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Quesada-Puga C, Izquierdo-Espin FJ, Membrive-Jiménez MJ, Aguayo-Estremera R, Cañadas-De La Fuente GA, Romero-Béjar JL, Gómez-Urquiza JL. Job satisfaction and burnout syndrome among intensive-care unit nurses: A systematic review and meta-analysis. Intensive Crit Care Nurs 2024; 82:103660. [PMID: 38394983 DOI: 10.1016/j.iccn.2024.103660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 02/02/2024] [Accepted: 02/16/2024] [Indexed: 02/25/2024]
Abstract
INTRODUCTION The severe conditions often experienced in an intensive care unit, combined with poor working conditions, increase stress and therefore decrease job satisfaction. Sustained stress in the workplace leads to the development of burnout, a syndrome characterised by three dimensions: emotional exhaustion, depersonalisation and perceived lack of personal fulfilment. OBJECTIVE To analyse the relationship between burnout syndrome and job satisfaction among ICU personnel. DATA SOURCES The PubMed, CINAHL and Scopus databases were used. STUDY DESIGN A systematic review and meta-analysis. The study sample consisted of 18 quantitative primary studies conducted in the last five years. Validated questionnaires were used to assess burnout in ICU healthcare workers, the most commonly used being the Maslach Burnout Inventory. EXTRACTION METHODS The search equation applied was: "job satisfaction AND nurs* AND burnout AND (ICU OR intensive care units)". The search was performed in October 2022. PRINCIPAL FINDINGS The search returned 514 results. Only 73 articles met the eligibility criteria. After reading the title and abstract, 20 articles were selected. After reading the full texts, 12 articles remained and after the reverse search, 18 articles were finally selected. The studies reported a 50% prevalence of burnout, all three dimensions of which were heightened by the COVID-19 pandemic. Analysis of the study findings revealed an inverse association between burnout and job satisfaction. CONCLUSIONS Job dissatisfaction of ICU nurses depends on lack of experience, working conditions or working environment among others. ICU nurses with lower job satisfaction have higher levels of burnout. IMPLICATIONS FOR CLINICAL PRACTICE This meta-analysis shows the potential value of job satisfaction on improving health outcomes related to burnout syndrome for nursing professional in Intensive Care Units. Different factors that could increase job satisfaction and consequently protect them from suffering high levels of burnout, such as salary, permanence in the service, mental health care are the responsibility of the hospital supervisor and, finally, of the own Health System. Knowledge of a risk profile based on the factors influencing job dissatisfaction would enable the implementation of effective workplace interventions to reduce or prevent the risk of burnout. Health policies should focus on protecting the worker, so in addition to improving working conditions, it would be interesting to promote coping skills in order to improve the quality of care and patient safety.
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Affiliation(s)
- Carmen Quesada-Puga
- University Hospital Torrecardenas, Andalusian Health Service, C/ Hermandad de Donantes de Sangre, s/n, 04009 Almería, Spain.
| | - Francisco José Izquierdo-Espin
- Critical Care Unit, General University Hospital of Jaen, Andalusian Health Service, Av. del Ejército Español, 10, 23007 Jaén, Spain.
| | | | - Raimundo Aguayo-Estremera
- Department of Psychobiology and Methodology in Behavioral Sciences, Complutense University of Madrid, Campus Univ. Somosaguas, 28223 Pozuelo de Alarcón, Spain.
| | - Guillermo A Cañadas-De La Fuente
- Faculty of Health Sciences, University of Granada and Brain, Mind and Behaviour Research Centre (CIMCYC), University of Granada, Av. de la Ilustración, 60, 18016 Granada, Spain.
| | - José Luis Romero-Béjar
- Department of Statistics and Operations Research, University of Granada, Instituto de Investigación Biosanitaria (ibs.GRANADA) and Institute of Mathematics of the University of Granada (IMAG), Campus Univ. Fuentenueva s/n, 18071 Granada, Spain.
| | - José Luis Gómez-Urquiza
- Faculty of Health Sciences, University of Granada, Cortadura del Valle s/n, 51001 Ceuta, Spain.
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Qian J, Wu G, Jevitt C, Sun S, Wang M, Sun X, Yu X. Psychological pathway to emotional exhaustion among nurses and midwives who provide perinatal bereavement care in China: a path analysis. BMC Psychiatry 2024; 24:90. [PMID: 38297253 PMCID: PMC10832229 DOI: 10.1186/s12888-024-05534-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 01/18/2024] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND A lack of confidence in perinatal bereavement care (PBC) and the psychological trauma experienced by nurses and midwives during bereavement care leads to their strong need for sufficient organisational support. The current study intended to test a hypothesised model of the specific impact paths among organisational support, confidence in PBC, secondary traumatic stress, and emotional exhaustion among nurses and midwives. METHODS A descriptive, cross-sectional survey was conducted in sixteen maternity hospitals in Zhejiang Province, China, from August to October 2021. The sample (n = 779) consisted of obstetric nurses and midwives. A path analysis was used to test the relationships among study variables and assess model fit. RESULTS Organisational support directly and positively predicted confidence in PBC and demonstrated a direct, negative, and significant association with secondary traumatic stress and emotional exhaustion. Confidence in PBC had a positive direct effect on secondary traumatic stress and a positive indirect effect on emotional exhaustion via secondary traumatic stress. Secondary traumatic stress exhibited a significant, direct effect on emotional exhaustion. CONCLUSIONS This study shows that nurses' and midwives' confidence in PBC and mental health were leadingly influenced by organisational support in perinatal bereavement practice. It is worth noting that higher confidence in PBC may lead to more serious psychological trauma symptoms in nurses and midwives. Secondary traumatic stress plays an essential role in contributing to emotional exhaustion. The findings suggest that support from organisations and self-care interventions were required to improve confidence in PBC and reduce negative psychological outcomes among those providing PBC. The development of objective measures for assessing competence in PBC and organizational support are essential.
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Affiliation(s)
- Jialu Qian
- Zhejiang University School of Medicine, Hangzhou, China
- Midwifery Division, Department of Family Medicine, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Gaoyan Wu
- Surgery Department of Thyroid and Breast, Huashan Hospital Fudan University, Shanghai, China
| | - Cecilia Jevitt
- Midwifery Division, Department of Family Medicine, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Shiwen Sun
- Department of Obstetrics, Women's Hospital School of Medicine, Zhejiang University, Hangzhou, China, 1st Xueshi Road, Zhejiang Province, 310006
| | - Man Wang
- Zhejiang University School of Medicine, Hangzhou, China
| | - Xiangyu Sun
- Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaoyan Yu
- Department of Obstetrics, Women's Hospital School of Medicine, Zhejiang University, Hangzhou, China, 1st Xueshi Road, Zhejiang Province, 310006.
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Aydin Dogan R. Compassion fatigue and moral sensitivity in midwives in COVID-19. Nurs Ethics 2023; 30:776-788. [PMID: 36927231 PMCID: PMC10028444 DOI: 10.1177/09697330221146224] [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: 03/18/2023]
Abstract
BACKGROUND The Covid-19 pandemic has impacted compassion fatigue and the mental health of health care providers, particularly midwives and nurses. Although there are studies involving health workers such as nurses and physicians affected by the pandemic's compassion fatigue, few studies include midwives. RESEARCH OBJECTIVE The present study seeks to investigate the effects of compassion fatigue experienced by midwives working under intense stress during the third wave of the COVID-19 pandemic on the level of moral sensitivity. RESEARCH DESIGN This is a descriptive-correlation study. PARTICIPANTS The statistical population consisted of all the midwives in Türkiye hospitals in 2021. This cross-sectional study was collected through a questionnaire using convenience sampling. Three hundred and ten midwives working in different units of the country participated in the study. ETHICAL CONSIDERATIONS Approval from the researcher's university Institutional Review Board for ethical review was obtained with the code of IRB 20/510. FINDINGS The average age of the midwives is 34.29 ± 8.39. It has been noticed that 43.5% of the midwives work in public hospitals and 38.1% in family health and community health centers. Midwives' mean MR-CS score is 67.11 ± 25.13, secondary trauma sub-dimension average 15.77 ± 6.23, and occupational burnout sub-dimension 40.69 ± 16.35. The mean moral sensitivity questionnaire score is determined as 93.86 ± 19.51. It has been observed that the working style and working time are effective on compassion fatigue. In the linear regression model, 98% of compassion fatigue was explained. Age, secondary trauma, and occupational burnout sub-dimensions affect the model. DISCUSSION Working year, working style, second trauma, age, and occupational burnout parameters may help explain some of the links between midwives' symptoms of compassion fatigue. CONCLUSION The pandemic affects the compassion fatigue of midwives. It is crucial to provide social support to midwives and health workers to prevent compassion fatigue and examine and control groups at risk in mental health.
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Affiliation(s)
- Reyhan Aydin Dogan
- Department of Midwifery, Faculty of Health
Sciences, Karabuk University, Turkey
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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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Amini K, Miyanaji H, Din Mohamadi M. Bullying and burnout in critical care nurses: A cross-sectional descriptive study. Nurs Crit Care 2023; 28:202-210. [PMID: 35146848 DOI: 10.1111/nicc.12744] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 12/07/2021] [Accepted: 12/09/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Employee bullying and burnout are two crucial, prevalent and challenging concepts that adversely affect organizational staff behaviours. Also, adverse patient care is associated with nurse bullying and burnout. AIM This study aimed to assess the incidence and association between workplace bullying and occupational burnout among nurses in critical care units in Iran. STUDY DESIGN A cross-sectional descriptive study. METHODS The subjects were 184 nurses from critical care units in 6 teaching hospitals in Iran. Three questionnaires were distributed among the study population; (a) demographic characteristics questionnaire, (b) Maslach Burnout Inventory (MBI) and (c) bullying at Workplace Questionnaire. Descriptive statistics were used to present the workplace bullying and occupational burnout status among nurses. Linear and logistic regression analyses were conducted to estimate the relationship between workplace bullying with MBI and nurses' demographic characteristics, respectively. RESULTS 62% of the nurses had moderate emotional exhaustion, 59.8% had moderate depersonalization and 46.2% had a moderate individual achievement. 75.5% faced workplace bullying. There was a positive and significant association between bullying scores and burnout in total (Pearson's r = 0.598, p < 0.001). Linear regression test showed a positive and significant relationship between bullying with MBI dimensions (R = 0.613, p < 0.001) for emotional exhaustion, (R = 0.679, p < 0.001) for depersonalization and (R = -0.417, p < 0.001) for individual achievement. CONCLUSIONS Among Iranian nurses, bullying is a prominent and substantial issue that significantly correlates with their negative performance by enhancing job burnout. RELEVANCE TO CLINICAL PRACTICE It is suggested that some measures are adopted to avoid workplace bullying and to reduce occupational burnout for nurses. Managers should create an environment that encourages nurses to voice their concerns - informing nurses about their rights and creating a positive atmosphere in the hospital.
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Affiliation(s)
- Kourosh Amini
- Department of Psychiatric Nursing, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Hamid Miyanaji
- Department of Critical Care Nursing, Zanjan University of Medical Sciences, Zanjan, Iran
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Jeong YJ, Shin S. The relationship between secondary traumatic stress and burnout in critical care nurses: The mediating effect of resilience. Intensive Crit Care Nurs 2023; 74:103327. [PMID: 36208974 DOI: 10.1016/j.iccn.2022.103327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 09/14/2022] [Accepted: 09/15/2022] [Indexed: 11/05/2022]
Abstract
PURPOSE To examine the mediating factor on the association of secondary traumatic stress and burnout among critical care nurses. DESIGN A correlational study. METHODS Data were collected from a convenience sampling of 147 nurses from two general hospitals who had six or more months of experience working in an intensive care unit. The collected data were analyzed through t-test, ANOVA, Scheffé test, Mann-Whitney test, Kruskal-Wallis test, Bonferroni correction, and Pearson's correlation coefficient using SPSS 25.0. The mediating effect of resilience was analyzed through the three-stage mediation effect test procedure using hierarchical regression analysis and the Sobel test. RESULTS Secondary traumatic stress had a statistically significant positive correlation with burnout (r = 0.45, p <.001), and a statistically significant negative correlation between burnout and resilience (r = -0.54, p <.001) was observed. Secondary traumatic stress was found to have a statistically significant effect on resilience, which was the mediating variable (β = -0.17, p =.042). Additionally, secondary traumatic stress had a statistically significant effect on burnout (β = 0.45, p <.001). The significance of the mediating effect of resilience on the relationship between secondary traumatic stress and burnout was investigated using the Sobel test, and the mediating effect of resilience was found to be statistically significant (Z = 1.98, p =.048). CONCLUSION Resilience was found to have a partial mediating effect in the relationship between critical care nurses' secondary traumatic stress and burnout. The study thus provides basic data on the importance of resilience in preventing burnout from secondary traumatic stress.
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Affiliation(s)
- Yun Jeong Jeong
- The Graduate School of Converging Clinical and Public Health, Ewha Womans University, Ewha Womans University, Mokdong Hospital, Republic of Korea.
| | - Sujin Shin
- College of Nursing, Ewha Womans University, Republic of Korea.
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Huang H, Xia Y, Zeng X, Lü A. Prevalence of depression and depressive symptoms among intensive care nurses: A meta-analysis. Nurs Crit Care 2022; 27:739-746. [PMID: 34989060 DOI: 10.1111/nicc.12734] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 11/07/2021] [Accepted: 11/08/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Nurses in intensive care units (ICUs) experience more stressful workplace conditions, making them more vulnerable to high levels of depression compared with those working in other healthcare settings. OBJECTIVES This meta-analysis aimed to estimate the pooled prevalence of depression in ICU nurses. METHODS A systematic search was conducted in Medline, EMBASE, CINHO, and Web of Science databases. Studies that reported depression among ICU nurses measured by a validated tool were synthesized using a random-effects model. Differences in prevalence of depression by study-level characteristics were estimated using sub-group analysis. Heterogeneity was investigated using standard Chi-squared tests and the I2 statistic. RESULTS Data were extracted from 19 cross-sectional studies (2003-2020) from 11 countries involving 7196 ICU nurses. The overall pooled prevalence of depression or depressive symptoms among ICU nurses was 24.99% (95% CI, 17.9%-32.7%) with high between-study heterogeneity (χ2 = 812, τ2 = 0.03, I2 = 98%, P < .01). CONCLUSION Depression appears to be common among ICU nurses. Considering its negative impact on the quality of life of staff, patient care, and the overall critical care work environment, effective interventions should be designed and implemented to improve psychological health in this population. RELEVANCE TO CLINICAL PRACTICE Findings of this review indicate that regular screening for depressive symptoms might be helpful, and access to professional help and supportive care should be provided if necessary.
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Affiliation(s)
- Huan Huang
- Department of Intensive Medicine, Changsha First Hospital, Changsha, China
| | - You Xia
- Nursing Department, Changsha First Hospital, Changsha, China
| | - Xiaoyan Zeng
- Department of Intensive Medicine, Changsha First Hospital, Changsha, China
| | - Ailian Lü
- Department of Intensive Medicine, Changsha First Hospital, Changsha, China
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Choflet A, Barnes A, Zisook S, Lee KC, Ayers C, Koivula D, Ye G, Davidson J. The Nurse Leader's Role in Nurse Substance Use, Mental Health, and Suicide in a Peripandemic World. Nurs Adm Q 2022; 46:19-28. [PMID: 34860798 DOI: 10.1097/naq.0000000000000510] [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: 11/26/2022]
Abstract
Nurses are known to be at an increased risk of death by suicide, and recent studies have found links between nurse suicide, substance use, mental health issues, and job problems. Because of stigma, inaccessibility of resources, and regulatory and legal issues, nurses are unlikely to seek help unless a crisis forces them into treatment. The purpose of this article is to review the current understanding of nurse suicide, the psychological impact of the novel coronavirus (COVID-19) pandemic, the strategic planning approach to identify the needs of nurses, and promising interventions and practices. Evidence-based strategies to intervene at the personal, institutional, and regulatory levels should be employed to reduce nurse suicide by focusing not only on suicide but also on treatment of substance and mental health issues, as well as a renewed focus on disciplinary procedures that may place nurses in immediate danger of death by suicide. Nurse leaders have a moral obligation to provide proactive, meaningful interventions to reduce the risk of death by suicide among nurses.
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Affiliation(s)
- Amanda Choflet
- San Diego State University, San Diego, California (Dr Choflet); University of California San Diego (Drs Zisook, Lee, and Davidson and Mr Ye); Department of Veterans Affairs, Washington, District of Columbia (Ms Ayers); Mission Hospital, Mission Viejo, California (Ms Barnes); and New York State Nurses Association, New York City, New York (Ms Koivula)
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