Anxiety symptoms and burnout among Chinese medical staff of intensive care unit: the moderating effect of social support

Job burnout and anxiety among medical staff: A latent profile and moderated mediation analysis

BACKGROUND

Due to work pressure, work intensity, and the impact of emergencies such as the epidemic, job burnout and mental health problems among medical staff have become increasingly prominent.

OBJECTIVES

Our study aims to characterize the patterns of burnout in Chinese medical staff, explore the profile differences on anxiety and self-esteem, examine whether the differences in these profiles on anxiety were mediated by self-esteem, and investigate whether this mediating process was moderated by positive coping styles among medical staff.

METHODS

Data were collected from 602 medical staff in China by a convenient sampling method. A latent profile and moderated mediation analysis were performed.

RESULTS

Latent profile analysis on three burnout dimensions [emotional exhaustion, cynicism, and professional efficacy] indicated two burnout profiles: low burnout (82.47% of the sample) and high burnout (17.53%). Medical staff with a low burnout profile had lower levels of emotional exhaustion and cynicism than those with a high burnout profile. It was also determined that self-esteem mediates burnout and anxiety in both high- and low-burnout medical staff. The moderating role of positive coping styles was also identified (β = 0.30, 95%CI: 0.058-0.550).

CONCLUSIONS

The identification of two distinct burnout patterns (low burnout and high burnout) provides clinical administrators with clear goals for individualizing support and interventions for medical staff with different levels of burnout. Furthermore, attention should be given to self-esteem and positive coping styles, as they act as potential mediators and moderators of medical staff's mental health problems.

Relationship between burnout and occupational fatigue exhaustion and recovery among orthopaedic nurses in Tabriz, Iran: a cross-sectional survey

OBJECTIVE

To examine the relationship between burnout and occupational fatigue exhaustion and recovery among orthopaedic nurses in Tabriz, Iran.

DESIGN

Descriptive, cross-sectional survey and correlational analysis.

SETTING

Two hospitals associated with Tabriz University of Medical Sciences, Iran, from August to September 2022.

PARTICIPANTS

92 bedside nurses in orthopaedic wards, each with >1 year of clinical experience.

OUTCOME MEASURES

Burnout was assessed using the Copenhagen Burnout Inventory, and occupational fatigue exhaustion/recovery was measured with the Occupational Fatigue Exhaustion/Recovery Scale. Pearson's correlation, independent t-test, one-way analysis of variance and multivariable linear regression analyses determined statistical significance.

RESULTS

The mean burnout score was 63.65 (±15.88) out of 100 and the recovery rate was 35.43 (±15.60) out of 100. There were significant correlations between total burnout and each of the exhaustion recovery dimensions: chronic fatigue (r=0.70), acute fatigue (r=0.65) and intershift recovery (r=0.56). Nurses exceeding 44 weekly work hours reported higher burnout (66.52±14.77, p=0.005) than those working fewer hours (56.25±16.12, p=0.005). Rotational shift status was associated with increased burnout (64.97±15.32) compared with fixed shifts (55.54±17.42, p=0.04). Chronic fatigue (B=0.39, 95% CI 0.21, 0.57; t=4.29, p<0.001) and intershift recovery (B=-0.241, 95% CI -0.46, -0.02; t=-2.16, p=0.035) were significant predictors of burnout.

CONCLUSIONS

Burnout is a critical concern among orthopaedic nurses and is significantly linked to occupational fatigue/recovery. Addressing chronic fatigue and enhancing intershift energy recovery could mitigate burnout risk. Therefore, optimising work conditions and schedules and developing tailored recovery protocols are vital to safeguarding orthopaedic nurses' well-being.

Association between occupational burnout and psychological symptoms among Chinese medical staff: moderating role of social support

This study aimed to examine the association between occupational burnout and psychological symptoms among Chinese medical staff, assuming social support to play a moderating role in the aforementioned relationship. The survey was conducted online from May 1 to June 28, 2022, and the questionnaires were distributed and retrieved through a web-based platform. The final sample was comprised of 1461 Chinese medical staff in this cross-sectional study. Several multiple linear regressions were performed to analyze the data. After controlling for potential confounding factors, all three dimensions of occupational burnout were associated with poorer psychological symptoms. Emotional exhaustion (β = 0.33; 95% confidence interval [CI], 1.018, 1.479) had the strongest association with psychological symptoms, followed by depersonalization and diminished personal accomplishment. Moreover, medical staff with higher levels of friend support (β =  -0.11; 95% CI, -4.063, -0.573) and significant other support (β =  -0.10; 95% CI, -3.965, -0.168) were less likely to suffer from psychological symptoms when faced with occupational burnout. The results suggested that interventions aimed at lessening occupational burnout and boosting social support can be an effective way to promote the psychological health of medical staff.

Correlation analysis of mental toughness, family social support, and anxiety of nursing staff

OBJECTIVE

This study aims to explore the impact of family social support affects anxiety levels and mental toughness among nursing staff, and to identify the pathways of how mental toughness develops.

METHODS

We selected 256 nursing staff from the Third People's Hospital of Chengdu using a convenience sampling method. Participants completed a questionnaire assessing family social support, anxiety level and mental toughness of the nursing staff. The questionnaires included the general information questionnaire, Perceived Social Support Scale (PSSS), Self-Rating Anxiety Scale (SAS), and the Connor-Davidson resilience scale (CD-RISC). Then, we analyzed the correlation between nursing staff' family social support, anxiety symptoms and mental toughness by using Pearson correlation. Finally, we analyzed the effect of family social support on mental toughness and anxiety levels by using linear regression, and analyzed the path of family social support and psychological toughness on anxiety symptoms by using structural equation modeling.

RESULTS

We finally collected 246 valid questionnaires with a valid recovery rate of 96.09%. 116 (47.15%) nursing staff reported a moderate level of family social support, with a mean PSSS score of (58.98 ± 7.64). Anxiety risk was identified in 43.39% of participants, with a mean SAS score of 50.47 ± 10.96. In terms of mental toughness, 104 (42.28%) nursing staff exhibited a low level of mental toughness, and 116 (47.15%) demonstrated moderate level of mental toughness with CD-RISC score of (58.23 ± 10.12). Correlation analyses revealed a strong negative correlation between the family social support, mental toughness and their anxiety (r = -0.586, -0.516, respectively), and a strong positive correlation between family social support and mental toughness (r = 0.571). Regression analysis showed that family social support was a significant negative predictor for anxiety (β = -0.841, t = -9.488), but a significant positive predictor for mental toughness (β = 0.756, t = 11.669). Mediation analysis indicated that mental toughness mediated 26.28% of the relationship between family social support and anxiety levels.

CONCLUSION

Family social support can significantly reduce anxiety levels in nursing staff directly, as well as indirectly by increasing mental toughness.

Investigating the effect of education based on PRECEDE-PROCEED model on the preventive behaviors of musculoskeletal disorders in a group of nurses

Background

One of the most important occupational complications that could occur in nurses is musculoskeletal disorders. In this study, we designed an educational intervention based on the PRECEDE-PROCEED model to investigate its effects on a group of nurses on preventive behaviors of musculoskeletal disorders.

Methods

A total of 120 nurses working in Izeh City, Iran, participated in this semi-experimental study. The sampling was performed through a convenient sampling method, and the participants were randomly assigned to the experimental and control groups (60 participants for each group). Both groups filled out a questionnaire based on the PRECEDE-PROCEED model before and 2 months after the educational program as part of the data collection process. The data were examined using a paired t-test, an independent t-test, and a chi-square test after being entered into SPSS version 24.

Results

According to the findings, prior to the intervention, there was no difference between the two groups in terms of their knowledge (p = 0.221), attitude (p = 0.136), enabling factors (p = 0.325), reinforcing factors (p = 0.548), self-efficacy (0.421), and behavior (0.257) levels. However, following the intervention, a substantial rise was witnessed in the experimental group in each of the mentioned variables (p = 0.001).

Conclusion

In the current study, education based on the PRECEDE-PROCEED model led to the improvement of knowledge, attitude, enabling and reinforcing factors, self-efficacy, and finally preventive behaviors with musculoskeletal disorders in the participants. Considering the importance of the role of health education in promoting behaviors related to musculoskeletal disorders in nurses and the importance of observing related behaviors in preventing long-term complications, the necessity of education in a wider dimension and with different tools is felt more and more in society. Therefore, longer interventions with this aim could be carried out on nurses and other healthcare personnel.

Stress and burnout among Greek critical care nurses during the COVID-19 pandemic

Occupational stress and burnout of health personnel during the COVID-19 pandemic, especially of the nursing population in intensive care units (ICUs), were quite frequent along with negative effects and a direct correlation with the manifestation of many physical, behavioral and psychological symptoms. For the purposes of this research, a quantitative survey was carried out, in which 153 ICU nurses of secondary and tertiary public hospitals in Greece participated. Nurses completed anonymously and voluntarily a special electronic questionnaire about stress, burnout, personal concerns about the pandemic, the consequences of the outbreak and their resilience toward COVID-19 patients' care. Specific validated scales were used in this study. Female nurses felt, to a greater extent than males, work-related burnout, especially patient-related burnout and total burnout. There was a statistically significant negative relationship between the existence of a psychological support group within a hospital and personal burnout. Participants who had experience in caring for SARS-CoV-2 patients had higher mental resilience than those without experience. As the consequences experienced by the health professionals of the reference COVID-19 hospitals were increased, so did mental resilience and stress coping strategies during the pandemic. The COVID-19 outbreak and the conditions configurated in the health system had negative effects on the psycho-emotional state of ICU nurses. The manifestation of anxiety, stress and burnout had a direct correlation with both the work and personal functionality of the nurses and the whole of the healthcare services provided. The early recognition of symptoms and their individualized management are imperative for the protection of the psycho-emotional well-being of nurses.

Reciprocal longitudinal associations of supportive workplace relationships with depressive symptoms and self-rated health: A study of Korean women

BACKGROUND

Supportive relationships in the workplace are important determinants of an individual's psychological health, buffering work stress. This study aimed to estimate the bidirectional association of workplace relationships with depressive symptoms and self-rated health in female workers.

METHODS

Based on the nationally representative biannual survey data from 2014 (T1) to 2020 (T4) (N = 2556), we used a random intercept cross-lagged panel model (RI-CLPM) to estimate autoregressive and cross-lagged bidirectional associations between workplace relationships and health variables.

RESULTS

Regarding satisfactory workplace relationships and depressive symptoms, a negative correlation was observed at the between-person level. At the within-person level, the cross-lagged path showed that an increase in satisfaction with workplace relationships was related to a subsequent decrease in depressive (T1 to T2: β = -0.039; B = -0.253, P = 0.017). Further, an increase in depressive symptoms was related to subsequent relationship deterioration in the workplace (T1 to T2: β = -0.049, B = -0.007, P = 0.003). Regarding workplace relationships and self-rated health, a positive correlation was observed at the between-person level. At the within-person level, there as was no significant within-person level association between WPR and self-rated health. and the effect sizes were small.

CONCLUSIONS

This study suggests a bidirectional association between workplace relationships and depressive symptoms. Therefore, it is important to implement intervention programs that promote workplace interpersonal relationships and workers' mental health.

Burnout, depression, and suicidal ideation among physicians before and during COVID-19 and the contribution of perfectionism to physicians' suicidal risk

Objectives

There is limited data regarding the prevalence of suicidal risk among physicians during COVID-19, and the risk factors relating to it. Dominant risk factors for suicide among physicians are depression and burnout. Maladaptive perfectionism may also serve as a profound risk factor for suicidality among physicians and may aggravate symptoms of distress under the challenges of COVID-19. This study aims to evaluate current suicidal risk, suicidal ideation, depression, and burnout before and during COVID-19 among physicians in Israel, and to identify the best sets of correlates between perfectionism and burnout, depression and suicidal ideation, during these time periods.

Methods

A sample of 246 Israeli physicians (160 before COVID-19 and 86 during COVID-19) completed online surveys assessing lifetime suicidal risk, suicidal ideation during the last year and current suicidal ideation, depression, burnout symptoms and maladaptive perfectionism.

Results

More than one-fifth of the sample (21.9%) reported high suicidal risk (Lifetime suicidal behaviors). More than one-fourth (27.2%) reported suicidal ideation during the last 12 months; and 13.4% reported suicidal ideation during the last 3 months. In addition, more than one-third (34.6%) exhibited moderate-severe levels of depressive symptoms and more than a half of the sample reported burnout symptoms. Maladaptive perfectionism was positively correlated with current suicidal ideation, burnout, and depression. Moderated serial mediation analysis demonstrated indirect effect of perfectionism on suicidal ideation by its impact on burnout and depression only during COVID-19. Before COVID-19, physicians were more likely to experience depressive symptoms.

Conclusion

Physicians in Israel are at increased risk for depression and suicidal ideation, regardless of the COVID-19 pandemic. Maladaptive perfectionism was found to be a risk factor for burnout, depression, and suicidal ideation. During the first waves of the pandemic, physicians were less likely to experience depressive symptoms. However, among physicians who were characterized with high maladaptive perfectionism, depression served as a significant risk factor for suicidal ideation during the pandemic, which places these individuals at increased risk for suicidality. These results highlight the importance of implementing intervention programs among physicians to reduce suicidal risk and to better identify rigid perfectionism and depressive symptoms.

Work-Family Conflict and Mental Health among Chinese Female Healthcare Workers during the COVID-19 Pandemic: The Moderating Effects of Resilience

(1) Background: The mental health of female healthcare workers is at greater risk during the COVID-19 pandemic due to increased psychological stress and heightened work-family conflict. This study investigated whether resilience, as a protective factor for mental health, can safeguard the well-being of female healthcare workers. This study assessed the mental health of female healthcare workers (n = 431) from a small inland city in Central China, explored the impact of work-family conflict on their mental health, and examined the moderating role of resilience. (2) Methods: The main variables were measured using standard tools administered via an online survey. A one-sample t-test, ANOVA, Pearson correlation analysis, and multiple regression were performed with SPSS. A simple slope test was conducted based on the multiple regression results. (3) Results: The analysis revealed that the mental health level of the surveyed female healthcare workers was significantly lower than the national norm (t = 16.36, p < 0.001). Work-family conflict had a significant negative impact on mental health (β = 0.39, p < 0.001), while the interaction effect of resilience and work-family conflict was significant (β = -0.13, p < 0.05), suggesting a moderating effect. (4) Conclusions: Female healthcare workers exhibited poor mental health during the COVID-19 pandemic, but resilience remained a protective factor, mitigating the negative impact of work-family conflict on female healthcare workers' mental health.

Psychological symptoms and correlates of Chinese healthcare professionals in the intensive care unit before and after the COVID-19 outbreak: A comparison of two cross-sectional studies

BACKGROUND

The outbreak of COVID-19 disarranged lives across mainland China. No study has examined changes in psychological symptoms of healthcare professionals in the intensive care unit (ICU) before and after the outbreak of COVID-19. The aim of this study was to estimate changes in psychological symptoms of ICU healthcare professionals before and after the COVID-19 outbreak, and to analyze factors related to psychological symptoms.

METHODS

Two waves' administrations were implemented between December 13 and December 14, 2018, and between April 5 and April 7, 2020, respectively. The symptom checklist-90 (SCL-90) were used to evaluate psychological symptoms. Multiple logistical regression was used to reveal the risk of psychological symptoms.

RESULTS

A total of 3902 and 3908 ICU healthcare professionals took part in the first and second surveys. The mean total score of the SCL-90 was 179.27 (70.02) at wave 1 and 147.75 (58.40) at wave 2, respectively. The proportion of psychological symptoms was 55.6 % (95%CI = 54.0-57.1) at wave 1. But rates of psychological symptoms decreased to 36.6 % (95%CI = 35.1-38.2) at wave 2. ICU healthcare professionals with western economic belt and 6-10 years of work were more likely to develop psychological symptoms, while ICU healthcare professionals with the later survey and doctoral degree were less likely to develop psychological symptoms.

CONCLUSION

Although COVID-19 period benefited psychological symptoms of ICU healthcare professionals, psychological symptoms still had a related high prevalence. Regular screening and appropriate interventions should still be implemented to decrease the risk for psychological symptoms among Chinese ICU healthcare professionals.

Hopelessness and burnout in Italian healthcare workers during COVID-19 pandemic: the mediating role of trait emotional intelligence

Objective

The study aims to assess the impact of COVID-19 on healthcare workers' work-related stress during the first wave of the pandemic in Italy. The main objective is to investigate the existence of a positive correlation between hopelessness and burnout, assuming that burnout may be a risk factor for the development of hopelessness, and to analyze the role that trait Emotional Intelligence (TEI) and changes in workload could have in this relationship. Furthermore, evaluate any significant differences in burnout and hopelessness levels in the function of some demographic variables, such as gender, professional profiles, and different working zones of Italy, to better understand how the diverse diffusion of pandemic had affected Italian healthcare workers.

Methods

An online survey was used to collect data between April and June, 2020, with 562 responses among nurses (52.1%) and physicians (47.9%). Demographics and changes in workload and work conditions were collected through an ad hoc questionnaire. The Trait Emotional Intelligence Questionnaire-Short Form (TEIQue-SF), The Beck Hopelessness Scale (BHS), and the Link Burnout Questionnaire (LBQ) were used to assess Trait Emotional Intelligence (TEI), hopelessness, and burnout, respectively.

Results

Correlation analysis showed a significant positive relationship between hopelessness and each burnout dimension. TEI showed negative correlations both with burnout dimensions and hopelessness. Significant differences in burnout and hopelessness levels emerged as a function of some demographic variables such as gender, professional profiles (nurses or physicians), and different working zone of Italy (northern or southern). Results showed that TEI partially mediated the relationship between hopelessness and every burnout dimension, while the interaction of changes in workload was non-significant.

Discussion

The mediating role of TEI in the burnout-hopelessness relationship partly explains the protective role that individual factors had on healthcare workers' mental health. Our findings support the need to integrate considerations on both psychological risk and protective factors into COVID-19 care, including the monitoring of psychological symptoms and social needs, especially among healthcare workers.

Effects of work-family conflict and anxiety in the relationship between work-related stress and job burnout in Chinese female nurses: A chained mediation modeling analysis

BACKGROUND

Job burnout among nurses has been a challenging problem in recent years globally and in China. Work-related stress, work-life interference and mental health have been shown to be associated with nurse job burnout. However, the underlying mechanisms remain not fully understood. This study aims to examine the complex relationships linking work-related stress to nurse burnout among Chinese nurses.

METHODS

Study data were collected from female nurses (n = 2172) in cities of Wuhan, Shiyan and Jingzhou, Hubei Province of China. Job burnout was used as outcome variable, work-related stress was the predictor, work-life interference and anxiety symptoms were mediators. Mediation and chained mediation modeling analysis were used for data analysis.

RESULTS

The association between work-related stress and job burnout was significantly mediated by work-family conflict (indirect effect[95%CI] = 0.05[0.05,0.06]) and anxiety symptoms (indirect effect = 0.42[0.36,0.49]), respectively. Further, a chained mediation mechanism was observed with work-family conflict and anxiety symptoms consecutively mediated the relationship between work-related stress and job burnout (indirect effect = 0.02[0.01,0.02]).

LIMITATIONS

The data were collected in one province in central China, so it needs caution when generalizing the study findings to other regions within or outside of China.

CONCLUSION

Work-related stress exerts effects on job burnout through work-family conflict and anxiety symptoms among female nurses in China. Work-related stress-based burnout prevention must consider both work-family conflict and mental health problems.

Burnout, Depression, and Job Stress Factors in Healthcare Workers of a Romanian COVID-19 Dedicated Hospital, after Two Pandemic Years

The COVID-19 pandemic put unprecedented pressure on all areas of activity, especially healthcare workers. Understanding the psychological response to the pandemic in healthcare workers is an important challenge. This study aims to investigate burnout, depression, and job stress factors in the medical personnel of a COVID-19-dedicated hospital, two years after the beginning of the pandemic. The survey was performed between the fifth and sixth pandemic waves in Romania. Employees of the Clinical Hospital for Infectious Diseases, Cluj-Napoca, completed an online survey using four tools: Maslach Burnout Inventory (MBI), Copenhagen Burnout Inventory (CBI), the Karasek Job factors questionnaire, and the Patient Health Questionnaire-9 (PHQ-9). A total of 114 employees completed the questionnaire (10.83% of total employees). The results showed 100% prevalence of Maslach burnout (56.1% moderate and severe burnout) and 63.1% prevalence of depression. The infectious disease resident doctors had the highest prevalence of burnout scores, depression, and perceived Karasek job demands. The 22- to 30-year-old age group and the group with fewer than ten years of professional experience had a significantly higher prevalence of burnout and depression than older employees or employees with more professional experience. The COVID-19 pandemic continues to have a high impact on the mental health of healthcare workers.

A Two-Wave Study On The Associations Of Burnout With Depression And Anxiety: The Mediating And Moderating Role Of Perceived Family Support

Studies have shown strong associations between burnout and depression and burnout and anxiety but their exact interrelationships still remain unclear. Few studies have examined the psychosocial mechanisms that might underlie these two relationships. Non-work social factors such as perceived family support can affect mental health. The present study investigated the distinctiveness and the reciprocal associations between burnout and depression, and burnout and anxiety by collecting data twice over an 8 month interval. Perceived family support was examined as a mediating and a moderating factor underlying the two relationships. The Maslach Burnout Inventory-General Survey, the Hospital Depression and Anxiety Scale, and the Julkunen Family Support Scale were administered to employees of the general working population (N = 52). First, our results revealed moderate associations between burnout and depression, and burnout and anxiety, supporting the distinctiveness of burnout from the two psychological phenomena. Second, the exhaustion and cynicism burnout dimensions showed reciprocal associations with depression. Moreover, anxiety was found to be a consequence of cynicism while it presented reciprocal associations with the exhaustion dimension of burnout. Perceived family support did not mediate the burnout-depression and burnout-anxiety relationships. However, it moderated the depression-exhaustion relationship in a direction opposite from our hypothesis.

The Association between Burnout, Social Support, and Psychological Capital among Primary Care Providers in Togo: A Cross-Sectional Study

Background and Objectives: Job burnout is prevalent among primary care providers (PCPs) in different countries, and the factors that can alleviate burnout in these countries have been explored. However, no study has addressed the prevalence and the correlates of job burnout among Togolese PCPs. Therefore, we aimed to examine the prevalence of burnout and its association with social support and psychological capital among PCPs in Togo. Material and Methods: We conducted a cross-sectional study in Togo from 5 to 17 November 2020 among 279 PCPs of 28 peripheral care units (PCUs). Participants completed the Maslach Burnout Inventory, Job Content Questionnaire, and Psychological Capital Questionnaire. Data were analyzed using the Mann-Whitney U test, Kruskal-Wallis H test, Pearson correlation analysis, and multiple linear regression. Results: We received 279 responses, out of which 37.28% experienced a high level of emotional exhaustion (EE), 13.62% had a high level of depersonalization (DP), and 19.71% experienced low levels of personal accomplishment (PA). EE had a significant negative correlation with the supervisor's support. In contrast, self-efficacy, hope, optimism, and resilience had a significant negative correlation with DP and a significant positive correlation with PA. Furthermore, supervisors' support significantly predicted lower levels of EE. Optimism significantly predicted lower levels of DP and higher levels of PA. Conclusions: Burnout is common among Togolese PCPs, and self-efficacy, optimism, and supervisors' support significantly contribute to low levels of job burnout among Togolese PCPs. This study provided insight into intervention programs to prevent burnout among PCPs in Togo.

Impact of long working hours on depressive symptoms among COVID-19 frontline medical staff: The mediation of job burnout and the moderation of family and organizational support

Background

During the COVID-19 pandemic, the frontline medical staff faced more workload and heavier physical and mental stress, which increased their job burnout and negative emotions. However, little is known about the potential factors mediating and moderating these relations. This study investigates the association between long working hours and depressive symptoms among frontline medical staff in China, and explores the potential mediating effect of job burnout, and moderating effect of family and organizational support on these associations.

Methods

Data of 992 frontline medical staff who participated in the prevention and control of COVID-19 was obtained from the online survey conducted in November to December 2021 in China. Depressive symptoms were evaluated using the Patient Health Questionaire-9 (PHQ-9). Moderated mediating model was employed to understand the relationship between long working hours (X), depressive symptoms (Y) mediated through job burnout (M), moderated by family support (W1) and organizational support (W2), while controlling all possible covariates.

Results

56.96% of participants worked more than 8 h per day. 49.8% of them had depressive symptoms (PHQ-9 ≥ 5) and 65.8% experienced job-related burnout. Long working hours was positively associated with depressive symptoms score (β = 0.26, 95% CI:0.13 ~ 0.40). Mediation analyses revealed that job burnout significantly mediated this relationship (indirect effect = 0.17, 95% CI: 0.08 ~ 0.26). Moderated mediation further indicated that both two interactions of social support (family support W1, organizational support W2) and job burnout were negatively related to depressive symptoms among frontline medical staff, indicating that higher social support being less job burnout with lower depressive symptoms.

Conclusion

Longer working hours and higher job burnout may contribute to worse mental health among frontline medical staff. Social support could buffer the detrimental effects by reducing their job burnout.

Contribution

The main contribution of this study was to estimate the negative effect of long working hours on depressive symptoms among frontline medical staff and explore the potential mediating role of job burnout and moderating role of social support on these associations.

Effect of social support on anxiety of medical staff one year after COVID-19 outbreak: a moderated mediating model

One year after the outbreak of COVID-19, medical staff are facing high anxiety due to multiple work stresses. Social support has become a protective factor for healthcare workers' anxiety symptoms, but the exact mechanism of action is not yet known. Based on the buffering model, this study aims to explore the impact and mechanisms of action of healthcare workers' perception of social support (PSS) on anxiety symptoms in the context of the epidemic and to further explore how the emotional characteristics of risk perception (ECRP) and resilience play their influence. To this end, this study measured 839 healthcare workers using an online questionnaire from 4 February to 1 March 2021. The results found that PSS among healthcare workers negatively predicted anxiety symptoms. ECRP partially mediated the relationship between PSS and anxiety symptoms, and resilience moderated the first half of the pathway in the model of PSS through ECRP on anxiety symptoms. The emotional characteristics of risk perception of COVID-19 in individuals with high resilience decrease significantly with the increase of PSS, while this change is not significant in individuals with low resilience.

Prevalence and associated factors of mental health outcomes among healthcare workers in Northern Colombia: A cross-sectional and multi-centre study

Background

Mental health outcomes in Healthcare Workers (HCWs) has been few evaluated during COVID-19 pandemic in low-and middle-income countries. Our aim was carry-out a study to identify the prevalence of stress, anxiety, depressive symptoms in HCWs and associated factors to severe illness in a northern region in Colombia.

Method

A cross-sectional, hospital-based survey was conducted to assess mental health outcomes in 1,149 HCWs in Colombia. The study used Perceived Stress Scale (PSS-10), 7-item Generalized Anxiety Disorder (GAD-7), and 9-item Patient Health Questionnaire (PHQ-9) to evaluate stress, anxiety, and depression symptoms, respectively.

Results

682 HCWs completed the questionnaire. The 58,21% (397/682) were nurses, 31,23% were physicians (213/682), and 10,56% (72/682) were other health professionals. The proportion of HCWs with stress, anxiety, and depressive symptoms were 59,97%, 44,87%, and 23,02%, respectively. HCWs in emergency room and Intensive Care Units (ICU) have 2-3-fold increase risk to have severe symptoms of stress. Staff in ICU have 64% more likely to have severe anxiety symptoms, and 97% more likely to have severe depression symptoms.

Limitations

Including HCWs only in the northern region in Colombia; a non-probabilistic sample, and a cross-sectional design to identify causality.

Conclusion

A higher proportion on mental health outcomes has been reported in HCWs in Colombia. There are work areas related with severe mental symptoms such as ICU and emergency room. Hospitals and patient-care institutions in Latin-America needs consider the mental and physical health of HCWs during outbreaks and identify health staff at-risk to implementing support strategies to mitigate adverse mental outcomes.

Social Support, Social Isolation, and Burnout: Cross-Sectional Study of U.S. Residents Exploring Associations With Individual, Interpersonal, Program, and Work-Related Factors

PURPOSE

To examine associations of social support and social isolation with burnout, program satisfaction, and organization satisfaction among a large population of U.S. residents and fellows and to identify correlates of social support and social isolation.

METHOD

All residents and fellows enrolled in graduate medical education programs at Mayo Clinic sites were surveyed in February 2019. Survey items measured social support (emotional and tangible), social isolation, burnout, program satisfaction, and organization satisfaction. Factors of potential relevance to social support were collected (via the survey, institutional administrative records, and interviews with program coordinators and/or program directors) and categorized as individual, interpersonal, program, or work-related factors (duty hours, call burden, elective time, vacation days used before survey administration, required away rotations, etc.). Multivariable regression analyses were conducted to examine relationships between variables.

RESULTS

Of 1,146 residents surveyed, 762 (66%) from 58 programs responded. In adjusted models, higher emotional and tangible support were associated with lower odds of burnout and higher odds of program and organization satisfaction, while higher social isolation scores were associated with higher odds of burnout and lower odds of program satisfaction and organization satisfaction. Independent predictors of social support and/or social isolation included age, gender, relationship status, parental status, postgraduate year, site, ratings of the program leadership team, ratings of faculty relationships and faculty professional behaviors, satisfaction with autonomy, and vacation days used before survey administration.

CONCLUSIONS

This study demonstrates that social support and social isolation are strongly related to burnout and satisfaction among residents and fellows. Personal and professional relationships, satisfaction with autonomy, and vacation days are independently associated with social support and/or social isolation, whereas most program and work-related factors are not. Additional studies are needed to determine if social support interventions targeting these factors can improve well-being and enhance satisfaction with training.

How Daily Obstacles Affect Frontline Healthcare Professionals' Mental Health during Omicron: A Daily Diary Study of Handwashing Behavior

Based on coping theory, the current research examines how and why COVID-19 phobia affects frontline healthcare professionals' mental health, as well as their burnout and work-related stress. We focused on the mediating role of burnout and work-related stress in this study. In the current study, we also examined the moderating influence of healthcare professionals' handwashing behavior using the Hayes Process model. We employed a daily diary approach to collect data from respondents in Pakistan's frontline healthcare professionals (n = 79, 79 × 10 = 790) who were directly treating COVID-19 patients during the omicron wave. According to the findings of the study, COVID-19 phobia significantly disturbs healthcare professionals' mental health, as well as significantly strengthens burnout and work-related stress. The findings also demonstrated that burnout significantly negatively influences mental health. The mediation influence of burnout and work-related stress in the association between COVID-19 phobia and mental health has shown to be significant. The moderation analysis revealed that high handwashing behavior significantly buffers the negative impact of COVID-19 phobia, as well as the adverse effect of burnout on healthcare professionals' mental health. Moreover, our findings have theoretical and managerial implications, as well as new research directions for scholars to understand the adverse impact of daily obstacles on professionals' (nurses and doctors, etc.) mental health and work performance, as well as issues based on resource conversation philosophy.

Three Mental Health Symptoms of Frontline Medical Staff Associated With Occupational Stressors During the COVID-19 Peak Outbreak in China: The Mediation of Perceived Stress and the Moderation of Social Support

The outbreak of COVID-19 epidemic has increased work demands for medical staff and has a certain impact on their mental health. The present study aimed to examine the role of perceived stress and social support in explaining the association between the occupational stressors and three mental health symptoms (i.e., anxiety, depression, and insomnia) of frontline medical staff. Five hundred twenty five frontline medical staff were investigated online after the outbreak of the COVID-19 (16 February, 2020-2 March, 2020) in China. The results found that the prevalence of anxiety, depression, and insomnia among frontline medical staff were 39.8, 29.9, and 37.9%, respectively. Occupational stressors were associated with anxiety, depression, and insomnia symptoms. Perceived stress significantly mediated this link. Social support moderated the second half of the indirect effect of occupational stressors on anxiety and depression symptoms. Under the epidemic situation of COVID-19, for frontline medical staff, high perceived stress and low social support may increase vulnerability for mental health symptoms triggered by occupational stressors. Thus, improving the social support and promoting the cognitive reappraisal of perceived stress may help to maintain mental health among medical staff.

Role Stress and Psychological Distress Among Chinese Nurses During the COVID-19 Pandemic: A Moderated Mediation Model of Social Support and Burnout

OBJECTIVE

Nurses are at high risk of psychological distress including stress, depression, and anxiety due to low personnel density and high work demand. Despite mounting evidence showing that role stress is a risk factor for nurses' psychological distress, the mediating and moderating mechanisms underlying this relationship are less known. This study tests the mediation effect of burnout in the association between role stress and psychological distress, and whether this mediation is moderated by social support.

METHODS

A sample of 623 Chinese nurses were recruited from all hepatological surgery departments in Hunan Province and filled out an online questionnaire to collect data on socio-demographics, role stress, burnout, psychological distress, and social support. Mediation and moderation analyses were carried out in SPSS macro-PROCESS.

RESULTS

Burnout partially mediated the positive association between role stress and psychological distress. Social support moderated the indirect effect of role stress on psychological distress via burnout, with the effect being stronger for nurses with low social support than those with high social support.

CONCLUSIONS

These findings demonstrated how role stress contributed to nurses' psychological distress both directly and indirectly through burnout, and how this indirect effect was moderated by social support. The results provide important practical implications for future prevention and intervention programs to improve nurses' mental health from multiple aspects such as decreasing role stress and burnout while increasing social support.

Prevalence and Associated Factors of Psychological Distress among Nurses in Public Hospitals, Southwest, Ethiopia: A cross-sectional Study

Background

Psychological distress is a state of emotional suffering and also characterized by somatic symptoms. Health care workers more prone psychological distress than general population. However, little attention was paid on psychological distress among nurses particularly in Ethiopia. Therefore, this study aimed at assessing the prevalence of psychological distress and its' associated factors among nurses in public hospitals, Southwest Ethiopia.

Method

An institutional-based cross-sectional study was conducted from February 1st, 2018 to April 1st, 2018. All 282 eligible nurses in the selected public hospitals were enrolled. Data was collected using the predesigned tool like Self-Reporting Questionnaire version 20. Data were entered using EPI INFO version 7 and was exported to statistical packages for social science (SPSS) version 21.0 for analysis. Logistic regression analysis was employed and variables with a P-value of < 0.05 were considered as statistically significant.

Result

A total of 282 eligible nurses were enrolled in the study with mean age of 28.71 [SD ±7.047]. The prevalence of psychological distress among nurses was 78(27.7%). Predictor variables like; nurses with job title of staff nurse, less working experience, poor interaction with staffs, fatigue, poor social support, perfectionism, and insomnia were more prone to develop the psychological distress.

Conclusion

The study revealed that a considerable proportion of nurses had psychological distress. Therefore, it needs to develop psychological support strategies to improve the mental health resilience of nurses.

A study of self-precaution against the background of the COVID-19 pandemic from the perspective of risk perception attitude theory and social support

BACKGROUND

In this research, the factors that influence the self-precautionary behavior during the pandemic are explored with the combination of social support and a risk perception attitude framework.

METHODS

An online survey was conducted among 429 members to collect information on demographic data, social support, perceptions of outbreak risk, health self-efficacy, and self-precautionary behaviors with the guide of the Social Support Scale, the COVID-19 Risk Perception Scale, the Health Self-Efficacy Scale and the Self-precautionary Behavior Scale.

RESULTS

The research shows that among the three dimensions of social support, both objective support and support utilization negatively predict risk perception, while subjective support positively predicts health self-efficacy; health self-efficacy and risk perception significantly predict self-precautionary behavior; the relationship between risk perception and self-precautionary behavior is significantly moderated by health self-efficacy.

CONCLUSIONS

The combined influence of social capital and risk perception attitudinal frameworks on self-precautionary behavior is highlighted in this study, with the relationship between the public's risk perception, health self-efficacy, and self-precautionary behavior intentions examined against the background of coronavirus disease 2019 (COVID-19). These findings contribute to understanding the impact of social capital factors on risk perception and health self-efficacy, which provides insight into the current status and influencing factors of the public's precautionary behavior and facilitates early intervention during a pandemic.

Working conditions of Nursing professionals in coping with the Covid-19 pandemic

OBJECTIVE

To trigger a reflection on the current working conditions of Nursing professionals in coping with the Covid-19 pandemic.

METHOD

A theoretical-reflective study supported by studies from the Marxist perspective, national and international scientific articles, and official documents from the World Health Organization and the Federal Nursing Council.

RESULTS

The daily work of Nursing professionals in the face of the Covid-19 pandemic presents unfavorable working conditions in Brazil and worldwide, with emphasis on the deficit of professionals, overload of activities, low pay, and personal protective equipment, often insufficient and inadequate, conditions that can lead to exhaustion, illness and death.

CONCLUSION

This study can contribute to raising discussions about the need for improvements in the working conditions of Nursing professionals, especially in pandemic times and the impact on the health of these professionals.

Burnout in Intensive Care Unit Workers during the Second Wave of the COVID-19 Pandemic: A Single Center Cross-Sectional Italian Study

The COVID-19 pandemic had a massive impact on the Italian healthcare systems, which became overwhelmed, leading to an increased risk of psychological pressure on ICU workers. The present study aimed to investigate the prevalence of distress (anxiety, depression and insomnia symptoms), burnout syndrome and resilience in healthcare workers during the COVID-19 pandemic and to detect potential factors associated with their psychological response. This cross-sectional, survey-based study enrolled 136 healthcare workers assisting COVID-19 patients in the new COVID-19 ward (Intensive Care Unit), at Milano Fiera, Lombardy. Participants completed an online survey that comprised different validated and standardized questionnaires: Maslach Burnout Inventory (MBI), Resilience Scale for adults (RSA), Hospital Anxiety and Depression scale (HADS) and Insomnia Severity Index (ISI). Socio-demographic and work characteristics were also collected. Out of 136 ICU specialists, there were 84 nurses (62%) and 52 physicians (38%). Over half (60%) met the criteria for burnout, with nearly the same percentages among nurses and physicians. Nurses reported significantly higher scores of anxiety and insomnia levels. Forty-five percent of participants reported symptoms of depression (of whom 13.9% in the clinical range) and most of the staff showed moderate to high levels (82.4%) of resilience. The COVID-19 pandemic can have a significant impact on ICU staff. Effective interventions are needed to maintain healthcare professionals' mental health and relieve burnout. Follow-up and tailored procedures should be provided to alleviate the psychological burden in the frontline staff at highest risk.

Prevalence and Associated Factors of Burnout syndrome among Nurses in Public Hospitals, Southwest Ethiopia

BACKGROUND

The Burnout syndrome has been defined as a response to the chronic work-related stress typically found in professionals working in care service organizations. Therefore, this study aimed at assessing the prevalence of burnout syndrome and factors associated with burnout syndrome among nurses in public hospitals, Southwest Ethiopia, 2018.

METHOD

An institutional-based cross-sectional study was conducted from February 1st, 2018 to April 1st, 2018. Total number of nurses who fulfill the inclusion criterias were enrolled. Data was collected using the predesigned tool. Data were entered using EPI INFO version 7 and was exported to statistical packages for social science (SPSS) version 21.0 for analysis. Logistic regression was employed and odds ratio with a 95% confidence interval was used. Variables with a P value of less than 0.05 was considered statistically significant.

RESULTS

A total of 282 eligible nurses were enrolled in the study with a mean age of 28.71 [SD ±7.047]. The prevalence of burnout syndrome among nurses was 96(34%). Predictor variables like; educational status, job title, work experience, fatigue, and social support were found to be strong predictor variables for burnout syndrome.

CONCLUSION

This study revealed that a considerable proportion of nurses had burnout syndrome. Therefore, improved educational status and strong social support should be encouraged among nurses working in the health setting for the betterment of health care services, job satisfaction and quality of care in general.

The prevalence and stressors of job burnout among medical staff in Liaoning, China: a cross-section study

BACKGROUND

Sustained attention to the prevalence and associated factors of burnout in China is important for the health care service quality and related reform. In this study, we investigated the prevalence of job burnout among medical staff in Liaoning province, China; performed a survey of subjective perception ranking for the main stressors among respondents; estimated the effect of stresses from work tasks and the relationship with patients on job burnout in order to provide improved strategy and suggestion for hospital administrators.

METHODS

The respondents were from 8 hospitals in 3 cities in Liaoning province, China. Data were collected and analyzed including the following sections: (1) demographic characteristics; (2) work situations; (3) ranking of six stressors; (4) job burnout scale; (5) effort-reward imbalance scale; (6) work violence scale; (7) fear of malpractice scale. A total of 1056 individuals became the study objects. A statistical analysis and hierarchical linear regression analysis were performed to explore the prevalence of burnout and the effects of stressors.

RESULTS

The prevalence of job burnout was 20.5, and 72.9% of all respondents reported a least one symptom of burnout. The respondents who were male, 30-39 years old, had a master's degree or high and working hours > 60 h per week, came from obstetrics and gynecology or pediatrics profession prone to job burnout. The relationship with patients and work tasks are the top two ranking stressors in the subjective perception survey. Regression analysis showed that the relationship with patients explained 19.2, 16.8 and 2.0% of variance in burnout subscales EE, DP and PA, respectively and work tasks explained 23.5, 16.0 and 5.24% of variance in burnout subscales EE, DP and PA, respectively.

CONCLUSION

The Chinese medical staff had high prevalence of job burnout. Some factors of demographic and work situations were associated with job burnout. The medical staff considered the relationship with patients and work tasks are the two major stressors. These two stressors are also the major indicators associated with job burnout. The hospital administrators should be aware of the risk of burnout. Efforts should be made to ameliorate the status of job burnout.

Association between social support and anxiety among pregnant women in the third trimester during the coronavirus disease 2019 (COVID-19) epidemic in Qingdao, China: The mediating effect of risk perception

BACKGROUND

Coronavirus disease 2019 (COVID-19) is a public health emergency of international concern and poses a threat to the mental health of pregnant women.

AIM

The purpose of this study was to investigate the relationship between social support and anxiety, and the mediating effect of risk perception during the COVID-19 epidemic in the third trimester pregnant women in Qingdao, China.

METHODS

From 16 to 21 February 2020, an online survey was conducted, which collected the information on demographic data, anxiety, social support and risk perception to COVID-19 of women with established medical records in the ambulatory of the Department of Obstetrics at the Affiliated Hospital of Qingdao University. Anxiety was assessed by the Self-Rating Anxiety Scale (SAS), social support was assessed by the Social Support Rating Scale (SSRS) and risk perception was assessed by a self-designed questionnaire.

RESULTS

This study had 308 participants with an average of 31.02 ± 3.91 years. During the period of prevention and control of the epidemic, most pregnant women adopted protective measures, such as wearing masks (97.4%), washing hands frequently (88.3%) and staying at home (76.3%). The average SAS, SSRS and risk perception scores of the participants were 42.45 ± 6.98, 44.60 ± 7.00 and 21.60 ± 5.74, respectively. The total effect of maternal social support on anxiety was -2.63 (95% confidence interval (CI): -4.40 ~ -1.44, p < .001), the direct effect was -1.44 (95% CI: -2.74 ~ -0.35, p < .05) and the indirect effect was -1.19 (95% CI: -2.49 ~ -0.51, p < .001).

CONCLUSION

The third trimester pregnant women had a high level of social support, a medium level of risk perception to COVID-19 and were susceptible to anxiety. Risk perception played a mediating role between social support and anxiety.

Burnout and Cognitive Performance

The aim of this study was to investigate the relationship between burnout and cognitive functioning. The associations of depression, anxiety and family support with burnout and cognitive functioning were also examined both independently and as potential moderators of the burnout–cognitive functioning relationship. Seven different cognitive tasks were administered to employees of the general working population and five cognitive domains were assessed; i.e., executive functions, working memory, memory (episodic, visuospatial, prospective), attention/speed of processing and visuospatial abilities. Burnout, depression, anxiety and family support were assessed with the Maslach Burnout Inventory-General Survey, the Hospital Anxiety and Depression Scale and the Family Support Scale respectively. In congruence with the first and fourth (partially) Hypotheses, burnout and perceived family support are significantly associated with some aspects of cognitive functioning. Moreover, in line with the third Hypothesis, perceived family support is inversely related to burnout. However, in contrast to the second and fourth Hypotheses, depression, anxiety and perceived family support do not moderate the burnout–cognitive functioning relationship. Additional results reveal positive associations between burnout depression and anxiety. Overall findings suggest that cognitive deficits, depression and anxiety appear to be common in burnout while they underpin the role of perceived family support in both mental health and cognitive functioning. Implications for practice are discussed.

Interactive anesthesiology educational program improves wellness for anesthesiologists and their children

STUDY OBJECTIVE

Anesthesiologists have a high prevalence of burnout with adverse effects on professionalism and safety. The objective of this study was to assess the impact of an interactive anesthesiology educational program on the wellness of anesthesia providers and their children, as assessed by a modified Professional Fulfillment Index.

DESIGN

Prospective observational study.

SETTING

Perioperative area.

PATIENTS

Thirty clinicians participated in the program. Twenty respondents, representing 67% of participants and each corresponding to a parent and their child or children, completed the post-event survey.

INTERVENTIONS

An interactive anesthesiology educational program incorporating children, between the ages of five and eighteen years old, of anesthesia providers was held in the perioperative area. The program was held over four hours and was comprised of four sessions including pediatric anesthesia, neuroanesthesia, airway, and ultrasound stations.

MEASUREMENTS

Anesthesia providers and their children were administered a post-event assessment, including a modified Professional Fulfillment Index and satisfaction survey.

MAIN RESULTS

All twenty (100%) of respondents indicated it was "very true" or "completely true" that their child was happy with the program, and that it was worthwhile and satisfying to both the anesthesia provider and their child. Nineteen (95%) of reporting participants indicated it was "very true" or "completely true" that it was meaningful to have the department host such a program and 17 (85%) respondents felt their child now better understands the anesthesia work of the parent. All clinician volunteers indicated it was "very true" or "completely true" that they were contributing professionally during the program in ways that they valued most.

CONCLUSION

An interactive educational wellness initiative provides an effective and feasible method for increasing professional fulfillment and satisfaction among anesthesia providers while educating our youngest generation of learners. Implementation of such a program may also occur with modifications such as televideo to maintain COVID-19 precautions.

COVID-19 Outbreak Can Change the Job Burnout in Health Care Professionals

Background: The outbreak of COVID-19 in China was a sudden bio-disaster, which may bring a negative impact on the job burnout of health care professionals (HCPs). Objective: We aim to find out the association factors, especially those closely related to this outbreak, of job burnout in Chinese HCPs. Method: The cross-sectional survey about HCPs' job burnout based on a network platform was conducted in high and low infection regions during the COVID-19 outbreak in China. The demographic characteristics, medical-work-related factors, risk of getting infected due to occupational exposure, and family factors were collected by the self-reported questionnaire. The Chinese version of the Maslach Burnout Inventory (CMBI) and the Trait Coping Style Questionnaire (TCSQ) were employed in this study to evaluate the job burnout and coping style, respectively. Furthermore, statistical analysis was done to find out the associated factors of job burnout. Results: We collected 880 complete questionnaires from doctors and nurses from February 9, 2020 to February 11, 2020. In this study, the positive rates of three dimensions of burnout (emotional exhaustion, depersonalization, and reduced personal accomplishment) and overall burnout were 9.09, 50.57, 56.59, and 73.98%, respectively. After the statistical analysis, we found that several factors can independently affect the dimensions. Working in the high infection region and negative coping styles can affect all three dimensions at once. More night shift quantity and having symptoms could increase emotional exhaustion and depersonalization, while higher work intensity and senior title could increase emotional exhaustion and reduce personal accomplishment, respectively. Conclusion: The rate of moderate and severe burnout had increased due to the outbreak. More attention should be paid to burnout in HCPs, especially those with negative coping. There were some potential ways to reduce burnout, such as reducing their workload and providing better protection from the virus.

The role of social support and emotional exhaustion in the association between work-family conflict and anxiety symptoms among female medical staff: a moderated mediation model

BACKGROUND

Limited work has been done to explain how work-family conflict is related to anxiety symptoms and the roles of emotional exhaustion and social support may play.

METHODS

Based on a sample of 764 female nurses and physicians, a model was tested in which emotional exhaustion served as a mediator and social support was regarded as a moderator between work-family conflict and anxiety symptoms.

RESULTS

This current study supported a moderated mediation model where the relationship between work-family conflict and anxiety symptoms via emotional exhaustion was weakest for female medical staff who reported high levels of social support.

CONCLUSIONS

This study contribute to providing an understanding of how and when work-family conflict affects anxiety symptoms. The results implicate a wide range of interventions aimed at promoting mental wellbeing among female medical staff for policymakers and individuals.