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Super J, Vinnicombe Z, Little M, Gunnee M, Anakwe R. The effect of socioeconomic status and training programmes on burnout in postgraduate trainees in the United Kingdom: a cross-sectional analysis. Postgrad Med J 2024; 100:305-308. [PMID: 38297961 DOI: 10.1093/postmj/qgad145] [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: 05/07/2023] [Revised: 11/21/2023] [Accepted: 12/10/2023] [Indexed: 02/02/2024]
Abstract
PURPOSE Burnout is described as a state of mental exhaustion caused by one's professional life and is characterised by three domains: emotional exhaustion, depersonalisation, and a reduced sense of accomplishment. The prevalence of stress is high amongst doctors and varies by specialty, gender, trainee level, and socioeconomic status. The authors set out to examine the scale of the problem, as well as to determine the influence of both socioeconomic status and chosen training programme on burnout amongst postgraduate trainees. This would identify at-risk groups and aid in future targeted interventions. METHODS Cross-sectional data were obtained, following approval from the General Medical Council, from The National Training Survey, completed annually by all trainees in the United Kingdom. Data were then anonymised and analysed. Burnout scores were derived from the Copenhagen Burnout Inventory and are positively framed (higher scores equal lower burnout). RESULTS The questionnaire was completed by 63 122 participants from 2019 to 2020. Mean burnout amongst all trainees was 52.4 (SD = 19.3). Burnout scores from the most deprived quintile was significantly lower compared with those from the least deprived quintile: 51.0 (SD = 20.6) versus 52.9 (SD = 18.9), respectively (P < 0.001). The highest levels of burnout were reported in Internal Medical Training, Emergency Medicine, Obstetrics and Gynaecology, and Core Surgical Training, respectively. CONCLUSION Postgraduates from lower socioeconomic backgrounds are more likely to encounter burnout during training. At-risk groups who may also benefit from targeted intervention have been identified, requiring further examination through future studies.
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Affiliation(s)
- Jonathan Super
- Department of Trauma and Orthopaedics, Royal Infirmary of Edinburgh, 51 Little France Crescent, Old Dalkeith Road, Edinburgh EH16 4SA, United Kingdom
| | - Zak Vinnicombe
- Department of Plastic Surgery, St. George's Hospital, Blackshaw Road, Tooting, London SW17 0QT, United Kingdom
| | - Max Little
- Department of Trauma and Orthopaedics, Imperial College Healthcare NHS Trust, Praed Street, London W2 1NY, United Kingdom
| | - Matthew Gunnee
- Department of Trauma and Orthopaedics, Imperial College Healthcare NHS Trust, Praed Street, London W2 1NY, United Kingdom
| | - Raymond Anakwe
- Department of Trauma and Orthopaedics, Imperial College Healthcare NHS Trust, Praed Street, London W2 1NY, United Kingdom
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Gillis K, van Diermen L, Lahaye H, De Witte M, De Wit Y, Roelant E, Lips D, Zhiri A, Hockley J, Van Bogaert P. Effect of need-based care on behavioural and psychological symptoms in residents with dementia and formal caregivers' distress in nursing homes: a three-arm cluster randomized controlled trial. Eur Geriatr Med 2023; 14:1083-1096. [PMID: 37405630 DOI: 10.1007/s41999-023-00825-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 06/19/2023] [Indexed: 07/06/2023]
Abstract
PURPOSE To evaluate to what extent the standardized concept of need-based care on Behavioural and Psychological Symptoms of Dementia (BPSD), and formal caregiver distress, is superior when compared to spending more time or standard care with residents with BPSD. METHODS A longitudinal cluster randomized controlled study in 23 nursing homes in Belgium with 3 parallel groups was set up. A total of 481 residents with dementia participated. Formal caregivers in the need-based care group treated residents who displayed agitated or aggressive behaviour with a non-pharmacological intervention, tailored to unmet needs, twice a week with re-evaluation every 8 weeks. In the time group, formal caregivers spent 'extra time'. In the standard care group, it was 'care as usual'. Outcomes were measured at four different time points with the Doloplus-2 (to assess pain behaviour), Cohen-Mansfield Agitation Inventory (CMAI) for agitation, the Neuropsychiatric Inventory (NPI-NH) for BPSD and formal caregivers' distress. RESULTS Need-based interventions had a significant effect on residents' levels of pain behaviour. In the need-based care group, scores on overall BPSD (agitation and aggression, depression, euphoria, irritability, sleep and night-time behaviour) improved significantly from baseline when compared to other timepoints. No significant different interactions over time were found between all three groups for categorized versions of NPI scores (ever versus never). CONCLUSION Need-based care reduced the level of BPSD in residents with dementia as well as formal caregivers' distress. The study supports the importance of tailored non-pharmacological interventions in the residential care for people with dementia. TRIAL REGISTRY Trial registration number B300201942084 (18/11/2019).
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Affiliation(s)
- Katrin Gillis
- Research Group Health for Older People (HOPE), Odisee University College, Hospitaalstraat 23, 9100, Sint-Niklaas, Belgium.
- Centre for Research and Innovation in Care, Antwerp University, Universiteitsplein 1, 2600, Wilrijk, Belgium.
| | - Linda van Diermen
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Collaborative Antwerp Psychiatric Research Institute (CAPRI), Antwerp University, Campus Drie Eiken, Universiteitsplein 1, 2610, Wilrijk, Belgium
- Psychiatric Centre Bethanië, Andreas Vesaliuslaan 39, 2980, Zoersel, Belgium
| | - Hilde Lahaye
- Research Group Health for Older People (HOPE), Odisee University College, Hospitaalstraat 23, 9100, Sint-Niklaas, Belgium
| | - Marianne De Witte
- Research Group Health for Older People (HOPE), Odisee University College, Hospitaalstraat 23, 9100, Sint-Niklaas, Belgium
- , Curando Vzw, Pensionaatstraat 58A, Ruiselede, Belgium
| | - Yentl De Wit
- Research Group Health for Older People (HOPE), Odisee University College, Hospitaalstraat 23, 9100, Sint-Niklaas, Belgium
- Department of Geriatrics, Ghent University Hospital, C. Heymanslaan, 10, 9000, Ghent, Belgium
| | - Ella Roelant
- Center for Statistics, StatUa, University of Antwerp, Prinsstraat 13, Antwerp, Belgium
- Clinical Trial Center (CTC), CRC Antwerp, Antwerp University Hospital, University of Antwerp, Drie Eikenstraat 655, Edegem, Belgium
| | - Dirk Lips
- , Curando Vzw, Pensionaatstraat 58A, Ruiselede, Belgium
| | - Abdesselam Zhiri
- R&D Department, Pranarôm International S.A. 37, Avenue des Artisans, 7822, Ghislenghien, Belgium
- Plant Biotechnology Research Unit, Université Libre de Bruxelles (ULB), Plant Biotechnology Research Unit, CP 300, Rue Prof. Jeener & Brachet 12, 6041, Gosselies, Belgium
| | - Jo Hockley
- Primary Palliative Care Research Group, University of Edinburgh, Edinburgh, EH8 9AG, Scotland, UK
| | - Peter Van Bogaert
- Centre for Research and Innovation in Care, Antwerp University, Universiteitsplein 1, 2600, Wilrijk, Belgium
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Alfadul ESA, Idrees Abdalmotalib MM, Alrawa SSK, Osman ROA, Hassan HMA, Albasheir AT, Hasabo EA, Mohamed SOO, Shaaban KMA. Burnout and its associated factors among healthcare workers in COVID-19 isolation centres in Khartoum, Sudan: A cross-sectional study. PLoS One 2023; 18:e0288638. [PMID: 37478101 PMCID: PMC10361487 DOI: 10.1371/journal.pone.0288638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 06/30/2023] [Indexed: 07/23/2023] Open
Abstract
BACKGROUND Burnout prevalence and its consequences on healthcare workers during the Omicron wave are not well investigated in Sudan. This study aims to assess the prevalence of burnout and its associated factors among doctors and nurses during the omicron wave in COVID-19 isolation centres in Khartoum, Sudan. METHOD This cross-sectional survey study was conducted at multiple COVID-19 isolation centres in Khartoum state during the omicron wave of Coronavirus Disease 2019 between 20th February 2022 and 10th April 2022. A total of 306 doctors and nurses filled out the questionnaire, with a response rate of 64.8℅. They were recruited from 5 isolation centers scattered in the three cities of Khartoum Metropolis. The level of burnout was assessed using an online semi-structured questionnaire based on the Oldenburg Burnout Inventory questionnaire. Descriptive statistics were used for continuous variables and frequencies with percentages for categorical variables. The Chi-square test and Fisher exact test were used to identify variables associated with burnout. Logistic regression was used to determine the factors associated with burnout, and the p-value of ≤ .05 is considered statistically significant. RESULTS The prevalence of burnout was 45.7%. Doctors were more likely to have burnout than nurses (OR: 2.01, CI 95% 1.24-3.27; p = 0.005). Also, married healthcare workers were more likely to suffer burnout than single healthcare workers (OR: 3.89, CI 95% 1.41-12.5; P = 0.013). The number of household members (p = 0.035) was associated with burnout among participants. CONCLUSION There is a high prevalence of burnout among healthcare workers in Khartoum Isolation Centers, which is more apparent among doctors.
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Guimarães MRC, Giacomin KC, Ferreira RC, Vargas AMD. Evaluation of Long-Term Institutions for Older People in Brazil: an overview of regional inequalities. CIENCIA & SAUDE COLETIVA 2023; 28:2035-2050. [PMID: 37436317 DOI: 10.1590/1413-81232023287.15792022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 01/05/2023] [Indexed: 07/13/2023] Open
Abstract
This article aims to evaluate the Brazilian Long-Term Institutions for Older People (LTIE), according to the Integrated Multidimensional Theoretical Model of Quality and Service (MIQA), and compare the performance achieved between the regions of the country. Descriptive ecological study carried out with public secondary data from the LTIE participating in the 2018 Census of the Unified Social Assistance System. An Evaluation Matrix was constructed from the Census variables and the MIQA Theoretical Model. Quality parameters were used to classify the institutions' performance for each indicator as "incipient", "developing" or "desirable". The disparity index was obtained for each indicator. 1,665 institutions were analyzed. Differences were observed in the percentages of LTIE with "desirable" performance between Brazilian regions, and the need for improvement in most LTIE in relation to the proportion of caregivers of older people, the composition of the multidisciplinary team, accessibility and supply of health promotion actions. There was a need for government support for the suppression of exclusionary differentiation criteria and for the expansion of services to overcome overcrowding.
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Affiliation(s)
- Mirna Rodrigues Costa Guimarães
- Programa de Pós-Graduação em Odontologia, Departamento de Odontologia Social e Preventiva, Universidade Federal de Minas Gerais. Av. Presidente Antônio Carlos 6627, Pampulha. 31270-901 Belo Horizonte MG Brasil.
| | - Karla Cristina Giacomin
- Secretaria Municipal de Saúde, Prefeitura Municipal de Belo Horizonte. Belo Horizonte MG Brasil
| | - Raquel Conceição Ferreira
- Programa de Pós-Graduação em Odontologia, Departamento de Odontologia Social e Preventiva, Universidade Federal de Minas Gerais. Av. Presidente Antônio Carlos 6627, Pampulha. 31270-901 Belo Horizonte MG Brasil.
| | - Andrea Maria Duarte Vargas
- Programa de Pós-Graduação em Odontologia, Departamento de Odontologia Social e Preventiva, Universidade Federal de Minas Gerais. Av. Presidente Antônio Carlos 6627, Pampulha. 31270-901 Belo Horizonte MG Brasil.
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Sun C, Xing Y, Wen Y, Wan X, Ding Y, Cui Y, Xu W, Wang X, Xia H, Zhang Q, Yuan M. Association between career adaptability and turnover intention among nursing assistants: the mediating role of psychological capital. BMC Nurs 2023; 22:29. [PMID: 36732804 PMCID: PMC9894670 DOI: 10.1186/s12912-023-01187-y] [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: 10/13/2022] [Accepted: 01/20/2023] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND High turnover intention of nursing assistants was detrimental to the sustainability of long-term care. Career adaptability is an important determinant in reducing turnover intention, but little research has explored the mechanism from the perspective of psychological capital. The aim of this study was to analyze the association between career adaptability and turnover intention and to examine the mediating role of psychological capital between career adaptability and turnover intention among nursing assistants in mainland China. METHODS A cross-sectional online study was conducted among 276 nursing assistants from eight nursing homes in Nanjing, China. The participants' career adaptability, psychological capital, and turnover intention were obtained. SPSS 26.0 and Amos 24.0 software were employed for statistical analysis. RESULTS Career adaptability was positively related to psychological capital and negatively linked to turnover intention (P < 0.01). Psychological capital played a fully mediating role (β = -0.085, P < 0.05) in the relationship between career adaptability and turnover intention, and the largest indirect effect was generated through the curiosity dimension. CONCLUSIONS The management of long-term care facilities should focus on assessing the level of career adaptability of nursing assistants. The overall improvement of career adaptability and psychological capital is conducive in reducing turnover intention. Targeted interventions are recommended to improve career adaptability and reduce turnover intentions by increasing career curiosity. Online career adaptability programs can be developed for nursing assistant students to improve their psychological capital and facilitate career transitions.
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Affiliation(s)
- Changxian Sun
- grid.89957.3a0000 0000 9255 8984Nanjing Medical University, Nanjing, China ,grid.495415.8Jiangsu Vocational Institute of Commerce, Nanjing, China
| | - Yurong Xing
- grid.89957.3a0000 0000 9255 8984Nanjing Medical University, Nanjing, China
| | - Yuting Wen
- grid.89957.3a0000 0000 9255 8984Nanjing Medical University, Nanjing, China
| | - Xia Wan
- grid.89957.3a0000 0000 9255 8984The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, China
| | - Yaping Ding
- grid.89957.3a0000 0000 9255 8984Nanjing Medical University, Nanjing, China
| | - Yan Cui
- grid.89957.3a0000 0000 9255 8984Nanjing Medical University, Nanjing, China
| | - Wenhui Xu
- grid.89957.3a0000 0000 9255 8984Nanjing Medical University, Nanjing, China
| | - Xiaoxiao Wang
- grid.89957.3a0000 0000 9255 8984Nanjing Medical University, Nanjing, China
| | - Hongling Xia
- grid.89957.3a0000 0000 9255 8984Nanjing Medical University, Nanjing, China
| | - Qian Zhang
- grid.89957.3a0000 0000 9255 8984Nanjing Medical University, Nanjing, China
| | - Min Yuan
- grid.495415.8Jiangsu Vocational Institute of Commerce, Nanjing, China ,grid.443514.30000 0004 1791 5258Jinshen College of Nanjing Audit University, Nanjing, China
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Bridey C, Le Dref G, Bocquier A, Bonnay S, Pulcini C, Thilly N. Nurses' perceptions of the potential evolution of their role in antibiotic stewardship in nursing homes: a French qualitative study. JAC Antimicrob Resist 2023; 5:dlad008. [PMID: 36743529 PMCID: PMC9891345 DOI: 10.1093/jacamr/dlad008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 01/10/2023] [Indexed: 02/04/2023] Open
Abstract
Background In nursing homes, infections and antibiotic prescriptions are frequent. Nursing home nurses (NHNs) and advanced practice registered nurses (APRNs) could promote antibiotic stewardship (ABS). Few studies have explored nurses' knowledge, perceptions and practices towards ABS in nursing homes and none has investigated the potential evolution of their roles. Objectives To explore French nurses' perceptions on ABS, current and future potential roles in ABS in nursing homes, as well as facilitators and barriers. Methods We conducted a qualitative study in north-eastern France between October 2020 and March 2021 using semi-structured individual interviews with NHNs and a focus group with APRNs. Transcripts of the interviews were analysed using a thematic analysis. Results Twenty NHNs and seven APRNs participated. They were aware of antibiotic misuse and potential adverse events but lacked knowledge on some ABS aspects. NHNs' current ABS roles ranged from the detection of clinical infectious signs to clinical monitoring of residents, with some heterogeneity between nurses. They had positive opinions towards playing a more prominent role in ABS. In the future, with additional training, changes in the legislative framework and greater multidisciplinary teamwork, NHNs thought they could prescribe laboratory microbiological analyses and some targeted antibiotic treatments. APRNs thought they could prescribe first-line antibiotics for urinary tract infections. Conclusions French NHNs' current ABS roles could be expanded and new roles might be considered while taking into account several facilitators and barriers. According to APRNs, they could help to compensate for the limited presence of doctors in nursing homes and develop infectious diseases skills.
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Affiliation(s)
| | | | | | | | - Céline Pulcini
- Université de Lorraine, APEMAC, F-54000 Nancy, France,Université de Lorraine, CHRU-Nancy, Service des Maladies Infectieuses et Tropicales, F-54000 Nancy, France
| | - Nathalie Thilly
- Université de Lorraine, APEMAC, F-54000 Nancy, France,Université de Lorraine, CHRU-Nancy, Département Méthodologie, Promotion, Investigation, F-54000 Nancy, France
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O adoecimento dos trabalhadores de enfermagem e os riscos psicossociais no trabalho. ACTA PAUL ENFERM 2022. [DOI: 10.37689/acta-ape/2022ao03447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
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Gherman MA, Arhiri L, Holman AC, Soponaru C. Injurious Memories from the COVID-19 Frontline: The Impact of Episodic Memories of Self- and Other-Potentially Morally Injurious Events on Romanian Nurses' Burnout, Turnover Intentions and Basic Need Satisfaction. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9604. [PMID: 35954961 PMCID: PMC9368272 DOI: 10.3390/ijerph19159604] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 07/28/2022] [Accepted: 08/01/2022] [Indexed: 12/14/2022]
Abstract
Nurses have been frequently exposed to Potentially Morally Injurious Events (PMIEs) during the COVID-19 pandemic. Due to resource scarcity, they both perpetrated (self-PMIEs) and passively witnessed (other-PMIEs) moral transgressions toward the patients, severely violating their moral values. Our study investigated the impact of self- and other-PMIEs on work outcomes by exploring nurses' episodic memories of these events and the basic psychological need thwarting associated with them. Using a quasi-experimental design, on a convenience sample of 463 Romanian nurses, we found that PMIEs memories were uniquely associated with burnout and turnover intentions, after controlling for socio-demographic characteristics, general basic psychological need satisfaction at work and other phenomenological characteristics. Both self- and other-PMIEs memories were need thwarting, with autonomy and competence mediating their differential impact on burnout, and with relatedness-on turnover intentions. Our findings emphasize the need for organizational moral repair practices, which should include enhancing nurses' feelings of autonomy, relatedness and competence. Psychological counseling and psychotherapy should be provided to nurses to prevent their episodic memories of PMIEs to be (fully) integrated in autobiographical knowledge, because this integration could have severe consequences on their psycho-social function and occupational health, as well as on the organizational climate in healthcare institutions.
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Affiliation(s)
| | | | - Andrei Corneliu Holman
- Faculty of Psychology and Education Sciences, Alexandru Ioan Cuza University, Str. Toma Cozma 3, 700554 Iasi, Romania
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A Conceptual Model of Nurses' Turnover Intention. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19138205. [PMID: 35805865 PMCID: PMC9266265 DOI: 10.3390/ijerph19138205] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 06/29/2022] [Accepted: 07/02/2022] [Indexed: 01/09/2023]
Abstract
The World Health Organisation predicts a lack of 15 million health professionals by 2030. The lack of licenced professionals is a problem that keeps emerging and is carefully studied on a global level. Strategic objectives aimed at stimulating employment, improving working conditions, and keeping the nurses on board greatly depends on identifying factors that contribute to their turnover. The aim of this study was to present a conceptual model based on predictors of nurses' turnover intention. Methods: A quantitative, non-experimental research design was used. A total of 308 registered nurses (RNs) took part in the study. The Multidimensional Work Motivation Scale (MWMS) and Practice Environment Scale of the Nursing Work Index (PES-NWI) were used. Results: The conceptual model, based on the binary regression models, relies on two direct significant predictors and four indirect significant predictors of turnover intention. The direct predictors are job satisfaction (OR = 0.23) and absenteeism (OR = 2.5). Indirect predictors that affect turnover intention via job satisfaction are: amotivation (OR = 0.59), identified regulation (OR = 0.54), intrinsic motivation (OR = 1.67), and nurse manager ability, leadership and support of nurses (OR = 1.51). Conclusions: The results of the study indicate strategic issues that need to be addressed to retain the nursing workforce. There is a need to ensure positive perceptions and support from managers, maintain intrinsic motivation, and promote even higher levels of motivation to achieve satisfactory levels of job satisfaction.
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Relationship between effort–reward imbalance, job satisfaction, and intention to leave the profession among the medical staff of Qom University of Medical Sciences †. FRONTIERS OF NURSING 2022. [DOI: 10.2478/fon-2022-0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Objective
The effort–reward imbalance (ERI) model claims that work that has the characteristics of high effort and low reward has a mutual defect between input and output and this imbalance may result in sustained and long-lasting results. This study aimed to investigate the relationship between the intention to leave the profession (ILP) and ERI and job satisfaction among the medical staff in Qom Province.
Methods
A descriptive-correlative study was conducted on 202 medical staff in Qom Province based on random sampling in 2018. Demographics checklist, standard ILP, job satisfaction, and Siegrist's ERI questionnaires were used for data collection. The chi-squared test, independent t-test, and one-way Analyses of Variance (ANOVA) were used to analyze data.
Results
The mean age of employees was 32.04 ± 7.9 years, and 165 (87.1%) of the employees were women. The results showed that the medical staff was willing to leave their profession at a moderate level (40.7 ± 10.3). There was no significant relationship between demographics and ILP. Nevertheless, a significant and inverse relationship was observed between ERI (r:0.318, P < 0.01) and ILP (r: 0.197, P < 0.01). Leave the profession (LP) had a negative correlation with the dimensions of job descriptive index (JDI) such as job, manager, coworker and wage score (P < 0.01, r: −0.147, r: −0.262, r: −0.292, r: −0.271, r: −0.396).
Conclusions
According to the results, managers need to make sure that their working staff is rewarded as they deserve. According to the results, managers need to ensure that the reward factor is observed for the staff, while an ERI imbalance may contribute to ILP of the staff. On the other hand, it leads to job satisfaction.
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COVID-19 Health Crisis Workloads and Screening for Psychological Impact in Nursing Home Staff: A Qualitative and Quantitative Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074061. [PMID: 35409741 PMCID: PMC8998048 DOI: 10.3390/ijerph19074061] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 03/25/2022] [Accepted: 03/26/2022] [Indexed: 02/01/2023]
Abstract
Background: Nursing homes were particularly affected by the COVID-19 pandemic. The purpose of this study was to evaluate qualitatively and quantitatively with the use of a self-reported questionnaire as a tool for screening for mental disorders in nursing home staff. Methods: A multicenter epidemiological study was conducted in 12 nursing homes in France with 1117 nursing home staff eligible. Socio-demographic, occupational, and medical data were collected by anonymous self-reported questionnaire using validated scales to assess anxiety/depressive symptoms (HAD scale) and post-traumatic stress disorder (PCL-5). A total of 12 semi-structured interviews were conducted to assess acceptance and expectations for the use of the questionnaire. Results: The participation rate was 34.5%. Data from 373 questionnaires were included in the analysis. The questionnaire was well accepted by the participants and met their wishes for prevention action. The sample was 82% female. More than half reported a feeling of powerlessness and lack of time or staffing. The prevalence of anxiety symptoms was 22%, depressive symptoms 10%, and post-traumatic stress 7%. Conclusions: This study underlines the interest in screening for mental disorders by self-reported questionnaire and deploying preventive actions in the workplace to reduce stress and facilitate the reconciliation of family and working life in this context of the pandemic.
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Trotter S. From Nursing Assistant to Nurse: Scoping Review of Transitional Career Opportunities. J Gerontol Nurs 2022; 48:36-42. [PMID: 35103526 DOI: 10.3928/00989134-20220110-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Nursing assistants (NAs) are an integral component of the older adult nursing care team. Although NAs provide the majority of hands-on care, they often experience disproportionate personal and professional challenges related to their roles and responsibilities. Likewise, NAs may have minimal opportunity to transition into a nursing career. The purpose of the current scoping review was to identify and examine nursing career transition pathways designed for NAs. A scoping review of the literature revealed nine career transition programs designed for this unique sector of the nursing workforce. Although NAs may express a desire to transition into a nursing career, sparse programs have been implemented. Effective NA-to-nurse career transition programs may help improve NAs' personal and professional outcomes, older adults' care outcomes, and ultimately, improve diversity in the nursing workforce. [Journal of Gerontological Nursing, 48(2), 36-42.].
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Impact of Intrinsic and Extrinsic Motivation on Work Engagement: A Cross-Sectional Study of Nurses Working in Long-Term Care Facilities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031284. [PMID: 35162307 PMCID: PMC8834725 DOI: 10.3390/ijerph19031284] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 01/18/2022] [Accepted: 01/19/2022] [Indexed: 11/16/2022]
Abstract
Nurses’ work motivation impacts their job satisfaction and work engagement, affecting their quality of care. Work motivation, a personal resource, can be categorized into intrinsic and extrinsic motivation, each of which may function differently in the job demands–resources (JD–R) model. To study the effect of nurses’ intrinsic and extrinsic work motivation on work engagement in long-term care (LTC) facilities, we randomly selected 1200 facilities from 6055 LTC facilities in eastern Japan. Two nurses from each facility completed a self-report questionnaire—newly developed for this study for evaluating intrinsic and extrinsic work motivation—to assess their work engagement, job satisfaction, and work motivation. Multiple regression analysis of 561 valid questionnaires investigated the relationship between work motivation and work engagement, indicating that intrinsic work motivation, job satisfaction, and age had a significant positive effect on work engagement, while extrinsic work motivation had no significant effect. However, half the nurses chose to work because of extrinsic work motivation, explaining the high turnover rate of nursing staff in LTC facilities. Findings indicate the importance of measures to foster nurses’ intrinsic motivation to improve work engagement. Further research should investigate how to improve the intrinsic motivation of nurses working in LTC facilities.
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Falatah R. The Impact of the Coronavirus Disease (COVID-19) Pandemic on Nurses' Turnover Intention: An Integrative Review. NURSING REPORTS 2021; 11:787-810. [PMID: 34968269 PMCID: PMC8715458 DOI: 10.3390/nursrep11040075] [Citation(s) in RCA: 97] [Impact Index Per Article: 32.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 10/11/2021] [Accepted: 10/12/2021] [Indexed: 12/18/2022] Open
Abstract
The COVID-19 pandemic has increased the demand and workload on nurses. In addition, the number of critical cases, the uncertainty about the disease, and the incidence rate of death from the disease impose a psychological stress on nurses. Considering the alarming issues of stress, burnout, and turnover among nurses even before the pandemic, the pandemic might have amplified such issues. Thus, the impact of the COVID-19 pandemic on nurses' turnover and turnover intention warrants investigation. The aim of this review is to appraise and integrate the current pre- and post-coronavirus disease (COVID-19) literature on nurse turnover, published between 2016 and 2021. Forty-three studies on nurses' turnover intention were appraised and synthesized. The reviewed literature suggested that nurses' turnover intention increased significantly after the COVID-19 pandemic. Post-COVID-19-pandemic studies focused more on predicting nurses' turnover intention through the pandemic's negative impact on the nurses' psychological wellbeing. The findings of this review should be considered by nurse managers and leaders in the development of policies and programs to reduce the negative impact of COVID-19 on nurse retention.
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Affiliation(s)
- Rawaih Falatah
- College of Nursing, King Saud University, Riyadh 11362, Saudi Arabia
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15
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Daouda OS, Hocine MN, Temime L. Determinants of healthcare worker turnover in intensive care units: A micro-macro multilevel analysis. PLoS One 2021; 16:e0251779. [PMID: 33989358 PMCID: PMC8121288 DOI: 10.1371/journal.pone.0251779] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 05/03/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND High turnover among healthcare workers is an increasingly common phenomenon in hospitals worldwide, especially in intensive care units (ICUs). In addition to the serious financial consequences, this is a major concern for patient care (disrupted continuity of care, decreased quality and safety of care, increased rates of medication errors, …). OBJECTIVE The goal of this article was to understand how the ICU-level nurse turnover rate may be explained from multiple covariates at individual and ICU-level, using data from 526 French registered and auxiliary nurses (RANs). METHODS A cross-sectional study was conducted in ICUs of Paris-area hospitals in 2013. First, we developed a small extension of a multi-level modeling method proposed in 2007 by Croon and van Veldhoven and validated its properties using a comprehensive simulation study. Second, we applied this approach to explain RAN turnover in French ICUs. RESULTS Based on the simulation study, the approach we proposed allows to estimate the regression coefficients with a relative bias below 7% for group-level factors and below 12% for individual-level factors. In our data, the mean observed RAN turnover rate was 0.19 per year (SD = 0.09). Based on our results, social support from colleagues and supervisors as well as long durations of experience in the profession were negatively associated with turnover. Conversely, number of children and impossibility to skip a break due to workload were significantly associated with higher rates of turnover. At ICU-level, number of beds, presence of intermediate care beds (continuous care unit) in the ICU and staff-to-patient ratio emerged as significant predictors. CONCLUSIONS The findings of this research may help decision makers within hospitals by highlighting major determinants of turnover among RANs. In addition, the new approach proposed here could prove useful to researchers faced with similar micro-macro data.
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Affiliation(s)
- Oumou Salama Daouda
- Modélisation Epidémiologie et Surveillance des Risques Sanitaires (MESuRS) Laboratory, Conservatoire National des Arts et Métiers (Cnam), Paris, France
| | - Mounia N. Hocine
- Modélisation Epidémiologie et Surveillance des Risques Sanitaires (MESuRS) Laboratory, Conservatoire National des Arts et Métiers (Cnam), Paris, France
| | - Laura Temime
- Modélisation Epidémiologie et Surveillance des Risques Sanitaires (MESuRS) Laboratory, Conservatoire National des Arts et Métiers (Cnam), Paris, France
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Hara Y, Asakura K, Sugiyama S, Takada N, Ito Y, Nihei Y. Nurses Working in Nursing Homes: A Mediation Model for Work Engagement Based on Job Demands-Resources Theory. Healthcare (Basel) 2021; 9:316. [PMID: 33809246 PMCID: PMC7999486 DOI: 10.3390/healthcare9030316] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 03/07/2021] [Accepted: 03/08/2021] [Indexed: 11/29/2022] Open
Abstract
This study examined the impact that the attractiveness of working in nursing homes and autonomous clinical judgment have on affective occupational commitment, and whether work engagement mediates these relationships. This analysis was based on the job demands-resources theory. The study setting was 1200 nursing homes (including long-term care welfare facilities and long-term care health facilities) in eastern Japan. An anonymous, self-report questionnaire survey was administered to two nurses from each facility, resulting in a prospective sample of 2400 participants. Overall, 552 questionnaires were analyzed, in which structural equation modeling and mediation analysis using the bootstrap method were performed. The results showed that the attractiveness of working in nursing homes does not directly affect affective occupational commitment; work engagement fully mediates the impact of attractiveness of working in nursing homes on affective occupational commitment. Additionally, autonomous clinical judgment showed a direct impact on both work engagement and affective occupational commitment, indicating that work engagement partially mediates the impact on affective occupational commitment. To increase the affective occupational commitment of nurses working in nursing homes, managers should help nurses recognize the attractiveness of working in nursing homes, and then provide appropriate support to help such nurses work in a motivated manner.
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Affiliation(s)
- Yukari Hara
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-Machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan; (K.A.); (S.S.); (N.T.); (Y.I.); (Y.N.)
| | - Kyoko Asakura
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-Machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan; (K.A.); (S.S.); (N.T.); (Y.I.); (Y.N.)
| | - Shoko Sugiyama
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-Machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan; (K.A.); (S.S.); (N.T.); (Y.I.); (Y.N.)
| | - Nozomu Takada
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-Machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan; (K.A.); (S.S.); (N.T.); (Y.I.); (Y.N.)
| | - Yoshimi Ito
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-Machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan; (K.A.); (S.S.); (N.T.); (Y.I.); (Y.N.)
- School of Nursing, Miyagi University, 1-1 Gakuen, Taiwa-cho, Kurokawa-gun, Miyagi 981-3298, Japan
| | - Yoko Nihei
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-Machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan; (K.A.); (S.S.); (N.T.); (Y.I.); (Y.N.)
- Department of Nursing, Faculty of Health Sciences, Tohoku Fukushi University, 1-8-1 Kunimi, Aoba-ku, Sendai, Miyagi 981-8522, Japan
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The Nursing Stress Scale-Spanish Version: An Update to Its Psychometric Properties and Validation of a Short-form Version in Acute Care Hospital Settings. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228456. [PMID: 33203132 PMCID: PMC7697776 DOI: 10.3390/ijerph17228456] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 11/08/2020] [Accepted: 11/12/2020] [Indexed: 11/17/2022]
Abstract
Stressful working conditions are correlated with a negative impact on the well-being of nurses, job satisfaction, quality of patient care and the health of the staff. The Nursing Stress Scale (NSS) has been shown to be a valid and reliable instrument to assess occupational stressors among nurses. This study updates the psychometric properties of the “NSS-Spanish version” and validates a short-form version. A cross-sectional design was carried out for this study. A reliability analysis and a confirmatory factor analysis and an exploratory factor analysis were undertaken. Items were systematically identified for reduction using statistical and theoretical analysis. Correlation testing and criterion validity confirmed scale equivalence. A total of 2195 Registered Nurses and 1914 Licensed Practical Nurses were enrolled. The original 34-item scale obtained a good internal consistency but an unsatisfactory confirmatory and exploratory factor analysis. The short-form Nursing Stress Scale (11-items) obtained a good internal consistency for Registered Nurses (α = 0.83) and for Licensed Practical Nurses (α = 0.79). Both Nursing Stress Scales obtained a strong correlation for Registered Nurses (rho = 0.904) and for Licensed Practical Nurses (rho = 0.888). The 11-item version of the Nursing Stress Scale is a valid and reliable scale to assess stress perception among Registered Nurses and Licensed Practical Nurses. Its short-form nature improves the psychometric properties and the feasibility of the tool.
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Helgesson M, Marklund S, Gustafsson K, Aronsson G, Leineweber C. Interaction Effects of Physical and Psychosocial Working Conditions on Risk for Sickness Absence: A Prospective Study of Nurses and Care Assistants in Sweden. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207427. [PMID: 33053900 PMCID: PMC7601317 DOI: 10.3390/ijerph17207427] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 10/08/2020] [Accepted: 10/09/2020] [Indexed: 11/16/2022]
Abstract
Employees in health and social care are often simultaneously exposed to both physical and psychosocial challenges that may increase their risk for sickness absence. The study examines interaction effects of physical and psychosocial work conditions on the future risk for sickness absence among nurses and care assistants in Sweden. The study was based on 14,372 participants in any of the Swedish Work Environment Surveys conducted during the years 1993–2013 with linked register information on background factors and compensated sickness absence. Adjusted hazard ratio (HR), stratified by occupation, and measures of additive interaction effects were estimated. The combinations of high psychosocial job demands and heavy physical work and strenuous postures, respectively, significantly increased the risks for sickness absence among nurses (HR 1.43; CI 1.09–1.88 and HR 1.42; CI 1.16–1.74, respectively), as well as among care assistants (HR 1.51; CI 1.36–1.67 and HR 1.49; CI 1.36–1.63, respectively). The combinations of low job control and both heavy physical work (HR 1.44; CI 1.30–1.60) and strenuous postures (HR 1.42; CI 1.30–1.56) were also associated with excess risk for sickness absence among care assistants. We also found interaction effects among care assistants but not among nurses. The results indicate that the high sickness absence rate among care workers in Sweden can be reduced if the simultaneous exposures of high psychosocial and high physical challenges are avoided. Management policies for reduced time pressure, improved lifting aids, and measures to avoid awkward work postures are recommended. For care assistants, increased influence over work arrangements is likely to lower their sickness absence risk.
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Affiliation(s)
- Magnus Helgesson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, SE-171 77 Stockholm, Sweden; (M.H.); (S.M.); (K.G.)
| | - Staffan Marklund
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, SE-171 77 Stockholm, Sweden; (M.H.); (S.M.); (K.G.)
| | - Klas Gustafsson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, SE-171 77 Stockholm, Sweden; (M.H.); (S.M.); (K.G.)
| | - Gunnar Aronsson
- Department of Psychology, Stockholm University, SE-106 91 Stockholm, Sweden;
| | - Constanze Leineweber
- Department of Psychology, Stress Research Institute, Stockholm University, SE-106 91 Stockholm, Sweden
- Correspondence:
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19
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Patel UK, Zhang MH, Patel K, Malik P, Shah M, Rasul BM, Habib A, Lavado L, Kavi T, Tadi P, Jani V, Lunagariya A. Recommended Strategies for Physician Burnout, a Well-Recognized Escalating Global Crisis Among Neurologists. J Clin Neurol 2020; 16:191-201. [PMID: 32319235 PMCID: PMC7174113 DOI: 10.3988/jcn.2020.16.2.191] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 11/22/2019] [Accepted: 11/25/2019] [Indexed: 12/16/2022] Open
Abstract
Several indexes are used to classify physician burnout, with the Maslach Burnout Inventory currently being the most widely accepted. This index measures physician burnout based on emotional exhaustion, detachment from work, and lack of personal achievement. The overall percentage of physicians with burnout is estimated to be around 40%, but the proportion varies between specialties. Neurology currently has the second-highest rate of burnout and is projected to eventually take the top position. The purpose of this review is to provide a comprehensive overview focusing on the causes and ramifications of burnout and possible strategies for addressing the crisis. Several factors contribute to burnout among neurologist, including psychological trauma associated with patient care and a lack of respect compared to other specialties. Various interventions have been proposed for reducing burnout, and this article explores the feasibility of some of them. Burnout not only impacts the physician but also has adverse effects on the overall quality of patient care and places a strain on the health-care system. Burnout has only recently been recognized and accepted as a health crisis globally, and hence most of the proposed action plans have not been validated. More studies are needed to evaluate the long-term effects of such interventions.
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Affiliation(s)
- Urvish K Patel
- Department of Neurology, Creighton University School of Medicine, Omaha, NE, USA.
| | - Michelle H Zhang
- Department of Biology & Psychological and Brain Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Karan Patel
- Department of Neuroscience, Johns Hopkins University, Baltimore, MD, USA
| | - Preeti Malik
- Department of Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Mansi Shah
- Department of Psychiatry, The Wright Center for Graduate Medical Education, Scranton, PA, USA
| | - Bakhtiar M Rasul
- Department of Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Anam Habib
- Department of Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Liseth Lavado
- Department of Psychiatry, The Wright Center for Graduate Medical Education, Scranton, PA, USA
| | - Tapan Kavi
- Department of Nursing, Rutgers School of Nursing, Newark, NJ, USA
| | - Prasanna Tadi
- Department of Neurology, Creighton University School of Medicine, Omaha, NE, USA
| | - Vishal Jani
- Department of Neurology, Creighton University School of Medicine, Omaha, NE, USA
| | - Abhishek Lunagariya
- Department of Neurology, Creighton University School of Medicine, Omaha, NE, USA
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Patel RS, Bachu R, Adikey A, Malik M, Shah M. Factors Related to Physician Burnout and Its Consequences: A Review. Behav Sci (Basel) 2018; 8:bs8110098. [PMID: 30366419 PMCID: PMC6262585 DOI: 10.3390/bs8110098] [Citation(s) in RCA: 357] [Impact Index Per Article: 59.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 10/19/2018] [Accepted: 10/23/2018] [Indexed: 12/20/2022] Open
Abstract
Physician burnout is a universal dilemma that is seen in healthcare professionals, particularly physicians, and is characterized by emotional exhaustion, depersonalization, and a feeling of low personal accomplishment. In this review, we discuss the contributing factors leading to physician burnout and its consequences for the physician’s health, patient outcomes, and the healthcare system. Physicians face daily challenges in providing care to their patients, and burnout may be from increased stress levels in overworked physicians. Additionally, the healthcare system mandates physicians to keep a meticulous record of their physician-patient encounters along with clerical responsibilities. Physicians are not well-trained in managing clerical duties, and this might shift their focus from solely caring for their patients. This can be addressed by the systematic application of evidence-based interventions, including but not limited to group interventions, mindfulness training, assertiveness training, facilitated discussion groups, and promoting a healthy work environment.
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Affiliation(s)
- Rikinkumar S Patel
- Department of Psychiatry, Griffin Memorial Hospital, 900 E Main St, Norman, OK 73071, USA.
| | - Ramya Bachu
- Department of Medicine, Providence Hospital, Washington, DC 20017, USA.
| | - Archana Adikey
- Department of Psychiatry, Zucker Hillside Hospital, Glens Oaks, NY 11004, USA.
| | - Meryem Malik
- Department of Psychiatry, Mindcare Clinic, Lincolnwood, IL 60712, USA.
| | - Mansi Shah
- Department of Psychiatry, Zucker Hillside Hospital, Glens Oaks, NY 11004, USA.
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