Prevalence of burnout syndrome among Italian volunteers of the Red Cross: a cross-sectional study

Stress, anxiety, depression and sleep disturbance among healthcare professional during the COVID-19 pandemic: An umbrella review of 72 meta-analyses

The outbreak of SARS-CoV-2, which causes COVID-19, has significantly impacted the psychological and physical health of a wide range of individuals, including healthcare professionals (HCPs). This umbrella review aims provide a quantitative summary of meta-analyses that have investigated the prevalence of stress, anxiety, depression, and sleep disturbance among HCPs during the COVID-19 pandemic. An umbrella review of systematic reviews and meta-analyses reviews was conducted. The search was performed using the EMBASE, PubMed, CINAHL, MEDLINE, PsycINFO, and Google Scholar databases from 01st January 2020 to 15th January 2024. A random-effects model was then used to estimate prevalence with a 95% confidence interval. Subgroup analysis and sensitivity analyses were then conducted to explore the heterogeneity of the sample. Seventy-two meta-analyses involved 2,308 primary studies were included after a full-text review. The umbrella review revealed that the pooled prevalence of stress, anxiety, depression, and sleep disturbance among HCPs during the COVID-19 pandemic was 37% (95% CI 32.87-41.22), 31.8% (95% CI 29.2-34.61) 29.4% (95% CI 27.13-31.84) 36.9% (95% CI 33.78-40.05) respectively. In subgroup analyses the prevalence of anxiety and depression was higher among nurses than among physicians. Evidence from this umbrella review suggested that a significant proportion of HCPs experienced stress, anxiety, depression, and sleep disturbance during the COVID-19 pandemic. This information will support authorities when implementing specific interventions that address mental health problems among HCPs during future pandemics or any other health crises. Such interventions may include the provision of mental health support services, such as counseling and peer support programs, as well as the implementation of organizational strategies to reduce workplace stressors.

Unexpected effects of urban food activism on community and human wellbeing

Participation in urban agriculture conducted through community gardens and allotments is known for its benefits to physical and mental health. Due to the recognition of these benefits, which include reduction of stress, depression and anxiety, such participation is increasingly being prescribed as a non-medical health intervention. Community gardens have the added advantage of immersion into a community, without the often-long waiting lists and level of commitment involved in allotment tenancies. What has not been explored is the demanding nature of the commitment required by volunteer coordinators, and ironically, the negative effects it can have on their wellbeing. In a study of food activism in Aberdeen, UK, we conducted 21 semi-structured interviews with participants from a range of bodies involved in the city's food growing projects. From the spectrum of food growers, we found that volunteer coordinators of community gardens experienced the greatest burdens on their time and wellbeing, with their demanding multi-functional roles leading to fatigue and feelings of over-commitment. Other problems encountered by community gardeners were over-reliance on grant funding and the disproportionate impacts of COVID closures on vulnerable groups. Policy interventions are required to reduce dependency on competitive grant funding and to support both coordinators and the long-term sustainability of community gardens.

A qualitative assessment of barriers and facilitators of telemedicine volunteerism during the COVID-19 pandemic in India

BACKGROUND

The COVID-19 pandemic further propelled the recent growth of telemedicine in low-resource countries, with new models of telemedicine emerging, including volunteer-based telemedicine networks. By leveraging existing infrastructure and resources to allocate health personnel more efficiently, these volunteer networks eased some of the pandemic burden placed on health systems. However, there is insufficient understanding of volunteer-based telemedicine models, especially on the human resources engagement on such networks. This study aims to understand the motivations and barriers to health practitioner engagement on a volunteer telemedicine network during COVID-19, and the mechanisms that can potentially sustain volunteer engagement to address healthcare demands beyond the pandemic.

METHODS

In-depth qualitative interviews were conducted with health practitioners volunteering on an Indian, multi-state telemedicine network during the COVID-19 pandemic. Data were analyzed using thematic content analysis methods.

RESULTS

Most practitioners reported being motivated to volunteer by a sense of duty to serve during the pandemic. Practitioners suggested organizational-level measures to make the process more efficient and facilitate a more rewarding provider-patient interaction. These included screening calls, gathering patient information prior to consultations, and allowing for follow-up calls with patients to close the loop on consultations. Many practitioners stated that non-financial incentives are enough to maintain volunteer engagement. However, practitioners expressed mixed feelings about financial incentives. Some stated that financial incentives are needed to maintain long-term provider engagement, while others stated that financial incentives would devalue the volunteer experience. Most practitioners highlighted that telemedicine could increase access to healthcare, especially to the rural and underserved, even after the pandemic. Practitioners also expressed an interest in continuing to volunteer with the network if the need arose again.

CONCLUSION

Our study findings suggest that practitioners are highly intrinsically motivated to volunteer during large healthcare emergencies and beyond to address the healthcare needs of the underserved. Following the recommendations presented in the study, telemedicine networks can more successfully engage and maintain volunteer practitioners. Volunteer-based telemedicine networks have the potential to bridge shortages of health personnel in resource-constrained settings both in times of crises and beyond.

Occupational Health Services Have a Relevant Role in Protecting the Health and Safety of Paramedics

In this Letter to the Editor, the authors point out occupational health and safety risks for paramedics, and highlight the relevant role carried out by multidisciplinary occupational health services in the prevention of occupational risks and the promotion of physical and mental well-being of these workers.

Prevalence and predictors of mental distress among Italian Red Cross auxiliary corps: A cross-sectional evaluation after deployment in anti-COVID-19 operations

The aim of the present study is to describe the prevalence and individual predictors of mental distress (anxiety, depression, and burnout) in a sample of volunteers engaged in emergency services. A total of 823 volunteers enrolled in the Red Cross auxiliary corps were surveyed between 28 June 2021 and 28 August 2021 (299 men and 524 women). After deployment in anti-COVID-19 operations, participants completed the Patient Health Questionnaire, Generalized Anxiety Disorder Questionnaire, Maslach Burnout Inventory, and Big Five Inventory through an online platform. A moderately severe risk of depression was found in 1.70% of the sample. A severe risk for anxiety disorders was found in 1.82%. A high risk for emotional exhaustion was found in 3.40%, depersonalization in 12.88%, and low personal accomplishment in 7.53%. Women showed a higher risk of both depression and anxiety in comparison to males. Personality factors were significant predictors for all dimensions. In contrast to the current literature, openness was found to be a predisposing personality factor in developing burnout dimensions. The relevance of the current findings for the development of effective screening tools before the deployment of reserve forces during medical crises is discussed.

Subjective mental workload in Spanish emergency nurses. A study on predictive factors

INTRODUCTION

Mental workload refers to the cognitive or intellectual requirements that a worker is subjected to in a workday. The objective of the present work was to discover the subjective mental workload of nursing staff at Hospital Emergency Units, and its relationship with sociodemographic, work, environmental factors at the workplace, and personality variables.

METHOD

A quantitative, descriptive, observational, and crosssectional study was conducted with 201 emergency nurses from 13 different provinces in Spain. Each participant completed 5 questionnaires (sociodemographic, work conditions, environmental conditions, personality, and subjective mental workload). Descriptive statistics were obtained, and Pearson's correlations and multivariate models (multiple linear regression) were performed.

RESULTS

The nurses had medium to high levels of mental workload. The environmental conditions had a direct relationship with the mental workload, especially with respect to noise and lighting. The participants obtained high scores in kindness, responsibility, openness/intellect, and extraversion. Positive and statistically significant relations were found between neuroticism and mental workload. Being female, older, and having stable employment or a permanent contract were associated with a greater mental workload of emergency nurses.

CONCLUSION

The domain of neuroticism personality, and the hygienic conditions in the workplace were the predictors with the most weight in the model. This study could be useful for defining aspects that need to be considered for the well-being of emergency nurses, such as lighting conditions or environmental noise in the workplace. It also invites reflection on the influence of personal factors (age, gender, personality) and work factors (type of contract, professional experience) on the mental workload of emergency nurses.

Resilience and Extrinsic Motivation as Mediators in the Relationship between Fear of Failure and Burnout

Athletes with fear of failure are at risk of developing the symptoms of a wide range of psychological problems, including burnout. Understanding the risks and protective factors of athletes' psychological health is an essential step in tailoring strategies and interventions to promote athletes' psychological and mental health. This study examined the mediating roles of resilience and extrinsic motivation in the relationship between fear of failure and burnout among Turkish athletes. The study included 335 young athletes (93.4% males) whose ages ranged from 18 to 55 years (M = 24.95, SD = 8.22). Participants completed the self-reported measures of fear of failure, resilience, extrinsic motivation, and burnout. The analysis revealed that fear of failure had significant predictive effects on resilience, extrinsic motivation, and burnout. Resilience and extrinsic motivation also had significant predictive effects on burnout. The mediation analysis results showed that both resilience and extrinsic motivation partially mediated the effect of fear of failure on athlete burnout. The findings of the study provide a better insight into the underlying mechanisms between fear of failure and athlete burnout by considering resilience and extrinsic motivation as mediators. These results suggest that the adverse impact of fear of failure on athlete burnout can be mitigated by cultivating resilience and hindering extrinsic motivation.

Communicating Unexpected and Violent Death: The Experiences of Police Officers and Health Care Professionals

BACKGROUND

The notification of unexpected and violent death represents a challenging experience for police officers and health workers. These professionals are exposed to very intense emotions during this task.

AIM

We aimed to investigate the degree of preparation, and the emotions and attitudes of police officers and health professionals while communicating such a death.

METHOD

An ad hoc online questionnaire was created and disseminated through Qualtrics software. The participants were recruited through the institutional channels of Police, the College of Physicians, the ONG De Leo Fund and the Department of General Psychology of the University of Padua. In this qualitative study, thematic content analysis was used to examine the responses.

RESULTS

A total of 155 individuals participated in the study (44 females, 111 males): 102 individuals were police officers, 23 were doctors and were 30 nurses. Five main themes were identified: (1) how the communication took place; (2) the experiences during the communication; (3) the difficulties encountered; (4) coping strategies, and (5) forms of support. Most communications were performed in person, and most represented an intense emotional experience for the notifiers. There is a generalised lack of specific preparation and training for this practice. The recipient's characteristics (culture of origin, language, age, health conditions, psychological vulnerability) may add to the difficulties of the notification process. Professionals unload their tension by practicing sport, relying on their hobbies or interacting socially. The presence of other colleagues during and after the death notification is usually able to alleviate the burden of the communication.

CONCLUSIONS

Communication modalities can have a profound impact on the recipients and intensify the trauma of the loss; however, they also have the possibility of mitigating it. The notification of a violent and unexpected death remains a difficult and challenging task for the notifier, which is potentially stressful and emotionally charged. The topic is of great relevance and more research should be promoted in this area.

Influence of Workload, Personality, and Psychological Flexibility on Occupational Stress Among Medical Staff: A Fuzzy-Set Qualitative Comparative Analysis

Objective

During the COVID-19 pandemic, the occupational stress of medical staff has been a major issue. This study aimed to suggest a new strategy to identify high-risk factor sets of occupational stress in medical staff using fuzzy-set qualitative comparative analysis (fs-QCA) and provide ideas for the prevention and intervention of occupational stress.

Methods

A total of 1,928 medical staff members were surveyed and tested using the Acceptance and Action Questionnaire-II (AAQ-II), Occupational Stress Inventory-Revised edition (OSI-R), and Eysenck Personality Questionnaire-Revised Short Scale (EPQ-RSC). The fs-QCA was used to explore the high-risk factors for occupational stress among medical staff.

Results

The psychological strain (PSY) score of the medical staff was 26.8 ± 7.13, and the physical strain (PHS) score was 24.3 ± 6.50. Low psychological flexibility score-introversion-high role overload, introversion-neuroticism-high role overload, and low psychological flexibility score-neuroticism were high-risk factor sets for PSY. Low psychological flexibility score-introversion-high role overload, low psychological flexibility score-introversion-neuroticism, low psychological flexibility score-neuroticism-high role overload, low psychological flexibility score-psychoticism-neuroticism, and psychoticism-neuroticism-high role overload were high-risk factor sets for PHS.

Conclusion

There are different combinations of high-risk factors for occupational stress among the medical staff. For occupational stress intervention and psychological counseling, targeted and individualized health intervention measures should be implemented according to specific characteristic combinations of different individuals.

Profiles of lateral violence in nursing personnel of the Spanish public health system

BACKGROUND

Workplace violence in healthcare settings has long been studied in scientific literature, particularly in the nursing profession. Research has explored mostly user violence probably for its high prevalence and impact on health and job satisfaction. Yet this focus may overshadow another dangerous type of workplace violence: coworker violence. Exerted by co-workers with similar status, lateral violence differs from that yielded by a co-worker with a higher rank, known as vertical. This study aims to deepen the knowledge about lateral violence perceived by nurses and its interaction with other variables commonly associated with workplace violence in healthcare: burnout, job satisfaction, and self-perceived health.

METHOD

A random block sampling was performed, prompting a total sample of 925 nursing professionals from 13 public hospitals located in the southeast of Spain. The sample distribution (mean and standard deviation) and the response percentages according to the study variables of the ad-hoc questionnaire were analyzed and classified with cluster analysis.

RESULTS

Through the cluster analysis, two subgroups were obtained: Cluster 1, composed of 779 participants, with low scores in the variables used for the classification, high levels of both extrinsic and intrinsic satisfaction, low levels of emotional exhaustion and cynicism, and low rates of somatization, anxiety, social dysfunction and depression; and Cluster 2, composed of 115 participants and characterized by moderate-high scores in the variables used for the classification, moderate extrinsic satisfaction, and low intrinsic satisfaction, high emotional exhaustion and cynicism and lower somatization, anxiety, social dysfunction, and depression scores. Excluded cases amounted to 31.

CONCLUSION

Nursing professionals who experience lateral violence reveal a lower intrinsic satisfaction, feeling less self-accomplished in their job, and less positive work experience. Emotional exhaustion rises as a concerning progressive and long-term outcome of experiencing this type of violence.

The Fear of COVID-19: Gender Differences among Italian Health Volunteers

Background: During the COVID-19 pandemic, the fear of being infected was a major concern, resulting in both physical and psychological effects. Despite several studies on fear of COVID-19 in the general population, the effects on healthy volunteers who face COVID-19 on the frontlines have not yet been investigated. Methods: An online survey on specific psychological variables related to COVID-19 was administered to 720 healthy volunteers, and gender differences were investigated. Results: The primary finding was that females showed higher scores in all dimensions assessed. A multiple linear regression conducted on both genders exhibited a similar pattern of predictors, highlighting the pivotal role of negative affect in the male group. Conclusions: The findings suggest that COVID-19 had significant effects on healthy volunteers, especially in the female group. Although the previous literature did not report the crucial role played by the negative affect in the male sample, these results highlight the need to deepen how both genders use different emotional strategies to cope with stressful situations. This study may be useful in the development of specific psychological support and ad hoc training for healthy volunteers.

The Effect of Surface Acting on Job Stress and Cognitive Weariness Among Healthcare Workers During the COVID-19 Pandemic: Exploring the Role of Sense of Community

Surface acting (SA) is a heavy emotional and cognitive task practiced by nurses, which has negative consequences on their wellbeing. The shortage of nurses along with the occurrence of the COVID-19 pandemic has worsened the situation. Based on job demands-resources (JD-R) and conservation of resources theories, this study aims to investigate the adverse impact of practicing SA and buffering effect of a sense of community (SOC) on job stress (JS) and cognitive weariness (CW) among Iranian nurses confronting COVID-19. As this study is written within the scope of Frontiers' call for research on "Spirituality in the workplace," the findings suggest that the aforementioned factors are in significant positive relationships. Furthermore, the empirical evidence indicates that there is a significant indirect effect of SA on CW through JS. In addition, results reveal that there is a buffering effect of SOC on the SA and JS relationship, while there is no significant moderation effect regarding the JS and cognitive weariness association. The findings of this study provide theoretical and practical implications within the scope of spirituality in the workplace.

Animal-Assisted Intervention and Health Care Workers’ Psychological Health: A Systematic Review of the Literature

Healthcare settings have recently increased the use of companion animals in the workplace to provide emotional support to people with disabilities, but there is limited empirical research on the effects of these programs on healthcare workers. However, it is reasonable to speculate that Animal-Assisted Interventions (AAIs) may have positive effects on health care workers (HCWs) by buffering the negative effects of work-related stress and other occupational psychosocial risk factors. The aim of this review was to examine the beneficial effects of AAIs on the psychological well-being of HCWs. A systematic review was conducted in December 2021 to gain insight into the positive effects of pets on HCWs in the workplace. Searches were conducted in the following databases: Scopus, PubMed/Medline, Web of Science, and Google Scholar, including studies between 2001 and December 2021, and 12 articles were included in the review. The results indicate that implementing the AAI program in a busy clinic is feasible and that the program is accepted by medical professionals because of the immense psychological benefits it provides. However, the healthcare professionals disliked the experimental design that forced them to leave their workplaces at a certain time.

Factors associated with peritraumatic stress symptoms among the frontline healthcare workers during the outbreak of COVID-19 in China

OBJECTIVES

This study aimed to examine the prevalence of peritraumatic stress symptoms (PTSSs), perceived threat, social support and factors contributing to clinically significant PTSS among frontline COVID-19 healthcare workers (HCWs) in China.

DESIGN AND SETTING

An online survey through self-administered questionnaires was conducted from 18 February to 4 March 2020, during the outbreak of COVID-19.

OUTCOMES MEASURES

PTSS was assessed using the post-traumatic stress disorder (PTSD) self-rating scale. Demographic and socioeconomic characteristics, self-reported health, physical/psychological symptoms, perceived threat from frontline work and perceived social support were investigated. Multivariable line regression analysis distinguished factors associated with HCWs' PTSS scores.

RESULTS

A total of 676 (58.1%) HCWs have shown clinically significant high levels of PTSS. Only 441 (37.9%) self-reported good health. Most had physical symptom(s) (915 (78.7%)), psychological symptom(s) (906 (77.9%)), inability to vent emotions (284 (24.4%)), emotional exhaustion (666 (57.3%)) and 1037 (89.2%) needed professional respect. Moreover, social support received was less than expected, and the receipt of psychological services/help scored the lowest (3.11±1.73). Combined psychological and physical symptoms, difficulty in releasing tension and venting emotions timely, fear of infection, emotional exhaustion and depersonalisation are significantly associated with PTSS scores among frontline HCWs. Working ≥8 hours, having the senior professional title, self-reported health, enjoying perfect protection and control measures, economic subsidy and control policy on reducing discriminatory practices are negatively correlated with PTSS scores.

CONCLUSIONS

During the outbreak of COVID-19, frontline HCWs experienced clinically significant high levels of PTSS and heavy workload, and the emergency resulted in their inadequate psychosocial support. If this is left unchecked, HCWs have a higher risk of developing PTSD. Early detection, identification and person-directed, targeted multidisciplinary interventions should be undertaken to address various influencing factors. Comprehensive measures, including setting up emotional release channels, as well as providing psychological and social support intervention for HCWs globally, are highly recommended.

Burnout and peritraumatic distress of healthcare workers in the COVID-19 pandemic

BACKGROUND

To evaluate the current status of emotional exhaustion and peritraumatic distress of healthcare workers (HCWs) in the COVID-19 pandemic, and identify factors associated with their mental health status.

METHODS

An online survey involving 1068 of consented HCWs that included nurses, physicians, and public health officers was conducted in May 2020. Descriptive statistics and multivariate regression analyses were performed on the collected data.

RESULTS

Although no significant difference in peritraumatic distress was observed among the surveyed HCWs, the workers' experience of emotional exhaustion varied according to work characteristics. Respondents who were female, older, living with a spouse, and/or full-time workers reported higher levels of emotional exhaustion. Public health officers and other medical personnel who did not have direct contact with confirmed patients and full-time workers had a higher level of peritraumatic distress. Forced involvement in work related to COVID-19, worry about stigma, worry about becoming infected, and perceived sufficiency of organizational support negatively predict emotional exhaustion and peritraumatic distress.

CONCLUSIONS

Job-related and emotional stress of HCWs should not be neglected. Evidence-based interventions and supports are required to protect HCWs from mental illness and to promote mental health of those involved in the response to the COVID-19 pandemic.

Burnout, stress and Type D personality amongst hospital/emergency physicians

INTRODUCTION

In previous studies, physicians have been identified as a high-risk group for burnout. Although the work environment has received more attention than specific determinants of personality traits, the latter might contribute to burnout.

STUDY OBJECTIVE

We aimed to investigate the association of Type D personality, job and organizational determinants with burnout, stress and work engagement as outcome factors among emergency physicians and hospital physicians working in intensive care and surgery departments. We specifically focused on our group of emergency physicians.

METHODS

In this cross-sectional study, self-report questionnaires were distributed via social media using a specific survey link to 531 Belgian hospital physicians working at the Emergency Department, Intensive Care, and Surgery Department between October 21, 2018, and April 11, 2019. The survey instrument included questions about sociodemographic characteristics, job characteristics, organizational factors, job satisfaction, social support by supervisors and colleagues (Leiden Quality of Work Questionnaire for Medical Doctors) and Type D personality (Distress Scale-14) and as outcomes burnout (Oldenburg Burnout Inventory) and work engagement (Utrecht Work Engagement Scale). A multiple regression analysis was used to examine the associations between the determinants and each of the outcomes with emergency physicians as the study population.

RESULTS

Eligible data were available for 436 questionnaires and involved 212 emergency physicians, 162 other hospital physicians (Intensive Care and Surgery Department) and 62 residents concerning both groups of physicians. Type D personality ranged from 28.5 to 29.1% in emergency physicians and other hospital physicians. Additionally, even after correcting for job-related and organizational factors, emergency physicians with Type D personality were seven times more likely to have a high risk for burnout.

CONCLUSION

As a result, this study offers a new perspective on the associations between burnout, stress and Type D personality. Type D personality might be a personality-related risk factor for burnout among emergency physicians. Therefore, we recommend enhanced prevention measures that take into account this individual factor in the further development of coaching programs. Improving the professional well-being of emergency physicians is necessary, especially in the scope of the recent COVID-19 pandemic, which has put a high demand on acute and emergency care departments.