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Khan S, Ntatamala I, Baatjies R, Adams S. Prevalence and determinants of burnout among South African doctors during the COVID-19 pandemic. S Afr J Psychiatr 2024; 30:2225. [PMID: 38726336 PMCID: PMC11079362 DOI: 10.4102/sajpsychiatry.v30i0.2225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 02/07/2024] [Indexed: 05/12/2024] Open
Abstract
Background Burnout, resulting from chronic workplace stress that has been unsuccessfully managed, has previously been documented in doctors. The coronavirus disease 2019 (COVID-19) pandemic has increased occupational challenges faced by doctors, potentiating their risk for burnout. Aim This study aimed to determine the prevalence and determinants of burnout among medical doctors during the COVID-19 pandemic. Setting Three public sector hospitals in Gqeberha, South Africa. Methods A cross-sectional study of 260 voluntary participants was conducted. Participants completed self-administered electronic questionnaires. Logistic regression analysis was performed to explore the determinants of burnout. Results The prevalence of burnout in this study was 78%. Burnout was significantly associated with being a medical intern or community-service medical officer (adjusted odd ratio [AOR] = 6.72, 1.71-26.40), being in the lowest income band (AOR = 10.78, 2.55-45.49), and using alcohol to manage work-related stress (AOR = 3.01, 1.12-8.04). Job-related factors associated with burnout were experiencing high conflict at work (AOR = 5.04, 1.92-13.20) and high role ambiguity and role conflict (AOR = 4.49, 1.98-10.18). Low support at work (AOR = 9.99, 3.66-27.23), medium job satisfaction (AOR = 5.38, 2.65-10.93) and medium support at work (AOR = 3.39, 1.71-6.73) were positively associated with burnout. Participants with medium (AOR = 0.28, 0.10-0.80) and high levels of resilience (AOR = 0.08, 0.03-0.25) were protected against burnout. Coronavirus disease 2019-related factors were not significantly associated with burnout. Conclusion The burnout prevalence among South African medical doctors at public hospitals during the COVID-19 pandemic was high and strongly associated with job stress factors. Contribution Given the increased prevalence of burnout among doctors and the strong associations with job stress factors, mitigation of burnout requires targeted organisational interventions.
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Affiliation(s)
- Saajida Khan
- Division of Occupational Medicine and Centre for Environmental and Occupational Health Research, School of Public Health, University of Cape Town, Cape Town, South Africa
| | - Itumeleng Ntatamala
- Division of Occupational Medicine and Centre for Environmental and Occupational Health Research, School of Public Health, University of Cape Town, Cape Town, South Africa
| | - Roslynn Baatjies
- Department of Environmental and Occupational Studies, Faculty of Applied Sciences, Cape Peninsula University of Technology, Cape Town, South Africa
| | - Shahieda Adams
- Division of Occupational Medicine and Centre for Environmental and Occupational Health Research, School of Public Health, University of Cape Town, Cape Town, South Africa
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Mũrage A, Morgan R, Samji H, Smith J. Gendered and racial experiences of moral distress: A scoping review. J Adv Nurs 2024; 80:1283-1298. [PMID: 37849045 DOI: 10.1111/jan.15901] [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: 03/13/2023] [Revised: 08/23/2023] [Accepted: 10/02/2023] [Indexed: 10/19/2023]
Abstract
AIM To inform efforts to integrate gender and race into moral distress research, the review investigates if and how gender and racial analyses have been incorporated in such research. DESIGN Scoping review. METHODS The PRISMA (Preferred Reporting Items for Systematic and Meta-Analysis) Extension for Scoping Reviews was adopted. DATA SOURCES Systematic literature search was conducted through PubMed, CINAHL and Web of Science databases. Boolean operators were used to identify moral distress literature which included gender and/or race data and published between 2012 and 2022. RESULTS After screening and full-text review, 73 articles reporting on original moral distress research were included. Analysis was conducted on how gender and race were incorporated in research and interpretation of moral distress experiences among healthcare professionals. IMPACT This study found that while there is an upward trend in including gender and race-disaggregated data in moral distress research, over half of such research did not conduct in-depth analysis of such data. Others only highlighted differential experiences such as moral distress levels of women vis-à-vis men. Only about 20% of publications interrogated how experiences of moral distress differed and/or explored factors behind their findings. CONCLUSION There is a need to not only collect disaggregated data in moral distress research but also engage this data through gender and race-based analysis. Particularly, we highlight the need for intersectional analysis, which can elucidate how social identities and categories (such as gender and race) and structural inequalities (such as those sustained by sexism and racism) interact to influence moral experiences. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE Moral distress as experienced by healthcare professionals is increasingly recognized as an important area of research with significant policy implications in the healthcare sector. This study offers insights for nuanced and targeted policy approaches. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Alice Mũrage
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
- Pacific Institute on Pathogens, Pandemics, and Society, Burnaby, British Columbia, Canada
| | - Rosemary Morgan
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Hasina Samji
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Julia Smith
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
- Pacific Institute on Pathogens, Pandemics, and Society, Burnaby, British Columbia, Canada
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Jin L, Jowsey T, Yin M. Medical students' perceptions of prosocial behaviors: a grounded theory study in China. BMC MEDICAL EDUCATION 2024; 24:353. [PMID: 38553677 PMCID: PMC10981338 DOI: 10.1186/s12909-024-05335-z] [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: 07/27/2023] [Accepted: 03/21/2024] [Indexed: 04/01/2024]
Abstract
INTRODUCTION Prosocial behavior has been shown to be protective against burnout. Yet, we know little about prosocial behavior in medical students. We wanted to know what are chinese medical students' understanding of prosocial behavior and which factors influence their participation in it? METHODS We undertook a grounded theory study, following Corbin & Strauss. We used convenience sampling and conducted semi-structured individual interviews. We analyzed data using open, axial, and selective coding techniques. Next, we grouped data into concepts. We noticed these concepts aligned with three existing social theories, so we developed our theory in concert with these: the Theory of Planned Behavior, Self-Determination Theory, and Social Support Theory. RESULTS Twenty-eight medical students participated in this study. Medical students hold especial views on the roles of medical physicians, and most of these views align with students' core values, including the value of prosocial behavior. Students are intrinsically motivated to engage in prosocial behaviors that align with their core values. Personal values, personality traits, perceived self-competence, career motivation, environmental factors, and family influences are the core factors influencing medically positive prosocial behavior. CONCLUSIONS This study supports a focus on prosocial behavior instead of altruistic behavior in medical education. We anticipate that promoting prosocial behavior through medical curricula will reduce moral distress and burnout among medical students.
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Affiliation(s)
- Linya Jin
- School of Medical Humanity, Harbin Medical University, Nangang District, Heilongjiang Province, Harbin, China
| | - Tanisha Jowsey
- School of Medicine, Bond University, 14 University Drive, Robina, Gold Coast, QLD, 4226, Australia
| | - Mei Yin
- School of Medical Humanity, Harbin Medical University, Nangang District, Heilongjiang Province, Harbin, China.
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Gómez-Brufal-Flores M, Hueso-Montoro C, Esteban-Burgos AA, Montoya-Juárez R, Mota-Romero E, Capilla-Díaz C, Puente-Fernández D. Attitudes and experiences related to the deaths of COVID-19 patients among nursing staff: A qualitative evidence synthesis. J Adv Nurs 2024; 80:580-596. [PMID: 37548340 DOI: 10.1111/jan.15815] [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: 09/18/2022] [Revised: 05/27/2023] [Accepted: 07/20/2023] [Indexed: 08/08/2023]
Abstract
AIM To identify and synthesize the experiences and attitudes of nursing staff regarding the deaths of COVID-19 patients. REVIEW METHODS A qualitative evidence synthesis was carried out, using Noblit and Hare's meta-ethnographic approach. The review protocol was listed in PROSPERO (CRD42022330928). Studies published from January 2020 to January 2022 that met the criteria were searched in PubMed, Web of Science, Scopus, CINAHL, CUIDEN and PsycInfo. A total of 12 articles were included. RESULTS Thirty-three metaphors emerged, which were grouped into three main themes: Determining factors of care, Feelings about death and Strategies for coping with death. Nurses reported the high emotional toll, the absence of family and the lack of staff, protocol and training as determining factors. Furthermore, staff had doubts about the quality of care that COVID-19 patients received. As coping strategies, nurses developed avoidance behaviours towards COVID-19 patients, selective memories, resilience, and/or leaving the profession. CONCLUSIONS The difficulty in providing adequate nursing care and the high number of deaths has increased anxiety and stress among nurses. These factors, alongside their lived experiences of seeing patients suffering, many dying alone without family members, have had psychological repercussions on nursing staff. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE The results demonstrate a high emotional toll and doubts surrounding their caregiving role caused by the lack of professional training needed to face a pandemic. This research shows what has been learned for future pandemics and highlights basic components that could provide a foundation for coping interventions for healthcare professionals. IMPACT WHAT PROBLEM DID THE STUDY ADDRESS?: The challenges posed by COVID-19 patient deaths for nursing staff around the world and also by the pandemic circumstances in which those deaths occurred. WHAT WERE THE MAIN FINDINGS?: The high number of deceased patients who were isolated from family members, communication with family members and doubts surrounding care given during the pandemic have created feelings of fear, stress and anxiety, as well as obsessive thoughts that have changed nursing staff's perception of death due to COVID-19. WHERE AND ON WHOM WILL THE RESEARCH HAVE AN IMPACT?: Results will be useful for preparing for future pandemics, and for policymakers and health staff in supporting healthcare professionals by creating programmes to help them cope with the emotional toll they have felt after dealing with death in such unprecedented circumstances. REPORTING METHOD The authors have adhered to the PRISMA guidelines and the eMERGe Reporting Guidance. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
| | - César Hueso-Montoro
- Department of Nursing, University of Jaén, Jaén, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Centro de Investigación Mente, Cerebro y Comportamiento (CIMCYC), Granada, Spain
| | - Ana Alejandra Esteban-Burgos
- Department of Nursing, University of Jaén, Jaén, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Rafael Montoya-Juárez
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Centro de Investigación Mente, Cerebro y Comportamiento (CIMCYC), Granada, Spain
- Department of Nursing, University of Granada, Granada, Spain
| | - Emilio Mota-Romero
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Department of Nursing, University of Granada, Granada, Spain
- Dr. Salvador Caballero García Primary Care Centre, Andalusian Health Service, Government of Andalusia, Granada, Spain
| | - Concepción Capilla-Díaz
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Department of Nursing, University of Granada, Granada, Spain
| | - Daniel Puente-Fernández
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Department of Nursing, University of Granada, Granada, Spain
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Szczerbińska K, Barańska I, Kijowska V, Stodolska A, Wójcik G, Różańska A, Wójkowska-Mach J. Factors associated with burnout among hospital-based healthcare workers during the COVID-19 pandemic: A cross-sectional CRACoV-HHS study. J Clin Nurs 2024; 33:304-321. [PMID: 36792068 DOI: 10.1111/jocn.16654] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 12/19/2022] [Accepted: 01/24/2023] [Indexed: 02/17/2023]
Abstract
AIMS To assess the prevalence of burnout and associated factors among healthcare workers (HCWs) working in a hospital admitting patients with COVID-19. BACKGROUND Burnout among HCWs is related to age, gender and occupation. However, little is known about organisational factors associated with burnout during the COVID-19 pandemic. DESIGN A cross-sectional study of 1412 hospital HCWs (748 nurses) was carried out via online survey during the COVID-19 pandemic between 4 and 19 January 2021. METHODS The Maslach Burnout Inventory-Human Services Survey, the Checklist Individual Strength questionnaire, the interRAI items covering mental health, the WHO questionnaire items assessing HCWs' preparedness and exposure to SARS-CoV-2 were used. Univariable and multivariable linear regression analyses were conducted to clarify factors associated with emotional exhaustion (EE), depersonalisation (DP) and personal accomplishment (PA). This study adheres to the STROBE guidelines. RESULTS Burnout prevalence varied from 10.0% to 22.0%. Most respondents (83.6%) reported low PA, 22.9% high EE and 18.7% high DP. Nurses and physicians had the highest levels of EE and DP. Staff exposed or uncertain if exposed to contaminated patients' body fluids and materials had higher levels of burnout. Preparedness (training) (b = 1.15; 95%CI 0.26 to 2.05) and adherence to infection prevention and control procedures (b = 1.57; 95%CI 0.67 to 2.47) were associated with higher PA, and accessibility of personal protective equipment (PPE) (b = -1.37; 95%CI -2.17 to -0.47) was related to lower EE. HCWs working in wards for patients with COVID-19 reported lower EE (b = -1.39; 95%CI -2.45 to -0.32). HCWs who contracted COVID-19 reported lower DP (b = -0.71, 95%CI -1.30 to -0.12). CONCLUSIONS Organisational factors such as better access to PPE, training, and adherence to infection prevention and control procedures were associated with a lower level of burnout. RELEVANCE TO CLINICAL PRACTICE Healthcare managers should promote strategies to reduce burnout among HCWs with regard to preparedness of all staff.
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Affiliation(s)
- Katarzyna Szczerbińska
- Laboratory for Research on Aging Society, Department of Sociology of Medicine, Epidemiology and Preventive Medicine Chair, Medical Faculty, Jagiellonian University Medical College, Kraków, Poland
- The University Hospital in Cracow, Kraków, Poland
| | - Ilona Barańska
- Laboratory for Research on Aging Society, Department of Sociology of Medicine, Epidemiology and Preventive Medicine Chair, Medical Faculty, Jagiellonian University Medical College, Kraków, Poland
| | - Violetta Kijowska
- Laboratory for Research on Aging Society, Department of Sociology of Medicine, Epidemiology and Preventive Medicine Chair, Medical Faculty, Jagiellonian University Medical College, Kraków, Poland
| | - Agata Stodolska
- Laboratory for Research on Aging Society, Department of Sociology of Medicine, Epidemiology and Preventive Medicine Chair, Medical Faculty, Jagiellonian University Medical College, Kraków, Poland
| | - Grzegorz Wójcik
- Laboratory for Research on Aging Society, Department of Sociology of Medicine, Epidemiology and Preventive Medicine Chair, Medical Faculty, Jagiellonian University Medical College, Kraków, Poland
- Faculty of Management and Social Communication, Institute of Applied Psychology, Jagiellonian University, Kraków, Poland
| | - Anna Różańska
- Chair of Microbiology Medical Faculty Jagiellonian University Medical College, Kraków, Poland
| | - Jadwiga Wójkowska-Mach
- Chair of Microbiology Medical Faculty Jagiellonian University Medical College, Kraków, Poland
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Apaydin EA, Rose DE, McClean MR, Mohr DC, Yano EM, Shekelle PG, Nelson KM, Guo R, Yoo CK, Stockdale SE. Burnout, employee engagement, and changing organizational contexts in VA primary care during the early COVID-19 pandemic. BMC Health Serv Res 2023; 23:1306. [PMID: 38012726 PMCID: PMC10683139 DOI: 10.1186/s12913-023-10270-8] [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: 06/15/2023] [Accepted: 11/02/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic involved a rapid change to the working conditions of all healthcare workers (HCW), including those in primary care. Organizational responses to the pandemic, including a shift to virtual care, changes in staffing, and reassignments to testing-related work, may have shifted more burden to these HCWs, increasing their burnout and turnover intent, despite their engagement to their organization. Our objectives were (1) to examine changes in burnout and intent to leave rates in VA primary care from 2017-2020 (before and during the pandemic), and (2) to analyze how individual protective factors and organizational context affected burnout and turnover intent among VA primary care HCWs during the early months of the pandemic. METHODS We analyzed individual- and healthcare system-level data from 19,894 primary care HCWs in 139 healthcare systems in 2020. We modeled potential relationships between individual-level burnout and turnover intent as outcomes, and individual-level employee engagement, perceptions of workload, leadership, and workgroups. At healthcare system-level, we assessed prior-year levels of burnout and turnover intent, COVID-19 burden (number of tests and deaths), and the extent of virtual care use as potential determinants. We conducted multivariable analyses using logistic regression with standard errors clustered by healthcare system controlled for individual-level demographics and healthcare system complexity. RESULTS In 2020, 37% of primary care HCWs reported burnout, and 31% reported turnover intent. Highly engaged employees were less burned out (OR = 0.57; 95% CI 0.52-0.63) and had lower turnover intent (OR = 0.62; 95% CI 0.57-0.68). Pre-pandemic healthcare system-level burnout was a major predictor of individual-level pandemic burnout (p = 0.014). Perceptions of reasonable workload, trustworthy leadership, and strong workgroups were also related to lower burnout and turnover intent (p < 0.05 for all). COVID-19 burden, virtual care use, and prior year turnover were not associated with either outcome. CONCLUSIONS Employee engagement was associated with a lower likelihood of primary care HCW burnout and turnover intent during the pandemic, suggesting it may have a protective effect during stressful times. COVID-19 burden and virtual care use were not related to either outcome. Future research should focus on understanding the relationship between engagement and burnout and improving well-being in primary care.
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Affiliation(s)
- Eric A Apaydin
- Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd. (151), Los Angeles, CA, 90073, USA.
- RAND Corporation, Santa Monica, CA, USA.
| | - Danielle E Rose
- Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd. (151), Los Angeles, CA, 90073, USA
| | - Michael R McClean
- Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd. (151), Los Angeles, CA, 90073, USA
| | - David C Mohr
- National Center for Organization Development, Veterans Health Administration, Cincinnati, OH, USA
- Department of Health Law, Policy & Management, School of Public Health, Boston University, Boston, MA, USA
| | - Elizabeth M Yano
- Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd. (151), Los Angeles, CA, 90073, USA
- Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Paul G Shekelle
- Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd. (151), Los Angeles, CA, 90073, USA
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Karin M Nelson
- Seattle-Denver Center of Innovation, VA Puget Sound Health Care System, Seattle, WA, USA
- Division of General Internal Medicine, Department of Medicine, University of Washington School of Medicine, University of Washington, Seattle, WA, USA
| | - Rong Guo
- Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd. (151), Los Angeles, CA, 90073, USA
| | - Caroline K Yoo
- Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd. (151), Los Angeles, CA, 90073, USA
- Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - Susan E Stockdale
- Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd. (151), Los Angeles, CA, 90073, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
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Wannarit K, Ratta-apha W, Pariwatcharakul P, Pukrittayakamee P. Burnout study during the COVID-19 pandemic in Thailand: psychometric evaluation of the Maslach Burnout Inventory-Human Services Survey for Medical Personnel. Health Psychol Behav Med 2023; 11:2268694. [PMID: 37854449 PMCID: PMC10580795 DOI: 10.1080/21642850.2023.2268694] [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: 05/01/2023] [Accepted: 10/02/2023] [Indexed: 10/20/2023] Open
Abstract
Objectives This study aimed (1) to determine the psychometric properties of a Thai version of the Maslach Burnout Inventory-Human Services Survey for Medical Personnel (MBI-HSS [MP]) and (2) to examine the mean scores of burnout and associated factors during the COVID-19 pandemic. Methods Forward and back translations of the MBI-HSS (MP) questionnaire were performed. The Thai version was subsequently completed by 682 Thai physicians and nurses who worked during the COVID-19 pandemic. Exploratory factor analysis was performed on the first subsample (n = 341) by conducting Kaiser Mayer-Olkin sampling adequacy measurement and Bartlett's test of sphericity whereas confirmatory factor analysis (CFA) was performed on the second subsample (n = 341) using fit indices of the normed chi-square (χ2/df), the comparative fit index, the Tucker-Lewis index, and the root mean square error of approximation. This version's internal consistency was investigated using Cronbach's alpha coefficient. Demographic profiles were evaluated with descriptive and analytical statistics. Results The Thai version of the MBI-HSS (MP) displayed good psychometric characteristics, as the Cronbach's alpha values of the 3 burnout factors ranged from 0.843 to 0.945. The CFA also showed good fit indices (χ2/df = 4.473; P < 0.001; RMSEA = 0.075 (95%CI = 0.055-0.079); CFI = 0.946; and TLI = 0.936). The physicians' mean EE, DP, and PA scores were 25.28 ± 13.27, 7.15 ± 6.11, and 36.83 ± 8.13, respectively, whereas The nurses' mean EE, DP, and PA scores were 23.10 ± 14.14, 4.43 ± 5.06, and 35.67 ± 10.24, respectively. Healthcare professionals who were younger, single, had fewer years of practice, and had more working hours per week tended to express more burnout scores. Conclusions The Thai version of the MBI-HSS (MP) demonstrates good psychometric properties in assessing burnout among healthcare professionals. Several factors may be pivotal in intensifying burnout.
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Affiliation(s)
- Kamonporn Wannarit
- Department of Psychiatry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Woraphat Ratta-apha
- Department of Psychiatry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
- Siriraj Center of Research Excellence Management, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Pornjira Pariwatcharakul
- Department of Psychiatry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Panate Pukrittayakamee
- Department of Psychiatry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Erjavec K, Leskovic L. Long-term healthcare professionals' experiences of burnout and correlation between burnout and fatigue: a cross-sectional study. Int J Occup Med Environ Health 2023; 36:396-405. [PMID: 37681427 PMCID: PMC10663998 DOI: 10.13075/ijomeh.1896.02182] [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: 03/14/2023] [Accepted: 07/03/2023] [Indexed: 09/09/2023] Open
Abstract
OBJECTIVES The aim of the study was to analyze the long-term burnout levels of healthcare professionals (HCPs) working in Slovenian nursing homes during the fifth wave of the pandemic; to compare the results of similar facilities in 2020 and 2013; and to examine the correlation between demographics and burnout and fatigue among HCPs. MATERIAL AND METHODS The study used a descriptive, correlational cross-sectional method. RESULTS In the fifth wave, HCPs suffered more from emotional exhaustion, depersonalization and lack of personal accomplishment than in the first wave of the pandemic and in the spring of 2013. The HCPs caring for COVID-19 patients and younger women had higher rates of burnout and fatigue than other occupational groups. There is a strong positive correlation between burnout and fatigue. CONCLUSIONS There is an urgent need to address the problem of fatigue and burnout with administrative measures. Int J Occup Med Environ Health. 2023;36(3):396-405.
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Affiliation(s)
- Karmen Erjavec
- University of Novo mesto, Faculty of Health Sciences, Department of Communication, Novo mesto, Slovenia
| | - Ljiljana Leskovic
- University of Novo mesto, Faculty of Health Sciences, Department of Healthcare, Novo mesto, Slovenia
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Kagan I, Tsamir J, Engelchin Nissan E. Public views on healthcare workers' burnout before and during COVID-19: A comparative study. J Nurs Scholarsh 2023; 55:1036-1043. [PMID: 36938840 DOI: 10.1111/jnu.12878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 01/02/2023] [Accepted: 01/20/2023] [Indexed: 03/21/2023]
Abstract
INTRODUCTION Understanding burnout among nurses and physicians may mobilize public support for increasing budgets, personnel, and trust in both routine and pandemic times. The study aimed to examine public views of nurse and physician burnout both before and 1 year after the COVID-19 outbreak. DESIGN This study was conducted in two phases in a pre-post design. METHODS The general public (a random sample) responded to a structured questionnaire with 1-2 open-ended questions: (a) before the COVID-19 pandemic, in 2019 during routine life (n = 504) and (b) 1 year after the COVID-19 outbreak, in 2021 (n = 500). Quantitative and qualitative data on public perceptions of nurse and physician burnout, its sources and consequences, were collected. RESULTS The public view was that hospital physicians and even more so hospital nurses suffer from higher burnout than those working in the community, and that this worsened during the pandemic. Three themes related to caregiver burnout were identified: (a) work overload, (b) lack of sensitivity, empathy, and motivation, and (c) impaired ability to provide quality care. CONCLUSIONS The public is aware of the experiences of caregivers both in times of routine and in emergency. Healthcare management must influence public opinion in order to receive support for organizational steps. CLINICAL RELEVANCE Healthcare leaders should leverage public support in order to receive backing for organizational moves aimed at improving work conditions and, in turn, the quality of care and patient outcomes.
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Affiliation(s)
- Ilya Kagan
- Nursing Department, Ashkelon Academic College, Ashkelon, Israel
| | - Judith Tsamir
- The Israel Academic College in Ramat Gan, Ramat Gan, Israel
| | - Esti Engelchin Nissan
- Head, The Bachelor's Degree Program in Economics, The Israel Academic College in Ramat Gan, Ramat Gan, Israel
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Chong YY, Frey E, Chien WT, Cheng HY, Gloster AT. The role of psychological flexibility in the relationships between burnout, job satisfaction, and mental health among nurses in combatting COVID-19: A two-region survey. J Nurs Scholarsh 2023; 55:1068-1081. [PMID: 36610054 DOI: 10.1111/jnu.12874] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 12/14/2022] [Accepted: 12/15/2022] [Indexed: 01/09/2023]
Abstract
BACKGROUND A growing body of evidence suggests that the COVID-19 pandemic is adversely impacting the mental health and well-being of frontline nurses worldwide. It is therefore important to understand how such impact can be mitigated, including by studying psychological capacities that could help the nurses regulate and minimize the impact. AIM To examine the role of psychological flexibility in mitigating the adverse impacts of burnout and low job satisfaction on mental health problems (i.e., anxiety, depression, and stress) and well-being among the frontline nurses in Hong Kong and Switzerland during the COVID-19 pandemic. DESIGN Cross-sectional, two-region survey study. METHOD Four hundred fifty-two nurses from Hong Kong (n = 158) and Switzerland (n = 294) completed an online survey. An adjusted structured equation model was used to examine the interrelationship of the constructs. RESULTS Psychological flexibility was found to partially mediate the effects of job satisfaction on mental well-being (β = 0.32, 95% CI [0.19, 0.57], p = 0.001) and mental health problems (β = -0.79, 95% CI [-1.57, -0.44], p = 0.001), respectively. Similarly, this partial mediation was found in the effects of burnout on mental well-being (β = -0.35, 95% CI [-0.89, -0.15], p = 0.002) and mental health problems (β = 0.89, 95% CI [0.48, 3.65], p = 0.001). CONCLUSION Psychological flexibility could be a crucial psychological resilience factor against the adverse impact of nurses' burnout on their mental health problems and well-being during COVID-19. CLINICAL RELEVANCE Organizational measures should focus on fostering psychological flexibility in nurses through highly accessible, brief psychotherapeutic interventions, such as Acceptance and Commitment Therapy, to reduce the impact on mental health.
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Affiliation(s)
- Yuen Yu Chong
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Eveline Frey
- Division of Clinical Psychology and Intervention Science, Faculty of Psychology, University of Basel, Switzerland
| | - Wai Tong Chien
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ho Yu Cheng
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Andrew T Gloster
- Division of Clinical Psychology and Intervention Science, Faculty of Psychology, University of Basel, Switzerland
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11
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Li L, Neubauer L, Stewart R, Roberts A. Characterizing the Differences in Descriptions of Violence on Reddit During the COVID-19 Pandemic. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:9290-9314. [PMID: 36987388 PMCID: PMC10064198 DOI: 10.1177/08862605231163885] [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] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Concerns have been raised over the experiences of violence such as domestic violence (DV) and intimate partner violence (IPV) during the COVID-19 pandemic. Social media such as Reddit represent an alternative outlet for reporting experiences of violence where healthcare access has been limited. This study analyzed seven violence-related subreddits to investigate the trends of different violence patterns from January 2018 to February 2022 to enhance the health-service providers' existing service or provide some new perspective for existing violence research. Specifically, we collected violence-related texts from Reddit using keyword searching and identified six major types with supervised machine learning classifiers: DV, IPV, physical violence, sexual violence, emotional violence, and nonspecific violence or others. The increase rate (IR) of each violence type was calculated and temporally compared in five phases of the pandemic. The phases include one pre-pandemic phase (Phase 0, the date before February 26, 2020) and four pandemic phases (Phases 1-4) with separation dates of June 17, 2020, September 7, 2020, and June 4, 2021. We found that the number of IPV-related posts increased most in the earliest phase; however, that for COVID-citing IPV was highest in the mid-pandemic phase. IRs for DV, IPV, and emotional violence also showed increases across all pandemic phases, with IRs of 26.9%, 58.8%, and 28.8%, respectively, from the pre-pandemic to the first pandemic phase. In the other three pandemic phases, all the IRs for these three types of violence were positive, though lower than the IRs in the first pandemic phase. The findings highlight the importance of identifying and providing help to those who suffer from such violent experiences and support the role of social media site monitoring as a means of informative surveillance for help-providing authorities and violence research groups.
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Affiliation(s)
| | | | - Robert Stewart
- King’s College London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
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12
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Fathuse N, Hlongwana KW, Ginindza TG. "Why Am I Even Here If I Can't Save the Patients?": The Frontline Healthcare Workers' Experience of Burnout during COVID-19 Pandemic in Mthatha, South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085451. [PMID: 37107733 PMCID: PMC10138325 DOI: 10.3390/ijerph20085451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 03/25/2023] [Accepted: 04/06/2023] [Indexed: 05/11/2023]
Abstract
INTRODUCTION Globally, the high prevalence of burnout in healthcare workers (HCWs) is of the utmost concern. Burnout is a state of emotional exhaustion, depersonalization and a decreased sense of personal accomplishment. While the 2019 Coronavirus (COVID-19) exacerbated the burnout prevalence among HCWs, limited studies have explored this phenomenon using qualitative methodologies in the Eastern Cape Province and South Africa generally. This study explored how frontline healthcare workers experienced burnout during the COVID-19 pandemic in Mthatha Regional Hospital. METHODS Ten face-to-face in-depth interviews were conducted with non-specialized medical doctors and nurses who directly cared for COVID-19-infected patients during the pandemic in Mthatha Regional Hospital (MRH). In-depth interviews were digitally recorded and transcribed verbatim. Data were managed through NVIVO 12 software before being thematically analyzed using Colaizzi's analysis method. RESULTS Four main themes emerged from the analysis. These themes were burnout manifestation (emotional strain, detachment and irritability, uncertainty-induced fear, and anxiety, physical exhaustion, yet, low job accomplishment, dread and professional responsibility), precursors of burnout (occupational exposure to high mortality, staff shortages, elongated high patient volume and workload, disease uncertainties and consistent feeling of grief), alleviating factors of burnout (time off work, psychologist intervention, periods of low infection rate and additional staff), and the last theme was every cloud has a silver lining (improved infection prevention and control (IPC) measures, learning to be more empathetic, the passion remains and confidence grows). CONCLUSION The COVID-19 pandemic brought about a rapid change in the work environment of healthcare workers who are the backbone of efficient healthcare services, thereby rendering them vulnerable to increased burnout risks. This study provides strategic information for policymakers and managers on developing and strengthening welfare policies to promote and protect frontline health workers' well-being and work functioning.
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Affiliation(s)
- Noluyolo Fathuse
- Discipline of Public Health Medicine, School of Nursing & Public Health, University of KwaZulu-Natal, Durban 4041, South Africa
- Correspondence: ; Tel.:+27-763368510
| | - Khumbulani W. Hlongwana
- Discipline of Public Health Medicine, School of Nursing & Public Health, University of KwaZulu-Natal, Durban 4041, South Africa
- Cancer & Infectious Diseases Epidemiology Research Unit (CIDERU), College of Health Sciences, University of KwaZulu-Natal, Durban 4041, South Africa
| | - Themba G. Ginindza
- Discipline of Public Health Medicine, School of Nursing & Public Health, University of KwaZulu-Natal, Durban 4041, South Africa
- Cancer & Infectious Diseases Epidemiology Research Unit (CIDERU), College of Health Sciences, University of KwaZulu-Natal, Durban 4041, South Africa
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13
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Puto G, Serafin L, Musiał Z, Zurzycka P, Kamińska A, Gniadek A. Professional challenges of nurses working during the SARS-CoV-2 virus pandemic. Int J Occup Med Environ Health 2023; 36:112-124. [PMID: 36661862 PMCID: PMC10464736 DOI: 10.13075/ijomeh.1896.02028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 10/31/2022] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVES The diverse list of tasks and needs related to the SARS-CoV-2 pandemic may lead to different professional experiences in nurses working with patients infected with and not infected with SARS-CoV-2. The aim of the study was to measure the professional challenges of nurses working during the SARS-CoV-2 pandemic in Poland. MATERIAL AND METHODS The study was conducted in 2021 in a group of 151 nurses. The following scales were used: the Perceived Stress Scale (PSS-10), the General Self-Efficacy Scale (GSES), the Impact of Event Scale - Revised (IES-R), the Minnesota Satisfaction Questionnaire (MSQ-SF), the Areas of Worklife Survey (AWS) and the Maslach Burnout Inventory - Human Services Survey (MBIHSS). RESULTS Nurses working with patients infected with SARS-CoV-2 showed a positive correlation between workload and emotional exhaustion (ρ = 0.26, p = 0.02), as well as positive correlations among control, community and depersonalization (ρ = 0.25, p = 0.02; ρ = 0.23, p = 0.04). Among nurses working with uninfected patients, positive correlations were found among control, community, fairness and emotional exhaustion (ρ = 0.40, p = 0.000; ρ = 0.41, p = 0.000; ρ = 0.25, p = 0.03), as well as correlations between control and depersonalization (ρ = 0.33, p = 0.01), and among control, community and personal accomplishment (ρ = 0.23, p = 0.05; ρ = 0.27, p = 0.02). CONCLUSIONS Nurses working during the SARS-CoV-2 pandemic with infected and uninfected patients both experienced a variety of psychosocial challenges in coping with the demands of their work, social relationships and personal life. Int J Occup Med Environ Health. 2023;36(1):112-24.
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Affiliation(s)
- Grażyna Puto
- Jagiellonian University Medical College, Kraków, Poland (Faculty of Health Sciences, Institute of Nursing and Midwifery)
| | - Lena Serafin
- Medical University of Warsaw, Warsaw, Poland (Health Sciences Faculty, Department of Clinical Nursing)
| | - Zofia Musiał
- Jagiellonian University Medical College, Kraków, Poland (Faculty of Health Sciences, Institute of Nursing and Midwifery)
| | - Patrycja Zurzycka
- Jagiellonian University Medical College, Kraków, Poland (Faculty of Health Sciences, Institute of Nursing and Midwifery)
| | - Alicja Kamińska
- Jagiellonian University Medical College, Kraków, Poland (Faculty of Health Sciences, Institute of Nursing and Midwifery)
| | - Agnieszka Gniadek
- Jagiellonian University Medical College, Kraków, Poland (Faculty of Health Sciences, Institute of Nursing and Midwifery)
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14
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Stodolska A, Wójcik G, Barańska I, Kijowska V, Szczerbińska K. Prevalence of burnout among healthcare professionals during the COVID-19 pandemic and associated factors - a scoping review. Int J Occup Med Environ Health 2023; 36:21-58. [PMID: 36727492 PMCID: PMC10464746 DOI: 10.13075/ijomeh.1896.02007] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 10/12/2022] [Indexed: 02/03/2023] Open
Abstract
The outbreak of the COVID-19 pandemic exerted significant mental burden on healthcare workers (HCWs) operating in the frontline of the COVID-19 care as they experienced high levels of stress and burnout. The aim of this scoping review was to identify prevalence and factors associated with burnout among HCWs during the first year of the COVID-19 pandemic. A literature search was performed in PubMed, Web of Science, and CINAHL. Studies were selected based on the following inclusion criteria: cross-sectional, longitudinal, case-control, or qualitative analyses, published in peer-reviewed journals, between January 1, 2020 and February 28, 2021. Studies carried out on other occupations than healthcare workers or related to other pandemics than COVID-19 were excluded. Following the abstract screen, from 141 original papers identified, 69 articles were eventually selected. A large variation in the reported burnout prevalence among HCWs (4.3-90.4%) was observed. The main factors associated with increase/ decrease of burnout included: demographic characteristics (age, gender, education level, financial situation, family status, occupation), psychological condition (psychiatric diseases, stress, anxiety, depression, coping style), social factors (stigmatisation, family life), work organization (workload, working conditions, availability of staff and materials, support at work), and factors related with COVID-19 (fear of COVID-19, traumatic events, contact with patients with COVID-19, having been infected with COVID-19, infection of a colleague or a relative with COVID-19, higher number of deaths observed by nurses during the COVID-19 pandemic). The findings should be useful for policy makers and healthcare managers in developing programs preventing burnout during the current and future pandemics. Int J Occup Med Environ Health. Int J Occup Med Environ Health. 2023;36(1):21-58.
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Affiliation(s)
- Agata Stodolska
- Jagiellonian University Medical College, Kraków, Poland (Medical Faculty, Department of Sociology of Medicine, Epidemiology and Preventive Medicine Chair)
| | - Grzegorz Wójcik
- Jagiellonian University Medical College, Kraków, Poland (Medical Faculty, Department of Sociology of Medicine, Epidemiology and Preventive Medicine Chair)
- Jagiellonian University, Kraków, Poland (Faculty of Management and Social Communication, Institute of Applied Psychology)
| | - Ilona Barańska
- Jagiellonian University Medical College, Kraków, Poland (Medical Faculty, Department of Sociology of Medicine, Epidemiology and Preventive Medicine Chair)
| | - Violetta Kijowska
- Jagiellonian University Medical College, Kraków, Poland (Medical Faculty, Department of Sociology of Medicine, Epidemiology and Preventive Medicine Chair)
| | - Katarzyna Szczerbińska
- Jagiellonian University Medical College, Kraków, Poland (Medical Faculty, Department of Sociology of Medicine, Epidemiology and Preventive Medicine Chair)
- University Hospital in Krakow, Kraków, Poland
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15
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Czeisler MÉ, Wolkow AP, Czeisler CA, Howard ME, Rajaratnam SMW, Lane RI. Association between burnout and adherence with mask usage and additional COVID-19 prevention behaviours: findings from a large-scale, demographically representative survey of US adults. BMJ Open 2023; 13:e066226. [PMID: 36858474 PMCID: PMC9979584 DOI: 10.1136/bmjopen-2022-066226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 02/02/2023] [Indexed: 03/03/2023] Open
Abstract
OBJECTIVES Studies have found associations between occupational burnout symptoms and reduced engagement with healthy behaviours. We sought to characterise demographic, employment and sleep characteristics associated with occupational burnout symptoms, and to evaluate their relationships with adherence to COVID-19 prevention behaviours (mask usage, hand hygiene, avoiding gatherings, physical distancing, obtaining COVID-19 tests if potentially infected). METHODS During December 2020, surveys were administered cross-sectionally to 5208 US adults (response rate=65.8%). Quota sampling and survey weighting were employed to improve sample representativeness of sex, age and race and ethnicity. Among 3026 employed respondents, logistic regression models examined associations between burnout symptoms and demographic, employment and sleep characteristics. Similar models were conducted to estimate associations between burnout and non-adherence with COVID-19 prevention behaviours. RESULTS Women, younger adults, unpaid caregivers, those working more on-site versus remotely and those with insufficient or impaired sleep had higher odds of occupational burnout symptoms. Burnout symptoms were associated with less frequent mask usage (adjusted odds ratio (aOR)=1.7, 95% CI 1.3-2.1), hand hygiene (aOR=2.1, 95% CI 1.7-2.7), physical distancing (aOR=1.3, 95% CI 1.1-1.6), avoiding gatherings (aOR=1.4, 95% CI 1.1-1.7) and obtaining COVID-19 tests (aOR=1.4, 95% CI 1.1-1.8). CONCLUSIONS Disparities in occupational burnout symptoms exist by gender, age, caregiving, employment and sleep health. Employees experiencing occupational burnout symptoms might exhibit reduced adherence with COVID-19 prevention behaviours. Employers can support employee health by addressing the psychological syndrome of occupational burnout.
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Affiliation(s)
- Mark É Czeisler
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
- Institute for Breathing and Sleep, Austin Health, Melbourne, Victoria, Australia
- Francis Weld Peabody Society, Harvard Medical School, Boston, Massachusetts, USA
| | - Alexander P Wolkow
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
| | - Charles A Czeisler
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Mark E Howard
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
- Institute for Breathing and Sleep, Austin Health, Melbourne, Victoria, Australia
- Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - Shantha M W Rajaratnam
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
- Institute for Breathing and Sleep, Austin Health, Melbourne, Victoria, Australia
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Rashon I Lane
- Department of Social and Behavioral Sciences, University of California San Francisco, San Francisco, California, USA
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16
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Coping mechanisms used by pharmacists to deal with stress, what is helpful and what is harmful? EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2023; 9:100205. [PMID: 36506648 PMCID: PMC9719933 DOI: 10.1016/j.rcsop.2022.100205] [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: 01/03/2022] [Revised: 11/05/2022] [Accepted: 11/29/2022] [Indexed: 12/12/2022] Open
Abstract
Background Australian pharmacists encountered increased stressors during the COVID-19 pandemic. This has raised questions regarding the effectiveness of the coping mechanisms used to manage this high work-related stress. Identifying useful and harmful coping mechanisms is critical for providing advice regarding addressing pharmacists' future work-related stress. Objectives This study aimed to explore the impact of pharmacy work on stress experienced by Australian pharmacists and the coping mechanisms used during the COVID-19 pandemic. This study also aimed to evaluate the pharmacists' perceptions of the impact of these coping mechanisms on their stress. Methods A cross-sectional study was conducted. Practising pharmacists and interns were recruited to complete an online survey that included the Perceived Stress Scale (PSS), which was used to measure pharmacists' work-related stress, and the Brief-COPE scale, used to assess the coping mechanisms used during the COVID-19 pandemic. The key outcome measure was the PSS score. A multiple regression analysis was used to evaluate the relationship between coping mechanisms and stress levels in a sample of Australian pharmacists. Results A total of 173 pharmacists and interns were recruited. The mean PSS was 18.02 (SD = 6.7). Avoidant coping mechanisms such as social withdrawal (β = 0.31; p = 0.0001) were significantly positively associated with work-related stress. In contrast, exercise was significantly negatively associated with work-related stress (β = -0.21; p = 0.009). The most frequently reported perceived barrier to seeking help was feeling burnt out and underappreciated. Conclusions This study highlights the association of coping mechanisms used by pharmacists during the COVID-19 pandemic with work-related stress. The study results demonstrate the importance of physical activity and spending time with pets in reducing work-related stress levels. Avoiding harmful coping mechanisms such as social withdrawal and drinking alcohol is recommended. This study also highlights the need for interventional studies to reduce work-related stress levels among pharmacists by addressing useful coping mechanisms.
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17
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Holliday R, Ricke DJ, Ricklefs C, Mealer M. Brief Narrative Writing Program Implemented in a Neurosurgical Intensive Care Unit During the COVID-19 Pandemic. Am J Crit Care 2023; 32:131-135. [PMID: 36635863 DOI: 10.4037/ajcc2023700] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND The COVID-19 pandemic has substantially affected health care professionals. Health care professionals have noted increased distress, psychiatric symptoms, and feelings of burnout during this time. Implementation of brief, easy-to-access psychosocial interventions might help health care professionals process stressful events, thus bolstering mental health. One such approach is the narrative expressive writing program, a 5-session cognitive behavioral writing intervention. OBJECTIVES The narrative expressive writing program was instituted in a neurosurgical intensive care unit during the COVID-19 pandemic. The program was delivered online and guided by a licensed mental health professional. METHODS Health care professionals completed measures of anxiety, depression, burnout, resilience, and perceived stress before and after completing the narrative expressive writing program. Fifty-eight health care professionals initiated the program; 31 (53% of initiators) completed it. RESULTS Health care professionals who completed the narrative expressive writing program experienced significant reductions in depressive symptoms and perceived stress (P < .05). CONCLUSIONS Preliminary data show that narrative expressive writing is an easy-to-access intervention that has the potential to decrease stress and depressive symptoms. Additional research on tailoring or augmenting the narrative expressive writing program may facilitate health care professionals' engagement and address other mental health domains (eg, burnout).
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Affiliation(s)
- Ryan Holliday
- Ryan Holliday is a clinical research psychologist at the Rocky Mountain Mental Illness Research, Education, and Clinical Center for Suicide Prevention, Aurora, Colorado, and an assistant professor at University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - David J Ricke
- David J. Ricke is a nurse manager at University of Colorado Hospital, Aurora, Colorado
| | - Claudia Ricklefs
- Claudia Ricklefs is program administrative support at University of Colorado Hospital
| | - Meredith Mealer
- Meredith Mealer is a psychiatric mental health nurse practitioner at the Rocky Mountain Mental Illness Research, Education, and Clinical Center for Suicide Prevention and an associate professor at University of Colorado Anschutz Medical Campus
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18
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Yang FH, Tan SL. Effects of Workplace Ostracism on Burnout among Nursing Staff during the COVID-19 Pandemic, Mediated by Emotional Labor. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4208. [PMID: 36901218 PMCID: PMC10002098 DOI: 10.3390/ijerph20054208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 02/23/2023] [Accepted: 02/23/2023] [Indexed: 06/18/2023]
Abstract
This study investigated the effects of workplace ostracism on emotional labor and burnout among current nursing staff during the COVID-19 pandemic, as well as the relationship between the surface acting and deep acting of emotional labor as the mediators of workplace ostracism and burnout. The sample for this study consisted of 250 nursing staff recruited from Taiwanese medical institutions, and the questionnaire was divided into two stages. The first stage included questions about ostracism and personal data, and then two months later the same respondents completed part two of the questionnaire regarding emotional labor and burnout, which solved the problem of common-method variance (CMV). The results of this study indicate that ostracism had a positive and significant effect on burnout and surface acting, but its negative effect on deep acting was not supported. While surface acting showed partial mediation between ostracism and burnout, deep acting did not have a significant mediating effect between ostracism and burnout. These results can provide a reference for practice and researchers.
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Affiliation(s)
- Feng-Hua Yang
- Department of International Business Management, Da-Yeh University, Changhua County 515006, Taiwan
| | - Shih-Lin Tan
- Ph.D. Program in Management, Da-Yeh University, Changhua County 515006, Taiwan
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19
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Abrams MP, Pelullo AP, Meisel ZF, Merchant RM, Purtle J, Agarwal AK. State and Federal Legislators’ Responses on Social Media to the Mental Health and Burnout of Health Care Workers Throughout the COVID-19 Pandemic: Natural Language Processing and Sentiment Analysis. JMIR INFODEMIOLOGY 2023; 3:e38676. [PMID: 37013000 PMCID: PMC10007003 DOI: 10.2196/38676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 01/26/2023] [Accepted: 02/10/2023] [Indexed: 02/26/2023]
Abstract
Background
Burnout and the mental health burden of the COVID-19 pandemic have disproportionately impacted health care workers. The links between state policies, federal regulations, COVID-19 case counts, strains on health care systems, and the mental health of health care workers continue to evolve. The language used by state and federal legislators in public-facing venues such as social media is important, as it impacts public opinion and behavior, and it also reflects current policy-leader opinions and planned legislation.
Objective
The objective of this study was to examine legislators’ social media content on Twitter and Facebook throughout the COVID-19 pandemic to thematically characterize policy makers’ attitudes and perspectives related to mental health and burnout in the health care workforce.
Methods
Legislators’ social media posts about mental health and burnout in the health care workforce were collected from January 2020 to November 2021 using Quorum, a digital database of policy-related documents. The total number of relevant social media posts per state legislator per calendar month was calculated and compared with COVID-19 case volume. Differences between themes expressed in Democratic and Republican posts were estimated using the Pearson chi-square test. Words within social media posts most associated with each political party were determined. Machine-learning was used to evaluate naturally occurring themes in the burnout- and mental health–related social media posts.
Results
A total of 4165 social media posts (1400 tweets and 2765 Facebook posts) were generated by 2047 unique state and federal legislators and 38 government entities. The majority of posts (n=2319, 55.68%) were generated by Democrats, followed by Republicans (n=1600, 40.34%). Among both parties, the volume of burnout-related posts was greatest during the initial COVID-19 surge. However, there was significant variation in the themes expressed by the 2 major political parties. Themes most correlated with Democratic posts were (1) frontline care and burnout, (2) vaccines, (3) COVID-19 outbreaks, and (4) mental health services. Themes most correlated with Republican social media posts were (1) legislation, (2) call for local action, (3) government support, and (4) health care worker testing and mental health.
Conclusions
State and federal legislators use social media to share opinions and thoughts on key topics, including burnout and mental health strain among health care workers. Variations in the volume of posts indicated that a focus on burnout and the mental health of the health care workforce existed early in the pandemic but has waned. Significant differences emerged in the content posted by the 2 major US political parties, underscoring how each prioritized different aspects of the crisis.
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Affiliation(s)
- Matthew P Abrams
- Department of Emergency Medicine Perelman School of Medicine University of Pennsylvania Philadelphia, PA United States
- Center for Digital Health University of Pennsylvania Philadelphia, PA United States
- Center for Emergency Care Policy and Research, Department of Emergency Medicine Perelman School of Medicine University of Pennsylvania Philadelphia, PA United States
| | - Arthur P Pelullo
- Center for Digital Health University of Pennsylvania Philadelphia, PA United States
| | - Zachary F Meisel
- Department of Emergency Medicine Perelman School of Medicine University of Pennsylvania Philadelphia, PA United States
- Center for Emergency Care Policy and Research, Department of Emergency Medicine Perelman School of Medicine University of Pennsylvania Philadelphia, PA United States
- Leonard Davis Institute of Health Care Economics University of Pennsylvania Philadelphia, PA United States
| | - Raina M Merchant
- Department of Emergency Medicine Perelman School of Medicine University of Pennsylvania Philadelphia, PA United States
- Center for Digital Health University of Pennsylvania Philadelphia, PA United States
- Center for Emergency Care Policy and Research, Department of Emergency Medicine Perelman School of Medicine University of Pennsylvania Philadelphia, PA United States
- Leonard Davis Institute of Health Care Economics University of Pennsylvania Philadelphia, PA United States
| | - Jonathan Purtle
- Department of Public Health Policy & Management School of Global Public Health New York University New York, NY United States
| | - Anish K Agarwal
- Department of Emergency Medicine Perelman School of Medicine University of Pennsylvania Philadelphia, PA United States
- Center for Digital Health University of Pennsylvania Philadelphia, PA United States
- Center for Emergency Care Policy and Research, Department of Emergency Medicine Perelman School of Medicine University of Pennsylvania Philadelphia, PA United States
- Leonard Davis Institute of Health Care Economics University of Pennsylvania Philadelphia, PA United States
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20
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Tang CSK, Siu TSU, Chow TS, Kwok HSH. The Role of Family Resilience and Pandemic Burnout on Mental Health: A Two-Wave Study in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3803. [PMID: 36900809 PMCID: PMC10001644 DOI: 10.3390/ijerph20053803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 02/17/2023] [Accepted: 02/18/2023] [Indexed: 06/18/2023]
Abstract
Family resilience refers to the processes through which a family adapts to and bounces back from adversities. Pandemic burnout refers to feeling emotionally exhausted, cynical, and lack of accomplishment during the pandemic and/or toward various preventive polices and measures. This two-wave, region-wide, longitudinal study included 796 adult participants residing in mainland China. Participants completed online surveys at two time points during the COVID-19 pandemic. Time 1 (T1) survey was conducted when the number of new infected cases in China stabilized, while Time 2 (T2) was conducted 5 months later when there was a sudden surge of new infected cases. Results of a hierarchical regression analysis revealed that the interaction and main effects of pandemic burnout and family resilience at T2 showed significant incremental prediction of depression and anxiety at T2, after controlling for demographic as well as individual and family resilience at T1. These results supported the hypotheses that current family resilience functions as a protective factor, whereas pandemic burnout functions as a risk factor of mental health during successive waves of pandemic outbreaks. In particular, family resilience at T2 mitigated the negative impact of high pandemic burnout on anxiety and depression at T2.
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Affiliation(s)
- Catherine So-kum Tang
- Department of Counselling and Psychology, Hong Kong Shue Yan University, North Point, Hong Kong SAR, China
- Centre for Interdisciplinary Evidence-based Practice and Research, Hong Kong Shue Yan University, North Point, Hong Kong SAR, China
| | - Tiffany Sok U Siu
- Centre for Interdisciplinary Evidence-based Practice and Research, Hong Kong Shue Yan University, North Point, Hong Kong SAR, China
| | - Tak Sang Chow
- Department of Counselling and Psychology, Hong Kong Shue Yan University, North Point, Hong Kong SAR, China
- Centre for Interdisciplinary Evidence-based Practice and Research, Hong Kong Shue Yan University, North Point, Hong Kong SAR, China
| | - Helen Sin-Hang Kwok
- Department of Counselling and Psychology, Hong Kong Shue Yan University, North Point, Hong Kong SAR, China
- Centre for Interdisciplinary Evidence-based Practice and Research, Hong Kong Shue Yan University, North Point, Hong Kong SAR, China
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Bae S. A Qualitative Study of Hospital Interior Environments during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3271. [PMID: 36833965 PMCID: PMC9967306 DOI: 10.3390/ijerph20043271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 02/06/2023] [Accepted: 02/11/2023] [Indexed: 06/18/2023]
Abstract
Human beings have encountered different infectious diseases. However, there is not much validated data available on the physical environments of hospitals when responding to highly contagious viruses, such as COVID-19. This study was conducted to assess the physical environments of hospitals during the COVID-19 pandemic. There exists a need to analyze whether the physical environments of hospitals were conducive or obstructive to medical practice during the pandemic. A total of forty-six staff working in intensive care units, progressive care units, and emergency rooms were invited to participate in a semi-structured interview. Out of this group, fifteen staff members participated in the interview. They were asked to list the changes made to the hospital's physical environment during the pandemic, which included equipping the hospital environment for medical practice and protecting staff from becoming infected. They were also asked about desirable improvements that they believe could increase their productivity and ensure safety. The results indicated the difficulty in isolating COVID-19 patients and converting a single occupancy room into a double occupancy room. Isolating COVID-19 patients made it easier for staff to care for the patients, but it made them feel isolated and at the same time increased the walking distance. Signs indicating a COVID area helped them to prepare for medical practices ahead of time. Glass doors provided greater visibility and enabled them to monitor the patients. However, the dividers installed at nursing stations were obstructive. This study suggests that further research should be conducted once the pandemic is over.
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Affiliation(s)
- Suyeon Bae
- Department of Housing & Interior Design, Age Tech-Convergence Major, Kyung Hee University, Seoul 02447, Republic of Korea
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22
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Prevalence and determinants of Italian physicians' burnout in the "post-COVID-19" era. Int Arch Occup Environ Health 2023; 96:377-387. [PMID: 36335513 PMCID: PMC9638242 DOI: 10.1007/s00420-022-01929-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 10/16/2022] [Indexed: 11/09/2022]
Abstract
PURPOSE Several studies investigated prevalence and determinants of physicians' burnout during the peak of the COVID-19 pandemic, but only a few during the chronic phase of the pandemic. This study thus aimed to examine this topic referring to the "post-COVID-19 era", defined as a chronic and likely-to-be endemic status quo. METHODS A cross-sectional, online survey (November 2021-January 2022) was addressed to physicians in Lombardia (Northern Italy). Besides socio-demographic and COVID-19-related data, measures of personal, work- and patient-related burnout (Copenhagen Burnout Inventory; CBI), depression (Patient Health Questionnaire-8), anxiety (General Anxiety Disorder-7), and self-efficacy (General Self-Efficacy Scale) were collected. Linear/generalized linear models were run to test associations/predictions of interest. RESULTS Among the 958 respondents, burnout symptoms were clinically significant in 18.5% of them. Predictive models showed that female sex (OR = 0.73, 95% CI 0.42-1.27), younger age (OR = 0.94, 95% CI 0.59-1.48), shorter job tenure (OR = 1.01, 95% CI 0.62-1.65), trainee status (OR = 1.41, 95% CI 1.16-7.10), higher PHQ-8 (OR = 1.260, 95% CI 1.16-1.37), and GAD-7 scores (OR = 1.19, 95% CI 1.10-1.30) increased the risk to suffer from clinical burnout. COVID-19-related variables were mostly not related/associated to burnout levels. CONCLUSION In Italy, physicians' burnout is moderately prevalent also in the chronic phase of the pandemic, with its determinants being more intrinsic than environmental. The development of effective interventions is needed to help physicians cope with the new challenges of their job.
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Fleming P, Caffrey L, Belle SV, Barry S, Burke S, Conway J, Siersbaek R, Mockler D, Thomas S. How International Health System Austerity Responses to the 2008 Financial Crisis Impacted Health System and Workforce Resilience - A Realist Review. Int J Health Policy Manag 2022; 12:7420. [PMID: 37579453 PMCID: PMC10125082 DOI: 10.34172/ijhpm.2022.7420] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 11/19/2022] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND The Great Recession, following the 2008 financial crisis, led many governments to adopt programmes of austerity. This had a lasting impact on health system functionality, resources, staff (numbers, motivation and morale) and patient outcomes. This study aimed to understand how health system resilience was impacted and how this affects readiness for subsequent shocks. METHODS A realist review identified legacies associated with austerity (proximal outcomes) and how these impact the distal outcome of health system resilience. EMBASE, CINAHL, MEDLINE, EconLit and Web of Science were searched (2007-May 2021), resulting in 1081 articles. Further theory-driven searches resulted in an additional 60 studies. Descriptive, inductive, deductive and retroductive realist analysis (utilising excel and Nvivo) aided the development of context-mechanism-outcome configurations (CMOCs), alongside stakeholder engagement to confirm or refute emerging results. Causal pathways, and the interplay between context and mechanisms that led to proximal and distal outcomes, were revealed. The refined CMOCs and policy recommendations focused primarily on workforce resilience. RESULTS Five CMOCs demonstrated how austerity-driven policy decisions can impact health systems when driven by the priorities of external agents. This created a real or perceived shift away from the values and interests of health professionals, a distrust in decision-making processes and resistance to change. Their values were at odds with the realities of implementing such policy decisions within sustained restrictive working conditions (rationing of staff, consumables, treatment options). A diminished view of the profession and an inability to provide high-quality, equitable, and needs-led care, alongside stagnant or degraded working conditions, led to moral distress. This can forge legacies that may adversely impact resilience when faced with future shocks. CONCLUSION This review reveals the importance of transparent, open communication, in addition to co-produced policies in order to avoid scenarios that can be detrimental to workforce and health system resilience.
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Affiliation(s)
- Padraic Fleming
- Centre for Health Policy and Management, Trinity College Dublin, The University of Dublin, Dublin 2, Ireland
| | - Louise Caffrey
- School of Social Work and Social Policy, Trinity College Dublin, The University of Dublin, College Green, Dublin 2, Ireland
| | | | - Sarah Barry
- Centre for Health Policy and Management, Trinity College Dublin, The University of Dublin, Dublin 2, Ireland
| | - Sara Burke
- Centre for Health Policy and Management, Trinity College Dublin, The University of Dublin, Dublin 2, Ireland
| | - Jacki Conway
- Everlake, 5 Marine Terrace, Dun Laoghaire, Dublin, Ireland
| | - Rikke Siersbaek
- Centre for Health Policy and Management, Trinity College Dublin, The University of Dublin, Dublin 2, Ireland
| | - David Mockler
- Library Reader Services, Trinity College Dublin, The University of Dublin, St James Hospital, Dublin 8, Ireland
| | - Steve Thomas
- Centre for Health Policy and Management, Trinity College Dublin, The University of Dublin, Dublin 2, Ireland
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Gilavand A. The effect of shift work on burnout and occupational fatigue among clinical faculty members during the COVID-19 pandemic. Front Public Health 2022; 10:973690. [PMID: 36324454 PMCID: PMC9621389 DOI: 10.3389/fpubh.2022.973690] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 09/09/2022] [Indexed: 01/21/2023] Open
Abstract
Introduction Shift work of clinical faculty members in the COVID-19 pandemic may cause burnout and occupational fatigue and as a result, may reduce the quality of student education and disrupt the treatment of patients, so this study was conducted to evaluate this case. Materials and methods The statistical population of this cross-sectional research included all clinical faculty members of Ahvaz Jundishapur University of Medical Sciences in southwestern Iran, who experienced a shift work system (night shift from 8 p.m. to 8 a.m.) during the COVID-19 pandemic, and finally, 71 of them participated in it. The sampling method was also available. Two inventories were used to collect data, namely the Maslach Burnout Inventory [MBI-HSS (MP)] and the Swedish Occupational Fatigue Inventory (SOFI-20). Results The self-reported burnout of faculty members was high (mean ± SD = 98.18 ± 17.18), which was graded into the range of emotional exhaustion (38.01 ± 10.2), range of personal accomplishment, (33.75 ± 6.75), and the range of depersonalization (26.42 ± 3.5), respectively. Perceived occupational fatigue of faculty members was also high (M ± SD = 82.25 ± 34.79), which included the dimensions of lack of motivation (18.69 ± 8.65), drowsiness (17.43 ± 8.7), lack of energy (16.33 ± 7.67), physical discomfort (15.65 ± 8.62), and physical stress (13.51 ± 6.9), respectively. In terms of demographic characteristics, occupational fatigue was significantly more common among women. Discussion and conclusion The self-reported burnout and occupational fatigue of clinical faculty members due to shift work were reported to be high in this study. Although our knowledge of burnout has advanced in recent years, many gaps in our knowledge still remain. In order for clinical faculty members to properly fulfill their mission to treat patients, educate students, and promote public health, it is necessary to provide all the necessary conditions for their effective activity. Some interventions, such as improving organizational strategies and providing technical solutions, incentives, and occupational facilities, can help reduce or eliminate these problems.
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Mann A, Fainstad T, Shah P, Dieujuste N, Thurmon K, Dunbar K, Jones C. "We're all going through it": impact of an online group coaching program for medical trainees: a qualitative analysis. BMC MEDICAL EDUCATION 2022; 22:675. [PMID: 36100880 PMCID: PMC9468533 DOI: 10.1186/s12909-022-03729-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 08/30/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Trainees in graduate medical education are affected by burnout at disproportionate rates. Trainees experience tremendous growth in clinical skills and reasoning, however little time is dedicated to metacognition to process their experiences or deliberate identity formation to create individualized definitions of success and wellbeing. The purpose of this study was to understand the perspectives and experiences of trainees who participated in a 6-month, web-based, group coaching program for women residents in training. METHODS Better Together Physician Coaching is a six-month, self-paced, online, asynchronous, coaching program with multiple components including live coaching calls, unlimited written coaching, and self-study modules. Semi-structured interviews of seventeen participants of Better Together from twelve GME programs within a single institution in Colorado were conducted from May to June of 2021. All identified as women and had participated in a 6-month coaching program. Both inductive and deductive methods were used in collecting and analyzing the data with an aim to understand learners' perceptions of the coaching program, including "how and why" the coaching program affected training experiences and wellbeing. RESULTS Three main themes emerged as benefits to the coaching program from the data: 1) practicing metacognition as a tool for healthy coping 2) building a sense of community, and 3) the value of a customizable experience. CONCLUSIONS Female trainees who participated in a group coaching program expressed that they found value in learning how to cope with stressors through metacognition-focused coaching. They also described that building a community and being able to customize the experience were positive aspects of the program. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT05280964 . Date of registration: March 15th 2022. Retrospectively registered. URL of trial registry record.
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Affiliation(s)
- Adrienne Mann
- Department of Medicine, Division of Hospital Medicine, University of Colorado Anschutz Medical Campus, Veterans Health Administration, Aurora, CO, USA.
- Rocky Mountain Regional VA Medical Center, 1700 N Wheeling St., Aurora, CO, 80045, USA.
| | - Tyra Fainstad
- Department of Medicine, Division of General Internal Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
- Lowry Internal Medicine, 8101 E Lowry Blvd Ste 120, Denver, CO, 80230, USA.
| | - Pari Shah
- Graduate School of Social Work, University of Denver, Denver, CO, USA
| | - Nathalie Dieujuste
- Adult & Child Consortium for Health Outcomes Research & Delivery Science (ACCORDS), University of Colorado, School of Medicine, Aurora, CO, USA
| | - Kerri Thurmon
- Department of Surgery, Division of Urology, Denver Health, Denver, USA
| | - Kimiko Dunbar
- Department of Pediatrics, Division of Hospital Medicine, Children's Hospital, Aurora, USA
| | - Christine Jones
- Department of Medicine, Division of Hospital Medicine, University of Colorado Anschutz Medical Campus, Veterans Health Administration, Aurora, CO, USA
- Veterans Health Administration, Eastern CO Health Care System, Denver-Seattle Center of Innovation for Veteran-Centered and Value Driven Care, Aurora, CO, USA
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Shaikh CF, Palmer Kelly E, Paro A, Cloyd J, Ejaz A, Beal EW, Pawlik TM. Burnout Assessment Among Surgeons and Surgical Trainees During the COVID-19 Pandemic: A Systematic Review. JOURNAL OF SURGICAL EDUCATION 2022; 79:1206-1220. [PMID: 35659443 PMCID: PMC9091165 DOI: 10.1016/j.jsurg.2022.04.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/22/2022] [Accepted: 04/30/2022] [Indexed: 05/07/2023]
Abstract
BACKGROUND The objective of the current study was to summarize current research on burnout among surgical trainees and surgeons during the COVID-19 pandemic. METHODS PubMed, SCOPUS, Embase, and Psych INFO were systematically searched for studies that evaluated burnout during the COVID-19 pandemic among surgical trainees and surgeons. RESULTS A total of 29 articles met inclusion criteria, most of which originated from the United States (n = 18, 62.1%). Rates of burnout ranged from 6.0% to 86.0%. Personal factors responsible for burnout were fear of contracting/transmitting COVID-19 (8 studies, 27.6%), female gender (8, 27.6%), and younger age (5, 17.2%). Professional factors contributing to burnout included increased COVID-19 patient clinical load (6, 20.7%), limited work experience (6, 20.7%), reduction in operative cases (5, 17.2%) and redeployment to COVID-19 wards (4, 13.8%). The COVID-19 pandemic negatively impacted surgical education due to reduced number of operative cases (11, 37.9%), decreased hands-on experience (4, 13.8%), and not being able to complete case requirements (3, 10.34%). The shift of didactics to virtual formats (3, 10.3%), increased use of telemedicine (2, 6.9%), and improved camaraderie among residents (1, 3.4%) were viewed as positive consequences. CONCLUSION COVID-19 related burnout was reported in as many as 1 in 2 surgical trainees and attending surgeons. Intrinsic- (i.e., gender, age), family- (i.e., family/being married/having children or being single/not having children), as well as work-related extrinsic- (i.e., work-force deployment, risk of infection/spread, changes in educational format) factors were strongly associated with risk of burnout. These factors should be considered when designing interventions to ameliorate burnout among surgical trainees and surgeons.
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Affiliation(s)
- Chanza Fahim Shaikh
- Department of Surgery, The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research Institute, Columbus, Ohio
| | - Elizabeth Palmer Kelly
- Department of Surgery, The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research Institute, Columbus, Ohio
| | - Alessandro Paro
- Department of Surgery, The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research Institute, Columbus, Ohio
| | - Jordan Cloyd
- Department of Surgery, The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research Institute, Columbus, Ohio
| | - Aslam Ejaz
- Department of Surgery, The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research Institute, Columbus, Ohio
| | - Eliza W Beal
- Department of Surgery, The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research Institute, Columbus, Ohio
| | - Timothy M Pawlik
- Department of Surgery, The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research Institute, Columbus, Ohio.
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Aiello EN, Fiabane E, Margheritti S, Magnone S, Bolognini N, Miglioretti M, Giorgi I. Psychometric properties of the Copenhagen Burnout Inventory (CBI) in Italian Physicians. LA MEDICINA DEL LAVORO 2022; 113:e2022037. [PMID: 36006095 PMCID: PMC9484286 DOI: 10.23749/mdl.v113i4.13219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 07/28/2022] [Indexed: 06/15/2023]
Abstract
UNLABELLED This study aimed to standardize the Copenhagen Burnout Inventory (CBI), a psychometrically sound, worldwide-spread tool among Italian physicians. METHODS Nine hundred and fifteen Italian physicians were web-administered the CBI, Patient Health Questionnaire-8 (PHQ-8), Generalized Anxiety Disorder-7 (GAD-7) and General Self-Efficacy Scale (GSE). The present CBI included 18 items (range=19-90) assessing Personal, Work-related and Client-related Burnout. Client-related adaptation was performed. Construct validity, factorial structure (Confirmatory Factor Analysis) and internal consistency were tested. Diagnostic accuracy was assessed simultaneously against the PHQ-8, GAD-7 and GSE. All CBI measures yielded optimal internal consistency (Cronbach's α=0.90-0.96). RESULTS The CBI met its original three-factor model (CFI=0.94; TLI=0.93; RMSEA=0.09; SRMR=0.04), was positively related to the PHQ-8 (r=0.76) and GAD-7 (r=0.73), whereas negatively with the GSE (r=0.39) and yielded optimal diagnostics (AUC=0.93; sensitivity=0.91 and specificity=0.85 at the optimal cutoff of 69/90). CONCLUSION The CBI is thus a valid, reliable, and normed tool to assess burnout levels in physicians.
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Affiliation(s)
| | - Elena Fiabane
- Department of Physical and Rehabilitation Medicine of Genova Nervi Institute, Istituti Clinici Scientifici Maugeri, Genova.
| | | | - Stefano Magnone
- Regional Secretary, ANAAO ASSOMED Lombardia Associazione Medici Dirigenti, Milano, Italy.
| | - Nadia Bolognini
- Department of Psychology, University of Milano-Bicocca, Milano.
| | | | - Ines Giorgi
- Dipartimento di Sanità pubblica, Medicina Sperimentale e Forense, University of Pavia, Pavia.
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Sun J, Sarfraz M, Ivascu L, Iqbal K, Mansoor A. How Did Work-Related Depression, Anxiety, and Stress Hamper Healthcare Employee Performance during COVID-19? The Mediating Role of Job Burnout and Mental Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10359. [PMID: 36011994 PMCID: PMC9408233 DOI: 10.3390/ijerph191610359] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 08/15/2022] [Accepted: 08/18/2022] [Indexed: 06/15/2023]
Abstract
The study objective was to examine the psychological impact of the COVID-19 pandemic on the performance of healthcare employees. The study was informed by a theoretical framework that incorporates different psychological issues (i.e., stress, depression, and anxiety) that influence healthcare workers' performance through the mediating roles of job burnout and mental health. The study data was gathered through structured questionnaires from 669 participants working in the healthcare sector in Pakistan. A structured equation modeling (SEM) technique was used for data analysis and hypothesis development. It was found that stress, depression, and anxiety positively affected healthcare employees' job performance during COVID-19. Psychological factors had a positive and significant impact on job burnout and mental health. Job burnout and mental health mediated the relationship between stress, anxiety, depression, and employee performance. The ongoing repercussions of COVID-19 include their impact on employee performance in the healthcare sector. Healthcare worker performance is critical to fostering industrial economic growth. Elevated levels of stress, depression, and anxiety have profoundly exacerbated employee mental health issues. COVID-19 has created challenging working conditions in organizations requiring that they address the growing psychological issues which impact negatively on worker performance.
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Affiliation(s)
- Jianmin Sun
- School of Management, Nanjing University of Posts and Telecommunications, Nanjing 210006, China
| | - Muddassar Sarfraz
- School of Management, Zhejiang Shuren University, Hangzhou 310015, China
| | - Larisa Ivascu
- Faculty of Management in Production and Transportation, Politehnica University of Timisoara, 300191 Timisoara, Romania
| | - Kashif Iqbal
- School of Business, Shanghai Dianji University, Nanhui Xincheng Town, Shanghai 201306, China
| | - Athar Mansoor
- Division of Public Policy, Hong Kong University of Science and Technology, Hong Kong
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29
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Chen C, Li F, Liu C, Li K, Yang Q, Ren L. The relations between mental well-being and burnout in medical staff during the COVID-19 pandemic: A network analysis. Front Public Health 2022; 10:919692. [PMID: 36033796 PMCID: PMC9399609 DOI: 10.3389/fpubh.2022.919692] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 07/19/2022] [Indexed: 01/22/2023] Open
Abstract
Background Although poor mental well-being (MW) has been documented among individuals experiencing burnout during the coronavirus-19 (COVID-19) pandemic, little is known about the complex interrelationship between different components of MW and burnout. This study investigates this relationship among medical staff during the COVID-19 pandemic through network analysis. Methods A total of 420 medical staff were recruited for this study. Components of MW were measured by the 14-item Warwick-Edinburgh Mental Well-being Scale (WEMWBS), and components of burnout were measured by a 15-item Maslach Burnout Inventory-General Survey (MBI-GS) Questionnaire. Network structure was constructed via network analysis. Bridge variables were identified via the bridge centrality index. Results The edges across two communities (i.e., MW community and burnout community) are almost negative, such as edge MW2 ("Useful") - B14 ("Worthwhile") and edge MW1 ("Optimistic about future") - B13 ("Happy"). The edges within each community are nearly positive. In the MW community, components MW1 ("Optimistic about future") and MW6 ("Dealing with problems") have the lowest bridge centrality. And in the community of burnout, components B13 ("Happy") and B14 ("Worthwhile") have the lowest bridge expected influence. Conclusion We present the first study to apply the network approach to model the potential pathways between distinct components of MW and burnout. Our findings suggest that promoting optimistic attitudes and problem-solving skills may help reduce burnout among medical staff during the pandemic.
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Affiliation(s)
- Chen Chen
- Military Medical Psychology School, Air Force Medical University, Xi'an, China
| | - Fengzhan Li
- Military Medical Psychology School, Air Force Medical University, Xi'an, China
| | - Chang Liu
- Brain Park, Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Kuiliang Li
- School of Psychology, Army Medical University, Chongqing, China
| | - Qun Yang
- Military Medical Psychology School, Air Force Medical University, Xi'an, China,*Correspondence: Qun Yang
| | - Lei Ren
- Military Medical Psychology School, Air Force Medical University, Xi'an, China,Lei Ren
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30
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Kelley MM, Zadvinskis IM, Miller PS, Monturo C, Norful AA, O'Mathúna D, Roberts H, Smith J, Tucker S, Zellefrow C, Chipps E. United States nurses' experiences during the COVID-19 pandemic: A grounded theory. J Clin Nurs 2022; 31:2167-2180. [PMID: 34606133 DOI: 10.1111/jocn.16032] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 08/24/2021] [Accepted: 08/26/2021] [Indexed: 12/17/2022]
Abstract
OBJECTIVE The objective of this study was to explore nurses' experiences and perceptions at selected United States (U.S.) healthcare sites during the COVID-19 pandemic. BACKGROUND The COVID-19 pandemic brought rapid changes to the healthcare community. While a few studies have examined the early pandemic experiences of nurses in China and Europe, nurses' experiences across the United States have remained relatively underexplored. DESIGN A qualitative study design was used. METHODS Using a constructivist grounded theory methodology and methods, we conducted eight focus groups across four hospital sites in the eastern, midwestern and western United States. Registered nurses with a minimum of six months' experience working in all clinical specialties were eligible. Forty-three nurses participated. Data were analysed iteratively using the constant comparative method. The COREQ guidelines supported the work and reporting of this study. RESULTS The nurses experiencing a pandemic (NEXPIC) grounded theory emerged positing associations between four interrelated themes: Challenges, Feelings, Coping and Ethics. Nurses reported Challenges associated with changes in the work environment, community and themselves. They expressed more negative than positive feelings. Nurses coped using self-care techniques, and teamwork within the healthcare organisation. Moral dilemmas, moral uncertainty, moral distress, moral injury and moral outrage were ethical issues associated with nurses' Challenges during the pandemic. Moral courage was associated with positive Coping. CONCLUSIONS Awareness of frontline nurses' complex and interrelated needs may help healthcare organisations protect their human resources. This new theory provides preliminary theoretical support for future research and interventions to address the needs of frontline nurses. RELEVANCE TO CLINICAL PRACTICE Nurses face added distress as frontline at-risk caregivers. Interventions to promote nurses' ability to cope with personal and professional challenges from the pandemic and address ethical issues are needed to protect the nursing workforce. This study offers a new substantive theory that may be used to underpin future interventions.
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Affiliation(s)
| | - Inga M Zadvinskis
- The Helene Fuld Health Trust National Institute for Evidence-Based Practice in Nursing and Healthcare, College of Nursing, The Ohio State University, Columbus, Ohio, USA
| | - Pamela S Miller
- UCLA Health, Center for Nursing Excellence, Los Angeles, California, USA
| | - Cheryl Monturo
- Chester County Hospital - Penn Medicine, West Chester, Pennsylvania, USA
| | | | - Dónal O'Mathúna
- The Helene Fuld Health Trust National Institute for Evidence-Based Practice in Nursing and Healthcare, College of Nursing, The Ohio State University, Columbus, Ohio, USA
| | - Haley Roberts
- College of Nursing, The Ohio State University, Columbus, Ohio, USA
| | - Julia Smith
- College of Nursing, The Ohio State University, Columbus, Ohio, USA
| | - Sharon Tucker
- College of Nursing, The Ohio State University, Columbus, Ohio, USA
- The Helene Fuld Health Trust National Institute for Evidence-Based Practice in Nursing and Healthcare, College of Nursing, The Ohio State University, Columbus, Ohio, USA
| | - Cindy Zellefrow
- College of Nursing, The Ohio State University, Columbus, Ohio, USA
- The Helene Fuld Health Trust National Institute for Evidence-Based Practice in Nursing and Healthcare, College of Nursing, The Ohio State University, Columbus, Ohio, USA
| | - Esther Chipps
- College of Nursing, The Ohio State University, Columbus, Ohio, USA
- The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
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Khoo E, Saeed SG, Chiu HY, Quach V, Janal M, Stewart K. Stress and anxiety in orthodontic residents during the coronavirus disease 2019 pandemic. Am J Orthod Dentofacial Orthop 2022; 162:e35-e43. [PMID: 35589506 PMCID: PMC9058028 DOI: 10.1016/j.ajodo.2022.04.011] [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: 10/10/2021] [Revised: 04/04/2022] [Accepted: 04/04/2022] [Indexed: 12/14/2022]
Abstract
INTRODUCTION The coronavirus disease 2019 pandemic has had far-reaching effects on health care providers and health professional students; however, little is known about the factors related to stress and anxiety levels, specifically among orthodontic residents during this time. METHODS A 2-part questionnaire, which included modified stress and anxiety inventories, was disseminated electronically to U.S. orthodontic residents between June and July 2020. Descriptive and comparative statistics were used to analyze the data. RESULTS Overall, 261 participants responded (56% female), representing a response rate of 26.8%. Significant gender differences were found in 18 stress items, with female respondents expressing more stress than their male counterparts. Only 1 stress item (ie, fear of being unable to catch up if behind) varied as a function of the difference on the basis of respondents' stage in the program. First-year residents reported more stress in relation to this than more senior residents. Responses to all anxiety items but 1 item varied by gender, with females reporting higher scores. Residents in the middle stages of their program responded with higher anxiety scores with significant differences on 3 anxiety items. CONCLUSIONS Although financial responsibilities and travel plans were the most stressful and anxiety-inducing items for orthodontic residents during the early aspect of the coronavirus disease 2019 pandemic, multiple items contributed to their stress and anxiety. In addition, both gender and stage of progress in a residency program impacted the level of stress and anxiety reported by respondents.
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Affiliation(s)
- Edmund Khoo
- Department of Orthodontics and Oral Facial Genetics, Indiana University School of Dentistry, Indianapolis, Ind; Eastman Institute of Oral Health, University of Rochester, Rochester, NY.
| | - Sophia G Saeed
- School of Dental Medicine, University of Connecticut, Farmington, Conn
| | - Hong-Yan Chiu
- Department of Orthodontics, College of Dentistry, New York University, New York, NY
| | - Vicky Quach
- College of Dentistry, New York University, New York, NY
| | - Malvin Janal
- Department of Epidemiology and Health Promotion, College of Dentistry, New York University, New York, NY
| | - Kelton Stewart
- Department of Orthodontics and Oral Facial Genetics, Indiana University School of Dentistry, Indianapolis, Ind
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Nyberg A, Rajaleid K, Demmelmaier I. The Work Environment during Coronavirus Epidemics and Pandemics: A Systematic Review of Studies Using Quantitative, Qualitative, and Mixed-Methods Designs. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116783. [PMID: 35682365 PMCID: PMC9180570 DOI: 10.3390/ijerph19116783] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/27/2022] [Accepted: 05/28/2022] [Indexed: 02/05/2023]
Abstract
We aimed to provide an overview of how work environment and occupational health are affected, and describe interventions designed to improve the work environment during epidemics and pandemics. The guidelines on Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) were followed. The databases Cinahl, Medline, PsycInfo, and Web of Science were searched for population: working population; exposure: coronavirus epidemic or pandemic; and outcome: work environment, in articles published until October 2020. Quality assessment was based on a modified version of the Mixed Methods Appraisal Tool (MMAT). After deduplication 3711 articles remained, of which 530 were selected for full-text screening and 119 for quality assessment. After the exclusion of studies that were low quality, 95 remained, of which 85 focused on healthcare personnel and 10 on employees in other industries; 73 used quantitative methods and 22 used qualitative or mixed methods; the majority were based on cross-sectional data. Healthcare staff experienced increased job demands, poor leadership, and lack of resources (personal protective equipment, personnel, and competence). High demands and work with infected patients were associated with negative mental health outcomes. There was a lack of studies assessing interventions, studies from industries other than healthcare, and studies of high quality.
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Affiliation(s)
- Anna Nyberg
- Department of Public Health and Caring Sciences, Uppsala University, P.O. Box 564, SE-751 22 Uppsala, Sweden;
- Correspondence: ; Tel.: +46-8-708-234318
| | - Kristiina Rajaleid
- Stress Research Institute, Department of Psychology, Stockholm University, SE-106 91 Stockholm, Sweden;
| | - Ingrid Demmelmaier
- Department of Public Health and Caring Sciences, Uppsala University, P.O. Box 564, SE-751 22 Uppsala, Sweden;
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Fleming P, Thomas S, Williams D, Kennedy J, Burke S. Implications for health system reform, workforce recovery and rebuilding in the context of the Great Recession and COVID-19: a case study of workforce trends in Ireland 2008-2021. HUMAN RESOURCES FOR HEALTH 2022; 20:48. [PMID: 35619111 PMCID: PMC9134726 DOI: 10.1186/s12960-022-00747-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 05/17/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Workforce is a fundamental health systems building block, with unprecedented measures taken to meet extra demand and facilitate surge capacity during the COVID-19 pandemic, following a prolonged period of austerity. This case study examines trends in Ireland's publicly funded health service workforce, from the global financial crisis, through the Recovery period and into the COVID-19 pandemic, to understand resource allocation across community and acute settings. Specifically, this paper aims to uncover whether skill-mix and staff capacity are aligned with policy intent and the broader reform agenda to achieve universal access to integrated healthcare, in part, by shifting free care into primary and community settings. METHODS Secondary analysis of anonymised aggregated national human resources data was conducted over a period of almost 14 years, from December 31st 2008 to August 31st 2021. Comparative analysis was conducted, by professional cadre, across three keys periods: 'Recession period' December 31st 2008-December 31st 2014; 'Recovery period' December 31st 2014-December 31st 2019; and the 'COVID-19 period' December 31st 2019-August 31st 2021. RESULTS During the Recession period there was an overall decrease of 8.1% (n = 9333) between December 31st 2008 and December 31st 2014, while the Recovery period saw the overall staff levels rebound and increase by 15.2% (n = 16,789) between December 31st 2014 and December 31st 2019. These figures continued to grow, at an accelerated rate during the most recent COVID-19 period, increasing by a further 8.9% (n = 10,716) in under 2 years. However, a notable shift occurred in 2013, when the number of staff in acute services surpassed those employed in community services (n = 50,038 and 49,857, respectively). This gap accelerated during the Recovery and COVID-19 phase. By August 2021, there were 13,645 more whole-time equivalents in acute settings compared to community, a complete reverse of the 2008 situation. This was consistent across all cadres. Workforce absence trends indicate short-term spikes resulting from shocks while COVID-19 redeployment disproportionately impacted negatively on primary care and community services. CONCLUSIONS This paper clearly demonstrates the prioritisation of staff recruitment within acute services-increasing needed capacity, without the same commitment to support government policy to shift care into primary and community settings. Concerted action including the permanent redistribution of personnel is required to ensure progressive and sustainable responses are learned from recent shocks.
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Affiliation(s)
- Padraic Fleming
- Centre for Health Policy and Management, Trinity College Dublin, The University of Dublin, 3-4 Foster Place, Dublin 2, Ireland.
| | - Steve Thomas
- Centre for Health Policy and Management, Trinity College Dublin, The University of Dublin, 3-4 Foster Place, Dublin 2, Ireland
| | - Des Williams
- National Human Resources Directorate, HSE, Dr. Steevens' Hospital, Dublin 8, Ireland
| | - Jack Kennedy
- National Human Resources Directorate, HSE, Dr. Steevens' Hospital, Dublin 8, Ireland
| | - Sara Burke
- Centre for Health Policy and Management, Trinity College Dublin, The University of Dublin, 3-4 Foster Place, Dublin 2, Ireland
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Symptoms of Burnout Syndrome among Physicians during the Outbreak of COVID-19 Pandemic—A Systematic Literature Review. Healthcare (Basel) 2022; 10:healthcare10060979. [PMID: 35742031 PMCID: PMC9223230 DOI: 10.3390/healthcare10060979] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 05/20/2022] [Accepted: 05/21/2022] [Indexed: 02/04/2023] Open
Abstract
Background: Studies in the recent decades show that the medical profession has a high risk to develop burnout due to constant exposure to mental and physical suffering or death. The pandemic period induced additional stress for healthcare professionals due to the likelihood of a high rate of infection, long working shifts, using protective equipment, staying away from family, implementing new medical procedures. The present study is focusing on assessing the prevalence of burnout among physicians working in the healthcare system during the COVID-19 pandemic, and discovering the main factors associated with burnout syndrome among the population of physicians. Material and methods: A systematic review was conducted by searching PubMed, Wiley, and Google Scholar in November 2021. A total of 35 studies were eligible for the evaluation. Results: The samples ranged from 39 to 3071 physicians, and the overall burnout ranged from 14.7% to 90.4%. Sociodemographic characteristics associated with a high prevalence of burnout were the female gender, less experienced, not having children, and single marital status, associated with high levels of anxiety, depression, and stress in the female gender. The highest level of burnout among all the studies was 90.4% on a sample of physicians from the Republic of Korea, 80.2% among psychiatrists in Saudi Arabia, followed by a study in Ireland with a 77% level of burnout among senior and specialist physicians, and 74.7% prevalence of burnout for emergency physicians in USA. Conclusions: During the pandemic, the factors that contribute to burnout are the lack of personal protective equipment and the violence of issues related to organizational health; the high prevalence of burnout symptoms is associated with anxiety, depression, and stress.
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Maskeliūnas R, Kulikajevas A, Damaševičius R, Pribuišis K, Ulozaitė-Stanienė N, Uloza V. Lightweight Deep Learning Model for Assessment of Substitution Voicing and Speech after Laryngeal Carcinoma Surgery. Cancers (Basel) 2022; 14:cancers14102366. [PMID: 35625971 PMCID: PMC9139213 DOI: 10.3390/cancers14102366] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 05/03/2022] [Accepted: 05/04/2022] [Indexed: 11/16/2022] Open
Abstract
Laryngeal carcinoma is the most common malignant tumor of the upper respiratory tract. Total laryngectomy provides complete and permanent detachment of the upper and lower airways that causes the loss of voice, leading to a patient's inability to verbally communicate in the postoperative period. This paper aims to exploit modern areas of deep learning research to objectively classify, extract and measure the substitution voicing after laryngeal oncosurgery from the audio signal. We propose using well-known convolutional neural networks (CNNs) applied for image classification for the analysis of voice audio signal. Our approach takes an input of Mel-frequency spectrogram (MFCC) as an input of deep neural network architecture. A database of digital speech recordings of 367 male subjects (279 normal speech samples and 88 pathological speech samples) was used. Our approach has shown the best true-positive rate of any of the compared state-of-the-art approaches, achieving an overall accuracy of 89.47%.
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Affiliation(s)
- Rytis Maskeliūnas
- Faculty of Informatics, Kaunas University of Technology, 51368 Kaunas, Lithuania; (R.M.); (A.K.)
| | - Audrius Kulikajevas
- Faculty of Informatics, Kaunas University of Technology, 51368 Kaunas, Lithuania; (R.M.); (A.K.)
| | - Robertas Damaševičius
- Faculty of Informatics, Kaunas University of Technology, 51368 Kaunas, Lithuania; (R.M.); (A.K.)
- Correspondence:
| | - Kipras Pribuišis
- Department of Otorhinolaryngology, Lithuanian University of Health Sciences, 50061 Kaunas, Lithuania; (K.P.); (N.U.-S.); (V.U.)
| | - Nora Ulozaitė-Stanienė
- Department of Otorhinolaryngology, Lithuanian University of Health Sciences, 50061 Kaunas, Lithuania; (K.P.); (N.U.-S.); (V.U.)
| | - Virgilijus Uloza
- Department of Otorhinolaryngology, Lithuanian University of Health Sciences, 50061 Kaunas, Lithuania; (K.P.); (N.U.-S.); (V.U.)
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Shin S, Yoo HJ. Frontline nurses' caring experiences in COVID-19 units: A qualitative study. J Nurs Manag 2022; 30:1087-1095. [PMID: 35338532 PMCID: PMC9115182 DOI: 10.1111/jonm.13607] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 03/02/2022] [Accepted: 03/23/2022] [Indexed: 11/30/2022]
Abstract
Aim Exploring nurses' caring and communication experiences in COVID‐19 units. Background Frontline nurses play a critical role in providing 24‐h bedside nursing care to COVID‐19 patients. An in‐depth understanding of frontline nurses' lived experiences is necessary to establish appropriate nursing strategies during crises, such as the COVID‐19 pandemic. Methods Qualitative descriptive design with content analysis. Results Fifteen nurses were interviewed, and three themes were identified: central role of therapeutic communication, compassion that deepens naturally and expansion of professionalism in nursing. Conclusion The nurses proactively provided care for COVID‐19 patients, and they acknowledged and accepted their roles in protecting the lives and ensuring the health of their patients daily. The nurses' experiences in COVID‐19 units served as an opportunity for ruminating and rediscovering the meaning of nursing. Implications for Nursing Management Hospital policymakers and nurse managers should strive to resolve the communication‐related challenges faced by nurses. Standardizing and implementing effective communication strategies should be considered in nursing management.
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Affiliation(s)
| | - Hye Jin Yoo
- College of Nursing, Dankook University, Cheonan, South Korea
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The Impact of the COVID-19 Pandemic on Burnout, Compassion Fatigue, and Compassion Satisfaction in Healthcare Personnel: A Systematic Review of the Literature Published during the First Year of the Pandemic. Healthcare (Basel) 2022; 10:healthcare10020364. [PMID: 35206978 PMCID: PMC8872521 DOI: 10.3390/healthcare10020364] [Citation(s) in RCA: 94] [Impact Index Per Article: 47.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 01/29/2022] [Accepted: 02/10/2022] [Indexed: 11/16/2022] Open
Abstract
This literature review aimed to determine the level of burnout, compassion fatigue, and compassion satisfaction, as well as their associated risks and protective factors, in healthcare professionals during the first year of the COVID-19 pandemic. We reviewed 2858 records obtained from the CINAHL, Cochrane Library, Embase, PsycINFO, PubMed, and Web of Science databases, and finally included 76 in this review. The main results we found showed an increase in the rate of burnout, dimensions of emotional exhaustion, depersonalization, and compassion fatigue; a reduction in personal accomplishment; and levels of compassion satisfaction similar to those before the pandemic. The main risk factors associated with burnout were anxiety, depression, and insomnia, along with some sociodemographic variables such as being a woman or a nurse or working directly with COVID-19 patients. Comparable results were found for compassion fatigue, but information regarding compassion satisfaction was lacking. The main protective factors were resilience and social support.
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Samudyatha UC, Kosambiya JK, Rathore MS. HIV Care in the Times of COVID-19 Pandemic in Urban South Gujarat: An Operational Overview. J Int Assoc Provid AIDS Care 2022; 21:23259582221084885. [PMID: 35285741 PMCID: PMC8922047 DOI: 10.1177/23259582221084885] [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] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 12/24/2021] [Accepted: 02/11/2022] [Indexed: 11/17/2022] Open
Abstract
In India, the nationwide lockdown was implemented from March to May 2020 due to COVID-19 pandemic. As of March 2020, there were 13.08 lakh PLHIV availing ART free of cost from Government run ART centres, To maintain the continuum of care, National AIDS Control Programme (NACP) of India adopted Multi Months Dispensation (MMD) through ART centres and Community Dispensation of ART through the various Targeted Interventions (TI) and Community Based Organizations (CBO). A mixed methods study was designed, with desk review of programmatic data, semi qualitative interviews of 250 PLHIV and 15 In-Depth Interviews of ART centre and TI/CBO staff to document the process, strengths and challenges of these strategies in Surat city of South Gujarat. While administrative, technical and networking strengths were documented, manpower constraints, interrupted laboratory services, migration and relatively passive role of PLHIV in availing services were major challenges described in this study among several others.
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Affiliation(s)
- U. C. Samudyatha
- Department of Community Medicine, MVJ Medical College and Research Hospital, Hoskote, Karnataka, India
| | - J. K. Kosambiya
- Department of Community Medicine, Government Medical College, Surat, Gujarat, India
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Botti S, Cannici C, Liptrott SJ, De Cecco V, Rostagno E, Gargiulo G, Orlando L, Caime A, Samarani E, Galgano L, Cioce M, Mordini N, Mandelli NE, Tombari L, Errichiello S, Celon N, Lupo R, Rea T, Serra N. Nurses' Physical and Psychological Symptoms During the first COVID-19 Lockdown in Italy: a Nationwide Cross-Sectional Study in Stem Cell Transplantation Setting. Mediterr J Hematol Infect Dis 2022; 14:e2022010. [PMID: 35070217 PMCID: PMC8747087 DOI: 10.4084/mjhid.2022.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 12/14/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Northern Italy was one of the first European territories to deal with the Coronavirus Disease 2019 (COVID-19) outbreak. Drastic emergency restrictions were introduced to contain the spread and limit pressure on healthcare facilities. However, nurses were at high risk of developing physical, mental, and working issues due to professional exposure. The aim of this cross-sectional study was to investigate these issues among nurses working in Italian hematopoietic stem cell transplant (HSCT) centers during the COVID-19 pandemic. METHODS Data were collected online immediately after the first "lockdown" period in order to investigate the prevalence of physical issues, sleep disorders, and burnout symptoms and explore correlations with COVID-19 territorial incidence in Northern Italian regions versus Central and Southern Italian regions. RESULTS Three hundred and eight nurses working in 61 Italian HSCT Units responded to the survey. Depression, cough, and fever were more frequently reported by nurses working in geographical areas less affected by the pandemic (p=0.0013, p<0.0001, and p=0.0005 respectively) as well as worst sleep quality (p=0.008). Moderate levels of emotional exhaustion (mean±SD -17.4±13.0), depersonalization (5.3±6.1), and personal accomplishment (33.2±10.7) were reported without significant differences between territories. CONCLUSIONS different COVID-19 incidence among territories did not influence nurses' burden of symptoms in the HSCT setting. However, burnout and insomnia levels should be considered by health care facilities in order to improve preventive strategies.
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Affiliation(s)
- Stefano Botti
- Hematology Unit, Azienda USL-IRCCS di Reggio Emilia, viale Risorgimento 80, 42123, Reggio Emilia, Italy
| | - Chiara Cannici
- Division of Hematology, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, via Venezia 16, 15121, Alessandria, Italy
| | | | - Valentina De Cecco
- Department of Onco-Haematology and Cell and Gene Therapy, Bambino Gesù Children's Hospital IRCCS, Piazza Sant'Onofrio 4, 00165, Rome, Italy
| | - Elena Rostagno
- Oncoematologia Pediatrica, IRCCS Azienda Ospedaliero Universitaria di Bologna, via Giuseppe Massarenti 13, 40138, Bologna, Italy
| | - Gianpaolo Gargiulo
- Haematology Unit, Federico II University Hospital of Naples, via S. Pansini 5, 80131, Naples, Italy
| | - Laura Orlando
- Istituto Oncologico della Svizzera Italiana, via A. Gallino 12, 6500, Bellinzona, Switzerland
| | - Alessandro Caime
- Division of Hemato-Oncology, European Institute of Oncology IRCCS, via Ripamonti 435, 20141, Milan, Italy
| | - Emanuela Samarani
- Unit of Blood Diseases and Stem Cell Transplantation, ASST Spedali Civili, Piazzale Spedali Civili 1, 25100, Brescia, Italy
| | - Letizia Galgano
- Transfusion Medicine and Cell Therapies, AOU-Careggi, Largo Brambilla 3, 50139, Firenze, Italy
| | - Marco Cioce
- Hematology and Trasplant Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy
| | - Nicola Mordini
- Hematology Division, AO S. Croce e Carle, via M. Coppino 26, 12100 Cuneo, Italy
| | - Nadia Elisa Mandelli
- Department of Pediatrics, University of Milano-Bicocca Fondazione MBBM/ASST, via Pergolesi 33, 20900 Monza, Italy
| | - Lucia Tombari
- Hematology and Stem Cell Transplant Center, Azienda Ospedaliera Ospedali Riuniti Marche Nord (AORMN), piazzale Carlo Cinelli 4, 61121 Pesaro, Italy
| | - Sara Errichiello
- Hematology Unit, Azienda Sanitaria Universitaria Friuli Centrale, piazzale Santa Maria della Misericordia 15, 33100, Udine, Italy
| | - Nicola Celon
- Pediatric Onco-hematology Unit, AOU Padova, via Giustiniani 2, 35128, Padova, Italy
| | - Roberto Lupo
- Emergency Unit, ASL Lecce “San Giuseppe da Copertino” Hospital, via Carmiano 1, 73043, Copertino Lecce, Italy
| | - Teresa Rea
- Department of Public Health, University Federico II of Naples, via S. Pansini 5, 80131, Naples, Italy
| | - Nicola Serra
- Department of Public Health, University Federico II of Naples, via S. Pansini 5, 80131, Naples, Italy
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Almulhem JA, Aldekhyyel RN, Binkheder S, Temsah MH, Jamal A. Stress and Burnout Related to Electronic Health Record Use among Healthcare Providers during the COVID-19 Pandemic in Saudi Arabia: A Preliminary National Randomized Survey. Healthcare (Basel) 2021; 9:1367. [PMID: 34683047 PMCID: PMC8544434 DOI: 10.3390/healthcare9101367] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 10/09/2021] [Accepted: 10/11/2021] [Indexed: 02/03/2023] Open
Abstract
Healthcare providers' burnout may potentially have a negative impact on patient care. The use of the electronic health record (EHR) increases the burden for healthcare providers (HCPs), particularly during the coronavirus disease-2019 (COVID-19) pandemic. This study assessed the stress and burnout related to the use of EHRs and health information technology (HIT) tools among HCPs during COVID-19 in Saudi Arabia. We used a self-developed survey tool. It consisted of five sections; demographics and professional data, experience using EHR, effects of EHR use, use of EHR and technology tools during COVID-19, and health and wellbeing. The survey link was emailed to a random sample of HCPs registered with a national scientific regulatory body. Univariate, bivariate, and multivariate analyses were performed to measure the association between burnout and study variables. A total of 182 participants completed the survey. 50.5% of participants reported a presence of HIT-related stress, and 40.1% reported a presence of burnout. The variables independently associated with burnout were providing tertiary level of care, working with COVID-19 suspected cases, dissatisfaction with EHRs, and agreement with the statement that using EHRs added frustration to the workday. Further research that explores possible solutions is warranted to minimize burnout among HCPs, especially during infectious outbreaks.
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Affiliation(s)
- Jwaher A. Almulhem
- Medical Informatics and E-learning Unit, Medical Education Department, College of Medicine, King Saud University, Riyadh 11362, Saudi Arabia; (R.N.A.); (S.B.)
| | - Raniah N. Aldekhyyel
- Medical Informatics and E-learning Unit, Medical Education Department, College of Medicine, King Saud University, Riyadh 11362, Saudi Arabia; (R.N.A.); (S.B.)
| | - Samar Binkheder
- Medical Informatics and E-learning Unit, Medical Education Department, College of Medicine, King Saud University, Riyadh 11362, Saudi Arabia; (R.N.A.); (S.B.)
| | - Mohamad-Hani Temsah
- Pediatric Department, College of Medicine, King Saud University, Riyadh 11362, Saudi Arabia;
| | - Amr Jamal
- Evidence-Based Health Care & Knowledge Translation Research Chair, King Saud University, Riyadh 11362, Saudi Arabia;
- Family & Community Medicine Department, College of Medicine, King Saud University, Riyadh 11362, Saudi Arabia
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Mantri S, Jooste K, Lawson J, Quaranta B, Vaughn J. Reframing the Conversation Around Physician Burnout and Moral Injury: "We're Not Suffering From a Yoga Deficiency". Perm J 2021; 25:21.005. [PMID: 35348087 PMCID: PMC8784069 DOI: 10.7812/tpp/21.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 03/05/2021] [Accepted: 04/26/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Sneha Mantri
- Department of Neurology, Duke University School of Medicine, Durham, NC
- Trent Center for Bioethics, Humanities, and History of Medicine, Duke University, Durham, NC
| | - Karen Jooste
- Trent Center for Bioethics, Humanities, and History of Medicine, Duke University, Durham, NC
- Department of Pediatrics, Duke University School of Medicine, Durham, NC
| | - Jennifer Lawson
- Trent Center for Bioethics, Humanities, and History of Medicine, Duke University, Durham, NC
- Department of Pediatrics, Duke University School of Medicine, Durham, NC
| | - Brian Quaranta
- Trent Center for Bioethics, Humanities, and History of Medicine, Duke University, Durham, NC
- Department of Radiation Oncology, Duke University School of Medicine, Durham, NC
| | - John Vaughn
- Trent Center for Bioethics, Humanities, and History of Medicine, Duke University, Durham, NC
- Department of Family Medicine & Community Health, Duke University School of Medicine,Durham, NC
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Mc Keaveney C, Reid J, Carswell C, Bonner A, de Barbieri I, Johnston W, Maxwell AP, O'Riordan J, Strini V, Walsh I, Noble H. Experiences of renal healthcare practitioners during the COVID-19 pandemic: a multi-methods approach. BMC Nephrol 2021; 22:301. [PMID: 34493246 PMCID: PMC8421457 DOI: 10.1186/s12882-021-02500-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 08/14/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Globally, renal healthcare practitioners provide intensive and protracted support to a highly complex multi-morbid patient population however knowledge about the impact of COVID-19 on these practitioners is extremely limited. OBJECTIVE This study aimed to explore the experiences of COVID-19 with renal healthcare practitioners during the first global lockdown between June 2020 and September 2020. METHODS A multi-methods approach was carried out including a quantitative survey and qualitative interviews. This was a multinational study of renal healthcare practitioners from 29 countries. Quantitative: A self-designed survey on COVID-19 experiences and standardised questionnaires (General Health Questionnaire-12; Maslach Burnout Inventory). Descriptive statistics were generated for numerical data. Qualitative: Online semi-structured interviews were conducted. Data was subjected to thematic analysis. Renal healthcare practitioners (n = 251) completed an online survey. Thirteen renal healthcare practitioners took part in semi-structured interviews (12 nurses and 1 dietician). RESULTS The majority of participants surveyed were female (86.9 %; n = 218), nurses (86.9 %; n = 218) with an average 21.5 (SD = 11.1) years' experience since professional qualification, and 16.3 years (SD = 9.3) working in renal healthcare. Survey responses indicated a level of preparedness, training and satisfactory personal protective equipment during the pandemic however approximately 40.3 % experienced fear about attending work, and 49.8 % experienced mental health distress. The highest prevalence of burnout was emotional exhaustion (35.9 %). Three themes emerged from the qualitative analysis highlighting the holistic complexities in managing renal healthcare, a neglected specialist workforce, and the need for appropriate support at work during a pandemic. CONCLUSIONS Results have highlighted the psychological impact, in terms of emotional exhaustion and mental health distress in our sample of renal healthcare practitioners. As the pandemic has continued, it is important to consider the long-term impact on an already stretched workforce including the risk of developing mental health disorders. Future research and interventions are required to understand and improve the provision of psychological support for specialist medical and nursing personnel.
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Affiliation(s)
- Clare Mc Keaveney
- School of Nursing and Midwifery, Queens University Belfast, Belfast, UK
| | - Joanne Reid
- School of Nursing and Midwifery, Queens University Belfast, Belfast, UK
| | - Claire Carswell
- School of Nursing and Midwifery, Queens University Belfast, Belfast, UK
- Department of Health Sciences, University of York, York, UK
| | - Ann Bonner
- Griffith University, Brisbane, Australia
| | | | - William Johnston
- Kidney Care, Alton, UK
- Northern Ireland Kidney Patient Association, Belfast, UK
| | - Alexander P Maxwell
- Regional Nephrology Unit, Belfast City Hospital, Belfast, UK
- Centre for Public Health, Queens University Belfast, Belfast, UK
| | - Julien O'Riordan
- Galway Hospice Foundation, Galway, Ireland
- National University of Ireland, Galway, Ireland
| | | | - Ian Walsh
- School of Medicine, Dentistry and Biomedical Sciences, Queens University Belfast, Belfast, UK
| | - Helen Noble
- School of Nursing and Midwifery, Queens University Belfast, Belfast, UK.
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Manteghinejad A. Web-Based Medical Examinations During the COVID-19 Era: Reconsidering Learning as the Main Goal of Examination. JMIR MEDICAL EDUCATION 2021; 7:e25355. [PMID: 34329178 PMCID: PMC8360339 DOI: 10.2196/25355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 02/18/2021] [Accepted: 05/23/2021] [Indexed: 06/13/2023]
Abstract
Like other aspects of the health care system, medical education has been greatly affected by the COVID-19 pandemic. To follow the requirements of lockdown and virtual education, the performance of students has been evaluated via web-based examinations. Although this shift to web-based examinations was inevitable, other mental, educational, and technical aspects should be considered to ensure the efficiency and accuracy of this type of evaluation in this era. The easiest way to address the new challenges is to administer traditional questions via a web-based platform. However, more factors should be accounted for when designing web-based examinations during the COVID-19 era. This article presents an approach in which the opportunity created by the pandemic is used as a basis to reconsider learning as the main goal of web-based examinations. The approach suggests using open-book examinations, using questions that require high cognitive domains, using real clinical scenarios, developing more comprehensive examination blueprints, using advanced platforms for web-based questions, and providing feedback in web-based examinations to ensure that the examinees have acquired the minimum competency levels defined in the course objectives.
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Affiliation(s)
- Amirreza Manteghinejad
- Cancer Prevention Research Center, Omid Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
- Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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44
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Gramaglia C, Marangon D, Azzolina D, Guerriero C, Lorenzini L, Probo M, Rudoni M, Gambaro E, Zeppegno P. The Mental Health Impact of 2019-nCOVID on Healthcare Workers From North-Eastern Piedmont, Italy. Focus on Burnout. Front Public Health 2021; 9:667379. [PMID: 34046391 PMCID: PMC8144493 DOI: 10.3389/fpubh.2021.667379] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 04/07/2021] [Indexed: 11/15/2022] Open
Abstract
The 2019-nCOVID pandemic as a public health emergency has faced healthcare systems with unprecedented challenges. Our study aimed to focus on the mental health impact of the 2019-nCOVID pandemic on healthcare workers (HCWs) from North-Eastern Piedmont, Italy. For this purpose, we performed an online survey which was e-mailed to HCWs at the end of the first peak of the pandemic. We involved both frontline and not-frontline HCWs, employed in the hospital or in healthcare services outside the hospital. The primary outcome of our research was the assessment of burnout, while secondary outcomes included the investigation of anxiety, depression, and post-traumatic stress symptoms. We observed higher levels of burnout (especially in the Depersonalization and Personal Accomplishment dimensions), in females, in HCWs aged <30 years, in those exposed to changes in their daily and family habits, in those who had to change their duties at work and in residents in training. In our HCWs sample we found lower levels of anxiety and depression than those reported in the literature. The problematic levels of burnout and adverse psychological outcomes observed during the pandemic cannot be underestimated. Given the recurrence in autumn 2020 of a new pandemic peak, which has once again put a strain on the health system and HCWs, it is supported the importance of a careful assessment of HCWs' mental health, and of the possible risk and protective factors both in the work environment and in the extra-work one.
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Affiliation(s)
- Carla Gramaglia
- Department of Translational Medicine, Università del Piemonte Orientale, Vercelli, Italy.,Psychiatry Unit, Maggiore della Carità Hospital, Novara, Italy
| | - Debora Marangon
- Psychiatry Unit, Maggiore della Carità Hospital, Novara, Italy
| | - Danila Azzolina
- Department of Translational Medicine, Università del Piemonte Orientale, Vercelli, Italy
| | - Chiara Guerriero
- Department of Translational Medicine, Università del Piemonte Orientale, Vercelli, Italy
| | - Luca Lorenzini
- Department of Translational Medicine, Università del Piemonte Orientale, Vercelli, Italy
| | - Manuela Probo
- Department of Mental Health, ASL NOVARA, Novara, Italy
| | - Marco Rudoni
- Department of Mental Health, ASL NOVARA, Novara, Italy
| | - Eleonora Gambaro
- Department of Translational Medicine, Università del Piemonte Orientale, Vercelli, Italy.,Psychiatry Unit, Maggiore della Carità Hospital, Novara, Italy
| | - Patrizia Zeppegno
- Department of Translational Medicine, Università del Piemonte Orientale, Vercelli, Italy.,Psychiatry Unit, Maggiore della Carità Hospital, Novara, Italy
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45
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Ghahramani S, Lankarani KB, Yousefi M, Heydari K, Shahabi S, Azmand S. A Systematic Review and Meta-Analysis of Burnout Among Healthcare Workers During COVID-19. Front Psychiatry 2021; 12:758849. [PMID: 34858231 PMCID: PMC8631719 DOI: 10.3389/fpsyt.2021.758849] [Citation(s) in RCA: 104] [Impact Index Per Article: 34.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 10/05/2021] [Indexed: 02/05/2023] Open
Abstract
Burnout among healthcare personnel has been exacerbated by the COVID-19 pandemic's unique features. During the COVID-19 pandemic, this systematic review and meta-analysis aims to provide a complete assessment of the prevalence of burnout across various healthcare personnel. Until January 2021, systematic searches for English language papers were conducted using PubMed, Scopus, EMBASE, Web of Science, Cochrane Library, and ProQuest. Thirty observational studies were found after conducting systematic searches. The pooled overall prevalence of burnout was 52% [95% confidence interval (CI) 40-63%]. Pooled emotional exhaustion (EE), depersonalization (DP), and lack of personal accomplishment (PA) were 51% (95% CI 42-61%), 52% (95% CI 39-65%), and 28% (95% CI 25-31%), respectively. This study demonstrated that nearly half of the healthcare workers experienced burnout during the COVID-19 pandemic. In the studies that were included, non-frontline COVID-19 exposed healthcare personnel also experienced burnout. From high to lower middle-income countries, there was a gradient in the prevalence of total burnout, EE, and lack of PA. Further studies on burnout in low and lower-middle-income countries are suggested. A uniform diagnostic tool for the assessment of burnout is warranted.
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Affiliation(s)
- Sulmaz Ghahramani
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Kamran Bagheri Lankarani
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Yousefi
- Department of Medicine, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran
| | - Keyvan Heydari
- Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.,Gastrointestinal Cancer Research Center, Non-Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Saeed Shahabi
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sajjad Azmand
- Medical Ethics and Philosophy of Health Department, Shiraz Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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Appelbom S, Bujacz A, Finnes A, Ahlbeck K, Bromberg F, Holmberg J, Larsson L, Olgren B, Wanecek M, Wetterborg D, Wicksell R. The Rapid Implementation of a Psychological Support Model for Frontline Healthcare Workers During the COVID-19 Pandemic: A Case Study and Process Evaluation. Front Psychiatry 2021; 12:713251. [PMID: 34539465 PMCID: PMC8446385 DOI: 10.3389/fpsyt.2021.713251] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 07/30/2021] [Indexed: 01/09/2023] Open
Abstract
The COVID-19 pandemic highlighted the need for psychological support initiatives directed toward frontline healthcare workers, which can be rapidly and sustainably implemented during an infectious disease outbreak. The current case study presents a comprehensive model of psychological support that was implemented at an intensive care unit (ICU) during the first wave of the COVID-19 pandemic. The psychological support model aimed at promoting a resilient stress reaction among frontline staff by protecting physical, social, and psychological resources. The initiatives, targeting different groups of workers, included education and training, peer support, psychologist-supervised and unsupervised group sessions, on-boarding for transferred staff, manager support, and individual sessions for workers experiencing strong stress reactions. The results of the process evaluation of this rapid implementation suggest that peer support initiatives as well as daily group sessions were the most appreciated forms of psychological support. Psychologists involved in organizing and providing the support highlighted several aspects of a successful implementation of the support model: offering support during work hours (preferably after shift), positive attitude of line managers that framed support initiatives as a team effort, and involvement of experienced psychologists able to quickly adjust the content of the support according to the current needs. The study also identified two main problems of the current implementation: the lack of efficient planning due to the use of volunteer work and the need for more structural resources on the organizational level to ensure long-term sustainability of the support model and its implementation among all groups of healthcare staff. The current case study highlights the importance of establishing permanent structural resources and routines for psychological support integrated in clinical practice by healthcare organizations to improve both rapid and sustainable response to future crises.
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Affiliation(s)
- Sophia Appelbom
- Department of Learning, Informatics, Management and Ethics, Health Informatics Centre, Karolinska Institutet, Stockholm, Sweden
| | - Aleksandra Bujacz
- Department of Learning, Informatics, Management and Ethics, Health Informatics Centre, Karolinska Institutet, Stockholm, Sweden
| | - Anna Finnes
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | | | - Filip Bromberg
- Pain Clinic, Capio S:t Görans Hospital, Stockholm, Sweden
| | - Johan Holmberg
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Liv Larsson
- Pain Clinic, Capio S:t Görans Hospital, Stockholm, Sweden
| | | | - Michael Wanecek
- Pain Clinic, Capio S:t Görans Hospital, Stockholm, Sweden.,Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Dan Wetterborg
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Rikard Wicksell
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Pain Clinic, Capio S:t Görans Hospital, Stockholm, Sweden
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47
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Chutiyami M, Cheong AMY, Salihu D, Bello UM, Ndwiga D, Maharaj R, Naidoo K, Kolo MA, Jacob P, Chhina N, Ku TK, Devar L, Pratitha P, Kannan P. COVID-19 Pandemic and Overall Mental Health of Healthcare Professionals Globally: A Meta-Review of Systematic Reviews. Front Psychiatry 2021; 12:804525. [PMID: 35111089 PMCID: PMC8801501 DOI: 10.3389/fpsyt.2021.804525] [Citation(s) in RCA: 80] [Impact Index Per Article: 26.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 12/23/2021] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE This meta-review aimed to provide a comprehensive overview of overall mental health of healthcare professionals during the COVID-19 pandemic. METHOD We conducted a comprehensive literature search on Academic Search Premier, CINAHL, Cochrane Library, and MEDLINE. A predefined eligibility criterion was used to screen the articles. The methodology quality of eligible studies was assessed using Joanna Briggs Institute checklist for systematic reviews. The data were narratively synthesised in line with the meta-review aim. RESULT Forty systematic reviews (represented as K = 40), which reported data from 1,828 primary studies (N) and 3,245,768 participants, met the inclusion criteria. The findings from a pooled prevalence indicate that anxiety (16-41%, K = 30, N = 701), depression (14-37%, K = 28, N = 584), and stress/post-traumatic stress disorder (18.6-56.5%, K = 24, N = 327) were the most prevailing COVID-19 pandemic-related mental health conditions affecting healthcare workers. Other reported concerns included insomnia, burnout, fear, obsessive-compulsive disorder, somatization symptoms, phobia, substance abuse, and suicidal thoughts. Considering regions/countries, the highest anxiety was reported in the United-Kingdom [22.3, 95% Confidence Interval (CI):7-38, N = 4] compared to other countries, while the highest depression was in the Middle-East, (41, 95% CI:16-60, N = 5) and stress in the Eastern Mediterranean region (61.6, 95% CI:56.4-66.8, N = 2) compared to other regions. The most significant risk factors include female gender, younger age, being a nurse, and frontline professional. The most-reported coping strategies include individual/group psychological support, family/relative support, training/orientation, and the adequacy of personal protective equipment. CONCLUSION It was concluded that healthcare professionals (nurses, doctors, allied health) have experienced various mental health issues during COVID-19 pandemic. The meta-review, therefore, recommends targeted interventions and health policies that address specific mental health issues to support health professionals worldwide during the duration of the COVID-19 pandemic and similar future health crises. SYSTEMATIC REVIEW REGISTRATION https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD4202126200, identifier: CRD42021262001.
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Affiliation(s)
- Muhammad Chutiyami
- School of Nursing, Institute of Health and Management, Sydney, NSW, Australia
| | - Allen M Y Cheong
- School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China.,Centre for Eye and Vision Research, Hong Kong, Hong Kong SAR, China
| | - Dauda Salihu
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Umar Muhammad Bello
- Centre for Eye and Vision Research, Hong Kong, Hong Kong SAR, China.,Department of Physiotherapy, Yobe State University Teaching Hospital (YSUTH), Damaturu, Nigeria
| | - Dorothy Ndwiga
- School of Nursing, Institute of Health and Management, Sydney, NSW, Australia
| | - Reshin Maharaj
- School of Nursing, Institute of Health and Management, Sydney, NSW, Australia
| | - Kogi Naidoo
- Institute of Health and Management, Melbourne, VIC, Australia
| | | | | | - Navjot Chhina
- Institute of Health and Management, Melbourne, VIC, Australia
| | - Tan Kan Ku
- Institute of Health and Management, Melbourne, VIC, Australia
| | - Liza Devar
- School of Nursing, Institute of Health and Management, Sydney, NSW, Australia
| | - Pratitha Pratitha
- School of Nursing, Institute of Health and Management, Sydney, NSW, Australia
| | - Priya Kannan
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
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