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Bååthe F, von Knorring M, Isaksson-Rø K. How hospital top managers reason about the central leadership task of balancing quality of patient care, economy and professionals' engagement: an interview study. Leadersh Health Serv (Bradf Engl) 2022; ahead-of-print:261-274. [PMID: 36573612 PMCID: PMC10427974 DOI: 10.1108/lhs-02-2022-0009] [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: 02/23/2022] [Revised: 05/27/2022] [Accepted: 10/04/2022] [Indexed: 12/28/2022]
Abstract
PURPOSE This study aims to deepen the understanding of how top managers reason about handling the relationships between quality of patient care, economy and professionals' engagement. DESIGN/METHODOLOGY/APPROACH Qualitative design. Individual in-depth interviews with all members of the executive management team at an emergency hospital in Norway were analysed using reflexive thematic method. FINDINGS The top managers had the intention to balance between quality of patient care, economy and professionals' engagement. This became increasingly difficult in times of high internal or external pressures. Then top management acted as if economy was the most important focus. PRACTICAL IMPLICATIONS For health-care top managers to lead the pursuit towards increased sustainability in health care, there is a need to balance between quality of patient care, economy and professionals' engagement. This study shows that this balancing act is not an anomaly top-managers can eradicate. Instead, they need to recognize, accept and deliberately act with that in mind, which can create virtuous development spirals where managers and health-professional communicate and collaborate, benefitting quality of patient care, economy and professionals' engagement. However, this study builds on a limited number of participants. More research is needed. ORIGINALITY/VALUE Sustainable health care needs to balance quality of patient care and economy while at the same time ensure professionals' engagement. Even though this is a central leadership task for managers at all levels, there is limited knowledge about how top managers reason about this.
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Affiliation(s)
- Fredrik Bååthe
- Institute for Studies of the Medical Profession, LEFO, Oslo, Norway; Institute of Stress Medicine at Region Västra Götaland, Gothenburg, Sweden and Institute of Health and Care Sciences, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden
| | - Mia von Knorring
- Department of Learning, Informatics, Management and Ethics, Medical Management Centre, Karolinska Institutet, Stockholm, Sweden
| | - Karin Isaksson-Rø
- Institute for Studies of the Medical Profession, LEFO, Oslo, Norway and Department of Behavioural Sciences in Medicine, Institute of Basic Medical Sciences, Medical Faculty, University of Oslo, Oslo, Norway
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Oh WO, Yeom I, Lim SH. Structural equation model based on salutogenesis theory for evaluating factors affecting health-related quality of life in adolescents with moyamoya disease. Sci Rep 2022; 12:20348. [PMID: 36437307 PMCID: PMC9701670 DOI: 10.1038/s41598-022-24825-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 11/21/2022] [Indexed: 11/28/2022] Open
Abstract
Moyamoya disease is a cerebrovascular disorder and a significant chronic health concern requiring regular monitoring to control the disease and its related complications. We examined a hypothetical model by integrating the concepts of a structural health-related quality-of-life model based on the salutogenesis theory, and to identify how social support, sense of coherence, and stress contribute to health behaviors, subjective health status, and quality of life in adolescents with moyamoya disease among 239 adolescents in Korea. A structural equation model was used to analyze the data. The fitness of the hypothetical model with the salutogenesis theory was satisfactory, showing that the goodness-of-fit index = 0.91, adjusted goodness-to-fit index = 0.90, comparative fit index = 0.92, normed fit index = 0.91, incremental fit index = 0.91, standardized root mean squared residual = 0.04, root mean square error of approximation = 0.07, parsimony normed fit index = 0.61, parsimony goodness of fit index = 0.51. The model explained 68.9% of quality of life. Health behavior (β = -0.173, p = 0.467) and stress (β = -0.557, p < 0.001) had significant direct and total effects on quality of life. Sense of coherence had a significant direct (β = 0.371, p = 0.003), indirect (β = 0.220, p = 0.013), and total (β = 0.590, p < 0.001) effect on quality of life. This study found that sense of coherence was significant factors contributing to lower stress, improved health status, and quality of life in adolescents with moyamoya disease. To improve the quality of life for adolescents with moyamoya disease, comprehensive nursing interventions need to be developed and applied.
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Affiliation(s)
- Won-oak Oh
- grid.222754.40000 0001 0840 2678Korea University College of Nursing, 145 Anam-ro, Seongbuk-gu, Seoul, Republic of Korea
| | - Insun Yeom
- grid.15444.300000 0004 0470 5454Brain Korea 21 FOUR Project, College of Nursing, Yonsei University, Seoul, Republic of Korea
| | - Sung-Hyun Lim
- grid.222754.40000 0001 0840 2678Korea University College of Nursing, 145 Anam-ro, Seongbuk-gu, Seoul, Republic of Korea
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Lima A, Moreira MT, Fernandes C, Ferreira M, Teixeira J, Parola V, Coelho A. The Burnout of Nurses in Intensive Care Units and the Impact of the Pandemic of SARS-CoV-2: Protocol of a Scoping Review. NURSING REPORTS 2022; 12:655-660. [PMID: 36135984 PMCID: PMC9502256 DOI: 10.3390/nursrep12030065] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 08/20/2022] [Accepted: 08/29/2022] [Indexed: 11/17/2022] Open
Abstract
Background: The SARS-CoV-2 pandemic has brought multiple challenges for health institutions and their professionals. The requirement of this disease forced nurses to confront organizational and clinical challenges to maintain the quality standards of care they provide. These requirements may have contributed to increased burnout symptoms. This study aims to map the scientific evidence related to nurses' burnout in intensive care units. Methods: A scoping review will be conducted according to the Joanna Briggs Institute methodology. Relevant databases will be used as well as grey literature, where the following words will be used: burnout, nurses, intensive care units and SARS-CoV-2. Results: This scoping review will include all types of studies-quantitative, qualitative and mixed-and all types of reviews that focus on the objective of this review. Conclusions: It is vital to determine the impact of the burnout caused by the pandemic of SARS-CoV-2 to assess amending measures of risk and protection factors. This will help in the implementation of guidelines according to the available evidence. Additionally, this will help to improve the skills of these professionals as well as to reduce their emotional and physical exhaustion. This protocol is registered with the Open Science Framework.
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Affiliation(s)
- Andreia Lima
- Health Sciences School—Fernando Pessoa, CINTESIS, 4200-253 Porto, Portugal
| | | | | | - Margarida Ferreira
- Health Sciences School Jean Piaget Vila Nova de Gaia, CINTESIS, 4405-678 Vila Nova de Gaia, Portugal
| | - Joana Teixeira
- Health Sciences School—Fernando Pessoa, 4200-253 Porto, Portugal
| | - Vítor Parola
- The Health Sciences Research Unit: Nursing (UICISA:E), Nursing School of Coimbra (ESEnfC), 3004-011 Coimbra, Portugal
| | - Adriana Coelho
- The Health Sciences Research Unit: Nursing (UICISA:E), Nursing School of Coimbra (ESEnfC), 3004-011 Coimbra, Portugal
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González-Siles P, Martí-Vilar M, González-Sala F, Merino-Soto C, Toledano-Toledano F. Sense of Coherence and Work Stress or Well-Being in Care Professionals: A Systematic Review. Healthcare (Basel) 2022; 10:1347. [PMID: 35885873 PMCID: PMC9323122 DOI: 10.3390/healthcare10071347] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 07/15/2022] [Accepted: 07/18/2022] [Indexed: 11/16/2022] Open
Abstract
Job-related stress affects the physical and psychological health of professionals dedicated to care. This work is a systematic review that aims to determine the relationships between a sense of coherence (SOC) and work stress and well-being perceived by care professionals. The review was carried out following the PRISMA guidelines, and the search was carried out using the Web of Science (WoS), PubMed, and Scopus databases, obtaining a final selection of 41 articles. The results indicate that stress, depression, burnout, and posttraumatic stress disorder (PTSD) negatively correlate with SOC; in contrast, job satisfaction, well-being, and quality of life positively correlate with SOC. It is concluded that SOC could act as a mediating variable and as a predictor variable of these health problems.
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Affiliation(s)
- Pablo González-Siles
- Departamento de Psicología Básica, Universitat de València, Avgda, Blasco Ibañez, 21, CP 46010 Valencia, Spain; (P.G.-S.); (M.M.-V.)
| | - Manuel Martí-Vilar
- Departamento de Psicología Básica, Universitat de València, Avgda, Blasco Ibañez, 21, CP 46010 Valencia, Spain; (P.G.-S.); (M.M.-V.)
| | - Francisco González-Sala
- Departamento de Psicología Evolutiva y de la Educación, Universitat de València, Avgda, Blasco Ibañez, 21, CP 46010 Valencia, Spain;
| | - César Merino-Soto
- Instituto de Investigación de Psicología, Universidad de San Martín de Porres, Av. Tomás Marsano 242, Lima 34, Peru;
| | - Filiberto Toledano-Toledano
- Unidad de Investigación en Medicina Basada en Evidencias, Hospital Infantil de México Federico Gómez, National Institute of Health, Dr. Márquez 162, Cuauhtémoc, Mexico City 06720, Mexico
- Unidad de Investigación Sociomédica, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra, Calzada Mexico-Xochimilco 289, Arenal de Guadalupe, Tlalpan, Mexico City 14389, Mexico
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Eriksson M, Kerekes N, Brink P, Pennbrant S, Nunstedt H. The level of sense of coherence among Swedish nursing staff. J Adv Nurs 2019; 75:2766-2772. [PMID: 31236952 DOI: 10.1111/jan.14137] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 04/19/2019] [Accepted: 05/14/2019] [Indexed: 11/30/2022]
Abstract
AIM To explore the level of sense of coherence among Swedish nursing staff. DESIGN An explorative quantitative study design was adopted using a short form for measuring sense of coherence. METHODS Data were collected in January 2018 from nurses working in full-time positions at two hospitals in Western Sweden. A total of 93 nurses completed the 13 item questionnaire measuring sense of coherence. Descriptive statistics were applied to obtain means and standard deviations. Spearman's rank correlation was used to describe strength of association between sense of coherence and socio-demographic categories. Between-group differences were defined using the nonparametric tests of Mann Whitney U test and Kruskal-Wallis test. RESULTS The internal consistency of the SOC-13 was low. An inter-item-correlation test indicated that two items decreased the internal consistency of the scale. The level of the three dimensions of sense of coherence varied; manageability was weakest and decreased the total sense of coherence. The meaningfulness dimension was as strongest. CONCLUSION On a national level, nurses reported weaker sense of coherence (SOC) than the general population, but stronger in an international comparison of nurses. They found their work difficult to manage, but meaningful. IMPACT On a national level, the nurses reported weaker SOC than the general population, but stronger in an international comparison of nurses. Findings from this study will have an impact on how nurses can manage work related stress in terms of sense of coherence. There will also be an impact on nurses' well-being, which in a long run benefits patients.
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Affiliation(s)
- Monica Eriksson
- Department of Health Sciences, University West, Trollhättan, Sweden
| | - Nóra Kerekes
- Department of Health Sciences, University West, Trollhättan, Sweden
| | - Peter Brink
- Department of Health Sciences, University West, Trollhättan, Sweden.,NU Hospital Group, Trollhättan, Sweden
| | - Sandra Pennbrant
- Department of Health Sciences, University West, Trollhättan, Sweden
| | - Håkan Nunstedt
- Department of Health Sciences, University West, Trollhättan, Sweden
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Storkholm MH, Savage C, Tessma MK, Salvig JD, Mazzocato P. Ready for the Triple Aim? Perspectives on organizational readiness for implementing change from a Danish obstetrics and gynecology department. BMC Health Serv Res 2019; 19:517. [PMID: 31340843 PMCID: PMC6657111 DOI: 10.1186/s12913-019-4319-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 07/02/2019] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND As health care strives towards the Triple Aim of improved population health, patient experience, and reduced costs, an organization's readiness for change may be a key factor. The concept refers to the collective commitment of organizational members to a change and belief in their shared ability to make that change happen (efficacy). This study aims to assess the organizational readiness for implementing large-scale change at a clinical department in pursuit of the Triple Aim and to determine key associated factors. METHODS A cross-sectional study at a Danish Obstetrics and Gynecology department faced with external pressure to become more efficient without compromising patient outcomes and experience. The Organisational Readiness for Implementing Change (ORIC) questionnaire was distributed to all employees (n = 403). Descriptive statistics was used to assess overall organizational readiness and single items. The between-group differences in subject characteristics were assessed with independent t-test and non-parametric test. Multiple linear regression was employed to control for potential confounders. RESULTS Response rate was 72%. The level of agreement with the commitment statements was high, and low with the efficacy statements. We did not observe statistically significant differences in the overall score between organizational sections or in relation to gender, age, or profession. Managerial status (B = 3.2, 95% CI = .52, 5.9, P = .02) or interim employment(B = 2.7, 95% CI = .47, 4.9, P = .02) were significant predictors of a high change efficacy score after controlling for potential confounders. CONCLUSIONS Changes related to pursuit of the Triple Aim were seen as something that "has to" be done, but left managers, and even more so staff, wondering what "to do" and "how to" do it. Change strategies should therefore address these uncertainties by translating political "have to's" proposals that resonate with staff, spark engagement, and clarify "how to" deal with the complexity of large-scale change.
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Affiliation(s)
- Marie Höjriis Storkholm
- Medical Management Centre, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Tomtebodavägen 18A, 171 77 Stockholm, Sweden
- Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark
| | - Carl Savage
- Medical Management Centre, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Tomtebodavägen 18A, 171 77 Stockholm, Sweden
| | - Mesfin Kassaye Tessma
- Medical Statistics Unit, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - Jannie Dalby Salvig
- Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark
| | - Pamela Mazzocato
- Medical Management Centre, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Tomtebodavägen 18A, 171 77 Stockholm, Sweden
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Baathe F, Rosta J, Bringedal B, Rø KI. How do doctors experience the interactions among professional fulfilment, organisational factors and quality of patient care? A qualitative study in a Norwegian hospital. BMJ Open 2019; 9:e026971. [PMID: 31129585 PMCID: PMC6537988 DOI: 10.1136/bmjopen-2018-026971] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES Doctors increasingly experience high levels of burnout and loss of engagement. To address this, there is a need to better understand doctors' work situation. This study explores how doctors experience the interactions among professional fulfilment, organisational factors and quality of patient care. DESIGN An exploratory qualitative study design with semistructured individual interviews was chosen. Interviews were transcribed verbatim and analysed by a transdisciplinary research group. SETTING The study focused on a surgical department of a mid-sized hospital in Norway. PARTICIPANTS Seven doctors were interviewed. A purposeful sampling was used with gender and seniority as selection criteria. Three senior doctors (two female, one male) and four in training (three male, one female) were interviewed. RESULTS We found that in order to provide quality care to the patients, individual doctors described 'stretching themselves', that is, handling the tensions between quantity and quality, to overcome organisational shortcomings. Experiencing a workplace emphasis on production numbers and budget concerns led to feelings of estrangement among the doctors. Participants reported a shift from serving as trustworthy, autonomous professionals to becoming production workers, where professional identity was threatened. They felt less aligned with workplace values, in addition to experiencing limited management recognition for quality of patient care. Management initiatives to include doctors in development of organisational policies, processes and systems were sparse. CONCLUSION The interviewed doctors described their struggle to balance the inherent tension among professional fulfilment, organisational factors and quality of patient care in their everyday work. They communicated how 'stretching themselves', to overcome organisational shortcomings, is no longer a feasible strategy without compromising both professional fulfilment and quality of patient care. Managers need to ensure that doctors are involved when developing organisational policies, processes and systems. This is likely to be beneficial for both professional fulfilment and quality of patient care.
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Affiliation(s)
- Fredrik Baathe
- LEFO – Institute for Studies of the Medical Profession, Oslo, Norway
- Institute of Stress Medicine, Gothenburg, Sweden
- Sahlgrenska University Hospital, Gothenburg, Sweden
- Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden
| | - Judith Rosta
- LEFO – Institute for Studies of the Medical Profession, Oslo, Norway
| | - Berit Bringedal
- LEFO – Institute for Studies of the Medical Profession, Oslo, Norway
| | - Karin Isaksson Rø
- LEFO – Institute for Studies of the Medical Profession, Oslo, Norway
- Dept. of Behavioural Sciences in Medicine, Institute of Basic Medical Sciences, MedicalFaculty, University of Oslo, Oslo, Norway
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Wilczek-Rużyczka E, Dębska G, Pasek M, Zwierzchowska M. The mediational effect of coherence on the relationship between mental load and job burnout among oncology nurses. Int J Nurs Pract 2019; 25:e12736. [PMID: 31087514 DOI: 10.1111/ijn.12736] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 01/15/2019] [Accepted: 03/08/2019] [Indexed: 11/30/2022]
Abstract
AIMS The purpose of this study was to determine the mediational effect of coherence on the relationship between mental load and job burnout among oncology nurses. BACKGROUND Working stress and strain cause high mental load and can lead to job burnout among oncology nurses. Sense of coherence protects against the negative consequences of occupational mental load and may prevent professional burnout. MATERIALS AND METHODS The study was carried out with 165 oncology nurses from chemotherapy departments. The data were collected from April to September 2013 using the Antonovsky Sense of Coherence Scale, Meister questionnaire, and Maslach Burnout Inventory. RESULTS Manageability mediated the relations between Mental Load and both Emotional Exhaustion and Depersonalization. Meaningfulness exerted significant mediational effect on the relationship between Mental Load and Depersonalization. Manageability and Meaningfulness attenuate the unfavourable effect of Monotony and Unspecific load on motional Exhaustion and Depersonalization. CONCLUSIONS Sense of coherence, especially Manageability and Meaningfulness, seems to be an important resource for oncology nurses, buffering the negative impact of mental load on well-being of nurses. Strengthening the sense of coherence can be helpful in preventing or dealing with professional burnout.
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Affiliation(s)
- Ewa Wilczek-Rużyczka
- Faculty of Psychology and Humanities, A.F. Modrzewski Krakow University, Krakow, Poland
| | - Grażyna Dębska
- Faculty of Health and Medical Studies, A.F. Modrzewski Krakow University, Krakow, Poland
| | - Małgorzata Pasek
- Faculty of Health and Medical Studies, A.F. Modrzewski Krakow University, Krakow, Poland
| | - Marta Zwierzchowska
- Faculty of Individual Differences and Psychological Diagnosis, SWPS University of Social Sciences and Humanities, Warszawa, Poland
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Vasconcelos EMD, Martino MMFD. Predictors of burnout syndrome in intensive care nurses. ACTA ACUST UNITED AC 2018; 38:e65354. [PMID: 29933422 DOI: 10.1590/1983-1447.2017.04.65354] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 07/18/2017] [Indexed: 11/21/2022]
Abstract
OBJECTIVES To identify the prevalence and analyse the existence of predictors of burnout syndrome in intensive care nurses. METHODS The quantitative, descriptive, cross sectional study with 91 intensive care nurses. Two instruments were used to collect data in July 2014: a sociodemographic form and the Maslach Burnout Inventory - Human Services Survey. Pearson's Chi-Square test or Fisher's exact test were applied to verify the association between the occurrence of burnout and the categorical variables. RESULTS Burnout affected 14.3% of the sample. Of the studied variables, only the duration of holidays had a significant association with the occurrence of burnout (p = 0034/OR = 3.92). CONCLUSIONS The prevalence of burnout in the nurses was 14.3%. Duration of the holidays was the only variable that showed a significant association with the occurrence of burnout.
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Affiliation(s)
- Eduardo Motta de Vasconcelos
- Universidade Federal de São Paulo (UNIFESP). Escola Paulista de Enfermagem, Programa de Pós-Graduação em Enfermagem. São Paulo, São Paulo, Brasil
| | - Milva Maria Figueiredo De Martino
- Universidade Federal de São Paulo (UNIFESP). Escola Paulista de Enfermagem, Programa de Pós-Graduação em Enfermagem. São Paulo, São Paulo, Brasil
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Zaninotto L, Rossi G, Danieli A, Frasson A, Meneghetti L, Zordan M, Tito P, Salvetti B, Conca A, Ferranti R, Salcuni S, Solmi M. Exploring the relationships among personality traits, burnout dimensions and stigma in a sample of mental health professionals. Psychiatry Res 2018; 264:327-333. [PMID: 29665563 DOI: 10.1016/j.psychres.2018.03.076] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2017] [Revised: 02/11/2018] [Accepted: 03/28/2018] [Indexed: 11/15/2022]
Abstract
A sample of mental health professionals (n = 215) from six Community Mental Health Services was examined using a short version of the Attribution Questionnaire-27, the Maslach Burnout Inventory and the Ten Items Personality Inventory to detect possible associations among stigma, burnout dimensions and personality traits. The role of demographic and professional variables was also explored. Perception of workplace safety resulted to significantly affect attitudes toward patients. The concern about being assaulted and a low level of Personal Accomplishment were both related to avoidant attitudes, while the presence of procedures for managing the violent patient was associated with a higher level of Personal Accomplishment. Conversely, Emotional Stability and Openness to new experiences were inversely correlated with burnout dimensions and avoidant attitudes, respectively. Overall, our study supports the view of a significant association among some dimensions of stigma, burnout and personality factors. In particular, avoidant attitudes toward patients may be influenced by Personal Accomplishment and Openness to new experiences.
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Affiliation(s)
- Leonardo Zaninotto
- Department of Mental Health, Local Health Unit n. 6 ("Euganea"), Via dei Colli n. 6/4, 35143, Padova, Italy.
| | - Genny Rossi
- Department of Mental Health, Local Health Unit n. 7 ("Pedemontana"), Via Cereria n. 14/B, 36061, Bassano del Grappa (VI), Italy
| | - Andrea Danieli
- Department of Mental Health, Local Health Unit n. 8 ("Berica"), Contrà Mure Corpus Domini n. 19, 36100, Vicenza, Italy
| | - Alberto Frasson
- Department of Mental Health, Local Health Unit n. 6 ("Euganea"), Via dei Colli n. 6/4, 35143, Padova, Italy
| | - Leonardo Meneghetti
- Department of Mental Health, Local Health Unit n. 6 ("Euganea"), Via dei Colli n. 6/4, 35143, Padova, Italy
| | - Maria Zordan
- Department of Mental Health, Local Health Unit n. 7 ("Pedemontana"), Via Cereria n. 14/B, 36061, Bassano del Grappa (VI), Italy
| | - Paolo Tito
- Department of Mental Health, Local Health Unit n. 7 ("Pedemontana"), Via Cereria n. 14/B, 36061, Bassano del Grappa (VI), Italy
| | - Beatrice Salvetti
- Department of Mental Health, Local Health Unit of Südtirol, Via Lorenz Böhler n. 5, 39100, Bolzano, Italy
| | - Andreas Conca
- Department of Mental Health, Local Health Unit of Südtirol, Via Lorenz Böhler n. 5, 39100, Bolzano, Italy
| | - Roberta Ferranti
- Department of Mental Health, Local Health Unit n. 6 ("Euganea"), Via dei Colli n. 6/4, 35143, Padova, Italy
| | - Silvia Salcuni
- Department of Developmental Psychology and Socialisation, University of Padova, Via Venezia n. 8, 35131, Padova, Italy
| | - Marco Solmi
- Department of Neurosciences, University of Padova, Via Giustiniani n. 2, 35128, Padova, Italy
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Mijakoski D, Karadzhinska-Bislimovska J, Stoleski S, Minov J, Atanasovska A, Bihorac E. Job Demands, Burnout, and Teamwork in Healthcare Professionals Working in a General Hospital that Was Analysed At Two Points in Time. Open Access Maced J Med Sci 2018; 6:723-729. [PMID: 29731948 PMCID: PMC5927511 DOI: 10.3889/oamjms.2018.159] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 12/16/2017] [Accepted: 12/17/2017] [Indexed: 11/29/2022] Open
Abstract
AIM: The purpose of the paper was to assess job demands, burnout, and teamwork in healthcare professionals (HPs) working in a general hospital that was analysed at two points in time with a time lag of three years. METHODS: Time 1 respondents (N = 325) were HPs who participated during the first wave of data collection (2011). Time 2 respondents (N = 197) were HPs from the same hospital who responded at Time 2 (2014). Job demands, burnout, and teamwork were measured with Hospital Experience Scale, Maslach Burnout Inventory, and Hospital Survey on Patient Safety Culture, respectively. RESULTS: Significantly higher scores of emotional exhaustion (21.03 vs. 15.37, t = 5.1, p < 0.001), depersonalization (4.48 vs. 2.75, t = 3.8, p < 0.001), as well as organizational (2.51 vs. 2.34, t = 2.38, p = 0.017), emotional (2.46 vs. 2.25, t = 3.68, p < 0.001), and cognitive (2.82 vs. 2.64, t = 2.68, p = 0.008) job demands were found at Time 2. Teamwork levels were similar at both points in time (Time 1 = 3.84 vs. Time 2 = 3.84, t = 0.043, p = 0.97). CONCLUSION: Actual longitudinal study revealed significantly higher mean values of emotional exhaustion and depersonalization in 2014 that could be explained by significantly increased job demands between analysed points in time.
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Affiliation(s)
- Dragan Mijakoski
- Institute of Occupational Health of Republic of Macedonia, WHO Collaborating Center, Skopje, Republic of Macedonia
| | | | - Sasho Stoleski
- Institute of Occupational Health of Republic of Macedonia, WHO Collaborating Center, Skopje, Republic of Macedonia
| | - Jordan Minov
- Institute of Occupational Health of Republic of Macedonia, WHO Collaborating Center, Skopje, Republic of Macedonia
| | - Aneta Atanasovska
- Institute of Occupational Health of Republic of Macedonia, WHO Collaborating Center, Skopje, Republic of Macedonia
| | - Elida Bihorac
- MPH candidate, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
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Time trends of comparative self-rated health in adults aged 25-34 in the Northern Sweden MONICA study, 1990-2014. PLoS One 2017; 12:e0187896. [PMID: 29155858 PMCID: PMC5695772 DOI: 10.1371/journal.pone.0187896] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 10/27/2017] [Indexed: 12/16/2022] Open
Abstract
Self-rated health (SRH) accounts comprehensively for many health domains. The aim of this paper was to investigate time trends and associations between age-comparative self-rated health and some known determinants in a general population aged 24-34 years. Population-based cross-sectional surveys were performed in 1990, 1994, 1999, 2004, 2009 and 2014 in Northern Sweden. Out of 3500 invited persons, 1811 responded. Comparative SRH was measured on a three-grade ordinal scale by the question: "How would you assess your general health condition compared to persons of your own age?" with the alternatives "better/worse/similar". Over the period 1990 to 2014, the percentage of women rating comparative SRH as "worse" increased steadily, from 8.5% in 1990 reaching 20% in 2014 (p for trend 0.007). Among men, this pattern was almost the opposite, with increasing proportions rating "better" (p for trend <0.000). Time trends for physical activity in leisure time; length of education; Body Mass Index; anxiety; depressive emotions and satisfaction with economy showed a similar pattern for men and women. Factors that might contribute to the development of time trends for comparative SRH are discussed.
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Salminen-Tuomaala M, Ala-Hynnilä L, Hämäläinen K, Ruohomäki H. Challenges and factors likely to promote coping as anticipated by nurses preparing for a merger of intensive and intermediate care units. Intensive Crit Care Nurs 2017; 43:68-74. [PMID: 28869147 DOI: 10.1016/j.iccn.2017.07.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2017] [Revised: 07/07/2017] [Accepted: 07/15/2017] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To describe challenges and factors that support coping as anticipated by nursing staff preparing for a merger of intensive and intermediate care units. RESEARCH METHODOLOGY The method of empathy-based stories was employed to collect data from staff. The stories (n=20) were analysed using inductive content analysis. SETTING Nursing staff from the cardiac observation and evaluation, intensive care and surgical observation units in a central hospital in Finland. FINDINGS Participants anticipated challenges related to personal factors that affect coping at work, challenges in co-operation among nursing staff and problems associated with the new work context. Participants expected to need informational, concrete and social support from colleagues in future clinical nursing situations. CONCLUSION Fostering peer support and team spirit is important to ensure staff co-operation and smooth care processes following restructuring.
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Affiliation(s)
- Mari Salminen-Tuomaala
- Seinäjoki University of Applied Sciences, School of Health Care and Social Work, Koskenalantie 17, 60220, Seinäjoki, Finland.
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Storkholm MH, Mazzocato P, Savage M, Savage C. Money's (not) on my mind: a qualitative study of how staff and managers understand health care's triple Aim. BMC Health Serv Res 2017; 17:98. [PMID: 28143539 PMCID: PMC5282791 DOI: 10.1186/s12913-017-2052-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 01/24/2017] [Indexed: 11/11/2022] Open
Abstract
Background The “Triple Aim” – provision of a better care experience and improved population health at a lower cost – may be theoretically sound, but paradoxical in practice as it forces together the logics of management and medicine. The aim of this study was to explore how staff and managers understand the change imperative inherent to the Triple Aim and the mental models underlying their understanding. Methods This qualitative study builds on thirty semi-structured interviews conducted with managers, nurses, midwives, medical secretaries, and physicians at a department of Gynecology and Obstetrics in Denmark who successfully cut costs through staff and bed reductions and, from what we can ascertain, maintained care quality. Mental models were articulated from a content analysis of the interviews. Results Staff and managers identified with the different dimensions of the Triple Aim along classic professional divides, i.e. nurses and midwives focused on patient experience, physicians on health outcomes, and manager on all three. Underlying these, we found four mental models. The understanding of change was guided by a Professional ethos (inner drive to improve care) and a Socio-political discourse (external requirement to become more efficient) mental model. The understanding of economics was guided by a You-get-what-you-pay-for and by a More-bang-for-the-buck mental model. A complex interplay could be discerned between all four, which led staff to see the Triple Aim as a dilemma between quality and economics and a threat to clinical care and quality, whereas managers saw it as a paradox that invited improvement efforts. Despite these differences, managers chose a change strategy in line with staff mental models. Conclusions The practical challenges inherent to the Triple Aim may be symptomatic of the interactions between the different mental models that guide staff and managers’ understanding and choice of change strategies. Pursuit of quality improvement in the face of financial constraints (the essence of the Triple Aim) may be facilitated through conscious exploration of these empirically identified mental models. Managers might do well to translate the socio-political discourse into a change process that resonates with the mental models held by staff.
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Affiliation(s)
- Marie Höjriis Storkholm
- Department of Learning, Informatics, Management and Ethics, Medical Management Centre, Karolinska Institutet, Tomtebodavägen 18A, 171 77, Stockholm, Sweden.,Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark
| | - Pamela Mazzocato
- Department of Learning, Informatics, Management and Ethics, Medical Management Centre, Karolinska Institutet, Tomtebodavägen 18A, 171 77, Stockholm, Sweden
| | - Mairi Savage
- Department of Learning, Informatics, Management and Ethics, Medical Management Centre, Karolinska Institutet, Tomtebodavägen 18A, 171 77, Stockholm, Sweden
| | - Carl Savage
- Department of Learning, Informatics, Management and Ethics, Medical Management Centre, Karolinska Institutet, Tomtebodavägen 18A, 171 77, Stockholm, Sweden.
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Vifladt A, Simonsen BO, Lydersen S, Farup PG. The association between patient safety culture and burnout and sense of coherence: A cross-sectional study in restructured and not restructured intensive care units. Intensive Crit Care Nurs 2016; 36:26-34. [DOI: 10.1016/j.iccn.2016.03.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 03/11/2016] [Accepted: 03/16/2016] [Indexed: 10/21/2022]
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Henriksen L, Lukasse M. Burnout among Norwegian midwives and the contribution of personal and work-related factors: A cross-sectional study. SEXUAL & REPRODUCTIVE HEALTHCARE 2016; 9:42-7. [PMID: 27634664 DOI: 10.1016/j.srhc.2016.08.001] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 07/27/2016] [Accepted: 08/01/2016] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Burnout can be the result of long-term exposure to personal and/or work-related stressors and affect midwives performance of care. AIM To assess burnout levels among Norwegian midwives and identify personal and work-related factors associated with burnout. METHODS A cross-sectional study. A total of 1500 Norwegian midwives were sent a questionnaire which included the Copenhagen Burnout Inventory (CBI) that measured personal, work- and client-related burnout. Of 1458 eligible midwives, 598 completed the CBI. Descriptive and comparative analyses were done in addition to logistic regression modelling. RESULTS Approximately 20% reported personal or work-related burnout. Less than 5% reported client-related burnout. Midwives with sick leave within the last three months reported higher levels of burnout. The prevalence of work-related burnout was higher among younger and single midwives. Working in outpatient care and experience of a recent reorganisation increased the likelihood of reporting personal and work-related burnout. CONCLUSION One in five midwives had high levels of personal and work-related burnout in this study and the different sub-groups of burnout were all associated with absence from work within the last three months. Work-related factors such as shift work and number of working hours did not seem to influence burnout in this population.
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Affiliation(s)
- Lena Henriksen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Postboks 4 St. Olavs plass, N-0130 Oslo, Norway; Division of General Gynaecology and Obstetrics, Oslo University Hospital, Postboks 4950 Nydalen, N-0424 Oslo, Norway.
| | - Mirjam Lukasse
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Postboks 4 St. Olavs plass, N-0130 Oslo, Norway
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Galindo RH, Feliciano KVDO, Lima RADS, de Souza AI. [Burnout syndrome among general hospital nurses in Recife]. Rev Esc Enferm USP 2016; 46:420-7. [PMID: 22576547 DOI: 10.1590/s0080-62342012000200021] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2010] [Accepted: 10/18/2011] [Indexed: 11/22/2022] Open
Abstract
This descriptive, cross sectional, census study identified the occurrence of Burnout and some associated factors among nurses working in obstetrics & gynecology and pediatric care at a general tertiary hospital in Recife. Sixty-three nurses (98.4%) answered a self-administered questionnaire (sociodemographic aspects, working conditions, and Maslach Burnout Inventory). Chi-square was used in the analysis with a 95% confidence level. Most participants were female (92.1%), with up to five years in the career (68.2%), 52.5% in pediatric area. High levels of emotional stress (49.2%) and depersonalization (27.0%) were identified, as well as low professional fulfillment (4.8%), and 4.7% presented Burnout. The following factors wee associated: high levels of emotional stress and often/always perform tasks very quickly (p=0.039) and receiving a salary incompatible to the effort employed (p=0.016); high levels of depersonalization and with up to five years in this career (p=0.010) and often/always perform tasks very quickly (p=0.009). For 19.0%, at least two of the three dimensions pointed to high propensity to the syndrome.
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Vifladt A, Simonsen BO, Lydersen S, Farup PG. Changes in patient safety culture after restructuring of intensive care units: Two cross-sectional studies. Intensive Crit Care Nurs 2015; 32:58-65. [PMID: 26604040 DOI: 10.1016/j.iccn.2015.06.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Revised: 05/21/2015] [Accepted: 06/30/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Compare changes in registered nurses' perception of the patient safety culture in restructured and not restructured intensive care units during a four-year period. METHODOLOGY/DESIGN Two cross-sectional surveys were performed, in 2008/2009 (time 1) and 2012/2013 (time 2). During a period of 0-3 years after time 1, three of six hospitals merged their general and medical intensive care units (restructured). The other hospitals maintained their structure of the intensive care units (not restructured). SETTING Intensive care units in hospitals at one Norwegian hospital trust. OUTCOME MEASURE The safety culture was measured with Hospital Survey on Patient Safety Culture. RESULTS At times 1 and 2, 217/302 (72%) and 145/289 (50%) registered nurses participated. Restructuring was negatively associated with change in the safety culture, in particular, the dimensions of the safety culture within the unit level. The dimensions most vulnerable for restructuring were manager expectations and actions promoting safety, teamwork within hospital units and staffing. CONCLUSION In this study, the restructuring of intensive care units was associated with a negative impact on the safety culture. When restructuring, the management should be particularly aware of changes in the safety culture dimensions manager expectations and actions promoting safety, teamwork within hospital units and staffing.
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Affiliation(s)
- Anne Vifladt
- Department of Research, Innlandet Hospital Trust, Brumunddal, Norway; Unit for Applied Clinical Research, Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
| | - Bjoerg O Simonsen
- Department of Quality and Patient Safety, Innlandet Hospital Trust, Brumunddal, Norway.
| | - Stian Lydersen
- Regional Centre for Child and Youth Mental Health and Child Welfare, Norwegian University of Science and Technology, Trondheim, Norway.
| | - Per G Farup
- Department of Research, Innlandet Hospital Trust, Brumunddal, Norway; Unit for Applied Clinical Research, Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
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Amamou B, Bannour AS, Ben Hadj Yahia M, Ben Nasr S, Ben Hadj Ali B. [High prevalence of burnout in the Tunisian units that support terminally ill patients]. Pan Afr Med J 2015; 19:9. [PMID: 25584122 PMCID: PMC4286216 DOI: 10.11604/pamj.2014.19.9.2865] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2013] [Accepted: 01/26/2014] [Indexed: 11/25/2022] Open
Abstract
Introduction Chez le personnel soignant, le burnout touche un infirmier sur trois. Ce taux est plus élevé dans les unités prenant en charge des patients en fin de vie. L'objectif de notre travail était d'évaluer la fréquence du burnout chez les infirmiers qui travaillent en soins de fin de vie. Méthodes Il s'agit d'une étude descriptive transversale réalisée entre le 1er Avril et le 31 Mai 2010. 60 infirmiers de six services de Sousse et de Monastir (Tunisie) ont été recrutés. L'évaluation du burnout a été réalisée par deux échelles: MBI (Maslach Burnout Inventory) et BMS (Burnout Measure Short version). Résultats La prévalence du burnout était de 70%; il était élevé chez 81.7%. 80% avaient un niveau élevé d'épuisement émotionnel, 70% avaient un niveau élevé de dépersonnalisation et 17% avaient un niveau bas de sentiment d'accomplissement personnel. Le burnout était plus élevé chez les hommes (70,8% vs 69,4%; p=0,013); ceux qui voulaient améliorer les conditions du travail (70.2% vs. 66.7%; p= 0.017); du salaire (70.2% vs. 66.7%; p= 0.017) et chez les infirmiers suivi en psychiatrie (71.4% vs. 69.8%; p= 0.008). Conclusion Dans notre étude le niveau de burnout était élevé chez les infirmiers prenant en charge des patients en fin de vie. Il était associé au sexe masculin et à l'insatisfaction des conditions de travail et du salaire. D'autres études longitudinales sont nécessaires pour suivre l'évolution de ce syndrome et mettre des stratégies de prévention adéquates.
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Affiliation(s)
- Badii Amamou
- Service de psychiatrie, CHU Farhat Hached de Sousse, Faculté de Médecine Ibn Jazzar de Sousse, Université de Sousse, Tunisie
| | - Ahmed Souhaiel Bannour
- Service de psychiatrie, CHU Farhat Hached de Sousse, Faculté de Médecine Ibn Jazzar de Sousse, Université de Sousse, Tunisie
| | - Meriem Ben Hadj Yahia
- Service de psychiatrie, CHU Farhat Hached de Sousse, Faculté de Médecine Ibn Jazzar de Sousse, Université de Sousse, Tunisie
| | - Selma Ben Nasr
- Service de psychiatrie, CHU Farhat Hached de Sousse, Faculté de Médecine Ibn Jazzar de Sousse, Université de Sousse, Tunisie
| | - Bechir Ben Hadj Ali
- Service de psychiatrie, CHU Farhat Hached de Sousse, Faculté de Médecine Ibn Jazzar de Sousse, Université de Sousse, Tunisie
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Ding Y, Qu J, Yu X, Wang S. The mediating effects of burnout on the relationship between anxiety symptoms and occupational stress among community healthcare workers in China: a cross-sectional study. PLoS One 2014; 9:e107130. [PMID: 25211025 PMCID: PMC4161428 DOI: 10.1371/journal.pone.0107130] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Accepted: 08/03/2014] [Indexed: 12/04/2022] Open
Abstract
Background Several occupational stress studies of healthcare workers have predicted a high prevalence of anxiety symptoms, which can affect their quality of life and the care that they provide. However, few studies have been conducted among community healthcare workers in China. We attempted to explore whether burnout mediates the association between occupational stress and anxiety symptoms. Methods A cross-sectional survey was completed in Liaoning Province, China from November to December 2012. A total of 1,752 healthcare workers from 52 Community Health Centers participated in this study, and all participants were given self-administered questionnaires. These questionnaires addressed the following aspects: the Zung Self-Rating Anxiety Scale, the Chinese version of the effort-reward imbalance scale and the Maslach Burnout Inventory–General Survey. Finally, the study included 1,243 effective respondents (effective response rate, 70.95%). Hierarchical linear regression analysis, performed with SPSS 17.0, was used to estimate the effect of burnout. Results The prevalence of anxiety symptoms among the community healthcare workers was 38.0%. After adjusting for demographic characteristics, the effort–reward ratio and overcommitment positively predicted anxiety symptoms. Meanwhile, the effort–reward ratio and overcommitment were positively related to the emotional exhaustion and cynicism subscales of burnout. In addition, the emotional exhaustion and cynicism subscales were positively related to anxiety symptoms. Thus, there is a link between burnout, occupational stress and anxiety symptoms. Conclusions Burnout mediates the effect of occupational stress on anxiety symptoms. To effectively reduce the impact of occupational stress on anxiety symptoms, burnout management should be considered.
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Affiliation(s)
- Yanwei Ding
- Department of General Practice, The First Affiliated Hospital, China Medical University, Shenyang, Liaoning, China
| | - Jianwei Qu
- Department of General Practice, The First Affiliated Hospital, China Medical University, Shenyang, Liaoning, China
| | - Xiaosong Yu
- Department of General Practice, The First Affiliated Hospital, China Medical University, Shenyang, Liaoning, China
- * E-mail:
| | - Shuang Wang
- Department of General Practice, The First Affiliated Hospital, China Medical University, Shenyang, Liaoning, China
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Åhlin J, Ericson-Lidman E, Norberg A, Strandberg G. A comparison of assessments and relationships of stress of conscience, perceptions of conscience, burnout and social support between healthcare personnel working at two different organizations for care of older people. Scand J Caring Sci 2014; 29:277-87. [DOI: 10.1111/scs.12161] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Accepted: 06/10/2014] [Indexed: 01/10/2023]
Affiliation(s)
- Johan Åhlin
- Department of Nursing; Umeå University; Umeå Sweden
| | | | - Astrid Norberg
- Department of Nursing; Umeå University; Umeå Sweden
- Ersta Sköndal University College; Stockholm Sweden
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Bouamrane MM, Mair FS. A study of clinical and information management processes in the surgical pre-assessment clinic. BMC Med Inform Decis Mak 2014; 14:22. [PMID: 24666471 PMCID: PMC4012827 DOI: 10.1186/1472-6947-14-22] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2013] [Accepted: 03/07/2014] [Indexed: 01/18/2023] Open
Abstract
Background Establishing day-case surgery as the preferred hospital admission route for all eligible patients requires adequate preoperative assessment of patients in order to quickly distinguish those who will require minimum assessment and are suitable for day-case admission from those who will require more extensive management and will need to be admitted as inpatients. Methods As part of a study to elucidate clinical and information management processes within the patient surgical pathway in NHS Scotland, we conducted a total of 10 in-depth semi-structured interviews during 4 visits to the Dumfries & Galloway Royal Infirmary surgical pre-assessment clinic. We modelled clinical processes using process-mapping techniques and analysed interview data using qualitative methods. We used Normalisation Process Theory as a conceptual framework to interpret the factors which were identified as facilitating or hindering information elucidation tasks and communication within the multi-disciplinary team. Results The pre-assessment clinic of Dumfries & Galloway Royal Infirmary was opened in 2008 in response to clinical and workflow issues which had been identified with former patient management practices in the surgical pathway. The preoperative clinic now operates under well established processes and protocols. The use of a computerised system for managing preoperative documentation substantially transformed clinical practices and facilitates communication and information-sharing among the multi-disciplinary team. Conclusion Successful deployment and normalisation of innovative clinical and information management processes was possible because both local and national strategic priorities were synergistic and the system was developed collaboratively by the POA staff and the health-board IT team, resulting in a highly contextualised operationalisation of clinical and information management processes. Further concerted efforts from a range of stakeholders are required to fully integrate preoperative assessment within the health-board surgical care pathway. A substantial – yet unfulfilled – potential benefit in embedding information technology in routine use within the preoperative clinic would be to improve the reporting of surgical outcomes.
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Havaei F, Dahinten VS, MacPhee M. The effects of perceived organisational support and span of control on the organisational commitment of novice leaders. J Nurs Manag 2013; 23:307-14. [DOI: 10.1111/jonm.12131] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Farinaz Havaei
- School of Nursing; University of British Columbia; Vancouver BC Canada
| | - V. Susan Dahinten
- School of Nursing; University of British Columbia; Vancouver BC Canada
| | - Maura MacPhee
- School of Nursing; University of British Columbia; Vancouver BC Canada
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Koivunen M, Kontio R, Pitkänen A, Katajisto J, Välimäki M. Occupational stress and implementation of information technology among nurses working on acute psychiatric wards. Perspect Psychiatr Care 2013; 49:41-9. [PMID: 23293996 DOI: 10.1111/j.1744-6163.2012.00339.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
PURPOSE The study describes nurses' occupational stress and implementation of information technology on acute psychiatric wards. DESIGN AND METHODS The sample consisted of 146 Finnish nurses. The data were collected using a structured questionnaire in 2006. FINDINGS Eleven percent of the nurses felt that work was very mentally strenuous and 45% felt that it was rather mentally strenuous. Male nurses reported more stress and dissatisfaction than female nurses. Nurses with very positive attitudes towards Internet use reported less stress and more job satisfaction than nurses with neutral attitudes towards Internet use. PRACTICE IMPLICATIONS By supporting positive attitudes to information technology in nurses' daily work, we may increase their job satisfaction and thereby reduce their stress experiences.
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Better Interprofessional Teamwork, Higher Level of Organized Care, and Lower Risk of Burnout in Acute Health Care Teams Using Care Pathways. Med Care 2013; 51:99-107. [DOI: 10.1097/mlr.0b013e3182763312] [Citation(s) in RCA: 81] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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