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Alhomoud IS, Alrasheedy AA. Prevalence and Factors Associated with Burnout among Community Pharmacists in Saudi Arabia: Findings and Implications. Healthcare (Basel) 2024; 12:1834. [PMID: 39337175 PMCID: PMC11430934 DOI: 10.3390/healthcare12181834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2024] [Revised: 09/09/2024] [Accepted: 09/11/2024] [Indexed: 09/30/2024] Open
Abstract
Burnout has negative consequences for the well-being of healthcare professionals and for the safety of patients. The prevalence of burnout varies among health professions and practice settings and across studies. Consequently, this cross-sectional study aimed to determine the prevalence and factors associated with burnout among community pharmacists in the Qassim region, Saudi Arabia. The study used the Copenhagen Burnout Inventory (CBI) to assess the burnout. The CBI consists of three scales, including personal burnout, work-related burnout, and client-related burnout. A total of 226 community pharmacists participated in the study. Of these, 63.72% were male, and 44.25% had experience of 1-5 years as community pharmacists. The prevalence of personal burnout was 83.63%, while the prevalence of work-related burnout was 83.19%, and the prevalence of client-related burnout was 76.11%. The prevalence of burnout was higher among younger age, early-career pharmacists; staff pharmacists; pharmacists working ≥6 days per week; and those working in pharmacies with fewer pharmacy teams. Multivariable logistic regression showed that compared to five workdays, working six and seven days per week was an independent risk factor for developing personal burnout [(adjusted odds ratio (aOR) = 3.60: CI = (1.29-10.05), p = 0.014) and (aOR = 4.72: CI = (1.17-19.08), p = 0.030), respectively]. Similarly, pharmacists working in pharmacies with one or two pharmacists were at higher odds of developing personal burnout compared to others working in a larger team (aOR = 3.41: CI = (1.09-10.66), p = 0.035). For work-related burnout, working six and seven days per week was also an independent risk factor [(aOR = 5.78: CI = (1.96-17.06), p = 0.001), and (aOR = 8.38: CI = (1.99-35.27), p = 0.004, respectively)]. For client-related burnout, staff pharmacists were at higher odds of developing client-related burnout compared to pharmacy managers [(aOR = 2.28: CI = (1.01-5.14), p = 0.046)]. Overall, the prevalence of burnout is alarmingly high among community pharmacists in Saudi Arabia. Consequently, it is crucial to urgently address it through robust initiatives, strategies, and interventions that support the well-being, quality of life, and resilience of community pharmacists.
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Affiliation(s)
- Ibrahim S Alhomoud
- Department of Pharmacy Practice, College of Pharmacy, Qassim University, Qassim 51452, Saudi Arabia
| | - Alian A Alrasheedy
- Department of Pharmacy Practice, College of Pharmacy, Qassim University, Qassim 51452, Saudi Arabia
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Schoondermark F, Spek A, Kiep M. Evaluating an Autistic Burnout Measurement in Women. J Autism Dev Disord 2024:10.1007/s10803-024-06438-8. [PMID: 38916695 DOI: 10.1007/s10803-024-06438-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2024] [Indexed: 06/26/2024]
Abstract
This study evaluated the suitability of an unpublished autistic burnout assessment tool, focusing on autistic women. Distinguishing autistic burnout from conditions like depression or anxiety is crucial for effective interventions, emphasizing the need for nuanced research and refined measures in understanding and addressing autistic burnout. The Dutch version of the AASPIRE Autistic Burnout Measure (AABM-NL) was evaluated within a sample of 45 autistic women from the Autism Expertise Center. Preliminary findings of the AABM-NL scores demonstrated promising evidence of good internal consistency and convergent validity. Positive associations were observed between AABM-NL scores and a Likert scale assessing identification with autistic burnout, as well as with an instrument measuring physical and psychological complaints (SCL-90-R; Symptom Checklist-90-Revised). Specifically, anxiety, somatization, cognitive-performance deficits, and depression were correlated with the severity of autistic burnout. There was no significant difference between work status and the severity of autistic burnout, implying no employment-related connection. The AABM-NL effectively differentiated between women with and without autistic burnout, with 62 points as a suitable cut-off point. However, these results may not be generalized to women requiring daily living support, individuals beyond outpatient psychiatric settings, or those in institutionalized populations. The preliminary findings provide empirical evidence supporting the use of the AABM-NL as a potential tool for assessing autistic burnout in women receiving outpatient psychiatric care. Its implementation may contribute to programs aimed at recognizing and preventing autistic burnout in women. Further research is needed to enhance intervention strategies for mitigating the risk of autistic burnout.
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Affiliation(s)
- Fleur Schoondermark
- Autism Expertise Center, Goyergracht Zuid 39, Eemnes, 3755 MZ, The Netherlands.
| | - Annelies Spek
- Autism Expertise Center, Goyergracht Zuid 39, Eemnes, 3755 MZ, The Netherlands
| | - Michelle Kiep
- Autism Expertise Center, Goyergracht Zuid 39, Eemnes, 3755 MZ, The Netherlands
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Vallabhaneni E, Cubeddu L, Petit R, Poli F, Patel P, Rivera C. The Impact of a 4-Domain Wellness-Initiative Curriculum on Internal Medicine Resident Physicians. HCA HEALTHCARE JOURNAL OF MEDICINE 2024; 5:353-361. [PMID: 39015586 PMCID: PMC11249190 DOI: 10.36518/2689-0216.1779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/18/2024]
Abstract
Background There is a trend toward fostering well-being, or the state of being happy and healthy, within the medical community. Historically, resident physicians have faced high rates of distress during training. A structured well-being curriculum in residency programs may shift residents' mindsets from survival and resilience to one centered on purpose, engagement, and joy. Methods An original well-being curriculum was administered to residents in person at a single institution every 5 weeks for approximately 10 well-being workshops, totaling around 20 hours of curriculum exposure during every academic year. The well-being curriculum was divided into 4 domains: cognitive distortions and problematic mindsets, mindfulness and meditation, creative outlets, and self-compassion.Residents exposed to at least 1 year of the well-being curriculum were asked to answer an anonymous survey. Four questions were asked for each of the 4 domains. The first and second questions asked how familiar they were with the topic before and after the workshops on a scale of 1-5 of familiarity. The third and fourth questions asked how much the knowledge acquired influenced their professional and personal life on a scale of 1-5 of influence. Results Before curriculum exposure, the average for moderate or higher levels of knowledge across all domains was 22.7%, which improved to 77.3% after curriculum completion. Overall, 58.6% of participants felt the knowledge of the domains was moderately or extremely influential in their professional lives and 83.6% in their personal lives. There were no significant differences between post-graduate year 2 and post-graduate year 3 residents for any domains examined before and after the wellness workshops. Conclusion A 4-domain well-being curriculum practiced in a group setting positively impacted participating residents in their personal and professional lives. Further studies need to be performed on a larger scale to assess if the curriculum fits the needs of the broader medical community.
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Affiliation(s)
| | - Luigi Cubeddu
- Nova Southeastern University, College of Pharmacy, Davie, FL
| | - Ryan Petit
- Mount Sinai Medical Center, Miami Beach, FL
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Chessa A, Sentissi O. [ICD-11: New revision and impact of this classification in psychiatry]. L'ENCEPHALE 2024; 50:329-338. [PMID: 38092593 DOI: 10.1016/j.encep.2023.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 09/26/2023] [Accepted: 10/27/2023] [Indexed: 05/31/2024]
Abstract
OBJECTIVES After more than 20 years of work, the World Health Organization's efforts have culminated in the adoption of the 11th revision of the International Classification of Diseases (ICD-11). The process has been guided by the principles of global applicability, scientific validity, and clinical utility. The update of the chapter on mental, behavioral, and neurodevelopmental disorders (MBND) within the ICD-11 has generated widespread interest worldwide. This has raised various questions about the status of mental disorder nosology, changes to diagnostic guidelines, and the potential implications for clinical practice. METHODS We conducted a narrative analysis of the literature in four different languages to track the various stages of the ICD-11 revision and to highlight the major changes. We searched databases such as PubMed, EMBASE, MEDLINE, and Google Scholar, and consulted the official websites of the WHO, APA, and UNICEF. A total of 79 articles from 40 different editorials and websites were analyzed and included in this study. RESULTS The new chapters on mental disorders in the ICD-11 include 21 groups, as opposed to the 11 in the ICD-10. The changes aim to align the diagnoses with those of the DSM-5 and introduce a new chapter structure, new diagnostic categories, modifications to diagnostic criteria, and advancements in dimensionality. For the first time in the history of the ICD, sleep and wakefulness disorders, as well as disorders related to sexual health, have been addressed in separate chapters of the international classification. Four new diagnoses have been added: complex post-traumatic stress disorder (PTSD), gaming disorder, prolonged grief disorder, and compulsive sexual behavior which replaces "excessive sexual activity" in the ICD-10. Moreover, the ICD-11 revision has brought about a fundamental change in the clinical conceptualization of addictive behaviors, introducing a distinction between substance use disorders and addictive behaviors. The criteria for many existing conditions have been revised, particularly those related to bipolar disorders, eating disorders, and gender identity disorders. CONCLUSIONS The revision process for mental, behavioral, and neurodevelopmental disorders in the ICD-11 has witnessed unprecedented participation in the history of mental disorder classification. These changes could have a significant impact on clinical practice in psychiatry. However, it is crucial to examine the advantages and limitations of this new classification compared to previous versions.
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Affiliation(s)
- Ambra Chessa
- Département de psychiatrie, service de psychiatrie adulte, CAPPI jonction, hôpitaux universitaires Genève, 35, rue des Bains, 1205 Genève, Suisse
| | - Othman Sentissi
- Département de psychiatrie, service de psychiatrie adulte, CAPPI jonction, hôpitaux universitaires Genève, 35, rue des Bains, 1205 Genève, Suisse.
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De Beer LT, Christensen M, Sørengaard TA, Innstrand ST, Schaufeli WB. The psychometric properties of the Burnout Assessment Tool in Norway: A thorough investigation into construct-relevant multidimensionality. Scand J Psychol 2024; 65:479-489. [PMID: 38146078 DOI: 10.1111/sjop.12996] [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: 08/29/2023] [Revised: 11/15/2023] [Accepted: 12/07/2023] [Indexed: 12/27/2023]
Abstract
OBJECTIVE The World Health Organization recognizes burnout as an occupational issue. Nevertheless, accurately identifying employee burnout remains a challenging task. To complicate matters, current measures of burnout have demonstrated limitations, prompting the development of the Burnout Assessment Tool (BAT). Given these circumstances, conducting an in-depth examination of the BAT's construct-relevant multidimensionality is crucial. METHOD This study focuses on both the original 23-item BAT and the short 12-item version, using modern factor analytic methods to investigate reliability, validity, and measurement invariance in a representative sample from Norway (n = 493; 49.54% women). RESULTS Our findings revealed that the bifactor exploratory structural equation modeling solution (burnout global factor and four specific burnout component factors) best explained the data for both BAT versions. All factors demonstrated adequate omega coefficients, with the global factor showing exceptional strength. Both BAT versions correlated highly with each other and with another burnout measure, suggesting convergent validity. Furthermore, both BAT versions achieved full (strict) measurement invariance based on gender. Finally, our results showed that burnout acts as a mediator in our proposed job demands-resources model as preliminary evidence of predictive validity. CONCLUSIONS The study validates the Burnout Assessment Tool in the Norwegian context. The study supports the reliability, validity, and unbiased nature of the tool across genders. The findings also reinforce the importance of job demands and resources, along with burnout as a key mediator, in understanding workplace dynamics in accordance with job demands-resources theory.
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Affiliation(s)
- Leon T De Beer
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
- WorkWell Research Unit, North-West University, Potchefstroom, South Africa
| | - Marit Christensen
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Torhild A Sørengaard
- Department of Leadership and Organizational Behaviour, BI Norwegian Business School, Trondheim, Norway
| | - Siw T Innstrand
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Wilmar B Schaufeli
- Department of Psychology, Utrecht University, Utrecht, the Netherlands
- Research Unit Occupational & Organizational Psychology and Professional Learning, KU Leuven, Leuven, Belgium
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Riethof N, Bob P. Traumatic stress symptoms, mental splitting and burnout in health care professionals: a cross-sectional study. Front Psychiatry 2024; 15:1332900. [PMID: 38666088 PMCID: PMC11043466 DOI: 10.3389/fpsyt.2024.1332900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 03/26/2024] [Indexed: 04/28/2024] Open
Abstract
Background Burnout syndrome usually begins with feelings of enthusiasm and idealized visualizations, and it is in contrast with subsequent disillusionment, disappointment, and symptoms which are related to chronic stress experienced later. This tendency to idealization is a parallel to the concept of "mental splitting" described by Kernberg with a pronounced "black and white" perceptual dichotomy between the early idealization and later disillusionment. This study intends examination of relationships between burnout syndrome, traumatic stress and Kernberg's concept of splitting. Methods and participants In this study we have assessed 90 health care professionals (50 women and 40 men) working with a population of diabetic patients utilizing Burnout Measure (BM), Splitting index (SI) and Traumatic Stress Checklist - 40 (TSC-40). Results Study results indicate significant Spearman correlations between burnout syndrome (BM) and traumatic stress (TSC-40) in population of men (R=0.75, p<0.01) and of women (R=0.61, p<0.01), as well as between burnout syndrome (BM) and splitting (SI) for both genders: men (R=0.40, p<0.01), women (R=0.51, p<0.01). These findings may have implications for prevention and treatment of burnout syndrome. Conclusion The current study findings provide implications that the defensive mechanisms of splitting and traumatic stress may allow for the prediction of burnout symptoms. This relation may potentially be of use in both the potential detection and prevention of burnout syndrome.
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Affiliation(s)
- Norbert Riethof
- Center for Neuropsychiatric Research of Traumatic Stress, Department of Psychiatry & UHSL, First Faculty of Medicine, Charles University, Prague, Czechia
- Department of Psychiatry, Faculty of Medicine Pilsen, Charles University, Prague, Czechia
| | - Petr Bob
- Center for Neuropsychiatric Research of Traumatic Stress, Department of Psychiatry & UHSL, First Faculty of Medicine, Charles University, Prague, Czechia
- Department of Psychiatry, Faculty of Medicine Pilsen, Charles University, Prague, Czechia
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van de Leur JC, Jovicic F, Åhslund A, McCracken LM, Buhrman M. Psychological Treatment of Exhaustion Due to Persistent Non-Traumatic Stress: A Scoping Review. Int J Behav Med 2024; 31:175-191. [PMID: 37308772 PMCID: PMC11001660 DOI: 10.1007/s12529-023-10185-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2023] [Indexed: 06/14/2023]
Abstract
BACKGROUND Exhaustion due to persistent non-traumatic stress (ENTS) is a significant health problem with substantial personal, social, and economic impact. While there are increasing studies of ENTS, there is no international agreement on how it should be diagnosed and treated. This scoping review aimed to map definitions, diagnoses, treatments, outcome measures, and outcomes in psychological treatment studies of ENTS. A further aim was to assess the quality of the treatments and map what change processes are described within ENTS interventions. METHODS A PRISMA-guided scoping review of psychological treatment studies delivered in a clinical setting for ENTS was conducted using the databases of PubMed, PsycINFO, and CINAHL. RESULTS Of the 60 studies included, the majority (87%) stemmed from Europe. The most recurrent term for ENTS was burnout, and the diagnosis most often utilized was exhaustion disorder. Several treatments were reported, the most frequent being cognitive behavioral therapy (CBT) (68%). Statistically significant outcomes relevant to ENTS were reported in 65% (n = 39) of the studies, with effect sizes between 0.13 and 1.80. In addition, 28% of the treatments were rated as high quality. The most frequent change processes described were dysfunctional sleep, avoidance, behavioral activation, irrational thoughts and beliefs, worry, perceived competence/positive management, psychological flexibility, and recuperation. CONCLUSIONS While several treatments based on CBT show promising results for ENTS, there do not seem to be any uniformly established methods, theoretical models, or change processes. Instead of adopting a monocausal, syndromal, and potentially bio-reductionist perspective on ENTS, a process-based approach to treatment is encouraged.
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Affiliation(s)
- Jakob Clason van de Leur
- Department of Psychology, Uppsala University, Box 1225, 751 42, Uppsala, Sweden.
- PBM Globen Rehab, Arenavägen 27, 121 77, Johanneshov, Sweden.
| | - Filip Jovicic
- Department of Psychology, Uppsala University, Box 1225, 751 42, Uppsala, Sweden
- Capio Centrum För Smärta Och Utmattning, Krukmakargatan 37A, 118 51, Stockholm, Sweden
| | - Andreas Åhslund
- Capio Centrum För Smärta Och Utmattning, Krukmakargatan 37A, 118 51, Stockholm, Sweden
| | - Lance M McCracken
- Department of Psychology, Uppsala University, Box 1225, 751 42, Uppsala, Sweden
| | - Monica Buhrman
- Department of Psychology, Uppsala University, Box 1225, 751 42, Uppsala, Sweden
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De Beer LT, Hakanen JJ, Schaufeli WB, De Witte H, Glaser J, Kaltiainen J, Seubert C, Morin AJS. The burnout-depression conundrum: investigating construct-relevant multidimensionality across four countries and four patient samples. Psychol Health 2024:1-28. [PMID: 38400520 DOI: 10.1080/08870446.2024.2321358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 02/15/2024] [Indexed: 02/25/2024]
Abstract
This research seeks to contribute to the ongoing discussion about the distinctive nature of burnout and depression. In a first study, we relied on employee samples from four European countries (N = 5199; 51.27% women; Mage = 43.14). In a second study, we relied on a large sample of patients (N = 5791; 53.70% women; Mage = 39.54) who received a diagnosis of burnout, depressive episode, job strain, or adaptation disorder. Across all samples and subsamples, we relied on the bifactor exploratory structural equation modelling to achieve an optimal disaggregation of the variance shared across our measures of burnout and depression from the variance uniquely associated with each specific subscale included in these measures. Our results supported the value of this representation of participants' responses, as well as their invariance across samples. More precisely, our results revealed a strong underlying global factor representing participants' levels of psychological distress, as well as the presence of equally strong specific factors supporting the distinctive nature of burnout and depression. This means that, although both conditions share common ground (i.e. psychological distress), they are not redundant. Interestingly, our results also unexpectedly suggested that suicidal ideation might represent a distinctive core component of depression.
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Affiliation(s)
- Leon T De Beer
- Department of Psychology, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- WorkWell Research Unit, North-West University, Potchefstroom, South Africa
| | - Jari J Hakanen
- Workability and Work Careers, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Wilmar B Schaufeli
- Research Unit Occupational & Organizational Psychology and Professional Learning, KU Leuven, Leuven, Belgium
- Department of Psychology, Utrecht University, Utrecht, The Netherlands
| | - Hans De Witte
- Research Unit Occupational & Organizational Psychology and Professional Learning, KU Leuven, Leuven, Belgium
- Optentia Research Unit, Vanderbijlpark Campus, North-West University, Vanderbijlpark, South Africa
| | - Jürgen Glaser
- Department of Psychology, University of Innsbruck, Innsbruck, Austria
| | - Janne Kaltiainen
- Workability and Work Careers, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Christian Seubert
- Department of Psychology, University of Innsbruck, Innsbruck, Austria
| | - Alexandre J S Morin
- Substantive Methodological Synergy Research Laboratory, Concordia University, Montreal, Canada
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Soames M, Willis M. Making Sense of Burnout: A Reflexive Thematic Analysis of How Teachers in England Discuss and Encounter the Term Burnout. QUALITATIVE HEALTH RESEARCH 2024; 34:61-71. [PMID: 37840523 DOI: 10.1177/10497323231203639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2023]
Abstract
Despite extensive research looking at the phenomenon of burnout, little is known about how individuals working in traditionally high-burnout occupations understand the term. Interviews were conducted with six teachers working in state schools in England centring on how the term burnout was understood and how it was used or encountered. Reflexive thematic analysis was employed from a critical realist perspective to analyse the data generated. All participants described burnout as a stress-related condition, yet for some participants the point at which stress became burnout was unclear leading to an understanding that burnout was the point at which one was unable to work. Many participants highlighted an individualistic understanding of burnout, perceiving it as representing an individual deficit rather than an organisational failing. This was often reinforced by where the term was encountered (at work or in the media) and was linked to the stigma many participants associated with burnout. This paper concludes that individualistic framings of burnout obscure its organisational determinants while reinforcing notions that mental well-being is something which should be personally - and privately - managed by individuals.
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Tavella G, Hadzi-Pavlovic D, Bayes A, Jebejian A, Manicavasagar V, Walker P, Parker G. Burnout and depression: Points of convergence and divergence. J Affect Disord 2023; 339:561-570. [PMID: 37479038 DOI: 10.1016/j.jad.2023.07.095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 07/13/2023] [Accepted: 07/17/2023] [Indexed: 07/23/2023]
Abstract
BACKGROUND Debate is ongoing as to whether burnout can be differentiated from depression. This study evaluated whether burnout and depression could be distinguished using a new burnout measure and other variables. METHODS Scores on the Sydney Burnout Measure (SBM) were compared between participants with self-diagnosed burnout (BO-all group; n = 622) and clinically-diagnosed depression (DEP-all group; n = 90). The latter group was split into melancholic (DEP-mel; n = 56) and non-melancholic (DEP-nonmel; n = 34) depression subgroups for subsequent analyses. Differences in reporting of depressive symptoms and causal attributions were also evaluated. RESULTS While total SBM scores showed poor differentiation, the BO-all group had lower social withdrawal and higher empathy loss subscale scores than the depression groups. Odds ratios were significant for several of the depressive symptoms and causal attribution items when comparing the BO-all group to the DEP-all and DEP-mel groups, while only a few items were significant when comparing the BO-all and DEP-nonmel groups. LIMITATIONS Participants in the depression group were assigned by clinician-based depression diagnoses, rather than by a standardised diagnostic interview, and the group had a relatively small sample size. Participants in the burnout group were self-diagnosed and not assessed for comorbid psychiatric diagnoses. CONCLUSIONS There were some nuanced symptoms differences between burnout and depression, but many of the SBM symptoms were not specific to burnout. Results also suggested that burnout overlaps more with non-melancholic than melancholic depression, and that differentiation of burnout and depression may rely more on weighting causal factors over symptoms.
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Affiliation(s)
- Gabriela Tavella
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Australia
| | - Dusan Hadzi-Pavlovic
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Australia
| | - Adam Bayes
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Australia; Black Dog Institute, Hospital Rd, Randwick, New South Wales, Australia
| | - Artin Jebejian
- Gordon Private Hospital, Sydney, New South Wales, Australia
| | - Vijaya Manicavasagar
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Australia; Black Dog Institute, Hospital Rd, Randwick, New South Wales, Australia
| | - Peter Walker
- Lumiere Clinical Psychology, Sydney, New South Wales, Australia
| | - Gordon Parker
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Australia; Gordon Private Hospital, Sydney, New South Wales, Australia.
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Lyon TR, Galbraith A. Mindful Self-Compassion as an Antidote to Burnout for Mental Health Practitioners. Healthcare (Basel) 2023; 11:2715. [PMID: 37893789 PMCID: PMC10606131 DOI: 10.3390/healthcare11202715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 10/08/2023] [Accepted: 10/10/2023] [Indexed: 10/29/2023] Open
Abstract
The objective of this correlational study was to explore the relationship between levels of self-compassion and burnout for currently practicing mental health practitioners (MHPs) in the United States. All professionals are vulnerable to burnout based on various types of organizational stressors, but burnout is of particular concern for health care service providers who may need to adopt a stance of detachment, or emotional distance, as relief from intense workloads, with clients. The data were collected through an online survey. Regression analysis found that scores from Neff's Self-Compassion Scale were a significant negative predictor of levels of MHP burnout, as assessed by Schaufeli et al.'s Burnout Assessment Tool, p < 0.001. The implication of this finding is that cultivating self-compassion appears to be a pragmatic self-care strategy for MHPs to mitigate the negative effects of burnout. More educational and occupational training in self-compassion practices as self-care should be provided to help protect the physical and emotional well-being of MHPs. The deleterious systemic effects of burnout make MHP self-care an ethical issue, along with the need to identify protective factors, prevention, and treatment of burnout.
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Affiliation(s)
| | - Anne Galbraith
- Marriage and Family Therapist, Los Angeles, CA 90025, USA;
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12
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Lindsäter E, Svärdman F, Rosquist P, Wallert J, Ivanova E, Lekander M, Söderholm A, Rück C. Characterization of exhaustion disorder and identification of outcomes that matter to patients: Qualitative content analysis of a Swedish national online survey. Stress Health 2023; 39:813-827. [PMID: 36645034 DOI: 10.1002/smi.3224] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 12/06/2022] [Accepted: 01/12/2023] [Indexed: 01/17/2023]
Abstract
Fatigue is a common presenting problem in healthcare settings, often attributed to chronic psychosocial stress. Understanding of fatigue and development of evidence-based treatments is hampered by a lack of consensus regarding diagnostic definitions and outcomes to be measured in clinical trials. This study aimed to map outcome domains of importance to the Swedish diagnosis stress-induced exhaustion disorder (ED; ICD-10, code F43.8 A). An online survey was distributed nationwide in Sweden to individuals who reported to have been diagnosed with ED and to healthcare professionals working with ED patients. To identify outcome domains, participants replied anonymously to four open-ended questions about symptoms and expectations for ED-treatment. Qualitative content analysis was conducted of a randomized subsample of respondents, using a mathematical model to determine data saturation. Six hundred seventy participants (573 with reported ED, 97 healthcare professionals) completed the survey. Qualitative content analysis of answers supplied by 105 randomized participants identified 87 outcomes of importance to ED encompassing physical, cognitive, and emotional symptoms as well as functional disability. Self-rating scales indicated that many ED participants, beyond reporting fatigue, also reported symptoms of moderate to severe depression, anxiety, insomnia, poor self-rated health, and sickness behavior. This study presents a map of outcome domains of importance for ED. Results shed light on the panorama of issues that individuals with ED deal with and can be used as a step to further understand the condition and to reach consensus regarding outcome domains to measure in clinical trials of chronic stress and fatigue. Preregistration: Open Science Framework (osf.io) with DOI https://doi.org/10.17605/OSF.IO/4VUAG.
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Affiliation(s)
- Elin Lindsäter
- Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institutet and Stockholm Health Care Services, Stockholm, Sweden
- Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden
| | - Frank Svärdman
- Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institutet and Stockholm Health Care Services, Stockholm, Sweden
| | - Patrik Rosquist
- Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institutet and Stockholm Health Care Services, Stockholm, Sweden
| | - John Wallert
- Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institutet and Stockholm Health Care Services, Stockholm, Sweden
| | - Ekaterina Ivanova
- Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institutet and Stockholm Health Care Services, Stockholm, Sweden
| | - Mats Lekander
- Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden
- Department of Psychology, Stress Research Institute, Stockholm University, Stockholm, Sweden
- Department of Clinical Neuroscience, Osher Center for Integrative Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Anna Söderholm
- Department of Psychology, Umeå Universitet, Umeå, Sweden
| | - Christian Rück
- Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institutet and Stockholm Health Care Services, Stockholm, Sweden
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Lindsäter E, van de Leur JC, Rück C, Hedman-Lagerlöf E, Bianchi R. Psychometric and structural properties of the Karolinska Exhaustion Disorder Scale: a 1,072-patient study. BMC Psychiatry 2023; 23:642. [PMID: 37660017 PMCID: PMC10475192 DOI: 10.1186/s12888-023-05138-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 08/24/2023] [Indexed: 09/04/2023] Open
Abstract
OBJECTIVE Exhaustion disorder is a stress-related diagnosis that was introduced in 2005 to the Swedish version of the International Statistical Classification of Diseases and Related Health Problems, 10th edition (ICD-10). The Karolinska Exhaustion Disorder Scale (KEDS) was developed to assess exhaustion disorder symptomatology. While the KEDS is intended to reflect a single construct and be used based on its total score, the instrument's characteristics have received limited attention. This study investigated the KEDS's psychometric and structural properties in a large clinical sample. METHODS The study relied on data from 1,072 patients diagnosed with exhaustion disorder that were included in two clinical trials in Sweden. We investigated the dimensionality, homogeneity, and reliability of the KEDS using advanced statistical techniques, including exploratory structural equation modeling (ESEM) bifactor analysis. RESULTS A one-factor confirmatory analytic model exhibited a poor fit, suggesting at least a degree of multidimensionality. The ESEM bifactor analysis found the general factor to explain about 72% of the common variance extracted, with an omega hierarchical coefficient of 0.680. Thus, the ESEM bifactor analysis did not clearly support the scale's essential unidimensionality. A homogeneity analysis revealed a scale-level H of only 0.296, suggesting that KEDS's total scores do not accurately rank individuals on the latent continuum assumed to underlie the measure. The KEDS's reliability was modest, signaling considerable measurement error. CONCLUSION Findings reveal important limitations to the KEDS with possible implications for the status of exhaustion disorder as a nosological category. TRIAL REGISTRATION This study was pre-registered on Open Science Framework (osf.io) on April 24, 2022 ( https://osf.io/p34sq/ ).
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Affiliation(s)
- Elin Lindsäter
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet. Gustavsberg Primary Care Clinic, Odelbergs Väg 19, 134 40, Gustavsberg, Sweden.
- Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Sweden.
| | | | - Christian Rück
- Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Sweden
| | - Erik Hedman-Lagerlöf
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet. Gustavsberg Primary Care Clinic, Odelbergs Väg 19, 134 40, Gustavsberg, Sweden
| | - Renzo Bianchi
- Department of Psychology, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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Parker G, Tavella G, Hopcraft M. Exploring the validity of the Sydney Burnout Measure. Psychiatry Res 2023; 326:115271. [PMID: 37290365 DOI: 10.1016/j.psychres.2023.115271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 05/25/2023] [Accepted: 05/28/2023] [Indexed: 06/10/2023]
Abstract
This study aimed to examine the convergent validity of a new measure of burnout, the Sydney Burnout Measure (SBM) by comparison against the field standard measure - the Maslach Burnout Inventory (MBI). A second aim was to consider burnout's association with psychological distress. 1483 dental professionals completed the two burnout measures as well as two measures of psychological distress. The overall correlation between total scores on the two measures (and on shared constructs) was high, and thus the convergent validity of the SBM was supported. Further, the SBM and MBI total scores correlated highly with total scores on the two measures of distress. Exploratory structural equation modelling (ESEM) also identified substantial overlap between the measures, especially in relation to the exhaustion subscales of the burnout measures and their overlap with psychological distress items. While future research is required to determine which burnout measure and its associated burnout definition is most valid, our findings argue for further consideration of how burnout may best be conceptualized, as well as whether the syndrome is worthy of elevation to mental disorder status.
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Affiliation(s)
- Gordon Parker
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia.
| | - Gabriela Tavella
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia
| | - Matthew Hopcraft
- Melbourne Dental School, University of Melbourne, Melbourne, Australia; eviDent Foundation, Melbourne, Australia
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Nonnis M, Agus M, Frau G, Urban A, Cortese CG. Job Seekers' Burnout and Engagement: A Qualitative Study of Long-Term Unemployment in Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5968. [PMID: 37297572 PMCID: PMC10252961 DOI: 10.3390/ijerph20115968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/29/2023] [Accepted: 05/23/2023] [Indexed: 06/12/2023]
Abstract
Long-term unemployment has major consequences from an economic, physical and psychosocial perspective. Several authors have pointed out that the search for employment is in itself work, which can generate feelings of exhaustion of psychophysical energies, cynicism and disinvestment, as well as a sense of ineffectiveness to the point of complete disillusion. The construct of burnout can be used to describe this psychological process. This study evaluated the burnout and engagement dimensions in individuals searching for work for a long time, from a qualitative perspective. Fifty-six semi-structured interviews were conducted with a sample of long-term unemployed job seekers (Sardinia, Italy), based on Maslach's model of burnout (exhaustion, cynicism, effectiveness in job search). The answers to the semi-structured interviews were processed through T-Lab, a semi-automatic textual analysis software. Four thematic cores emerged: exhaustion vs. engagement, cynicism vs. trust, inefficacy vs. efficacy in job search and disillusion vs. hope. This result is consistent with the four-dimensional theoretical model of burnout, originally proposed by Edelwich and Brodsky, recently taken up by Santinello, and framed as the opposite of engagement, as shown in the JD-R model. This study highlights that burnout can describe the psychosocial experiences of long-term unemployed job seekers.
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Affiliation(s)
- Marcello Nonnis
- Department of Pedagogy, Psychology, Philosophy, University of Cagliari, 09123 Cagliari, Italy; (M.A.); (G.F.)
| | - Mirian Agus
- Department of Pedagogy, Psychology, Philosophy, University of Cagliari, 09123 Cagliari, Italy; (M.A.); (G.F.)
| | - Gianmarco Frau
- Department of Pedagogy, Psychology, Philosophy, University of Cagliari, 09123 Cagliari, Italy; (M.A.); (G.F.)
| | - Antonio Urban
- Cagliari University Hospital, 09124 Cagliari, Italy;
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Abstract
OBJECTIVE There is currently little consensus as to how burnout is best defined and measured, and whether the syndrome should be afforded clinical status. The latter issue would be advanced by determining whether burnout is a singular dimensional construct varying only by severity (and with some level of severity perhaps indicating clinical status), or whether a categorical model is superior, presumably reflecting differing 'sub-clinical' versus 'clinical' or 'burning out' vs 'burnt out' sub-groups. This study sought to determine whether self-diagnosed burnout was best modelled dimensionally or categorically. METHODS We recently developed a new measure of burnout which includes symptoms of exhaustion, cognitive impairment, social withdrawal, insularity, and other psychological symptoms. Mixture modelling was utilised to determine if scores from 622 participants on the measure were best modelled dimensionally or categorically. RESULTS A categorical model was supported, with the suggestion of a sub-syndromal class and, after excluding such putative members of that class, two other classes. Analyses indicated that the latter bimodal pattern was not likely related to current working status or differences in depression symptomatology between participants, but reflected subsets of participants with and without a previous diagnosis of a mental health condition. CONCLUSION Findings indicated that sub-categories of self-identified burnout experienced by the lay population may exist. A previous diagnosis of a mental illness from a mental health professional, and therefore potentially a psychological vulnerability factor, was the most likely determinant of the bimodal data, a finding which has theoretical implications relating to how best to model burnout.
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On the Combined Role of Work Engagement and Burnout Among Novice Nurses: A Longitudinal Person-Centered Analysis. JOURNAL OF CAREER ASSESSMENT 2022. [DOI: 10.1177/10690727221148720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
This study examined the profiles taken by global and specific facets of work engagement and burnout among a sample of novice ( M tenure = 3.77 years) nurses ( n = 570; 88.4% females; M age = 29.3 years). This study also investigated the role of psychological need satisfaction in the prediction of profile membership, and the implications of these profiles for attitudinal (job satisfaction), behavioral (in-role and extra-role performance, absenteeism, and presenteeism) and health (perceived health difficulties) outcomes. Latent profile analyses revealed six profiles: High Global Engagement and Low Global Burnout, Moderately High Global Engagement and Moderately Low Global Burnout, Low Dedication and Efficacy and Highly Cynical, Dedicated but Exhausted Burned-Out, Low Efficacy Burned-Out, and Very Low Global Engagement and Very High Global Burnout. Although these profiles were replicated over a 1-year period, profile membership was only weakly stable. The most beneficial outcomes were observed in the High Global Engagement and Low Global Burnout profile, and the most detrimental in the Very Low Global Engagement and Very High Global Burnout profile. Need satisfaction was also associated with profile membership, although associations were stronger for global levels of need satisfaction than for specific levels of autonomy, competence, and relatedness need satisfaction.
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Parker G, Tavella G. Burnout: a case for its formal inclusion in classification systems. World Psychiatry 2022; 21:467-468. [PMID: 36073702 PMCID: PMC9453885 DOI: 10.1002/wps.21025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Gordon Parker
- Discipline of Psychiatry and Mental Health, School of Clinical MedicineUniversity of New South WalesSydneyNSWAustralia
| | - Gabriela Tavella
- Discipline of Psychiatry and Mental Health, School of Clinical MedicineUniversity of New South WalesSydneyNSWAustralia
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Gherman MA, Arhiri L, Holman AC, Soponaru C. Protective Factors against Morally Injurious Memories from the COVID-19 Pandemic on Nurses' Occupational Wellbeing: A Cross-Sectional Experimental Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11817. [PMID: 36142089 PMCID: PMC9517277 DOI: 10.3390/ijerph191811817] [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: 07/31/2022] [Revised: 09/04/2022] [Accepted: 09/14/2022] [Indexed: 06/16/2023]
Abstract
The COVID-19 pandemic was a fertile ground for nurses' exposure to self- and other-Potentially Morally Injurious Events (PMIEs). Our study explored the effects of nurses' memories of self- and other-PMIEs on occupational wellbeing and turnover intentions. Using an experimental design on a convenience sample of 634 Romanian nurses, we tested a conceptual model with PLS-SEM, finding adequate explanatory and predictive power. Memories of self- and other-PMIEs were uniquely associated with work engagement, burnout, and turnover intentions, compared to a control group. These relationships were mediated by the three basic psychological needs. Relatedness was more thwarted for memories of other-PMIEs, while competence and autonomy were more thwarted for memories of self-PMIEs. Perceived supervisor support weakened the indirect effect between type of PMIE and turnover intentions, through autonomy satisfaction, but not through burnout. Self-disclosure weakened the indirect effect between type of PMIE and turnover intentions, through autonomy satisfaction, and both burnout and work engagement. Our findings emphasize the need for different strategies in addressing the negative long-term effects of nurses' exposure to self- and other-PMIEs, according to the basic psychological need satisfaction and type of wellbeing indicator.
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Affiliation(s)
- Mihaela Alexandra Gherman
- Faculty of Psychology and Education Sciences, Alexandru Ioan Cuza University, Str. Toma Cozma 3, 700554 Iasi, Romania
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Houle SA, Morin AJ, Fernet C. Longitudinal trajectories of affective commitment to the occupation among school principals: A person-centered perspective. JOURNAL OF VOCATIONAL BEHAVIOR 2022. [DOI: 10.1016/j.jvb.2022.103758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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