Burnout Syndrome and Work-Related Stress in Physical and Occupational Therapists Working in Different Types of Hospitals: Which Group Is the Most Vulnerable?

Perceptions and experiences of burnout: A survey of physical therapists across practice settings and patient populations

INTRODUCTION/OBJECTIVE

The purposes of this study were to determine the presence of burnout in physical therapists and physical therapist assistants, examine differences in burnout between demographic groups, and explore circumstances that contribute to and alleviate burnout.

METHODS

A cross-sectional survey consisting of demographic questions, the Maslach Burnout Inventory, and open-ended questions was conducted within two health systems. Descriptive statistics and nonparametric tests were used to analyze responses to close-ended questions and to examine differences between groups. Thematic analysis was used to analyze open-ended questions.

RESULTS

In total, 202 individuals participated in the study; 146 participants responded to at least one open-ended question (72.3%). Participants, regardless of demographic characteristic, demonstrated at least some degree of burnout on each subscale. Ten major themes emerged from analysis of circumstances that contribute to and alleviate burnout: 1) workload; 2) schedule; 3) work-life balance; 4) care continuum; 5) coping/morale; 6) team dynamics and resources; 7) psychological or emotional burden; 8) compensation and recognition; 9) physical therapy as a profession; and 10) COVID-19.

CONCLUSION

Burnout is present within physical therapists regardless of demographic group. Understanding circumstances that contribute to and alleviate burnout is an important first step to develop and research strategies to address these circumstances to positively impact the provider, patient, and the healthcare system.

The effects of occupational and mental stress among home care rehabilitation professionals working during the COVID-19 pandemic: An exploratory qualitative study

Home care rehabilitation professionals (hcRPs) provide health services for clients with a broad range of medical conditions. During the COVID-19 pandemic, home care rehabilitation professionals experienced exacerbations of pre-existing work-related stressors, increased risk of transmission of the COVID-19 virus, reduced resource availability, greater workloads, and staffing shortages. The primary aim of this study was to examine the experience and impact of occupational and mental stress on hcRPs working during the COVID-19 pandemic. Semi-structured interviews were conducted with 24 hcRPs working in Ontario, Canada during the COVID-19 pandemic. Inductive thematic analysis was used to interpret and organize the data into conceptualized themes. Interview data was organized into three themes: (a) unique challenges of a home care rehabilitation professional, (b) COVID-19 exacerbations of home care occupational and mental stress, and (c) personal and workplace coping strategies. Many participants reported reducing their hours or taking on adjunctive roles in different clinical settings outside of home care due to work-related stress exacerbated by the COVID-19 pandemic. With a focus on the effects of COVID-19 on the practice of home care, this study provides a unique perspective on the challenges experienced by hcRPs during an emergent and evolving global public health concern. The exploratory nature of this research works towards providing a framework of factors to be addressed when creating sustainable healthcare interventions, as well as recommendations to support hcRPs to benefit both the community and health-care providers.

Pediatric Occupational Therapists and Occupational Stress: A Scoping Review

The purpose of this scoping review was to provide further insight into the stress and the stressors experienced by pediatric occupational therapists in the work environment. Using the Arksey and O'Malley framework, the search was conducted in eight databases, nine electronic journals, and eight gray literature sources to identify articles related to stress and stressors of pediatric occupational therapists. Review selection and characterization were performed by two independent reviewers. Twelve articles published from 2011 to 2020 were identified and varied in terms of purpose, population, and results although the articles all shared similar methodologies and outcome measures. Only 25% of the articles (3/12) addressed pediatric occupational therapy stress and stressors directly while the remaining addressed occupational stress, but with varying levels of attention to pediatric occupational therapists. Stress and stressors experienced by pediatric occupational therapists have been studied to a limited extent. Occupational stress is associated with increased burnout, decreased health, and decreased job satisfaction and performance. Several knowledge gaps have been identified, as well as priorities for future research into pediatric occupational therapists and occupational stress.

Stress among Pediatric Occupational Therapists: A Study of Prevalence, Work and Demographic Factors

This study aimed to evaluate the self-reported stress levels of pediatric occupational therapists, examine specific work factors and determine if demographic factors predict occupational stress. A cross-sectional survey design study, using voluntary response sampling, was conducted. The survey included demographics, the Workplace Stress Scale, and the Stress Index. The sample included 289 pediatric occupational therapists. Using descriptive analysis, a one-sample t-test, and multiple linear regressions, results indicated that pediatric occupational therapists had significantly higher stress levels than the validating sample of the Workplace Stress Scale. Self-reported work factors included too much work to do in a limited time and lack of time to plan or evaluate treatments. No demographic factors predicted work stress, while several work factors did. Occupational stress exists in pediatric occupational therapy work settings, especially in settings where high productivity is self-reported.

The relationship between burnout and work engagement levels of nurses and physiotherapists working during the COVID-19 pandemic period

BACKGROUND

The COVID-19 pandemic has affected all health professionals worldwide. This has also influenced their working lives, affecting burnout and work engagement.

OBJECTIVE

This study aims to investigate the relationship between burnout and work engagement among nurses and physiotherapists during the COVID-19 pandemic.

METHODS

This cross-sectional study was conducted with total 509 nurses and physiotherapists who were working at any of the private, public, or university hospitals from two large and one small cities. A Personal Introduction Form, the Maslach Burnout Scale, and the Work Engagement Scale were used in the study. Frequency, percentage, mean, and Pearson correlation analysis were used for statistical analysis. Necessary ethical approvals were taken for the research.

RESULTS

There was a significant, moderate, negative relationship between the average scores of the nurses on the vigor and devotion dimensions and the Work Engagement Scale and their average scores on emotional exhaustion, personal accomplishment, depersonalization dimensions and their average score on the Maslach Burnout Scale (p <  0.05). There was a significant, moderate, negative relationship between the scores of the physiotherapists on the Work Engagement Scale and its dimensions and their average scores on the Maslach Burnout Scale and its dimensions (p <  0.05).

CONCLUSION

In our study, it was found that the burnout levels of nurses and physiotherapists had an effect on their work engagement during the COVID-19 pandemic. During and after the COVID-19 process, managers should take measures to reduce the burnout levels of health professionals and increase their level of work engagement.

The Feasibility and Impact of an Asynchronous Interprofessional Well-Being Course on Burnout in Health Care Professionals

Background

Well-being initiatives are essential components in fostering an engaged workforce and creating an effective health care ecosystem. Health care professional (HCP) burnout is widespread and has worsened since the COVID-19 pandemic. In 2014, with Health Resources and Services Administration funding support, the Andrew Weil Center for Integrative Medicine created an online course for HCP well-being. It was subsequently studied in medical residents and revised in 2020. In this study, we explore the impact of the course across larger systems, as well as the long-term impact on HCPs.

Methods

The Health Care Professional Well-Being course is 4.5 hours of interactive online education that explores personal well-being, promoters and detractors of well-being, and systemic factors that influence the overall impact of well-being in health care systems. Participants were recruited through institutional members of the Academic Consortium for Integrative Medicine and Health and were randomized to either active or waitlist control groups. Assessments were taken pre-course, 1-month post-course, and 6-months post-course in the areas of burnout, compassion, resiliency, and lifestyle behaviors.

Results

Burnout measures of depersonalization and emotional exhaustion showed a significant improvement amongst active participants, sustained for 6 months after the course. However, no significant improvement in either the resiliency or the compassion measurements was noted for the active group. Initially, the active group showed improvement in personal accomplishment; however, both groups showed a decline overall. Most noteworthy, a large number of active participants demonstrated adoption of new health-promoting behavior; 95% incorporated at least 1 new lifestyle behavior learned from the course.

Conclusion

This study of a brief, asynchronous, online well-being course with interprofessional HCPs, demonstrates that the course is associated with improvement in individual burnout measures and can educate HCPs about healthy behaviors and a framework for professional engagement.

Burnout among the podiatry profession: A survey of podiatrists in Aotearoa New Zealand

INTRODUCTION

Burnout and occupational stress have not yet been explored within the Aotearoa New Zealand (AoNZ) podiatry workforce despite research suggesting an increased risk among this population. This study aimed to: (i) determine the prevalence and severity of burnout risk and occupational stress among AoNZ podiatrists; (ii) determine the factors associated with burnout risk and occupational stress among AoNZ podiatrists; and (iii) examine the relationship between burnout risk and occupational stress.

METHODS

A cross-sectional online survey study was undertaken involving registered podiatrists practicing in AoNZ. Personal and professional demographic characteristics were captured. Participants also completed the Maslach Burnout Inventory (assessing three domains of emotional exhaustion, depersonalisation and personal accomplishment) and the Workplace Stress Scale as measures of burnout risk and occupational stress, respectively. Descriptive statistics, multiple regression analyses and correlation analyses were performed to address the research aims.

RESULTS

Responses from 112 AoNZ podiatrists were included in the analyses. High levels of emotional exhaustion were identified in 43.8% of practitioners and were associated with physical activity status, sector of work, working in isolation and work hours (R2 = 0.304, F (8, N = 110) = 5.519, p < 0.001). High levels of depersonalisation were seen in 13.4% of practitioners and were associated with patient caseload and work hours, (R2 = 0.183, F (4, N = 108) = 5.770, p < 0.001). Low levels of personal accomplishment were observed in 8.9% of practitioners and associated with ethnicity, physical activity status and patient caseload, (R2 = 0.152, F (5, N = 106) = 3.577, p < 0.005). A total of 27.7% of practitioners exhibited an overall moderate to high risk of developing burnout. Over a fifth of practitioners exhibited stress at severe or dangerous levels. Stress levels were significantly associated with physical activity status, sector of work and management responsibility, (R2 = 0.282, F (5, N = 47) = 3.218, p = 0.15). A strong positive relationship was found between emotional exhaustion and stress (rho = 0.59, p < 0.001).

CONCLUSIONS

The findings reflect a moderate to severe risk of developing burnout within the workforce, with high workloads and collegial isolation constituting the primary modifiable factors driving burnout development. To maintain retention and well-being within the workforce, mitigation strategies must be implemented to address this issue.

Association between characteristics of employing healthcare facilities and healthcare worker infection rates and psychosocial experiences during the COVID-19 pandemic

BACKGROUND

Healthcare facility characteristics, such as ownership, size, and location, have been associated with patient outcomes. However, it is not known whether the outcomes of healthcare workers are associated with the characteristics of their employing healthcare facilities, particularly during the COVID-19 pandemic.

METHODS

This was an analysis of a nationwide registry of healthcare workers (the Healthcare Worker Exposure Response and Outcomes (HERO) registry). Participants were surveyed on their personal, employment, and medical characteristics, as well as our primary study outcomes of COVID-19 infection, access to personal protective equipment, and burnout. Participants from healthcare sites with at least ten respondents were included, and these sites were linked to American Hospital Association data to extract information about sites, including number of beds, teaching status, urban/rural location, and for-profit status. Generalized estimating equations were used to estimate linear regression models for the unadjusted and adjusted associations between healthcare facility characteristics and outcomes.

RESULTS

A total of 8,941 healthcare workers from 97 clinical sites were included in the study. After adjustment for participant demographics, healthcare role, and medical comorbidities, facility for-profit status was associated with greater odds of COVID-19 diagnosis (aOR 1.76, 95% CI 1.02-3.03, p = .042). Micropolitan location was associated with decreased odds of COVID-19 infection after adjustment (aOR = 0.42, 95% CI 0.24, 0.71, p = .002. For-profit facility status was associated with decreased odds of burnout after adjustment (aOR = 0.53, 95% CI 0.29-0.98), p = .044).

CONCLUSIONS

For-profit status of employing healthcare facilities was associated with greater odds of COVID-19 diagnosis but decreased odds of burnout after adjustment for demographics, healthcare role, and medical comorbidities. Future research to understand the relationship between facility ownership status and healthcare outcomes is needed to promote wellbeing in the healthcare workforce.

TRIAL REGISTRATION

The registry was prospectively registered: ClinicalTrials.gov Identifier (trial registration number) NCT04342806, submitted April 8, 2020.

From Crisis to Opportunity: A Qualitative Study on Rehabilitation Therapists' Experiences and Post-Pandemic Perspectives

Rehabilitation therapists (RTs) have developed substantial mental health problems since the pandemic. Our study aimed to understand the experience of COVID-19 on occupational therapists and physiotherapists practicing in Canada, how the pandemic may have affected care delivery, and to identify new learnings articulated by RTs. A qualitative descriptive study design guided data collection through one-on-one interviews, dyadic interviews, and focus groups. We recruited active RTs across Canada, advertising on professional practice networks and social media platforms and using snowball sampling. Forty-nine RTs representing seven Canadian provinces participated. The four overarching themes developed using thematic analysis were (1) navigating uncertainty along with ever-changing practices, policies, and attitudes, (2) morphing roles within a constrained system, (3) witnessing patients suffering and experiencing moral distress, and (4) recognizing the personal toll of the pandemic on self and others, as well as lessons learned. Our study demonstrated that many RTs suffered moral distress, poor mental health, and some from challenging financial situations, especially those in the private sector. They also expressed a resilient attitude in response to these stressors. Implications in the future include identifying promising communication strategies that could act as protective factors, addressing workforce constraints and diminishing resources through innovative models of care.

Randomized controlled trial study of intelligent rehabilitation training system for functional ankle instability

To investigate the intervention effect of an intelligent rehabilitation training system on patients with functional ankle instability (FAI) and to advance the research to optimise the effect of FAI rehabilitation training. Thirty-four FAI patients who participated in this trial in Guilin City from April 2023 to June 2023 were recruited as research subjects, and all subjects were randomly divided into the control group (n = 17) and the observation group (n = 17). Both groups received the conventional rehabilitation training intervention for 6 weeks, and the observation group received the additional training using the intelligent rehabilitation training system training invented by our team. Visual analogue scale (VAS), ankle active mobility, ankle muscle strength and Y-balance test (YBT) were assessed before and after treatment. Two-way repeated measures ANOVA shows that the interaction effect between time and group of VAS scores was significant (F = 35.644, P < 0.05). The interaction effect between time and group of plantar flexion mobility was significant (F = 23.948, P < 0.05), the interaction effect between time and group of dorsiflexion mobility was significant (F = 6.570, P < 0.05), the interaction effect between time and group of inversion mobility was significant (F = 8.360, P < 0.05), the interaction effect between time and group of eversion mobility was significant (F = 10.113, P < 0.05). The interaction effect between time and group of inversion muscle strength was significant (F = 18.107, P < 0.05). The interaction effect between time and group of YBT scores was significant (F = 33.324, P < 0.05). The Intelligent Rehabilitation Training System can effectively reduce pain in FAI patients, improve joint range of motion, increase inversion strength, and improve dynamic balance of the affected limb.

Risk and prediction of job burnout in responding nurses to public health emergencies

BACKGROUND

In public health emergencies, nurses are vulnerable to adverse reactions, especially job burnout. It is critical to identify nurses at risk of burnout early and implement interventions as early as possible.

METHODS

A cross-sectional survey of the hospitals in Xiangyang City was conducted in January, 2023 using stratified cluster sampling. Anonymized data were collected from 1584 working nurses. The Impact of Events Scale-Revised (IES-R) and the Chinese version of the Maslach Burnout Inventory-General Survey (MBI-GS) were used to evaluate the post-traumatic stress disorder (PTSD) and burnout of nurses in public health emergencies. Logistic regression analysis was established to screen for risk factors of burnout, and a nomogram was developed to predict the risk of burnout. A calibration curve and the area under the receiver operating characteristic (ROC) curve were used to validate the nomogram internally.

RESULTS

This study showed that only 3.7% of nurses were completely free of PTSD during a public health emergency. We found that PTSD varied by age, marital status, procreation status, length of service, employee status, and whether working in the ICU. The nurses aged 30 ~ 40 years old, single, married without children, non-regular employees, worked for less than three years or worked in the ICU had higher levels of PTSD. Regarding the prevalence of burnout, 27.4%, 48.5%, and 18.6% of nurses had a high level of emotional exhaustion (EE), depersonalization (DP), and diminished personal accomplishment (PA), respectively. There, 31.1% of nurses had more than two types of job burnout. The number of night shifts, the type of hospital, marital status, and the severity of PTSD were all associated with higher rates of exhaustion among nurses. As a graphical representation of the model, a nomogram was created and demonstrated excellent calibration and discrimination in both sets (AUC = 0.787).

CONCLUSIONS

This study confirmed the PTSD and burnout are common problems for in-service nurses during public health emergencies and screened out the high-risk groups of job burnout. It is necessary to pay more attention nurses who are single and working in general hospitals with many night shifts, especially nurses with severe PTSD. Hospitals can set up nurses' personal health records to give timely warnings to nurses with health problems, and carry out support interventions to relieve occupational stress.

Impact of psychosocial risk on intention to leave work during COVID-19 in Indonesia: The mediatory roles of burnout syndrome and job satisfaction

The COVID-19 pandemic intensified the complexity of work in the health sector, leading to an increase in the intention to leave work (ITL) in Indonesia. Previous research has revealed a theoretical gap in investigating the roles of burnout syndrome (BS) and job satisfaction (JS) as mediators of the effect of psychosocial risk (PR) on ITL. This research study aimed to fill this gap by examining the effect of PR on ITL during the COVID-19 pandemic, with BS and JS as mediators. Data was collected from 306 health workers in public and private hospitals of Central Jakarta, Indonesia. This data was analyzed as part of a cross-sectional research study involving the partial least square-structural equation modeling (PLS-SEM) method and using SmartPLS software. The questionnaire was based on the Copenhagen Psychosocial Questionnaire (COPSOQ) III short version, the Burnout Assessment Tools (BAT), and a modified Turnover Intention. The findings revealed that, within the direct effect pathways, JS was the highest predictor of health workers' ITL, and workplace PR significantly impacted employees' JS and BS. Another notable finding was related to the research gap vis-a-vis the indirect effect pathways: it showed that JS and BS had partial mediatory power over the relationship between PR and ITL. BS and JS were found to have a high and significant impact on employees' ITL. Therefore, this research study has contributed to the model's novelty in measuring ITL mediated by JS and BS.

A Comparison of the Self-Perceived Organisational and Social Work Environment among Swedish Occupational Therapists in Different Job Sectors: An Observational Study

Sick leave due to mental health problems is increasing, and there is evidence that it is associated with the individual's self-perceived organisational and social work environment. The aim of this study was to compare occupational therapists' self-perceived organisational and social work environments in different job sectors. The goal is to identify the sectors with the most unfavourable work environment and thus where the need to improve the work environment, to prevent mental health problems, is greatest. A web survey was emailed to working members of the Swedish Association of Occupational Therapists in February 2018 (n = 7600). The response rate was 48% (n = 3658). Studied job sectors were somatic specialist health care; elderly care; habilitation; psychiatric health care; primary health care; and university (n = 2648). This sample is representative of Swedish occupational therapists with respect to age, gender, and job sector. The web survey included questions on their sociodemographic characteristics and self-perceived organisational and social work environment regarding workload, control, community in the workplace, reward, justice, and values. Questions on the self-perceived organisational and social work environment were assessed by the QPS mismatch questionnaire. Differences in work environmental conditions between the job sectors were tested with ANOVA and post hoc multiple-group analysis. The results showed that occupational therapists working in psychiatric health care perceived the highest proportion of unfavourable working conditions. Occupational therapists who worked at universities perceived a higher workload than occupational therapists in most of the other studied job sectors. These job sectors need to be specifically addressed with adjustments to prevent mental health problems.

Clinical education-related stressors and emotional states during clinical education among physical therapy students

BACKGROUND

While clinical education-related stressors in other healthcare professions have been reported, clinical education stressors in physical therapy students are not yet clear.

PURPOSE

This study aimed to identify clusters of stressors associated with clinical education among Japanese physical therapy students and determine the association between these clusters and emotional states.

METHODS

Participants were physical therapy students who had completed five weeks of clinical education. In addition to demographic data, the survey included the Brief Job Stress Questionnaire (BJSQ) and the Stress Reaction Scale (SRS-18). Exploratory factor analysis was used to extract latent variables for sub-items of the BJSQ. Spearman's correlation coefficients between the extracted latent variables and the subscales of the SRS-18 were calculated.

RESULTS

Data from 114 individuals (median age 21 years, 68 men and 46 women) were analyzed. The variables identified as clusters of stressors were: 1) "adaptation to clinical education"; 2) "task burden"; and 3) "appropriate work environment." These three clusters of stressors were significantly but only weakly correlated with the subscales of the SRS-18 (|rs| ≤ |-.39|).

CONCLUSION

The stressors associated with physical therapy clinical education need to be understood in terms of the students' active attitude toward clinical education, the burden of practice tasks, and the physical environment during practice.

Psychosocial Factors Associated with Burnout and Self-Perceived Health in Spanish Occupational Therapists

(1) Background: There are few studies of burnout syndrome (BS) in occupational therapists (OTs), and protective factors for BS have received little attention in the scientific literature. This research aimed to estimate the prevalence of BS, characterize the associated psychosocial factors, and analyze their relationship with health in a sample of Spanish OTs. (2) Methods: A total of 127 therapists completed the Maslach Burnout Inventory (MBI) and other standardized questionnaires measuring: personality traits (reduced five-factor personality inventory, NEO-FFI), coping styles (Coping Strategies Questionnaire, CAE), work-family conflict (Survey Work-Home Interaction Nijmegen, SWING), professional factors (role ambiguity/clarity and modified role conflict questionnaires), and the perception of health (Goldberg's General Health Questionnaire). Several correlational and multiple regression analyses were performed to study the psychosocial predictors of burnout and its relationship with health perceptions. (3) Results: 15.8% of the professionals presented BS, with emotional exhaustion (EE; 38.7%) being the most compromised dimension. Neuroticism, role conflict, negative work-family interaction, and open emotional expression (OE) significantly predicted a higher EE. The main predictors of cynicism (CY) were being male, role conflict, and OE. Role conflict, role ambiguity and social support-seeking were significant predictors of reduced professional efficiency (PE). (4) Conclusions: A high percentage of OTs with BS suggests the need for increased awareness of the importance of this syndrome in the health community. It would be critical to consider the protective factors (i.e., emotional management, social support) that help promote OTs' well-being and health.

Influence of Palliative Care Qualifications on the Job Stress Factors of General Practitioners in Palliative Care: A Survey Study

Due to demographic change, the number of patients in palliative care (PC) is increasing. General Practitioners (GPs) are important PC providers who often have known their patients for a long time. PC can be demanding for GPs. However, there are few studies on the job stress factors of GPs performing PC and the potential influence of their PC training. To get more insights, a postal survey was performed with GPs in North Rhine, Germany. The questionnaire was based on a literature search, qualitative pre-studies, and the Hospital Consultants' Job Stress & Satisfaction Questionnaire (HCJSSQ). Participants state that a high level of responsibility, conflicting demands, and bureaucracy are the most important stressors they experienced in PC. The influence of PC qualification level on their perceived job stress factors is low. Only advanced but not specialist qualification shows a correlation with renumeration-related stress. Gender and work experience are more dominant influences. In our study, female GPs and physicians with more work experience tend to be more stressed. In conclusion, organisational barriers, such as administration, should be reduced and renumeration should be increased to facilitate the daily work of GPs.

Remote Interventions to Support Students' Psychological Well-Being during the COVID-19 Pandemic: A Narrative Review of Recent Approaches

The COVID-19 pandemic has negatively affected students' mental health, and it is important to implement mental health management strategies. The purpose of this study was to present current findings on the implementation of remote mental health interventions in students during the pandemic. The PubMed and Web of Science electronic databases were searched and, from a total of 174 articles, 106 records were excluded according to the inclusion criteria and 23 were assessed as full texts. After the full-text screening, 12 studies were included in the review. The included publications were randomized clinical trials focused on remote mental support interventions among students from 10 countries, representing both genders, and were in the average age range of 17-55 years with an overall number of 892 participants. The included studies covered the effectiveness of strictly psychotherapeutic programs, such as cognitive-behavioral therapy (CBT) and dialectical behavior therapy (DBT), as well as other techniques such as mindfulness, laughter therapy, the brain wave modulation technique (BWM-T), and physical activity-based interventions. This narrative review provides an overview of studies with a wide range of types of remote mental health support interventions. Each of the forms of intervention analyzed in this review resulted in positive changes in students' mental health, which indicates hope for widespread help via various forms of intervention implemented remotely.

Job Satisfaction and Burnout in Croatian Physiotherapists

BACKGROUND

Physiotherapists are important healthcare professionals in modern and multidisciplinary health forces. However, they are exposed to a high risk of occupational burnout, which is associated with reduced job satisfaction. Job satisfaction is essential for medical professionals because it directly influences patient safety and the quality of medical care. Therefore, this study aimed to determine the association between sociodemographic variables of Croatian physiotherapists, job satisfaction, and occupational burnout.

METHODS

A cross-sectional study was performed among 404 physiotherapists using a sociodemographic questionnaire, the Job Descriptive Index (JDI), and Oldenburg Burnout Inventory (OLBI).

RESULTS

The study group of Croatian physiotherapists was marked by a high level of job satisfaction and occupational burnout. However, a higher level of occupational burnout is associated with lower job satisfaction. The main determinants of job satisfaction were younger age, female gender, less work experience, and married or partnership. At the same time, a higher level of occupational burnout was associated with working in government institutions and being single.

CONCLUSIONS

As a reaction to psychological stress at work with the main components of exhaustion and disengagement, occupational burnout is negatively associated with job satisfaction. Therefore, assessing the factors influencing job satisfaction and burnout in the workplace can help develop physiotherapists' mental health prevention strategies.

Russian Physicians Burnout during the COVID-19 Pandemic: A Cross-Sectional Survey Study

Objective: To study burnout of Russian physicians in the conditions of COVID-19 pandemic and how their work with coronavirus-infected patients influenced it. According to a three-factor model of burnout developed by Maslach and Jackson, this syndrome includes emotional exhaustion, depersonalization, and reduction of personal accomplishment.Design: A cross-sectional survey study.Setting: Large medical practice.Participants: Physicians of different specialties.Methods: Data collection was conducted from June 23 to July 12, 2020. We developed a Google form including a questionnaire and psychological inventories and placed it in a medical portal. Maslach Burnout Inventory - Human Services Survey for Medical Personnel was used to study burnout; the Hospital Anxiety and Depression Scale was used to determine anxiety and depression.Results: Of all the physicians who took part in the study (N = 599), 31.2 % worked with coronavirus-infected patients. Of the medical personnel who treated COVID-19 patients, 63.6% noted increased workload during the pandemic. Compared to other physicians, they more often had a high degree of emotional exhaustion (43.3 % vs 33.0 %, φ* = 2.404, P ≤ 0.01) and depersonalization (41.7 % vs 34, 0%, φ* = 1.803, P ≤ 0.05). An overwhelming majority of physicians, without any dependence on work with infected patients, had an absence of anxiety and depression. The identified interrelations between the symptoms of burnout, anxiety, depression; age and career stage in medical personnel were identical, except for weak correlations between age and emotional exhaustion (rs = -0.097, P ≤ 0.05), as well as career stage and personal accomplishment (rs = 0.102, P ≤ 0.05) in those physicians who worked with COVID-19 patients. The structure of burnout was identical in all physicians and did not depend on interaction with the infected patients.Conclusion: Public health authorities should reduce the workload on physicians involved in treating infected patients against the backdrop of the pandemic. Psychotherapeutic measures focused on preventing burnout should reduce its number among physicians interacting with patients infected with the coronavirus.

Meta-Analysis of Factors Associated with Occupational Therapist Burnout

Burnout, a reaction to chronic emotional stress, affects health and reduces the quality of service. Reportedly, healthcare professionals are especially vulnerable to burnout. This meta-analysis is aimed at examining the factors associated with occupational therapists' burnout. The results of 2,430 occupational therapists, across 17 peer-reviewed English articles, the most recent published in 2020, were analysed. Results revealed significant associations between related variables and burnout. Marital status, work field, and work hours, job challenges, patient age, position, turnover intention, working type, and work addiction showed significant positive correlation effect sizes in relation to burnout, whereas age, education, engagement, job satisfaction, personal identity, professional identity, rewards, and feeling valued showed significant negative correlation effect sizes. The results of this meta-analysis suggest that strategies to reduce occupational therapists' burnout need to consider organizational as well as psychological aspects.

Designing the careful and kind clinic: an evidence-based approach

Background

There is evidence that creating a ‘healthy workplace’ can be of profound importance for clinicians, team members and patients. Yet there have been few papers that have proposed mechanisms to take decades of research and translate this into a practical list of options for leaders and managers to take into account when structuring a clinic based on care and kindness to achieve optimal health.

Evidence

We bring together 20 years of scholarship linking care of the caregivers with outcomes for caregivers and patients. The data are used to support both structures and cultures that will result in satisfied and thriving healthcare team members, as well as satisfied and healthy patients.

Results

The clinic based on care of the caregivers will be structured to address key aspects of worklife that are known to cause either satisfaction or burnout. Aspects of care, such as time pressure, chaotic environments and worker control of their workplace, will be taken into account in clinical design; organisational culture will be supportive and cohesive, emphasising quality, values and communication. Experiences based on gender and race will be measured and continuously improved; and performance will be evaluated in a new, human-centred manner.

Outcomes

The careful and kind clinic will be a remarkable place to work; in contrast to industrialised healthcare, this will be an environment where health can indeed be optimised, for both workers and patients.

Job Satisfaction among Occupational Therapy Practitioners: A Systematic Review of Quantitative Studies

A comprehensive description of the factors associated with job satisfaction among occupational therapy practitioners is needed to promote their work well-being. This systematic review aimed to describe occupational therapy practitioners' job satisfaction and the related intra-, inter-, and extra-personal factors. Original peer-reviewed studies published between 2010 and 2019 were retrieved from four databases with the review including fourteen studies. The review was conducted according to the Joanna Briggs Institute guideline. The data were analyzed by narrative synthesis. Occupational therapy practitioners experienced high job satisfaction. Job satisfaction was found to be associated with significantly lower rates of turnover intention and higher rates of rewards. The relationships between job satisfaction, professional identity, exhaustion, and social environment showed conflicting results.

Burnout profiles among French workers in health units for inmates: results of the EHCAU study

BACKGROUND

Health care personnel who work in penitentiary environments are at risk of burnout due to a variety of factors. Latest research have brought forward a classification system consisting of five burnout profiles on a continuum between engagement and burnout. The objective of this study was to measure the prevalence of these profiles among professionals working in French health units providing health services for inmates according to the three levels of care and to investigate their characteristics to propose appropriate management and prevention approaches.

METHODS

This study involved a cross-sectional analysis of data from the Evaluation of Health CAre in Units for inmates (EHCAU) study, a multicentric cohort study of professionals practising in health units for inmates in eastern France. Burnout was assessed by the Maslach Burnout Inventory (MBI) at the levels of emotional exhaustion, depersonalization and personal accomplishment. Job conditions and characteristics were measured using the Karasek Job Content Questionnaire and the Effort-Reward Imbalance Questionnaire. Data on sociodemographic characteristics and self-reported health status were also collected. Differences between MBI profiles were identified using Fisher's exact test and the Wilcoxon test.

RESULTS

Of the 350 professionals surveyed, 150 responded (42.9%). The most frequent profiles were ineffective (36.9%) and engagement (34.8%). The burnout (7.8%), overextended (15.6%) and disengaged (5.0%) profiles made up the remaining quarter. Significant differences in the burnout profiles were observed in regard to professional occupation (p = 0.01), irregular eating hours (p = 0.04), history of complaint procedures (p = 0.05), anxiety (p < 0.0001), depression (p < 0.0001) and the mental component of self-reported quality of life (p < 0.0001).

CONCLUSIONS

These results confirm that special attention should be given to professionals working in these challenging settings. The results have important implications for theory and research and for more customized approach interventions.

TRIAL REGISTRATION

ID RCB: 2018-A03029-46.

Job Stress and Mental Well-Being among Working Men and Women in Europe: The Mediating Role of Social Support

Job stress is one of the most common health issues in many organizations, particularly among women. Moreover, an increase in job stress with low social support may have an adverse effect on mental well-being. This study investigated the mediating role of social support in the relationship between job stress and mental well-being among working men and women in Europe. A cross sectional data set from the 2015 6th European Working Conditions Survey on 14,603 men and 15,486 women from 35 countries in Europe was analyzed. The study applied Hayes process macro 4 modelling technique to estimate the direct, indirect, and total effects of job stress on mental well-being among working adults. The study further used the Hayes process macro 59 model to estimate the gender difference in the mediating effect. The results showed that job stress had a direct negative effect on mental well-being among workers in Europe (β=−0.2352,p<0.05). However, there were significant gender differences in the relationship (β=−0.3729,p<0.05), with women having higher effect size than men (men: β=−3.9129,p<0.05 vs. women: β=−4.2858,p<0.05). Furthermore, the indirect effect showed that social support mediated the relationship of job stress on mental well-being (β=−0.0181, CI: −0.0212−0.0153). Nevertheless, the mediating effect of social support did not differ among men and women. This study provides evidence that job stress has a negative impact on mental well-being among working adults, and social support mediates this relationship. The results highlight the importance of the role of support from colleagues and supervisors at the work place, which may help reduce job stress, and improve mental well-being. Sociological and occupational health researchers should not ignore the role of gender when studying work environment and jobs in general.

Job demands and job control among occupational therapists in public sector in Finland

BACKGROUND

Although health care professionals' increased job demands and strain have generated much public debate in recent years, the way in which occupational therapists' job strain has developed remains unknown.

OBJECTIVE

To examine how Finnish occupational therapists working in municipalities experienced job demands and control in 2014-2018 compared with physiotherapists and registered nurses.

MATERIAL AND METHODS

Occupational therapists (OT, n = 107), physiotherapists (PT, n = 331) and registered nurses (RN, n = 1389) responded to repeated surveys in the Finnish Public Sector Study in 2014-2018. We used the Job Content Questionnaire and analyzed the data using repeated measures analysis of variance and multiple linear regression with generalized estimating equations to identify the trends and differences.

RESULTS

More OTs had lower job demands and higher job control than PTs and RNs in each year of study. These differences were statistically significant. Most OTs had low job strain. The changes in job control and job demands of participants in different years were not statistically significant.

CONCLUSIONS

The OTs consistently experienced low job strain as compared to the PTs and RNs. Developing good practices in OT's work may be beneficial for improving employee health and well-being and high-quality client care.