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Bould MD, Tuyishime E, Nkurunziza C, Mpirimbanyi C, Mutabezi G, Wiwchar L, Yilma L, Charles C, Rangel C. Lived experience of burnout and fatigue in perioperative healthcare professionals in Rwanda: a qualitative study. Br J Anaesth 2024:S0007-0912(24)00458-6. [PMID: 39304463 DOI: 10.1016/j.bja.2024.07.018] [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: 01/26/2024] [Revised: 07/29/2024] [Accepted: 07/30/2024] [Indexed: 09/22/2024] Open
Abstract
BACKGROUND There is a lack of qualitative data on the negative effects of workplace stressors on the well-being of healthcare professionals in hospitals in Africa. It is unclear how well research methods developed for high-income country contexts apply to different cultural, social, and economic contexts in the global south. METHODS We conducted a qualitative interview-based study including 64 perioperative healthcare professionals across all provinces of Rwanda. We used an iterative thematic analysis and aimed to explore the lived experience of Rwandan healthcare professionals and to consider to what extent the Maslach model aligns with these experiences. RESULTS We found mixed responses of the effects on individuals, including the denial of burnout and fatigue to the points of physical exhaustion. Responses aligned with Maslach's three-factor model of emotional exhaustion, decreased personal accomplishment, and depersonalisation, with downstream effects on the healthcare system. Other factors included strongly patriotic culture, goals framed by narratives of Rwanda's recovery after the genocide, and personal and collective investment in developing the Rwandan healthcare system. CONCLUSIONS The Rwandan healthcare system presents many challenges which can become profoundly stressful for the workforce. Consideration of reduced personal and collective accomplishment, of moral injury, and its diverse downstream effects on the whole healthcare system may better represent the costs of burnout Rwanda. It is likely that improving the causes of work-based stress will require a significant investment in improving staffing and working conditions.
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Affiliation(s)
- M Dylan Bould
- Department of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, ON, Canada; Department of Innovation in Medical Education, University of Ottawa, Ottawa, ON, Canada.
| | - Eugene Tuyishime
- Department of Anesthesia Critical Care and Emergency Medicine, University of Rwanda, Kigali, Rwanda
| | - Charles Nkurunziza
- Department of Obstetrics and Gynecology, University Teaching Hospital of Butare (CHUB), Butare, Rwanda
| | | | - Gedeon Mutabezi
- Intensive Care Unit, University Teaching Hospital of Kigali (CHUK), Kigali, Rwanda
| | - Logan Wiwchar
- Department of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Lydia Yilma
- The Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Christopher Charles
- Department of Anesthesiology and Pain Medicine, Mount Sinai Hospital, Toronto, ON, Canada
| | - Christian Rangel
- Department of Innovation in Medical Education, University of Ottawa, Ottawa, ON, Canada
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Kiflu M, Tsega SS, Alem HA, Gedif AA, Getachew M, Dagnew FN, Haimanot AB, Mihiretie EA, Moges TA. Barriers to pharmaceutical care provision in the community and hospital pharmacies of Motta town, Northwest Ethiopia: a cross-sectional study. BMC Health Serv Res 2024; 24:1082. [PMID: 39289690 PMCID: PMC11409481 DOI: 10.1186/s12913-024-11538-3] [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: 06/27/2024] [Accepted: 09/04/2024] [Indexed: 09/19/2024] Open
Abstract
BACKGROUND Although pharmaceutical care has tangible positive importance in ensuring patient pharmacotherapy safety, its provision encounters several barriers. Therefore, this study investigated the obstacles pharmacy professionals faced while providing pharmaceutical care in Motta town, Northwest Ethiopia. METHODS A cross-sectional study was conducted from July 30, 2022, to August 30, 2022, at all community and hospital pharmacies in Motta town, Northwest Ethiopia. The data were collected via a self-administered questionnaire and analyzed via SPSS version 26.0. Descriptive statistics and statistical analysis tests, such as the independent t-test, variance, and multiple linear regressions, were employed to analyze the data. RESULTS The study had a 97.7% response rate. Among the 130 participants, 71 (54.6%) were females. The mean (± SD) total score of pharmaceutical care provision barriers was 85.06 (± 20.2). The highest and lowest mean subscale scores of pharmaceutical care provision barriers were related to lack of resources and skill, respectively. Among resource-related barriers, lack of time and money, lack of trained staff, and lack of private space for consultation scored higher than other barriers. Concerning vision/attitudinal barriers, patients and other healthcare workers' inappropriate attitudes toward pharmaceutical care obtained the highest scores. The lack of clinical education in pharmaceutical care, lack of communication, and lack of documentation skills of pharmacists scored higher than other barriers in the educational and skill-related barriers subscales. For the regulatory/environmental subscale, a lack of clinical practice guidelines and legal barriers scored higher than the other subscales did. Pharmaceutical care provision barriers were significantly associated with age (B = 14.008), years of practice (B = 13.009), and graduating institution (B=-16.773). CONCLUSIONS Resource and attitudinal/vision-related barriers were reported to be the most common barriers to pharmaceutical care implementation. Stakeholders should work together to develop strategic solutions to overcome these barriers and thus achieve optimal pharmaceutical care provision. These strategies should include optimizing the number of trained pharmacy staff, time and financial problems should be resolved, communication and documentation skills should be improved, pharmacy layouts should incorporate private counseling rooms, policies that support the pharmacist's role in patient care should be developed, and effective training and continuing professional education programs should be offered.
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Affiliation(s)
- Mekdes Kiflu
- Department of Pharmacy, College of Health Science, Debre Markos University, Debre Markos, Ethiopia.
| | - Sintayehu Simie Tsega
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Helen Abebaw Alem
- Department of Pharmacy, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Abebaw Abie Gedif
- Department of Pharmacy, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Melese Getachew
- Department of Pharmacy, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Fisseha Nigussie Dagnew
- Department of Pharmacy, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia
| | | | - Endalamaw Aschale Mihiretie
- Clinical Pharmacy Unit, Department of Pharmacy, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Tilaye Arega Moges
- Department of Pharmacy, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia
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Mengistie BA, Endale ZM, Azene ZN, Haile TT, Gebremichael Tsega A, Demeke M, Wassie YA, Abiy SA, Taye EB, Aragaw GM, Tsega NT. Predictors of burnout among midwives working at public hospitals in northwest Ethiopia, 2022: A multi-centred study. Women Birth 2024; 37:101654. [PMID: 39024981 DOI: 10.1016/j.wombi.2024.101654] [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: 11/24/2023] [Revised: 06/14/2024] [Accepted: 07/04/2024] [Indexed: 07/20/2024]
Abstract
PROBLEM Midwives are susceptible to burnout due to the physically and emotionally demanding nature of their job. Burnout is an occupational phenomenon with far-reaching consequences. AIM This study aimed to assess the magnitude of burnout and predictors among midwives working at public hospitals in northwest Ethiopia. METHODS An institutional-based cross-sectional study was conducted from February 7 to April 30, 2022. A simple random sampling method was employed to include 640 study participants. Data were collected using a self-administered questionnaire, entered into Epi-data 4.6 software, and exported to SPSS version 25 for analysis. A multivariable linear regression analysis model was fitted to identify factors contributing to midwives' burnout. FINDINGS The overall prevalence of midwives' burnout was 55.3 % (95 % CI = 51.7-58.9). The prevalence of personal, work-related, and client-related burnout was 58.3 %, 60.3 %, and 55.5 %, respectively. Factors that were significantly associated with burnout includes workplace violence (β = 5.02, CI: 2.90, 7.13), not receiving training (β = 4.32 CI: 1.81, 6.80), being exposed to blood and body fluids or needle stick injuries (β = 5.13 CI: 3.12, 7.13), low superior support (β = 5.13 CI: 1.94, 5.30), working in tertiary hospitals (β = 12.77 CI: 9.48, 16.06), and job rotation of six months or less (β = 16.75, CI: 13.12, 20.39). CONCLUSION This study found that the prevalence of burnout among midwives was significantly high. Addressing burnout requires implementing effective burnout prevention measures including enhancing management support, offering professional training, creating a conducive working environment, and adhering to standard precautions.
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Affiliation(s)
- Berihun Agegn Mengistie
- Department of General Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Zerfu Mulaw Endale
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Zelalem Nigussie Azene
- Department of Women's and Family Health, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Tsion Tadesse Haile
- Department of General Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Agnche Gebremichael Tsega
- Department of General Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Muluken Demeke
- Department of Midwifery, College of Medicine and Health Sciences, Dilla University, Dilla, Ethiopia.
| | - Yilkal Abebaw Wassie
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Saron Abeje Abiy
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Eden Bishaw Taye
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Getie Mihret Aragaw
- Department of General Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Nuhamin Tesfa Tsega
- Department of Women's and Family Health, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
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Batanda I. Prevalence of burnout among healthcare professionals: a survey at fort portal regional referral hospital. NPJ MENTAL HEALTH RESEARCH 2024; 3:16. [PMID: 38710834 DOI: 10.1038/s44184-024-00061-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 02/29/2024] [Indexed: 05/08/2024]
Abstract
The work environment in most hospitals is characterised by activities that are strenuous both physically and mentally. These can result in physical and mental exhaustion, which can lead to burnout if not adequately addressed. Burnout among healthcare professionals can negatively affect their clinical decision-making, quality of communication with patients and colleagues as well as their ability to cope with work-related pressure, and ultimately affect the quality of care and patient outcomes. The inclusion of burnout in the 11th revision of the International Classification of Diseases (ICD-11) as an occupational phenomenon indicates that it is an issue of concern in the workplace for which people may need professional attention. This descriptive cross-sectional survey aimed to determine the point prevalence of burnout among healthcare professionals at Fort Portal Regional Referral Hospital and the factors contributing to burnout. The study also evaluated the linear relationship between the age of workers, their work duration at the hospital, and their burnout score, in addition to the possible impact on patient care. Participants were selected from the hospital WhatsApp group and invitations to participate were sent to their individual accounts. Burnout was assessed using the Copenhagen Burnout Inventory. Generally, burnout scores ranged from 16% to 86%, with an overall mean burnout score of 57.4%. The notable factors contributing to burnout included imbalances in duty allocation, physically strenuous work, and resource constraints. Burnout of varying levels was found to be prevalent across all carders in the hospital, although the results indicate that most healthcare professionals experience moderate burnout. Most of the factors contributing to burnout are within the scope of hospital leadership to address. The possible impact on staff performance and patients' clinical outcomes is speculative, and additional studies are required.
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Affiliation(s)
- Ian Batanda
- Fort Portal Regional Referral Hospital, Fort Portal, Uganda.
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Shrivastava R, Singh A, Khan A, Choubey S, Haney JR, Karyotaki E, Tugnawat D, Bhan A, Naslund JA. Stress Alleviation Methods for community-Based Health ActiVists (SAMBHAV): Development of a digital program for stress reduction for community health workers in rural India. SSM - MENTAL HEALTH 2023; 4:100230. [PMID: 38188869 PMCID: PMC10769151 DOI: 10.1016/j.ssmmh.2023.100230] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2024] Open
Abstract
Background Community health workers (CHWs) face high levels of stress (both professional and personal) and risk of burnout, highlighting the need for efforts to promote their mental health and well-being. This study seeks to develop a digital stress reduction program for CHWs in rural India. Methods A stepwise design process was employed to adapt and digitize the evidence-based World Health Organization's Self-Help Plus (SH+) intervention for addressing psychological distress among CHWs in Madhya Pradesh, India. This involved participatory design workshops with CHWs to ensure that the digital stress reduction intervention would be relevant for their needs and the local culture and context. Small groups of CHWs reviewed the adapted program content, allowing the research team to make refinements such as simplifying language, tailoring content to the local setting, and ensuring that program materials are both interesting and relevant. Simultaneously, the research team digitized the content, leveraging a combination of video and graphical content, and uploaded it to the Sangath Learning Management System, a digital platform accessible on a smartphone app. Results In total, 18 CHWs contributed to the adaptation of the SH+ content and digital intervention development. Participants commented on finding some terms difficult to follow and recommended simplifying the language and providing detailed explanations. Participants offered positive feedback on the adapted content, expressing that they found the examples covered in the material both relatable and relevant to their own personal experiences at home and in the workplace. By combining participants' insights and comments with feedback from content experts, it was possible to finalize a digital Hindi version of the SH+ intervention for CHWs in rural India. Conclusions This study is timely given the continued detrimental impacts of the COVID-19 pandemic, and offers a promising and potentially scalable digital program to alleviate psychological distress among frontline health workers.
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Affiliation(s)
| | | | | | | | | | - Eirini Karyotaki
- Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | | | | | - John A. Naslund
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
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Shrivastava R, Sharma L, Jolly M, Ahuja R, Sharma R, Naslund JA, Agrawal J, Shidhaye R, Mehrotra S, Hollon SD, Patel V, Tugnawat D, Kumar A, Bhan A, Bondre AP. "We are everyone's ASHAs but who's there for us?" a qualitative exploration of perceptions of work stress and coping among rural frontline workers in Madhya Pradesh, India. Soc Sci Med 2023; 336:116234. [PMID: 37778144 DOI: 10.1016/j.socscimed.2023.116234] [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: 10/17/2022] [Revised: 08/23/2023] [Accepted: 09/09/2023] [Indexed: 10/03/2023]
Abstract
OBJECTIVE More than a million female village-level lay providers called 'Accredited Social Health Activists (ASHAs)', who deliver primary care, face high levels of stress due to work demands and low compensation, within the context of poverty and gender inequality. Evidence on ASHAs has focused on workplace challenges from a system perspective, without sufficient probing into individual-level stress. This study aims to gain perspectives into the experiences of work stress, the related health symptoms, and the responses to stress among ASHAs in India. METHODS Focus group discussions (FGDs) conducted with ASHAs in Sehore district, Madhya Pradesh, were audio-recorded and transcribed. Grounded theory was used to generate themes under the various domains of ASHAs' work and domestic life. We identified pathways between the conditions that trigger stressful events, experiences of these events, resulting perceptions, effects on health and wellbeing, and approaches used by ASHAs to respond to stress. RESULTS Six FGDs with 59 ASHAs generated the following themes: (a) Facility: Workload, undue pressures, unstructured work; ASHAs' relationships with seniors (e.g., feelings of being disrespected, blamed, or targeted), and low access to physical and administrative resources; (b) Home: Feelings of guilt for putting less time for family/child care; disrespect by the elderly for a poorly incentivised job; (c) Community: Low acceptance by the villagers; caste- and gender-bias; difficult community-level relationships (emotional labour, fear/stigma towards her services); (d) Somatic and psychological symptoms: headache, exhaustion, depressive symptoms (to cite a few); and (e) Responses to stress: Motivation (support from peers, family, a sense of identity/pride, incentives), Individual strengths (e.g., social responsibility), and spiritual recourse mechanisms. CONCLUSIONS This study will inform the development of a strengths-based coaching intervention to address work stress among ASHAs. The findings are relevant to building the evidence on alleviation of work stress among female frontline cadres in low-resource settings globally.
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Affiliation(s)
- Ritu Shrivastava
- Sangath, 106, Good Shepherd Colony, Kolar Road, Bhopal, Madhya Pradesh, 462042, India.
| | - Lochan Sharma
- Sangath, 106, Good Shepherd Colony, Kolar Road, Bhopal, Madhya Pradesh, 462042, India
| | - Mehak Jolly
- Sangath, 106, Good Shepherd Colony, Kolar Road, Bhopal, Madhya Pradesh, 462042, India
| | - Romi Ahuja
- Sangath, 106, Good Shepherd Colony, Kolar Road, Bhopal, Madhya Pradesh, 462042, India
| | - Radhika Sharma
- Sangath, 106, Good Shepherd Colony, Kolar Road, Bhopal, Madhya Pradesh, 462042, India
| | - John A Naslund
- Department of Global Health and Social Medicine, Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, United States
| | - Jyotsna Agrawal
- National Institute of Mental Health and Neurosciences, Hosur Road, Lakkasandra, Wilson Garden, Bengaluru, Karnataka, 560029, India
| | - Rahul Shidhaye
- Pravara Institute of Medical Sciences, Tal: Rahata, Dist: Ahmednagar, Maharashtra, 413736, India
| | - Seema Mehrotra
- National Institute of Mental Health and Neurosciences, Hosur Road, Lakkasandra, Wilson Garden, Bengaluru, Karnataka, 560029, India
| | - Steve D Hollon
- Vanderbilt University, Brentwood, TN, 37027, United States
| | - Vikram Patel
- Department of Global Health and Social Medicine, Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, United States
| | - Deepak Tugnawat
- Sangath, 106, Good Shepherd Colony, Kolar Road, Bhopal, Madhya Pradesh, 462042, India
| | - Ananth Kumar
- National Health Systems Resource Centre, National Institute of Health & Family Welfare Campus, Baba Gang Nath Marg, Block F, Munirka, New Delhi, Delhi, 110067, India
| | - Anant Bhan
- Sangath, 106, Good Shepherd Colony, Kolar Road, Bhopal, Madhya Pradesh, 462042, India
| | - Ameya P Bondre
- Sangath, 106, Good Shepherd Colony, Kolar Road, Bhopal, Madhya Pradesh, 462042, India
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Cardile D, Corallo F, Ielo A, Cappadona I, Pagano M, Bramanti P, D’Aleo G, Ciurleo R, De Cola MC. Coping and Quality of Life Differences between Emergency and Rehabilitation Healthcare Workers. Healthcare (Basel) 2023; 11:2235. [PMID: 37628433 PMCID: PMC10454017 DOI: 10.3390/healthcare11162235] [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: 06/19/2023] [Revised: 08/02/2023] [Accepted: 08/07/2023] [Indexed: 08/27/2023] Open
Abstract
Audit and Feedback (A&F) is a systematic process involving the collection of data, which are subsequently compared with the established reference standards and then subsequently disseminated to healthcare providers through feedback meetings. This allows continuous improvement to be ensured in the quality of care processes. Often, the parameters taken into account concern only the patient and the treatment processes, neglecting other variables. Quality of life in the workplace and coping skills are determining variables for the clinical performance of all healthcare professionals. For this reason, in this study, these variables were investigated and differences were highlighted in two different role categories and context: cardiovascular emergency and neurological rehabilitation. A psychological screening was carried out by sending the computerized Coping Orientation to Problems Experienced-Nuova Versione Italiana (COPE-NVI) and Professional Quality of Life Scale-5 (ProQoL) questionnaires to all healthcare workers involved. Ninety-five healthcare providers (mean ± SD age: 47 ± 10.4 years; 37.9% male) answered the questionnaire and were assigned into two groups (G1 and G2) based on the ward in which they worked. These were further divided into two subgroups (R1 and R2) based on their role. The obtained results show that avoidance strategies are used more by health professionals working in rehabilitation (G2) wards than in intensive-care units (G1). Moreover, in G1 nurses, physical therapists and speech therapists (R2) obtained higher scores in terms of turning to religion (TR) and compassion satisfaction (CS), while physicians and psychologists (R1) obtained higher scores on the burnout scale (BO). The TR score for R2 was found to be higher, even in G2. The response trend of the two groups in the different departments was analyzed and commented on.
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Affiliation(s)
- Davide Cardile
- IRCCS Centro Neurolesi Bonino-Pulejo, S.S. 113 Via Palermo, C.da Casazza, 98124 Messina, Italy; (D.C.); (A.I.); (I.C.); (M.P.); (P.B.); (G.D.); (R.C.); (M.C.D.C.)
| | - Francesco Corallo
- IRCCS Centro Neurolesi Bonino-Pulejo, S.S. 113 Via Palermo, C.da Casazza, 98124 Messina, Italy; (D.C.); (A.I.); (I.C.); (M.P.); (P.B.); (G.D.); (R.C.); (M.C.D.C.)
| | - Augusto Ielo
- IRCCS Centro Neurolesi Bonino-Pulejo, S.S. 113 Via Palermo, C.da Casazza, 98124 Messina, Italy; (D.C.); (A.I.); (I.C.); (M.P.); (P.B.); (G.D.); (R.C.); (M.C.D.C.)
| | - Irene Cappadona
- IRCCS Centro Neurolesi Bonino-Pulejo, S.S. 113 Via Palermo, C.da Casazza, 98124 Messina, Italy; (D.C.); (A.I.); (I.C.); (M.P.); (P.B.); (G.D.); (R.C.); (M.C.D.C.)
| | - Maria Pagano
- IRCCS Centro Neurolesi Bonino-Pulejo, S.S. 113 Via Palermo, C.da Casazza, 98124 Messina, Italy; (D.C.); (A.I.); (I.C.); (M.P.); (P.B.); (G.D.); (R.C.); (M.C.D.C.)
| | - Placido Bramanti
- IRCCS Centro Neurolesi Bonino-Pulejo, S.S. 113 Via Palermo, C.da Casazza, 98124 Messina, Italy; (D.C.); (A.I.); (I.C.); (M.P.); (P.B.); (G.D.); (R.C.); (M.C.D.C.)
- Faculty of Psychology, Università degli Studi eCampus, Via Isimbardi 10, 22060 Novedrate, Italy
| | - Giangaetano D’Aleo
- IRCCS Centro Neurolesi Bonino-Pulejo, S.S. 113 Via Palermo, C.da Casazza, 98124 Messina, Italy; (D.C.); (A.I.); (I.C.); (M.P.); (P.B.); (G.D.); (R.C.); (M.C.D.C.)
| | - Rosella Ciurleo
- IRCCS Centro Neurolesi Bonino-Pulejo, S.S. 113 Via Palermo, C.da Casazza, 98124 Messina, Italy; (D.C.); (A.I.); (I.C.); (M.P.); (P.B.); (G.D.); (R.C.); (M.C.D.C.)
| | - Maria Cristina De Cola
- IRCCS Centro Neurolesi Bonino-Pulejo, S.S. 113 Via Palermo, C.da Casazza, 98124 Messina, Italy; (D.C.); (A.I.); (I.C.); (M.P.); (P.B.); (G.D.); (R.C.); (M.C.D.C.)
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Villiger S, Hämmig O. Work Related Demands and Resources as Predictors of Well-being at Work Among Healthcare Workers in Switzerland. J Occup Environ Med 2023; 65:689-693. [PMID: 37193642 DOI: 10.1097/jom.0000000000002885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
OBJECTIVE The aim was to examine the effects of work-related demands and resources on well-being at work among employees in Swiss hospitals. METHODS Self-reported survey data from 1840 employees of six hospitals/clinics were analyzed using multivariate linear regression analyses (all professions included). RESULTS Of all demands, work-life imbalance had the strongest negative effect on well-being at work. The most relevant resource varied depending on the dimension of well-being: for job satisfaction it was good leadership, for work engagement job decision latitude and for satisfaction with relationships at work social support at work. The resources were more relevant for well-being at work than the demands. They also buffered against the negative effects of the demands. CONCLUSIONS To enhance well-being at work in hospitals, it is necessary to enable a good work-life balance and to strengthen work-related resources.
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Affiliation(s)
- Simone Villiger
- From the Epidemiology, Biostatistics and Prevention Institute, University of Zürich, Zürich, Switzerland
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Deng W, Yang T, Deng J, Liu R, Sun X, Li G, Wen X. Investigating Factors Influencing Medical Practitioners' Resistance to and Adoption of Internet Hospitals in China: Mixed Methods Study. J Med Internet Res 2023; 25:e46621. [PMID: 37523226 PMCID: PMC10425818 DOI: 10.2196/46621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 06/23/2023] [Accepted: 06/23/2023] [Indexed: 08/01/2023] Open
Abstract
BACKGROUND The swift shift toward internet hospitals has relied on the willingness of medical practitioners to embrace new systems and workflows. Low engagement or acceptance by medical practitioners leads to difficulties in patient access. However, few investigations have focused on barriers and facilitators of adoption of internet hospitals from the perspective of medical practitioners. OBJECTIVE This study aims to identify both enabling and inhibiting predictors associated with resistance and behavioral intentions of medical practitioners to use internet hospitals by combining the conservation of resources theory with the Unified Theory of Acceptance and Use of Technology and technostress framework. METHODS A mixed methods research design was conducted to qualitatively identify the factors that enable and inhibit resistance and behavioral intention to use internet hospitals, followed by a quantitative survey-based study that empirically tested the effects of the identified factors. The qualitative phase involved conducting in-depth interviews with 16 experts in China from June to August 2022. Thematic analysis was performed using the qualitative data analysis software NVivo version 10 (QSR International). On the basis of the findings and conceptual framework gained from the qualitative interviews, a cross-sectional, anonymous, web-based survey of 593 medical practitioners in 28 provincial administrative regions of China was conducted. The data collected were analyzed using the partial least squares method, with the assistance of SPSS 27.0 (IBM Corp) and Mplus 7.0 (Muthen and Muthen), to measure and validate the proposed model. RESULTS On the basis of qualitative results, this study identified 4 facilitators and inhibitors, namely performance expectancy, social influence, work overload, and role ambiguity. Of the 593 medical practitioners surveyed in the quantitative research, most were female (n=364, 61.4%), had a middle title (n=211, 35.6%) or primary title (n=212, 35.8%), and had an average use experience of 6 months every year. By conducting structural equation modeling, we found that performance expectancy (β=-.55; P<.001) and work overload (β=.16; P=.005) had the most significant impact on resistance to change. Resistance to change fully mediated the influence of performance expectancy and partially mediated the influences of social influence (variance accounted for [VAF]=43.3%; P=.002), work overload (VAF=37.2%; P=.03), and role ambiguity (VAF=12.2%; P<.001) on behavioral intentions to use internet hospitals. In addition, this study found that the sex, age, professional title, and use experience of medical practitioners significantly moderated the aforementioned influencing mechanisms. CONCLUSIONS This study investigated the factors that facilitate or hinder medical practitioners' resistance to change and their behavioral intentions to use internet hospitals. The findings suggest that policy makers avoid the resistance and further promote the adoption of internet hospitals by ensuring performance expectancy and social influence and eliminating work overload and role ambiguity.
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Affiliation(s)
- Wenhao Deng
- School of Management and Economics, Beijing Institute of Technology, Beijing, China
- Sustainable Development Research Institute for Economy and Society of Beijing, Beijing, China
| | - Tianan Yang
- School of Management and Economics, Beijing Institute of Technology, Beijing, China
- Sustainable Development Research Institute for Economy and Society of Beijing, Beijing, China
| | - Jianwei Deng
- School of Management and Economics, Beijing Institute of Technology, Beijing, China
- Sustainable Development Research Institute for Economy and Society of Beijing, Beijing, China
| | - Ran Liu
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
| | - Xueqin Sun
- Department of Medical Insurance Management, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Gang Li
- TongJi Hospital, TongJi Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xinmei Wen
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
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Gelaw YM, Hanoch K, Adini B. Burnout and resilience at work among health professionals serving in tertiary hospitals, in Ethiopia. Front Public Health 2023; 11:1118450. [PMID: 37346106 PMCID: PMC10279861 DOI: 10.3389/fpubh.2023.1118450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 05/16/2023] [Indexed: 06/23/2023] Open
Abstract
Background The quality of healthcare service is strongly affected by the health professionals' levels of burnout and resilience at work (RaW). Developing resilience is a key component of medical professionalism. Although burnout and resilience are indicators used to assess the level of workplace hardship, there is a dearth of information in most developing countries, including Ethiopia. Objective To assess the levels of burnout and 'resilience at work' among health professionals who work in the surgical care departments in teaching Ethiopian hospitals. Methods A cross-sectional study design was applied among health professionals employed in surgical, gynecologic, and obstetric (Gyn/Obs) departments of two acute-care hospitals (n = 388). A structured self-administered English version questionnaire, consisting of validated scales to measure RaW and burnout, was used to collect the data;22 items of Maslach's burnout inventory human service survey tool and 20 items of Win wood's resilience at work' measuring tool" was employed to assess the health professionals' burnout level and Resilience at work, respectively. Linear logistics regression was employed for inferential statistical analysis to identify factors that predict RaW and burnout. Results Burnout syndrome was shown among 101 (26.0%) study participants. Furthermore, 205 (52.8%), 150 (38.7%), and 125 (32.2%) participants presented high emotional exhaustion, high depersonalization, and low personal accomplishment, respectively. Emotional exhaustion was predicted by the participants' profession, the hope of promotion, professional recognition, and workload. Depersonalization was predicted by age, profession, and perceived workload of the participants. The predictors for personal accomplishment were profession, relationship at work, professional recognition, and having a managerial position in addition to clinical duty. The participants' mean RaW score was 78.36 (Standard deviation ±17.78). A negative association was found between RaW and emotional exhaustion and depersonalization. In contrast, a positive association was identified between RaW and personal accomplishment. The type of profession and marital status were positive predictors of RaW. Conclusion A substantial amount of health professionals experience high burnout in one or more burnout dimensions. Level of RaW is more affected by burnout syndrome. Therefore, promoting activities that increase the level of professional RaW and recognition in their professional practice is needed to reduce job burnout. These findings are especially important concerning low socio-economic countries, as resilience is a vital component of the development of healthcare systems.
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Affiliation(s)
- Yared Mulu Gelaw
- Department of Emergency and Disaster Management, Sackler Faculty of Medicine, School of Public Health, Tel-Aviv University, Tel Aviv, Israel
- Department of Health Service Management, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Kashtan Hanoch
- Department of Health Service Management, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Bruria Adini
- Department of Surgery, Rabin Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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11
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Astale T, Abebe T, Mitike G. Workload and emerging challenges of community health workers in low- and middle-income countries: A mixed-methods systematic review. PLoS One 2023; 18:e0282717. [PMID: 36913362 PMCID: PMC10010520 DOI: 10.1371/journal.pone.0282717] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 02/21/2023] [Indexed: 03/14/2023] Open
Abstract
BACKGROUND Community health workers (CHWs) play an important role in improving access to health services to a broader population; particularly to communities living in remote areas. However, the productivity of CHWs is affected by the workload they have. We aimed to summarize and present CHWs' perceived workload in low-and middle-income countries (LMICs). METHODS We searched three electronic databases (PubMed, Scopus, and Embase). A search strategy customized for the three electronic databases was developed using the two key terms of the review (CHWs and workload). Primary studies conducted in LMICs that explicitly measured workload of CHWs and published in English were included, without date restrictions. Methodological quality of the articles was assessed by two reviewers independently using mixed-methods appraisal tool. We applied a convergent integrated approach to synthesize the data. This study is registered on PROSPERO, number CRD42021291133. RESULTS Of 632 unique records, 44 met our inclusion criteria, and 43 (20 qualitative, 13 mixed-methods, and 10 quantitative studies) passed the methodological quality assessment and were included in this review. In 97.7% (n = 42) of the articles, CHWs reported that they have a high workload. Having multiple tasks was the most commonly reported subcomponent of workload, followed by lack of transport; which was reported in 77.6% (n = 33) and 25.6% (n = 11) of the articles respectively. CONCLUSION CHWs in LMICs reported that they have a high workload; mainly related to having to manage multiple tasks and the lack of transport to access households. Program managers need to make careful consideration when additional tasks are shifted to CHWs and the practicability to be performed in the environment they work in. Further research is also required to make a comprehensive measure of the workload of CHWs in LMICs.
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Affiliation(s)
- Tigist Astale
- International Institute for Primary Health Care-Ethiopia, Addis Ababa, Ethiopia
| | - Tsegereda Abebe
- International Institute for Primary Health Care-Ethiopia, Addis Ababa, Ethiopia
| | - Getnet Mitike
- International Institute for Primary Health Care-Ethiopia, Addis Ababa, Ethiopia
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12
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Getahun M, Oboke EN, Ogolla BA, Kinyua J, Ongeri L, Sterling M, Oluoch I, Lyndon A, Afulani PA. Sources of stress and coping mechanisms: Experiences of maternal health care providers in Western Kenya. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001341. [PMID: 36962929 PMCID: PMC10022275 DOI: 10.1371/journal.pgph.0001341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 01/11/2023] [Indexed: 02/12/2023]
Abstract
The dynamic and complex nature of care provision predisposes healthcare workers to stress, including physical, emotional, or psychological fatigue due to individual, interpersonal, or organizational factors. We conducted a convergent mixed-methods study with maternity providers to understand their sources of stress and coping mechanisms they adopt. Data were collected in Migori County in western Kenya utilizing quantitative surveys with n = 101 maternity providers and in-depth interviews with a subset of n = 31 providers. We conducted descriptive analyses for the quantitative data. For qualitative data, we conducted thematic analysis, where codes were deductively developed from interview guides, iteratively refined based on emergent data, and applied by a team of five researchers using Dedoose software. Code queries were then analysed to identify themes and organized using the socioecological (SE) framework to present findings at the individual, interpersonal, and organizational levels. Providers reported stress due to high workloads (61%); lack of supplies (37%), poor salary (32%), attitudes of colleagues and superiors (25%), attitudes of patients (21%), and adverse outcomes (16%). Themes from the qualitative analysis mirrored the quantitative analysis with more detailed information on the factors contributing to each and how these sources of stress affect providers and patient outcomes. Coping mechanisms adopted by providers are captured under three themes: addressing stress by oneself, reaching out to others, and seeking help from a higher power. Findings underscore the need to address organizational, interpersonal, and individual level stressors. Strategies are needed to support staff retention, provide adequate resources and incentives for providers, and ultimately improve patient outcomes. Interventions should support and leverage the positive coping mechanisms identified.
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Affiliation(s)
- Monica Getahun
- Institute for Global Health Sciences, University of California, San Francisco, San Francisco, California, United States of America
| | | | | | | | | | - Mona Sterling
- Institute for Global Health Sciences, University of California, San Francisco, San Francisco, California, United States of America
| | | | - Audrey Lyndon
- NYU Rory Meyers College of Nursing, New York, NY, United States of America
| | - Patience A. Afulani
- Institute for Global Health Sciences, University of California, San Francisco, San Francisco, California, United States of America
- Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, California, United States of America
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Ward MC, Crinall K, McDonald R, Crinall W, Aridas J, Leung C, Quittner D, Hodges RJ, Rolnik DL. The kindness COVID-19 toolkit: a mixed-methods evaluation of a programme designed by doctors in training for doctors in training. BMJ Open 2022; 12:e060575. [PMID: 36414290 PMCID: PMC9684278 DOI: 10.1136/bmjopen-2021-060575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 10/10/2022] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES The impact of a coronavirus disease (COVID-19)-specific professional development programme on the well-being of obstetrics and gynaecology (O&G) doctors in training (DiT) working during the pandemic. DESIGN A mixed-method evaluation of a single group pre-post test design study. SETTING Melbourne, Australia between September 2020 and April 2021. PARTICIPANTS 55 O&G DiT working across four healthcare sites of a major tertiary hospital in Victoria, Australia, were included in the programme. INTERVENTIONS The delivery of a codesigned peer-to-peer programme, which identified and addressed the well-being goals of O&G DiT. Seven interactive workshops were run alongside the implementation of a number of participant-led wellness initiatives. MAIN OUTCOME MEASURES Repeated-measures analysis of WHO Well-being Index (WHO-5) and Copenhagen Burnout Innovatory (CBI) scores across three time points during the programme. Multilevel generalised linear mixed-effects models with random intercept were fit to the data, both in the entire population (intention-to-treat) and restricted to those who attended the workshop ('per-protocol' analysis). Participatory experiences and programme learning were captured using the Most Significant Change (MSC) technique, which included inductive thematic analysis. RESULTS We demonstrated an overall 31.9% improvement in well-being scores (p=0.006). The MSC evaluation captured a shift in workplace culture as a result of the programme, with improvement across the domains of connection, caring, communication, confidence and cooperation. CONCLUSIONS We have successfully used a mixed-method approach to contextualise a productive programme to improve the well-being of COVID-19 front-line healthcare workers.
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Affiliation(s)
- Madeleine C Ward
- Obstetrics and Gynaecology, Monash University, Clayton, Victoria, Australia
- Women's & Newborn, Monash Health, Clayton, Victoria, Australia
| | | | - Rebecca McDonald
- Obstetrics and Gynaecology, Monash University, Clayton, Victoria, Australia
- Women's & Newborn, Monash Health, Clayton, Victoria, Australia
| | | | - James Aridas
- Women's & Newborn, Monash Health, Clayton, Victoria, Australia
- The Ritchie Centre, Hudson Institute of Medical Research, Clayton, Victoria, Australia
| | - Cheryl Leung
- Women's & Newborn, Monash Health, Clayton, Victoria, Australia
| | | | - Ryan J Hodges
- Obstetrics and Gynaecology, Monash University, Clayton, Victoria, Australia
- Women's & Newborn, Monash Health, Clayton, Victoria, Australia
| | - Daniel L Rolnik
- Obstetrics and Gynaecology, Monash University, Clayton, Victoria, Australia
- Women's & Newborn, Monash Health, Clayton, Victoria, Australia
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Abate M, Mulissa Z, Magge H, Bitewulign B, Kiflie A, Biadgo A, Alemu H, Seman Y, Woldesenbet D, Estifanos AS, Parry G, Quaife M. Key factors influencing motivation among health extension workers and health care professionals in four regions of Ethiopia: A cross-sectional study. PLoS One 2022; 17:e0272551. [PMID: 36178908 PMCID: PMC9524639 DOI: 10.1371/journal.pone.0272551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 07/22/2022] [Indexed: 11/22/2022] Open
Abstract
Background Although Ethiopia has improved access to health care in recent years, quality of care remains low. Health worker motivation is an important determinant of performance and affects quality of care. Low health care workers motivation can be associated with poor health care quality and client experience, non-attendance, and poor clinical outcome. Objective this study sought to determine the extent and variation of health professionals’ motivation alongside factors associated with motivation. Methods We conducted a facility based cross-sectional study among health extension workers (HEWs) and health care professionals in four regions: Amhara, Oromia, South nations, and nationalities people’s region (SNNPR) and Tigray from April 15 to May 10, 2018. We sampled 401 health system workers: skilled providers including nurses and midwives (n = 110), HEWs (n = 210); and non-patient facing health system staff representing case team leaders, facility and district heads, directors, and officers (n = 81). Participants completed a 30-item Likert scale ranking tool which asked questions across 17 domains. We used exploratory factor analysis to explore latent motivation constructs. Results Of the 397 responses with complete data, 61% (95% CI 56%-66%) self-reported motivation as “very good” or “excellent”. Significant variation in motivation was seen across regions with SNNPR scoring significantly lower on a five-point Likert scale by 0.35 points (P = 0.003). The exploratory factor analysis identified a three-factors: personal and altruistic goals; pride and personal satisfaction; and recognition and support. The personal and altruistic goals factor varied across regions with Oromia and SNNPR being significantly lower by 0.13 (P = 0.018) and 0.12 (P = 0.039) Likert points respectively. The pride and personal satisfaction factor were higher among those aged > = 30 years by 0.14 Likert scale points (P = 0.045) relative to those aged between 19-24years. Conclusions Overall, motivation was high among participants but varied across region, cadre, and age. Workload, leave, and job satisfaction were associated with motivation.
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Affiliation(s)
- Mehiret Abate
- Institute for Healthcare Improvement, Addis Ababa, Ethiopia
- * E-mail:
| | - Zewdie Mulissa
- Institute for Healthcare Improvement, Addis Ababa, Ethiopia
| | - Hema Magge
- Institute for Healthcare Improvement, Addis Ababa, Ethiopia
- Division of Global Health Equity, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
| | | | - Abiyou Kiflie
- Institute for Healthcare Improvement, Addis Ababa, Ethiopia
| | - Abera Biadgo
- Institute for Healthcare Improvement, Addis Ababa, Ethiopia
| | | | - Yakob Seman
- Medical Service General Directorate, Ministry of Health of Ethiopia, Addis Ababa, Ethiopia
| | - Dorka Woldesenbet
- Department of Reproductive, Family and Population Health, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Abiy Seifu Estifanos
- Department of Reproductive, Family and Population Health, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Gareth Parry
- Department of Plastic and Oral Surgery, Boston Children’s Hospital, Boston, Massachusetts, United States of America
| | - Matthew Quaife
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Silarova B, Brookes N, Palmer S, Towers A, Hussein S. Understanding and measuring the work-related quality of life among those working in adult social care: A scoping review. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:1637-1664. [PMID: 35066964 PMCID: PMC9543435 DOI: 10.1111/hsc.13718] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 11/23/2021] [Accepted: 12/13/2021] [Indexed: 06/14/2023]
Abstract
The main aim of this scoping review was to understand how work-related quality of life (WRQoL) in adult social care has been defined and measured in the literature and to map key components of WRQoL among those working in adult social care and similar contexts. The scoping review included studies that: 1- focused on WRQoL/work-related wellbeing (and their synonyms); and 2- included adult social care or community health care. We searched existing evidence from November 2019 until July 2020 through an electronic literature search of eight major databases complemented by the grey literature, searching the reference lists and by contacting our existing network of experts in the field. In addition, we repeated the searches to identify any relevant literature published in 2021. Reporting followed the PRISMA Extension for Scoping Reviews (PRISMA-ScR) checklist. In total, we included 68 publications. These publications indicate that there is an absence of agreement on a definition and measurement of WRQoL in adult social care. Based on a thematic analysis we identified six key components of WRQoL: organisational characteristics; job characteristics; mental wellbeing and health; physical wellbeing and health; spill-over from work to home; and professional identity. In summary, at the moment, there is no agreement on what WRQoL is and how to measure it in adult social care. As a result, there is very limited evidence on how to improve WRQoL among people working in adult social care. However, this scoping review suggests that there are six key components of WRQoL that researchers may consider to include in their future studies.
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Affiliation(s)
- Barbora Silarova
- Personal Social Services Research UnitUniversity of KentCornwallis CentralCanterburyUK
| | - Nadia Brookes
- Personal Social Services Research UnitUniversity of KentCornwallis CentralCanterburyUK
- Present address:
Centre For Health Services StudiesGeorge Allen WingCornwallis BuildingUniversity of KentCanterburyCT2 7NFUK
| | - Sinead Palmer
- Personal Social Services Research UnitUniversity of KentCornwallis CentralCanterburyUK
| | - Ann‐Marie Towers
- Centre For Health Services StudiesGeorge Allen WingCornwallis BuildingUniversity of KentCanterburyUK
| | - Shereen Hussein
- Personal Social Services Research UnitUniversity of KentCornwallis CentralCanterburyUK
- Present address:
Faculty of Public Health PolicyLondon School of Hygiene & Tropical MedicineLondonWC1E 7HTUK
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Idaiani S, Waris L. Depression and Psychological Stress Among Health Workers in Remote Areas in Indonesia. Front Public Health 2022; 10:743053. [PMID: 35602154 PMCID: PMC9118013 DOI: 10.3389/fpubh.2022.743053] [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: 10/06/2021] [Accepted: 03/18/2022] [Indexed: 11/17/2022] Open
Abstract
Background The Indonesian government launched the Nusantara Sehat program in 2015, under which teams of health workers were assigned to community health care centers in remote, border, and island areas for 2 years. The deployment to remote areas is likely to affect their psychological condition if they are not equipped with facilities and strong motivation. This study aimed to describe the psychological condition of health workers in remote areas in Indonesia, focusing on the proportion of the prevalence of depression and psychological stress. Materials and Methods This cross-sectional study was conducted between April and December of 2018. Participants were 140 health workers placed in 26 community healthcare centers in 13 provinces. Interviews were conducted by enumerators using a questionnaire that included questions from the Mini International Neuropsychiatric Interview (MINI) and Self-Reporting Questionnaire-20 (SRQ-20). Results Of the participants, 7.1% experienced depression and 10.0% experienced psychological stress. Motivation was related to psychological stress in participants with an odds ratio of 0,218 (95% confidence interval = 0.065–0.729, p = 0.013). Health workers with high motivation tend not to experience psychological stress compared to individuals with lower motivation. Conclusion Health workers with high motivation experience relatively low levels of psychological stress. To overcome stress, high motivation is needed to control psychological risk factors before and during placement.
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Affiliation(s)
- Sri Idaiani
- National Research and Innovation Agency, Jakarta, Indonesia
| | - Lukman Waris
- Department of Public Health, Universitas Falatehan, Banten, Indonesia
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17
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Abi Hana R, Arnous M, Heim E, Aeschlimann A, Koschorke M, Hamadeh RS, Thornicroft G, Kohrt BA, Sijbrandij M, Cuijpers P, El-Chammay R. Mental health stigma at primary health care centres in Lebanon: qualitative study. Int J Ment Health Syst 2022; 16:23. [PMID: 35525972 PMCID: PMC9077642 DOI: 10.1186/s13033-022-00533-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 03/29/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Mental health-related stigma is a global public health concern and a major barrier to seeking care. In this study, we explored the role of stigma as a barrier to scaling up mental health services in primary health care (PHC) centres in Lebanon. We focused on the experiences of Healthcare Providers (HCPs) providing services to patients with mental health conditions (MHCs), the views of policy makers, and the perceptions of stigma or discrimination among individuals with MHCs. This study was conducted as part of INDIGO-PRIMARY, a larger multinational stigma reduction programme. METHODS Semi-structured qualitative interviews (n = 45) were carried out with policy makers (n = 3), PHC management (n = 4), PHC staff (n = 24), and service users (SUs) (n = 14) between August 2018 and September 2019. These interviews explored mental health knowledge, attitudes and behaviour of staff, challenges of providing treatment, and patient outcomes. All interviews were coded using NVivo and a thematic coding framework. RESULTS The results of this study are presented under three themes: (1) stigma at PHC level, (2) stigma outside PHC centres, and (3) structural stigma. SUs did not testify to discrimination from HCPs but did describe stigmatising behaviour from their families. Interestingly, at the PHC level, stigma reporting differed among staff according to a power gradient. Nurses and social workers did not explicitly report incidents of stigma but described patients with MHCs as uncooperative, underscoring their internalized negative views on mental health. General practitioners and directors were more outspoken than nurses regarding the challenges faced with mental health patients. Mental health professionals revealed that HCPs still hold implicitly negative views towards patients with MHCs however their attitude has improved recently. Our analysis highlights five layers of stigma affecting SUs. CONCLUSION This qualitative study reveals that stigma was still a key concern that affects patients with MHC. SUs reported experiencing overt stigmatising behaviour in the community but less explicit discrimination in a PHC setting. Our findings emphasise the importance of (1) combatting structural stigma through legal reform, (2) addressing interpersonal stigma, (3) committing PHC management to deliver high quality mental health integrated services, and (4) reducing intrapersonal stigma by building public empathy.
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Affiliation(s)
- Racha Abi Hana
- Ministry of Public Health, National Mental Health Programme, Beirut, Lebanon.
- Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit, Amsterdam, The Netherlands.
| | - Maguy Arnous
- Ministry of Public Health, National Mental Health Programme, Beirut, Lebanon
| | - Eva Heim
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland
| | | | - Mirja Koschorke
- Centre for Global Mental Health and Centre for Implementation Science, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England
| | - Randa S Hamadeh
- Primary Healthcare Department at Ministry of Public Health, Beirut, Lebanon
- Global Health Team of Experts (GHTE), Beirut, Lebanon
| | - Graham Thornicroft
- Centre for Global Mental Health and Centre for Implementation Science, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England
| | - Brandon A Kohrt
- Department of Psychiatry and Behavioral Sciences, Division of Global Mental Health George Washington University, Washington, DC, USA
| | - Marit Sijbrandij
- Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit, Amsterdam, The Netherlands
| | - Pim Cuijpers
- Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit, Amsterdam, The Netherlands
| | - Rabih El-Chammay
- Ministry of Public Health, National Mental Health Programme, Beirut, Lebanon
- Department of Psychiatry, Saint Joseph University, Beirut, Lebanon
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Delhomme P, Gheorghiu A. Perceived stress, mental health, organizational factors, and self-reported risky driving behaviors among truck drivers circulating in France. JOURNAL OF SAFETY RESEARCH 2021; 79:341-351. [PMID: 34848014 DOI: 10.1016/j.jsr.2021.10.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 08/29/2021] [Accepted: 10/04/2021] [Indexed: 06/13/2023]
Abstract
INTRODUCTION The growth of the European market for road-freight transport has recently led to important changes. The growing number of foreign pavilion drivers transiting in France, which plays a bridging role among European countries, has influenced the lives of truck drivers by increasing competition, pressure on day-to-day activities, and constraints related to delivery deadlines. Adding this new pressure to those inherent in the road-freight transport sector has raised concerns, especially ones linked to levels of perceived stress by truck drivers. METHOD With safety concerns in mind, we devised a questionnaire aimed at understanding how French truck drivers and non-French truck drivers, passing through four highway rest areas in France perceive stress, organizational factors, mental health, and risky driving behaviors. A sample of 515 truck drivers took part in the survey (260 French nationals), 97.9% of whom were male. RESULTS The results of a structural equation model indicated that perceived stress can increase self-reported risky driving behaviors among truck drivers. Furthermore, organizational factors and mental health were closely linked to perceived stress. Finally, some differences were found between French and non-French truck drivers with respect to mind-wandering and mental health, and to perceive driving difficulties to overcome and driving skills. Practical Applications: Several recommendations based on the findings are provided to policymakers and organizations.
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Affiliation(s)
- Patricia Delhomme
- Univ Gustave Eiffel, Université de Paris, LaPEA, F-78000 Versailles, France.
| | - Alexandra Gheorghiu
- Alexandru Ioan Cuza University, Center for European Studies, Faculty of Law, Iasi, Romania
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19
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Behind closed doors: Are sonographers coping? A nation‐wide survey investigating the emotional well‐being of sonographers working for private organisations within Australia. SONOGRAPHY 2021. [DOI: 10.1002/sono.12282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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20
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Quaife M, Estafinos AS, Keraga DW, Lohmann J, Hill Z, Kiflie A, Marchant T, Borghi J, Schellenberg J. Changes in health worker knowledge and motivation in the context of a quality improvement programme in Ethiopia. Health Policy Plan 2021; 36:1508-1520. [PMID: 34374420 PMCID: PMC8597962 DOI: 10.1093/heapol/czab094] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 06/14/2021] [Accepted: 07/26/2021] [Indexed: 11/13/2022] Open
Abstract
A knowledgeable and motivated workforce is critical for health systems to provide high-quality services. Many low- and middle-income countries face shortages in human resources and low health worker motivation but are also home to a burgeoning number of quality improvement (QI) programmes. This study evaluates whether and how motivation and clinical knowledge in three cadres of health workers changed in the context of a QI programme for maternal and newborn health in Ethiopia. This mixed-methods study used a pre–post comparison group design with matched comparison areas. We interviewed 395 health workers at baseline in April 2018 and 404 at endline in June 2019 from seven districts (woredas) with QI and seven comparison woredas. Three cadres were interviewed: health extension workers, facility-based skilled midlevel maternal and newborn care providers, and non-patient-facing staff. A qualitative component sought to triangulate and further elucidate quantitative findings using in-depth interviews with 22 health workers. Motivation was assessed quantitatively, exploratory factor analysis was used to categorize motivation dimensions, and regression-based difference-in-difference analyses were conducted. Knowledge was assessed through a clinical vignette. Qualitative data were analysed in a deductive process based on a framework derived from quantitative results. Although knowledge of the QI programme was high (79%) among participants from QI woreda at endline, participation in QI teams was lower (56%). There was strong evidence that health worker knowledge increased more in areas with QI than comparison areas. Three motivation dimensions emerged from the data: (1) ‘helping others’, (2) ‘pride and satisfaction’ and (3) ‘external recognition and support’. We found strong evidence that motivation across these factors improved in both QI and comparison areas, with weak evidence of greater increases in comparison areas. Qualitative data suggested the QI programme may have improved motivation by allowing staff to provide better care. This study suggests that although QI programmes can increase health worker knowledge, there may be little effect on motivation. Programme evaluations should measure a wide range of outcomes to fully understand their impact.
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Affiliation(s)
- Matthew Quaife
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK
| | | | | | - Julia Lohmann
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK
| | - Zelee Hill
- Institute for Global Health, University College London, Gower Street, London WC1E 6BT, UK
| | - Abiyou Kiflie
- Institute for Healthcare Improvement, Addis Ababa, Ethiopia
| | - Tanya Marchant
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Josephine Borghi
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK
| | - Joanna Schellenberg
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
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21
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Mengist B, Amha H, Ayenew T, Gedfew M, Akalu TY, Assemie MA, Alene M, Desta M. Occupational Stress and Burnout Among Health Care Workers in Ethiopia: A Systematic Review and Meta-analysis. Arch Rehabil Res Clin Transl 2021; 3:100125. [PMID: 34179761 PMCID: PMC8212011 DOI: 10.1016/j.arrct.2021.100125] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE To estimate the pooled national burden of occupational stress, burnout, and contributing factors among health care workers in Ethiopia. DATA SOURCES Both published and unpublished observational studies conducted on the burden of occupational stress and burnout among health workers in Ethiopia were included. STUDY SELECTION This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and was registered on PROSPERO (CRD42020166585). The eligibility of the studies was evaluated based on predetermined inclusion and exclusion criteria. DATA EXTRACTION Data extraction was conducted using major databases; PubMed, Google Scholar, Cumulative Index to Nursing and Allied Health, Scopes, Cochrane Library, the Web of Science, and African Journals Online were involved in the review. Two reviewers extracted data independently using a standardized data extraction checklist on Microsoft Excel. Any discrepancy was resolved by including the third reviewer for a possible consensus. DATA SYNTHESIS Fourteen studies, with a total of 4066 health care workers, were included in the meta-analysis. The pooled burdens of occupational stress and burnout were 52.9% (95% confidence interval [CI], 46.2-59.7) and 39.1% (95% CI, 23.9-52.3), respectively. Major determinants of occupational stress were being female (odds ratio [OR], 1.9; 95% CI, 1.1-3.3), being younger (OR, 1.4; 95% CI, 1.03-1.9), having a lower educational level (OR, 2.7; 95% CI, 1.05-7.2), and being satisfied with a job (OR, 0.3; 95% CI, 0.2-0.5). Being married (OR, 0.7; 95% CI, 0.5-0.9), having a lower educational level (OR, 0.5; 95% CI, 0.4-0.8), and working in shifts (OR, 0.7; 95% CI, 0.5-0.9) were significant predictors of burnout. CONCLUSIONS More than half and more than one-third of health care workers were affected by occupational stress and burnout, respectively, in Ethiopia, and sociodemographic and occupation-related factors were significant factors. Measures that improve job satisfaction, career development, and educational opportunities should be strengthened.
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Affiliation(s)
- Belayneh Mengist
- Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos
| | - Haile Amha
- Department of Nursing, College of Health Sciences, Debre Markos University, Debre Markos
| | - Temesgen Ayenew
- Department of Nursing, College of Health Sciences, Debre Markos University, Debre Markos
| | - Mihretie Gedfew
- Department of Nursing, College of Health Sciences, Debre Markos University, Debre Markos
| | - Tadesse Yirga Akalu
- Department of Nursing, College of Health Sciences, Debre Markos University, Debre Markos
| | - Moges Agazhe Assemie
- Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos
| | - Muluneh Alene
- Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos
| | - Melaku Desta
- Department of Midwifery, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
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22
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Afulani PA, Gyamerah AO, Nutor JJ, Laar A, Aborigo RA, Malechi H, Sterling M, Awoonor-Williams JK. Inadequate preparedness for response to COVID-19 is associated with stress and burnout among healthcare workers in Ghana. PLoS One 2021; 16:e0250294. [PMID: 33861808 PMCID: PMC8051822 DOI: 10.1371/journal.pone.0250294] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 04/01/2021] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION The COVID-19 pandemic has compounded the global crisis of stress and burnout among healthcare workers. But few studies have empirically examined the factors driving these outcomes in Africa. Our study examined associations between perceived preparedness to respond to the COVID-19 pandemic and healthcare worker stress and burnout and identified potential mediating factors among healthcare workers in Ghana. METHODS Healthcare workers in Ghana completed a cross-sectional self-administered online survey from April to May 2020; 414 and 409 completed stress and burnout questions, respectively. Perceived preparedness, stress, and burnout were measured using validated psychosocial scales. We assessed associations using linear regressions with robust standard errors. RESULTS The average score for preparedness was 24 (SD = 8.8), 16.3 (SD = 5.9) for stress, and 37.4 (SD = 15.5) for burnout. In multivariate analysis, healthcare workers who felt somewhat prepared and prepared had lower stress (β = -1.89, 95% CI: -3.49 to -0.30 and β = -2.66, 95% CI: -4.48 to -0.84) and burnout (β = -7.74, 95% CI: -11.8 to -3.64 and β = -9.25, 95% CI: -14.1 to -4.41) scores than those who did not feel prepared. Appreciation from management and family support were associated with lower stress and burnout, while fear of infection was associated with higher stress and burnout. Fear of infection partially mediated the relationship between perceived preparedness and stress/burnout, accounting for about 16 to 17% of the effect. CONCLUSIONS Low perceived preparedness to respond to COVID-19 increases stress and burnout, and this is partly through fear of infection. Interventions, incentives, and health systemic changes to increase healthcare workers' morale and capacity to respond to the pandemic are needed.
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Affiliation(s)
- Patience A. Afulani
- Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, California, United States of America
- Institute for Global Health Sciences, University of California, San Francisco, San Francisco, California, United States of America
| | - Akua O. Gyamerah
- Center for AIDS Prevention Studies, University of California, San Francisco, San Francisco, California, United States of America
| | - Jerry J. Nutor
- Department of Family Health Care Nursing, University of California, San Francisco, San Francisco, California, United States of America
| | - Amos Laar
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana
| | | | | | - Mona Sterling
- Institute for Global Health Sciences, University of California, San Francisco, San Francisco, California, United States of America
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23
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Qian JL, Pan PE, Wu MW, Zheng Q, Sun SW, Liu L, Sun YP, Yu XY. The experiences of nurses and midwives who provide surgical abortion care: A qualitative systematic review. J Adv Nurs 2021; 77:3644-3656. [PMID: 33855749 DOI: 10.1111/jan.14853] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 03/16/2021] [Accepted: 03/21/2021] [Indexed: 12/29/2022]
Abstract
AIM To synthesize qualitative evidence on nurses' and midwives' experiences in the provision of surgical abortion care. We address three specific questions: (a) what are the experiences of nurses and midwives in surgical abortion care? (b) what are their responses and coping strategies? (c) what are the deficiencies in surgical abortion care? DESIGN Qualitative studies were synthesized using Thomas and Harden's qualitative thematic synthesis method. DATA SOURCES Electronic databases, including PubMed, Embase, CINAHL, PsycINFO, Scopus and Web of Science were searched. Grey literature using ProQuest was searched. The databases were searched from inception to 5 August 2020. REVIEW METHODS The SPIDER (Sample, Phenomenon of Interest, Design, Evaluation and Research type) search tool was used in the literature search. Data synthesis was conducted using the three-stage thematic synthesis method described by Thomas and Harden. RESULTS 966 studies were identified in the initial search and 18 studies were included. Four analytical themes were generated: 'Providing abortion care requires high emotional labour'; 'Professionalism of abortion care providers'; 'Initiatives in professional development' and 'Improving directions for high-quality abortion care'. CONCLUSION Nurses and midwives indicated that they require support to enhance psychological health and improve professional skills. Hospital managers should organize regular debriefing or structured group workshops for exchange of practical experiences and strengthening emotional support. More research is required to establish comprehensive training related to abortion care for nurses and midwives. The findings demonstrate that optimization of abortion services should start from hospital management models, pain management and bereavement care. IMPACT Understanding the experiences of nurses and midwives in abortion provision will inform future clinical practice in surgical abortion care, which would be helpful in improving the professionalism and confidence of abortion providers. Our findings have implications for the training, development of policies and standards for surgical abortion care for nurses and midwives.
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Affiliation(s)
- Jia-Lu Qian
- Zhejiang University School of Medicine, Hangzhou, China.,Department of Obstetrics and Gynecology, Women's Hospital School of Medicine, Zhejiang University, Hangzhou, China
| | - Pang-E Pan
- Department of Obstetrics and Gynecology, Ninghai Maternal and Child Health Hospital, Ningbo, China
| | - Meng-Wei Wu
- Zhejiang University School of Medicine, Hangzhou, China.,Department of Obstetrics and Gynecology, Women's Hospital School of Medicine, Zhejiang University, Hangzhou, China
| | - Qiong Zheng
- Zhejiang University School of Medicine, Hangzhou, China.,Department of Obstetrics and Gynecology, Women's Hospital School of Medicine, Zhejiang University, Hangzhou, China
| | - Shi-Wen Sun
- Department of Obstetrics and Gynecology, Women's Hospital School of Medicine, Zhejiang University, Hangzhou, China
| | - Lu Liu
- Zhejiang University School of Medicine, Hangzhou, China.,Department of Obstetrics and Gynecology, Women's Hospital School of Medicine, Zhejiang University, Hangzhou, China
| | - Ya-Ping Sun
- Zhejiang University School of Medicine, Hangzhou, China.,Department of Obstetrics and Gynecology, Women's Hospital School of Medicine, Zhejiang University, Hangzhou, China
| | - Xiao-Yan Yu
- Department of Obstetrics and Gynecology, Women's Hospital School of Medicine, Zhejiang University, Hangzhou, China.,Department of Obstetrics and Gynecology, Ninghai Maternal and Child Health Hospital, Ningbo, China
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24
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Akkoç İ, Okun O, Türe A. The effect of role-related stressors on nurses' burnout syndrome: The mediating role of work-related stress. Perspect Psychiatr Care 2021; 57:583-596. [PMID: 32686153 DOI: 10.1111/ppc.12581] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 07/01/2020] [Accepted: 07/05/2020] [Indexed: 11/29/2022] Open
Abstract
PURPOSE This study sought to investigate the effects of role conflict, role ambiguity, and workload on burnout syndrome among clinical nurses working in university hospitals and the mediating role of work-related stress in these effects. DESIGN AND METHODS Cross-sectional questionnaire-based survey was conducted. Data from 386 nurses were evaluated. The research variables were analyzed using statistical methods such as factor analysis, correlation analysis, regression analysis, Sobel tests, and bootstrapping method. FINDINGS It was determined that role conflict, role ambiguity, workload, and work-related stress affect nurses' burnout significantly and work-related stress has a mediator role between burnout and the independent variables. PRACTICE IMPLICATIONS Nurses' burnout syndrome can be prevented if managerial practices to reduce the sources of role-related stressors and work-related stress are implemented by managers.
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Affiliation(s)
| | | | - Aysun Türe
- Department of Nursing Management, Faculty of Health Sciences, Eskisehir Osmangazi University, Eskisehir, Turkey
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25
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Sahni PS, Singh K, Sharma N, Garg R. Yoga an effective strategy for self-management of stress-related problems and wellbeing during COVID19 lockdown: A cross-sectional study. PLoS One 2021; 16:e0245214. [PMID: 33566848 PMCID: PMC7875402 DOI: 10.1371/journal.pone.0245214] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 12/23/2020] [Indexed: 12/27/2022] Open
Abstract
This cross-sectional research aims to study the effect of yoga practice on the illness perception, and wellbeing of healthy adults during 4-10 weeks of lockdown due to COVID19 outbreak. A total of 668 adults (64.7% males, M = 28.12 years, SD = 9.09 years) participated in the online survey. The participants were grouped as; yoga practitioners, other spiritual practitioners, and non-practitioners based on their responses to daily practices that they follow. Yoga practitioners were further examined based on the duration of practice as; long-term, mid-term and beginners. Multivariate analysis indicates that yoga practitioners had significantly lower depression, anxiety, & stress (DASS), and higher general wellbeing (SWGB) as well as higher peace of mind (POMS) than the other two groups. The results further revealed that the yoga practitioners significantly differed in the perception of personal control, illness concern and emotional impact of COVID19. However, there was no significant difference found for the measure of resilience (BRS) in this study. Yoga practitioners also significantly differed in the cognitive reappraisal strategy for regulating their emotions than the other two groups. Interestingly, it was found that beginners -those who had started practicing yoga only during the lockdown period reported no significant difference for general wellbeing and peace of mind when compared to the mid- term practitioner. Evidence supports that yoga was found as an effective self- management strategy to cope with stress, anxiety and depression, and maintain wellbeing during COVID19 lockdown.
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Affiliation(s)
- Pooja Swami Sahni
- National Resource Centre for Value Education in Engineering, Indian Institute of Technology Delhi, Noida, India
| | - Kamlesh Singh
- National Resource Centre for Value Education in Engineering, Indian Institute of Technology Delhi, Noida, India
- Department of Humanities and Social Sciences, Indian Institute of Technology Delhi, New Delhi, India
| | - Nitesh Sharma
- National Resource Centre for Value Education in Engineering, Indian Institute of Technology Delhi, Noida, India
| | - Rahul Garg
- National Resource Centre for Value Education in Engineering, Indian Institute of Technology Delhi, Noida, India
- Department of Computer Science and Engineering, Indian Institute of Technology Delhi, New Delhi, India
- Amar Nath and Shahsi Khosla School of Information Technology, Indian Institute of Technology Delhi, New Delhi, India
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26
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Havsteen-Franklin D, Tjasink M, Kottler JW, Grant C, Kumari V. Arts-Based Interventions for Professionals in Caring Roles During and After Crisis: A Systematic Review of the Literature. Front Psychol 2020; 11:589744. [PMID: 33414746 PMCID: PMC7783413 DOI: 10.3389/fpsyg.2020.589744] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 11/20/2020] [Indexed: 11/13/2022] Open
Abstract
Crisis events, such as the COVID-19 pandemic, can have a devastating effect on communities and the care professionals within them. Over recent years, arts-based interventions have helped in a wide range of crisis situations, being recommended to support the workforce during and after complex crisis but there has been no systematic review of the role of arts-based crisis interventions and whether there are cogent themes regarding practice elements and outcomes. We, therefore, conducted a systematic review to (i) define the arts-based change process used during and after crisis events, and (ii) explore the perceptions of intermediate and long-term mental health benefits of arts-based interventions for professionals in caring roles. Our search yielded six studies (all qualitative). All data were thematically aggregated and meta-synthesized, revealing seven practice elements (a safe place, focusing on strengths and protective factors, developing psychosocial competencies to support peers, emotional expression and processing, identifying and naming the impact of the crisis, using an integrative creative approach, and cultural and organizational sensitivity) applied across all six studies, as well as a range of intermediate and long-term benefits shared common features (adapting, growing, and recovering; using the community as a healing resource; reducing or preventing symptoms of stress or trauma reactions, psychophysiological homeostasis). The ways in which these studies were designed independently from one another and yet used the same practice elements in their crisis interventions indicates that there is comparability about how and why the arts-based practice elements are being used and to what effect. Our findings provide a sound basis and meaningful parameters for future research incorporating quantitative and qualitative approaches to firmly establish the effectiveness of art-based interventions, and how arts can support cultural sensitivity, acceptability and indicated outcomes, particularly those relating to stress and trauma during or following a crisis.
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Affiliation(s)
- Dominik Havsteen-Franklin
- CNWL NHS Foundation Trust, London, United Kingdom.,Brunel University London, Uxbridge, United Kingdom
| | | | | | - Claire Grant
- CNWL NHS Foundation Trust, London, United Kingdom
| | - Veena Kumari
- Brunel University London, Uxbridge, United Kingdom
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27
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Kohrt BA, Ottman K, Panter-Brick C, Konner M, Patel V. Why we heal: The evolution of psychological healing and implications for global mental health. Clin Psychol Rev 2020; 82:101920. [PMID: 33126037 DOI: 10.1016/j.cpr.2020.101920] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 09/02/2020] [Accepted: 09/13/2020] [Indexed: 01/10/2023]
Abstract
Why do humans heal one another? Evolutionary psychology has advanced our understanding of why humans suffer psychological distress and mental illness. However, to date, the evolutionary origins of what drives humans to alleviate the suffering of others has received limited attention. Therefore, we draw upon evolutionary theory to assess why humans psychologically support one another, focusing on the interpersonal regulation of emotions that shapes how humans heal and console one another when in psychosocial distress. To understand why we engage in psychological healing, we review the evolution of cooperation among social species and the roles of emotional contagion, empathy, and self-regulation. We discuss key aspects of human biocultural evolution that have contributed to healing behaviors: symbolic logic including language, complex social networks, and the long period of childhood that necessitates identifying and responding to others in distress. However, both biological and cultural evolution also have led to social context when empathy and consoling are impeded. Ultimately, by understanding the evolutionary processes shaping why humans psychologically do or do not heal one another, we can improve our current approaches in global mental health and uncover new opportunities to improve the treatment of mental illness across cultures and context around the world.
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Affiliation(s)
- Brandon A Kohrt
- Division of Global Mental Health, Department of Psychiatry and Behavioral Sciences, George Washington University, Washington, DC, USA.
| | - Katherine Ottman
- Division of Global Mental Health, Department of Psychiatry and Behavioral Sciences, George Washington University, Washington, DC, USA
| | - Catherine Panter-Brick
- Jackson Institute of Global Affairs, Yale University, New Haven, and Department of Anthropology, Yale University, New Haven, USA
| | - Melvin Konner
- Department of Anthropology, Emory University, Atlanta, USA
| | - Vikram Patel
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, and Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Harvard University, Boston, USA
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28
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Almeida S, Bowden A, Bloomfield J, Jose B, Wilson V. Caring for the carers in a public health district: A well-being initiative to support healthcare professionals. J Clin Nurs 2020; 29:3701-3710. [PMID: 32619287 DOI: 10.1111/jocn.15398] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 04/23/2020] [Accepted: 06/21/2020] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To assess the impact of the proactive organisational resource allocation in terms of a 6-week well-being initiative to support public healthcare professionals' workplace engagement, well-being and job satisfaction. BACKGROUND Burnout of healthcare professionals can be a major cost to the Australian economy and public healthcare sector. According to the social exchange theory, when healthcare professionals perceive that their organisation proactively allocates resources to caring for its employees, then they are more likely to reciprocate and become more engaged in their work roles. DESIGN The study used a pre- and postsurvey of healthcare professionals who participated in the well-being initiative. METHODS Between February-June 2019, 172 healthcare professionals were surveyed before and after a well-being initiative. The survey included questions on workplace engagement, workplace well-being and job satisfaction. Paired t tests were used to determine whether the difference between before and after averages was significant. The TREND statement was used to ensure the quality reporting of this study. RESULTS The well-being initiative had a positive impact on the healthcare professionals involved in the initiative. Nursing staff benefitted the most from the well-being initiative, while the full-time staff members and highly experienced demonstrated an increase in engagement. CONCLUSION Well-being initiatives can be a targeted strategy to help alleviate burnout amongst healthcare professionals and build a mutually beneficial relationship between management and employees. RELEVANCE TO CLINICAL PRACTICE This study shows how implementing a staff well-being initiative increases workplace engagement, which benefits both the individual and the organisation.
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Affiliation(s)
| | - Alera Bowden
- University of Wollongong, Wollongong, NSW, Australia.,Illawarra Shoalhaven Local Health District, Wollongong, NSW, Australia
| | | | - Besty Jose
- Illawarra Shoalhaven Local Health District, Wollongong, NSW, Australia
| | - Valerie Wilson
- University of Wollongong, Wollongong, NSW, Australia.,Illawarra Shoalhaven Local Health District, Wollongong, NSW, Australia
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29
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Ishimwe AB, Kaufman J, Uwamahoro D, Wall JT, Herth K, Chang E, Ngirabega JDD, Leonard W. Cross-cultural adaptation and psychometric properties of the Herth Hope Index in Kinyarwanda: adapting a positive psychosocial tool for healthcare recipients and providers in the Rwandan setting. Health Qual Life Outcomes 2020; 18:286. [PMID: 32831084 PMCID: PMC7444040 DOI: 10.1186/s12955-020-01537-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 08/11/2020] [Indexed: 11/23/2022] Open
Abstract
Background The lack of culturally appropriate instruments to measure hope across cultural settings is a barrier to assessing and addressing the relationship between hope and health outcomes. The study aim was to adapt and evaluate the psychometric properties of the Herth Hope Index (HHI) in Kinyarwanda in a population of healthcare recipients and healthcare workers in Rwanda. Methods A transcultural translation and adaptation of the HHI was conducted using qualitative methods (n = 43) to achieve semantic, content, and technical equivalence. The adapted instrument was administered to a purposive sample (n = 206) of Rwandan healthcare patients and providers. Temporal reliability, internal reliability using Cronbach’s alpha, and construct validity using confirmatory factor analysis (CFA) were assessed. Results The Herth Hope Index-Kinyarwanda (HHI-K) was found to have strong internal consistency (α = 0.85) and test-retest reliability (r = 0.85). The original HHI three-factor structure fit the data well in CFA (normed chi-square = 1.53; root mean square error of approximation = 0.05; standardized root mean square residual = 0.05; comparative fit index = 0.96; Tucker-Lewis Index = 0.95). Conclusion This article presents the first rigorous cultural adaptation of the HHI in a low-income country. The HHI-K has acceptable psychometric properties, resulting in a new useful tool for research, program development, and evaluation in Rwandan healthcare settings. The HHI-K instrument can be used to assess the effectiveness of programs that aim to promote hope and health outcomes across health system- and individual-levels. The process also provides a feasible model for adaptation of a positive psychosocial tool for both patients and providers in low-resource settings.
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Affiliation(s)
| | - Julia Kaufman
- TIP Global Health, PO Box 1285, KN 4 St, Kigali, Rwanda
| | | | - Jonathan Taylor Wall
- Duke Global Health Institute, Duke University, 310 Trent Dr, Durham, NC, 27710, USA
| | - Kaye Herth
- Minnesota State University, Mankato, 228 Wiecking Center, Mankato, MN, 56001, USA
| | - Emery Chang
- UCLA Health, 757 Westwood Plaza, Los Angeles, CA, 90095, USA
| | - Jean de Dieu Ngirabega
- East African Health Research Commission, Quartier Kigobe, Avenue des Etats Unis, no. 71, B.P, 350, Bujumbura, Burundi
| | - Wendy Leonard
- TIP Global Health, PO Box 1285, KN 4 St, Kigali, Rwanda
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Mutambo C, Shumba K, Hlongwana KW. Post-training and mentorship experiences of KidzAlive-trained healthcare workers at primary healthcare facilities in KwaZulu-Natal, South Africa. Afr J Prim Health Care Fam Med 2020; 12:e1-e11. [PMID: 32634017 PMCID: PMC7343958 DOI: 10.4102/phcfm.v12i1.2109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 02/06/2020] [Accepted: 02/27/2020] [Indexed: 11/18/2022] Open
Abstract
Background KidzAlive, a multicomponent, child-centred capacity building model was adopted by South Africa’s National Department of Health to address the challenges of quality of care among HIV+ children. This model involves training and mentoring healthcare workers (HCWs) on a child-centred care approach of communicating with children and their primary caregivers (PCGs). This study explored HCWs’ post-training experiences after a 6-months implementation period. Aim To evaluate the KidzAlive model as a healthcare approach that seeks to improve the quality of HIV care among children. Setting The study was conducted in 20 PHC rural and urban facilities across four districts in KwaZulu-Natal. Methods Interviews were conducted by trained interviewers who followed a structured interview guide. These were audio-recorded, transcribed, and imported into NVivo 10 software for thematic analysis. Thematic analysis was used to develop a coding framework from the participant’s responses. Results Five themes, namely: (1) increased healthcare worker knowledge, skills and confidence to provide child-friendly HIV services to children; (2) increased involvement of HIV + children in own healthcare journey; (3) the involvement of primary caregivers in children’s healthcare journey; (4) improved health outcomes for HIV + children; and e) transformation of the PHC environment towards being more child-friendly. Conclusion The findings present preliminary evidence of successful KidzAlive trained HCWs’ buy-in of KidzAlive intervention. KidzAlive has been well integrated into current service delivery processes in PHC facilities. However, more rigorous research is warranted to fully understand the impact of this intervention on children and their primary caregivers.
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Affiliation(s)
- Chipo Mutambo
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban.
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Mao Y, Fu H, Feng Z, Feng D, Chen X, Yang J, Li Y. Could the connectedness of primary health care workers involved in social networks affect their job burnout? A cross-sectional study in six counties, Central China. BMC Health Serv Res 2020; 20:557. [PMID: 32552752 PMCID: PMC7302340 DOI: 10.1186/s12913-020-05426-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 06/12/2020] [Indexed: 11/24/2022] Open
Abstract
Background This study aimed to reveal the effects of the connectedness of primary health care (PHC) workers in social networks on their job burnout. Methods Cross-sectional survey data of rural PHC workers in China were analyzed. A total of 663 respondents were enrolled. Chi-square and cumulative logistic regression were used to determine the effects of the connectedness of PHC workers in social networks on their job burnout. Results PHC workers in rural China had high levels of emotional exhaustion (24.1%), depersonalization (15.7%), and lack of personal accomplishment (34.7%). More than half of the participants were in the middle connectedness level in terms of their advisory (70.4%) and friendship (70.3%) networks. The degree of emotional exhaustion seemed to increase when participants had a low connectedness in their friendship networks (β = 0.769, 95% CI = 0.080–1.458, P = 0.029). Respondents with the middle level of connectedness in advisory networks had higher levels of depersonalization (β = 0.739, 95% CI = 0.130–1.348, P = 0.017) and lack of personal accomplishment (β = 0.583, 95% CI = 0.111–1.055, P = 0.015) than those with the high degree of connectedness in advisory networks. Conclusions The connectedness of PHC workers in social networks influenced their job burnout. Thus, organizations should establish an informal communication platform and information feedback mechanism, promote and manage friendship networks, and help PHC workers overcome emotional exhaustion. Managers should also encourage individuals with a high level of connectedness in advisory networks play the role of “opinion leader” so that they can help others mitigate burnout.
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Affiliation(s)
- Yiqing Mao
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China.,Research center for Rural Health Services, Hubei Province Key Research Institute of Humanities and Social Sciences, Wuhan, 430030, Hubei, China
| | - Hang Fu
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Zhanchun Feng
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China. .,Research center for Rural Health Services, Hubei Province Key Research Institute of Humanities and Social Sciences, Wuhan, 430030, Hubei, China.
| | - Da Feng
- School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Xiaoyu Chen
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China.,Research center for Rural Health Services, Hubei Province Key Research Institute of Humanities and Social Sciences, Wuhan, 430030, Hubei, China
| | - Jian Yang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China.,Research center for Rural Health Services, Hubei Province Key Research Institute of Humanities and Social Sciences, Wuhan, 430030, Hubei, China
| | - Yuanqing Li
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China.,Research center for Rural Health Services, Hubei Province Key Research Institute of Humanities and Social Sciences, Wuhan, 430030, Hubei, China
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Gullo S, Galavotti C, Sebert Kuhlmann A, Msiska T, Hastings P, Marti CN. Effects of the Community Score Card approach on reproductive health service-related outcomes in Malawi. PLoS One 2020; 15:e0232868. [PMID: 32428027 PMCID: PMC7236973 DOI: 10.1371/journal.pone.0232868] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 04/23/2020] [Indexed: 12/04/2022] Open
Abstract
Background Social accountability approaches are increasingly being employed in low-resource settings to improve government services. In line with the continuous quality improvement (CQI) philosophy that quality is the product of a linked chain, collaborative social accountability approaches like the Community Score Card (CSC) aim to empower clients and frontline service providers to transform their own lives and hold public officials to account for state obligations. Despite being a critical focus of collaborative social accountability approaches, to our knowledge, a quantitative survey of health workers to understand the impact of these approaches on their self-reported responsibilities and service provision has not been conducted. To fill this gap, we carried out a quantitative survey with health workers to assess the CSC’s impact on health worker-reported service responsibilities and provision and complement women’s self-reports. Methods We evaluated the effect of the CSC on reproductive health-related outcomes using a cluster-randomized design in Ntcheu district, Malawi. We matched 10 pairs of health facilities and surrounding catchment communities; one from each pair was randomly assigned to the intervention and control arms. The intervention communities and health workers each completed 3–4 cycles of the CSC process by endline. We then surveyed all health workers in the 20 intervention and comparison sites at endline (n = 412) to estimate the intervention’s impact. Results Significantly (p < .05) more health workers in the CSC intervention areas compared to control areas reported responsibility for antenatal care, comprehensive antenatal care counseling, recording of the number of pregnant and postpartum women seen each month, and the average age of their last family planning client was younger. In addition, marginally significantly (p < .10) more health workers in treatment versus control areas report visiting women at their home at least once during their pregnancy. However, health worker-reported responsibility for HIV testing was significantly lower in intervention areas than in control. Conclusions The CSC aims to empower health workers to collaborate with the community and rest of the health system to identify and overcome the diverse and context-specific range of performance barriers they face. In doing so, it aims to support them to demand and ensure quality care for themselves from the health system so they can, in turn, deliver quality services to clients. Our results contribute to the evidence that the CSC may hold promise at improving service provision. While there is increasing evidence that collaborative social accountability approaches like the CSC are effective means to improving reproductive health-related service provision and outcomes in low-resource settings, additional research is needed.
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Affiliation(s)
- Sara Gullo
- CARE USA, Atlanta, Georgia, United States of America
- * E-mail:
| | | | - Anne Sebert Kuhlmann
- College for Public Health & Social Justice, Saint Louis University, St. Louis, Missouri, United States of America
| | | | - Phil Hastings
- Far Harbor, LLC, Austin, TX, United States of America
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Teffo M, Rispel L. Resilience or detachment? Coping strategies among termination of pregnancy health care providers in two South African provinces. CULTURE, HEALTH & SEXUALITY 2020; 22:336-351. [PMID: 31032716 DOI: 10.1080/13691058.2019.1600720] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 03/25/2019] [Indexed: 06/09/2023]
Abstract
There is global recognition that competent and willing health care providers remain the most important determinant of safe abortion or termination of pregnancy services. The psychosocial well-being of providers is critical to the provision of responsive termination of pregnancy services. In light of the dearth of scholarly attention on termination of pregnancy providers' coping strategies in low- and middle-income countries, this paper explores coping strategies among these providers in the urban Gauteng and the mixed rural-urban North West provinces of South Africa. During 2015, in-depth interviews were conducted with 30 termination of pregnancy providers working at abortion facilities in these provinces. Questions focused on providers' lived experiences of abortion service provision, the meanings they attached to their work and their reported coping strategies. Interpretative phenomenological analysis was used to analyse the interviews. Interviewees' mean age was 45.8 years, all were professional nurses and the majority were female (82%), working for an average of 3.6 years in abortion services. Four overlapping themes emerged in relation to reported coping strategies: silence and concealing emotions; seeking support; detachment or disengagement; and belief systems. Study findings point to the need for effective, sustainable employee wellness programmes, within an overall context of positive practice environments.
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Affiliation(s)
- Mantshi Teffo
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Laetitia Rispel
- Centre for Health Policy & Department of Science and Technology/National Research Foundation Research Chair, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Gray P, Senabe S, Naicker N, Kgalamono S, Yassi A, Spiegel JM. Workplace-Based Organizational Interventions Promoting Mental Health and Happiness among Healthcare Workers: A Realist Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E4396. [PMID: 31717906 PMCID: PMC6888154 DOI: 10.3390/ijerph16224396] [Citation(s) in RCA: 117] [Impact Index Per Article: 23.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 10/27/2019] [Accepted: 11/02/2019] [Indexed: 02/03/2023]
Abstract
Mental illness, deemed globally to account for 32% of years lived with a disability, generates significant impacts on workplaces. In particular, healthcare workers experience high rates of mental ill health such as burnout, stress, and depression due to workplace conditions including excessive workloads, workplace violence and bullying, which also produces negative effects on patients as well as on the happiness and wellbeing of those who remain at work. This review was undertaken to synthesize the evidence on workplace-based interventions at the organizational level promoting mental health and wellbeing among healthcare workers, to identify what has been receiving attention in this area and why, especially considering how such positive effects are produced. A search of three premier health-related databases identified 1290 articles that discussed healthcare workers, workplace interventions, and mental health. Following further examination, 46 articles were ultimately selected as meeting the criteria specifying interventions at the organizational level and combined with similar studies included in a relevant Cochrane review. The 60 chosen articles were then analyzed following a realist framework analyzing context, mechanism, and outcome. Most of the studies included in the realist review were conducted in high-income countries, and the types of organizational-level interventions studied included skills and knowledge development, leadership development, communication and team building, stress management as well as workload and time management. Common themes from the realist review highlight the importance of employee engagement in the intervention development and implementation process. The literature review also supports the recognized need for more research on mental health and happiness in low- and middle-income countries, and for studies evaluating the longer-term effects of workplace mental health promotion.
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Affiliation(s)
- Patricia Gray
- School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada; (P.G.); (A.Y.)
| | - Sipho Senabe
- Gauteng Department of Health, Gauteng Provincial Government, 45 Commissioner Street, Marshall Town (Johannesburg) 2147, South Africa;
| | - Nisha Naicker
- National Institute of Occupational Health, National Health Laboratory Service, Braamfontein, Johannesburg 2001, South Africa; (N.N.); (S.K.)
- School of Public Health, University of Witwatersrand, Parktown 2000, South Africa
- Department of Environmental Health, Faculty of Health Sciences, University of Johannesburg, Johannesburg 2028, South Africa
| | - Spo Kgalamono
- National Institute of Occupational Health, National Health Laboratory Service, Braamfontein, Johannesburg 2001, South Africa; (N.N.); (S.K.)
- School of Public Health, University of Witwatersrand, Parktown 2000, South Africa
| | - Annalee Yassi
- School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada; (P.G.); (A.Y.)
| | - Jerry M. Spiegel
- School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada; (P.G.); (A.Y.)
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Haile YG, Senkute AL, Alemu BT, Bedane DM, Kebede KB. Prevalence and associated factors of burnout among Debre Berhan University medical students: a cross-sectional study. BMC MEDICAL EDUCATION 2019; 19:413. [PMID: 31703674 PMCID: PMC6842173 DOI: 10.1186/s12909-019-1864-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Accepted: 10/31/2019] [Indexed: 06/02/2023]
Abstract
BACKGROUND Burnout, a measure of professional distress, is more common among medical professionals. About half of medical students have this problem. However, little is known about the burnout status of medical students in Ethiopia. Therefore, the aim of this study was to assess the prevalence and associated factors of burnout among medical students of Debre Berhan University (DBU). METHODS A cross-sectional study was conducted on randomly selected 151 medical students of DBU. Burnout was assessed using the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). Participants were reported as having burnout if they scored ≥27 on Emotional Exhaustion (EE), ≥13 on Depersonalization (DP) sub-scales, and ≤ 31 on Personal Accomplishment (PA) sub-scale of the MBI-HSS. EpiData version 3.1 was used for data entry while SPSS version 20 and STATA version 13 for windows were used for data analysis. Both univariable and multivariable binary logistic regression analyses were conducted. The degree of association between variables was assessed using odds ratio (OR) with 95% confidence interval (CI) at two-tailed p-value of < 0.05. RESULT Of 144 medical students took part, 34.0% had symptoms of burnout. Regarding domains of burnout, 61.8% scored high on EE, 47.9% scored high on DP and 59.7% scored low on PA. Dissatisfaction with practice lecturer (AOR = 3.8, 95% CI (1.3, 11.6)), moderate social support (AOR = 0.2, 95% CI (0.1, 0.8)), and satisfaction with their education (AOR = 0.1 95% CI (0.0, 0.7)) were associated with burnout. CONCLUSION More than one-third of medical students at DBU had burnout. Individual and organizational level interventions targeting students who had poor social support, dissatisfied by their lecturer at the hospitals and their education are recommended.
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Affiliation(s)
| | | | | | - Dawit Mamo Bedane
- Department of Medicine, Debre Berhan University, Debre Berhan, Ethiopia
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Selamu M, Hanlon C, Medhin G, Thornicroft G, Fekadu A. Burnout among primary healthcare workers during implementation of integrated mental healthcare in rural Ethiopia: a cohort study. HUMAN RESOURCES FOR HEALTH 2019; 17:58. [PMID: 31319872 PMCID: PMC6639922 DOI: 10.1186/s12960-019-0383-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 06/05/2019] [Indexed: 05/17/2023]
Abstract
BACKGROUND The short-term course of burnout in healthcare workers in low- and middle-income countries has undergone limited evaluation. The aim of this study was to assess the short-term outcome of burnout symptoms in the context of implementation of a new mental health programme in a rural African district. METHODS We followed up 145 primary healthcare workers (HCWs) working in 66 rural primary healthcare (PHC) facilities in Southern Ethiopia, where a new integrated mental health service was being implemented. Burnout was assessed at baseline, i.e. when the new service was being introduced, and after 6 months. Data were collected through self-administered questionnaires, including the Maslach Burnout Inventory (MBI) and instruments measuring professional satisfaction and psychosocial factors. Generalised estimating equations (GEE) were used to assess the association between change in the core dimension of burnout (emotional exhaustion) and relevant work-related and psychosocial factors. RESULTS A total of 136 (93.8%) of HCWs completed and returned their questionnaires at 6 months. There was a non-significant reduction in the burnout level between the two time points. In GEE regression models, high depression symptom scores (adjusted mean difference (aMD) 0.56, 95% CI 0.29, 0.83, p < 0.01), experiencing two or more stressful life events (aMD 1.37, 95% CI 0.06, 2.14, p < 0.01), being a community health extension worker vs. facility-based HCW (aMD 5.80, 95% CI 3.21, 8.38, p < 0.01), perceived job insecurity (aMD 0.73, 95% CI 0.08, 1.38, p = 0.03) and older age (aMD 0.36, 95% CI 0.09, 0.63, p = 0.01) were significantly associated with higher levels of emotional exhaustion longitudinally. CONCLUSION In the short-term, there was no significant change in the level of burnout in the context of adding mental healthcare to the workload of HCWs. However, longer term and larger scale studies are required to substantiate this. This evidence can serve as baseline information for an intervention development to enhance wellbeing and reduce burnout.
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Affiliation(s)
- Medhin Selamu
- College of Health Sciences, School of Medicine, Department of Psychiatry, Addis Ababa University, PO Box 9086, Addis Ababa, Ethiopia
| | - Charlotte Hanlon
- College of Health Sciences, School of Medicine, Department of Psychiatry, Addis Ababa University, PO Box 9086, Addis Ababa, Ethiopia
- Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Girmay Medhin
- Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Graham Thornicroft
- Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Abebaw Fekadu
- College of Health Sciences, School of Medicine, Department of Psychiatry, Addis Ababa University, PO Box 9086, Addis Ababa, Ethiopia
- Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Global Health & Infection Department, Brighton and Sussex Medical School, Brighton, United Kingdom
- Department of Psychological Medicine, Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
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Assefa Y, Gelaw YA, Hill PS, Taye BW, Van Damme W. Community health extension program of Ethiopia, 2003-2018: successes and challenges toward universal coverage for primary healthcare services. Global Health 2019; 15:24. [PMID: 30914055 PMCID: PMC6434624 DOI: 10.1186/s12992-019-0470-1] [Citation(s) in RCA: 188] [Impact Index Per Article: 37.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 03/15/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Ethiopia has been implementing a community health extension program (HEP) since 2003. We aimed to assess the successes and challenges of the HEP over time, and develop a framework that may assist the implementation of the program toward universal primary healthcare services. METHODS We conducted a systematic review and synthesis of the literature on the HEP in Ethiopia between 2003 and 2018. Literature search was accomplished in PubMed, Embase and Google scholar databases. Literature search strategies were developed using medical subject headings (MeSH) and text words related to the aim of the review. We used a three-stage screening process to select the publications. Data extraction was conducted by three reviewers using pre-prepared data extraction form. We conducted an interpretive (not aggregative) synthesis of studies. FINDINGS The HEP enabled Ethiopia to achieve significant improvements in maternal and child health, communicable diseases, hygiene and sanitation, knowledge and health care seeking. The HEP has been a learning organization that adapts itself to community demands. The program is also dynamic enough to shift tasks between health centers and community. The community has been a key player in the successful implementation of the HEP. In spite of these successes, the program is currently facing challenges that remain to be addressed. These challenges are related to productivity and efficiency of health extension workers (HEWs); working and living conditions of HEWs; capacity of health posts; and, social determinants of health. These require a systemic approach that involves the wider health system, community, and sectors responsible for social determinants of health. We developed a framework that may assist in the implementation of the HEP. CONCLUSION The HEP has enabled Ethiopia to achieve significant improvements. However, several challenges remain to be addressed. The framework can be utilized to improve community health programs toward universal coverage for primary healthcare services.
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Affiliation(s)
- Yibeltal Assefa
- School of Public Health, the University of Queensland, Brisbane, Australia.
| | | | - Peter S Hill
- School of Public Health, the University of Queensland, Brisbane, Australia
| | | | - Wim Van Damme
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
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Kruk ME, Gage AD, Arsenault C, Jordan K, Leslie HH, Roder-DeWan S, Adeyi O, Barker P, Daelmans B, Doubova SV, English M, García-Elorrio E, Guanais F, Gureje O, Hirschhorn LR, Jiang L, Kelley E, Lemango ET, Liljestrand J, Malata A, Marchant T, Matsoso MP, Meara JG, Mohanan M, Ndiaye Y, Norheim OF, Reddy KS, Rowe AK, Salomon JA, Thapa G, Twum-Danso NAY, Pate M. High-quality health systems in the Sustainable Development Goals era: time for a revolution. Lancet Glob Health 2018; 6:e1196-e1252. [PMID: 30196093 PMCID: PMC7734391 DOI: 10.1016/s2214-109x(18)30386-3] [Citation(s) in RCA: 1554] [Impact Index Per Article: 259.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 05/16/2018] [Accepted: 08/10/2018] [Indexed: 12/19/2022]
Affiliation(s)
| | - Anna D Gage
- Harvard T H Chan School of Public Health, Boston, MA, USA
| | | | - Keely Jordan
- New York University College of Global Public Health, New York, NY, USA
| | | | | | | | - Pierre Barker
- Institute for Healthcare Improvement, Cambridge, MA, USA
| | | | | | - Mike English
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
| | | | | | - Oye Gureje
- WHO Collaborating Centre for Research and Training in Mental Health, Neuroscience, Drug and Alcohol Abuse, University of Ibadan, Ibadan, Nigeria
| | - Lisa R Hirschhorn
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Lixin Jiang
- National Centre for Cardiovascular Disease, Beijing, China
| | | | | | | | - Address Malata
- Malawi University of Science and Technology, Limbe, Malawi
| | - Tanya Marchant
- London School of Hygiene & Tropical Medicine, London, UK
| | | | - John G Meara
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Manoj Mohanan
- Duke University Sanford School of Public Policy, Durham, NC, USA
| | - Youssoupha Ndiaye
- Ministry of Health and Social Action of the Republic of Senegal, Dakar, Senegal
| | - Ole F Norheim
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | | | - Alexander K Rowe
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Gagan Thapa
- Legislature Parliament of Nepal, Kathmandu, Nepal
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Guan S, Xiaerfuding X, Ning L, Lian Y, Jiang Y, Liu J, Ng TB. Effect of Job Strain on Job Burnout, Mental Fatigue and Chronic Diseases among Civil Servants in the Xinjiang Uygur Autonomous Region of China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14080872. [PMID: 28771199 PMCID: PMC5580576 DOI: 10.3390/ijerph14080872] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 07/31/2017] [Accepted: 08/01/2017] [Indexed: 11/16/2022]
Abstract
Job strain is a major concern in view of its effects among civil servants associated with job burnout, mental fatigue and chronic diseases. The objective of this study was to assess the job strain level among civil servants and examine the effect of job strain on job burnout, mental fatigue and the resulting chronic diseases. A cross-sectional study with a representative sample consisting of 5000 civil servants was conducted from March to August 2014. Using a structured questionnaire, the job strain level, job burnout and mental fatigue were measured by using the Personal Strain Questionnaire (PSQ), Maslach Burnout Inventory (MBI) and Multidimensional Fatigue Inventory (MFI-20), respectively. Overall, 33.8% of the civil servants were found to be afflicted with high and moderate job strain. The characteristics of most of the civil servants with a higher-job strain level were as follows: female, Uygur, lower educational level and job title rank, shorter working experience, married marital status, and lower income level. Civil servants suffering from chronic disease mainly had hypertension and coronary heart disease, which accounted for 18.5% of the diseases. Civil servants with a high-job strain level exhibited higher rates of burnout, mental fatigue scores and incidence of chronic diseases. There was a multiple linear regression model composed of three predictor variables in job burnout, which accounted for 45.0% of its occurrence: female gender, lower-income level, higher-job strain in civil servants, the greater the rate of job burnout was. Four factors—male gender, lower-job title rank, higher-job strain, shorter-job tenure of civil servants—explained 25.0% of the mental fatigue model. Binary logistic regression showed that intermediate-rank employees (OR = 0.442, 95% CI: 0.028–0.634; p < 0.05), job tenure of 10–20 years (OR = 0.632, 95% CI: 0.359–0.989; p < 0.05), and low-job strain (OR = 0.657, 95% CI: 0.052–0.698; p < 0.05) were all associated with significantly lower odds of chronic disease. The risk of chronic disease was higher in civil servants with high-job burnout scores and mental fatigue scores compared with civil servants with lower scores (OR = 1.139, 95% CI: 1.012–3.198; OR = 1.697, 95% CI: 1.097–2.962). These data provide evidence for the effects of job strain on job burnout, mental fatigue and chronic diseases among civil servants.
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Affiliation(s)
- Suzhen Guan
- Department of Social Medicine, College of Public Health, Xinjiang Medical University, Urumqi 830011, China.
- Department of Occupational Health and Environmental Health, College of Public Health, Ningxia Medical University, Yinchuan 750000, China.
| | - Xiadiya Xiaerfuding
- Department of Social Medicine, College of Public Health, Xinjiang Medical University, Urumqi 830011, China.
| | - Li Ning
- Department of Occupational Health and Environmental Health, College of Public Health, Xinjiang Medical University, Urumqi 830011, China.
| | - Yulong Lian
- Department of Occupational Health and Environmental Health, College of Public Health, Nantong University, Nantong 226000, China.
| | - Yu Jiang
- Department of Occupational Health and Environmental Health, College of Public Health, Xinjiang Medical University, Urumqi 830011, China.
| | - Jiwen Liu
- Department of Occupational Health and Environmental Health, College of Public Health, Xinjiang Medical University, Urumqi 830011, China.
| | - Tzi Bun Ng
- School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
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