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Bener A, Ventriglio A, Almas F, Bhugra D. Determinants of brain drain among physicians in Turkey: Findings from a national exploratory study. Int J Soc Psychiatry 2024:207640241285834. [PMID: 39369289 DOI: 10.1177/00207640241285834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/07/2024]
Abstract
BACKGROUND The shortage of physicians in Turkey is a highly critical emergency. In fact, physicians' migration to developing or high-income countries, defined as brain drain, threatens the sustainability of the national healthcare system. AIMS This study explored the driving factors associated with Turkish Physicians' brain drain, including high-economic inflation, social-politics, poor-living, equity, violence, and the desire to practice medical activity abroad. METHODS A cross-sectional survey of 1,861 Turkish physicians aged 25 to 65 years old was conducted employing the Brain Drain questionnaire, the Depression Anxiety Stress Scale (DASS-21), the Patient Health Questionnaire 9 (PHQ-9), and the Fatigue Assessment Scale (FAS). RESULTS Significant differences were observed among physicians staying in Turkey versus considering migration to Western countries, regarding their age, gender, marital status, educational level, occupational status, work years, hospital night shifts, income, and cigarette/nargileh smoking habits (all p ⩽ .018). The main reasons for brain drain included transport problems, harassment, low salary, malpractice, bad environment, job insecurity, workload, burnout, treating difficult patients, inadequate postgraduate systems, peer-pressure, health safety concerns, and favoritism in the workplace, as well as stress and depression caused by work overload. In fact, depression, anxiety, stress, fatigue, and burnout varied significantly among the different groups of physicians (all p ⩽ .013). Additionally, key predictors of brain drain were better job opportunities, poor hospital management (in Turkey), job-related stress, dealing with difficult patients, research deficiencies, workload, burnout, transportation issues, short consultation time, low salary, and fatigue. Among the general factors contributing to the brain drain in the Turkish Health System, we identified significant issues related to research deficiencies, compulsory working duties, poor quality of postgraduate, inadequate medical-schools, poor hospital management, and shortage of consultants. CONCLUSION Physicians' migration is a major global public health concern, leading to substantial risks for healthcare services, especially in Turkey. Many physicians decide to migrate to work in Western countries.
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Affiliation(s)
- Abdulbari Bener
- Department of Biostatistics & Medical Informatics, Faculty of Medicine, Istanbul Medipol University, Turkey
- Department of Evidence for Population Health Unit, School of Epidemiology and Health Sciences, The University of Manchester, UK
- Department of Public Health, Medipol International School of Medicine, Istanbul Medipol University, Turkey
| | - Antonio Ventriglio
- Department of Clinical & Experimental Medicine, University of Foggia, Italy
| | - Furkan Almas
- Department of Public Health, Medipol International School of Medicine, Istanbul Medipol University, Turkey
| | - Dinesh Bhugra
- Department of Psychiatry, HSPRD, Institute of Psychiatry, King's College London, UK
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Abdullah Sharin I, Jinah N, Bakit P, Adnan IK, Zakaria NH, Mohmad S, Ahmad Subki SZ, Zakaria N, Lee KY. Psychoeducational Burnout Intervention for Nurses: Protocol for a Systematic Review. JMIR Res Protoc 2024; 13:e58692. [PMID: 39348680 DOI: 10.2196/58692] [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: 03/27/2024] [Revised: 06/18/2024] [Accepted: 07/16/2024] [Indexed: 10/02/2024] Open
Abstract
BACKGROUND Nurses face high levels of stress and emotional exhaustion due to heavy workloads and demanding work environments. Prolonged exposure to these stressors predisposes nurses to burnout, which can adversely affect patient care. Addressing burnout among nurses requires a multifaceted approach, involving both personal and organizational strategies. While organizational strategies target systemic workplace issues, personal interventions are often favored for their ease of implementation, immediate benefits, and empowerment of health care workers through stress management and resilience-building. Prioritizing evidence-based interventions to mitigate burnout among nurses is crucial for managing occupational stress and promoting well-being. Person-directed psychoeducation is an effective personal intervention strategy used to equip nurses with the appropriate knowledge and skills to handle stressors, thereby safeguarding their mental health and ensuring high-quality patient care. OBJECTIVE This protocol proposes a systematic review that aims to identify and assess the effectiveness of person-directed psychoeducational interventions for nurses. The review aims to pinpoint effective interventions that can be implemented to manage burnout and support the mental health of nurses. METHODS This systematic review will follow the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines. In total of 5 electronic databases (PubMed-MEDLINE, EBSCOhost, Ovid MEDLINE, Scopus, and ScienceDirect) will be searched for studies published between January 1, 2014, and December 31, 2023. The search will encompass 3 main keywords: "nurses," "burnout intervention," and "burnout." Predefined eligibility criteria will guide the screening process. Data will be extracted to address the objectives of the review. The risk of bias for each study will be assessed using Joanna Briggs Institute Critical Appraisal Tools. RESULTS Preliminary searches have been initiated since February 2024, with the review expected to be completed by June 2024. The expected results will include a comprehensive list of psychoeducational interventions and their effectiveness in reducing burnout among nurses. The review will highlight interventions that demonstrate significant impact in published studies from various countries. CONCLUSIONS Given the rising prevalence of burnout among nurses and its detrimental effects on individuals and health care organizations, the findings from this systematic review are expected to inform health care policy and practice. By evaluating different interventions, it will provide insights into the most effective strategies, contributing to evidence-based practices that support nurses' mental health and well-being. The findings can support stakeholders in developing and implementing targeted strategies to combat nurse burnout, ultimately enhancing the quality of patient care and health care delivery. In addition, the findings will also offer valuable information for researchers, guiding future practice and research in this area. TRIAL REGISTRATION PROSPERO CRD42024505762; https://tinyurl.com/4p84dk3d. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/58692.
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Affiliation(s)
- Ili Abdullah Sharin
- Centre of Leadership & Professional Development (CLPD), Institute for Health Management (IHM), National Institutes of Health (NIH), Ministry of Health Malaysia, Shah Alam, Malaysia
| | - Norehan Jinah
- Centre of Leadership & Professional Development (CLPD), Institute for Health Management (IHM), National Institutes of Health (NIH), Ministry of Health Malaysia, Shah Alam, Malaysia
| | - Pangie Bakit
- Centre of Leadership & Professional Development (CLPD), Institute for Health Management (IHM), National Institutes of Health (NIH), Ministry of Health Malaysia, Shah Alam, Malaysia
| | - Izzuan Khirman Adnan
- Centre of Leadership & Professional Development (CLPD), Institute for Health Management (IHM), National Institutes of Health (NIH), Ministry of Health Malaysia, Shah Alam, Malaysia
| | - Nor Haniza Zakaria
- Centre of Leadership & Professional Development (CLPD), Institute for Health Management (IHM), National Institutes of Health (NIH), Ministry of Health Malaysia, Shah Alam, Malaysia
| | - Shazwani Mohmad
- Centre of Leadership & Professional Development (CLPD), Institute for Health Management (IHM), National Institutes of Health (NIH), Ministry of Health Malaysia, Shah Alam, Malaysia
| | - Siti Zubaidah Ahmad Subki
- Centre of Leadership & Professional Development (CLPD), Institute for Health Management (IHM), National Institutes of Health (NIH), Ministry of Health Malaysia, Shah Alam, Malaysia
| | - Nursyahda Zakaria
- Centre of Leadership & Professional Development (CLPD), Institute for Health Management (IHM), National Institutes of Health (NIH), Ministry of Health Malaysia, Shah Alam, Malaysia
| | - Kun Yun Lee
- Centre of Leadership & Professional Development (CLPD), Institute for Health Management (IHM), National Institutes of Health (NIH), Ministry of Health Malaysia, Shah Alam, Malaysia
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Almahmoud O, Asmar I, Kahala A, Awadallah N, Awad W, Sarhan N, Joulany S. Burnout Among Nurses Working in Critical Care Units During the COVID-19 Pandemic. Crit Care Nurs Q 2024; 47:257-268. [PMID: 38860954 DOI: 10.1097/cnq.0000000000000514] [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: 06/12/2024]
Abstract
Burnout is a state of emotional and physical depletion. Its occurrence among critical care nurses (CCNs) is a concept that has gained traction yet remains an issue with global consequences. Nurses are especially vulnerable to burnout due to the persistent stressors they are exposed to, which include the general work environment, biological factors, and emerging changes caused by COVID-19. This study aims to assess the severity of burnout among CCNs during the COVID-19 pandemic and its associated factors. A descriptive cross-sectional questionnaire was used in this study to measure the estimated burnout rate among CCNs in Palestine and establish associations with potential factors. Maslach Burnout Inventory questionnaire was used for the task. The results showed out of the 173 participants, more than 35% reported severe overall burnout. Per burnout domains, it was found that around 70% of participants suffered from low personal accomplishment, while 59.5% had severe levels of depersonalization, and finally, more than 65% of critical nurses had severe emotional exhaustion. Out of the various variables tested, gender, age, type of hospital, PPE, and fear of transmission were found to be associated with overall burnout. CCNs in Palestine were found to be severely burned out and should be dealt with before getting out of hand. The research found variables related to burnout contributed to burnout. Recommendations for further studies and prioritization should be made.
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Affiliation(s)
- Omar Almahmoud
- Department of Nursing, Faculty of Pharmacy, Nursing and Health Professions, Birzeit University, Palestine
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Yaqian Z, Chonggao W, Fan Z. The relationship between job stress and job burnout of preschool teachers during the COVID-19: The moderation of perceived organizational support. Work 2024:WOR230151. [PMID: 38759080 DOI: 10.3233/wor-230151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND COVID-19 poses great challenges for preschool teachers in China, which will increase the level of job stress and job burnout, and have an impact on the relationship between job stress, job burnout, and perceived organizational support (POS). However, few studies have examined trilateral relationships, especially the role of POS concerning job stress and job burnout of preschool teachers. OBJECTIVE This study aimed to investigate the relationship among the three variables of job burnout, job stress, and POS, as well as explore the moderating effects of POS between job stress and job burnout. METHODS A cross-sectional study was conducted among preschool teachers in six provinces of China. A total of 408 preschool teachers completed a self-report questionnaire, including three scales that measured job burnout, job stress, and POS respectively. The Pearson correlation coefficient and regression analysis were used to examine the relationship among variables. RESULTS The results showed that job burnout among Chinese preschool teachers was at a medium level during the COVID-19 pandemic. Job stress was positively related to job burnout, and the POS was negatively related to job burnout. Additionally, POS moderated the relationship between job stress and job burnout and alleviated the adverse effects of job stress on the job burnout of preschool teachers. CONCLUSION POS can play a moderating role between job stress and job burnout of Chinese preschool teachers during the COVID-19 pandemic.
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Affiliation(s)
- Zhang Yaqian
- Institute of Early Childhood Education, Faculty of Education, Beijing Normal University, Beijing, China
| | - Wang Chonggao
- School of Education, Central China Normal University, Wuhan, China
| | - Zhang Fan
- Faculty of Education, Northeast Normal University, Changchun, China
- Shenyang Art Preschool Normal School Kindergarten, Shenyang, China
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Shah AN, Vinaithirthan V, Syed AS, Thurmon K, Mann A, Fainstad T. National Comparison of Burnout for a Cohort of Surgical and Nonsurgical Female Trainees. J Surg Res 2024; 296:404-410. [PMID: 38310655 DOI: 10.1016/j.jss.2024.01.010] [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: 08/08/2023] [Revised: 12/07/2023] [Accepted: 01/02/2024] [Indexed: 02/06/2024]
Abstract
INTRODUCTION Studies have shown that female physician trainees have an increased risk of burnout. We describe the current state of surgical and nonsurgical female trainee well-being and examine differences between surgical and nonsurgical specialties. METHODS Survey responses were received from 1017 female identifying trainees from 26 graduate medical education institutions across the United States. These survey responses included demographic data and well-being measures. Specifically, burnout was assessed using the Maslach Burnout Inventory. Data were analyzed using Wilcoxon rank sum test, Fisher's exact test, and Pearson's Chi-squared test data with significance defined as a P < 0.05. This survey was reported in line with strengthening the reporting of cohort studies in surgery criteria. RESULTS Nine-hundred ninety-nine participants completed the demographic and well-being section of the surveys and were included in analysis. Demographic data between the surgical versus nonsurgical group were similar, aside from surgeons being slightly older. Burnout was prevalent among all surveyed trainees with 63% scoring positive. Trainees also scored high in imposter syndrome and moral injury with low levels of self-compassion, although respondents also reported themselves flourishing. Surgical trainees scored higher than nonsurgical trainees in the personal accomplishment domain of burnout (P < 0.048). There was no difference between surgical and nonsurgical trainees in measures of the emotional exhaustion or depersonalization domains of burnout, or in impostor syndrome, self-compassion, moral injury, or flourishing. CONCLUSIONS While personal accomplishment was noted to be higher in surgical trainees as compared to nonsurgical trainees, overall rates of burnout are high among both groups. Targeted interventions for well-being, such as coaching, can help decrease the levels of burnout experienced by female physician trainees and do not need to be specialty specific.
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Affiliation(s)
- Ami N Shah
- Division of Pediatric Surgery, Department of Surgery, Rush University Medical Center, Chicago, Illinois.
| | | | - Adnan S Syed
- School of Medicine, University of Colorado, Aurora, Colorado
| | - Kerri Thurmon
- School of Medicine, University of Colorado, Aurora, Colorado
| | - Adrienne Mann
- School of Medicine, University of Colorado, Aurora, Colorado; Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colorado
| | - Tyra Fainstad
- School of Medicine, University of Colorado, Aurora, Colorado
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Hutchings HA, Rahman M, Carter K, Islam S, O'Neill C, Roberts S, John A, Fegan G, Dave U, Hawkes N, Ahmed F, Hasan M, Azad AK, Rahman MM, Kibria MG, Rahman MM, Mia T, Akhter M, Williams JG. Did the COVID-19 pandemic affect levels of burnout, anxiety and depression among doctors and nurses in Bangladesh? A cross-sectional survey study. BMJ Open 2024; 14:e079350. [PMID: 38453200 PMCID: PMC10921535 DOI: 10.1136/bmjopen-2023-079350] [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: 09/04/2023] [Accepted: 02/14/2024] [Indexed: 03/09/2024] Open
Abstract
INTRODUCTION COVID-19 has caused severe disruption to clinical services in Bangladesh but the extent of this, and the impact on healthcare professionals is unclear. We aimed to assess the perceived levels of anxiety, depression and burnout among doctors and nurses during COVID-19 pandemic. METHODS We undertook an online survey using RedCap, directed at doctors and nurses across four institutions in Bangladesh (The Sheikh Russel Gastro Liver Institute & Hospital (SRNGIH), Dhaka Medical College Hospital (DMCH), Mugda Medical College Hospital (MMCH) and M Abdur Rahim Medical College (MARMC) Hospital). We collected information on demographics, awareness of well-being services, COVID-19-related workload, as well as anxiety, depression and burnout using two validated questionnaires: the Hospital Anxiety and Depression Scale (HADS) and the Maslach Burnout Inventory (MBI). RESULTS Of the 3000 participants approached, we received responses from 2705 (90.2%). There was a statistically significant difference in anxiety, depression and burnout scores across institutions (p<0.01). Anxiety, depression and burnout scores were statistically worse in COVID-19 active staff compared with those not working on COVID-19 activities (p<0.01 for HADS anxiety and depression and MBI emotional exhaustion (EE), depersonalisation (DP) and personal accomplishment (PA)). Over half of the participants exhibited some level of anxiety (SRNGIH: 52.2%; DMCH: 53.9%; MMCH: 61.3%; MARMC: 68%) with a high proportion experiencing depression (SRNGIH: 39.5%; DMCH: 38.7%; MMCH: 53.7%; MARMC: 41.1%). Although mean burnout scores were within the normal range for each institution, a high proportion of staff (almost 20% in some instances) were shown to be classified as experiencing burnout by their EE, DP and PA scores. CONCLUSION We identified a high prevalence of perceived anxiety, depression and burnout among doctors and nurses during the COVID-19 pandemic. This was worse in staff engaged in COVID-19-related activities. These findings could help healthcare organisations to plan for future similar events.
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Affiliation(s)
| | - Mesbah Rahman
- Swansea Bay University Health Board, Port Talbot, UK
| | | | | | | | | | | | | | - Umakant Dave
- Swansea Bay University Health Board, Port Talbot, UK
| | - Neil Hawkes
- Cwm Taf Morgannwg University Health Board, Abercynon, UK
| | - Faruque Ahmed
- Department of Gastroenterology, Sheikh Russel National Gastroliver Institute and Hospital, Dhaka, Bangladesh
| | | | | | | | - Md Golam Kibria
- Sheikh Russel National Gastroliver Institute, Dhaka, Bangladesh
| | | | - Titu Mia
- Mugda Medical College and Hospital, Dhaka, Bangladesh
| | | | - John G Williams
- Faculty of Medicine, Health and Life Science, Swansea University, Swansea, UK
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Wang MK, Geen O, Mach ZH, Khalid Z. Resident Burnout on the Internal Medicine Ward. J Gen Intern Med 2024; 39:366-372. [PMID: 37946021 PMCID: PMC10897070 DOI: 10.1007/s11606-023-08505-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 10/20/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND Burnout is common among medical trainees. Whether brief periods of training on the internal medicine ward leads to resident burnout is unknown. METHODS A survey-based study was conducted at a single academic institution. Medical residents undertaking four-week rotations on the internal medicine ward were included. Burnout was measured at the beginning and end of each rotation using the Maslach Burnout Inventory - Human Services Survey. Burnout was defined as either an emotional exhaustion score of ≥ 27 or a depersonalization score of ≥ 10. Self-reported workplace conditions, behaviors and attitudes were recorded. RESULTS The survey response rate was 71% and included 148 participants. The overall prevalence of burnout was 17% higher at the end of the rotation compared to the beginning of the rotation (71% vs. 54%; P < 0.001). Forty-three percent of residents without pre-rotation burnout developed post-rotation burnout. Residents with post-rotation burnout were more likely to report at least one suboptimal behavior or attitude related to patient care or professionalism (84% vs. 35%; P < 0.001). Respondents with new onset burnout were less likely to report being appreciated for their work, having their role as a learner emphasized, and receiving satisfactory support from allied healthcare professionals. New onset burnout was inversely associated with completing a second consecutive internal medicine ward rotation (adjusted OR 0.19; 95% CI, 0.04-0.90; P = 0.04). CONCLUSION Seven in ten residents are in a state of burnout after completing internal medicine ward rotations. Interventions to mitigate burnout development during periods of high intensity clinical training are needed.
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Affiliation(s)
- Michael Ke Wang
- Department of Medicine, McMaster University, Hamilton, Canada.
| | - Olivia Geen
- Department of Medicine, Trillium Health Partners, Mississauga, Canada
| | - Zi Hymn Mach
- Department of Medicine, Trillium Health Partners, Mississauga, Canada
| | - Zahira Khalid
- Department of Medicine, McMaster University, Hamilton, Canada
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Coleman A, McLaughlin E, Floren M. Practitioner Burnout and Productivity Levels in Skilled Nursing and Assisted Living Facilities, Part 1: A Descriptive Quantitative Account. Am J Occup Ther 2024; 78:7801205090. [PMID: 38224353 DOI: 10.5014/ajot.2024.050341] [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: 01/16/2024] Open
Abstract
IMPORTANCE Understanding burnout among practitioners in skilled nursing facilities (SNFs) and assisted living facilities (ALFs) while considering contextual factors may lead to practices that enhance therapist and patient satisfaction as well as quality of care. OBJECTIVE To examine productivity standards and burnout in the context of setting and role, as reported by therapy practitioners in geriatric settings, and to explore relationships between productivity standards and perceived ethical pressures. DESIGN Cross-sectional online survey with descriptive data. PARTICIPANTS Practitioners (N = 366) included occupational therapists, physical therapists, speech-language pathologists, and occupational and physical therapy assistants working in SNFs and ALFs in the United States. A survey integrating the Maslach Burnout Inventory: Human Services Survey for Medical Personnel (MBI-HSS) and questions addressing demographics and contextual factors was distributed via social media. RESULTS Of 366 practitioners, 20.5% were burned out, exhibiting extreme scores for Emotional Exhaustion (EE), Depersonalization (DP), and Personal Accomplishment (PA) on the MBI-HSS. Significant relationships between productivity requirements and EE, DP, and PA, after accounting for covariates, were evident. Significant relationships between productivity standards and five of the six ethically questionable behaviors existed. Role affected productivity requirements, specifically between therapists and assistants, whereas setting did not. CONCLUSIONS AND RELEVANCE Productivity standards and related pressures are associated with concerning aspects of burnout among practitioners working in geriatric settings. Advocating for change in defining productivity and incorporating positive support in the work environment may assist in reducing burnout and turnover rates and improve patient satisfaction and care. Plain-Language Summary: This research highlights the prevalence of burnout and perceived pressures related to productivity requirements among occupational therapy practitioners working in skilled nursing and assisted living facilities.
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Affiliation(s)
- Ashley Coleman
- Ashley Coleman, OTD, OTR/L, is Occupational Therapist, Virginia Beach, VA;
| | - Ellen McLaughlin
- Ellen McLaughlin, EdD, OTR/L, FAOTA, is Professor, Occupational Therapy Department, Misericordia University, Dallas, PA
| | - Michael Floren
- Michael Floren, PhD, is Assistant Professor, Data Analytics, University of North Alabama, Florence
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Badrfam R, Zandifar A, Mohammadian Khonsari N, Qorbani M. Suicidal ideation, burnout, and their correlation among health care workers at the end of the fourth wave of the COVID-19 pandemic in Alborz Province, Iran. Front Psychiatry 2023; 14:1261105. [PMID: 37900293 PMCID: PMC10603268 DOI: 10.3389/fpsyt.2023.1261105] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 09/25/2023] [Indexed: 10/31/2023] Open
Abstract
Background During the COVID-19 pandemic, Health Care Workers (HCWs) were more vulnerable than ever to Burnout and Suicidal thoughts due to stressful work conditions. This study, investigated the level of Burnout and Suicidal thoughts among HCWs during the fourth wave of the pandemic in Alborz Province in Iran and compared it with the conditions at the beginning of the pandemic. Methods A total of 305 HCWs from 3 referral hospitals for COVID-19, including 155 men and 150 women, participated in the study. A cross-sectional study was carried out with a sample of HCWs dealing with COVID-19 patients using the available sampling method. The results of this online survey, which was conducted from June 7 to July 5, 2021 (at the end of the Fourth Wave of the COVID-19 Pandemic in Iran), have been compared with the conditions of the First Wave of the Pandemic (from February 24 to April 27, 2020). The participants were evaluated by the Beck Scale for Suicidal Ideations (BSSI) and Maslach Burnout Inventory (MBI). Results The mean age of the participants was 36.34 ± 7.37. The means of Suicide Index (SI), Emotional Exhaustion (EE), Depersonalization (DP), and Personal Accomplishment (PA) scores were 0.76 ± 1.74, 19.94 ± 4.69, 4.92 ± 1.51, and 31.30 ± 5.88, respectively. SI and PA were significantly higher in workers other than nurses and physicians and EE was higher among workers with night shifts (p value<0.05 in all indices). Age had a significant and negative correlation with EE (p value<0.01) and DP (p value<0.05) and a significant and positive correlation with PA (p value<0.01). Conclusion This study showed a high level of SI and Burnout indices among HCWs in the fourth wave of the pandemic in Iran. Paying attention to the factors affecting the development of social capital and creating health policy changes may be effective in reducing Burnout indices and high Suicide index among HCWs.
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Affiliation(s)
- Rahim Badrfam
- Department of Psychiatry, Imam Hossein Hospital, Alborz University of Medical Sciences, Karaj, Iran
| | - Atefeh Zandifar
- Department of Psychiatry, Imam Hossein Hospital, Alborz University of Medical Sciences, Karaj, Iran
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | | | - Mostafa Qorbani
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
- Chronic Diseases Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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Messinger A, Das S. Erosion of the 'ethical' doctor-patient relationship and the rise of physician burn-out. MEDICAL HUMANITIES 2023; 49:390-395. [PMID: 36526412 DOI: 10.1136/medhum-2022-012506] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/16/2022] [Indexed: 06/17/2023]
Abstract
This paper examines the topic of physician burn-out from a philosophical lens. We explore the question of how the rise of physician burn-out may be related to an underlying erosion of meaning in medicine, characterised by the breakdown of the intersubjective relationship between doctors and patients. We argue that while commonly cited strategies for addressing burnout-including promoting work-life integration, cultivating workplace community, and fostering resilience-are critical for enhancing physician well-being, the common thread linking these approaches is that each identifies the physician as the primary locus of intervention. We propose that physician-centric approaches alone may be insufficient in addressing burnout, as the work might also involve shifting our attention to the intersubjective space that exists between the physician and the patient. To further elucidate the connection between intersubjectivity and the creation of meaning in medicine, we call on twentieth-century philosopher Emmanuel Levinas. Applying Levinas's philosophy to the clinical context, we discuss the phenomenon of 'depersonalisation' and ask whether, rather than a mere consequence of burnout, depersonalisation might be a core cause of this condition. With these points we shed light on an idea that is relatively absent from the burn-out literature: that a person-oriented approach is vital not only for patient well-being but for physician wellness as well, as a process that 'de-personalizes' patients might result in a simultaneous dehumanisation of physicians themselves. Drawing inspiration from Levinas, we explore how a reorientation towards the intersubjective, dialogical dimension of the doctor-patient dyad could serve as one important ingredient in healing not only the patient, but the physician as well.
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Affiliation(s)
- Atara Messinger
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Sunit Das
- Division of Neurosurgery and Centre for Ethics, University of Toronto, Toronto, Ontario, Canada
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Boden LM, Rodriguez C, Kelly JD, Khalsa AS, Casper DS. Mindfulness Applications: Can They Serve as a Stress, Anxiety, and Burnout Reduction Tool in Orthopaedic Surgery Training? A Randomized Control Trial. JB JS Open Access 2023; 8:e22.00114. [PMID: 37497194 PMCID: PMC10368388 DOI: 10.2106/jbjs.oa.22.00114] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/28/2023] Open
Abstract
Stress and burnout are prevalent within the orthopaedic surgery community. Mindfulness techniques have been shown to improve wellness, yet traditional courses are generally time-intensive with low surgeon utilization. We sought to determine whether the introduction of a simple mindfulness-based phone application would help decrease stress, anxiety, and burnout in orthopaedic surgery residents. Methods Twenty-four residents participated in this prospective, randomized controlled trial. After simple 1:1 randomization, the treatment group received access to a mindfulness-based phone application for 2 months while the control group did not receive access. All participants completed the Perceived Stress Scale, Generalized Anxiety Disorder-7, and Maslach Burnout Inventory with emotional exhaustion (EE), depersonalization (DP), and personal accomplishment subscores to measure stress, anxiety, and burnout at baseline and after 2 months. Paired t tests were used to compare baseline scores and conclusion scores for both groups. Results There was no difference in baseline burnout scores between groups, but the treatment group had higher stress and anxiety scores at baseline. On average, the treatment group spent approximately 8 minutes per day, 2 days per week using the mindfulness application. After 2 months, the treatment group had significantly decreased stress (mean = -7.42, p = 0.002), anxiety (mean = -6.16, p = 0.01), EE (mean = -10.83 ± 10.72, p = 0.005), and DP (mean = -5.17 ± 5.51, p = 0.01). The control group did not have any significant differences in stress, anxiety, or burnout subscores. Conclusions Use of a mindfulness-based phone app for 2 months led to significant reductions in stress, anxiety, and burnout scores in orthopaedic surgery residents. Our results support the use of a mindfulness-based app to help decrease orthopaedic resident stress, anxiety, and burnout. Benefits were seen with only modest use, suggesting that intensive mindfulness training programs may not be necessary to effect a change in well-being. The higher baseline stress and anxiety in the treatment group may suggest that mindfulness techniques are particularly effective in those who perceive residency to be more stressful. Level of Evidence I.
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Affiliation(s)
- Lauren M. Boden
- Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Christian Rodriguez
- Department of Orthopaedic Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - John D. Kelly
- Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Amrit S. Khalsa
- Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
| | - David S. Casper
- Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
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Roundy PE, Stearns ZR, Willis MW, Blevins JJ, Linton TA, Medlin TR, Winger JG, Dorfman CS, Shelby RA. Relationships Between Burnout and Resilience: Experiences of Physical Therapists and Occupational Therapists During the COVID-19 Pandemic. Phys Ther 2023; 103:7066981. [PMID: 37245217 DOI: 10.1093/ptj/pzad022] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 11/07/2022] [Accepted: 12/19/2022] [Indexed: 05/30/2023]
Abstract
OBJECTIVE Research on burnout among physical therapists and occupational therapists in the context of the coronavirus disease 2019 (COVID-19) pandemic is limited. Resilience may be important for reducing burnout and promoting well-being among rehabilitation specialists, especially during periods of elevated occupational demand and stress. The purpose of this study was to investigate experiences of burnout, COVID-19 pandemic-related distress, and resilience among physical therapists and occupational therapists during the first year of the COVID-19 pandemic. METHODS Physical therapists and occupational therapists working in a university-affiliated health system were invited to complete an online survey assessing burnout, COVID-19 pandemic-related distress, state- and trait-like resilience, physical activity, sleep disturbance, and financial concerns. Multiple linear regressions were used to examine variables associated with burnout as well as the contribution of specific aspects of resilience to burnout. RESULTS Greater COVID-19 pandemic-related distress was associated with greater emotional exhaustion and depersonalization, whereas state-like resilience at work was associated with lower emotional exhaustion, greater personal accomplishment, and lower depersonalization. Analyses examining the impact of specific components of resilience at work suggested that several components are associated with less burnout, with finding one's calling being particularly relevant for all 3 domains of burnout. CONCLUSION Symptoms of burnout were reported by many physical therapists and occupational therapists. COVID-19-related distress and state-like resilience at work, particularly the perception of finding one's calling, emerged as consistently being associated with burnout in the context of the COVID-19 pandemic. IMPACT These findings can inform the development of interventions to reduce burnout among physical therapists and occupational therapists amid the continuing COVID-19 pandemic.
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Affiliation(s)
- Preston E Roundy
- Department of Physical Therapy and Occupational Therapy, Duke University Health System, Durham, North Carolina, USA
| | - Zachary R Stearns
- Department of Physical Therapy and Occupational Therapy, Duke University Health System, Durham, North Carolina, USA
| | - Michael W Willis
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina, USA
| | - Joshua J Blevins
- Department of Physical Therapy and Occupational Therapy, Duke University Health System, Durham, North Carolina, USA
| | - Travis A Linton
- Department of Physical Therapy and Occupational Therapy, Duke University Health System, Durham, North Carolina, USA
| | - Thomas R Medlin
- Department of Physical Therapy and Occupational Therapy, Duke University Health System, Durham, North Carolina, USA
| | - Joseph G Winger
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina, USA
| | - Caroline S Dorfman
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina, USA
| | - Rebecca A Shelby
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina, USA
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Štěpánek L, Nakládalová M, Janošíková M, Ulbrichtová R, Švihrová V, Hudečková H, Sovová E, Sova M, Vévoda J. Prevalence of Burnout in Healthcare Workers of Tertiary-Care Hospitals during the COVID-19 Pandemic: A Cross-Sectional Survey from Two Central European Countries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3720. [PMID: 36834414 PMCID: PMC9962650 DOI: 10.3390/ijerph20043720] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 02/12/2023] [Accepted: 02/17/2023] [Indexed: 05/25/2023]
Abstract
COVID-19 has led to an unprecedented strain on healthcare workers (HCWs). This study aimed to determine the prevalence of burnout in hospital employees during a prolonged pandemic-induced burden on healthcare systems. An online survey among employees of a Czech and Slovak university hospital was conducted between November 2021 and January 2022, approximately when the incidence rates peaked in both countries. The Maslach Burnout Inventory-Human Services Survey was applied. We obtained 807 completed questionnaires (75.1% from Czech employees, 91.2% from HCWs, 76.2% from women; mean age of 42.1 ± 11 years). Burnout in emotional exhaustion (EE) was found in 53.2%, depersonalization (DP) in 33%, and personal accomplishment (PA) in 47.8% of respondents. In total, 148 (18.3%) participants showed burnout in all dimensions, 184 (22.8%) in two, and 269 (33.3%) in at least one dimension. Burnout in EE and DP (65% and 43.7%) prevailed in physicians compared to other HCWs (48.6% and 28.8%). Respondents from COVID-19-dedicated units achieved burnout in the EE and DP dimensions with higher rates than non-frontline HCWs (58.1% and 40.9% vs. 49.9% and 27.7%). Almost two years of the previous overloading of healthcare services, caused by the COVID-19 pandemic, resulted in the relatively high prevalence of burnout in HCWs, especially in physicians and frontline HCWs.
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Affiliation(s)
- Ladislav Štěpánek
- Department of Occupational Medicine, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacký University Olomouc, I. P. Pavlova 6, 779 00 Olomouc, Czech Republic
| | - Marie Nakládalová
- Department of Occupational Medicine, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacký University Olomouc, I. P. Pavlova 6, 779 00 Olomouc, Czech Republic
| | - Magdaléna Janošíková
- Department of Occupational Medicine, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacký University Olomouc, I. P. Pavlova 6, 779 00 Olomouc, Czech Republic
| | - Romana Ulbrichtová
- Department of Public Health, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 11149/4B, 036 01 Martin, Slovakia
| | - Viera Švihrová
- Department of Public Health, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 11149/4B, 036 01 Martin, Slovakia
| | - Henrieta Hudečková
- Department of Public Health, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 11149/4B, 036 01 Martin, Slovakia
| | - Eliška Sovová
- Department of Exercise Medicine and Cardiovascular Rehabilitation, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacký University Olomouc, 779 00 Olomouc, Czech Republic
| | - Milan Sova
- Department of Pulmonary Diseases and Tuberculosis, University Hospital Brno and Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
| | - Jiří Vévoda
- Department of Humanities and Social Sciences, Faculty of Health Sciences, Palacký University in Olomouc, Hněvotínská 976/3, 775 15 Olomouc, Czech Republic
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Whitehead IO, Moffatt S, Jagger C, Hanratty B. A national study of burnout and spiritual health in UK general practitioners during the COVID-19 pandemic. PLoS One 2022; 17:e0276739. [PMID: 36322555 PMCID: PMC9629610 DOI: 10.1371/journal.pone.0276739] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 10/12/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES To quantify the burnout and spiritual health of general practitioners (GPs) in the United Kingdom (UK) who worked during the Covid-19 Pandemic. DESIGN Online survey, April/May 2021, distributed via emails to general practices, Clinical Commissioning Groups (CCGs), Health boards, Clinical Research Networks, professional groups, social media GP groups and networks. SETTING United Kingdom. PARTICIPANTS 1318 GPs who had worked in the National Health Service (NHS) during the COVID-19 pandemic (March 2020 -May 2021). MAIN OUTCOME MEASURES Burnout scores, measured by the Maslach Burnout Inventory (MBI) for Medical Personnel; spiritual health, measured using the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being, Non-Illness (FACIT-SP-NI). RESULTS 19% of surveyed GPs were at the highest risk for burnout, using accepted MBI 'cut off' levels. There was no evidence of a difference in burnout by gender, ethnicity, or length of service. GP burnout was associated with GP spiritual health, regardless of identification with a religion. GPs with low spiritual health were five times more likely to be in the highest risk group for burnout. CONCLUSIONS Burnout is at crisis levels amongst GPs in the UK NHS. A comprehensive response is required, identifying protective and precipitating factors for burnout. The potentially protective impact of spiritual health merits further investigation.
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Affiliation(s)
- Ishbel Orla Whitehead
- Population Health Sciences Institute, Faculty of Medical Sciences, Campus for Ageing and Vitality, Newcastle upon Tyne, United Kingdom
- * E-mail:
| | - Suzanne Moffatt
- Population Health Sciences Institute, Faculty of Medical Sciences, Campus for Ageing and Vitality, Newcastle upon Tyne, United Kingdom
| | - Carol Jagger
- Population Health Sciences Institute, Faculty of Medical Sciences, Campus for Ageing and Vitality, Newcastle upon Tyne, United Kingdom
| | - Barbara Hanratty
- Population Health Sciences Institute, Faculty of Medical Sciences, Campus for Ageing and Vitality, Newcastle upon Tyne, United Kingdom
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McClafferty HH, Hubbard DK, Foradori D, Brown ML, Profit J, Tawfik DS. Physician Health and Wellness. Pediatrics 2022; 150:189767. [PMID: 36278292 DOI: 10.1542/peds.2022-059665] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/25/2022] [Indexed: 12/03/2022] Open
Abstract
Physician health and wellness is a complex topic relevant to all pediatricians. Survey studies have established that pediatricians experience burnout at comparable rates to colleagues across medical specialties. Prevalence of burnout increased for all pediatric disciplines from 2011 to 2014. During that time, general pediatricians experienced a more than 10% increase in burnout, from 35.3% to 46.3%. Pediatric medical subspecialists and pediatric surgical specialists experienced slightly higher baseline rates of burnout in 2011 and similarly increased to just under 50%. Women currently constitute a majority of pediatricians, and surveys report a 20% to 60% higher prevalence of burnout in women physicians compared with their male counterparts. The purpose of this report is to update the reader and explore approaches to pediatrician well-being and reduction of occupational burnout risk throughout the stages of training and practice. Topics covered include burnout prevalence and diagnosis; overview of national progress in physician wellness; update on physician wellness initiatives at the American Academy of Pediatrics; an update on pediatric-specific burnout and well-being; recognized drivers of burnout (organizational and individual); a review of the intersection of race, ethnicity, gender, and burnout; protective factors; and components of wellness (organizational and individual). The development of this clinical report has inevitably been shaped by the social, cultural, public health, and economic factors currently affecting our communities. The coronavirus disease 2019 (COVID-19) pandemic has layered new and significant stressors onto medical practice with physical, mental, and logistical challenges and effects that cannot be ignored.
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Affiliation(s)
- Hilary H McClafferty
- Department of Pediatrics, Section Chief, Pediatric Emergency Medicine, Tucson Medical Center, Tucson, Arizona
| | - Dena K Hubbard
- Children's Mercy Kansas City, School of Medicine, University of Missouri Kansas City, Kansas City, Missouri
| | - Dana Foradori
- Department of Pediatric Hospital Medicine, Cleveland Clinic Children's Hospital, Cleveland, Ohio
| | - Melanie L Brown
- Johns Hopkins University School of Medicine, Baltimore, Maryland
| | | | - Daniel S Tawfik
- Pediatric Critical Care Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, California
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16
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Dunbar TK, Olsen MK, Yang H, Kennedy D, Jackson LR, Thomas KL, Alkon A, Prose NS, Pollak KI. Characteristics Associated with Burnout among Cardiologists in an Academic Medical Setting: Baseline Survey Results from a Communication Coaching RCT. Behav Sci (Basel) 2022; 12:362. [PMID: 36285931 PMCID: PMC9598081 DOI: 10.3390/bs12100362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 09/19/2022] [Accepted: 09/21/2022] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES Clinician burnout poses risks not just to clinicians but also to patients and the health system. Cardiologists might be especially prone to burnout due to performing high-risk procedures, having to discuss serious news, and treating diseases that incur significant morbidity and mortality. Few have attempted to examine which cardiologists might be at higher risk of burnout. Knowing at-risk cardiologists can help frame resilience interventions. METHODS We enrolled 41 cardiologists across five ambulatory cardiology clinics into a randomized controlled trial where we assessed the Maslach Burnout Inventory at baseline. We used bivariate analyses to assess associations between cardiologist demographics and burnout. RESULTS Cardiologists reported low burnout for depersonalization and personal accomplishment and moderate levels for emotional exhaustion. Female cardiologists reported emotional exhaustion scores in the "low" range (M = 12.3; SD = 10.06), compared to male cardiologists whose score was in the "moderate" range 19.6 (SD = 9.59; p = 0.113). Cardiologists who had greater than 15 years in practice reported higher mean scores of emotional exhaustion, indicating moderate burnout (M = 20.0, SD = 10.63), compared to those with less than 15 years in practice (M = 16.6, SD = 9.10; p = 0.271). CONCLUSIONS In this sample, unlike prior studies, male cardiologists reported more burnout. Consistent with prior work, mid-level cardiologists might be at highest risk of emotional exhaustion.
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Affiliation(s)
- Travia Kayla Dunbar
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC 27710, USA
| | - Maren K. Olsen
- Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC 27710, USA
- Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System, Durham, NC 27705, USA
| | - Hongqiu Yang
- Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC 27710, USA
| | | | - Larry R. Jackson
- Division of Cardiology, Duke University School of Medicine, Durham, NC 27710, USA
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC 27705, USA
| | - Kevin L. Thomas
- Division of Cardiology, Duke University School of Medicine, Durham, NC 27710, USA
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC 27705, USA
| | - Aviel Alkon
- Department of General Internal Medicine, Duke University School of Medicine, Durham, NC 27710, USA
| | - Neil S. Prose
- Department of Dermatology and Pediatrics, Duke University School of Medicine, Durham, NC 27710, USA
| | - Kathryn I. Pollak
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC 27710, USA
- Duke Cancer Research Institute, Durham, NC 27710, USA
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Burnout Syndrome among Otorhinolaryngologists during the COVID-19 Pandemic. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58081089. [PMID: 36013556 PMCID: PMC9415072 DOI: 10.3390/medicina58081089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 08/07/2022] [Accepted: 08/09/2022] [Indexed: 11/17/2022]
Abstract
Background and Objectives: To determine the prevalence of burnout syndrome among otorhinolaryngologists in Lithuania and investigate associations with sociodemographic and professional factors during the COVID-19 pandemic. Materials and Methods: Burnout was measured using the validated Lithuanian version of the Maslach Burnout Inventory. Demographic characteristics and professional characteristics were collected utilizing an anonymous questionnaire. Results: Eighty otorhinolaryngologists (ORL group) and 30 information technology professionals (the control group) were enrolled in this study. A high level of professional burnout in at least one of the subscales was observed in 82.5% of the ORL group subjects. Depersonalization and burnout syndrome were more frequently detected with increasing age in the ORL group (r = 0.2, p < 0.04). Greater satisfaction with salary and working environment resulted in a lower burnout incidence (r = 0.31, p = 0.001). Conclusions: During the COVID-19 pandemic, the incidence of burnout syndrome has been high among Lithuanian otorhinolaryngologists. Demographic and professional characteristics are significantly related to burnout syndrome among Lithuanian otorhinolaryngologists.
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18
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Safon CB, Estela MG, Rosenberg J, Feinberg E, Drainoni ML, Morris A, Durham MP, Bair-Merritt M, Sheldrick RC. Implementation of a Novel Pediatric Behavioral Health Integration Initiative. J Behav Health Serv Res 2022; 50:1-17. [PMID: 35915197 DOI: 10.1007/s11414-022-09803-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2022] [Indexed: 11/27/2022]
Abstract
This study explores healthcare professionals' perspectives about the impact of behavioral health integration (BHI) on pediatric primary care delivery in community health centers (CHCs). A concurrent, qualitative-dominant mixed methods empirical study design was utilized, applying semi-structured interviews with healthcare professionals at the end of the implementation phase of a 3-year co-development, implementation, and evaluation process. Surveys were also administered at three time points. Via thematic analysis, emergent qualitative themes were mapped onto the Relational Coordination (RC) conceptual framework to triangulate and complement final qualitative results with quantitative results. Interview findings reveal five emergent themes aligning with RC domains. Survey results show that healthcare professionals reported increased behavioral healthcare integration into clinic practice (p = 0.0002) and increased clinic readiness to address behavioral health needs (p = 0.0010). Effective pediatric BHI and care delivery at CHCs may rely on strong professional relationships and communication. Additional research from the patient/caregiver perspective is needed.
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Affiliation(s)
- Cara B Safon
- Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA, USA.
| | | | | | - Emily Feinberg
- Boston University School of Medicine, Boston, MA, USA
- Boston University School of Public Health, Boston, MA, USA
| | - Mari-Lynn Drainoni
- Boston University School of Medicine, Boston, MA, USA
- Boston University School of Public Health, Boston, MA, USA
| | | | - Michelle P Durham
- Boston Medical Center, Boston, MA, USA
- Boston University School of Medicine, Boston, MA, USA
| | - Megan Bair-Merritt
- Boston Medical Center, Boston, MA, USA
- Boston University School of Medicine, Boston, MA, USA
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Cohen JB, Reiser VL, Althouse AD, Resick JM, Chu E, Smith TJ, Arnold RM, Rosenzweig MQ, Schenker Y. Burnout Among Oncology Nurses: The Effects of Providing a Primary Palliative Care Intervention Using CONNECT Protocol. Clin J Oncol Nurs 2022; 26:391-398. [PMID: 35939720 PMCID: PMC11460563 DOI: 10.1188/22.cjon.391-398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Palliative care clinicians display less burnout than oncology clinicians. Little is known about the impact of providing both oncology care and primary palliative care in the same setting. OBJECTIVES The aim was to determine whether nurses providing primary palliative care in addition to oncology care would experience less burnout over time than nurses providing oncology care only. METHODS The authors performed secondary analysis of the CONNECT study. Three groups of nurses were evaluated: primary palliative care, non-primary palliative care, and standard care. On study enrollment and after one year, nurses completed the Maslach Burnout Inventory. Multivariable regression analyses were performed to test differences in follow-up burnout scores between groups. FINDINGS Overall burnout rates were low at enrollment for all groups. There were no differences in burnout scores at one year between nurses who provided palliative care and nurses in the other two groups. .
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20
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Higgins MC, Siddiqui AA, Kosowsky T, Unan L, Mete M, Rowe S, Marchalik D. Burnout, Professional Fulfillment, Intention to Leave, and Sleep-Related Impairment among Radiology Trainees across the United States (US): A Multisite Epidemiologic Study. Acad Radiol 2022; 29 Suppl 5:S118-S125. [PMID: 35241358 DOI: 10.1016/j.acra.2022.01.022] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 01/28/2022] [Accepted: 01/31/2022] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To examine the prevalence of burnout among radiology trainees in the United States, and to study the relationships between burnout and professional fulfillment (PF), intent-to-leave (ITL), sleep-related impairment and self-compassion by gender. METHODS This cross-sectional study was conducted via an anonymous electronic survey sent to 11 large academic medical centers (Physician Wellness Academic Consortium) between January 2017 and September 2018. The survey included the Professional Fulfillment Index (PFI) and an abbreviated form of the PROMIS Sleep-related impairment (SRI) scale. Two-sample t-tests and chi-square exact tests were used for analysis (p < 0.05). RESULTS Two hundred forty-seven radiology residents responded to the survey. Out of these, 36.2% reported burnout, 37.4% endorsed PF, 64.8% reported sleep-related impairment, 7.6% expressed ITL. There were no significant differences between genders. Burnout was associated with reduced PF, increased sleep-impairment (p < 0.001 for both) and increased ITL (p = 0.02). Lower PF, peer support, perceived appreciation for and meaningfulness in work, alignment of organizational and personal values, self-compassion, and higher sleep impairment were associated with burnout (p < 0.001 for all). Burnout was associated with perceptions of less support from department leaders (p = 0.003), control over schedules (p = 0.001) and helpfulness of electronic health record systems (p = 0.01). ITL was associated with reduced PF, perceived work appreciation, and leadership support (p = 0.03, p = 0.04, and p = 0.007, respectively). DISCUSSION Burnout is prevalent among radiology residents. Many demonstrate sleep-impairment and reduced professional fulfillment, with a lesser fraction desiring to leave their institution. Key factors to burnout included peer and organizational support, electronic health record systems helpfulness, and personal factors like self-compassion and work appreciation.
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Civilotti C, Acquadro Maran D, Garbarino S, Magnavita N. Hopelessness in Police Officers and Its Association with Depression and Burnout: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095169. [PMID: 35564562 PMCID: PMC9100122 DOI: 10.3390/ijerph19095169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 04/13/2022] [Accepted: 04/22/2022] [Indexed: 11/23/2022]
Abstract
Hopelessness is a particularly critical condition and a risk factor for suicide. Many studies have reported that this condition is common in some occupations and is associated with high stress that is not properly managed. This study examined the prevalence of hopeless status (HS) in a sample of police officers (POs) and the association of hopelessness with depression, burnout, and suicidality. In total, 127 out of 231 POs participated in the survey; they were assessed with the Beck Hopelessness Scale, the Beck Depression Scale, and the Maslach Burnout Inventory. A total of 26.5% of POs reported hopelessness, and a significant association was found with depression and burnout; in individual cases, these conditions were associated with suicidal thoughts. In a multivariate logistic regression model adjusted for confounding variables, depression, emotional exhaustion, and reduction of personal accomplishment were significantly associated with HP status. Depression (OR = 3.02, 95% CI: 1–9.12) and emotional exhaustion (OR = 1.88, 95% CI: 1.06–3.32) significantly increased the risk of hopelessness, while personal accomplishment (OR = 0.57, 95% CI: 0.32–1) was a protective factor. Hopelessness appears to be a very important factor to consider when assessing POs’ mental health.
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Affiliation(s)
- Cristina Civilotti
- Department of Psychology, Università di Torino, Via Verdi 10, 10124 Torino, Italy;
| | - Daniela Acquadro Maran
- Department of Psychology, Università di Torino, Via Verdi 10, 10124 Torino, Italy;
- WOW-Work and Organizational Wellbeing Research Group, 10124 Torino, Italy
- Correspondence:
| | - Sergio Garbarino
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal/Child Sciences (DI-14 NOGMI), University of Genoa, 16132 Genoa, Italy;
| | - Nicola Magnavita
- Postgraduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
- Department of Woman, Child & Public Health Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
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22
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Brady KJS, Ni P, Carlasare L, Shanafelt TD, Sinsky CA, Linzer M, Stillman M, Trockel MT. Establishing Crosswalks Between Common Measures of Burnout in US Physicians. J Gen Intern Med 2022; 37:777-784. [PMID: 33791938 PMCID: PMC8904666 DOI: 10.1007/s11606-021-06661-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 02/11/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Physician burnout is often assessed by healthcare organizations. Yet, scores from different burnout measures cannot currently be directly compared, limiting the interpretation of results across organizations or studies. OBJECTIVE To link common measures of burnout to a single metric in psychometric analyses such that group-level scores from different assessments can be compared. DESIGN Cross-sectional survey. SETTING US practices. PARTICIPANTS A total of 1355 physicians sampled from the American Medical Association Physician Masterfile. MAIN MEASURES We linked the Stanford Professional Fulfillment Index (PFI) and Mini-Z Single-Item Burnout (MZSIB) scale to the Maslach Burnout Inventory (MBI) in item response theory (IRT) fixed-calibration and equipercentile analyses and created crosswalks mapping PFI and MZSIB scores to corresponding MBI scores. We evaluated the accuracy of the results by comparing physicians' actual MBI scores to those predicted by linking and described the closest cut-point equivalencies across scales linked to the same MBI subscale using the resulting crosswalks. KEY RESULTS IRT linking produced the most accurate results and was used to create crosswalks mapping (1) PFI Work Exhaustion (PFI-WE) and MZSIB scores to MBI Emotional Exhaustion (MBI-EE) scores and (2) PFI Interpersonal Disengagement (PFI-ID) scores to MBI Depersonalization (MBI-DP) scores. The commonly used MBI-EE raw score cut-point of ≥27 corresponded most closely with respective PFI-WE and MZSIB raw score cut-points of ≥7 and ≥3. The commonly used MBI-DP raw score cut-point of ≥10 corresponded most closely with a PFI-ID raw score cut-point of ≥9. CONCLUSIONS Our findings allow healthcare organizations using the PFI or MZSIB to compare group-level scores to historical, regional, or national MBI scores (and vice-versa).
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Affiliation(s)
- Keri J S Brady
- Health Law, Policy & Management Department, Boston University School of Public Health, Boston, MA, USA.
| | - Pengsheng Ni
- Health Law, Policy & Management Department, Boston University School of Public Health, Boston, MA, USA.,Biostatistics & Epidemiology Data Analytic Center, Boston University School of Public Health, Boston, MA, USA
| | | | - Tait D Shanafelt
- Stanford Medicine WellMD Center, Stanford University, Stanford, CA, USA
| | | | - Mark Linzer
- Hennepin Healthcare Research Institute and Department of Medicine, Hennepin Healthcare, University of Minnesota, Minneapolis, MN, USA
| | - Martin Stillman
- Hennepin Healthcare Research Institute and Department of Medicine, Hennepin Healthcare, University of Minnesota, Minneapolis, MN, USA
| | - Mickey T Trockel
- Stanford Medicine WellMD Center, Stanford University, Stanford, CA, USA.,Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
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Kukihara H, Ando M, Yamawaki N. The effects of yoga and mindful meditation on elderly care worker's burnout: a CONSORT-compliant randomized controlled trial. J Rural Med 2022; 17:14-20. [PMID: 35047097 PMCID: PMC8753257 DOI: 10.2185/jrm.2021-021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 08/11/2021] [Indexed: 12/25/2022] Open
Abstract
Objectives: This study aims to investigate the effects of mindful meditation
and yoga on reducing burnout and stress in care workers who assist elderly individuals.
Knowing how to reduce burnout is important because that of care workers is associated with
the quality of client care, worker productivity, and job turnover. Patients and Methods: The participants included 44 care workers who worked
for elderly care facilities in rural Fukuoka. They were randomly assigned to one of three
intervention groups: control, yoga, or mindfulness. In the yoga intervention group, a
certified yoga instructor taught a 60-minute yoga session each week for six weeks. In the
mindfulness group, an experienced medical doctor instructed a mindful meditation program
for the same length. Participants were asked to complete the Japanese Burnout Scale (JBS),
and the research team collected the level of α-amylase in saliva using NIPRO: T-110-N pre-
and post-interventions. Results: MANOVA was performed with each intervention (control, yoga,
mindfulness) as the independent variable on the three subscales of the JBS (emotional
exhaustion, depersonalization, and personal achievement) and a biomarker of stress level
(α-amylase). The results indicated a significant main effect of interventions, and a
follow-up ANOVA showed a significant effect of interventions on emotional exhaustion and
personal achievement. Conclusion: The results indicate that practicing mindful meditation or yoga
for 60 minutes once a week for six weeks can reduce care workers’ burnout. This study was
notable because the biomarker of stress also improved. It is strongly recommended and
encouraged that institutions caring for the elderly population provide mindful meditation
or yoga intervention to reduce burnout, which benefits not only care workers but also
their clients.
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Affiliation(s)
- Hiroko Kukihara
- School of Nursing, Faculty or Medicine, Fukuoka University, Japan
| | - Michiyo Ando
- School of Nursing, Daiichi University of Pharmacy, Japan
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Humphris G, Knights J, Beaton L, Araujo M, Yuan S, Clarkson J, Young L, Freeman R. Exploring the Effect of the COVID-19 Pandemic on the Dental Team: Preparedness, Psychological Impacts and Emotional Reactions. FRONTIERS IN ORAL HEALTH 2022; 2:669752. [PMID: 35048012 PMCID: PMC8757713 DOI: 10.3389/froh.2021.669752] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 03/31/2021] [Indexed: 12/03/2022] Open
Abstract
Background: The COVID-19 pandemic has placed increased demands on clinical staff in primary dental care due to a variety of uncertainties. Current reports on staff responses have tended to be brief enquiries without some theoretical explanation supported by developed measurement systems. Aim: To investigate features of health and well-being as an outcome of the uncertainties surrounding COVID-19 for dentists and dental health professionals in primary dental care and for those in training. In addition, the study examined the well-being indices with reference to normative values. Finally a theoretical model was explored to explain depressive symptoms and investigate its generalisability across dentists and dental health professionals in primary dental care and those in postgraduate training. Methods: A cross-sectional survey of dental trainees and primary dental care staff in Scotland was conducted in June to October 2020. Assessment was through “Portal,” an online tool used for course bookings/management administered by NHS Education for Scotland. A non-probability convenience sample was employed to recruit participants. The questionnaire consisted of four multi-item scales including: preparedness (14 items of the DPPPS), burnout (the 9 item emotional exhaustion subscale and 5 items of the depersonalisation subscale of the MBI), the 22 item Impact of Event Scale-Revised, and depressive symptomatology using the Patient Health Questionnaire-2. Analysis was performed to compare the levels of these assessments between trainees and primary dental care staff and a theoretically based path model to explain depressive symptomology, utilising structural equation modelling. Results: Approximately, 27% of all 329 respondents reported significant depressive symptomology and 55% of primary care staff rated themselves as emotionally exhausted. Primary care staff (n = 218) felt less prepared for managing their health, coping with uncertainty and financial insecurity compared with their trainee (n = 111) counterparts (all p's < 0.05). Depressive symptomology was rated higher than reported community samples (p < 0.05) The overall fit of the raw data applied to the theoretical model confirmed that preparedness (negative association) and trauma associated with COVID-19 (positive association) were significant factors predicting lowered mood (chi-square = 46.7, df = 21, p = 0.001; CFI = 0.98, RMSEA = 0.06, SRMR = 0.03). Burnout was indirectly implicated and a major path from trauma to burnout was found to be significant in primary care staff but absent in trainees (p < 0.002). Conclusion: These initial findings demonstrate the possible benefit of resourcing staff support and interventions to assist dental staff to prepare during periods of high uncertainty resulting from the recent COVID-19 pandemic.
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Affiliation(s)
- Gerry Humphris
- School of Medicine, University of St Andrews, St Andrews, United Kingdom
| | | | - Laura Beaton
- NHS Education for Scotland, Edinburgh, United Kingdom
| | | | - Siyang Yuan
- Dental Health Services Research Unit, School of Dentistry, University of Dundee, Dundee, United Kingdom
| | - Jan Clarkson
- NHS Education for Scotland, Edinburgh, United Kingdom.,Dental Health Services Research Unit, School of Dentistry, University of Dundee, Dundee, United Kingdom
| | - Linda Young
- NHS Education for Scotland, Edinburgh, United Kingdom
| | - Ruth Freeman
- Dental Health Services Research Unit, School of Dentistry, University of Dundee, Dundee, United Kingdom
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25
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Singh V, Young JQ, Malhotra P, McCann-Pineo M, Rasul R, Corley SS, Yacht AC, Friedman K, Barone S, Schwartz RM. Evaluating burnout during the COVID-19 pandemic among physicians in a large health system in New York. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2022; 77:819-827. [PMID: 35000576 DOI: 10.1080/19338244.2021.2023084] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PURPOSE The COVID-19 pandemic has generated significant psychological distress among health care workers worldwide. New York State, particularly New York City and surrounding counties, were especially affected, and experienced over 430,000 COVID-19 cases and 25,000 deaths by mid-August 2020. We hypothesized that physicians and trainees (residents/fellows) who were redeployed outside of their specialty to treat COVID-19 inpatients would have higher burnout. METHODS We conducted a cross-sectional survey to assess burnout among attending and trainee physicians who provided patient care during the COVID-19 pandemic between March-May 2020 across a diverse health care system in New York. Separate multivariable logistic regressions were performed to determine the association between redeployment and measures of burnout: Emotional Exhaustion (EE) and Depersonalization. Burnout measures were also compared by physician vs trainee status. The differential association between redeployment and outcomes with respect to trainee status was also evaluated. RESULTS Redeployment was significantly associated with increased odds of EE {OR =1.53, 95% CI: 1.01-2.31} after adjusting for gender and Epidemic-Pandemic Impacts Inventory (EPII) score. Similarly, being a trainee, especially a junior level trainee, was associated with increased odds of EE {OR = 1.59, 95% CI: 1.01-2.51} after adjusting for gender and EPII scores. However, neither redeployment nor trainee status were significantly associated with Depersonalization. Interactions between redeployment and trainee status were not significant for any of the outcomes (p>.05). CONCLUSION Physicians who were redeployed to treat COVID-19 patients had higher reported measures of EE. Trainees, irrespective of redeployment status, had higher EE as compared with attendings. Additional research is needed to understand the long-term impact of redeployment on burnout among redeployed physicians. Programs to identify and address potential burnout among physicians, particularly trainees, during pandemics may be beneficial.
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Affiliation(s)
- Vansha Singh
- Infectious Disease Department, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - John Q Young
- Department of Psychiatry, Zucker Hillside Hospital at Northwell Health, Manhasset, NY, USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Prashant Malhotra
- Infectious Disease Department, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Molly McCann-Pineo
- Department of Occupational Medicine, Epidemiology and Prevention, The Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | - Rehana Rasul
- Biostatistics Unit, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
| | - Samantha S Corley
- Department of Occupational Medicine, Epidemiology and Prevention, The Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | - Andrew C Yacht
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Karen Friedman
- Department of Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Stephen Barone
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Cohen Children's Medical Center, New Hyde Park, NY, USA
| | - Rebecca M Schwartz
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Department of Occupational Medicine, Epidemiology and Prevention, The Feinstein Institutes for Medical Research, Manhasset, NY, USA
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26
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Parayitam S, Usman AS, Olson BJ, Shea T. Effect of Emotional Exhaustion and Knowledge Sharing on Depersonalization, Work Accomplishment, and Organizational Performance. INTERNATIONAL JOURNAL OF KNOWLEDGE MANAGEMENT 2022. [DOI: 10.4018/ijkm.291101] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The objective of the present study is to empirically investigate the relationship between emotional exhaustion and knowledge sharing of individual and organizational outcomes. Data was collected from 672 respondents from the information technology (IT) sector. The results from path analysis revealed that emotional exhaustion is (i) positively related to depersonalization, and (ii) negatively related to work accomplishment and organizational performance. The results also reveal that knowledge sharing is (i) negatively related to depersonalization, and (ii) positively related to work accomplishment and organizational performance. However, depersonalization is not negatively related to organizational performance. As predicted, work accomplishment is positively related to organizational performance. The diametrically opposite results of emotional exhaustion and knowledge sharing are particularly interesting. The implications for management and practicing mangers are discussed.
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27
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Cabo JJ, Tallman JE, Koch GE, Scarpato KR, Chang SS. How a Large Academic Training Program Influences Early Career Decision-making and Employment Stability in Urology. Urology 2022; 165:106-112. [DOI: 10.1016/j.urology.2022.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 11/21/2021] [Accepted: 01/03/2022] [Indexed: 11/27/2022]
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28
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Zelman S, Goodman E, Proctor A, Cline D. Burnout and the Sexual Assault Nurse Examiner: Who Is Experiencing Burnout and Why? J Emerg Nurs 2021; 48:202-210.e1. [PMID: 34969537 DOI: 10.1016/j.jen.2021.10.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 10/23/2021] [Accepted: 10/30/2021] [Indexed: 10/19/2022]
Abstract
INTRODUCTION A sexual assault nurse examiner role exemplifies the high-stress and highly emotional patient interactions that are often associated with burnout. The purpose of this study was to examine the frequency of burnout among sexual assault nurse examiners in North Carolina. METHODS This cross-sectional study was an anonymous survey of practicing sexual assault nurse examiners within North Carolina using the Maslach Burnout Inventory and additional demographics. Results were analyzed with odds ratios, confidence intervals, Fisher exact, chi-square, and Kruskal Wallis tests as appropriate. RESULTS Among 95 respondents, burnout was more frequent in sexual assault nurse examiners who stopped both emergency and nurse examiner work (55.6%, odds ratio 4.41, 95% confidence interval 1.07-18.06) and in dual function nurses (both emergency and nurse examiner work, 35.7%, odds ratio 2.71, 95% confidence interval 1.04-7.06). Sexual assault nurse examiners who had a high percentage of pediatric cases (above the median of 40%) were more likely to meet burnout thresholds for emotional exhaustion scores > 26 (48.78% vs 25.93%, χ2 = 5.30, P = .02) and more likely to meet burnout thresholds for depersonalization scores > 9 (48.78% vs 24.07%, χ2 = 6.28, P = .01). DISCUSSION Higher frequency of burnout threshold criteria was found in those people who worked concurrently as a sexual assault nurse examiner and an emergency nurse and in those who had retired from both specialties. We also found that sexual assault nurse examiners with a higher case mix of pediatric cases had higher emotional exhaustion scores and higher depersonalization scores.
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29
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Turalde CWR, Espiritu AI, Macinas IDN, Jamora RDG. Burnout among neurology residents during the COVID-19 pandemic: a national cross-sectional study. Neurol Sci 2021; 43:1503-1511. [PMID: 34846584 PMCID: PMC8630990 DOI: 10.1007/s10072-021-05675-4] [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: 04/13/2021] [Accepted: 10/15/2021] [Indexed: 11/06/2022]
Abstract
Background Neurology residents are particularly vulnerable to burnout because of the novel logistical and clinical challenges brought about by the coronavirus disease 2019 (COVID-19) pandemic. Despite its implications, knowledge on burnout and its predictors among neurology residents is lacking. This study aimed to determine the prevalence of burnout among neurology residents during the pandemic, to compare burnout subscale scores and sociodemographic and work characteristics, and to explore residents’ perceptions on how to address burnout. Methods We conducted a cross-sectional survey among all 120 residents from the nine institutions in the Philippines offering neurology residency programs from March to August 2020. We obtained sociodemographic and work characteristics using questionnaire. We measured burnout using the Maslach Burnout Inventory. We performed an inductive thematic analysis to analyze perceptions on how to reduce burnout. Results The response rate was 71.67% (86/120). The mean age was 30.1 ± 3.1 years. Using predefined subscale critical boundaries, the prevalence of burnout was 94% (95% CI 89, 99). The lack of compensation and number of on-duty days influenced emotional exhaustion scores. The number of on-duty days influenced depersonalization scores. Thematic analysis revealed five themes: increasing manpower; self-care; reducing clerical tasks; improving work environment; and adequate compensation. Conclusions The prevalence of burnout among neurology residents during the COVID-19 pandemic was alarmingly high. Reforms in hiring policies, work-hour management, manpower organization, work environment, and logistics may be considered. Supplementary Information The online version contains supplementary material available at 10.1007/s10072-021-05675-4.
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Affiliation(s)
- Christian Wilson R Turalde
- Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
| | - Adrian I Espiritu
- Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines.,Department of Clinical Epidemiology, College of Medicine, University of the Philippines Manila, Manila, Philippines
| | | | - Roland Dominic G Jamora
- Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines. .,Institute for Neurosciences, St. Luke's Medical Center, Quezon City & Global City, Philippines.
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30
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Shanafelt TD. Physician Well-being 2.0: Where Are We and Where Are We Going? Mayo Clin Proc 2021; 96:2682-2693. [PMID: 34607637 DOI: 10.1016/j.mayocp.2021.06.005] [Citation(s) in RCA: 60] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 06/09/2021] [Accepted: 06/21/2021] [Indexed: 12/13/2022]
Abstract
Although awareness of the importance of physician well-being has increased in recent years, the research that defined this issue, identified the contributing factors, and provided evidence on effective individual and system-level solutions has been maturing for several decades. During this interval, the field has evolved through several phases, each influenced not only by an expanding research base but also by changes in the demographic characteristics of the physician workforce and the evolution of the health care delivery system. This perspective summarizes the historical phase of this journey (the "era of distress"), the current state (Well-being 1.0), and the early contours of the next phase based on recent research and the experience of vanguard institutions (Well-being 2.0). The key characteristics and mindset of each phase are summarized to provide context for the current state, to illustrate how the field has evolved, and to help organizations and leaders advance from Well-being 1.0 to Well-being 2.0 thinking. Now that many of the lessons of the Well-being 1.0 phase have been internalized, the profession, organizations, leaders, and individual physicians should act to accelerate the transition to Well-being 2.0.
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Affiliation(s)
- Tait D Shanafelt
- Department of Medicine, Division of Hematology, Stanford University, Palo Alto, CA.
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31
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Rehder K, Adair KC, Sexton JB. The Science of Health Care Worker Burnout: Assessing and Improving Health Care Worker Well-Being. Arch Pathol Lab Med 2021; 145:1095-1109. [PMID: 34459858 DOI: 10.5858/arpa.2020-0557-ra] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2021] [Indexed: 11/06/2022]
Abstract
CONTEXT.— Problems with health care worker (HCW) well-being have become a leading concern in medicine given their severity and robust links to outcomes like medical error, mortality, and turnover. OBJECTIVE.— To describe the state of the science regarding HCW well-being, including how it is measured, what outcomes it predicts, and what institutional and individual interventions appear to reduce it. DATA SOURCES.— Peer review articles as well as multiple large data sets collected within our own research team are used to describe the nature of burnout, associations with institutional resources, and individual tools to improve well-being. CONCLUSIONS.— Rates of HCW burnout are alarmingly high, placing the health and safety of patients and HCWs at risk. To help address the urgent need to help HCWs, we summarize some of the most promising early interventions, and point toward future research that uses standardized metrics to evaluate interventions (with a focus on low-cost institutional and personal interventions).
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Affiliation(s)
- Kyle Rehder
- From the Duke Center for Healthcare Safety and Quality, Duke University Health System, Durham, North Carolina
| | - Kathryn C Adair
- From the Duke Center for Healthcare Safety and Quality, Duke University Health System, Durham, North Carolina
| | - J Bryan Sexton
- From the Duke Center for Healthcare Safety and Quality, Duke University Health System, Durham, North Carolina
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32
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Zhang X, Wang J, Hao Y, Wu K, Jiao M, Liang L, Gao L, Ning N, Kang Z, Shan L, He W, Wang Y, Wu Q, Yin W. Prevalence and Factors Associated With Burnout of Frontline Healthcare Workers in Fighting Against the COVID-19 Pandemic: Evidence From China. Front Psychol 2021; 12:680614. [PMID: 34484037 PMCID: PMC8415624 DOI: 10.3389/fpsyg.2021.680614] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 07/27/2021] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVES The sudden outbreak of the novel coronavirus disease (COVID-19) plunged healthcare workers (HCWs) into warfare. This study aimed to determine the prevalence of burnout and the factors associated with it among frontline HCWs fighting COVID-19. METHODS A cross-sectional survey was conducted among frontline HCWs fighting against the COVID-19 in Wuhan, Harbin, and Shenzhen during the period from February 18 to March 4. Finally, HCWs were recruited using cluster sampling, 1,163 HCWs were included in the final analysis. Burnout was measured using a 22-item Maslach Burnout Inventory scale (MBI scale). RESULTS Of the participants, 48.6% suffered from burnout, and 21.8% showed a high degree of burnout. Doctors (b = 3.954, P = 0.011) and nurses (b = 3.067, P = 0.042) showed higher emotional exhaustion (EE) than administrators. Participants who worked continuously for more than 8 h a day (b = 3.392, P = 0.000), those who were unable to eat three regular daily meals (b = 2.225, P = 0.008), whose daily water intake was no more than 800 ml (b = 3.007, P = 0.000), who slept for no more than 6 h (b = 1.609, P = 0.036), and who were infected or had colleagues who were infected with COVID-19 (b = 4.182, P = 0.000) experienced much higher levels of EE, while those who could adhere to infection control procedures (b = -5.992, P = 0.000), who were satisfied with their hospital's infection control measures(b = -3.709, P = 0.001), and who could receive sufficient psychological crisis intervention (b = -1.588, P = 0.039) reported lower levels of EE. CONCLUSION The study reveals that burnout is prevalent among frontline HCWs and that the known factors associated with burnout, such as workload, and the factors directly associated with COVID-19, such as having insufficient protection, can affect burnout symptoms in frontline HCWs. Synergized and comprehensive interventions should be targeted at reducing its occurrence among frontline HCWs fighting COVID-19.
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Affiliation(s)
- Xin Zhang
- Centre of Health Policy & Management, Health Management College, Harbin Medical University, Harbin, China
- Department of Social Medicine, School of Public Health, Health Management College, Harbin Medical University, Harbin, China
| | - Jiahui Wang
- Centre of Health Policy & Management, Health Management College, Harbin Medical University, Harbin, China
- Department of Social Medicine, School of Public Health, Health Management College, Harbin Medical University, Harbin, China
| | - Yanhua Hao
- Centre of Health Policy & Management, Health Management College, Harbin Medical University, Harbin, China
- Department of Social Medicine, School of Public Health, Health Management College, Harbin Medical University, Harbin, China
| | - Ke Wu
- Tong Zhou District’s Volunteer Services Guidance Center of Beijing Municipality, Beijing, China
| | - Mingli Jiao
- Centre of Health Policy & Management, Health Management College, Harbin Medical University, Harbin, China
- Department of Social Medicine, School of Public Health, Health Management College, Harbin Medical University, Harbin, China
| | - Libo Liang
- Centre of Health Policy & Management, Health Management College, Harbin Medical University, Harbin, China
- Department of Social Medicine, School of Public Health, Health Management College, Harbin Medical University, Harbin, China
| | - Lijun Gao
- Centre of Health Policy & Management, Health Management College, Harbin Medical University, Harbin, China
- Department of Social Medicine, School of Public Health, Health Management College, Harbin Medical University, Harbin, China
| | - Ning Ning
- Centre of Health Policy & Management, Health Management College, Harbin Medical University, Harbin, China
- Department of Social Medicine, School of Public Health, Health Management College, Harbin Medical University, Harbin, China
| | - Zheng Kang
- Centre of Health Policy & Management, Health Management College, Harbin Medical University, Harbin, China
- Department of Social Medicine, School of Public Health, Health Management College, Harbin Medical University, Harbin, China
| | - Linghan Shan
- Centre of Health Policy & Management, Health Management College, Harbin Medical University, Harbin, China
- Department of Social Medicine, School of Public Health, Health Management College, Harbin Medical University, Harbin, China
| | | | - Yongchen Wang
- The Second Hospital Affiliated of Harbin Medical University, Harbin, China
| | - Qunhong Wu
- Centre of Health Policy & Management, Health Management College, Harbin Medical University, Harbin, China
- Department of Social Medicine, School of Public Health, Health Management College, Harbin Medical University, Harbin, China
| | - Wenqiang Yin
- School of Public Health and Management, Weifang Medical University, Weifang, China
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33
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Brady KJS, Sheldrick RC, Ni P, Trockel MT, Shanafelt TD, Rowe SG, Kazis LE. Examining the measurement equivalence of the Maslach Burnout Inventory across age, gender, and specialty groups in US physicians. J Patient Rep Outcomes 2021; 5:43. [PMID: 34089412 PMCID: PMC8179856 DOI: 10.1186/s41687-021-00312-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 04/28/2021] [Indexed: 11/29/2022] Open
Abstract
Background Disparities in US physician burnout rates across age, gender, and specialty groups as measured by the Maslach Burnout Inventory-Human Services Survey for Medical Personnel (MBI) are well documented. We evaluated whether disparities in US physician burnout are explained by differences in the MBI’s functioning across physician age, gender, and specialty groups. Methods We assessed the measurement equivalence of the MBI across age, gender, and specialty groups in multi-group item response theory- (IRT-) based differential item functioning (DIF) analyses using secondary, cross-sectional survey data from US physicians (n = 6577). We detected DIF using two IRT-based methods and assessed its impact by estimating the overall average difference in groups’ subscale scores attributable to DIF. We assessed DIF’s practical significance by comparing differences in individuals’ subscale scores and burnout prevalence estimates from models unadjusted and adjusted for DIF. Results We detected statistically significant age-, gender-, and specialty- DIF in all but one MBI item. However, in all cases, average differences in expected subscale-level scores due to DIF were < 0.10 SD on each subscale. Differences in physicians’ individual-level subscale scores and burnout symptom prevalence estimates across DIF- adjusted and unadjusted IRT models were also small (in all cases, mean absolute differences in individual subscale scores were < 0.04 z-score units; prevalence estimates differed by < 0.70%). Conclusions Age-, gender-, and specialty-related disparities in US physician burnout are not explained by differences in the MBI’s functioning across these demographic groups. Our findings support the use of the MBI as a valid tool to assess age-, gender-, and specialty-related disparities in US physician burnout. Supplementary Information The online version contains supplementary material available at 10.1186/s41687-021-00312-2.
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Affiliation(s)
- Keri J S Brady
- Department of Health Law, Policy & Management, Boston University School of Public Health, Boston, MA, 02118, USA.
| | - R Christopher Sheldrick
- Department of Health Law, Policy & Management, Boston University School of Public Health, Boston, MA, 02118, USA
| | - Pengsheng Ni
- Department of Health Law, Policy & Management, Boston University School of Public Health, Boston, MA, 02118, USA.,Biostatistics & Epidemiology Data Analytic Center, Boston University School of Public Health, Boston, MA, USA
| | - Mickey T Trockel
- Department of Psychiatry and Behavioral Sciences, Stanford School of Medicine, Stanford, CA, USA.,Stanford Medicine WellMD Center, Stanford School of Medicine, Stanford, CA, USA
| | - Tait D Shanafelt
- Stanford Medicine WellMD Center, Stanford School of Medicine, Stanford, CA, USA
| | - Susannah G Rowe
- Boston Medical Center, Boston, MA, USA.,Department of Ophthalmology, Boston University School of Medicine, Boston, MA, USA
| | - Lewis E Kazis
- Department of Health Law, Policy & Management, Boston University School of Public Health, Boston, MA, 02118, USA
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