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Corpuz JCG. Workplace Interventions in Alleviating Occupational Stress Among Healthcare Professionals. Workplace Health Saf 2024:21650799241266272. [PMID: 39066615 DOI: 10.1177/21650799241266272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2024]
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Taylor C, Maben J, Jagosh J, Carrieri D, Briscoe S, Klepacz N, Mattick K. Care Under Pressure 2: a realist synthesis of causes and interventions to mitigate psychological ill health in nurses, midwives and paramedics. BMJ Qual Saf 2024; 33:523-538. [PMID: 38575309 PMCID: PMC11287552 DOI: 10.1136/bmjqs-2023-016468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 02/18/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND Nurses, midwives and paramedics comprise over half of the clinical workforce in the UK National Health Service and have some of the highest prevalence of psychological ill health. This study explored why psychological ill health is a growing problem and how we might change this. METHODS A realist synthesis involved iterative searches within MEDLINE, CINAHL and HMIC, and supplementary handsearching and expert solicitation. We used reverse chronological quota screening and appraisal journalling to analyse each source and refine our initial programme theory. A stakeholder group comprising nurses, midwives, paramedics, patient and public representatives, educators, managers and policy makers contributed throughout. RESULTS Following initial theory development from 8 key reports, 159 sources were included. We identified 26 context-mechanism-outcome configurations, with 16 explaining the causes of psychological ill health and 10 explaining why interventions have not worked to mitigate psychological ill health. These were synthesised to five key findings: (1) it is difficult to promote staff psychological wellness where there is a blame culture; (2) the needs of the system often over-ride staff psychological well-being at work; (3) there are unintended personal costs of upholding and implementing values at work; (4) interventions are fragmented, individual-focused and insufficiently recognise cumulative chronic stressors; and (5) it is challenging to design, identify and implement interventions. CONCLUSIONS Our final programme theory argues the need for healthcare organisations to rebalance the working environment to enable healthcare professionals to recover and thrive. This requires high standards for patient care to be balanced with high standards for staff psychological well-being; professional accountability to be balanced with having a listening, learning culture; reactive responsive interventions to be balanced by having proactive preventative interventions; and the individual focus balanced by an organisational focus. PROSPERO REGISTRATION NUMBER CRD42020172420.
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Affiliation(s)
- Cath Taylor
- School of Health Sciences, University of Surrey, Guildford, UK
| | - Jill Maben
- School of Health Sciences, University of Surrey, Guildford, UK
| | - Justin Jagosh
- School of Health Sciences, University of Surrey, Guildford, UK
| | | | - Simon Briscoe
- Exeter Medical School, University of Exeter, Exeter, UK
| | - Naomi Klepacz
- School of Health Sciences, University of Surrey, Guildford, UK
- School of Health Sciences, University of Southampton, Southampton, UK
| | - Karen Mattick
- Exeter Medical School, University of Exeter, Exeter, UK
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Qureshi N, Huilgol SS, Timmins G, Meredith LS, Gidengil CA. Misaligned Supports: Differences in Reported Health Care Worker Well-being Supports Provided and Needed During the COVID-19 Pandemic. Am J Health Promot 2024:8901171241255764. [PMID: 38907369 DOI: 10.1177/08901171241255764] [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: 06/24/2024]
Abstract
PURPOSE To describe the well-being supports provided to health care workers (HCWs) during the COVID-19 pandemic in health centers and hospitals. DESIGN Cross-sectional qualitative interviews before and after implementation of a peer-based support intervention. SETTING Purposively sampled hospitals and health centers across the US. PARTICIPANTS 28 site leaders and 56 HCWs sampled from 16 hospitals and 12 health centers. METHOD Site leaders and HCWs were asked to describe supports available to HCWs during the COVID-19 pandemic. Thematic and content coding and analysis of interview responses were conducted using Dedoose. RESULTS Both site leaders and HCWs identified a range of support resources available. Communication resources were the most frequently cited in both groups. Health care workers reported bi-directional communication, while one-way communication was emphasized by site leaders. Hospitals highlighted counseling support, particularly Employee Assistance Programs (EAP), while health centers prioritized community support. Wellness activities were more prevalent in hospital settings, while health centers offered specific workplace-provided training for HCWs. Health care workers encountered barriers when accessing support, including limited time, fear of stigma, and disruptions to their existing support networks attributable to the pandemic. CONCLUSION While there are resources for HCWs, the available supports may not align with their needs and barriers to access may limit the effectiveness of these supports. Continued engagement between leaders and HCWs could help better align resources with needs.
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Affiliation(s)
- Nabeel Qureshi
- RAND Corporation, Santa Monica, CA, USA
- Pardee RAND Graduate School, Santa Monica,CA, USA
| | | | - George Timmins
- RAND Corporation, Santa Monica, CA, USA
- Pardee RAND Graduate School, Santa Monica,CA, USA
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Campos ML, Bolgeri P, Bascur A. The effect of a collective competence intervention on collective efficacy, psychological wellbeing, and social wellbeing: a quasi-experimental study of a sample of healthcare workers during the COVID-19 crisis. Front Psychol 2024; 15:1369251. [PMID: 38962231 PMCID: PMC11220720 DOI: 10.3389/fpsyg.2024.1369251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 05/24/2024] [Indexed: 07/05/2024] Open
Abstract
Background The health crisis associated with COVID-19 led to a period of increased demand on the operational and social organization of healthcare centers, which often had a negative impact on the psychological and social wellbeing of healthcare workers. In order to tackle this issue, an intervention plan was designed to develop collective competences through various participatory strategies. This study sought to determine the effect of this intervention on the variables collective efficacy, psychological wellbeing, and social wellbeing in healthcare workers by performing a pretest and posttest comparison with a control group. Method The variables were evaluated using a non-probability, purposive sample of 80 healthcare workers from three Family Healthcare Centers (CESFAM) located in the Coquimbo Region, Chile, within health crisis context. The intervention group was composed of voluntary participants, while the control group only completed the evaluations. The intervention consisted in 6 training workshops focused on improving collective management, group synergy, collaborative problem-solving, communicative strategies, and overall team care. Results The analysis shows that the collective competence intervention had a positive effect on the collective efficacy, psychological wellbeing, and social wellbeing of the participating healthcare workers during the COVID-19 crisis. Only specific factors of these variables did not undergo a significant impact. Conclusion The results of this study suggest that interventions aimed at improving collective organizational competences, apart from increasing collective efficacy, can have a positive impact on healthcare workers' psychological and social wellbeing in a context of occupational adversity.
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Ruzycki S, Adisesh A, Burstyn I, Durand-Moreau Q, Labreche F, Zadunayski T, Cherry N. Availability, use, and impact of workplace mental health supports during the COVID-19 pandemic in a Canadian cohort of healthcare workers. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2024; 79:57-66. [PMID: 38804906 DOI: 10.1080/19338244.2024.2350956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 04/26/2024] [Indexed: 05/29/2024]
Abstract
We investigated the availability and use of workplace mental health (MH) supports during the COVID-19 pandemic in a Canadian cohort of healthcare workers (HCW) and measured anxiety and depression by the Hospital Anxiety and Depression Scale (HADS) completed at four contacts 2020-2022. Reports were available for 4400 HCW working with patients. Half the HCWs had a clinically significant HADS score at one or more contacts Access to MH supports increased during the pandemic, with 94% reporting access to some workplace support by 2022: 47% had made use of at least one support. 25% of those with high HADS scores used no support. Older women and men with depressive conditions were less likely to report use. Reported use of an Employee Assistance Program was associated with a reduction in HADS scores in the following months.
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Affiliation(s)
- Shannon Ruzycki
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Anil Adisesh
- Division of Occupational Medicine, Department of Medicine, University of Toronto, Toronto, Canada
| | - Igor Burstyn
- Department of Environmental and Occupational Health, Drexel University, Philadelphia, PA, USA
| | | | - France Labreche
- Research Department, Institut de recherche Robert-Sauvé en santé et en sécurité du travail, Montreal, Canada
| | - Tanis Zadunayski
- Division of Preventive Medicine, University of Alberta, Edmonton, Canada
| | - Nicola Cherry
- Division of Preventive Medicine, University of Alberta, Edmonton, Canada
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Araújo D, Bártolo A, Fernandes C, Pereira A, Monteiro S. Intervention Programs Targeting Burnout in Health Professionals: A Systematic Review. IRANIAN JOURNAL OF PUBLIC HEALTH 2024; 53:997-1008. [PMID: 38912141 PMCID: PMC11188645 DOI: 10.18502/ijph.v53i5.15580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 09/10/2023] [Indexed: 06/25/2024]
Abstract
Background Burnout is an occupational syndrome, with a higher prevalence in professionals whose close involvement with other people is significant. There is a great diversity of professionals at risk of burnout, and therefore the implementation of intervention programs is relevant, as helping people to maintain their mental and emotional health enables them to become more meaningfully involved in their communities and become more effective and active global citizens. We aimed to review systematically the characteristics of interventions targeting burnout in health professionals. Methods The search was conducted in three databases: Scopus, Web of Science, and PubMed, following the PRISMA model, and 16 eligible articles were identified between 2012 and 2023. Results Mindfulness showed great efficacy in preventing burnout, by reducing stress levels and promoting empathy. In addition, relaxation and breathing techniques, yoga, and music therapy showed to improve burnout and occupational stress levels. Balint groups have also helped slow the progression of burnout. Implications about the need for future research to foster the promotion of well-being and mental health of health professionals are mentioned. Conclusion Mindfulness, relaxation and breathing techniques, yoga, music therapy and balint groups proved to be effective in preventing burnout.
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Affiliation(s)
- Diana Araújo
- Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
| | - Ana Bártolo
- Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
- CINTESIS@RISE, CINTESIS.UPT, Portucalense University, Porto, Portugal
- Research in Education and Community Intervention, Piaget Institute – ISEIT/Viseu, Viseu, Portugal
- Center for Global Studies, Open University, Lisboa, Portugal
| | - Claúdia Fernandes
- CATIM -Technological Center for the Metal Working Industry, Porto, Portugal
| | - Anabela Pereira
- Department of Psychology, Colégio Pedro da Fonseca, University of Évora, Évora, Portugal
- Center for Research in Education and Psychology (CIEP), University of Évora, Évora, Portugal
- William James Center for Research – WJCR/UA, Aveiro, Portugal
| | - Sara Monteiro
- Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
- Center for Global Studies, Open University, Lisboa, Portugal
- Department of Social Sciences and Management, Universidade Aberta, Lisboa, Portugal
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Maben J, Taylor C, Jagosh J, Carrieri D, Briscoe S, Klepacz N, Mattick K. Causes and solutions to workplace psychological ill-health for nurses, midwives and paramedics: the Care Under Pressure 2 realist review. HEALTH AND SOCIAL CARE DELIVERY RESEARCH 2024; 12:1-171. [PMID: 38662367 DOI: 10.3310/twdu4109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
Background Nurses, midwives and paramedics are the largest collective group of clinical staff in the National Health Service and have some of the highest prevalence of psychological ill-health. Existing literature tends to be profession-specific and focused on individual interventions that place responsibility for good psychological health with nurses, midwives and paramedics themselves. Aim To improve understanding of how, why and in what contexts nurses, midwives and paramedics experience work-related psychological ill-health; and determine which high-quality interventions can be implemented to minimise psychological ill-health in these professions. Methods Realist synthesis methodology consistent with realist and meta-narrative evidence syntheses: evolving standards' reporting guidelines. Data sources First round database searching in Medical Literature Analysis and Retrieval System Online Database ALL (via Ovid), cumulative index to nursing and allied health literature database (via EBSCO) and health management information consortium database (via Ovid), was undertaken between February and March 2021, followed by supplementary searching strategies (e.g. hand searching, expert solicitation of key papers). Reverse chronology screening was applied, aimed at retaining 30 relevant papers in each profession. Round two database searches (December 2021) targeted COVID-19-specific literature and literature reviews. No date limits were applied. Results We built on seven key reports and included 75 papers in the first round (26 nursing, 26 midwifery, 23 paramedic) plus 44 expert solicitation papers, 29 literature reviews and 49 COVID-19 focused articles in the second round. Through the realist synthesis we surfaced 14 key tensions in the literature and identified five key findings, supported by 26 context mechanism and outcome configurations. The key findings identified the following: (1) interventions are fragmented, individual-focused and insufficiently recognise cumulative chronic stressors; (2) it is difficult to promote staff psychological wellness where there is a blame culture; (3) the needs of the system often override staff well-being at work ('serve and sacrifice'); (4) there are unintended personal costs of upholding and implementing values at work; and (5) it is challenging to design, identify and implement interventions to work optimally for diverse staff groups with diverse and interacting stressors. Conclusions Our realist synthesis strongly suggests the need to improve the systemic working conditions and the working lives of nurses, midwives and paramedics to improve their psychological well-being. Individual, one-off psychological interventions are unlikely to succeed alone. Psychological ill-health is highly prevalent in these staff groups (and can be chronic and cumulative as well as acute) and should be anticipated and prepared for, indeed normalised and expected. Healthcare organisations need to (1) rebalance the working environment to enable healthcare professionals to recover and thrive; (2) invest in multi-level system approaches to promote staff psychological well-being; and use an organisational diagnostic framework, such as the NHS England and NHS Improvement Health and Wellbeing framework, to self-assess and implement a systems approach to staff well-being. Future work Future research should implement, refine and evaluate systemic interventional strategies. Interventions and evaluations should be co-designed with front-line staff and staff experts by experience, and tailored where possible to local, organisational and workforce needs. Limitations The literature was not equivalent in size and quality across the three professions and we did not carry out citation searches using hand searching and stakeholder/expert suggestions to augment our sample. Study registration This study is registered as PROSPERO CRD42020172420. Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020172420. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR129528) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 9. See the NIHR Funding and Awards website for further award information.
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Affiliation(s)
- Jill Maben
- School of Health Sciences, University of Surrey, Guildford, UK
| | - Cath Taylor
- School of Health Sciences, University of Surrey, Guildford, UK
| | - Justin Jagosh
- School of Health Sciences, University of Surrey, Guildford, UK
| | - Daniele Carrieri
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Simon Briscoe
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Naomi Klepacz
- School of Health Sciences, University of Surrey, Guildford, UK
- School of Health Sciences, University of Southampton, Southampton, UK
- National Institute for Health and Care Research (NIHR) Applied Research Collaboration (ARC) Wessex, Southampton, UK
| | - Karen Mattick
- University of Exeter Medical School, University of Exeter, Exeter, UK
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Delafontaine AC, Anders R, Mathieu B, Salathé CR, Putois B. Impact of confrontation to patient suffering and death on wellbeing and burnout in professionals: a cross-sectional study. BMC Palliat Care 2024; 23:74. [PMID: 38486209 PMCID: PMC10941396 DOI: 10.1186/s12904-024-01393-8] [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: 12/02/2022] [Accepted: 02/19/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Palliative care and oncology generate a risk of burnout and psychological distress in professionals. The purpose of this study is to identify both psychopathological and positive factors related to mental health at work. It aims (i) to explore the extent to which these professionals are confronted with suffering, illness, and death; and to explore the prevalence of psychological distress and/or burnout, (ii) to identify potential determinants of burnout and psychological wellbeing at work, (iii) to develop an integrative model of mental health; and to identify frequency and impact of confrontations with death, and (iv) to identify profiles of professionals are at risk of developing a mental health disorder or, conversely, characterized by wellbeing. METHODS A cross-sectional questionnaire study was conducted in palliative care and oncology evaluating confrontations with death, coping, burnout, psychological distress, personality, self-esteem, well-being and meaning at work. Regressions, clustering, and structural equation modeling analyses were performed. RESULTS 109 professionals participated (58% from oncology and 42% from palliative care), of which 79% were female, and 65% were between 30 and 49 years old. Aim i: 30% witnessed an intolerable suffering at least 9 times a month, 45% reported moderate to high levels of burnout, 39% suffered from anxiety and 11% from depression. Aim ii: the determinants of burnout were the personality traits conscientiousness and neuroticism, low meaning of work, and low wellbeing (R2 = 0.44). The determinants of wellbeing were work meaning, depersonalization, self-esteem, fulfillment and low emotional exhaustion (R2 = 0.71). Aim iii: the integrative model included both well-being (self-esteem, conscientiousness) and psychopathology (neuroticism, anxiety) parameters, and strongly satisfied the standard SEM goodness of fit indices (e.g., CFI, IFI, and TLI ≥ 0.95). Aim iv: three profiles were identified: (a) a "distressed profile" with a majority of professionals at the patient's bedside, (b) a "disengaged profile" with professionals working as second-line consultants, (c) a "wellbeing profile" contains profiles of caregivers insensitive to psychological distress and with a high level of positive Impact of confrontation on different areas of their lives. CONCLUSIONS An integrative approach is essential to understand the full range of mental health issues for professionals. Meaning of work is a key factor in professional interventions that should primarily affect front-line professionals with limited experience.
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Affiliation(s)
- Anne-Catherine Delafontaine
- Faculty of Psychology, Swiss Distance Learning University, Technopôle 5, Sierre, 3960, Switzerland.
- Chair of palliative psychology, Lausanne University Hospital and University of Lausanne, Hôpital Nestlé, Av. Pierre-Decker 5, Lausanne, 1011, Switzerland.
| | - Royce Anders
- Department of Psychology, Department of Psychology, Epsylon Laboratory UR4556, University Paul Valéry Montpellier 3, Montpellier, 34000, France
| | - Bernard Mathieu
- Chair of palliative psychology, Lausanne University Hospital and University of Lausanne, Hôpital Nestlé, Av. Pierre-Decker 5, Lausanne, 1011, Switzerland
| | - Cornelia Rolli Salathé
- Faculty of Psychology, Swiss Distance Learning University, Technopôle 5, Sierre, 3960, Switzerland
- Department of Psychology, University of Fribourg, Fribourg, 1700, Switzerland
| | - Benjamin Putois
- Faculty of Psychology, Swiss Distance Learning University, Technopôle 5, Sierre, 3960, Switzerland
- Lyon Neuroscience Research Centre, CNRS UMR 5292 - INSERM U1028, Lyon, France
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Blake H, Mancini H, Coyne E, Cooper J, Stanulewicz-Buckley N. Workforce wellbeing centres and their positive role for wellbeing and presenteeism in healthcare workers during the COVID-19 pandemic: secondary analysis of COVID-Well data. BMC Health Serv Res 2024; 24:302. [PMID: 38448919 PMCID: PMC10918935 DOI: 10.1186/s12913-024-10730-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 02/15/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND Supported wellbeing centres established during the COVID-19 pandemic provided high quality rest spaces and access to peer-to-peer psychological first aid for healthcare workers (HCWs). The centres were well accessed and valued by HCWs, but their relationship with wellbeing and job-related factors is not well established. The aim of this study was to explore the relationship between wellbeing centre use, HCWs wellbeing and job-related factors (job stressfulness, job satisfaction, presenteeism, turnover intentions). METHODS Secondary analysis of data from 819 HCWs from an acute hospital trust who completed an online survey in April-July 2020, as part of the COVID-Well study. Measures included the Warwick Edinburgh Mental Wellbeing Scale, and four single-item global measures of job stressfulness, job satisfaction, presenteeism and turnover intentions. ANCOVA models and regression analyses were conducted on these data. RESULTS HCWs who had not accessed the wellbeing centres had lower wellbeing (β = 0.12, p < .001), higher job stressfulness (β = - 0.22, p < .001), lower job satisfaction (β = 0.39, p < .001), higher presenteeism (β = - 0.22, p < .001) and were of younger age (β = 0.09, p = .002). Centre use was associated with wellbeing irrespective of job stressfulness. Those reporting presenteeism and who accessed the centre (M = 3.30, SE = 0.04) had higher wellbeing than those who accessed the centre but did not report presenteeism (M = 3.06, SE = 0.04) (F(1, 791) = 18.65, p < .001, ηp2 = 0.02). Centre use was not significantly associated with turnover intentions (B = - 0.30, p = .13; Wald = 2.26; odds = 0.74), while job stress and job satisfaction showed significant effects. CONCLUSIONS Accessing wellbeing centres was associated with higher wellbeing of HCWs, particularly for those reporting presenteeism. Therefore, the centres may have provided greatest respite and restoration for those present at work but not in optimal health. Younger workers were disproportionately affected in terms of wellbeing, and targeted support for this population is needed. Strategies to decrease presenteeism and maximise job satisfaction are urgently required. Healthcare organisations should provide rest spaces and psychological support to HCWs for the long-term, as part of a systems-wide approach to improving workforce health and wellbeing.
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Affiliation(s)
- Holly Blake
- School of Health Sciences, University of Nottingham, Nottingham, UK.
- NIHR Nottingham Biomedical Research Centre, Nottingham, UK.
| | - Helen Mancini
- Human Resources, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Emma Coyne
- Clinical Psychology Department, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Joanne Cooper
- Nursing and Midwifery, Nottingham University Hospitals NHS Trust, Nottingham, UK
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O'Hare D, Gaughran F, Stewart R, Pinto da Costa M. A cross-sectional investigation on remote working, loneliness, workplace isolation, well-being and perceived social support in healthcare workers. BJPsych Open 2024; 10:e50. [PMID: 38406834 PMCID: PMC10897687 DOI: 10.1192/bjo.2024.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 01/08/2024] [Accepted: 01/08/2024] [Indexed: 02/27/2024] Open
Abstract
BACKGROUND Following the onset of the COVID-19 pandemic, healthcare trusts began to implement remote working arrangements, with little knowledge of their impact on staff well-being. AIMS To investigate how remote working of healthcare workers during the pandemic may have been associated with stress, productivity and work satisfaction at that time, and associations between loneliness, workplace isolation, perceived social support and well-being. METHOD A questionnaire was developed to explore remote working and productivity, stress and work satisfaction during time spent working remotely. Associations between current loneliness, workplace isolation and well-being, and the influence of perceived social support, were explored with perceived social support as a potential moderator. RESULTS A total of 520 participants responded to the study, of whom 112 were men (21.5%) and 406 were women (78.1%), with an age range of 21-77 years (mean 40.0, s.d. = 12.1). Very few (3.1%) worked remotely before the COVID-19 pandemic, and this had increased significantly (96.9%). Those who worked ≥31 h a week remotely reported higher stress and lower workplace satisfaction at that time, compared with office work, yet also felt more productive. Current loneliness, workplace isolation and perceived social support were cross-sectionally associated with lower current well-being. CONCLUSIONS Those who worked more hours a week remotely during the pandemic reported increased stress, which may be related to the lack of resources in place to support this change in work.
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Affiliation(s)
- Dearbhla O'Hare
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Fiona Gaughran
- Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; and National Psychosis Service, South London and Maudsley NHS Foundation Trust, London, UK
| | - Robert Stewart
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Mariana Pinto da Costa
- South London and Maudsley NHS Foundation Trust, London, UK; and Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
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Gomes Souza L, Bouba DA, Corôa RDC, Dofara SG, Robitaille V, Blanchette V, Kastner K, Bergeron F, Guay-Bélanger S, Izumi SS, Totten AM, Archambault P, Légaré F. The Impact of Advance Care Planning on Healthcare Professionals' Well-being: A Systematic Review. J Pain Symptom Manage 2024; 67:173-187. [PMID: 37827454 DOI: 10.1016/j.jpainsymman.2023.09.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 09/08/2023] [Accepted: 09/16/2023] [Indexed: 10/14/2023]
Abstract
CONTEXT Advance care planning (ACP) improves care for patients with chronic illnesses and reduces family stress. However, the impact of ACP interventions on healthcare professionals' well-being remains unknown. OBJECTIVE To systematically review the literature evaluating the impact of ACP interventions on healthcare professionals' well-being. METHODS We followed the Joanna Briggs Institute methodology for systematic reviews and registered the protocol in PROSPERO (CRD42022346354). We included primary studies in all languages that assessed the well-being of healthcare professionals in ACP interventions. We excluded any studies on ACP in psychiatric care and in palliative care that did not address goals of care. Searches were conducted on April 4, 2022, and March 6, 2023 in Embase, CINAHL, Web of Science, and PubMed. We used the Mixed Methods Appraisal Tool for quality analysis. We present results as a narrative synthesis because of their heterogeneity. RESULTS We included 21 articles published in English between 1997 and 2021 with 17 published after 2019. All were conducted in high-income countries, and they involved a total of 1278 participants. Three reported an interprofessional intervention and two included patient partners. Studies had significant methodological flaws but most reported that ACP had a possible positive impact on healthcare professionals' well-being. CONCLUSION This review is the first to explore the impact of ACP interventions on healthcare professionals' well-being. ACP interventions appear to have a positive impact, but high-quality studies are scarce. Further research is needed, particularly using more rigorous and systematic methods to implement interventions and report results.
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Affiliation(s)
- Lucas Gomes Souza
- Department of Social and Preventive Medicine (L.G.S., D.A.B.), Faculty of Medicine, Université Laval, Québec, Canada, and VITAM, Centre de recherche en santé durable, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, QC, Canada
| | - Dalil Asmaou Bouba
- Department of Social and Preventive Medicine (L.G.S., D.A.B.), Faculty of Medicine, Université Laval, Québec, Canada, and VITAM, Centre de recherche en santé durable, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, QC, Canada
| | - Roberta de Carvalho Corôa
- Department of Family Medicine and Emergency Medicine (R.C.C.), VITAM, Centre de recherche en santé durable, Unité de soutien au système de santé apprenant, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Faculty of Medicine, Université Laval, Québec, QC, Canada
| | - Suélène Georgina Dofara
- VITAM, Centre de recherche en santé durable (S.G.B., S.G.D.), Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, QC, Canada
| | - Vincent Robitaille
- Faculty of Medicine, Université Laval (V.R.), VITAM, Centre de recherche en santé durable, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec, QC, Canada
| | - Virginie Blanchette
- Department of Human Kinetics and Podiatric Medicine (V.B.), Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | | | | | - Sabrina Guay-Bélanger
- VITAM, Centre de recherche en santé durable (S.G.B., S.G.D.), Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, QC, Canada
| | | | - Annette M Totten
- Department of Medical Informatics and Clinical Epidemiology (A.M.T.), School of Medicine, Oregon Health & Science University, Portland, OR
| | - Patrick Archambault
- Department of Family Medicine and Emergency Medicine (P.A.), Faculty of Medicine, Université Laval, VITAM, Centre de recherche en santé durable, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Centre de recherche intégrée pour un système apprenant en santé et services sociaux, Centre intégré de santé et services sociaux de Chaudière-Appalaches, Québec, QC, Canada
| | - France Légaré
- Department of Family Medicine and Emergency Medicine (F.L.), Faculty of Medicine, Université Laval, VITAM, Centre de recherche en santé durable, Researcher, Centre de recherche du CHU de Québec, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, QC, Canada.
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Fronteira I, Mathews V, Dos Santos RLB, Matsumoto K, Amde W, Pereira A, de Oliveira APC, Craveiro I, Chança R, Boniol M, Ferrinho P, Poz MRD. Impacts for health and care workers of Covid-19 and other public health emergencies of international concern: living systematic review, meta-analysis and policy recommendations. HUMAN RESOURCES FOR HEALTH 2024; 22:10. [PMID: 38273317 PMCID: PMC10809470 DOI: 10.1186/s12960-024-00892-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 01/11/2024] [Indexed: 01/27/2024]
Abstract
BACKGROUND Health and care workers (HCW) faced the double burden of the SARS-CoV-2 pandemic: as members of a society affected by a public health emergency and as HWC who experienced fear of becoming infected and of infecting others, stigma, violence, increased workloads, changes in scope of practice, among others. To understand the short and long-term impacts in terms of the COVID-19 pandemic and other public health emergencies of international concern (PHEICs) on HCW and relevant interventions to address them, we designed and conducted a living systematic review (LSR). METHODS We reviewed literature retrieved from MEDLINE-PubMed, Embase, SCOPUS, LILACS, the World Health Organization COVID-19 database, the ClinicalTrials.org and the ILO database, published from January 2000 until December 2021. We included quantitative observational studies, experimental studies, quasi-experimental, mixed methods or qualitative studies; addressing mental, physical health and well-being and quality of life. The review targeted HCW; and interventions and exposures, implemented during the COVID-19 pandemic or other PHEICs. To assess the risk of bias of included studies, we used the Johanna Briggs Institute (JBI) Critical Appraisal Tools. Data were qualitatively synthetized using meta-aggregation and meta-analysis was performed to estimate pooled prevalence of some of the outcomes. RESULTS The 1013 studies included in the review were mainly quantitative research, cross-sectional, with medium risk of bias/quality, addressing at least one of the following: mental health issue, violence, physical health and well-being, and quality of life. Additionally, interventions to address short- and long-term impact of PHEICs on HCW included in the review, although scarce, were mainly behavioral and individual oriented, aimed at improving mental health through the development of individual interventions. A lack of interventions addressing organizational or systemic bottlenecks was noted. DISCUSSION PHEICs impacted the mental and physical health of HCW with the greatest toll on mental health. The impact PHEICs are intricate and complex. The review revealed the consequences for health and care service delivery, with increased unplanned absenteeism, service disruption and occupation turnover that subvert the capacity to answer to the PHEICs, specifically challenging the resilience of health systems.
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Affiliation(s)
- Inês Fronteira
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Rua da Junqueira, 100, 1349-008, Lisbon, Portugal.
- National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, NOVA University of Lisbon, Avenida Padre Cruz, 1600-560, Lisbon, Portugal.
| | - Verona Mathews
- School of Public, Health University of the Western Cape, South Africa, Private Bag X17, Bellville, 7535, Republic of South Africa
| | - Ranailla Lima Bandeira Dos Santos
- Escola Nacional de Saúde Pública Sérgio Arouca, Fundação Osvaldo Cruz, Rua Leopoldo Bulhões, 1480 - Manguinhos, Rio de Janeiro, Brazil
| | - Karen Matsumoto
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rua São Francisco Xavier 524 - 7º andar, Blocos D e E - Maracanã, Rio de Janeiro, RJ, 20550-013, Brazil
| | - Woldekidan Amde
- School of Public, Health University of the Western Cape, South Africa, Private Bag X17, Bellville, 7535, Republic of South Africa
| | - Alessandra Pereira
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rua São Francisco Xavier 524 - 7º andar, Blocos D e E - Maracanã, Rio de Janeiro, RJ, 20550-013, Brazil
| | - Ana Paula Cavalcante de Oliveira
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rua São Francisco Xavier 524 - 7º andar, Blocos D e E - Maracanã, Rio de Janeiro, RJ, 20550-013, Brazil
| | - Isabel Craveiro
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Rua da Junqueira, 100, 1349-008, Lisbon, Portugal
| | - Raphael Chança
- Instituto Nacional de Cancer, Ministério da Saúde, Rua Marquês de Pombal, 125, Centro, Rio de Janeiro, RJ, 20230240, Brazil
| | - Mathieu Boniol
- Health Workforce Department, World Health Organization, Av. Appia 20, 1202, Geneva, Switzerland
| | - Paulo Ferrinho
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Rua da Junqueira, 100, 1349-008, Lisbon, Portugal
| | - Mario Roberto Dal Poz
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rua São Francisco Xavier 524 - 7º andar, Blocos D e E - Maracanã, Rio de Janeiro, RJ, 20550-013, Brazil
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Gelaw A, Parker S, Johnson A, Nguyen H, Jolly A, Forner V, Deng C, Collie A. Determinants of psychological injury among health and social care workers in community settings: A systematic review. Work 2024; 78:3-27. [PMID: 38578915 DOI: 10.3233/wor-230426] [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] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND Health and Social Care (HSC) workers face psychological health risks in the workplace. While many studies have described psychological injuries in HSC workers, few have examined the determinants. Previous research has primarily focused on hospitals, lacking systematic reviews of community-based settings. OBJECTIVE To systematically identify and appraise current evidence on the determinants of psychological injuries among HSC workers in community settings. METHODS Searches were conducted in three bibliographic databases, supplemented by citation searches. Included studies focused on community-based HSC workers, reporting statistical associations between psychological injury and personal, health, occupational, or organizational factors. Quantitative studies published in English between January 1, 2000 and August 15, 2023 were included. Quality appraisal was undertaken using the JBI critical appraisal checklist. RESULTS Sixty-six studies were included. Study quality was highly variable, and all studies were cross-sectional. Twenty-three studies linked psychological injury with occupational factors (e.g. low job control, high job demands and low job satisfaction). Thirteen studies observed an association between work environment and psychological injury, and a further eleven between workplace social support and psychological injury. Fewer studies have examined the relationship between psychological injury and personal/individual factors. CONCLUSION Occupational and organisational factors are significantly associated with psychological health among HSA workers, in community settings. These aspects of job design, work environment and workplace relationships are modifiable, suggesting an opportunity for work design interventions to improve workers' psychological health and reduce the prevalence of psychological injury in this sector.
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Affiliation(s)
- Asmare Gelaw
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Sharon Parker
- Future of Work Institute, Curtin University, Perth, WA, Australia
| | - Anya Johnson
- The University of Sydney Business School, The University of Sydney, Sydney, NSW, Australia
| | - Helena Nguyen
- The University of Sydney Business School, The University of Sydney, Sydney, NSW, Australia
| | - Anu Jolly
- Future of Work Institute, Curtin University, Perth, WA, Australia
| | - Vivien Forner
- The University of Sydney Business School, The University of Sydney, Sydney, NSW, Australia
| | - Connie Deng
- The University of Sydney Business School, The University of Sydney, Sydney, NSW, Australia
| | - Alex Collie
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
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Månsson Sandberg H, Landstad BJ, Tjulin Å, Brulin E. COVID-19- related work, managerial factors and exhaustion among general practitioners in Sweden: a cross-sectional study. BMC PRIMARY CARE 2023; 24:269. [PMID: 38087223 PMCID: PMC10717449 DOI: 10.1186/s12875-023-02228-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 11/29/2023] [Indexed: 12/18/2023]
Abstract
INTRODUCTION A significant number of international studies show that general practitioners (GPs) suffered from burnout when working during the COVID-19 pandemic. A Swedish study found that more than 16% of GPs had exhaustion in spring 2021. Exhaustion can be regarded as an initial stage of burnout. A knowledge gap remains on GPs´ working conditions, the impact of management during the pandemic and how it was associated with exhaustion. This study aims to explore the association between severe symptoms of exhaustion and COVID-19 pandemic-related work and managerial factors among Swedish GPs and whether managerial factors have an impact on the association between exhaustion and COVID-19-related work factors. METHODS Cross-sectional data was drawn from the Longitudinal Occupational Health survey in Health Care Sweden (LOHHCS), which included a representative sample of practicing doctors in Sweden. The sample consisted of 6699 doctors with a response rate of 41.2%. This study constitutes a sample of doctors who reported working in primary care facilities at the time of data collection, i.e. 1013 GPs. The Burnout Assessment Tool (BAT) was used to assess severe symptoms of exhaustion. Questions were also asked about pandemic-related work and managerial factors. The data was analysed using descriptive statistics and multivariate logistic regression to identify the association between exhaustion, work and managerial factors. RESULTS The multivariate analysis showed that GPs who managed COVID-19 patients were about twice as likely to report severe symptoms of exhaustion. Further, GPs who reported that management was unsupportive, provided unsatisfactory working conditions and unsatisfactory policies for patient prioritisation were between two and four times more likely to report severe symptoms of exhaustion. CONCLUSIONS COVID-19-related work and managerial factors had a significant impact on the mental health of GPs. Furthermore, the potentially protective effect that satisfactory management actions had on mental health was limited. In the aftermath of the COVID-19 pandemic and in preparation for future major crises that have a high impact on healthcare, there is a need to investigate the measures that can be taken to enable GPs to carry out their work, while maintaining their wellbeing.
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Affiliation(s)
- Helena Månsson Sandberg
- Department of Health Sciences, Mid Sweden University, Östersund, Sweden.
- Unit of Occupational Medicine, Karolinska Institutet, Stockholm, Sweden.
| | - Bodil J Landstad
- Faculty of Human Sciences, Mid Sweden University, Östersund, Sweden
- Unit of Research, Education and Development, Östersund Hospital, Östersund, Sweden
| | - Åsa Tjulin
- Department of Health Sciences, Mid Sweden University, Östersund, Sweden
| | - Emma Brulin
- Unit of Occupational Medicine, Karolinska Institutet, Stockholm, Sweden
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Cecere L, de Novellis S, Gravante A, Petrillo G, Pisani L, Terrenato I, Ivziku D, Latina R, Gravante F. Quality of life of critical care nurses and impact on anxiety, depression, stress, burnout and sleep quality: A cross-sectional study. Intensive Crit Care Nurs 2023; 79:103494. [PMID: 37556987 DOI: 10.1016/j.iccn.2023.103494] [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: 04/20/2023] [Revised: 07/04/2023] [Accepted: 07/09/2023] [Indexed: 08/11/2023]
Abstract
OBJECTIVES To investigate how anxiety, depression, stress, burnout, and sleep quality impact on Quality of life of critical care nurses. BACKGROUND Several studies reported that critical care nurses are exposed to a high risk of anxiety, depression, burnout, stress, and sleep quality, but we do not know the impact of critical care nurses. DESIGN A cross-sectional study. METHODS We have included all critical care nurses working in the intensive care unit for at least six months. Data were collected from December 1, 2021, to March 18, 2022. We evaluated the critical care nurses using the Depression Anxiety Stress Scale (DASS), Maslach Burnout Inventory scale, Pittsburgh Sleep Quality Index and Nurse Quality of Life. The primary endpoint is Quality of Life. Associations were tested using multivariate modelling. RESULTS A total of 140 critical care nurses were included. Multivariate regression showed the relation between emotional QoL and emotional exhaustion and DASS total score [OR = 0.14; 95% CI (0.03-0.73); p = 0.019 and OR = 3.64; 95% CI (1.07-12.32); p = 0.038, respectively]. Personal accomplishment and DASS total score have a direct relationship on quality of work-life [OR = 0.21; 95% CI (0.05-0.82); p = 0.024 and OR = 4.18; 95% CI (1.01-17.33); p = 0.049, respectively]. CONCLUSIONS The physical quality of life is not optimal in critical care nurses, while burnout and the DASS score directly impact the emotional and work-life quality of life. IMPLICATIONS FOR CLINICAL PRACTICE Our research has highlighted the importance of detecting the quality of life of critical care nurses. The nurses should take proper care of their health by adopting the right health behaviours to create correct work conditions and increase the quality of care for critically ill patients.
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Affiliation(s)
- Luciano Cecere
- Cardiology Unit and Coronary Intensive Care, Emergency Department, Antonio Cardarelli Hospital in Naples, Italy
| | - Salvatore de Novellis
- Cardiology Unit and Coronary Intensive Care, Department of Clinical Medicine and Aging, Federico II University Hospital, Naples, Italy
| | - Agostino Gravante
- Intensive Care Unit, Emergency Department, Antonio Cardarelli Hospital in Naples, Italy
| | - Giovanni Petrillo
- Operating Theaters, Division of Anesthesia and Pain Medicine, "Fondazione G. Pascale" National Cancer Institute, Naples, Italy
| | - Luigi Pisani
- Mahidol Oxford Research Unit, Bangkok, Thailand; Intensive Care Unit, General Regional Hospital Miulli, Acquaviva delle Fonti, Italy
| | - Irene Terrenato
- Biostatistics and Bioinformatic Unit, Scientific Direction, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Dhurata Ivziku
- Department of Health Professions, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo 200, 00128 Rome, Italy
| | - Roberto Latina
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Piazza delle Cliniche, 2, 90127 Palermo, Italy
| | - Francesco Gravante
- Department of Anesthesiology, Intensive Care Unit, Local Health Authority of Caserta Viale Unità Italiana, 28, 81100 Caserta, Italy.
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Carroll C, McCray S, Utter J. Acceptability and Feasibility of a Hospital-Based Herb and Vegetable Garden for Health Care Workers. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2023; 55:877-883. [PMID: 37921799 DOI: 10.1016/j.jneb.2023.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 10/09/2023] [Accepted: 10/10/2023] [Indexed: 11/04/2023]
Abstract
OBJECTIVE Evaluate the acceptability and feasibility and explore the potential health impacts of a hospital-based herb and vegetable garden. METHODS Mixed-method program evaluation assessed dietetic and food service staff health, well-being, and garden engagement. Surveys were administered at baseline and follow-up (6 months). Key informant interviews (n = 6) were conducted at 6 months to evaluate program feasibility. RESULTS There was good acceptance and engagement with the garden, with 18 participants volunteering to maintain the garden. Key informant interviews identified workforce, leadership, and garden design engagement factors. Participants also noted several psychosocial benefits. CONCLUSION AND IMPLICATIONS A hospital-based garden for staff is feasible if programmatic improvements are addressed. More robust evaluations considering challenges with measuring key outcomes with survey methodology and extended periods are warranted.
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Affiliation(s)
- Chloe Carroll
- Faculty of Health Science and Medicine, Bond University, Robina, Queensland, Australia
| | - Sally McCray
- Mater Dietetic and Foodservice, Mater Health, South Brisbane, Queensland, Australia
| | - Jennifer Utter
- Faculty of Health Science and Medicine, Bond University, Robina, Queensland, Australia; Mater Dietetic and Foodservice, Mater Health, South Brisbane, Queensland, Australia.
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Bilek E, Gündel H. [Working in a team and mental health]. DER NERVENARZT 2023; 94:993-1000. [PMID: 37874383 DOI: 10.1007/s00115-023-01555-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/11/2023] [Indexed: 10/25/2023]
Abstract
Humans have always naturally lived in groups, which has a significant impact on the well-being and mental stability of the individual. Various physiological processes are coregulated via the closeness of other persons. About one third of our adulthood is spent at work where social relationships often play an important role, because we are typically working with other individuals in groups or a team. In these situations, mutual support and successful cooperation can develop, which promotes the mental and physical health of the employees of a company ("social capital"). From various perspectives it becomes obvious that the quality of relationships at the workplace is a key factor for the satisfaction and health of individual employees as well as for the cohesion, resilience and performance of the entire team. This is confirmed by empirical findings that still need to be expanded, especially with respect to the neurobiological associations of the cooperation in teams and individual health.
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Affiliation(s)
- Edda Bilek
- Abteilung für Psychiatrie and Psychotherapie, Zentralinstitut für Psychische Gesundheit, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Deutschland.
- Zentralinstitut für Psychische Gesundheit, Medizinische Fakultät Mannheim, Universität Heidelberg, Quadrat J5, 68159, Mannheim, Deutschland.
| | - Harald Gündel
- Abteilung für Psychosomatische Medizin, Universitätsklinikum Ulm, Ulm, Deutschland
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Zhao Y, Mbuthia D, Gathara D, Nzinga J, Tweheyo R, English M. 'We were treated like we are nobody': a mixed-methods study of medical doctors' internship experiences in Kenya and Uganda. BMJ Glob Health 2023; 8:e013398. [PMID: 37940204 PMCID: PMC10632815 DOI: 10.1136/bmjgh-2023-013398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 10/21/2023] [Indexed: 11/10/2023] Open
Abstract
OBJECTIVE Medical interns are an important workforce providing first-line healthcare services in hospitals. The internship year is important for doctors as they transition from theoretical learning with minimal hands-on work under supervision to clinical practice roles with considerable responsibility. However, this transition is considered stressful and commonly leads to burn-out due to challenging working conditions and an ongoing need for learning and assessment, which is worse in countries with resource constraints. In this study, we provide an overview of medical doctors' internship experiences in Kenya and Uganda. METHODS Using a convergent mixed-methods approach, we collected data from a survey of 854 medical interns and junior doctors and semistructured interviews with 54 junior doctors and 14 consultants. Data collection and analysis were guided by major themes identified from a previous global scoping review (well-being, educational environment and working environment and condition), using descriptive analysis and thematic analysis respectively for quantitative and qualitative data. FINDINGS Most medical interns are satisfied with their job but many reported suffering from stress, depression and burn-out, and working unreasonable hours due to staff shortages. They are also being affected by the challenging working environment characterised by a lack of adequate resources and a poor safety climate. Although the survey data suggested that most interns were satisfied with the supervision received, interviews revealed nuances where many interns faced challenging scenarios, for example, poor supervision, insufficient support due to consultants not being available or being 'treated like we are nobody'. CONCLUSION We highlight challenges experienced by Kenyan and Ugandan medical interns spanning from burn-out, stress, challenging working environment, inadequate support and poor quality of supervision. We recommend that regulators, educators and hospital administrators should improve the resource availability and capacity of internship hospitals, prioritise individual doctors' well-being and provide standardised supervision, support systems and conducive learning environments.
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Affiliation(s)
- Yingxi Zhao
- NDM Centre for Global Health Research, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | | | - David Gathara
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
- MARCH Centre, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Raymond Tweheyo
- Department of Health Policy Planning and Management, Makerere University School of Public Health, Kampala, Uganda
- Centre for Health Systems Research and Development (CHSRD), The University of Free State, Bloemfontein, South Africa
| | - Mike English
- NDM Centre for Global Health Research, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
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Malgaroli M, Tseng E, Hull TD, Jennings E, Choudhury TK, Simon NM. Association of Health Care Work With Anxiety and Depression During the COVID-19 Pandemic: Structural Topic Modeling Study. JMIR AI 2023; 2:e47223. [PMID: 38875560 PMCID: PMC11041488 DOI: 10.2196/47223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 06/28/2023] [Accepted: 09/07/2023] [Indexed: 06/16/2024]
Abstract
BACKGROUND Stressors for health care workers (HCWs) during the COVID-19 pandemic have been manifold, with high levels of depression and anxiety alongside gaps in care. Identifying the factors most tied to HCWs' psychological challenges is crucial to addressing HCWs' mental health needs effectively, now and for future large-scale events. OBJECTIVE In this study, we used natural language processing methods to examine deidentified psychotherapy transcripts from telemedicine treatment during the initial wave of COVID-19 in the United States. Psychotherapy was delivered by licensed therapists while HCWs were managing increased clinical demands and elevated hospitalization rates, in addition to population-level social distancing measures and infection risks. Our goal was to identify specific concerns emerging in treatment for HCWs and to compare differences with matched non-HCW patients from the general population. METHODS We conducted a case-control study with a sample of 820 HCWs and 820 non-HCW matched controls who received digitally delivered psychotherapy in 49 US states in the spring of 2020 during the first US wave of the COVID-19 pandemic. Depression was measured during the initial assessment using the Patient Health Questionnaire-9, and anxiety was measured using the General Anxiety Disorder-7 questionnaire. Structural topic models (STMs) were used to determine treatment topics from deidentified transcripts from the first 3 weeks of treatment. STM effect estimators were also used to examine topic prevalence in patients with moderate to severe anxiety and depression. RESULTS The median treatment enrollment date was April 15, 2020 (IQR March 31 to April 27, 2020) for HCWs and April 19, 2020 (IQR April 5 to April 27, 2020) for matched controls. STM analysis of deidentified transcripts identified 4 treatment topics centered on health care and 5 on mental health for HCWs. For controls, 3 STM topics on pandemic-related disruptions and 5 on mental health were identified. Several STM treatment topics were significantly associated with moderate to severe anxiety and depression, including working on the hospital unit (topic prevalence 0.035, 95% CI 0.022-0.048; P<.001), mood disturbances (prevalence 0.014, 95% CI 0.002-0.026; P=.03), and sleep disturbances (prevalence 0.016, 95% CI 0.002-0.030; P=.02). No significant associations emerged between pandemic-related topics and moderate to severe anxiety and depression for non-HCW controls. CONCLUSIONS The study provides large-scale quantitative evidence that during the initial wave of the COVID-19 pandemic, HCWs faced unique work-related challenges and stressors associated with anxiety and depression, which required dedicated treatment efforts. The study further demonstrates how natural language processing methods have the potential to surface clinically relevant markers of distress while preserving patient privacy.
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Affiliation(s)
- Matteo Malgaroli
- Department of Psychiatry, Grossman School of Medicine, New York University, New York, NY, United States
| | - Emily Tseng
- Ann S Bowers College of Computing and Information Science, Cornell University, Ithaca, NY, United States
| | - Thomas D Hull
- Research and Development, Talkspace, New York, NY, United States
| | - Emma Jennings
- Department of Psychiatry, Grossman School of Medicine, New York University, New York, NY, United States
| | - Tanzeem K Choudhury
- Ann S Bowers College of Computing and Information Science, Cornell University, Ithaca, NY, United States
| | - Naomi M Simon
- Department of Psychiatry, Grossman School of Medicine, New York University, New York, NY, United States
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Longo BA, Schmaltz SP, Williams SC, Shanafelt TD, Sinsky CA, Baker DW. Clinician Well-Being Assessment and Interventions in Joint Commission-Accredited Hospitals and Federally Qualified Health Centers. Jt Comm J Qual Patient Saf 2023; 49:511-520. [PMID: 37248109 DOI: 10.1016/j.jcjq.2023.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 04/24/2023] [Accepted: 04/24/2023] [Indexed: 05/31/2023]
Abstract
BACKGROUND Clinician burnout is a longstanding national problem threatening clinician health, patient outcomes, and the health care system. The aim of this study is to determine the proportion of hospitals and Federally Qualified Health Centers (FQHCs) that are measuring and taking system actions to promote clinician well-being. METHODS This cross-sectional study used an electronic questionnaire from April 21 to June 27, 2022, to assess the current state of organizational efforts to assess and address clinician well-being among a national sample of 1,982 Joint Commission-accredited hospitals and 256 accredited FQHCs. Outcomes of interest included the proportion of hospitals and FQHCs that assessed the prevalence of clinician burnout, established a chief wellness officer position, established a wellness committee, made clinician well-being an organizational performance metric, and implemented other activities/interventions that target clinician burnout. RESULTS A total of 481 (21.5%) organizations responded to the survey (hospital n = 396 [20.0%], FQHC n = 85 [33.2%]). Response rates did not differ by organization size, type, teaching status or urban vs. rural location. Approximately one third (34.0%) of the organizations in the sample conducted an organizational well-being assessment among clinicians at least once in the past three years. Although nearly half of responding organizations reported implementing some kind of intervention to address clinician burnout, only 28.7% of organizations had adopted a comprehensive approach to address clinician well-being/burnout. Only 10.1% of hospitals and 5.4% of FQHCs reported having an established senior leadership position responsible for assessing and promoting clinician well-being at the organization level, and less than half (29.3% FQHCs, 37.6% hospitals) of organizations reported having an established wellness committee. Among 500+ bed hospitals, 61.2% had surveyed, 75.6% had established a well-being committee, 78.0% had implemented interventions to promote clinician well-being, and 26.8% had established a chief wellness officer. CONCLUSION Although half of Joint Commission-accredited hospitals and FQHCs reported taking steps to improve clinician well-being, a minority are measuring clinician well-being, and few are taking a comprehensive approach or established a chief wellness officer position to advance clinician well-being as an organizational priority. Organizational clinician well-being improvement efforts are unlikely to be successful without measurement and leadership in place to drive change.
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Alidu L, Al-Khudairy L, Bharatan I, Bird P, Campbell N, Currie G, Hemming K, Jolly K, Kudrna L, Lilford R, Martin J, Quinn L, Schmidtke KA, Yates J. Protocol for a cluster randomised waitlist-controlled trial of a goal-based behaviour change intervention for employees in workplaces enrolled in health and wellbeing initiatives. PLoS One 2023; 18:e0282848. [PMID: 37769002 PMCID: PMC10538707 DOI: 10.1371/journal.pone.0282848] [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] [Received: 05/09/2022] [Accepted: 02/19/2023] [Indexed: 09/30/2023] Open
Abstract
Many workplaces offer health and wellbeing initiatives to their staff as recommended by international and national health organisations. Despite their potential, the influence of these initiatives on health behaviour appears limited and evaluations of their effectiveness are rare. In this research, we propose evaluating the effectiveness of an established behaviour change intervention in a new workplace context. The intervention, 'mental contrasting plus implementation intentions', supports staff in achieving their health and wellbeing goals by encouraging them to compare the future with the present and to develop a plan for overcoming anticipated obstacles. We conducted a systematic review that identified only three trials of this intervention in workplaces and all of them were conducted within healthcare organisations. Our research will be the first to evaluate the effectiveness of mental contrasting outside a solely healthcare context. We propose including staff from 60 organisations, 30 in the intervention and 30 in a waitlisted control group. The findings will contribute to a better understanding of how to empower and support staff to improve their health and wellbeing. Trial registration: ISRCTN17828539.
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Affiliation(s)
- Lailah Alidu
- Institute of Applied Health Research, University of Birmingham, Birmingham, England
| | - Lena Al-Khudairy
- Warwick Medical School, Health Sciences, University of Warwick, Coventry, England
| | - Ila Bharatan
- Warwick Business School, Entrepreneurship & Innovation Group, University of Warwick, Coventry, England
| | - Paul Bird
- West Midlands Academic Health Science Network, West Midlands, England
| | - Niyah Campbell
- Institute of Applied Health Research, University of Birmingham, Birmingham, England
| | - Graeme Currie
- Warwick Business School, Entrepreneurship & Innovation Group, University of Warwick, Coventry, England
| | - Karla Hemming
- Institute of Applied Health Research, University of Birmingham, Birmingham, England
| | - Kate Jolly
- Institute of Applied Health Research, University of Birmingham, Birmingham, England
| | - Laura Kudrna
- Institute of Applied Health Research, University of Birmingham, Birmingham, England
| | - Richard Lilford
- Institute of Applied Health Research, University of Birmingham, Birmingham, England
| | - James Martin
- Institute of Applied Health Research, University of Birmingham, Birmingham, England
| | - Laura Quinn
- Institute of Applied Health Research, University of Birmingham, Birmingham, England
| | - Kelly Ann Schmidtke
- University of Health Science and Pharmacy, St Louis, MO, United States of America
| | - James Yates
- Institute of Applied Health Research, University of Birmingham, Birmingham, England
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22
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Mira JJ. [Errores Honestos y Segundas Víctimas: Hacia una Cultura Justa para la Seguridad del Paciente]. J Healthc Qual Res 2023; 38:259-261. [PMID: 37657855 DOI: 10.1016/j.jhqr.2023.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 08/02/2023] [Indexed: 09/03/2023]
Affiliation(s)
- José Joaquín Mira
- Chair ERNST Consortium (funded by European Cooperation in Science and Technology, COST Action 19113). ATENEA Research Group Director, FISABIO. Professor at Miguel Hernández University of Elche.
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23
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Boskma A, van der Braak K, Ansari N, Hooft L, Wietasch G, Franx A, van der Laan M. Assessing the Well-Being at Work of Nurses and Doctors in Hospitals: Protocol for a Scoping Review of Monitoring Instruments. JMIR Res Protoc 2023; 12:e43692. [PMID: 37624632 PMCID: PMC10492165 DOI: 10.2196/43692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 04/03/2023] [Accepted: 04/27/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND Well-being at work can be defined as "creating an environment to promote a state of contentment which allows an employee to flourish and achieve their full potential for the benefit of themselves and their organisation." In the health care context, well-being at work of nurses and doctors is important for good patient care. Moreover, it is strongly associated with individual- and organization-level consequences. Relevant literature presents models and concepts of physical, mental, and social well-being. This study uses the 6 elements of the job demands-resources (JD-R) model to interpret well-being at work (job demands, job resources, personal resources, leadership, well-being, and outcomes) as part of a Netherlands Federation of University Medical Hospitals program to find ways to improve and monitor health care professionals' well-being in Dutch hospitals. Many instruments exist to measure well-being at work in terms of population, setting, and other aspects. An overview of available and eligible instruments assessing and monitoring the well-being of nurses and doctors is currently missing. OBJECTIVE We will perform a scoping review aiming to provide an overview of validated instruments assessing and monitoring the well-being of nurses and doctors at work. METHODS We will perform a search of published literature in the following databases: Medline, Embase, and CINAHL. Studies will be eligible if they (1) assess well-being at work of nurses and doctors employed in hospitals; (2) describe an evaluation of an instrument or review an instrument; (3) measure well-being at work or aspects of well-being at work according to the elements of the JD-R model, and (4) were published in English from 2011 onwards. Title/abstract screening according to the eligibility criteria will be followed by full-text screening. Data extraction of included studies will be conducted by 3 reviewers independently. Reviewers will use standardized data extraction forms that include study characteristics, sample characteristics, measurement instrument details, and psychometric properties. The analysis will be descriptive. When synthesizing the data, a distinction will be made between comprehensive instruments and common instruments. RESULTS This scoping review identifies instruments that have been developed and validated for monitoring the well-being of nurses and doctors at work. Studies were searched between September and December 2021 and screened between December 2021 and May 2022. A total of 739 studies were included. CONCLUSIONS Timely screening of well-being at work may be beneficial for individual health care workers, the organization, and patients. There is often a substantial gap and mismatch between employer perceptions of well-being and well-being interventions. It is important to develop and implement suitable interventions adapted to the needs of nurses and doctors and their health or other problems. Well-being screening should be timely to gain insight into these needs and problems. Moreover, to determine the effectiveness of well-being interventions, measurement is mandatory. The results will be critical for organizations to select a monitoring instrument that best fits the needs of employees and organizations. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/43692.
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Affiliation(s)
- Amber Boskma
- Department of Surgery, University Medical Center Groningen, Groningen, Netherlands
- Netherlands Federation of University Medical Centres, Utrecht, Netherlands
| | - Kim van der Braak
- Cochrane Netherlands, University Medical Center Utrecht, Utrecht, Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
| | - Neda Ansari
- Department of Surgery, University Medical Center Groningen, Groningen, Netherlands
| | - Lotty Hooft
- Cochrane Netherlands, University Medical Center Utrecht, Utrecht, Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
| | - Götz Wietasch
- Department of Anesthesiology, University Medical Center Groningen, Groningen, Netherlands
| | - Arie Franx
- Department of Obstetrics and Gynecology, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Maarten van der Laan
- Department of Surgery, University Medical Center Groningen, Groningen, Netherlands
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Villiger S, Hämmig O. Work Related Demands and Resources as Predictors of Well-being at Work Among Healthcare Workers in Switzerland. J Occup Environ Med 2023; 65:689-693. [PMID: 37193642 DOI: 10.1097/jom.0000000000002885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
OBJECTIVE The aim was to examine the effects of work-related demands and resources on well-being at work among employees in Swiss hospitals. METHODS Self-reported survey data from 1840 employees of six hospitals/clinics were analyzed using multivariate linear regression analyses (all professions included). RESULTS Of all demands, work-life imbalance had the strongest negative effect on well-being at work. The most relevant resource varied depending on the dimension of well-being: for job satisfaction it was good leadership, for work engagement job decision latitude and for satisfaction with relationships at work social support at work. The resources were more relevant for well-being at work than the demands. They also buffered against the negative effects of the demands. CONCLUSIONS To enhance well-being at work in hospitals, it is necessary to enable a good work-life balance and to strengthen work-related resources.
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Affiliation(s)
- Simone Villiger
- From the Epidemiology, Biostatistics and Prevention Institute, University of Zürich, Zürich, Switzerland
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25
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Peng K, Jiang J, Jiang N, An R, Zheng J, Yan S. Self-rated health and its related influencing factors among emergency department physicians: a national cross-sectional study. Front Public Health 2023; 11:1147403. [PMID: 37521980 PMCID: PMC10372430 DOI: 10.3389/fpubh.2023.1147403] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 04/10/2023] [Indexed: 08/01/2023] Open
Abstract
Background Protecting and improving the personal health of healthcare workers is critical to improving the efficiency and quality of care. To effectively meet the needs of the emergency service system, emergency physicians need to be in a good state of health. However, due to the special characteristics of work in the emergency department, emergency physicians have to face various psychosocial pressures, which may bring them physical and mental distress. Therefore, this study aims to explore the emergency physicians' self-rated health status and its related factors, to provide an empirical study for the improvement of emergency physicians' self-rated health status. Method A cross-sectional survey of emergency physicians was conducted in China between July and August 2018. The questionnaires contained items on demographic characteristics, behavioral lifestyle and job-related factors, as well as self-rated health. The generalized ordinal logistic model was used to identify related factors of emergency physicians' self-rated health status. Results Only 14.4% of Chinese emergency physicians considered themselves in good health status. Results showed that emergency physicians who never exercised (β = 0.76, p < 0.001) and exercised <2 times per week (β = 0.34, p < 0.001) were more likely to report poor health status. In addition, emergency physicians with good sleep quality (β = -3.84, p < 0.001), fewer night work shifts (β = -0.47, p < 0.001), less frequency of visiting patients (β = -0.33, p < 0.001), never suffered the workplace violence (β = -0.47, p < 0.001) and never perceived effort-reward imbalance (β = -0.68, p < 0.001) were more likely to report good self-rated health. Conclusion Chinese emergency physicians' self-rated health status was not optimistic. Self-rated health is associated with multiple domains of work-related factors and personal lifestyle. Feasible measures should be taken to improve the working environment of emergency physicians, develop acceptable shift schedules for employees, monitor and maintain the health status of emergency department physicians.
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Affiliation(s)
- Ke Peng
- Department of Finance, Southampton Business School, University of Southampton, Southampton, United Kingdom
| | - Jingjing Jiang
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Nan Jiang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Rongrong An
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jianwei Zheng
- Department of Biliary-Pancreatic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shijiao Yan
- School of Public Health, Hainan Medical University, Haikou, Hainan, China
- Key Laboratory of Emergency and Trauma of Ministry of Education, Hainan Medical University, Haikou, China
- Department of Emergency Medicine, Hunan Provincial Key Laboratory of Emergency and Critical Care Metabolomics, Hunan Provincial Institute of Emergency Medicine, Hunan Provincial People's Hospital/The First Affiliated Hospital, Hunan Normal University, Changsha, China
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26
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Cohen C, Pignata S, Bezak E, Tie M, Childs J. Workplace interventions to improve well-being and reduce burnout for nurses, physicians and allied healthcare professionals: a systematic review. BMJ Open 2023; 13:e071203. [PMID: 37385740 PMCID: PMC10314589 DOI: 10.1136/bmjopen-2022-071203] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 05/23/2023] [Indexed: 07/01/2023] Open
Abstract
There is a growing need for interventions to improve well-being in healthcare workers, particularly since the onset of COVID-19. OBJECTIVES To synthesise evidence since 2015 on the impact of interventions designed to address well-being and burnout in physicians, nurses and allied healthcare professionals. DESIGN Systematic literature review. DATA SOURCES Medline, Embase, Emcare, CINAHL, PsycInfo and Google Scholar were searched in May-October 2022. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Studies that primarily investigated burnout and/or well-being and reported quantifiable preintervention and postintervention outcomes using validated well-being measures were included. DATA EXTRACTION AND SYNTHESIS Full-text articles in English were independently screened and quality assessed by two researchers using the Medical Education Research Study Quality Instrument. Results were synthesised and presented in both quantitative and narrative formats. Meta-analysis was not possible due to variations in study designs and outcomes. RESULTS A total of 1663 articles were screened for eligibility, with 33 meeting inclusion criterium. Thirty studies used individually focused interventions, while three were organisationally focused. Thirty-one studies used secondary level interventions (managed stress in individuals) and two were primary level (eliminated stress causes). Mindfulness-based practices were adopted in 20 studies; the remainder used meditation, yoga and acupuncture. Other interventions promoted a positive mindset (gratitude journaling, choirs, coaching) while organisational interventions centred on workload reduction, job crafting and peer networks. Effective outcomes were reported in 29 studies, with significant improvements in well-being, work engagement, quality of life and resilience, and reductions in burnout, perceived stress, anxiety and depression. CONCLUSION The review found that interventions benefitted healthcare workers by increasing well-being, engagement and resilience, and reducing burnout. It is noted that the outcomes of numerous studies were impacted by design limitations that is, no control/waitlist control, and/or no post intervention follow-up. Suggestions are made for future research.
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Affiliation(s)
- Catherine Cohen
- Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Silvia Pignata
- STEM, University of South Australia, Adelaide, South Australia, Australia
| | - Eva Bezak
- Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Mark Tie
- Australian Radiology Clinics, Adelaide, South Australia, Australia
| | - Jessie Childs
- Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
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Hurtado DA, Greenspan SA, Valenzuela S, McGinnis W, Everson T, Lenhart A. Promise and Perils of Leader-Employee Check-ins in Reducing Emotional Exhaustion in Primary Care Clinics: Quasi-Experimental and Qualitative Evidence. Mayo Clin Proc 2023:S0025-6196(22)00708-X. [PMID: 37024355 DOI: 10.1016/j.mayocp.2022.12.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 11/29/2022] [Accepted: 12/01/2022] [Indexed: 04/08/2023]
Abstract
OBJECTIVE To analyze the role of short (<30 minutes) and frequent (quarterly) check-ins between clinic leaders and employees in reducing emotional exhaustion. METHODS Three interrelated studies were conducted: a 3-year repeated cross-sectional survey at 10 primary care clinics (n=505; we compared emotional exhaustion, perceived stress, and values alignment among employees of a clinic where check-ins were conducted vs 9 control clinics); interviews with leaders and employees (n=10) regarding the check-ins process and experiences; and interviews with leaders and employees (n=10) after replicating the check-ins at a new clinic. RESULTS Outcomes were similar at baseline. After a year, emotional exhaustion was lower at the check-ins compared with control clinics (standardized mean difference, d, -0.71 [P<.05]). After 2 years, emotional exhaustion remained lower at the check-ins clinic, but this difference was not significant. The check-ins were associated with an increment in values alignment (2018 vs 2017, d=0.59 [P<.05]; 2019 vs 2017, d=0.76 [P<.05]). There were no differences for perceived job stress. Interviews indicated that work-life challenges were discussed in the check-ins. However, employees need confidentiality and to feel safe to do so. The replication suggested that the check-ins are feasible to implement even amid turbulent times. CONCLUSION Periodic check-ins wherein leaders acknowledge and address work-life stressors might be a practical tactic to reduce emotional exhaustion in primary care clinics.
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Affiliation(s)
- David A Hurtado
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland; OHSU-PSU School of Public Health, Portland, OR.
| | - Samuel A Greenspan
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland
| | - Steele Valenzuela
- Department of Family Medicine, Oregon Health & Science University, Portland
| | - Wendy McGinnis
- Department of Internal Medicine and Geriatrics, Oregon Health & Science University, Portland
| | - Teresa Everson
- Department of Family Medicine, Oregon Health & Science University, Portland; OHSU-PSU School of Public Health, Portland, OR; Multnomah County Health Department, Portland, OR
| | - Abigail Lenhart
- Department of Internal Medicine and Geriatrics, Oregon Health & Science University, Portland
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28
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Gebhard D, Herz M. How to Address the Health of Home Care Workers: A Systematic Review of the Last Two Decades. J Appl Gerontol 2023; 42:689-703. [PMID: 36440715 PMCID: PMC9996797 DOI: 10.1177/07334648221141084] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Making home care a healthy workplace is a societal concern but research on specific interventions is still scarce. The aim of this systematic review was to provide an initial overview of interventions addressing home care workers' health. All (quasi-) experimental studies, presenting any intervention among home care employees, and reporting any outcome related to occupational health, safety, or well-being were included. PsycArticles, Medline, PubMed, and Web of Science were searched from January 2000 to February 2022. From 16,345 publications, 18 studies with 2432 participants were included and assessed with the Joanna Briggs Institute Critical Appraisal Tools. Organizational and training/educational approaches were found in five studies each, a behavioral approach in one, and seven studies presented a combined approach. Due to methodological limitations and the heterogeneity of interventions, the existing studies are insufficient to inform new programs, but emphasize the need for tailored approaches, integrated concepts, and participatory intervention development.
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Affiliation(s)
- Doris Gebhard
- Department of Sport and Health Sciences, 9184Technical University of Munich, Germany
| | - Michael Herz
- Department of Sport and Health Sciences, 9184Technical University of Munich, Germany
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29
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Pradère P, Degoulet C, d'Ussel M, Credico C. ["Wellness Bubbles" for caregivers, a way to improve the quality of life at work]. SOINS; LA REVUE DE REFERENCE INFIRMIERE 2023; 68:11-15. [PMID: 37127382 DOI: 10.1016/j.soin.2023.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Improving the well-being at work of caregivers is a major challenge for our healthcare system. Both global and local solutions must be proposed. At the Marie-Lannelongue hospital, located in the Paris region, a structure dedicated to the well-being of caregivers at work, the "Bubble", has been set up. How does it work and what are its beneficial effects? How have the professionals received it? Is it an example to follow? These are some of the questions that a survey has enabled us to answer.
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Affiliation(s)
- Pauline Pradère
- Service de pneumologie Hôpital Marie-Lannelongue, Groupe hospitalier Paris Saint-Joseph et université Paris Saclay, 133 avenue de la Résistance, 92350 Le Plessis-Robinson, France.
| | - Cécile Degoulet
- Cellule douleur, Hôpital Marie-Lannelongue, Groupe hospitalier Paris Saint-Joseph et université Paris Saclay, 133 avenue de la Résistance, 92350 Le Plessis-Robinson, France
| | - Marguerite d'Ussel
- Consultation douleur chronique, Hôpital Saint-Joseph, Groupe hospitalier Paris Saint-Joseph et université Paris Saclay, 185 rue Raymond-Losserand, 75014 Paris, France
| | - Carmen Credico
- Service d'anesthésie, Hôpital Marie-Lannelongue, Groupe hospitalier Paris Saint-Joseph et université Paris Saclay, 133 avenue de la Résistance, 92350 Le Plessis-Robinson, France
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30
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Manley K, Saunders K, Wilkinson D, Faruqui R, Sakel M. Co-creating system-wide improvement for people with traumatic brain injury across one integrated care system in the United Kingdom to initiate a transformation journey through co-production. Health Expect 2023; 26:869-881. [PMID: 36715266 PMCID: PMC10010072 DOI: 10.1111/hex.13712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 01/05/2023] [Accepted: 01/11/2023] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND AND OBJECTIVE There is a need for better integration of services across communities and sectors for people living with traumatic brain injury (TBI) to meet their complex needs. Building on insights gained from earlier pilot work, here we report the outcomes of a participatory workshop that sought to better understand the challenges, barriers and opportunities that currently exist within the care pathway for survivors of TBI. METHODS A diverse range of stakeholders from the acute and rehabilitation care pathway and the health and social care system were invited to participate in a 3-h workshop. The participants worked in four mixed subgroups using practice development methodology, which promotes person-centred, inclusive and participatory action. RESULTS Thematic analysis identified shared purposes and values that were used to produce a detailed implementation and impact framework for application at both the level of the care interface and the overarching integrated care system. A variety of enablers were identified that related to collective values and behaviours, case management, team leadership and integrated team working, workforce capability, evidence-based practice and resourcing. The clinical, economic, cultural and social outcomes associated with these enablers were also identified, and included patient safety, independence and well-being, reduced waiting times, re-admission rates, staff retention and professional development. CONCLUSION The co-produced recommendations made within the implementation and impact framework described here provide a means by which the culture and delivery of health and social care services can be better tailored to meet the needs of people living with TBI. We believe that the recommendations will help shape the formation of new services as well as the development of existing ones. PATIENT OR PUBLIC CONTRIBUTION Patient and public involvement have been established over a 10-year history of relationship building through a joint forum and events involving three charities representing people with TBI, carers, family members, clinicians, service users, researchers and commissioners, culminating in a politically supported event that identified concerns about the needs of people following TBI. These relationships formed the foundation for the interactive workshop, the focus of this publication.
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Affiliation(s)
- Kim Manley
- Practice Development and Co Director ImpACT Research Group, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK.,England Centre for Practice Development, Faculty of Medicine, Health & Social Care, Canterbury Christ Church University, Canterbury, Kent, UK
| | - Karen Saunders
- Division for the Study of Law, Society and Social Justice, School of Social Policy, Sociology and Social Research, University of Kent, Canterbury, UK.,Department of Physiotherapy and Rehabilitation, Jashore University of Science and Technology, Jashore, Bangladesh
| | - David Wilkinson
- Director of the Division of Human and Social Sciences, School of Psychology, University of Kent, Canterbury, UK
| | - Rafey Faruqui
- Department of Psychiatry, Kent and Medway NHS and Social Care Partnership Trust, Maidstone, UK.,Division for the Study of Law, Society and Social Justice, Centre for Health Services Studies, University of Kent, Canterbury, UK
| | - Mohamed Sakel
- Department of Physiotherapy and Rehabilitation, Jashore University of Science and Technology, Jashore, Bangladesh.,Director of Neuro-Rehabilitation Service, East Kent Hospitals University NHS Foundation Trust, Canterbury, UK
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Bleier H, Lützerath J, Schaller A. Organizational facilitators and barriers for participation in workplace health promotion in healthcare: A qualitative interview study among nurses. Front Psychol 2023; 14:1101235. [PMID: 36936007 PMCID: PMC10017985 DOI: 10.3389/fpsyg.2023.1101235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 02/01/2023] [Indexed: 03/06/2023] Open
Abstract
Background There is evidence for the positive effects of workplace health promotion (WHP) for nurses. Although this highly stressed target group also actively desires WHP, the number of participants is low. Individual reasons play a role in the decision to engage in WHP activities, yet it is interesting to consider which organizational factors a company could address to improve participation. In this regard, the question arises of what organizational factors facilitate participation in WHP activities from the perspective of nurses in inpatient care facility (ICF), outpatient care service (OCS), and acute care hospitals (ACH). Method Sixteen semi-structured interviews were conducted in different care settings between May and September 2021. Questions about everyday working life, WHP activities, and organizational framework conditions were asked. Result The results show that there is a wide range of influencing factors at the organizational level, some overall settings, and others setting-specific. High workload and the fit of WHP activities with shift times were particularly inhibiting overall settings. A negative association with the employer worked as a barrier in ICF and ACH. Conclusion When implementing WHP activities, it can be useful to consider organizational facilitators and barriers to promote sustainable and attractive WHP activities and higher participation rates in the different settings of nursing.
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Affiliation(s)
- Hannah Bleier
- Working Group Physical Activity-Related Prevention Research, Institute of Movement Therapy and Movement-oriented Prevention and Rehabilitation, German Sport University Cologne, Cologne, Germany
| | - Jasmin Lützerath
- Working Group Physical Activity-Related Prevention Research, Institute of Movement Therapy and Movement-oriented Prevention and Rehabilitation, German Sport University Cologne, Cologne, Germany
- Institute for Workplace Health Promotion, Cologne, Germany
| | - Andrea Schaller
- Working Group Physical Activity-Related Prevention Research, Institute of Movement Therapy and Movement-oriented Prevention and Rehabilitation, German Sport University Cologne, Cologne, Germany
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Clarkson C, Scott HR, Hegarty S, Souliou E, Bhundia R, Gnanapragasam S, Docherty MJ, Raine R, Stevelink SA, Greenberg N, Hotopf M, Wessely S, Madan I, Rafferty AM, Lamb D. 'You get looked at like you're failing': A reflexive thematic analysis of experiences of mental health and wellbeing support for NHS staff. J Health Psychol 2023:13591053221140255. [PMID: 36597919 PMCID: PMC10387714 DOI: 10.1177/13591053221140255] [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: 01/05/2023] Open
Abstract
Staff in the National Health Service (NHS) are under considerable strain, exacerbated by the COVID-19 pandemic; whilst NHS Trusts provide a variety of health and wellbeing support services, there has been little research investigating staff perceptions of these services. We interviewed 48 healthcare workers from 18 NHS Trusts in England about their experiences of workplace health and wellbeing support during the pandemic. Reflexive thematic analysis identified that perceived stigma around help-seeking, and staffing shortages due to wider socio-political contexts such as austerity, were barriers to using support services. Visible, caring leadership at all levels (CEO to line managers), peer support, easily accessible services, and clear communication about support offers were enablers. Our evidence suggests Trusts should have active strategies to improve help-seeking, such as manager training and peer support facilitated by building in time for this during working hours, but this will require long-term strategic planning to address workforce shortages.
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The Future of Health and Science: Envisioning an Intelligent HealthScience System. Pharmaceut Med 2023; 37:1-6. [PMID: 36456682 PMCID: PMC9715402 DOI: 10.1007/s40290-022-00455-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2022] [Indexed: 12/03/2022]
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Lovell T, Mitchell M, Powell M, Cummins B, Tonge A, Metcalf E, Ownsworth T, O'Neill K, Morris L, Ranse K. Fostering positive emotions, psychological well-being, and productive relationships in the intensive care unit: A before-and-after study. Aust Crit Care 2023; 36:28-34. [PMID: 36114097 DOI: 10.1016/j.aucc.2022.08.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 07/25/2022] [Accepted: 08/04/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Intensive care units (ICUs) are emotionally demanding workplaces. Exposure to stress can negatively impact ICU staff members' emotional resilience, health, and capacity to provide care. Despite recognition of the benefits of promoting "healthy workplaces", there are limited interventional studies aimed at improving the well-being of ICU staff. AIM The aim of this study was to assess the effectiveness of a multifaceted intervention for improving well-being of staff working in a tertiary ICU. METHODS A before-and-after interventional study was conducted over a 2-year period, between 2019 and 2021. Interventions included social activities, fitness, nutrition, and emotional support. An electronic version of the PERMA-Profiler questionnaire was used to assess the well-being of a convenience sample of ICU staff before (n = 96) and after (n = 137) the intervention. Ten focus groups (each involving 12-18 nurses) were held to explore nurses' perceptions of the intervention's effectiveness. RESULTS After the intervention, a significantly greater proportion of participants described their work week as draining (32% vs 19%, χ2 = 4.4 df + 1, P = 0.03) and at least a bit harder than normal (38% vs 22%, χ2 = 6.4 df + 1, p = 0.01) compared to baseline surveys. However, well-being scores after the intervention (mean = 6.95, standard deviation = 1.28) were not statistically different (p = 0.68) from baseline scores (mean = 7.02, standard deviation = 1.29). Analysis of focus groups data revealed three key categories: boosting morale and fostering togetherness, supporting staff, and barriers to well-being. CONCLUSIONS After the intervention, there was a preserved level of well-being from baseline despite a statistically significant increase in staff reporting the work week as draining and at least a little bit harder than normal. These findings must be considered in light of the COVID-19 pandemic, which started after baseline data collection and continues to impact the community, including staff workload and pressures in intensive care. The study findings may inform strategies for improving ICU staff members' well-being.
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Affiliation(s)
- Tania Lovell
- Intensive Care Unit, Princess Alexandra Hospital, Metro South Hospital Health Service, Queensland, Australia.
| | - Marion Mitchell
- Intensive Care Unit, Princess Alexandra Hospital, Metro South Hospital Health Service, Queensland, Australia; School of Nursing & Midwifery, Griffith University, Queensland, Australia; Patient Centred Health Services, Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Madeleine Powell
- School of Population Health, University of New South Wales, NSW, Australia; National Drug and Alcohol Research Centre, University of New South Wales, NSW, Australia
| | - Braddon Cummins
- Intensive Care Unit, Princess Alexandra Hospital, Metro South Hospital Health Service, Queensland, Australia
| | - Angela Tonge
- Intensive Care Unit, Princess Alexandra Hospital, Metro South Hospital Health Service, Queensland, Australia
| | - Emma Metcalf
- Intensive Care Unit, Princess Alexandra Hospital, Metro South Hospital Health Service, Queensland, Australia
| | - Tamara Ownsworth
- School of Applied Psychology and The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Queensland, Australia
| | - Kylie O'Neill
- Intensive Care Unit, Princess Alexandra Hospital, Metro South Hospital Health Service, Queensland, Australia
| | - Lynne Morris
- Intensive Care Unit, Princess Alexandra Hospital, Metro South Hospital Health Service, Queensland, Australia
| | - Kristen Ranse
- Intensive Care Unit, Princess Alexandra Hospital, Metro South Hospital Health Service, Queensland, Australia; School of Nursing & Midwifery, Griffith University, Queensland, Australia; Patient Centred Health Services, Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
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Kasdovasilis P, Cook N, Montasem A. UK healthcare support workers and the COVID-19 pandemic: an explorative analysis of lived experiences during the COVID-19 pandemic. Home Health Care Serv Q 2023; 42:14-39. [PMID: 36124970 DOI: 10.1080/01621424.2022.2123757] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Support workers are an underrepresented profession that receives less attention with a high degree of responsibilities. The aim of this study was to explore the lived experiences of healthcare support workers within the care sector during the COVID-19 pandemic. This is a qualitative semi-structured interview study using an interpretative phenomenology (IP) framework. Fifteen (15) support workers were interviewed while all COVID-19 restrictions from the government were still in place. We identified five main themes: (1) challenging experiences; (2) coping mechanisms; (3) emotions and behaviors arising from the COVID-19 pandemic; (4) external interest on support worker's health; (5) take-home message from the COVID-19 pandemic. The organization selected for the research is a good representative of how care organizations operate within the UK both in terms of policies and staff selection.
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Affiliation(s)
| | - Neil Cook
- School of Dentistry, University of Central Lancashire, Preston, UK
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Lucas D, Brient S, Le Grand T, Dewitte JD, Loddé B, Pougnet R, Eveillard BM. Evolution of Global Health and Psychosocial Factors among Hospital Workers during First Year of SARS-CoV-2 Pandemic: A Longitudinal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15260. [PMID: 36429989 PMCID: PMC9696107 DOI: 10.3390/ijerph192215260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 11/15/2022] [Accepted: 11/16/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVES To assess trends in overall health (mental and physical) and psychosocial factors in a population of workers (both healthcare and non-healthcare) in a French teaching hospital during the first year of the SARS-CoV-2 pandemic in France. METHODS A validated version of the SATIN questionnaire with adapted scoring was used to collect data on health and impacts of work stressors. This questionnaire was sent to all workers at the hospital in T1 (July-August 2020) and T2 (July-August 2021) and self-administered online. RESULTS A total of 1313 participants who completed the questionnaire at T1 and 826 at T2 were included. Overall, 568 workers completed the questionnaire at T1 and T2. We found a deterioration in overall health and especially stress and mental health in hospital workers and healthcare workers (HCWs), with a negative impact of the workload and work environment. CONCLUSIONS The SARS-CoV-2 pandemic impacted negatively the mental health, work stressors, and psychosocial perceptions of both HCW and non-HCW in a French hospital. The study confirms that hospital workers are an important target.
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Affiliation(s)
- David Lucas
- ORPHY Laboratory, University Brest, F-29200 Brest, France
- Occupational Health Service, Teaching Hospital, F-29200 Brest, France
- Laboratoire d’Etude et de Recherche en Sociologie (EA 3149), Université de Brest-Bretagne Occidentale, F-29200 Brest, France
| | - Sandrine Brient
- Occupational Health Service, Teaching Hospital, F-29200 Brest, France
| | - Tanguy Le Grand
- Occupational Health Service, Teaching Hospital, F-29200 Brest, France
| | - Jean-Dominique Dewitte
- Occupational Health Service, Teaching Hospital, F-29200 Brest, France
- Laboratoire d’Etude et de Recherche en Sociologie (EA 3149), Université de Brest-Bretagne Occidentale, F-29200 Brest, France
| | - Brice Loddé
- ORPHY Laboratory, University Brest, F-29200 Brest, France
- Occupational Health Service, Teaching Hospital, F-29200 Brest, France
| | - Richard Pougnet
- Occupational Health Service, Teaching Hospital, F-29200 Brest, France
- Laboratoire d’Etude et de Recherche en Sociologie (EA 3149), Université de Brest-Bretagne Occidentale, F-29200 Brest, France
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Zeinolabedini M, Heidarnia A, Shakerinejad G, Motlagh ME. Perceived job demands: a qualitative study of workplace stress in the Iranian healthcare workers (HCWs). BMJ Open 2022; 12:e061925. [PMID: 36385035 PMCID: PMC9670948 DOI: 10.1136/bmjopen-2022-061925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES Work-related stress is a common risk factor among healthcare workers (HCWs). In Iran, the healthcare system has undergone extensive changes to develop services. Organisational change has led to the creation of new working conditions for HCWs. The purpose of this study is to identify job demands that health workers perceive as stressors. DESIGN As a qualitative study, semistructured interviews, a focus group, and related data were analysed both inductively and deductively with reference to the job demand component based on the job demands-resources model and MAXQDA. SETTING This investigation was conducted in 18 primary healthcare centres in Qazvin, Iran. PARTICIPANT Twenty-one female HCWs with at least 6 months of work experience and an average age of 34.4 years. RESULTS The participants identified six key elements as the stressful job demands including organisation's supervisory function, role characteristics, workload, job insecurity, client service challenges and perceived job content. CONCLUSIONS After organisational changes and development, HCWs were faced with role changes and increased workload. In addition, organisational supervision in terms of quantity and quality and lack of job security intensified the pressures. These factors led to the high level of stress among employees who dealt with people and those who perceived their job content as unfavourable. Perhaps teaching stress control skills and organisational support interventions can be useful to reduce and control stress among HCWs.
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Affiliation(s)
- Masoume Zeinolabedini
- Department of Health Education and Health Promotion, Faculty of Medical Sciences, Tarbiat Modares University (TMU), Tehran, Iran (the Islamic Republic of)
| | - Alireza Heidarnia
- Department of Health Education and Health Promotion, Faculty of Medical Sciences, Tarbiat Modares University (TMU), Tehran, Iran (the Islamic Republic of)
| | - Ghodratollah Shakerinejad
- Health Education Research Department, Academic Center for Education, Culture and Research (ACECR)-Khuzestan, Ahvaz, Iran (the Islamic Republic of)
| | - Mohammad Esmaeil Motlagh
- Department of Pediatrics, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran (the Islamic Republic of)
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Cable M, Watts T, Reagon C, Kelly D. Experiences of early‐career nurses working in specialist adolescent/young adult cancer units: A narrative inquiry. J Adv Nurs 2022. [DOI: 10.1111/jan.15488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 10/18/2022] [Accepted: 10/19/2022] [Indexed: 11/14/2022]
Affiliation(s)
- Maria Cable
- School of Healthcare Sciences Cardiff University Cardiff UK
| | - Tessa Watts
- School of Healthcare Sciences Cardiff University Cardiff UK
| | - Carly Reagon
- School of Healthcare Sciences Cardiff University Cardiff UK
| | - Daniel Kelly
- School of Healthcare Sciences Cardiff University Cardiff UK
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Oleksa-Marewska K, Tokar J. Facing the Post-Pandemic Challenges: The Role of Leadership Effectiveness in Shaping the Affective Well-Being of Healthcare Providers Working in a Hybrid Work Mode. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192114388. [PMID: 36361264 PMCID: PMC9655828 DOI: 10.3390/ijerph192114388] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 10/27/2022] [Accepted: 11/02/2022] [Indexed: 06/09/2023]
Abstract
The COVID-19 pandemic has brought new challenges to the medical industry, including hybrid work, in which specialists can perform some of their duties remotely, in addition to physical contact with patients and their teams. Hybrid work provides opportunities, but also generates difficulties (e.g., accurate long-distance diagnosis); therefore, there is a need to ensure the well-being of healthcare workers, especially in the context of leadership strategies. As there is little research on leadership practices in remote and hybrid medical worker management, this study analyses the relationship between certain behavioural strategies and competencies of leaders and the affective well-being of hybrid employees. The research was conducted among a group of employees (N = 135) from seven countries who provide healthcare in a hybrid model. The correlations between the variables showed the statistical significance of all leadership strategies introduced into the model and focused on building involvement (employee empowerment and team orientation), creating a shared vision, defining clear goals and strategies, promoting adaptability (change management, promotion of organisational learning and patient focus), managing consistency through shared values, agreement and effective coordination, as well as competencies such as communicativeness, credibility, self-development and digital readiness. Despite the significance of all the relationships, the linear regression showed that the variability of affective well-being was explained mainly by the adaptability leadership strategy. The results of the study expand the knowledge on the competencies of healthcare leaders, and shed new light on the management of medical employees performing remote and hybrid work. Because such research into well-being has not been published to date, the analysis begins an important discussion on redefining leadership in the healthcare sector, taking into account the digital transformation.
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Affiliation(s)
| | - Joanna Tokar
- Institute of Management and Quality Sciences, Humanitas University in Sosnowiec, 41-200 Sosnowiec, Poland
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Villarreal-Zegarra D, Lázaro-Illatopa WI, Castillo-Blanco R, Cabieses B, Blukacz A, Bellido-Boza L, Mezones-Holguin E. Relationship between job satisfaction, burnout syndrome and depressive symptoms in physicians: a cross-sectional study based on the employment demand-control model using structural equation modelling. BMJ Open 2022; 12:e057888. [PMID: 36261241 PMCID: PMC9582405 DOI: 10.1136/bmjopen-2021-057888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To evaluate the relationship between job satisfaction, burnout syndrome (BS) and depressive symptoms (DS) based on the job demand-control framework model on a nationally representative sample of physicians working in the Peruvian Health System. SETTING We carried out a secondary data analysis of the National Survey of Satisfaction of Users in Health 2016 in Peru. PRIMARY AND SECONDARY OUTCOME MEASURES Our study assessed the development of the predictive model and had two parts: (1) to evaluate the association among the variables based on the job demand-control framework, and (2) to assess the proposed model acceptability using the structural equation modelling approach to estimate goodness-of-fit indices (GOFIs). PARTICIPANTS We excluded physicians older than 65 years, who did not report income levels or who had missing data related to the workplace. Thus, we analysed 2100 participants. RESULTS The prevalence of DS was 3.3%. Physicians' work-related illnesses had more probability to result in DS (prevalence ratio=2.23). DS was moderately related to BS dimensions (r>0.50); nevertheless, the relationships between DS and the three job satisfaction scales were weak (r<0.30). The first predictive model based on the variables, DS, BS and job satisfaction, had low GOFIs (comparative fit index (CFI)=0.883; root mean square error of approximation (RMSEA)=0.125). In a second evaluation, we used models with correlated errors obtaining optimal GOFIs (CFI=0.974; RMSEA=0.060). CONCLUSIONS Our study identified a stable model to explain the relationship between job satisfaction, BS and DS among physicians. The results are consistent with the job demand-control framework. They could be applied to decision-making in occupational contexts in Latin American low/middle-income countries.
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Affiliation(s)
- David Villarreal-Zegarra
- Escuela de Medicina, Universidad César Vallejo, Trujillo, Peru
- Instituto Peruano de Orientación Psicológica, Lima, Lima, Peru
| | | | - Ronald Castillo-Blanco
- Departamento de Gestión del Aprendizaje y Aseguramiento de la Calidad, Universidad del Pacífico, Lima, Peru
| | - Baltica Cabieses
- Facultad de Medicina Clínica Alemana, Instituto de Ciencias e Innovación en Medicina (ICIM), Universidad del Desarrollo, Santiago de Chile, Chile
| | - Alice Blukacz
- Facultad de Medicina Clínica Alemana, Instituto de Ciencias e Innovación en Medicina (ICIM), Universidad del Desarrollo, Santiago de Chile, Chile
| | - Luciana Bellido-Boza
- Facultad de Ciencias de la Salud, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | - Edward Mezones-Holguin
- Centro de Excelencia en Investigaciones Económicas y Sociales en Salud, Universidad San Ignacio de Loyola, Lima, Peru
- Epi-gnosis Solutions, Piura, Peru
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Spendelow J. Improving wellbeing for veterinary professionals in chronically stressful workplaces. Vet Rec 2022; 191:337-339. [PMID: 36269241 DOI: 10.1002/vetr.2365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
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Hobby J, Crowley J, Barnes K, Mitchell L, Parkinson J, Ball L. Effectiveness of interventions to improve health behaviours of health professionals: a systematic review. BMJ Open 2022; 12:e058955. [PMID: 36167392 PMCID: PMC9516219 DOI: 10.1136/bmjopen-2021-058955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE To evaluate the effectiveness of interventions designed to improve the health behaviours of health professionals. DESIGN Systematic review. DATA SOURCES Database searches: Medline, Cochrane library, Embase and CINAHL. REVIEW METHODS This systematic review used Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to compare randomised controlled trials of health professionals, published between 2010 and 2021, which aimed to improve at least one health behaviour such as physical activity, diet, smoking status, mental health and stress. Two independent reviewers screened articles, extracted data and assessed quality of studies and reporting. The quality of articles was assessed using the Effective Public Health Practice Project quality assessment tool and the completeness of intervention reporting was assessed. OUTCOME MEASURES The outcome assessed was change in behaviour between intervention and control groups from baseline to follow-up. RESULTS Nine studies met the eligibility criteria, totalling 1107 participants. Health behaviours targeted were mental health and stress, physical activity, and smoking cessation, physical activity and nutrition. Six interventions observed significant improvements in the health behaviour in the intervention compared with control groups. Seven of the studies selected in person workshops as the mode of intervention delivery. The quality of the included studies was high with 80% (7/9) graded as moderate or strong. CONCLUSIONS Although high heterogeneity was found between interventions and outcomes, promising progress has occurred across a variety of health behaviours. Improving reporting and use of theories and models may improve effectiveness and evaluation of interventions. Further investigation is needed to recommend effective strategies. PROSPERO REGISTRATION NUMBER CRD42021238684.
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Affiliation(s)
- Julie Hobby
- Griffith University Menzies Health Institute Queensland, Gold Coast, Queensland, Australia
- School of Health Sciences and Social Work, Griffith University-Gold Coast Campus, Gold Coast, Queensland, Australia
| | - Jennifer Crowley
- Department of Nutrition & Dietetics, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, Grafton, New Zealand
| | - Katelyn Barnes
- Griffith University Menzies Health Institute Queensland, Gold Coast, Queensland, Australia
| | - Lana Mitchell
- Griffith University Menzies Health Institute Queensland, Gold Coast, Queensland, Australia
- School of Health Sciences and Social Work, Griffith University-Gold Coast Campus, Gold Coast, Queensland, Australia
| | - Joy Parkinson
- Griffith University Menzies Health Institute Queensland, Gold Coast, Queensland, Australia
- Department of Marketing, Griffith University Griffith Business School, Nathan, Queensland, Australia
| | - Lauren Ball
- Griffith University Menzies Health Institute Queensland, Gold Coast, Queensland, Australia
- School of Health Sciences and Social Work, Griffith University-Gold Coast Campus, Gold Coast, Queensland, Australia
- The University of Queensland, Brisbane, Queensland, Australia
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Thusini S, Milenova M, Nahabedian N, Grey B, Soukup T, Henderson C. Identifying and understanding benefits associated with return-on-investment from large-scale healthcare Quality Improvement programmes: an integrative systematic literature review. BMC Health Serv Res 2022; 22:1083. [PMID: 36002852 PMCID: PMC9404657 DOI: 10.1186/s12913-022-08171-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 06/08/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND We previously developed a Quality Improvement (QI) Return-on-Investment (ROI) conceptual framework for large-scale healthcare QI programmes. We defined ROI as any monetary or non-monetary value or benefit derived from QI. We called the framework the QI-ROI conceptual framework. The current study describes the different categories of benefits covered by this framework and explores the relationships between these benefits. METHODS We searched Medline, Embase, Global health, PsycInfo, EconLit, NHS EED, Web of Science, Google Scholar, organisational journals, and citations, using ROI or returns-on-investment concepts (e.g., cost-benefit, cost-effectiveness, value) combined with healthcare and QI. Our analysis was informed by Complexity Theory in view of the complexity of large QI programmes. We used Framework analysis to analyse the data using a preliminary ROI conceptual framework that was based on organisational obligations towards its stakeholders. Included articles discussed at least three organisational benefits towards these obligations, with at least one financial or patient benefit. We synthesized the different QI benefits discussed. RESULTS We retrieved 10 428 articles. One hundred and two (102) articles were selected for full text screening. Of these 34 were excluded and 68 included. Included articles were QI economic, effectiveness, process, and impact evaluations as well as conceptual literature. Based on these literatures, we reviewed and updated our QI-ROI conceptual framework from our first study. Our QI-ROI conceptual framework consists of four categories: 1) organisational performance, 2) organisational development, 3) external outcomes, and 4) unintended outcomes (positive and negative). We found that QI benefits are interlinked, and that ROI in large-scale QI is not merely an end-outcome; there are earlier benefits that matter to organisations that contribute to overall ROI. Organisations also found positive aspects of negative unintended consequences, such as learning from failed QI. DISCUSSION AND CONCLUSION Our analysis indicated that the QI-ROI conceptual framework is made-up of multi-faceted and interconnected benefits from large-scale QI programmes. One or more of these may be desirable depending on each organisation's goals and objectives, as well as stage of development. As such, it is possible for organisations to deduce incremental benefits or returns-on-investments throughout a programme lifecycle that are relevant and legitimate.
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Affiliation(s)
| | | | | | - Barbara Grey
- South London and Maudsley NHS Foundation Trust, London, UK
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Experiences, Perceptions, and Coping Patterns of Emergency Department Nurses with Occupational Stressors in Saudi Arabian Hospitals: Mixed-Method Study. Healthcare (Basel) 2022; 10:healthcare10081504. [PMID: 36011161 PMCID: PMC9408710 DOI: 10.3390/healthcare10081504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 08/05/2022] [Accepted: 08/07/2022] [Indexed: 11/24/2022] Open
Abstract
Extended working hours, a complicated workplace environment, and engagement in numerous physical and psychological stressors have been associated with the stressful nature of the nursing profession. Only a few studies have provided some insight into workplace stress and coping strategies adopted by nurses in Saudi Arabia and neighboring countries. Therefore, this study utilized a mixed-method design to explore the numerous factors that lead to stress among emergency nurses, their experience and perception of stress, and the coping mechanisms they find useful. A survey containing four domains and 86 items was adapted, pilot tested, and validated. The quantitative phase recruited 296 nurses who returned completed questionnaires, and then 21 nurses were interviewed for the qualitative phase. In total, 89.5% (n = 265) of the participants were female, 51% (n = 151) were aged 20–29 years, 83% (n = 246) were non-Saudi nationals, 49% (n = 145) were married, and 82% (n = 245) had a bachelor’s degree. The most common causes of occupational stress were work overload, personnel shortages, and inadequate pay. The qualitative phase data revealed five primary themes, including increased workload, rising living costs despite equal compensation, and staff shortages as main stressors. In addition, the study found that praying and spending quality time with friends are the primary coping techniques among nurses. The study results contribute to a better understanding of nurses’ working conditions in the emergency department. Additionally, they may contribute to the development of policies and practice reforms to improve Saudi nurses’ well-being, health, and overall work experience.
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Bella VD, Fiorini J, Gioiello G, Zaghini F, Sili A. Towards a New Conceptual Model for Nurses' Organizational Well-being: An Integrative Review. J Nurs Manag 2022; 30:2833-2844. [PMID: 35943839 DOI: 10.1111/jonm.13750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 08/03/2022] [Indexed: 11/28/2022]
Abstract
AIM To summarize conceptual models of nurses' organizational well-being and identify common variables among them. BACKGROUND To understand how the characteristics of an organizational context affect workers' well-being, numerous conceptual models have been developed. Such models have been conceptualized in various working contexts other than healthcare, and not always considering the particularities of the profession of nursing. Evaluation This integrative review was conducted using the resources of PubMed, CINAHL, Scopus and the Cochrane Library, up until March 2022, and by applying a modified version of Cooper's five-stage methodology, in accordance with the PRISMA guideline. Key issues Six reference models focused on different organizational variables and used to evaluate nurses' organizational well-being were identified: the Effort-Reward Imbalance (ERI) model, the Job Demands-Resources (JD-R) model, the Utriainen et al. model, the Demands-Resources and Individual-Effects (DRIVE) model, the Well-Being, Health-Promoting Lifestyle and Work Environment Satisfaction (WHS) model, and the Nursing Worklife Model (NWM). CONCLUSION There is no consensus in the nursing literature on an all-encompassing conceptual model of nurses' organizational well-being, or on working environment characteristics to be studied or monitored for defining nurses' well-being. IMPLICATIONS FOR NURSING MANAGEMENT Coming to a consensus on the definition of a nurses' organizational well-being model and its variables would facilitate nursing management in monitoring and intervening on nurses' work-life quality, and in improving nursing performance and caring outcomes.
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Affiliation(s)
- Valerio Della Bella
- MSN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Jacopo Fiorini
- Research Nurse, Nursing Department, Tor Vergata University Hospital, Rome, Italy
| | - Giovanni Gioiello
- MSN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Francesco Zaghini
- Research Nurse, Nursing Department, Tor Vergata University Hospital, Rome, Italy
| | - Alessandro Sili
- Director of Nursing Department, Tor Vergata University Hospital, Rome, Italy
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Cheng KH, Wu NK, Chen CT, Hsu CY, Lin YA, Luo JJC, Lee LA, Chuang HH. Effectiveness and response differences of a multidisciplinary workplace health promotion program for healthcare workers. Front Med (Lausanne) 2022; 9:930165. [PMID: 35957848 PMCID: PMC9360800 DOI: 10.3389/fmed.2022.930165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 06/27/2022] [Indexed: 11/13/2022] Open
Abstract
Background Workplace health promotion (WHP) in the healthcare industry is an important yet challenging issue to address, given the high workload, heterogeneity of work activities, and long work hours of healthcare workers (HCWs). This study aimed to investigate the effectiveness and response differences of a multidisciplinary WHP program conducted in HCWs. Methods This retrospective cohort study included HCWs participating in a multidisciplinary WHP program in five healthcare facilities. The 20-week intervention included multiple easy-to-access 90-min exercise classes, one 15-min nutrition consultation, and behavioral education. Pre- and post-interventional anthropometrics, body composition, and physical fitness (PF) were compared with paired sample t-tests. Response differences across sex, age, weight status, and shiftwork status were analyzed with a generalized estimating equation. Results A total of 302 HCWs were analyzed. The intervention effectively improved all anthropometric (body mass index, waist circumference, waist-hip ratio, and waist-to-height ratio), body composition (body fat percentage, muscle weight, visceral fat area), and PF (grip strength, high jump, sit-up, sit-and-reach, step test) parameters in all participants (all p < 0.05). Subgroup analyses revealed shift workers had a more significant mean reduction in body mass index than non-shift workers (adjusted p = 0.045). However, there was no significant response difference across sex, age, and weight subgroups. Conclusion This study suggested that a multidisciplinary WHP program can improve anthropometric and PF profiles regardless of sex, age, and weight status for HCWs, and shifter workers might benefit more from the intervention.
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Affiliation(s)
- Kai-Hung Cheng
- Department of Family Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Ning-Kuang Wu
- Department of Education, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Chao-Tung Chen
- Department of Family Medicine, Chang Gung Memorial Hospital, Kaoshiung, Taiwan
| | - Chih-Yu Hsu
- Department of Family Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yen-An Lin
- Department of Family Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - John Jiin-Chyuan Luo
- Department of Occupational Medicine, New Taipei Municipal Tucheng Hospital, Chang Gung Memorial Hospital, New Taipei City, Taiwan
| | - Li-Ang Lee
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- School of Medicine, National Tsing Hua University, Hsinchu, Taiwan
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Hai-Hua Chuang
- Department of Family Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- School of Medicine, National Tsing Hua University, Hsinchu, Taiwan
- Health Promotion Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
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Shikuku DN, Nyaoke I, Maina O, Eyinda M, Gichuru S, Nyaga L, Iman F, Tallam E, Wako I, Bashir I, Allott H, Ameh C. The determinants of staff retention after Emergency Obstetrics and Newborn Care training in Kenya: a cross-sectional study. BMC Health Serv Res 2022; 22:872. [PMID: 35794569 PMCID: PMC9261014 DOI: 10.1186/s12913-022-08253-2] [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: 05/01/2021] [Accepted: 06/27/2022] [Indexed: 11/14/2022] Open
Abstract
Introduction Kenya’s maternal mortality ratio is relatively high at 342/100,000 live births. Confidential enquiry into maternal deaths showed that 90% of the maternal deaths received substandard care with health workforce related factors identified in 75% of 2015/2016 maternal deaths. Competent Skilled Health Personnel (SHP) providing emergency obstetric and newborn care (EmONC) in an enabling environment reduces the risk of adverse maternal and newborn outcomes. The study objective was to identify factors that determine the retention of SHP 1 – 5 years after EmONC training in Kenya. Methods A cross-sectional review of EmONC SHP in five counties (Kilifi, Taita Taveta, Garissa, Vihiga and Uasin Gishu) was conducted between January–February 2020. Data was extracted from a training database. Verification of current health facilities where trained SHP were deployed and reasons for non-retention were collected. Descriptive data analysis, transfer rate by county and logistic regression for SHP retention determinants was performed. Results A total of 927 SHP were trained from 2014–2019. Most SHP trained were nurse/midwives (677, 73%) followed by clinical officers (151, 16%) and doctors (99, 11%). Half (500, 54%) of trained SHP were retained in the same facility. Average trained staff transfer rate was 43%, with Uasin Gishu lowest at 24% and Garissa highest at 50%. Considering a subset of trained staff from level 4/5 facilities with distinct hospital departments, only a third (36%) of them are still working in relevant maternity/newborn/gynaecology departments. There was a statistically significant difference in transfer rate by gender in Garissa, Vihiga and the combined 5 counties (p < 0.05). Interval from training in years (1 year, AOR = 4.2 (2.1–8.4); cadre (nurse/midwives, AOR = 2.5 (1.4–4.5); and county (Uasin Gishu AOR = 9.5 (4.6- 19.5), Kilifi AOR = 4.0 (2.1–7.7) and Taita Taveta AOR = 1.9 (1.1–3.5), p < 0.05, were significant determinants of staff retention in the maternity departments. Conclusion Retention of EmONC trained SHP in the relevant maternity departments was low at 36 percent. SHP were more likely to be retained by 1-year after training compared to the subsequent years and this varied from county to county. County policies and guidelines on SHP deployment, transfers and retention should be strengthened to optimise the benefits of EmONC training.
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Affiliation(s)
- Duncan N Shikuku
- Liverpool School of Tropical Medicine, P.O. Box, Nairobi, 24672-00100, Kenya.
| | - Irene Nyaoke
- Liverpool School of Tropical Medicine, P.O. Box, Nairobi, 24672-00100, Kenya
| | - Onesmus Maina
- Liverpool School of Tropical Medicine, P.O. Box, Nairobi, 24672-00100, Kenya
| | - Martin Eyinda
- Liverpool School of Tropical Medicine, P.O. Box, Nairobi, 24672-00100, Kenya
| | - Sylvia Gichuru
- Liverpool School of Tropical Medicine, P.O. Box, Nairobi, 24672-00100, Kenya
| | - Lucy Nyaga
- Liverpool School of Tropical Medicine, P.O. Box, Nairobi, 24672-00100, Kenya
| | | | | | - Ibrahim Wako
- Clinical Officers Council of Kenya, Nairobi, Kenya
| | - Issak Bashir
- Department of Family Health, Ministry of Health, Nairobi, Kenya
| | - Helen Allott
- Liverpool School of Tropical Medicine, Liverpool, UK
| | - Charles Ameh
- Liverpool School of Tropical Medicine, Liverpool, UK.,Department of Obstetrics and Gynaecology, University of Nairobi, Nairobi, Kenya
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Shin Y, Park B, Kim NE, Choi EJ, Ock M, Jee SH, Park SK, Ahn HS, Park H. Well-being Index Scores and Subjective Health Status of Korean Healthcare Workers. J Prev Med Public Health 2022; 55:226-233. [PMID: 35677996 PMCID: PMC9201093 DOI: 10.3961/jpmph.22.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 05/12/2022] [Indexed: 11/09/2022] Open
Abstract
Objectives: The aim of this study was to evaluate the subjective level of health-related quality of life of Korean healthcare workers using various quality-of-life instruments.Methods: This study included 992 participants, who were doctors and nurses. A survey was conducted between November 28 and December 4, 2019. Data from 954 participants divided into 3 groups (physicians, residents, and nurses) were analyzed. Four measurement tools (29 questions) were used in the survey to evaluate subjective health status and well-being.Results: In the Mayo Well-being Index, burnout during work (88.5%) and emotional difficulties caused by work (84.0%) were frequently cited by the respondents. Regarding questions on burnout and emotional difficulties, residents and nurses had the highest scores (91.0 and 89.6%, respectively). Emotional problems, such as anxiety, depression, and irritability, accounted for a high percentage (73.1%) of the total, while 82.2% of respondents reported that their work schedules interfered with their leisure and family time. There was no significant difference among the groups in subjective health status. However, 10.1% of the residents experienced very low quality of life, which was a higher proportion than that of physicians (2.7%) and nurses (5.2%).Conclusions: The level of well-being that Korean medical workers experienced in relation to work was lower than the results of the United States healthcare workers surveyed using the same tool. This study was unique in that it conducted a subjective quality-of-life survey on Korean healthcare workers.
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Affiliation(s)
- Yoonhee Shin
- Advanced Biomedical Research Institute, Ewha Womans University Seoul Hospital, Seoul,
Korea
- College of Nursing, Ewha Womans University, Seoul,
Korea
| | - Bohyun Park
- National Cancer Control Institute, National Cancer Center, Goyang,
Korea
| | - Nam-eun Kim
- Department of Preventive Medicine, Ewha Womans University College of Medicine, Seoul,
Korea
| | - Eun Jeong Choi
- Graduate Program for System Health Science and Engineering, Ewha Womans University, Seoul,
Korea
| | - Minsu Ock
- Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan,
Korea
| | - Sun Ha Jee
- Department of Epidemiology and Health Promotion, Institute for Health Promotion, Graduate School of Public Health, Yonsei University, Seoul,
Korea
| | - Sue K. Park
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul,
Korea
| | - Hyeong Sik Ahn
- Department of Preventive Medicine, Korea University College of Medicine, Seoul,
Korea
| | - Hyesook Park
- Department of Preventive Medicine, Ewha Womans University College of Medicine, Seoul,
Korea
- Graduate Program for System Health Science and Engineering, Ewha Womans University, Seoul,
Korea
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Niestrój-Jaworska M, Dębska-Janus M, Polechoński J, Tomik R. Health Behaviors and Health-Related Quality of Life in Female Medical Staff. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073896. [PMID: 35409579 PMCID: PMC8997715 DOI: 10.3390/ijerph19073896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/16/2022] [Accepted: 03/22/2022] [Indexed: 02/04/2023]
Abstract
The aim of this study was to evaluate the relationship between the intensity of health behaviors and health-related quality of life in female mid-level medical staff. The study group consisted of 153 female mid-level medical staff members. The intensity of health behaviors was examined with the Polish version of Health Behavior Inventory. Health-related quality of life was verified with the Short Form Health Survey questionnaire (SF 36v2). Among the participants, 33% had low, 39% average, and 28% high intensity of health behaviors. The mental component of health-related quality of life was rated higher (83.3 ± 15.3 points) compared to the physical one. The lowest health-related quality of life was observed in the domain of “bodily pain”, while the highest was found for the domain of “social functioning”. Both the physical and mental components of health-related quality of life were significantly positively correlated with health behavior prevalence in all its categories. The post-hoc tests revealed the variation in physical and mental components of HRQoL according to the level of health behavior intensity.
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Affiliation(s)
- Maria Niestrój-Jaworska
- Department of Health-Related Physical Activity and Tourism, The Jerzy Kukuczka Academy of Physical Education in Katowice, 40-065 Katowice, Poland; (M.N.-J.); (R.T.)
| | - Małgorzata Dębska-Janus
- Institute of Sport Sciences, The Jerzy Kukuczka Academy of Physical Education in Katowice, 40-065 Katowice, Poland;
- Correspondence:
| | - Jacek Polechoński
- Institute of Sport Sciences, The Jerzy Kukuczka Academy of Physical Education in Katowice, 40-065 Katowice, Poland;
| | - Rajmund Tomik
- Department of Health-Related Physical Activity and Tourism, The Jerzy Kukuczka Academy of Physical Education in Katowice, 40-065 Katowice, Poland; (M.N.-J.); (R.T.)
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Sousa P, Paiva SG, Lobão MJ, Van-Innis AL, Pereira C, Fonseca V. Contributions to the Portuguese National Plan for Patient Safety 2021–2026: A Robust Methodology Based on the Mixed-Method Approach. PORTUGUESE JOURNAL OF PUBLIC HEALTH 2022. [DOI: 10.1159/000521722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
<b><i>Introduction:</i></b> Several countries prioritize patient safety in their health policies. In Portugal, following the implementation of the National Plan for Patient Safety (NPPS) 2015–2020, the research team of the National School of Public Health (NSPH) carried out extensive work to continue improving aspects of the previous Plan. This work was focused on identifying the strengths and weaknesses of NPPS 2015–2020 and aspects related to its applicability and main challenges and opportunities for the implementation of the NPPS 2021–2026. <b><i>Methods:</i></b> Methodological dynamic process was based on the most relevant international and national guidelines and the feedback from key patient safety stakeholders. We developed a cross-sectional mixed-methods study from January to August 2021. We used documentation and periodical reports from National Health Service (NHS) healthcare institutions as secondary sources of information. For primary data collection, we used an online survey (applied to elements in the different quality and safety structures of hospitals and primary care units), interviews, and focus groups to collect information from patient safety experts. <b><i>Results and Discussion:</i></b> Strengthening safety culture, patient safety training, communication, leadership involvement, patient and family engagement, and monitorization process is considered essential. We also identified local limitations such as the lack of resources and protected time for the healthcare professionals and lack of leadership involvement on patient safety strategies for dedicating to patient safety actions. Most of the patient safety stakeholders agreed that the safety and health of clinical teams and new modalities of healthcare (such as telemedicine, home hospitalization, home care) should be a priority for patient safety strategies. <b><i>Conclusions:</i></b> In our study, we used a robust methodology with a participatory process involving different stakeholders. An alignment between local, regional, and national levels in terms of measuring indicators, the definition of priorities, and actions and activities to improve patient safety is recommended. Reinforced partnerships and alignment between the institution’s mission, and safety priorities will be crucial to enhance patient safety. Additionally, this work highlights the added value for health systems achieved through strong partnerships between public administration and academic institutions to improve healthcare quality and patient safety.
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