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Wang Q, Luan Y, Liu D, Dai J, Wang H, Zhang Y, Wang S, Dong X, Bi H. Guided self-help mindfulness-based intervention for increasing psychological resilience and reducing job burnout in psychiatric nurses: A randomized controlled trial. Int J Nurs Pract 2024; 30:e13204. [PMID: 37727093 DOI: 10.1111/ijn.13204] [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: 01/11/2023] [Revised: 08/30/2023] [Accepted: 09/01/2023] [Indexed: 09/21/2023]
Abstract
AIMS The present study aimed to explore the effects of a guided self-help mindfulness intervention on psychological resilience and job burnout among psychiatric nurses. BACKGROUND Psychiatric nurses work in challenging and potentially high stress settings. Mindfulness interventions can improve psychological resilience and reduce job burnout of nurses. However, face-to-face delivery of mindfulness interventions may be inconvenient for individuals. Guided self-help interventions may be more accessible. METHODS This randomized controlled trial was conducted from January to August 2022. One hundred and eighteen psychiatric nurses were randomized into the intervention and control groups. The individuals in the intervention group received an 8-week guided self-help mindfulness intervention, while the individuals in the control group received a psycho-educational brochure. The Five Facet Mindfulness Questionnaire, the Connor-Davidson Resilience Scale and the Maslach Burnout Inventory-Human Services Survey were used to evaluate the levels of mindfulness, psychological resilience and job burnout, respectively. RESULTS After an 8-week intervention, compared with the control group, the levels of mindfulness and psychological resilience were higher, while the level of job burnout was lower in the intervention group. CONCLUSIONS The guided self-help mindfulness intervention can improve psychological resilience and reduce job burnout among psychiatric nurses.
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Affiliation(s)
- Qi Wang
- Department of Psychiatry and Psychology, General Hospital of Northern Theater Command, Shenyang, Liaoning, China
| | - Yue Luan
- Third Hospital of Daqing, Daqing, Heilongjiang, China
| | - Dandan Liu
- Third Hospital of Daqing, Daqing, Heilongjiang, China
| | - Jiali Dai
- Third Hospital of Daqing, Daqing, Heilongjiang, China
| | - Haina Wang
- Third Hospital of Daqing, Daqing, Heilongjiang, China
| | - Yang Zhang
- Third Hospital of Daqing, Daqing, Heilongjiang, China
| | - Shuang Wang
- Third Hospital of Daqing, Daqing, Heilongjiang, China
| | - Xiaomei Dong
- Department of Psychiatry and Psychology, General Hospital of Northern Theater Command, Shenyang, Liaoning, China
| | - Hongsheng Bi
- Third Hospital of Daqing, Daqing, Heilongjiang, China
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Merino-Soto C, Angulo-Ramos M, Llaja-Rojas V, Chans GM. Academic performance, emotional intelligence, and academic burnout: A cross-sectional study of a mediational effect in nursing students. NURSE EDUCATION TODAY 2024; 139:106221. [PMID: 38691900 DOI: 10.1016/j.nedt.2024.106221] [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: 07/19/2023] [Revised: 04/06/2024] [Accepted: 04/17/2024] [Indexed: 05/03/2024]
Abstract
BACKGROUND Course failure arises as the ultimate result of students' declining academic performance in the face of high course demands. It can eventually lead to dropout and academic dissatisfaction. Emotional intelligence may play an essential role in decreasing the emotional effects of stress, such as academic burnout in nursing students. However, emotional intelligence is conceptualized multidimensionally, and each of its attributes may have a different impact on burnout reduction. OBJECTIVE To explore the dimensions of emotional intelligence that may mediate the association between academic performance (course failure) and academic burnout in nursing students. DESIGN The design was cross-sectional, with survey-based data collection. SETTINGS Educational setting, undergraduate nursing students at a private university in Metropolitan Lima, Peru. PARTICIPANTS 154 students (77.3 % female) with a mean age of 25.9 years. METHODS A multiple mediation strategy was used, using the Wong-Law Emotional Intelligence Scale. Four emotional intelligence attributes (self-emotional appraisal, others' emotional appraisal, use of emotion, and regulation of emotion) were evaluated in the relationship of failed courses (dichotomous variable: yes/no) and academic burnout (single item based on physical and emotional exhaustion). The structural equation modeling framework was used. RESULTS Course failure (academic performance) positively affects academic burnout. Regulation of emotion is the only dimension of emotional intelligence mediating between course failure and academic burnout. The proportion of the mediating effect was 0.315, while the rest was around zero. Statistically significant gender differences were detected concerning burnout, with men scoring moderately higher than women. CONCLUSIONS The results indicate that the regulation of emotion may have a relevant role in reducing burnout compared to other emotional intelligence attributes. These regulatory skills are important for developing health care and positive patient relationships. Interventions focused on the regulatory characteristics of emotions and distinguishing different attributes of emotional intelligence while exploring its mediating effect should be strengthened. These implications are linked to the growing call to include EI in university education.
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Affiliation(s)
- César Merino-Soto
- Tecnologico de Monterrey, Institute for the Future of Education, Monterrey 64849, Mexico.
| | | | - Victoria Llaja-Rojas
- Universidad Nacional Mayor de San Marcos, Lima 15081, Peru; Hospital Nacional Edgardo Rebagliati Martins, Lima 15072, Peru
| | - Guillermo M Chans
- Tecnologico de Monterrey, Institute for the Future of Education, Monterrey 64849, Mexico; Tecnologico de Monterrey, School of Engineering and Sciences, Mexico City 01389, Mexico.
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Hu J, Zhai M, Fu D, Duan Z, Chen X. Mediating role of loneliness and emotional disturbance in the association between childhood trauma and occupational burnout among nurses: a cross-sectional study. Front Psychiatry 2024; 15:1394289. [PMID: 38827443 PMCID: PMC11140593 DOI: 10.3389/fpsyt.2024.1394289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 04/29/2024] [Indexed: 06/04/2024] Open
Abstract
Background The occupational burnout status of nurses in China warrants attention. Childhood trauma, loneliness, and emotional disturbance are significant predictors of this burnout, yet few studies have delved into the underlying mechanisms. This study seeks to explore the mediating pathway from childhood trauma to loneliness, emotional disturbance, and ultimately occupational burnout among nurses through a cross-sectional analysis. Method Data for the study were collected from Yunnan province, China, from 11 July to 26 July 2022. Key variables were measured using standardized scales: the Childhood Trauma Questionnaire Short Form for childhood trauma, the three-item loneliness scale for loneliness, the Patient Health Questionnaire and the Generalized Anxiety Disorder questionnaire for emotional disturbance, and the Maslach Burnout Inventory-Human Service Survey for occupational burnout. Mediation modeling analysis was employed for data analysis to test the effect of loneliness and emotional disturbance on the association between childhood trauma and occupational burnout. Data analysis was conducted using AMOS and SPSS software. Results Loneliness and emotional disturbance fully mediated the association between childhood trauma and emotional exhaustion [indirect effect (95% CI) = 0.228 (0.196, 0.270)]. Loneliness and emotional disturbance partially mediated the association between childhood trauma [indirect effect (95% CI) = -0.020 (-0.039, 0.002)] and personal accomplishment or depersonalization [indirect effect (95% CI) = 0.221 (0.186, 0.255)]. Conclusion Childhood trauma could affect occupational burnout through loneliness and emotional disturbance among nurses. Preventive strategies could include protective interventions like treatment of loneliness and emotional disturbance, especially in nurses who experienced childhood trauma.
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Affiliation(s)
- Jing Hu
- Department of Cardiovascular, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
| | - Mengxi Zhai
- School of Public Health, Wuhan University, Wuhan, Hubei, China
| | - Donghui Fu
- Department of Urology, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
| | - Zhizhou Duan
- Preventive Health Service, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
| | - Xiangfan Chen
- Department of Biobank, Nantong First People’s Hospital, Nantong, Jiangsu, China
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Yslado Mendez RM, Sanchez-Broncano J, Mendoza Ramirez GD, Villarreal-Zegarra D. Prevalence and factors associated with burnout syndrome in Peruvian health professionals before the COVID-19 pandemic: A systematic review. Heliyon 2024; 10:e30125. [PMID: 38726126 PMCID: PMC11078627 DOI: 10.1016/j.heliyon.2024.e30125] [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: 07/22/2023] [Revised: 04/09/2024] [Accepted: 04/19/2024] [Indexed: 05/12/2024] Open
Abstract
Introduction Burnout syndrome (BS) is a prevalent occupational health problem in health professionals. To describe the prevalence and factors associated with BS in Peruvian health professionals. Method A systematic review and meta-analysis were performed. The key terms "burnout" and "professional exhaustion" were used with words related to Peru. The databases consulted were LILACS/Virtual Health Library, Medline/PubMed, Science Direct, EBSCO, Scopus, SciELO, and RENATI-SUNEDU; articles published between January 2000 to December 2020 were considered for inclusion. Methodological quality was evaluated using the Newcastle-Ottawa scale. Results Thirty studies were identified (8 scientific articles and 22 graduate theses). The median sample size was 78, with an interquartile range of 50-110. A meta-analysis was performed to calculate a dichotomic prevalence of burnout syndrome in health professionals of 25 % (95%CI: 9 %-45 %; I2 = 97.14 %; 5 studies). Also, our meta-analysis estimated the overall prevalence of mild burnout (27 %; 95%CI: 16%-41 %; I2 = 96.50 %), moderate burnout (48 %; 95%CI: 32%-65 %; I2 = 97.54 %), and severe burnout (17 %; 95%CI: 10%-24 %; I2 = 92.13 %; 18 studies). We present meta-analyses by region, profession, hospital area, and by dimension of the Maslach Burnout Inventory. Overall, the studies presented adequate levels of quality in 96.7 % of the included studies (n = 29). In addition, our narrative review of factors associated with BS and its three dimensions identified that different studies find associations with labor, socio-demographic, individual, and out-of-work factors. Conclusions There is a higher prevalence of moderate BS in Peruvian health professionals at MINSA and EsSalud hospitals in Peru, with severity differing by region of Peru, type of profession, work area, and dimensions of BS.
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Siddique S, Gore R, Zhang Y, Punnett L. Emotional Exhaustion in Healthcare Workers: Moving Beyond Coping Skills to Improve Organizational Conditions. J Occup Environ Med 2024; 66:e125-e130. [PMID: 38349324 DOI: 10.1097/jom.0000000000003063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
OBJECTIVE Emotional exhaustion (EE)-the first stage of burnout-is related to preventable work environment exposures. We examined the understudied impact of organizational support for safety (OSS) and safety hazards (SH) on EE in a mixed licensed and unlicensed population of healthcare workers (HCWs). METHODS A work environment exposures survey was conducted in five US public healthcare facilities in 2018-2019. A total of 1059 questionnaires were collected from a predominantly female population of mixed HCWs. RESULTS Mean EE scores were higher among women, direct care workers, and younger subjects. In linear regression models, EE was positively associated with SH, emotional labor, psychological demands, physical demands, job strain, assault, and negative acts, while OSS was negatively associated. Safety hazard s both mediated and moderated the relationship between OSS and EE. CONCLUSIONS When perception of SH is high, OSS has less impact on reducing EE, suggesting a need to effectively put safety policies to practice for improving EE in HCWS.
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Affiliation(s)
- Sundus Siddique
- From the Center for the Promotion of Health in the New England Workplace, Lowell, Massachusetts (CPH-NEW) (S.S., R.G., L.P.); Department of Public Health, Zuckerberg College of Health Sciences, University of Massachusetts Lowell, Lowell, Massachusetts (S.S.); Department of Biomedical Engineering, Francis College of Engineering, University of Massachusetts Lowell, Lowell, Massachusetts (R.G.); Solomont School of Nursing, Zuckerberg College of Health Sciences, University of Massachusetts Lowell, Lowell, Massachusetts (Y.Z.); and Department of Biomedical Engineering, Francis College of Engineering, University of Massachusetts Lowell, Lowell, Massachusetts (L.P.)
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Endalamaw A, Khatri RB, Erku D, Zewdie A, Wolka E, Nigatu F, Assefa Y. Barriers and strategies for primary health care workforce development: synthesis of evidence. BMC PRIMARY CARE 2024; 25:99. [PMID: 38539068 PMCID: PMC10967164 DOI: 10.1186/s12875-024-02336-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 03/11/2024] [Indexed: 07/23/2024]
Abstract
BACKGROUND Having a sufficient and well-functioning health workforce is crucial for reducing the burden of disease and premature death. Health workforce development, focusing on availability, recruitment, retention, and education, is inseparable from acceptability, motivation, burnout, role and responsibility, and performance. Each aspect of workforce development may face several challenges, requiring specific strategies. However, there was little evidence on barriers and strategies towards comprehensive health workforce development. Therefore, this review explored barriers and strategies for health workforce development at the primary health care level around the world. METHODS A scoping review of reviews was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analysis Extension for Scoping Reviews. The article search was performed in Google Scholar, PubMed, Web of Science, and EMBASE. We used EndNote x9 for managing the collected articles, screening processes, and citation purpose. The scoping review included any kind of review articles on the application of health workforce development concepts, such as availability, recruitment, retention, role and responsibility, education and training, motivation, and burnout, with primary health care and published in English anywhere in the world. Based on the concepts above, barriers and strategies for health workforce development were identified. The findings were synthesized qualitatively based on the building blocks of the health system framework. The analysis involved specific activities such as familiarization, construction of the thematic framework, indexing, charting, and interpretation. The results were presented in texts, tables, and figures. RESULTS The search strategies yielded 7,276 papers were found. Of which, 69 were included in the scoping review. The most frequently cited barriers were financial challenges and issues related to health care delivery, such as workloads. Barriers affecting healthcare providers directly, including lack of training and ineffective teamwork, were also prominent. Other health system and governance barriers include lack of support, unclear responsibility, and inequity. Another notable barrier was the shortage of health care technology, which pertains to both health care supplies and information technology. The most common cited effective strategies were ongoing support and supervision, engaging with communities, establishing appropriate primary care settings, financial incentives, fostering teamwork, and promoting autonomous health care practice. CONCLUSIONS Effective leadership/governance, a robust health financing system, integration of health information and technology, such as mobile health and ensuring a consistent supply of adequate resources are also vital components of primary health care workforce development. The findings highlight the importance of continuous professional development, which includes training new cadres, implementing effective recruitment and retention mechanisms, optimising the skill mix, and promoting workplace wellness. These elements are essential in fostering a well-trained and resilient primary health care workforce.
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Affiliation(s)
- Aklilu Endalamaw
- School of Public Health, The University of Queensland, Brisbane, Australia.
- College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
| | - Resham B Khatri
- School of Public Health, The University of Queensland, Brisbane, Australia
- Health Social Science and Development Research Institute, Kathmandu, Nepal
| | - Daniel Erku
- School of Public Health, The University of Queensland, Brisbane, Australia
- Centre for Applied Health Economics, School of Medicine, Griffith University, Brisbane, Australia
| | - Anteneh Zewdie
- International Institute for Primary Health Care in Ethiopia, Addis Ababa, Ethiopia
| | - Eskinder Wolka
- International Institute for Primary Health Care in Ethiopia, Addis Ababa, Ethiopia
| | - Frehiwot Nigatu
- International Institute for Primary Health Care in Ethiopia, Addis Ababa, Ethiopia
| | - Yibeltal Assefa
- School of Public Health, The University of Queensland, Brisbane, Australia
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Küppers L, Göbel J, Aretz B, Rieger MA, Weltermann B. Associations between COVID-19 Pandemic-Related Overtime, Perceived Chronic Stress and Burnout Symptoms in German General Practitioners and Practice Personnel-A Prospective Study. Healthcare (Basel) 2024; 12:479. [PMID: 38391854 PMCID: PMC10888352 DOI: 10.3390/healthcare12040479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 02/07/2024] [Accepted: 02/08/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND The mental burdens of general practitioners (GPs) and practice assistants (PrAs) during the COVID-19 pandemic are well investigated. Work-related conditions like overtime are known to contribute to perceived chronic stress and burnout symptoms. However, there is limited evidence regarding the specific mechanisms, which link pandemic-related overtime, chronic stress and burnout symptoms. This study used data from the IMPROVEjob trial to improve psychological well-being in general practice personnel. METHODS This prospective study with 226 German GPs and PrAs used the baseline (pre-pandemic: October 2019 to March 2020) and follow-up data (pandemic: October 2020 to April 2021) of the IMPROVEjob trial. Overtime was self-reported as hours above the regular work time. Perceived chronic stress was assessed using the Trier Inventory for the Assessment of Chronic Stress Screening Scale (TICS-SSCS), while burnout symptoms were evaluated using a short version of the Maslach Burnout Inventory (MBI). A mediation analysis investigated the differences of the three main variables between pre-pandemic and pandemic periods. RESULTS Burnout symptoms increased significantly from baseline to follow-up (p = 0.003). Overtime correlated positively with burnout symptoms (Total Effect: 0.13; 95% CI: 0.03, 0.23). Decomposition of the total effect revealed a significant indirect effect over perceived chronic stress (0.11; 95% CI: 0.06, 0.18) and no significant direct effect (0.02; 95% CI: -0.08, 0.12), indicating a full mediation. CONCLUSION In this large longitudinal study, pandemic-related overtime led to significantly higher levels of burnout symptoms, linked by a pathway through perceived chronic stress. Future prevention strategies need to aim at reducing the likelihood of overtime to ensure the mental well-being of practice personnel.
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Affiliation(s)
- Lucas Küppers
- Institute of General Practice and Family Medicine, University Hospital Bonn, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Julian Göbel
- Institute of General Practice and Family Medicine, University Hospital Bonn, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Benjamin Aretz
- Institute of General Practice and Family Medicine, University Hospital Bonn, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Monika A Rieger
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tuebingen, 72074 Tuebingen, Germany
| | - Birgitta Weltermann
- Institute of General Practice and Family Medicine, University Hospital Bonn, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
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Candon M, Bergman A, Rose A, Song H, David G, Spetz J. The Relationship Between Scope of Practice Laws for Task Delegation and Nurse Turnover in Home Health. J Am Med Dir Assoc 2023; 24:1773-1778.e2. [PMID: 37634547 PMCID: PMC10735229 DOI: 10.1016/j.jamda.2023.07.023] [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: 04/14/2023] [Revised: 07/24/2023] [Accepted: 07/26/2023] [Indexed: 08/29/2023]
Abstract
OBJECTIVE Nurse turnover can compromise the quality and continuity of home health care. Scope of practice laws, which determine the tasks nurses are allowed to perform and delegate, are an important element of autonomy and vary across states. In this study, we used human resource records from a multistate home health organization to examine the relationship between nurse turnover and whether nurses can delegate tasks to unlicensed aides. DESIGN A retrospective, cross-sectional analysis. SETTING AND PARTICIPANTS The study sample included 1820 licensed practical nurses and 3309 registered nurses, who spanned 30 states. The study period was 2016 through 2018. METHODS We used weighted least squares to study the relationship between nurse turnover for registered and licensed practical nurses and task delegation across state-years. We measured task delegation continuously (0-16 tasks) and as a binary variable (14 or more tasks, which indicated the state was in the top half of the distribution). RESULTS Across state-years, the turnover rate was 30.8% for licensed practical nurses and 36.8% for registered nurses. Although there was no significant relationship between task delegation and turnover among registered nurses, we found that states in which nurses could delegate the most tasks had lower turnover rates among licensed practical nurses. CONCLUSION AND IMPLICATIONS The ability to delegate tasks to unlicensed aides was correlated with lower turnover rates among licensed practical nurses, but not among registered nurses. This suggests that the ability to delegate tasks is more likely to affect the workload of licensed practical nurses. This also points to a potential and unexplored element of expanding the scope of practice for nurses: reduced turnover. Given the added work-related hazards associated with home health care, including working in isolation, a lack of social recognition, and inadequate reimbursement, states should consider whether changes in their policy environment could benefit nurses working in home health.
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Affiliation(s)
- Molly Candon
- Departments of Psychiatry and Health Care Management, Perelman School of Medicine and the Wharton School, University of Pennsylvania, Philadelphia, PA, USA.
| | - Alon Bergman
- Departments of Medical Ethics and Health Policy and Health Care Management, Perelman School of Medicine and the Wharton School, University of Pennsylvania, Philadelphia, PA, USA
| | - Amber Rose
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, CA, USA
| | - Hummy Song
- Department of Operations, Information, and Decisions, The Wharton School, University of Pennsylvania, Philadelphia, PA, USA
| | - Guy David
- Departments of Medical Ethics and Health Policy and Health Care Management, Perelman School of Medicine and the Wharton School, University of Pennsylvania, Philadelphia, PA, USA
| | - Joanne Spetz
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, CA, USA
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Gasperini G, Renzi E, Massimi A, Mazzotta R, Stievano A, Cianciulli A, Villari P, De Maria M. Psychometric testing of the nurses professional values scale-revised on family and community health nurses. Nurs Ethics 2023:9697330231204986. [PMID: 37797312 DOI: 10.1177/09697330231204986] [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: 10/07/2023]
Abstract
BACKGROUND Family and Community Health Nurses (FCHNs) are at a higher risk of experiencing emotional exhaustion and feelings of low personal accomplishment. Higher levels of professional identity may decrease these negative feelings. Its measurement could produce positive effects for FCHNs and the quality of care they offer. AIM This study aims to evaluate the psychometric properties (validity and reliability) of the Nurses Professional Values Scale-Revised (NPVS-R) on FCHNs in Italy. RESEARCH DESIGN A cross-sectional research design was used. PARTICIPANTS AND RESEARCH CONTEXT A convenience sample of FCHNs was recruited in an out-of-hospital setting from Italy. A total of 202 nurses were eligible (mean age of 41.11 ± 10.55 years; 78.2% female). ETHICAL CONSIDERATIONS The study was performed in accordance with the World Medical Association Declaration of Helsinki. Participants were asked for their consent and were guaranteed anonymity in the information collected. The study was approved by the internal review board of the university. RESULTS Confirmatory Factor Analysis (CFA) supported a unidimensional factorial structure of the NPVS-R with an adequate fit to the data. Internal consistency reliability was also supported. The construct validity was further reinforced by the concurrent validity results showing a positive and significant correlation of professional identity with job satisfaction. CONCLUSION The NPVS-R is a valid and reliable instrument to measure professional identity among FCHNs. It can be used in clinical practice to improve FCHNs' psychological-emotional feelings and quality of care provided, in research to allow comprehensive understanding of professional identity, and in educational settings to monitor the professional identity levels of Family and Community Health Nursing students.
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Kraus M, Stegner C, Reiss M, Riedel M, Børsch AS, Vrangbaek K, Michel M, Turmaine K, Cseh B, Dózsa CL, Dandi R, Mori AR, Czypionka T. The role of primary care during the pandemic: shared experiences from providers in five European countries. BMC Health Serv Res 2023; 23:1054. [PMID: 37784101 PMCID: PMC10546726 DOI: 10.1186/s12913-023-09998-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 09/04/2023] [Indexed: 10/04/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic necessitated wide-ranging adaptations to the organisation of health systems, and primary care is no exception. This article aims to collate insights on the role of primary care during the pandemic. The gained knowledge helps to increase pandemic preparedness and resilience. METHODS The role of primary care during the pandemic in five European countries (Austria, Denmark, France, Hungary, Italy) was investigated using a qualitative approach, namely case study, based on document analysis and semi-structured interviews. In total, 31 interviews were conducted with primary care providers between June and August 2022. The five country case studies were subjected to an overarching analysis focusing on successful strategies as well as gaps and failures regarding pandemic management in primary care. RESULTS Primary care providers identified disruptions to service delivery as a major challenge emerging from the pandemic which led to a widespread adoption of telehealth. Despite the rapid increase in telehealth usage and efforts of primary care providers to organise face-to-face care delivery in a safe way, some patient groups were particularly affected by disruptions in service delivery. Moreover, primary care providers perceived a substantial propagation of misinformation about COVID-19 and vaccines among the population, which also threatened patient-physician relationships. At the same time, primary care providers faced an increased workload, had to work with insufficient personal protective equipment and were provided incongruous guidelines from public authorities. There was a consensus among primary care providers that they were mostly sidelined by public health policy in the context of pandemic management. Primary care providers tackled these problems through a diverse set of measures including home visits, implementing infection control measures, refurbishing used masks, holding internal meetings and relying on their own experiences as well as information shared by colleagues. CONCLUSION Primary care providers were neither well prepared nor the focus of initial policy making. However, they implemented creative solutions to the problems they faced and applying the learnings from the pandemic could help in increasing the resilience of primary care. Attributes of an integrated health system with a strong primary care component proved beneficial in addressing immediate effects of the pandemic.
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Affiliation(s)
- Markus Kraus
- Institute for Advanced Studies (IHS), Josefstädter Straße 39, Vienna, 1080, Austria.
| | - Christoph Stegner
- Institute for Advanced Studies (IHS), Josefstädter Straße 39, Vienna, 1080, Austria
| | - Miriam Reiss
- Institute for Advanced Studies (IHS), Josefstädter Straße 39, Vienna, 1080, Austria
| | - Monika Riedel
- Institute for Advanced Studies (IHS), Josefstädter Straße 39, Vienna, 1080, Austria
| | - Anne Sofie Børsch
- University of Copenhagen, Øster Farimagsgade 5, Copenhagen K, 1353, Denmark
| | - Karsten Vrangbaek
- University of Copenhagen, Øster Farimagsgade 5, Copenhagen K, 1353, Denmark
| | - Morgane Michel
- Université Paris Cité, ECEVE, UMR 1123, 10 avenue de Verdun, Inserm, Paris, 75010, France
- Unité d'épidémiologie clinique, Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, 48 boulevard Sérurier, Paris, 75019, France
| | - Kathleen Turmaine
- Université Paris Cité, ECEVE, UMR 1123, 10 avenue de Verdun, Inserm, Paris, 75010, France
| | - Borbála Cseh
- University of Miskolc, Egyetem út 1, Miskolc-Egyetemváros, 3515, Hungary
| | - Csaba László Dózsa
- University of Miskolc, Egyetem út 1, Miskolc-Egyetemváros, 3515, Hungary
| | - Roberto Dandi
- Luiss Business School, Via Nomentana 216, Roma, 00162, RM, Italy
| | - Angelo Rossi Mori
- Institute for Research on Population and Social Policies, Via Palestro 32, Roma, 00185, Italy
| | - Thomas Czypionka
- Institute for Advanced Studies (IHS), Josefstädter Straße 39, Vienna, 1080, Austria
- London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, UK
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Martínez-Rodríguez A, Martínez-Faneca L, Fabrellas N. Construction of nursing knowledge in commodified contexts: Views and experiences of nurses regarding primary care. Nurs Inq 2023; 30:e12579. [PMID: 37427491 DOI: 10.1111/nin.12579] [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: 01/16/2023] [Revised: 06/17/2023] [Accepted: 06/23/2023] [Indexed: 07/11/2023]
Abstract
The commodification of health care, particularly primary care, presents challenges to care and knowledge development. The purpose of this study is to examine how nurses perceive and develop their knowledge in a commodified context. A mixed-methods study was conducted that included a closed-question survey and in-depth interviews with nurses in public primary care in Catalonia. There were 104 valid responses to the questionnaire and 10 in-depth interviews. The main findings of the survey were related to workload and limited time for nursing care. Six themes emerged from the in-depth interviews: (1) limited time for nursing, (2) feelings of burnout, (3) awareness of patient and family satisfaction, (4) organizational factors that favor nurses' needs, (5) organizational factors that hinder nurses' needs, and finally (6) public administration requirements. Participants perceive excessive workload and time constraints and feel that this affects their nursing care and their physical and mental health. However, nurses purposefully use knowledge patterns to cope with the problems associated with commodification. Nurses have multidimensional, contextualized, and integrated knowledge that allows them to optimize their care based on the needs of their patients. This research examines many challenges related to nursing practice and the nursing discipline and opens the door for further research that encompasses all areas of nursing.
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Affiliation(s)
- Ana Martínez-Rodríguez
- Departament d'infermeria fonamental i mèdicoquirúrgica, Facultat de Medicina i Ciències de la Salut, Escola d'Infermeria, Universitat de Barcelona, Barcelona, Spain
- August Pi i Sunyer Campus Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - Laura Martínez-Faneca
- August Pi i Sunyer Campus Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - Núria Fabrellas
- Departament d'infermeria fonamental i mèdicoquirúrgica, Facultat de Medicina i Ciències de la Salut, Escola d'Infermeria, Universitat de Barcelona, Barcelona, Spain
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12
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Rodríguez-González R, Martínez-Santos AE, De La Fuente NV, López-Pérez ME, Fernandez-De-La-Iglesia JDC. Identifying engagement and associated factors in nursing students: An exploratory study. J Prof Nurs 2023; 48:77-83. [PMID: 37775245 DOI: 10.1016/j.profnurs.2023.06.003] [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: 09/09/2022] [Revised: 06/09/2023] [Accepted: 06/13/2023] [Indexed: 10/01/2023]
Abstract
BACKGROUND Burnout and engagement in health students surpass work life. Although levels of burnout in Nursing students are high, academic engagement is an understudied topic in Nursing, which has shown benefits. The aims were to know the level of engagement of Nursing students and to identify factors that prompt higher levels of engagement. METHODS An exploratory study was conducted during 2019 in three Universities in Spain. The UWES-S-17 questionnaire was used. RESULTS The sample consisted of 808 Nursing students. An average level of engagement was found. Engagement differed significantly by gender and age, with females and older students showing greater attitudes. Participants in the second year showed lower scores in the willingness to dedicate effort and persistence than those in the first and third year (p < 0.05). CONCLUSIONS The identification of the level of engagement and factors involved are an opportunity to probe into this approach by reinforcing positive attitudes in Nursing students. These findings show the need to seek strategies through specific educational interventions and policies. Engagement should be upheld throughout the degree and once they enter the job market to ensure the well-being during academic and future work life, a high-quality nursing care and patient safety.
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Affiliation(s)
- Raquel Rodríguez-González
- Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, Faculty of Nursing, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Alba-Elena Martínez-Santos
- Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, Faculty of Nursing, University of Santiago de Compostela, Santiago de Compostela, Spain; DIPO Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Spain; Dermatology Department, Complexo Hospitalario Universitario de Pontevedra, Pontevedra, Spain
| | - Noelia Vicho De La Fuente
- Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, Faculty of Nursing, University of Santiago de Compostela, Santiago de Compostela, Spain; Nursing Department, Galician Health Service, Galicia, Spain
| | - María-Elena López-Pérez
- Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, Faculty of Nursing, University of Santiago de Compostela, Santiago de Compostela, Spain
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Sousa VTDS, Dias HG, de Sousa FP, Oliveira RM, Costa EC, de Vasconcelos PF. Professional burnout and patient safety culture in Primary Health Care. Rev Bras Enferm 2023; 76:e20220311. [PMID: 37556689 PMCID: PMC10405387 DOI: 10.1590/0034-7167-2022-0311] [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: 06/27/2022] [Accepted: 01/30/2023] [Indexed: 08/11/2023] Open
Abstract
OBJECTIVES to analyze the association between the risk of occupational exhaustion (burnout) and safety culture in Primary Health Care. METHODS ross-sectional study conducted in 18 Primary Health Care Units in the Northeast of Brazil. Three questionnaires were used: sociodemographic, Maslach Burnout Inventory, and the Medical Office Survey on Patient Safety Culture. The study was approved by the Research Ethics Committee. RESULTS seventy-eight healthcare workers participated, of which 64.1% presented a reduced risk of burnout; and 11.5%, a high risk (p=0.000). The following were identified as weakened dimensions of safety culture: Work pressure and pace; Owner, managing partners, leadership support; Overall ratings on quality; and Overall rating on patient safety. CONCLUSIONS an association was found between low risk of developing burnout syndrome and positive evaluation of safety culture.
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Affiliation(s)
| | - Hirlana Girão Dias
- Universidade da Integração Internacional da Lusofonia Afro-Brazileira. Redenção, Ceará, Brazil
| | | | | | - Edmara Chaves Costa
- Universidade da Integração Internacional da Lusofonia Afro-Brazileira. Redenção, Ceará, Brazil
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Nikpour J, Carthon JMB. Characteristics, work environments, and rates of burnout and job dissatisfaction among registered nurses in primary care. Nurs Outlook 2023; 71:101988. [PMID: 37329590 PMCID: PMC10592661 DOI: 10.1016/j.outlook.2023.101988] [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: 02/06/2023] [Revised: 04/05/2023] [Accepted: 04/30/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Although more people than ever are seeking primary care, the ratio of primary care providers to the population continues to rapidly decline. As such, registered nurses (RNs) are taking on increasingly central roles in primary care delivery. Yet little is known about their characteristics, their work environments, and the extent to which they experience poor job outcomes such as nurse burnout. PURPOSE The purpose of this study was to examine the characteristics of the primary care RN workforce and analyze the association of the nurse work environment with job outcomes in primary care. METHODS Cross-sectional analysis of survey data representing N = 463 RNs who worked in 398 primary care practices, including primary care offices, community clinics, retail/urgent care clinics, and nurse-managed clinics. Survey questions included measures of the nurse work environment and levels of burnout, job dissatisfaction, and intent to leave. DISCUSSION Approximately one-third of primary care RNs were burnt out and dissatisfied with their jobs, with the highest risk of these outcomes among RNs in community clinics. Community clinic RNs were also significantly more likely to be Black or Hispanic/Latino, hold a Bachelor of Science in Nursing, and speak English as a second language (all p < .01). Across all settings, better nurse work environments were significantly associated with lower levels of burnout and job dissatisfaction (both p < .01). CONCLUSION Primary care practices must be equipped to support their RN workforce. Adequate nursing resources are especially needed in community clinics, as patients receiving primary care in these settings frequently face structural inequities.
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Affiliation(s)
- Jacqueline Nikpour
- Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, PA; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA.
| | - J Margo Brooks Carthon
- Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, PA; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA.
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Hennein R, Lowe SR, Feingold JH, Feder A, Peccoralo LA, Ripp JA, Mazure CM, Pietrzak RH. Pre- and peri-traumatic event stressors drive gender differences in chronic stress-related psychological sequelae: A prospective cohort study of COVID-19 frontline healthcare providers. J Psychiatr Res 2023; 162:88-94. [PMID: 37105023 DOI: 10.1016/j.jpsychires.2023.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 03/07/2023] [Accepted: 04/05/2023] [Indexed: 04/29/2023]
Abstract
Women are at heightened risk for chronic stress-related psychological sequelae (SRPS), including major depressive disorder (MDD), generalized anxiety disorder (GAD), and posttraumatic stress disorder (PTSD) in response to potentially traumatic events, including the COVID-19 pandemic. However, few studies have examined pre- and peri-event stressors that could account for gender differences in chronic SRPS. To address this gap, we conducted a prospective cohort study of healthcare providers (HCPs) caring for patients with COVID-19 at a large tertiary care hospital in New York City, and measured mental health risk factors and symptoms of MDD, GAD, and PTSD at baseline (April 2020) and at a 7-month follow-up (December 2020). We defined chronic SRPS as the presence of probable MDD, GAD, and/or PTSD at both timepoints. We conducted a mediation analysis to evaluate whether pre- and peri-event stressors explained women's increased risk for chronic SRPS. Among our sample of 786 HCPs, 571 (72.6%) were women. Compared with men, women were twice as likely to have chronic SRPS (18.7% vs. 8.8%, χ2[1] = 11.38, p < 0.001). However, after accounting for pre- and peri-event stressors, being a woman was no longer associated with chronic SRPS (p = 0.58). The pre- and peri-event stressors that accounted for this heightened risk among women included being in a woman-prevalent profession (specifically nursing; estimate = 0.08, SE = 0.04, p = 0.05), pre-pandemic burnout (estimate = 0.11, SE = 0.05, p = 0.04), greater family-related (estimate = 0.09, SE = 0.03, p = 0.004), infection-related (estimate = 0.06, SE = 0.02, p = 0.007), and work-related concerns (estimate = 0.11, SE = 0.03, p < 0.001), and lower leadership support (estimate = 0.07, SE = 0.03, p = 0.005). These findings can inform institutional interventions to mitigate the risk of chronic SRPS among women HCPs.
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Affiliation(s)
- Rachel Hennein
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA; Yale School of Medicine, New Haven, CT, USA
| | - Sarah R Lowe
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA; Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA.
| | - Jordyn H Feingold
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Adriana Feder
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Lauren A Peccoralo
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Office of Well-Being and Resilience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jonathan A Ripp
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Office of Well-Being and Resilience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Carolyn M Mazure
- Yale School of Medicine, New Haven, CT, USA; Women's Health Research at Yale, Yale School of Medicine, New Haven, CT, USA
| | - Robert H Pietrzak
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA; Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Veterans Affairs, National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA; Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Hurtado DA, Greenspan SA, Valenzuela S, McGinnis W, Everson T, Lenhart A. Promise and Perils of Leader-Employee Check-ins in Reducing Emotional Exhaustion in Primary Care Clinics: Quasi-Experimental and Qualitative Evidence. Mayo Clin Proc 2023:S0025-6196(22)00708-X. [PMID: 37024355 DOI: 10.1016/j.mayocp.2022.12.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 11/29/2022] [Accepted: 12/01/2022] [Indexed: 04/08/2023]
Abstract
OBJECTIVE To analyze the role of short (<30 minutes) and frequent (quarterly) check-ins between clinic leaders and employees in reducing emotional exhaustion. METHODS Three interrelated studies were conducted: a 3-year repeated cross-sectional survey at 10 primary care clinics (n=505; we compared emotional exhaustion, perceived stress, and values alignment among employees of a clinic where check-ins were conducted vs 9 control clinics); interviews with leaders and employees (n=10) regarding the check-ins process and experiences; and interviews with leaders and employees (n=10) after replicating the check-ins at a new clinic. RESULTS Outcomes were similar at baseline. After a year, emotional exhaustion was lower at the check-ins compared with control clinics (standardized mean difference, d, -0.71 [P<.05]). After 2 years, emotional exhaustion remained lower at the check-ins clinic, but this difference was not significant. The check-ins were associated with an increment in values alignment (2018 vs 2017, d=0.59 [P<.05]; 2019 vs 2017, d=0.76 [P<.05]). There were no differences for perceived job stress. Interviews indicated that work-life challenges were discussed in the check-ins. However, employees need confidentiality and to feel safe to do so. The replication suggested that the check-ins are feasible to implement even amid turbulent times. CONCLUSION Periodic check-ins wherein leaders acknowledge and address work-life stressors might be a practical tactic to reduce emotional exhaustion in primary care clinics.
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Affiliation(s)
- David A Hurtado
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland; OHSU-PSU School of Public Health, Portland, OR.
| | - Samuel A Greenspan
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland
| | - Steele Valenzuela
- Department of Family Medicine, Oregon Health & Science University, Portland
| | - Wendy McGinnis
- Department of Internal Medicine and Geriatrics, Oregon Health & Science University, Portland
| | - Teresa Everson
- Department of Family Medicine, Oregon Health & Science University, Portland; OHSU-PSU School of Public Health, Portland, OR; Multnomah County Health Department, Portland, OR
| | - Abigail Lenhart
- Department of Internal Medicine and Geriatrics, Oregon Health & Science University, Portland
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Pienkowski T, Keane A, de Lange E, Kapoor V, Khanyari M, Ravi R, Smit IPJ, Castelló y Tickell S, Hazenbosch M, Arlidge WNS, Baranyi G, Brittain S, Papworth S, Saxena S, Hout V, Milner‐Gulland EJ. Psychological distress and workplace risk inequalities among conservation professionals. CONSERVATION SCIENCE AND PRACTICE 2023. [DOI: 10.1111/csp2.12918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
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18
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McCammon LC, Gillen P, Kernohan WG. Explaining and addressing the limitations in usefulness of available estimated prevalence figures relating to burnout in family doctors: Evidence from a systematic scoping literature review. J Psychiatr Res 2023; 158:261-272. [PMID: 36621182 DOI: 10.1016/j.jpsychires.2022.12.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 11/06/2022] [Accepted: 12/11/2022] [Indexed: 12/15/2022]
Abstract
Burnout in family doctors (FDs) affects their well-being, patient care, and healthcare organizations, and is considered common worldwide. However, its measurement has been so inconsistent that whether the widely divergent prevalence figures can be meaningfully interpreted has been questioned. Our aim was to go further than previous systematic reviews to explore the meaning contribution and usefulness of FD-burnout prevalence estimates. Worldwide literature was systematically reviewed using Levac's scoping framework, with 249 papers undergoing full-text review. Of 176 studies measuring burnout, 78% used the Maslach Burnout Inventory (MBI), which measures burnout as now defined by the World Health Organization. We, therefore, concentrated on the MBI. Its burnout measurement was markedly inconsistent, with prevalence estimates ranging from 2.8% to 85.7%. Researchers made prevalence claims relating to burnout severity and implied diagnoses based on participants' MBI scores, even though the MBI has not been validated as a clinical or diagnostic tool. Except when comparisons were possible between certain studies, prevalence figures provided limited meaning and added little to the understanding of burnout in FDs. Our review revealed a lack of research-supported meaningful information about the prevalence of FD burnout and that care is required to avoid drawing unsubstantiated conclusions from prevalence results. This paper's overall purpose is to propose how obtaining meaningful prevalence estimates can begin, which are recognized as key to developing improved prevention policies and interventions. Researchers must adopt a consistent means to measure burnout, use the MBI as its authors intended, and explore making progress through quantitative and qualitative collaboration.
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Affiliation(s)
- Leonard C McCammon
- Ulster University, School of Nursing and Paramedic Science, Faculty of Life and Health Sciences, York Street, Belfast, Co. Antrim, Northern Ireland, BT15 1ED, UK.
| | - Patricia Gillen
- Ulster University, School of Nursing and Paramedic Science, Faculty of Life and Health Sciences, York Street, Belfast, Co. Antrim, Northern Ireland, BT15 1ED, UK; Southern Health and Social Care Trust, Gilford, Co. Armagh, Northern Ireland, BT63 5JX, UK
| | - W George Kernohan
- Ulster University, School of Nursing and Paramedic Science, Faculty of Life and Health Sciences, York Street, Belfast, Co. Antrim, Northern Ireland, BT15 1ED, 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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Australian cancer nurses' experiences of burnout: Exploring the job demands and job resources of metropolitan cancer nurses during 2019-2020. Health Care Manage Rev 2023; 48:61-69. [PMID: 36066549 DOI: 10.1097/hmr.0000000000000352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Existing studies that seek to understand nurses' experiences of burnout are dominated by cross-sectional, quantitative survey designs employing predetermined measures, often overlooking important job-related stressors that can be highly dependent on industry and professional contexts. Cancer nurses are a group of professionals who warrant special attention, as burnout in this profession is often attributed to high job demands and the challenge of caring for a vulnerable cohort of patients. A deeper understanding of the job demands associated with cancer nursing is required to provide insights about the work experiences of cancer nurses and identify aspects that mitigate burnout and stress. PURPOSE This study describes the antecedents of burnout among Australian cancer nurses by focusing on the demands and resources inherent in their work. We aim to build on the existing literature by identifying job resources that may serve to mitigate the antecedents of burnout. METHODOLOGY/APPROACH An in-depth interview study of cancer nurses across a spectrum of age and experience in Australian metropolitan public health care services was conducted over a 2-year period that coincided with the COVID-19 pandemic. The job demands and resources model framed this study of job-related factors associated with burnout and conversely job resources that may foster work engagement. RESULTS Patient aggression, workload, emotional demands, and abusive peers and managers were reported as distinct job demands, whereas job significance and supportive peers who demonstrated leadership, along with task variety, were identified as job resources. CONCLUSION Australian cancer nurses work in an environment where job demands are increasingly disproportionate to job resources, leading to significant risk of burnout. PRACTICE IMPLICATIONS Our study identifies modifiable strategies for improving work conditions for this group who play a critical role in the health care system.
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Petersen J, Wendsche J, Melzer M. Nurses' emotional exhaustion: Prevalence, psychosocial risk factors and association to sick leave depending on care setting-A quantitative secondary analysis. J Adv Nurs 2023; 79:182-193. [PMID: 36281066 DOI: 10.1111/jan.15471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 09/06/2022] [Accepted: 10/03/2022] [Indexed: 12/15/2022]
Abstract
AIMS To explore differences in the prevalence, psychosocial risk factors and the connection to annual sick leave of nurses' emotional exhaustion depending on the care setting. DESIGN Quantitative study. METHODS We conducted a secondary data analysis of a cross-sectional, representative survey with German nurses (BIBB/BAuA-Employment Survey 2018). We analysed data from three groups of nurses (hospital care HC: n = 333, nursing homes NH: n = 143, home health care HHC: n = 109). We calculated prevalence estimates for all psychosocial risk factors and emotional exhaustion and utilized Χ2 -tests to explore differences relating to the care setting. We calculated risk estimates using logistic regression analyses. RESULTS Forty-four per cent of all nurses reported symptoms of emotional exhaustion. Care settings did not affect prevalence estimates (HC: 45.3%, NH: 37.8%, HHC: 50.5%). Weekend work was a risk factor for exhaustion. Being at the limit of efficiency was the only work-related psychosocial risk factor being independent of the care setting. Emotional demands were a significant risk factor for nurses working in HC and NH, and low team cooperation was a risk factor for nurses working in NH. Nurses' emotional exhaustion is associated with more sick leave days. CONCLUSIONS The high prevalence of nurses' emotional exhaustion is independent of the care setting. This threatens nurses' health and negatively affects the organization and society due to the relation to sick leave. Weekend work and quantitative demands relate to exhaustion independently of the care context. Emotional demands and low team cooperation show context-specific correlations. IMPACT Organizational interventions that limit quantitative demands are needed to prevent exhaustion among nurses. In HC and NH, measures are needed to improve coping with emotional demands and to strengthen team cooperation. Policymakers and nursing managers should take action to address nurses' emotional exhaustion. NO PATIENT OR PUBLIC CONTRIBUTION Due to the study design.
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Affiliation(s)
- Julia Petersen
- Federal Institute for Occupational Safety and Health, Unit 3.3 Designing Service Work, Dresden, Germany
| | - Johannes Wendsche
- Federal Institute for Occupational Safety and Health, Unit 3.3 Designing Service Work, Dresden, Germany
| | - Marlen Melzer
- Federal Institute for Occupational Safety and Health, Unit 3.3 Designing Service Work, Dresden, Germany
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22
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van Elk F, Robroek SJW, Burdorf A, Oude Hengel KM. Impact of the COVID-19 pandemic on psychosocial work factors and emotional exhaustion among workers in the healthcare sector: a longitudinal study among 1915 Dutch workers. Occup Environ Med 2023; 80:27-33. [PMID: 36424169 PMCID: PMC9763172 DOI: 10.1136/oemed-2022-108478] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 10/12/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVES This study aims to investigate across subgroups of healthcare workers (1) the changes in psychosocial working conditions and emotional exhaustion during the pandemic compared with the situation before, and (2) the impact of different stages of the COVID-19 pandemic in terms of hospital pressure on psychosocial working conditions and emotional exhaustion. METHODS Five questionnaire measurements during 2 years from 1915 healthcare workers in the longitudinal study 'the Netherlands Working Conditions Survey-COVID-19' were used. At each measurement, three subgroups were defined: working with patients with COVID-19, working with other patients and not working with patients. For each measurement, hospital pressure was determined by number of hospitalisations per day. Linear mixed models were fitted to analyse differences across subgroups of healthcare workers. RESULTS During COVID-19, psychosocial working conditions deteriorated among healthcare workers working with patients, in particular with patients with COVID-19, compared with healthcare workers not working with patients after correcting for the situation before COVID-19. No changes were observed for emotional exhaustion in any of the subgroups. An increasing hospital pressure improved job autonomy and reduced emotional demands among healthcare workers in COVID-19 wards, but had no influence on other psychosocial working conditions and emotional exhaustion. CONCLUSION Psychosocial working conditions deteriorated for healthcare workers working with (COVID-19) patients during the pandemic, while emotional exhaustion did not change among all groups of healthcare workers.
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Affiliation(s)
- Fleur van Elk
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Suzan J W Robroek
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Alex Burdorf
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
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Burnout Levels in Italian Nurses during the First and the Second Wave in the COVID-19 Outbreak: A Pilot Cohort-Data Comparison. PSYCH 2022. [DOI: 10.3390/psych4040070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
(1) Background: Nurses show higher psychological distress associated with physical difficulties during the COVID-19 outbreak. To compare burnout levels among nurses engaged in the front line of patients with COVID-19 during the first wave and the second wave of the pandemic. (2) Methods: Two cohort online surveys were conducted thanks to the Google Modules function: the first one was administered from March 2020 to April 2020 and the second survey, which included the same questionnaire, was administered from September 2020 to October 2020. (3) Results: There were significant differences in the emotional exhaustion sub dimension (p < 0.001): The first wave group recorded higher levels than the second wave one. While, as regards to the values of the dimension of the depersonalization, the second wave group reported significantly higher values than the first wave group (p = 0.006). No significant difference was recorded for the personal accomplishment sub dimension (p = 0.108). By considering the gender variable, significant difference was reported in personal accomplishment sub dimension, as during the second wave, females recorded lower levels in personal accomplishment while males reported significantly higher levels in the same sub dimension than the first wave (p = 0.012); while no statistically significant differences were reported in burnout sub dimensions during the first and the second waves according to years of work experience. (4) Conclusions: The COVID-19 pandemic represents an important provocation for nurses all around the world and, at the same time, constitutes a learning lesson to improve better approaches for the subsequent waves. Several interventions could be introduced to moderate the mental health influence of the COVID-19 pandemic on nurses.
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Pastor-López Á, Ventura-Puertos PE, Hernández-Ascanio J, Cantón-Habas V, Martínez-Angulo P, Rich-Ruiz M. Emotional Universe of Nurse Case Managers Regarding Care for Elderly at Risk in Spain: A Hermeneutical Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16445. [PMID: 36554326 PMCID: PMC9778613 DOI: 10.3390/ijerph192416445] [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: 11/08/2022] [Revised: 12/03/2022] [Accepted: 12/05/2022] [Indexed: 06/17/2023]
Abstract
The role of nurse case managers (NCM) involves a rarely visible emotional labor, even more when their role focuses on the care of elders at risk (EAR). Motivated by the lack of qualitative research on the emotional universe of NCM, this study explores the emotional universe (EU) of NCM regarding the care they provide to EAR in primary health care as well as the reasons that generate these emotions. An interpretative-phenomenological approach was implemented in southern Spain, with a purposive sampling that included nurses playing the NCM role for at least three years. Data collection was conducted in two periods (between September 2019 and July 2022). The primary collection tool was the semi-structured individual interview, with starting categories based on Bisquerra's EU taxonomy. The analysis followed Ricoeur's considerations, using the Nvivo software. In the NCM's EU, the recognition of the social phenomena stands out, with an open feeling of empathy regarding the desire of the EAR to continue living at home. However, there was also helplessness, resignation, disappointment, and frustration when EAR rejected their proposals. Furthermore, the system's limitations aroused compassion in the NCM and made them go beyond the limits of their role. This EU requires that their role be valued more, and higher responsiveness must be enforced to improve EAR care.
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Affiliation(s)
- Ángeles Pastor-López
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba (UCO), Hospital Universitario Reina Sofía (HURS), 14004 Córdoba, Spain
- Distrito Sanitario Córdoba-Guadalquivir, Servicio Andaluz de Salud (SAS), 14011 Córdoba, Spain
| | - Pedro E. Ventura-Puertos
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba (UCO), Hospital Universitario Reina Sofía (HURS), 14004 Córdoba, Spain
- Interdisciplinary Research Group in Discourse Analysis (HUM380), Universidad de Córdoba (UCO), 14071 Córdoba, Spain
| | - José Hernández-Ascanio
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba (UCO), Hospital Universitario Reina Sofía (HURS), 14004 Córdoba, Spain
| | - Vanesa Cantón-Habas
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba (UCO), Hospital Universitario Reina Sofía (HURS), 14004 Córdoba, Spain
| | - Pablo Martínez-Angulo
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba (UCO), Hospital Universitario Reina Sofía (HURS), 14004 Córdoba, Spain
- Interdisciplinary Research Group in Discourse Analysis (HUM380), Universidad de Córdoba (UCO), 14071 Córdoba, Spain
| | - Manuel Rich-Ruiz
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba (UCO), Hospital Universitario Reina Sofía (HURS), 14004 Córdoba, Spain
- Ciber Fragility and Healthy Aging (CIBERFES), 28029 Madrid, Spain
- Nursing and Healthcare Research Unit (Investén-isciii), Instituto de Salud Carlos III, 28029 Madrid, Spain
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Lizcano‐Álvarez A, Esteban‐Hernández J, Alameda‐Cuesta A, Cid‐Expósito G, Palacios‐Ceña D. Chronic cardiovascular nursing care in Spanish primary care: A qualitative study. Int J Nurs Pract 2022:e13117. [DOI: 10.1111/ijn.13117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 07/25/2022] [Accepted: 11/13/2022] [Indexed: 12/12/2022]
Affiliation(s)
- Angel Lizcano‐Álvarez
- Department of Nursing, Faculty of Health Sciences Universidad Rey Juan Carlos Madrid Spain
| | - Jesús Esteban‐Hernández
- Department of Medical Specialties and Public Health, Faculty of Health Sciences Universidad Rey Juan Carlos Madrid Spain
| | | | - Gema Cid‐Expósito
- Department of Nursing, Faculty of Health Sciences Universidad Rey Juan Carlos Madrid Spain
| | - Domingo Palacios‐Ceña
- Research Group of Humanities and Qualitative Research in Health Science of Universidad Rey Juan Carlos (Hum&QRinHS) Universidad Rey Juan Carlos Madrid Spain
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Youssef D, Youssef J, Abou-Abbas L, Kawtharani M, Hassan H. Prevalence and correlates of burnout among physicians in a developing country facing multi-layered crises: a cross-sectional study. Sci Rep 2022; 12:12615. [PMID: 35871153 PMCID: PMC9308770 DOI: 10.1038/s41598-022-16095-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 07/04/2022] [Indexed: 02/07/2023] Open
Abstract
AbstractBurnout among physicians is a serious concern that cultivates its seeds during their education. This study assessed the prevalence of burnout among Lebanese physicians and explored its correlates and the combined effects of the pandemic and the economic crisis on burnout. A web-based cross-sectional study was conducted in December 2020 using a snowball sampling technique. Moderate and high levels of burnout hit 90.7% of the physicians where personal, work-related, and client-related burnout were detected among 80.4%, 75.63%, and 69.6% of them respectively. A strong association was found between the higher level of burnout and female gender, younger age, being single, having a dependent child, living with an elderly or a family member with comorbidities, and insufficient sleeping hours. Physicians’ specialties, working in a public health facility, limited years of professional experience, lack of previous experience in a pandemic, and extensive working hours were also associated with increased burnout. Furthermore, low income, working in the frontline, higher threat perception, and fear of COVID-19 were contributing to higher burnout. The combined effect of threat perception and financial hardship significantly increased burnout levels. The alarming burnout level detected among physicians urges health authorities to take prompt actions to enhance the physicians’ well-being.
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de Souza e Silva D, das Merces MC, Lua I, Coelho JMF, Santana AIC, Reis DA, Barbosa CDS, D’Oliveira Júnior A. Association between burnout syndrome and obesity: A cross-sectional population-based study. Work 2022; 74:991-1000. [PMID: 36463471 DOI: 10.3233/wor-210245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND: Burnout Syndrome (BS) is a response of organism against long-lasting exposure to occupational stressors. Those affected usually have comorbidities, as well as cardiovascular and metabolic problems. OBJECTIVE: Estimating the association between BS and obesity in primary health care nurses of in the state of Bahia, Brazil. METHODS: Population-analytical, cross-confirmatory, integrated and multicenter study, conducted with a random sample of primary health care nursing professionals in 43 municipalities from 07 mesoregions of Bahia, Brazil. This study was funded by the Brazilian Board for Scientific and Technological Development. The independent variable (BS) was evaluated by using the Maslach Burnout Inventory (MBI) scale, and the dependent one (obesity) was based on the Body Mass Index (BMI)≥30. Effect modification and confounding factors were verified by crude, stratified, and multivariate analysis. RESULTS: The prevalence of BS and obesity was 17.7% and 12.7%, respectively. BS was statistically associated with obesity, even after adjustment (RPa: 1.85; CI 95% 1.11–3.06) per gender, age, physical activity, healthy eating, satisfaction with occupation, another job, night shift, primary health care (PHC) time, and working conditions. Effect-modifying variables were not identified. CONCLUSIONS: The specialized literature points out a path to the association identified here. New studies on the subject are relevant and should have more robust methodologies so that the path of causality is better clarified. In addition, occupational health programs become an alternative to control stress and, therefore, its complications, such as burnout and other health aggravations.
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Affiliation(s)
- Douglas de Souza e Silva
- Graduate Program in Health Sciences, School of Medicine, Federal University of Bahia (UFBA), Salvador, Brazil
| | - Magno Conceição das Merces
- Graduate Program in Health Sciences, School of Medicine, Federal University of Bahia (UFBA), Salvador, Brazil
- Department of Life Sciences, State University of Bahia (UNEB), Salvador, Brazil
| | - Iracema Lua
- Department of Health Sciences, Feira de Santana State University (UEFS), Feira de Santana, Brazil
| | | | - Amália Ivine Costa Santana
- Graduate Program in Health Sciences, School of Medicine, Federal University of Bahia (UFBA), Salvador, Brazil
| | | | - Caroline da Silva Barbosa
- Graduate Program in Health Sciences, School of Medicine, Federal University of Bahia (UFBA), Salvador, Brazil
| | - Argemiro D’Oliveira Júnior
- Graduate Program in Health Sciences, School of Medicine, Federal University of Bahia (UFBA), Salvador, Brazil
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Chen Y, You Y, Shen Y, Du Z, Dai T. Village doctors' dilemma in China: A systematic evaluation of job burnout and turnover intention. Front Public Health 2022; 10:970780. [PMID: 36438210 PMCID: PMC9684668 DOI: 10.3389/fpubh.2022.970780] [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] [Received: 06/16/2022] [Accepted: 09/05/2022] [Indexed: 11/11/2022] Open
Abstract
Background Village doctors (VDs) in China undertook arduous primary healthcare missions. However, they received little attention in comparison to doctors in urban public secondary and tertiary hospitals. There is an urgent need to explore the overall situation of turnover intention and job burnout among VDs to evaluate and adjust current health manpower policy. Methods In this study, seven databases like PubMed, EMBASE, Web of Science (WOS), WanFang, China Science and Technology Journal Database (VIP), Chinese BioMedical Literature Database (CBM), and China National Knowledge Infrastructure (CNKI) were systematically searched, relevant experts were consulted, and empirical research on job burnout and turnover intention among VDs in international publications was evaluated. Therefore, we evaluated the prevalence of job burnout among VDs in general, across all dimensions and different severity levels, as well as the scores of each category. For turnover intention, we assessed the prevalence of different groups and their overall situation and also identified significant contributors. Results In this study, we integrated 20 research evidences on job burnout and turnover intention among 23,284 VDs from almost all provinces in China, and the prevalence of turnover intention among VDs in China was as high as 44.1% [95% confidence interval (CI): 34.1-54.2], which was two to four times that of primary health workers in high-income countries, but not much different from some developing countries. Simultaneously, VDs with the highest risk of turnover intention were men [odds ratio (OR): 1.22 (1.05-1.43)], those with a monthly income below USD 163.4 [OR: 0.88 (0.78-0.98)], those with a high educational level [OR: 0.88 (0.78-0.98)], and those <40 years old [OR: 1.27 (1.16-1.40)]. Similarly, the detection rate of job burnout toward them was 59.8% (95% CI: 38.7-79.1) with the MBI-GS score being 44.44 (95% CI: 37.02-51.86) in a total of 90, while the detection rate of job burnout in moderate and above almost reached 20%. The most significant contributor that affects job burnout was low personal accomplishment (LPA), and the detection rate for moderate and higher severity was 65.2% (95% CI: 58.7-71.7). Conclusion Attention should be paid to the high turnover intention and severe job burnout of primary health workers in rural areas of developing countries, and targeted measures should be taken to improve the situation. Health policymakers should increase financial subsidies for VDs, set a reasonable workload, improve various health policies such as pension insurance for VDs, and encourage "targeted training" for medical students to enrich and expand their team. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42021289139.
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Affiliation(s)
- Yuquan Chen
- Institute of Medical Information/Medical Library, Chinese Academy of Medical Sciences, Beijing, China,Peking Union Medical College, Beijing, China
| | - Yanwei You
- School of Social Sciences, Tsinghua University, Beijing, China,Division of Sports Science and Physical Education, Tsinghua University, Beijing, China
| | - Yaying Shen
- Institute of Medical Information/Medical Library, Chinese Academy of Medical Sciences, Beijing, China,Peking Union Medical College, Beijing, China
| | - Zifei Du
- The Affiliated TCM Hospital of Guangzhou Medical University, Guangzhou, China
| | - Tao Dai
- Institute of Medical Information/Medical Library, Chinese Academy of Medical Sciences, Beijing, China,*Correspondence: Tao Dai
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Kimpe V, Sabe M, Sentissi O. No increase in burnout in health care workers during the initial COVID-19 outbreak: Systematic review and meta-analysis. World J Meta-Anal 2022; 10:206-219. [DOI: 10.13105/wjma.v10.i4.206] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 06/21/2022] [Accepted: 07/27/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND For decades and before the coronavirus disease 2019 (COVID-19) pandemic, for health care workers (HCWs) burnout can be experienced as an upsetting confrontation with their self and the result of a complex a multifactorial process interacting with environmental and personal features.
AIM To literature review and meta-analysis was to obtain a comprehensive understanding of burnout and work-related stress in health care workers around the world during the first outbreak of the COVID-19 pandemic.
METHODS We performed a database search of Embase, Google Scholar and PubMed from June to October 2020. We analysed burnout risk factors and protective factors in included studies published in peer-reviewed journals as of January 2020, studying a HCW population during the first COVID-19 wave without any geographic restrictions. Furthermore, we performed a meta-analysis to determine overall burnout levels. We studied the main risk factors and protective factors related to burnout and stress at the individual, institutional and regional levels.
RESULTS Forty-one studies were included in our final review sample. Most were cross-sectional, observational studies with data collection windows during the first wave of the COVID-19 surge. Of those forty-one, twelve studies were included in the meta-analysis. Of the 27907 health care professionals who participated in the reviewed studies, 70.4% were women, and two-thirds were either married or living together. The most represented age category was 31-45 years, at 41.5%. Approximately half of the sample comprised nurses (47.6%), and 44.4% were working in COVID-19 wards (intensive care unit, emergency room and dedicated internal medicine wards). Indeed, exposure to the virus was not a leading factor for burnout. Our meta-analytic estimate of burnout prevalence in the HCW population for a sample of 6784 individuals was 30.05%.
CONCLUSION There was a significant prevalence of burnout in HCWs during the COVID-19 pandemic, and some of the associated risk factors could be targeted for intervention, both at the individual and organizational levels. Nevertheless, COVID-19 exposure was not a leading factor for burnout, as burnout levels were not notably higher than pre-COVID-19 levels.
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Affiliation(s)
- Vincent Kimpe
- Faculty of Medicine, Geneva University, Geneva 1208, Geneva, Switzerland
| | - Michel Sabe
- Division of Adult Psychiatry, Department of Psychiatry, Geneva University Hospitals, Geneva 1205, Geneva, Switzerland
| | - Othman Sentissi
- Division of Adult Psychiatry, Department of Psychiatry, Geneva University Hospitals, Geneva 1205, Geneva, Switzerland
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Albendín-García L, Suleiman-Martos N, Ortega-Campos E, Aguayo-Estremera R, Romero-Béjar JL, Cañadas-De la Fuente GA. Explanatory Models of Burnout Diagnosis Based on Personality Factors in Primary Care Nurses. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9170. [PMID: 35954541 PMCID: PMC9368137 DOI: 10.3390/ijerph19159170] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 07/22/2022] [Accepted: 07/24/2022] [Indexed: 02/01/2023]
Abstract
Burnout in the primary care service takes place when there is a high level of interaction between nurses and patients. Explanatory models based on psychological and personality related variables provide an approximation to level changes in the three dimensions of the burnout syndrome. A categorical-response ordinal logistic regression model, based on a quantitative, crosscutting, multicentre, descriptive study with 242 primary care nurses in the Andalusian Health Service in Granada (Spain) is performed for each dimension. The three models included all the variables related to personality. The risk factor friendliness was significant at population level for the three dimensions, whilst openness was never significant. Neuroticism was significant in the models related to emotional exhaustion and depersonalization, whilst responsibility was significant for the models referred to depersonalization and personal accomplishment dimensions. Finally, extraversion was also significant in the emotional exhaustion and personal accomplishment dimensions. The analysis performed provides useful information, making more readily the diagnosis and evolution of the burnout syndrome in this collective.
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Affiliation(s)
- Luis Albendín-García
- Casería de Montijo Health Center, Granada-Metropolitan Health District, Andalusian Health Service, Calle Virgen de la Consolación, 12, 18015 Granada, Spain;
| | - Nora Suleiman-Martos
- Faculty of Health Sciences, University of Granada, Avenida de la Ilustración, 60, 18016 Granada, Spain; (N.S.-M.); (G.A.C.-D.l.F.)
| | | | - Raimundo Aguayo-Estremera
- Department of Psychobiology and Methodology in Behavioral Sciences, Complutense University of Madrid, Campus de Somosaguas, 28223 Pozuelo de Alarcón, Spain;
| | - José L. Romero-Béjar
- Department of Statistics and Operations Research, University of Granada, Fuentenueva s/n, 18071 Granada, Spain
- Instituto de Investigación Biosanitaria (ibs. GRANADA), 18012 Granada, Spain
- Institute of Mathematics of the University of Granada (IMAG), Ventanilla 11, 18001 Granada, Spain
| | - Guillermo A. Cañadas-De la Fuente
- Faculty of Health Sciences, University of Granada, Avenida de la Ilustración, 60, 18016 Granada, Spain; (N.S.-M.); (G.A.C.-D.l.F.)
- Brain, Mind and Behaviour Research Center (CIMCYC), University of Granada, 18071 Granada, Spain
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Francetic I, Gibson J, Spooner S, Checkland K, Sutton M. Skill-mix change and outcomes in primary care: Longitudinal analysis of general practices in England 2015-2019. Soc Sci Med 2022; 308:115224. [PMID: 35872540 DOI: 10.1016/j.socscimed.2022.115224] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 06/21/2022] [Accepted: 07/14/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND Increasing the employment of staff with new clinical roles in primary care has been proposed as a solution to the shortages of GPs and nurses. However, evidence of the impacts this has on practice outcomes is limited. We examine how outcomes changed following changes in skill-mix in general practices in England. METHODS We obtained annual data on staff in 6,296 English general practices between 2015 and 2019 and grouped professionals into four categories: GPs, Nurses, Health Professionals, and Healthcare Associate Professionals. We linked 10 indicators of quality of care covering the dimensions of accessibility, clinical effectiveness, user experiences and health system costs. We used both fixed-effect and first-differences regressions to model changes in staff composition and outcomes, adjusting for practice and population factors. RESULTS Employment increased over time for all four staff groups, with largest increases for Healthcare Professionals (from 0.04 FTE per practice in 2015 to 0.28 in 2019) and smallest for Nurses who experienced a 3.5 percent growth. Increases in numbers of GPs and Nurses were positively associated with changes in practice activity and outcomes. The introduction of new roles was negatively associated with patient satisfaction: a one FTE increase in Health Professionals was associated with decreases of 0.126 [-0.175, -0.078] and 0.116 [-0.161, -0.071] standard deviations in overall patient satisfaction and satisfaction with making an appointment. Pharmacists improved medicine prescribing outcomes. All staff categories were associated with higher health system costs. There was little evidence of direct complementarity or substitution between different staff groups. CONCLUSIONS Introduction of new roles to support GPs does not have straightforward effects on quality or patient satisfaction. Problems can arise from the complex adaptation required to adjust practice organisation and from the novelty of these roles to patients. These findings suggest caution over the implementation of policies encouraging more employment of different professionals in primary care.
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Affiliation(s)
- Igor Francetic
- Centre for Primary Care and Health Services Research, Health Organisation, Policy and Economics (HOPE) Group, University of Manchester, Manchester, UK.
| | - Jon Gibson
- Centre for Primary Care and Health Services Research, Health Organisation, Policy and Economics (HOPE) Group, University of Manchester, Manchester, UK
| | - Sharon Spooner
- Centre for Primary Care and Health Services Research, Health Organisation, Policy and Economics (HOPE) Group, University of Manchester, Manchester, UK
| | - Katherine Checkland
- Centre for Primary Care and Health Services Research, Health Organisation, Policy and Economics (HOPE) Group, University of Manchester, Manchester, UK
| | - Matt Sutton
- Centre for Primary Care and Health Services Research, Health Organisation, Policy and Economics (HOPE) Group, University of Manchester, Manchester, UK; Melbourne Institute, Applied Economic and Social Research, University of Melbourne, Melbourne, Australia
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Hausswirth C, Nesi X, Dubois A, Duforez F, Rougier Y, Slattery K. Four Weeks of a Neuro-Meditation Program Improves Sleep Quality and Reduces Hypertension in Nursing Staff During the COVID-19 Pandemic: A Parallel Randomized Controlled Trial. Front Psychol 2022; 13:854474. [PMID: 35645851 PMCID: PMC9130829 DOI: 10.3389/fpsyg.2022.854474] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 04/07/2022] [Indexed: 11/13/2022] Open
Abstract
The purpose of this study was to examine the effectiveness of a neuro-meditation program to support nurses during the COVID-19 pandemic. Forty-five (10 men and 35 women) nurses were classified into three groups based on their systolic blood pressure: normotensive (G-nor; n = 16, 43.8 ± 11.0 year), hypertensive (G-hyp; n = 13, 45.2 ± 10.7 year) and control (G-con; n = 16, 44.9 ± 10.6 year). Using a parallel, randomly controlled design across a 4-week period, 10 × 30-min sessions using the Rebalance© Impulse were completed. Sleep was assessed by wrist actigraphy and subjective sleep questionnaires; perceived sleep quality, Ford Insomnia Response to Stress Test questionnaire and the Spiegel Sleep Quality questionnaire (SSQ). Blood pressure, resting heart rate, mean heart rate (HRmean), heart rate variability index (RMSSD), cortisol, and alpha-amylase were also measured. Statistical analysis was completed using factorial ANOVA. Sleep improved in the G-hyp group; SSQ (p < 0.01); perceived sleep quality (p < 0.01); sleep efficiency and fragmentation index (p < 0.05). In the G-nor group, sleep was improved to a lesser extent; perceived sleep quality (p < 0.01). A significant time-group interaction was reported in resting heart rate (p < 0.01), systolic blood pressure (p < 0.01), and diastolic blood pressure (p < 0.05) with these measures being significantly reduced in the G-hyp group. RMSSD increased in the G-nor group (p < 0.01). This initial evidence suggests that neuro-meditation reduces excessive sympathetic activity, promoting enhanced sleep quality and autonomic control during periods of increased work-related stress. Clinical Trial Registration The study was conducted at Bioesterel, Sophia-Antipolis, France as a clinical trial: Neuro-meditation improves sleep quality, https://www.drks.de/ui_data_web/DrksUI.html?locale=en, DRKS00025731.
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Affiliation(s)
- Christophe Hausswirth
- LAMHESS, University of Côte d'Azur, Nice, France.,BeScored Institute, Sophia Antipolis, France.,School of Sport, Exercise and Rehabilitation, University of Technology, Sydney, NSW, Australia
| | - Xavier Nesi
- BeScored Institute, Sophia Antipolis, France
| | - Alexandre Dubois
- Hotel-Dieu de Paris, Centre du Sommeil et de la Vigilance, Paris, France
| | - François Duforez
- Hotel-Dieu de Paris, Centre du Sommeil et de la Vigilance, Paris, France
| | | | - Katie Slattery
- School of Sport, Exercise and Rehabilitation, University of Technology, Sydney, NSW, Australia
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Bergman A, Song H, David G, Spetz J, Candon M. The Role of Schedule Volatility in Home Health Nursing Turnover. Med Care Res Rev 2022; 79:382-393. [PMID: 34311619 PMCID: PMC9122113 DOI: 10.1177/10775587211034310] [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: 11/17/2022]
Abstract
Despite considerable research on nursing turnover, few studies have considered turnover among nurses working in home health care. Using novel administrative data from one of the largest home health care organizations in the United States, this study examined turnover among home health nurses, focusing on the role of schedule volatility. We estimated separation rates among full-time and part-time registered nurses and licensed practical nurses and used daily visit logs to estimate schedule volatility, which was defined as the coefficient of variation of the number of daily visits in the prior four weeks. Between 2016 and 2019, the average annual separation rate of home health nurses was over 30%, with most separations occurring voluntarily. Schedule volatility and turnover were positively associated for full-time nurses, but not for part-time nurses. These results suggest that reducing schedule volatility for full-time nurses could mitigate nursing turnover in home health care.
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Affiliation(s)
- Alon Bergman
- University of Pennsylvania, Philadelphia, PA, USA
| | - Hummy Song
- University of Pennsylvania, Philadelphia, PA, USA
| | - Guy David
- University of Pennsylvania, Philadelphia, PA, USA
| | - Joanne Spetz
- University of California, San Francisco, CA, USA
| | - Molly Candon
- University of Pennsylvania, Philadelphia, PA, USA
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Loerbroks A, Vu-Eickmann P, Dreher A, Mambrey V, Scharf J, Angerer P. The Relationship of Medical Assistants' Work Engagement with Their Concerns of Having Made an Important Medical Error: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116690. [PMID: 35682274 PMCID: PMC9180158 DOI: 10.3390/ijerph19116690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 05/24/2022] [Accepted: 05/27/2022] [Indexed: 12/04/2022]
Abstract
Objectives: We aimed to examine associations of work engagement with self-reported concerns of having made medical errors among medical assistants. Methods: We used cross-sectional questionnaire data from 424 medical assistants in Germany (collected between March and May 2021). The nine-item Utrecht Work Engagement Scale assessed the subdimensions vigor, dedication, and absorption. Participants further reported whether they were concerned that they had made an important medical error in the last three months. Work engagement scores were used both as categorized variables (i.e., highest tertile vs. remaining tertiles) and continuous variables (i.e., z-scores) and their associations with concerns to have made an important medical error were examined using multivariable logistic regression to estimate odds ratios (ORs) and corresponding 95% confidence intervals (CIs). Results: High vigor (versus low vigor) and high dedication (versus low dedication) were associated with substantially reduced odds of expressing concerns to have made an important medical error (OR = 0.19, 95%CI = 0.04–0.85 and OR = 0.25, 95%CI = 0.07–0.88, respectively), but absorption was not (OR = 1.10, 95%CI = 0.43–2.86). Analyses with z-scores confirmed this pattern of associations for vigor and absorption, but less so for dedication (OR = 0.72, 95%CI = 0.47–1.11). Conclusions: Vigor and possibly also dedication are inversely related to concerns of having made an important medical error. Our findings may suggest that promotion of these subdimensions of work engagement may improve patient safety.
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Affiliation(s)
- Adrian Loerbroks
- Correspondence: ; Tel.: +49-(0)-211-81-08032; Fax: +49-(0)-211-81-18586
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May S, Gabb F, Ignatyev Y, Ehrlich-Repp J, Stahlhut K, Heinze M, Allsop M, Stanze H, Muehlensiepen F. Mental and Physical Well-Being and Burden in Palliative Care Nursing: A Cross-Setting Mixed-Methods Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:6240. [PMID: 35627781 PMCID: PMC9141775 DOI: 10.3390/ijerph19106240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 05/16/2022] [Accepted: 05/18/2022] [Indexed: 02/04/2023]
Abstract
The working routines in palliative care nursing are associated with a variety of causes of stress with regional and setting-specific differences in Germany. This mixed-methods study aimed to investigate the mental and physical well-being among nurses in German palliative and hospice care and to gain a deeper understanding of procedural and structural aspects that may influence the mental and physical burden in palliative nursing care. The mixed-methods approach combined qualitative interviews, (n = 16) an online survey (n = 101), and subsequent data validation in a focus group (n = 6). Interview and focus group data were analysed using structured qualitative content analysis. Survey data were analysed using descriptive statistics and an explorative quantitative analysis. Moderate to very high levels of stress were reported across all settings, but were highest for nurses in specialized outpatient palliative care settings. Underlying causes of stress related to working conditions in the nursing profession across all palliative care settings were poor working hours, perceived inadequate remuneration, and high demands for documentation. To ensure sustainable high-quality palliative care, adaptations to working conditions that target causes of stress and burden in palliative care nurses are required.
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Affiliation(s)
- Susann May
- Center for Health Services Research, Brandenburg Medical School Theodor Fontane, 15562 Rüdersdorf, Germany; (F.G.); (Y.I.); (M.H.); (F.M.)
| | - Franziska Gabb
- Center for Health Services Research, Brandenburg Medical School Theodor Fontane, 15562 Rüdersdorf, Germany; (F.G.); (Y.I.); (M.H.); (F.M.)
| | - Yuriy Ignatyev
- Center for Health Services Research, Brandenburg Medical School Theodor Fontane, 15562 Rüdersdorf, Germany; (F.G.); (Y.I.); (M.H.); (F.M.)
| | - Jana Ehrlich-Repp
- Landesarbeitsgemeinschaft Onkologische Versorgung im Land Brandenburg e.V., 14469 Potsdam, Germany;
| | - Kerstin Stahlhut
- Department of Oncology and Palliative Medicine, Immanuel Klinik Rüdersdorf, 15562 Rüdersdorf, Germany;
| | - Martin Heinze
- Center for Health Services Research, Brandenburg Medical School Theodor Fontane, 15562 Rüdersdorf, Germany; (F.G.); (Y.I.); (M.H.); (F.M.)
- Department of Psychiatry and Psychotherapy, Immanuel Klinik Rüdersdorf, 15562 Rüdersdorf, Germany
| | - Matthew Allsop
- Academic Unit of Palliative Care, Leeds Institute of Health Sciences, University of Leeds, Leeds LS2 9JT, UK;
| | - Henrikje Stanze
- Hochschule Bremen, Centre for Nursing Research and Counselling, 28199 Bremen, Germany;
| | - Felix Muehlensiepen
- Center for Health Services Research, Brandenburg Medical School Theodor Fontane, 15562 Rüdersdorf, Germany; (F.G.); (Y.I.); (M.H.); (F.M.)
- Faculty for Health Sciences, Brandenburg Medical School, 16816 Neuruppin, Germany
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Balancing standardisation and individualisation in transitional care pathways: a meta-ethnography of the perspectives of older patients, informal caregivers and healthcare professionals. BMC Health Serv Res 2022; 22:430. [PMID: 35365140 PMCID: PMC8974038 DOI: 10.1186/s12913-022-07823-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 03/22/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Transitional care implies the transfer of patients within or across care settings in a seamless and safe way. For frail, older patients with complex health issues, high-quality transitions are especially important as these patients typically move more frequently within healthcare settings, requiring treatment from different providers. As transitions of care for frail people are considered risky, securing the quality and safety of these transitions is of great international interest. Nevertheless, despite efforts to improve quality in transitional care, research indicates that there is a lack of clear guidance to deal with practical challenges that may arise. The aim of this article is to synthesise older patients, informal caregivers and healthcare professionals' experiences of challenges to achieving high-quality transitional care. METHODS We used the seven-step method for meta-ethnography originally developed by Noblit and Hare. In four different but connected qualitative projects, the authors investigated the challenges to transitional care for older people in the Norwegian healthcare system from the perspectives of older patients, informal caregivers and healthcare professionals. In this paper, we highlight and discuss the cruciality of these challenging issues by synthesising the results from twelve articles. RESULTS The analysis resulted in four themes: i) balancing person-centred versus efficient care, ii) balancing everyday patient life versus the treatment of illness, iii) balancing user choice versus "What Matters to You", and iv) balancing relational versus practical care. These expressed challenges represent tensions at the system, organisation and individual levels based on partial competing assumptions on person-centred-care-inspired individualisation endeavours and standardisation requirements in transitional care. CONCLUSIONS There is an urgent need for a clearer understanding of the tension between standardisation and individualisation in transitional care pathways for older patients to ensure better healthcare quality for patients and more realistic working environments for healthcare professionals. Incorporating a certain professional flexibility within the wider boundary of standardisation may give healthcare professionals room for negotiation to meet patients' individual needs, while at the same time ensuring patient flow, equity and evidence-based practice.
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Smallheer B. Impact of Career Burnout Across Nursing. Nurs Clin North Am 2022; 57:ix-x. [DOI: 10.1016/j.cnur.2021.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Dalton KR, Altekruse W, Campbell P, Ruble K, Carroll KC, Thorpe RJ, Agnew J, Davis MF. Perceptions and Practices of Key Worker Stakeholder Groups in Hospital Animal-Assisted Intervention Programs on Occupational Benefits and Perceived Risks. PEOPLE AND ANIMALS (WEST LAFAYETTE, IN) 2022; 5:4. [PMID: 35765567 PMCID: PMC9235541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Animal-assisted intervention (AAI) programs, used widely for patient benefit, have increasingly been used for healthcare workers (HCW) to reduce occupational stress. However, there are barriers to these programs which limit their utilization, for both patients and HCW, specifically infectious disease concerns. The aim of the research project is to identify barriers and facilitators to AAI program use for healthcare worker benefit, and determine knowledge, beliefs, and practices regarding infectious disease risk and control policies, in order to understand the contextual parameters of program implementation. METHODS We collected perceptions of key stakeholders involved with hospital AAI programs (HCW and AAI workers) through semi-structured in-depth interviews. We used framework analysis to guide thematic coding, completed independently by three researchers. RESULTS We interviewed 37 participants in this study. We divided our themes into two topic areas: program use for HCW and perceived infectious disease risk. Use for healthcare workers included perspectives on the benefits for HCW and program barriers and facilitators (specifically collaboration and leadership). Perceived risk included opinions on infection concerns with AAI, thoughts on control measures to reduce this risk, and responsibility for safety during these programs. CONCLUSIONS While significant benefits were reported for HCW, they were limited by administrative barriers and hazard concerns. Facilitators to surmount these barriers are best implemented with collaboration across the hospital and appropriate leadership roles to direct safe program implementation. By addressing these barriers through targeted facilitators in the form of evidence-backed guidelines, AAI programs can be used to benefit both patients and HCW.
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Affiliation(s)
- Kathryn R. Dalton
- Johns Hopkins University Bloomberg School of Public Health, Department of Environmental Health and Engineering, Baltimore Maryland
| | | | | | - Kathy Ruble
- Johns Hopkins University School of Medicine, Department of Pediatric Oncology, Baltimore Maryland
| | - Karen C. Carroll
- Johns Hopkins University School of Medicine, Department of Pathology, Division of Medical Microbiology, Baltimore Maryland
| | - Roland J. Thorpe
- Johns Hopkins University Bloomberg School of Public Health, Department of Health, Behavior and Society, Baltimore Maryland
| | - Jacqueline Agnew
- Johns Hopkins University Bloomberg School of Public Health, Department of Environmental Health and Engineering, Baltimore Maryland
| | - Meghan F. Davis
- Johns Hopkins University Bloomberg School of Public Health, Department of Environmental Health and Engineering, Baltimore Maryland
- Johns Hopkins Medicine, Department of Molecular and Comparative Pathobiology, Baltimore Maryland
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Kim HD, Park SG, Kim WH, Min KB, Min JY, Hwang SH. Development of Korean Version Burnout Syndrome Scale (KBOSS) Using WHO's Definition of Burnout Syndrome. Saf Health Work 2021; 12:522-529. [PMID: 34900372 PMCID: PMC8640625 DOI: 10.1016/j.shaw.2021.08.001] [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] [Received: 10/15/2020] [Revised: 07/22/2021] [Accepted: 08/13/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Burnout syndrome (BOS) is defined by the World Health Organization (WHO) as a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed. This study aims to create the Korean version burnout syndrome scale (KBOSS) that conforms to WHO's definition of BOS and present the cut-off points for screening. METHODS We developed the KBOSS based on WHO's definition of BOS. An online survey was conducted through a specialized online research company. We recruited 444 workers for this research. The validity of the KBOSS was assessed using factor analysis and Pearson's correlation. The KBOSS reliability was assessed using Cronbach's alpha coefficient. The cut-off points for each of the three dimensions were derived using the upper quartile score. RESULTS The validity and reliability of the KBOSS were good. Regarding reliability, the scale's overall Cronbach's alpha was 0.813. Cronbach's alpha of each three-dimension was as follows: exhaustion, 0.916; cynicism, 0.865; and professional inefficacy, 0.819. The cut-off points of BOS three dimensions are exhaustion ≧ 21; cynicism ≧ 18; and inefficacy ≧ 15. CONCLUSION The developed questionnaire (KBOSS) can be a useful tool for screening of BOS.
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Key Words
- BCSQ, Burnout Clinical Subtypes Questionnaire
- BOS, burnout syndrome
- Burnout syndrome
- Burnout, Professional
- Burnout, Professional / diagnosis
- Exhaustion
- FSS, Fatigue Severity Scale
- GAD, Generalized Anxiety Disorder
- KBOSS, Korean version burnout syndrome scale
- MBI, Maslach Burnout Inventory
- Mental disorder
- Mental health
- PHQ, Patient Health Questionnaires
- WHO, World Health Organization
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Affiliation(s)
- Hyung Doo Kim
- Department of Occupational and Environmental Medicine, Inha University Hospital, Incheon, Republic of Korea
- Department of Environmental Sciences, Seoul National University Graduate School of Public Health, Seoul, Republic of Korea
| | - Shin-Goo Park
- Department of Occupational and Environmental Medicine, Inha University Hospital, Incheon, Republic of Korea
| | - Won-Hyoung Kim
- Department of Psychiatry, Inha University Hospital, Inha University School of Medicine, Incheon, Republic of Korea
| | - Kyoung-Bok Min
- Department of Preventive Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea
| | - Jin-Young Min
- Institute of Health and Environment, Seoul National University, Seoul, Republic of Korea
| | - Sang-Hee Hwang
- Department of Dentistry, Keimyung University School of Medicine, Dalseo-Gu, Daegu, Republic of Korea
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Sullivan EE, Dwiel K, Hunt LS, Conroy K, Gergen Barnett K. Moving the needle on primary care burnout: Using a driver diagram to accelerate impact. Healthcare (Basel) 2021; 9:100595. [PMID: 34800785 PMCID: PMC8595316 DOI: 10.1016/j.hjdsi.2021.100595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 10/31/2021] [Accepted: 10/31/2021] [Indexed: 11/24/2022] Open
Abstract
Prior to the COVID-19 pandemic, studies demonstrated an alarming prevalence of burnout in primary care. In the midst of the pandemic, primary care clinician wellbeing deteriorated and burnout rates increased, yet many organizational efforts to reduce burnout were put on hold due to the urgency of the pandemic. In this article, we present the “Reducing Burnout Driver Diagram” as a tool that clinical leaders and policy makers can use to address and mitigate primary care clinician burnout.
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Ramírez-Elvira S, Romero-Béjar JL, Suleiman-Martos N, Gómez-Urquiza JL, Monsalve-Reyes C, Cañadas-De la Fuente GA, Albendín-García L. Prevalence, Risk Factors and Burnout Levels in Intensive Care Unit Nurses: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11432. [PMID: 34769948 PMCID: PMC8583312 DOI: 10.3390/ijerph182111432] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 10/19/2021] [Accepted: 10/27/2021] [Indexed: 01/21/2023]
Abstract
Nursing is considered to be an at-risk profession of burnout due to daily exposure to difficult situations such as death and pain care. In addition, some units such as the intensive care unit (ICU), can be stressful due to high levels of morbidity and mortality and ethical dilemmas. Burnout causes a deterioration in quality of care, increasing the risk of mortality in patients due to poor performance and errors in the healthcare environment. The aim of this study was to analyse the levels, prevalence and related factors of burnout in ICU nurses. A systematic review and meta-analysis were carried out in the Medline, Scopus and CINAHL databases. Fifteen articles were found for the systematic review and four for the meta-analysis. With a sample of n = 1986 nurses, the meta-analytic estimate prevalence for high emotional exhaustion was 31% (95% CI, 8-59%), for high depersonalization was 18% (95% CI, 8-30%), and for low personal accomplishment was 46% (95% CI, 20-74%). Within the dimensions of burnout, emotional exhaustion had a significant relationship with depression and personality factors. Both sociodemographic factors (being younger, single marital status, and having less professional experience in ICU) and working conditions (workload and working longer hours) influence the risk of burnout syndrome.
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Affiliation(s)
- Santiago Ramírez-Elvira
- Catalan Health Service, Vall d’Hebron Hospital, Passeig de la Vall d’Hebron, 119, 08035 Barcelona, Spain;
| | - José L. Romero-Béjar
- Statistics and Operational Research Department, University of Granada, Avda. Fuentenueva S/N, 18071 Granada, Spain
| | - Nora Suleiman-Martos
- Nursing Department, Faculty of Health Sciences, Campus Universitario de Ceuta, University of Granada, C/Cortadura del Valle S/N, 51001 Ceuta, Spain; (N.S.-M.); (J.L.G.-U.)
| | - José L. Gómez-Urquiza
- Nursing Department, Faculty of Health Sciences, Campus Universitario de Ceuta, University of Granada, C/Cortadura del Valle S/N, 51001 Ceuta, Spain; (N.S.-M.); (J.L.G.-U.)
| | - Carolina Monsalve-Reyes
- Departamento de Ciencias Sociales, Universidad Católica de La Santísima Concepción, Avenida Alonso de Ribera, Concepción 2850, Chile;
| | | | - Luis Albendín-García
- Andalusian Health Service, Granada-Northeast Health Management Area, Ctra. de Murcia S/N, 18800 Granada, Spain;
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The Experience of Emotional Labor and Its Related Factors among Nurses in General Hospital Settings in Republic of Korea: A Systematic Review and Meta-Analysis. SUSTAINABILITY 2021. [DOI: 10.3390/su132111634] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
This systematic review and meta-analysis aimed to investigate the status of emotional labor and its related factors among nurses in general hospital settings in Korea. A total of seven electronic databases were comprehensively searched to find relevant cross-sectional studies published up to 28 January 2021. The meta-analysis was performed using Stata version 13.1. In total, 131 studies were included. The population showed a standardized mean difference of 3.38 (95% confidence interval, 3.34 to 3.42) in emotional labor assessed by a 1–5 Likert scale. The level of emotional labor had significant negative correlations with job satisfaction, social support, organizational engagement, coworker support, resilience, and nurses’ work environment, while it had significant positive correlations with emotional labor and burnout, turnover intention, and job stress. Although the methodological quality of the included studies was generally good, 24 of the included studies (18.32%) were evaluated as lacking generalization potential or otherwise as unclear. In conclusion, nurses in general hospital settings in Korea experience mild-to-moderate levels of emotional labor. There is some evidence that the emotional labor of nurses and its detrimental effects can be buffered at both the individual and hospital levels, and future research should focus on developing targeted interventions and evaluating their effectiveness.
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Lee H, An S, Lim GY, Sohn YW. Ethical Leadership and Followers' Emotional Exhaustion: Exploring the Roles of Three Types of Emotional Labor toward Leaders in South Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10862. [PMID: 34682605 PMCID: PMC8535228 DOI: 10.3390/ijerph182010862] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/12/2021] [Accepted: 10/14/2021] [Indexed: 12/19/2022]
Abstract
Employees' emotional exhaustion caused by their leaders has significant consequences for both individuals and organizations. Identifying the roles of intra-organizational emotional labor is important to prevent employees' emotional exhaustion. This study examined the relationships between ethical leadership, followers' emotional labor toward leaders, and emotional exhaustion using Hobfoll's conservation of resources theory. Data collected from 259 employees working in South Korea were analyzed using regression and SEM. The results indicate that ethical leadership was negatively related to followers' emotional exhaustion. It is demonstrated that ethical leadership has a significant indirect relationship with followers' emotional exhaustion through three types of emotional labor strategies; genuine display, faked display, and suppressed display. Through genuine display and suppressed display, ethical leadership had an indirect and negative relationship with followers' emotional exhaustion, whereas ethical leadership and followers' emotional exhaustion showed a positive indirect relationship through faked display. We discuss the implications and limitations of this research and future research directions.
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Affiliation(s)
| | | | | | - Young Woo Sohn
- Psychology Department, Yonsei University, Seoul 06695, Korea; (H.L.); (S.A.); (G.Y.L.)
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Salvado M, Marques DL, Pires IM, Silva NM. Mindfulness-Based Interventions to Reduce Burnout in Primary Healthcare Professionals: A Systematic Review and Meta-Analysis. Healthcare (Basel) 2021; 9:healthcare9101342. [PMID: 34683022 PMCID: PMC8544467 DOI: 10.3390/healthcare9101342] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 10/05/2021] [Accepted: 10/06/2021] [Indexed: 01/23/2023] Open
Abstract
Mindfulness-based interventions (MBIs) are reported by experimental studies as practical approaches to reduce burnout in primary healthcare professionals (PHCP). However, to date, no research has synthesized the evidence to determine the overall effects of MBIs for reducing burnout in PHCP. We conducted a systematic review and meta-analysis to analyze the effects of MBIs to reduce burnout in PHCP. We searched articles in the PubMed/MEDLINE, Web of Science, Cochrane, and Scopus databases from inception to September 2021 using MeSH terms: "mindfulness", "burnout", and "primary healthcare". Two reviewers extracted the data and assessed the risk of bias. We used a random-effects meta-analysis to calculate the standardized mean differences (SMD) and mean differences (MD) with 95% confidence intervals (CI) of emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA) domains of burnout. Of 61 records, ten were included (n = 417). Overall, the studies were rated as having a high risk of bias and limited quality evidence. MBIs significantly reduced EE (SMD = -0.54, 95%CI: -0.72 to -0.36; MD = -5.89, 95%CI: -7.72 to -4.05), DP (SMD = -0.34, 95%CI: -0.52 to -0.17; MD = -1.96, 95%CI: -2.96 to -0.95), and significantly increased PA (SMD = 0.34, 95%CI: 0.17 to 0.52; MD = 2.05, 95%CI: 1.04 to 3.06). Although further high-quality research is needed, our findings support the implementation of MBIs for reducing burnout in PHCP.
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Affiliation(s)
- Mafalda Salvado
- Centro de Saúde Dr. Gorjão Henriques, Unidade de Saúde Familiar Cidade do Lis, 2410-272 Leiria, Portugal;
- Correspondence:
| | - Diogo Luís Marques
- Department of Sport Sciences, University of Beira Interior, 6201-001 Covilhã, Portugal;
| | - Ivan Miguel Pires
- Instituto de Telecomunicações, Universidade da Beira Interior, 6200-001 Covilhã, Portugal;
- Escola de Ciências e Tecnologias, University of Trás-os-Montes e Alto Douro, Quinta de Prados, 5001-801 Vila Real, Portugal
| | - Nádia Mendes Silva
- Centro de Saúde Dr. Gorjão Henriques, Unidade de Saúde Familiar Cidade do Lis, 2410-272 Leiria, Portugal;
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Rehder K, Adair KC, Sexton JB. The Science of Health Care Worker Burnout: Assessing and Improving Health Care Worker Well-Being. Arch Pathol Lab Med 2021; 145:1095-1109. [PMID: 34459858 DOI: 10.5858/arpa.2020-0557-ra] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2021] [Indexed: 11/06/2022]
Abstract
CONTEXT.— Problems with health care worker (HCW) well-being have become a leading concern in medicine given their severity and robust links to outcomes like medical error, mortality, and turnover. OBJECTIVE.— To describe the state of the science regarding HCW well-being, including how it is measured, what outcomes it predicts, and what institutional and individual interventions appear to reduce it. DATA SOURCES.— Peer review articles as well as multiple large data sets collected within our own research team are used to describe the nature of burnout, associations with institutional resources, and individual tools to improve well-being. CONCLUSIONS.— Rates of HCW burnout are alarmingly high, placing the health and safety of patients and HCWs at risk. To help address the urgent need to help HCWs, we summarize some of the most promising early interventions, and point toward future research that uses standardized metrics to evaluate interventions (with a focus on low-cost institutional and personal interventions).
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Affiliation(s)
- Kyle Rehder
- From the Duke Center for Healthcare Safety and Quality, Duke University Health System, Durham, North Carolina
| | - Kathryn C Adair
- From the Duke Center for Healthcare Safety and Quality, Duke University Health System, Durham, North Carolina
| | - J Bryan Sexton
- From the Duke Center for Healthcare Safety and Quality, Duke University Health System, Durham, North Carolina
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Fish JA, Sharplin G, Wang L, An Y, Fan X, Eckert M. Cross-cultural differences in nurse burnout and the relationship with patient safety: An East-West comparative study. J Adv Nurs 2021; 78:1001-1011. [PMID: 34435692 DOI: 10.1111/jan.15024] [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: 04/16/2021] [Revised: 07/25/2021] [Accepted: 08/11/2021] [Indexed: 11/27/2022]
Abstract
AIMS To compare levels of nurse burnout across eastern and western cultures, as well as examine the influence of burnout on patient safety cross-culturally. DESIGN Comparative cross-sectional study. METHODS Survey data were collected from nurses between August and October 2017 in Australia (n = 730) and between April and October 2019 in China (n = 1107). Variables included burnout (emotional exhaustion, depersonalization, personal accomplishment), nurse leadership and support, staffing and resource adequacy, and perceived patient safety. Data were analysed separately for each jurisdiction using bootstrapped hierarchical regressions, which tested the relationships between burnout indicators and patient safety, controlling for support resources. RESULTS Emotional exhaustion and depersonalization scores were significantly higher in the Australian sample compared with the Chinese sample. Australian participants reported significantly lower patient safety grades than Chinese participants and were less likely to agree that support resources were present in their current job. Separate regressions indicated that patient safety was significantly associated with staffing and resource adequacy, nurse leadership and support, and depersonalization among Australian participants (30% of variance explained in the final regression model), while staffing and resource adequacy, nurse leadership and support, personal accomplishment and emotional exhaustion predicted patient safety for Chinese participants (22% of variance explained in the final model). CONCLUSION Australian nurses are at greater risk of burnout than Chinese nurses. Burnout dimensions are differentially associated with patient safety across cultures. Culturally relevant interventions may be more optimal than universal approaches for improving burnout and patient safety in nursing. IMPACT This study increased understanding of cross-cultural differences in nurse burnout and the relationship with patient safety. Australian nurses were at greater risk of burnout than Chinese nurses. Emotional exhaustion, depersonalization and personal accomplishment influenced patient safety distinctively across the countries. These findings inform interventions designed to reduce nurse burnout and improve patient safety internationally.
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Affiliation(s)
- Jennifer A Fish
- Rosemary Bryant AO Research Centre, Clinical & Health Sciences, University of South Australia, Adelaide, South Australia, Australia
| | - Greg Sharplin
- Rosemary Bryant AO Research Centre, Clinical & Health Sciences, University of South Australia, Adelaide, South Australia, Australia
| | - Lyu Wang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, PR China
| | - Yan An
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, PR China
| | - Xiuzhen Fan
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, PR China
| | - Marion Eckert
- Rosemary Bryant AO Research Centre, Clinical & Health Sciences, University of South Australia, Adelaide, South Australia, Australia
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Jung SE, Ha DJ, Park JH, Lee B, Kim MS, Sim KL, Choi YH, Kwon CY. The Effectiveness and Safety of Mind-Body Modalities for Mental Health of Nurses in Hospital Setting: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8855. [PMID: 34444604 PMCID: PMC8393251 DOI: 10.3390/ijerph18168855] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 08/11/2021] [Accepted: 08/17/2021] [Indexed: 12/18/2022]
Abstract
The mental health of nurses including burnout is an important issue. The purpose of this systematic review was to evaluate whether mind-body modalities improve burnout and other mental health aspects of nurses. A comprehensive search was conducted using six electronic databases. Randomized controlled trials using mind-body modalities on the mental health of nurses, up to January 2021, were included. The methodological quality of the included studies was assessed using the Cochrane Risk of Bias tool. Seventeen studies were included in the review. Data on mindfulness-based interventions (MBIs) and yoga were available for burnout, and there was no evidence that multimodal resilience programs including MBIs statistically significantly improved burnout levels compared to no intervention or active control groups. However, one study reported that yoga could significantly improve emotional exhaustion and depersonalization, which are subscales of burnout, compared to usual care. In addition, the effects of MBIs, relaxation, yoga, and music on various mental health outcomes and stress-related symptoms have been reported. In conclusion, there was some evidence that yoga was helpful for improvement in burnout of nurses. However, due to the heterogeneity of interventions and outcomes of the studies included, further high-quality clinical trials are needed on this topic in the future.
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Affiliation(s)
- Su-Eun Jung
- Department of Clinical Korean Medicine, Graduate School, Dong-eui University, Busan 47227, Korea; (S.-E.J.); (D.-J.H.); (J.-H.P.)
| | - Da-Jung Ha
- Department of Clinical Korean Medicine, Graduate School, Dong-eui University, Busan 47227, Korea; (S.-E.J.); (D.-J.H.); (J.-H.P.)
| | - Jung-Hyun Park
- Department of Clinical Korean Medicine, Graduate School, Dong-eui University, Busan 47227, Korea; (S.-E.J.); (D.-J.H.); (J.-H.P.)
| | - Boram Lee
- Clinical Research Coordinating Team, Korea Institute of Oriental Medicine, Daejeon 34054, Korea;
| | - Myo-Sung Kim
- Department of Nursing, College of Nursing, Healthcare Sciences & Human Ecology, Dong-eui University, Busan 47340, Korea;
| | - Kyo-Lin Sim
- Department of Music, Graduate School, Pyeongtaek University, Pyeongtaeksi 17869, Gyeonggi-do, Korea;
| | - Yung-Hyun Choi
- Department of Biochemistry, College of Korean Medicine, Dong-eui University, Busan 47227, Korea;
| | - Chan-Young Kwon
- Department of Oriental Neuropsychiatry, College of Korean Medicine, Dong-eui University, Busan 47227, Korea
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Zhang X, Bai X, Bian L, Wang M. The influence of personality, alexithymia and work engagement on burnout among village doctors in China: a cross-sectional study. BMC Public Health 2021; 21:1507. [PMID: 34348678 PMCID: PMC8335472 DOI: 10.1186/s12889-021-11544-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 07/22/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In China, as the "gatekeepers"of rural residents' health, the primary-level village doctors, play a very crucial role in ensuring and serving the health level of rural residents. However, the burnout of village doctors is gravely threatening the stability of rural primary medical system step by step. This study systematically evaluated the effects of personality, work engagement and alexithymia on burnout of village doctors, and further measured and assessed the mediating effect of alexithymia and work engagement in the association between personality and burnout. METHODS The subjects were 2684 village doctors in Jining, Shandong Province, China, from May to June 2019. Sociodemographic characteristics, alexithymia, personality, work engagement and job burnout were quantitated by self-completed questionnaire and measured by Likert 5-7 scale. One-way ANOVA, Person correlation analysis, and Structural Equation Modelling (SEM) were used for statistical analysis and mediating effect evaluation. RESULTS 2693 questionnaires were collected in total, of which 2684 were valid, with an effective rate of 96.2%. 65.2% of village doctors were diagnosed with burnout, and 54.3% showed moderate to severe emotional exhaustion, 61.6% showed moderate to severe low sense of personal achievement, and 33.9% showed moderate to severe depersonalization burnout. Personality had a direct positive effect on work engagement (β = 0.50, p < 0.001), a direct negative effect on alexithymia (β = - 0.52, p < 0.001) and burnout (β = - 0.50, p < 0.001) respectively. Work engagement had a direct negative effect on burnout (β = - 0.10, p < 0.001), while alexithymia had a direct positive effect on burnout (β = 0.16, p < 0.001). In the path between personality and burnout, both work engagement 95%CI:(- 0.17)-(- 0.08), and alexithymia 95%CI:(- 0.36)-(- 0.09), have significant mediating effects. These results strongly confirm that personality, alexithymia, and work engagement are early and powerful predicators of burnout. CONCLUSION According to the results, medical administrators should pay attention to the personality characteristics of village doctors in vocational training, practice selection and job assignment, encourage village doctors to reflect on their own personality actively, and to reduce job burnout by obtaining necessary social support, constructing reasonable achievable career expectations, improving time management ability, and participating in psychological counselling programs.
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Affiliation(s)
- Xuewen Zhang
- School of Integrated Traditional Chinese and Western Medicine, Jining Medical University, Jining, 272067 China
| | - Xue Bai
- School of the First Clinical Medicine, Jining Medical University, Jining, 272067 China
| | - Liyan Bian
- School of the First Clinical Medicine, Jining Medical University, Jining, 272067 China
| | - Min Wang
- School of Integrated Traditional Chinese and Western Medicine, Jining Medical University, Jining, 272067 China
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Matsuishi Y, Mathis BJ, Masuzawa Y, Okubo N, Shimojo N, Hoshino H, Enomoto Y, Inoue Y. Severity and prevalence of burnout syndrome in paediatric intensive care nurses: A systematic review. Intensive Crit Care Nurs 2021; 67:103082. [PMID: 34340889 DOI: 10.1016/j.iccn.2021.103082] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 04/02/2021] [Accepted: 04/05/2021] [Indexed: 12/11/2022]
Abstract
OBJECTIVES The aim of this study is to identify burnout syndrome severity and prevalence in paediatric intensive care unit nurses. DESIGN Systematic review. SETTING Paediatric intensive care unit. MAIN OUTCOME MEASURES A librarian was consulted on methodology before the search process. MEDLINE (via PubMed), EMBASE, the Cochrane Library, CINAHL, and PsycINFO were searched for full-text studies published before September 2019 in any language. Only those observational studies exploring burnout syndrome, including paediatric intensive care unit nurses, were included. Two authors independently screened studies. We assessed the risk of bias within each study based on the Office of Health Assessment and Translation tool. RESULT After screening 1238 articles, we identified six studies which met the systematic review criteria. All studies included were published after 2012 and participant sample sizes were between 35 and 195 nurses. Three studies were conducted in the United States of America while the others were from the United Kingdom, Turkey and Taiwan. Prevalence of burnout syndrome in pediatric intensive care unit nurses was reported in these studies as between 42% and 77%. The assessment tools used in these studies were the (abbreviated) Maslach Burnout Inventory, Abbreviated Maslach Burnout Inventory, Occupational Burnout Inventory, and Professional Quality of Life Scale Version 5. We could not conduct a meta-analysis due to the lack of studies. CONCLUSION Our systematic review identifies that a low number (6 total) of relevant studies focused on burnout syndrome for pediatric intensive care unit nurses with a prevalence of burnout syndrome in paediatric intensive care unit nurses of between 42% and 77%.
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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
| | - Yuko Masuzawa
- Department of Health Informatics, School of Public Health, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Nobuko Okubo
- Neuroscience Nursing, St. Luke's International University, Tokyo, Japan
| | - Nobutake Shimojo
- Department of Emergency and Critical Care Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Haruhiko Hoshino
- Adult Health Nursing, Department of Nursing, International University of Health and Welfare, Narita, Japan
| | - Yuki Enomoto
- Department of Emergency and Critical Care Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Yoshiaki Inoue
- Department of Emergency and Critical Care Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
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Sarabia-Cobo C, Pérez V, de Lorena P, Fernández-Rodríguez Á, González-López JR, González-Vaca J. Burnout, Compassion Fatigue and Psychological Flexibility among Geriatric Nurses: A Multicenter Study in Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147560. [PMID: 34300009 PMCID: PMC8305508 DOI: 10.3390/ijerph18147560] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 07/08/2021] [Accepted: 07/14/2021] [Indexed: 02/02/2023]
Abstract
Nurses working at nursing homes are one of the most vulnerable populations for suffering burnout and compassion fatigue. In Spain, the concept of compassion fatigue and psychological flexibility related to stress in geriatric nurses has not been fully explored until now. It is important to analyze their situation in order to design robust coping and management strategies. The aim was to analyze the relationship between burnout, compassion fatigue and psychological flexibility in geriatric nurses in Spain. Participants included 291 nurses from 97 centers in 51 cities across Spain. Psychological flexibility (AAQ-II), burnout (MBI) and compassion fatigue (ProQOL) were evaluated. Responses were recievced from 281 nurses (91% women), with an average of 7.6 years of work experience. The MBI results were average (26.71), and the ProQOL scores were average for compassion fatigue (40.2%) and high for compassion satisfaction (70.3%), whereas for AAQ-II, the mean score was 37.34 (SD 4.21). The correlation was significant and negative for flexibility, burnout and compassion fatigue, and positive for compassion satisfaction. The ANOVA indicated a significant association between all variables (p < 0.05). We can conclude that geriatric nurses suffer from medium levels of burnout and compassion fatigue, together with high levels of psychological flexibility, which appears to act as a stress reliever, supporting compassion satisfaction.
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Affiliation(s)
- Carmen Sarabia-Cobo
- Facultad de Enfermería, IDIVAL, Universidad de Cantabria, Avda Valdecilla s/n, 39011 Cantabria, Spain;
- Correspondence:
| | | | | | | | - José Rafael González-López
- Department of Nursing, Faculty of Nursing, Physiotherapy and Podiatry, Universidad de Sevilla, C/Avenzoar nº6, 41009 Seville, Spain;
| | - Julia González-Vaca
- Departament D’Ínfermeria Medicoquirurgica, Campus Bellvitge, Universidad de Barcelona, 08907 Barcelona, Spain;
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