcare workers at the forefront, fighting to save lives. This study sought to assess the relationship between job factors and the perceived risk of contracting COVID-19 at the workplace among healthcare workers and how the relationships are augmented when sociodemographic characteristics are taken into consideration in a limited resource setting (Ghana). Methods A cross-sectional survey of 455 respondents was conducted. Results Overall, 5.93% of the respondents perceived low risk of contracting COVID-19 while 69.45% and 24.62% perceived medium and high risks of contracting COVID-19 at the workplace, respectively. The odds of a high perceived risk versus the combined medium and low perceived risk of contracting COVID-19 at the workplace was 0.461 times lower for healthcare workers who rated their workplace safety systems as good and 0.515 and 0.170 times lower for healthcare workers who indicated occasional and frequent work environment situational assessment (situational awareness), respectively. The odds of high perceived risk were 2.239 times higher for workers who are always emotionally fatigued and 1.829 times higher for healthcare workers who frequently contribute personally to workplace decision-making. The perceived risk of contracting COVID-19 at the workplace was also 1.780 times higher for healthcare workers with tertiary education. Conclusion In terms of health and safety at work, this study recommends that there should be an improvement in implementing safety protocols at health facilities to increase the confidence of healthcare workers. Furthermore, social and psychological support and work environment situational assessment, which can reduce stress and anxiety levels among the healthcare workers, should be implemented if contributing factors such as working outside their area of expertise or job scope cannot be eliminated.
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Affiliation(s)
- Simon Appah Aram
- Department of Environmental ScienceUniversity of Cape CoastCape CoastGhana
- College of Safety and Emergency Management EngineeringTaiyuan University of TechnologyTaiyuanChina
| | | | - Erica Odwira Opoku
- Department of Economics and ManagementTaiyuan University of TechnologyTaiyuanChina
| | - Isaac Sam Hayford
- Department of Economics and ManagementTaiyuan University of TechnologyTaiyuanChina
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Best C. Exploring the role of authentic leadership in nursing. Nurs Stand 2022; 37:45-49. [PMID: 35437974 DOI: 10.7748/ns.2022.e11927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2022] [Indexed: 06/14/2023]
Abstract
Authentic leadership is a relatively new concept in nursing, with limited studies undertaken into its application in healthcare. Authentic leadership emphasises the importance of the leader being true to their personal core values and developing honest relationships with team members, valuing their contributions, and behaving ethically and transparently. Trust is a central tenet of authentic leadership that aims to lead to increased staff engagement, and enhanced individual and team performance. This article explores the principles, benefits and challenges of authentic leadership, as well as examining its potential role in nursing.
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Curtis JR, Levy MM. Providing Compassionate Care in the ICU. Am J Respir Crit Care Med 2022; 205:990-991. [PMID: 35130470 PMCID: PMC9851474 DOI: 10.1164/rccm.202112-2787ed] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Affiliation(s)
- J. Randall Curtis
- Cambia Palliative Care Center of Excellence,Department of MedicineUniversity of Washington School of MedicineSeattle, Washington
| | - Mitchell M. Levy
- Department of MedicineThe Warren Albert Medical School of Brown UniversityProvidence, Rhode Island
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Mehta AB, Lockhart S, Reed K, Griesmer C, Glasgow RE, Moss M, Douglas IS, Morris MA. Drivers of Burnout Among Critical Care Providers: A Multicenter Mixed-Methods Study. Chest 2022; 161:1263-1274. [PMID: 34896094 PMCID: PMC9131031 DOI: 10.1016/j.chest.2021.11.034] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 11/11/2021] [Accepted: 11/28/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Critical care practitioners have some of the highest levels of burnout in health care. RESEARCH QUESTION What are key drivers of burnout across the multidisciplinary ICU team? STUDY DESIGN AND METHODS We conducted a multicenter mixed-methods cohort study in ICUs at three diverse hospitals. We recruited physicians, nurses, respiratory therapists, and other staff members who worked primarily in an ICU. Participants completed the Maslach Burnout Inventory for Human Services Survey for Medical Personnel (MBI) and a qualitative focus group or interview using a phenomenologic approach. MBI subscales for emotional exhaustion, depersonalization, and lack of personal accomplishment were calculated. Emergent shared themes contributing to burnout were identified from qualitative interviews. RESULTS Fifty-eight providers (26 physicians, 22 nurses, six respiratory therapists, three pharmacists, and one case manager) participated. Ten participants (17.9%) described their burnout as moderate to high. However, participants scored moderate or high levels across the three MBI subscales (emotional exhaustion, 71.4%; depersonalization, 53.6%; and lack of personal achievement, 53.6%). Drivers of burnout aligned with three core themes: patient factors, team dynamics, and hospital culture. Individual drivers included medically futile cases, difficult families, contagiousness of burnout, lack of respect between team members, the increasing burden of administrative or regulatory requirements at the cost of time with patients, lack of recognition from hospital leadership, and technology. All were highly interconnected across the three larger domains. Despite differences in MBI scores, most provider types described very similar drivers of burnout. INTERPRETATION High levels of burnout were identified through the MBI, but participants did not self-report high levels of burnout, suggesting a lack of awareness. Drivers of burnout were highly interconnected, but factors related to team dynamics and hospital culture were most prominent and shared across provider types. The shared drivers of burnout across multiple provider types highlights the need for interventions focused on team- and system-level drivers.
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Affiliation(s)
- Anuj B Mehta
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Denver Health & Hospital Association, Denver, CO; Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, National Jewish Health, Denver, CO; Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, CO.
| | - Steven Lockhart
- Adult and Child Consortium for Outcomes Research and Delivery Science, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO
| | - Kathryne Reed
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Denver Health & Hospital Association, Denver, CO
| | - Christine Griesmer
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, National Jewish Health, Denver, CO
| | - Russell E Glasgow
- Adult and Child Consortium for Outcomes Research and Delivery Science, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO; Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO
| | - Marc Moss
- Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, CO
| | - Ivor S Douglas
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Denver Health & Hospital Association, Denver, CO; Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, CO
| | - Megan A Morris
- Adult and Child Consortium for Outcomes Research and Delivery Science, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO; Division of General Internal Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, CO
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Gaetani M, Min KS, Proulx C, Mema B. Reflection, refraction, resilience: the transformative potential of art. Can J Anaesth 2022; 69:568-571. [PMID: 34782998 PMCID: PMC8592672 DOI: 10.1007/s12630-021-02147-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Revised: 10/24/2021] [Accepted: 10/25/2021] [Indexed: 11/06/2022] Open
Affiliation(s)
- Melany Gaetani
- Department of Critical Care Medicine, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
- Interdepartmental Division of Critical Care Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Kyung-Seo Min
- Department of History of Art, Johns Hopkins University, Baltimore, MD, USA
| | - Catherine Proulx
- Department of Critical Care Medicine, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
- Interdepartmental Division of Critical Care Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Briseida Mema
- Department of Critical Care Medicine, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.
- Interdepartmental Division of Critical Care Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
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Gabay G, Netzer D, Elhayany A. Shared trust of resident physicians in top‐management and professional burnout: A cross‐sectional study towards capacity for patient‐focussed care, peer support and job expectations. Int J Health Plann Manage 2022; 37:2395-2409. [DOI: 10.1002/hpm.3479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 01/27/2022] [Accepted: 04/01/2022] [Indexed: 11/10/2022] Open
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Matsuishi Y, Mathis BJ, Hoshino H, Enomoto Y, Shimojo N, Kawano S, Sakuramoto H, Inoue Y. PERSonality, Ehical, and PROfessional quality of life in Pediatric/Adult Intensive Nurses study: PERSEPRO PAIN study. PLoS One 2022; 17:e0259721. [PMID: 35255088 PMCID: PMC8901072 DOI: 10.1371/journal.pone.0259721] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 10/25/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND The World Health Organization included burnout syndrome criteria that reduce both professional quality of life and work satisfaction in its 11th Revision of the International Classification of Diseases in 2019 while nursing bodies have issued action calls to prevent burnout syndrome. Despite this, the effect of social factors, personality traits and cross-interaction on professional quality of life is still unclear. AIM To reveal the association between ethical climate, personal trait and professional quality of life. METHOD An online survey of registered nurses working in adult, pediatric or both ICUs. We used the ten-item personality measure based on The Big Five theory and Type-D personality Scale-14 then measured the ethical climate with the Hospital Ethical Climate Survey and the professional domains of burnout syndrome, secondary traumatic stress and compassion satisfaction by the Professional Quality of Life Scale Version 5 simultaneously. Multivariate analysis confirmed the triangular association of hospital ethical climate, personality traits and professional quality of life. RESULT We enrolled 310 participants from September 2019 to February 2020. Mean age was 33.1 years (± 5.9) and about 70% were female. In the multivariate analysis, neuroticism (p = 0.03, p = 0.01) and Type D personality (both of p<0.01) were associated with burnout syndrome and secondary traumatic stress while agreeableness (p<0.01) was associated with secondary traumatic stress. Conversely, extraversion (p = 0.01), agreeableness (p<0.01) and openness (p<0.01) were associated with compassion satisfaction. We also observed interactions between hospital ethical climate and conscientiousness (p = 0.01) for burnout syndrome and secondary traumatic stress. Neuroticism was related to (p<0.01) BOS and compassion satisfaction while Type D personality (p<0.01) correlated with burnout syndrome and secondary traumatic stress. CONCLUSION Hospital ethical climate strongly affects professional quality of life in nurses with specific personality traits. Therefore, it is important to maintain an ethical hospital climate, considering individual personalities to prevent burnout syndrome.
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Affiliation(s)
- Yujiro Matsuishi
- Neuroscience Nursing, St. Luke’s International University, Tokyo, Japan
| | - Bryan J. Mathis
- International Medical Center, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan
| | - Haruhiko Hoshino
- Adult Health Nursing, Department of Nursing, International University of Health and Welfare, Narita, Japan
| | - Yuki Enomoto
- Department of Pediatrics, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan
- Department of Emergency and Critical Care Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Nobutake Shimojo
- Department of Emergency and Critical Care Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Satoru Kawano
- Department of Emergency and Critical Care Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Hideaki Sakuramoto
- Adult Health Nursing, College of Nursing, Ibaraki Christian University, Hitachi, Ibaraki, Japan
| | - Yoshiaki Inoue
- Department of Emergency and Critical Care Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
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