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Alwatban L, Alageel MS, Alshehri LA, Alfehaid NS, Albahlal RA, Almazrou NH, Almubarak R. The Stigma of Burnout Impeding Formal Help: A Qualitative Study Exploring Residents' Experiences During Training. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2024; 15:333-342. [PMID: 38646001 PMCID: PMC11032676 DOI: 10.2147/amep.s453564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 04/02/2024] [Indexed: 04/23/2024]
Abstract
Purpose Burnout is an occupational stress syndrome that gives rise to emotional exhaustion (EE) depersonalization (DP) and reduced personal accomplishment (PA). Increasing rates of burnout among health care professionals has been reported globally. Saudi Arabia appears to be among the highest in prevalence with reports of higher than 70%. Medical residents in training are the highest group at risk. The literature has repeatedly linked burnout among residents with poor academic performance on training exams, impaired quality of life, career choice regret and intentions to abandon medicine. In this study, we explore the factors that contribute to resident burnout, their experiences with burnout and how they choose to mitigate it. Methods A qualitative design was used to conduct this study in the city of Riyadh, Saudi Arabia. A total of 14 residents from surgical and non-surgical programs were interviewed through in-depth interviews. Interpretive thematic analysis was used in coding and generated coding templates. Categories were repetitively reviewed and revised, expanding to include new data as it emerged and collapsing to remove redundant codes. Categories were organized into the final themes and sub-themes. Results All participants demonstrated a shared thread of shame in reaching the level of burnout. Three main interlinked themes were identified: Burnout stigma cycle, amalgamated causes of burnout and self-coping with burnout. One of the concerning findings in our study is the participants' pursuit of self-coping strategies and the avoidance of formal help, creating a cycle of suffering in silence. Conclusion The literature has repeatedly reported high levels of burnout among residents in training. This study has added another dimension to those findings through the exploration of residents actual accounts and appears to link burnout with suboptimal training and working conditions. We have highlighted the pivotal role stigma and shame play in completely preventing residents from seeking professional help.
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Affiliation(s)
- Lemmese Alwatban
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- University Family Medicine Center, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Mai S Alageel
- Department of Family Medicine, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Lina A Alshehri
- Department of Neurosurgery, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
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Abdul Aziz AF, Ong T. Prevalence and associated factors of burnout among working adults in Southeast Asia: results from a public health assessment. Front Public Health 2024; 12:1326227. [PMID: 38550314 PMCID: PMC10972957 DOI: 10.3389/fpubh.2024.1326227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 03/04/2024] [Indexed: 04/02/2024] Open
Abstract
The COVID-19 pandemic has spotlighted the mental health crisis among employees worldwide. However, burnout research is often industry- or occupation-specific, and limited knowledge currently exists on the prevalence of burnout in the general working population of Southeast Asia. This study aims to examine the prevalence of employee burnout and its associated factors among working adults in Southeast Asia using secondary data. 4,338 full-time employees aged 18-65 years old living in Malaysia, Singapore, Philippines, and Indonesia were assessed for burnout, depression, anxiety, stress, and sociodemographic characteristics as part of an online public health assessment in October 2022. The prevalence of burnout in the region was 62.91%. Burnout was highest among employees in the Philippines (70.71%) and lowest in Malaysia (58.13%). Experiencing burnout was associated with severe or extremely severe depression (AOR = 6.48 [95% CI = 5.06-8.33]), anxiety (AOR = 2.22 [1.74-2.85]), and stress (AOR = 5.51 [4.13-7.39]). Working more than 50 hours a week (AOR = 1.38 [1.04-1.82]) and being very dissatisfied with the job led to higher odds of burnout (AOR = 16.46 [8.99-30.53]). Alarmingly, more than half of working adults in the region are reporting increased levels of burnout, and improving employee mental health and work conditions may be key to improving employee burnout in the region. Findings contribute to existing research on burnout prevalence in the region and provide more comprehensive insights into understanding the factors driving employee burnout in the working population of Southeast Asia 2 years after the onset of the pandemic.
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Li W, Chen L, Hsu M, Mo D, Xia L, Min K, Jiang F, Liu T, Liu Y, Liu H, Tang YL. The association between workload, alcohol use, and alcohol misuse among psychiatrists in China. Front Psychiatry 2023; 14:1171316. [PMID: 37426098 PMCID: PMC10325676 DOI: 10.3389/fpsyt.2023.1171316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 06/07/2023] [Indexed: 07/11/2023] Open
Abstract
Aim Survey alcohol use and workload among Chinese psychiatrists and explore their associations. Methods We conducted an online questionnaire among psychiatrists working in large psychiatric institutions across the country. We collected data including demographic factors, alcohol use, and workload. Alcohol use was assessed using the Alcohol Use Disorder Identification Test-Consumption (AUDIT-C), and workload-related questions included working hours, night shifts, and caseloads. Results In total, 3,549 psychiatrists completed the survey. Nearly half (47.6%) reported alcohol use, and the percentage of alcohol use in males (74.1%) was significantly higher than in females. 8.1% exceeded the AUDIT-C cutoff scores for probable alcohol misuse (19.6%in males and 2.6%in females). AUDIT-C scores were significantly correlated with working hours per week (p = 0.017) and the number of outpatient visits per week (p = 0.006). Regressional analysis showed that alcohol use was significantly associated with the following factors: longer working hours (Working more than 44 h/week, OR = 1.315), having an administrative position (OR = 1.352), being male (OR = 6.856), being single (OR = 1.601), being divorced or widowed (OR = 1.888), smoking (OR = 2.219), working in the West (OR = 1.511) or the Northeast (OR = 2.440). Regressional analysis showed that alcohol misuse was significantly associated with the following factors: fewer night shifts (Three to four night shifts/month, OR = 1.460; No more than 2 night shifts/month, OR = 1.864), being male (OR = 4.007), working in the Northeast (OR = 1.683), smoking (OR = 2.219), frequent insomnia (OR = 1.678). Conclusion Nearly half of the psychiatrists in China reported alcohol use and 8.1% had probable AUD. Alcohol consumption is significantly associated with several workload-related factors, such as long working hours, heavy caseload, and administrative duties. Alcohol misuse was inversely associated with the number of night shifts per month. While the direction of causality is unclear, our findings may help identify vulnerable professional groups and develop more targeted interventions to improve healthcare professionals' well-being.
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Affiliation(s)
- Wenzheng Li
- Department of Psychiatry, Chao Hu Hospital of Anhui Medical University, Hefei, China
- Hefei Fourth People’s Hospital, Hefei, China
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, China
| | - Long Chen
- Department of Psychiatry, Chao Hu Hospital of Anhui Medical University, Hefei, China
- Hefei Fourth People’s Hospital, Hefei, China
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, China
| | - Michael Hsu
- Addiction Psychiatry Fellowship Program, Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States
| | - Daming Mo
- Hefei Fourth People’s Hospital, Hefei, China
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, China
| | - Lei Xia
- Department of Psychiatry, Chao Hu Hospital of Anhui Medical University, Hefei, China
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Anhui Psychiatric Center, Hefei, China
| | - Kaiyuan Min
- State Key Laboratory of Medical Molecular Biology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Feng Jiang
- School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China
- Institute of Healthy Yangtze River Delta, Shanghai Jiao Tong University, Shanghai, China
| | - Tingfang Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yuanli Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Huanzhong Liu
- Department of Psychiatry, Chao Hu Hospital of Anhui Medical University, Hefei, China
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Anhui Psychiatric Center, Hefei, China
| | - Yi-lang Tang
- Addiction Psychiatry Fellowship Program, Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States
- Atlanta Veterans Affairs Medical Center, Decatur, GA, United States
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Claponea RM, Iorga M. Burnout, Organizational Justice, Workload, and Emotional Regulation among Medical and Non-Medical Personnel Working in Romanian Healthcare Units. Behav Sci (Basel) 2023; 13:bs13030225. [PMID: 36975250 PMCID: PMC10045892 DOI: 10.3390/bs13030225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 02/25/2023] [Accepted: 02/28/2023] [Indexed: 03/08/2023] Open
Abstract
Background and objectives: The goal of this study was to evaluate the levels of organizational justice, emotional regulation, and workload associated with the level of burnout experienced in medical and non-medical staff from public and private medical units. Materials and Methods: A cross-sectional study was conducted on a sample of 230 healthcare professionals, including 139 medical personnel and 91 non-medical staff respondents. The collected socio-demographic and organizational data and psychological tools were the Maslach Burnout Inventory (MBI HSS), the ECO System, and the emotional regulation questionnaire (ERQ). Results: For medical staff, burnout was measured in terms of emotional exhaustion (M = 27.05 ± 12.34), depersonalization (M = 8.26 ± 3.95), and personal accomplishment (M = 47.35 ± 6.78). The scores for non-medical staff were emotional exhaustion (M = 35.84 ± 14.71), depersonalization (M = 11.79 ± 6.30), and personal accomplishment (M = 44 ± 7.37). In terms of workload, higher scores were observed for non-medical staff (M = 25.43 ± 7.87), while medical staff recorded lower values (M = 20.35 ± 7.65). The scores for the cognitive reappraisal dimension were as follows: medical personnel (M = 32.02 ± 5.37) and non-medical staff (M = 31.67 ± 6.19). In terms of the expressive suppression dimension, medical staff registered at M = 17.99 ± 5.61, and non-medical staff registered at M = 17.19 ± 5.53. For organizational justice, higher scores were registered for medical staff (M = 25.87 ± 6.02) and lower scores for non-medical staff (M = 21.34 ± 5.72). Conclusions: Medical staff felt a higher sense of organizational justice than non-medical staff, as is also evidenced by the level of the workload dimension, which registers higher values for non-medical personnel. In the case of burnout, higher levels of emotional exhaustion and depersonalization dimensions were also revealed for non-medical staff and, in the case of the professional fulfillment dimension, higher scores were registered for medical staff.
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Affiliation(s)
- Roxana Mihaela Claponea
- Faculty of Psychology and Education Sciences, “Alexandru Ioan Cuza” University of Iasi, 700554 Iasi, Romania
| | - Magdalena Iorga
- Faculty of Psychology and Education Sciences, “Alexandru Ioan Cuza” University of Iasi, 700554 Iasi, Romania
- Behavioral Sciences Department, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
- Correspondence:
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Stan R, Ciobanu C. The Mediation Chain Effect of Cognitive Crafting and Personal Resources on the Relationship between Role Ambiguity and Dentists' Emotional Exhaustion. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16617. [PMID: 36554497 PMCID: PMC9779455 DOI: 10.3390/ijerph192416617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 11/23/2022] [Accepted: 11/28/2022] [Indexed: 06/17/2023]
Abstract
Based on Job Demands-Resources (JD-R), Conservation of Resources (COR) and self-regulation theories integration, this study investigated the association between role ambiguity and emotional exhaustion among 191 Romanian dentists, as well as the chain mediating role of cognitive crafting and three personal resources (resilience, optimism, and self-efficacy). Three conceptual models which included, separately, the three personal resources were proposed. PROCESS macros were used to verify the hypotheses related to the testing of the path mediation models. The results indicated that role ambiguity was directly and positively associated with dentists' burnout. More importantly, the sequential indirect effect of role ambiguity on burnout via mediators in chains (cognitive crafting and resilience for the first model; cognitive crafting and optimism for the second model; cognitive crafting and self-efficacy for the third model) was significant. The findings provide a direction for dentists' health intervention because it reveals how the negative impact of role ambiguity on emotional exhaustion increasing can be buffered by the cumulative effect of cognitive crafting and different personal resources, as a result of their chain reinforcement.
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Affiliation(s)
- Rosana Stan
- Department of Psychology, University of Oradea, 410087 Oradea, Romania
| | - Cristina Ciobanu
- Department of Dental Medicine, University of Oradea, 410087 Oradea, Romania
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Server A, Suso-Ribera C, Pérez-Carrasco M, Medel J, Mesas Á, Ayora A, Gracia RM. Feasibility of a brief mindfulness-based program for burnout in pain healthcare professionals. Front Psychol 2022; 13:1009266. [DOI: 10.3389/fpsyg.2022.1009266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 10/18/2022] [Indexed: 11/09/2022] Open
Abstract
IntroductionStress inherent to health care, which is characterized by work overload and shortage of specialized staff, is associated with decreased quality of life and suboptimal patient care. Mindfulness-based programs have proved to be effective in reducing stress in healthcare providers. This study aims to assess the feasibility of an 8-week mindfulness program to reduce the burnout levels of the staff of a pain clinic in a tertiary public hospital.Materials and methodsA longitudinal study with a within subject pre/post-intervention design, consisting of daily face-to-face 10-min sessions and the creation of a virtual group using a social media platform. Variables measured: burnout, mindfulness, empathy, self-compassion, and demographic characteristics.ResultsProgram feasibility (i.e., reach, adherence, acceptability, and preliminary effectiveness) was evaluated in 10 participants (6 physicians, 2 nurse practitioners, 1 nursing assistant, and 1 administrative). The results revealed a high reach (i.e., participation rate of 90%), excellent adherence to the program (daily practice 95% of times), and very good acceptability of the group format and satisfaction with most treatment components. Regarding potential effectiveness, we report the results of the Wilcoxon signed-rank tests and its associated effect size (r). We observed improvements in mindfulness and all its subscales (−2.077 ≤ Z ≤ −2.703, 0.69 ≤ r ≤ 0.90, all p < 0.05) except for non-reactivity and all subcomponents of self-compassion (−2.501 ≤ Z ≤ −2.611, 0.83 ≤ r ≤ 0.87, all p < 0.05) but not on its global self-compassion score. Empathy and burnout did not change. In an exploratory manner, however, we found significant reductions in the burnout component of emotional exhaustion, but only in physicians (Z = −2.201, p = 0.028, r = 0.73).DiscussionWe believe that the 8-week mindfulness-based program described in the present investigation might be a feasible and potentially effective method that can be easily implemented to reduce burnout and promote mindfulness in specialized pain clinics.
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Vogeli JM, Abraham D. Anesthesiology Residency and Relationship Health: A Psychological Approach. Anesthesiol Clin 2022; 40:325-336. [PMID: 35659404 DOI: 10.1016/j.anclin.2022.01.006] [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] [Indexed: 06/15/2023]
Abstract
This article explores an often-untouched subject in anesthesiology residency: relationships. The authors examine the importance of fostering all types of relationships (eg, personal, professional, self) and the impact of the training process on relationships and total well-being. Common issues in relationships during anesthesiology residency are shared through real-life anecdotes from physicians who are currently in or have completed their residencies. Psychological principles including optimism bias, cognitive dissonance, social comparison, and self-efficacy are explored as contributing to dysfunction in relationships. Strategies are offered for each psychological domain as a resource for faculty and program leadership to improve the residency experience in anesthesiology.
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Affiliation(s)
- Jo M Vogeli
- Department of Anesthesiology Wellbeing Program, University of Colorado School of Medicine, Anschutz Medical Campus, 12631 East 17th Avenue, Mailstop 8202, Suite L15-2007, Aurora, CO 80045, USA.
| | - Daniel Abraham
- Department of Anesthesiology and Critical Care, Perelman School of Medicine at the University of Pennsylvania, 3400 Spruce Street, 6 Dulles Building, Philadelphia, PA 19104, USA
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BURNOUT SYNDROME IN DENTISTS: WORK-RELATED FACTORS. J Dent 2022; 121:104143. [DOI: 10.1016/j.jdent.2022.104143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 04/20/2022] [Accepted: 04/21/2022] [Indexed: 11/18/2022] Open
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Castilla D, Navarro-Haro MV, Suso-Ribera C, Díaz-García A, Zaragoza I, García-Palacios A. Ecological momentary intervention to enhance emotion regulation in healthcare workers via smartphone: a randomized controlled trial protocol. BMC Psychiatry 2022; 22:164. [PMID: 35248015 PMCID: PMC8897724 DOI: 10.1186/s12888-022-03800-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 02/19/2022] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND CUIDA-TE is an APP that offers transdiagnostic cognitive behavioral therapy focused on enhancing emotion regulation. As a novelty, it incorporates ecological momentary interventions (EMI), which can provide psychological support in real time, when suffering arises. The main goal of the study is to evaluate the efficacy of CUIDA-TE to improve emotion regulation in healthcare workers, a population that has been particularly emotionally impacted by the COVID-19 pandemic. METHODS In this three-arm, randomized controlled trial (RCT) the study sample will be composed of a minimum of 174 healthcare workers. They will be randomly assigned to a 2-month EMI group (CUIDA-TE APP, n ≥ 58), a 2-month ecological momentary assessment (EMA) only group (MONITOR EMOCIONAL APP, n ≥ 58), or a wait-list control group (no daily monitoring nor intervention, n ≥ 58). CUIDA-TE will provide EMI if EMA reveals emotional problems, poor sleep quality/quantity, burnout, stress, or low perceived self-efficacy when regulating emotions. Depression will be the primary outcome. Secondary outcomes will include emotion regulation, quality of life, and resilience. Treatment acceptance and usability will also be measured. Primary and secondary outcomes will be obtained at pre- and post-intervention measurements, and at the 3-month follow-up for all groups. DISCUSSION To our knowledge, this is the first RCT that evaluates the efficacy of an APP-based EMI to improve emotion regulation skills in healthcare workers. This type of intervention might ultimately help disseminate treatments and reach a larger number of individuals than traditional face-to-face individual therapies. TRIAL REGISTRATION ClinicalTrial.gov : NCT04958941 Registered 7 Jun 2021. STUDY STATUS Participant recruitment has not started.
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Affiliation(s)
- Diana Castilla
- grid.5338.d0000 0001 2173 938XDepartment of Personality, Evaluation and Psychological Treatment, University of Valencia, Avenida Blasco Ibáñez, 21, 46010 Valencia, Spain ,grid.413448.e0000 0000 9314 1427CIBER of Physiopathology of Obesity and Nutrition (CIBEROBN), ISCIII CB06/03/0052, Instituto Salud Carlos III, 28029 Madrid, Spain
| | - María Vicenta Navarro-Haro
- Department of Psychology and Sociology, University of Zaragoza, Calle Atarazana, 4, 44003 C/ Ciudad Escolar, s/n, 44001, Teruel, Spain. .,Instituto de Investigación Sanitaria Aragón, Avenida de San Juan Bosco, 13, 50009, Zaragoza, Spain.
| | - Carlos Suso-Ribera
- grid.413448.e0000 0000 9314 1427CIBER of Physiopathology of Obesity and Nutrition (CIBEROBN), ISCIII CB06/03/0052, Instituto Salud Carlos III, 28029 Madrid, Spain ,grid.9612.c0000 0001 1957 9153Department of Basic Psychology, Clinical Psychology and Psychobiology, Universitat Jaume I, Avenida de Vicent Sos Baynat, s/n, 12071 Castellón de la Plana, Spain
| | - Amanda Díaz-García
- grid.11205.370000 0001 2152 8769Department of Psychology and Sociology, University of Zaragoza, Calle Atarazana, 4, 44003 C/ Ciudad Escolar, s/n, 44001 Teruel, Spain
| | - Irene Zaragoza
- grid.413448.e0000 0000 9314 1427CIBER of Physiopathology of Obesity and Nutrition (CIBEROBN), ISCIII CB06/03/0052, Instituto Salud Carlos III, 28029 Madrid, Spain
| | - Azucena García-Palacios
- grid.413448.e0000 0000 9314 1427CIBER of Physiopathology of Obesity and Nutrition (CIBEROBN), ISCIII CB06/03/0052, Instituto Salud Carlos III, 28029 Madrid, Spain ,grid.9612.c0000 0001 1957 9153Department of Basic Psychology, Clinical Psychology and Psychobiology, Universitat Jaume I, Avenida de Vicent Sos Baynat, s/n, 12071 Castellón de la Plana, Spain
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Graham JMK, Ambroggio L, Leonard JE, Ziniel SI, Grubenhoff JA. Evaluation of feedback modalities and preferences regarding feedback on decision-making in a pediatric emergency department. Diagnosis (Berl) 2021; 9:216-224. [PMID: 34894116 DOI: 10.1515/dx-2021-0122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 11/17/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To compare pediatric emergency clinicians' attitudes toward three feedback modalities and assess clinicians' case-based feedback preferences. METHODS Electronic survey sent to pediatric emergency medicine (PEM) physicians and fellows; general pediatricians; and advanced practice providers (APPs) with nine questions exploring effectiveness and emotional impact of three feedback modalities: case-based feedback, bounce-back notifications, and biannual performance reports. Additional questions used a four-point ordinal agreement response scale and assessed clinicians' attitudes toward case review notification, case-based feedback preferences, and emotional support. Survey responses were compared by feedback modality using Pearson's chi-squared. RESULTS Of 165 eligible providers, 93 (56%) responded. Respondents agreed that case-based feedback was timely (81%), actionable (75%), prompted reflection on decision-making (92%), prompted research on current clinical practice (53%), and encouraged practice change (58%). Pediatric Emergency Care Applied Research Network (PECARN) performance reports scored the lowest on all metrics except positive feedback. No more than 40% of providers indicated that any feedback modality provided emotional support. Regarding case-based feedback, 88% of respondents desired email notification before case review and 88% desired feedback after case review. Clinicians prefer receiving feedback from someone with similar or more experience/training. Clinicians receiving feedback desire succinctness, supporting evidence, consistency, and sensitive delivery. CONCLUSIONS Case-based feedback scored highest of the three modalities and is perceived to be the most likely to improve decision-making and promote practice change. Most providers did not perceive emotional support from any feedback modality. Emotional safety warrants purposeful attention in feedback delivery. Critical components of case-based feedback include succinctness, supporting evidence, consistency, and sensitive delivery.
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Affiliation(s)
- Jessica M K Graham
- Pediatric Emergency Medicine, Children's Hospital of Colorado, Aurora, CO, USA
| | - Lilliam Ambroggio
- Pediatric Emergency Medicine, Children's Hospital of Colorado, Aurora, CO, USA.,Pediatric Hospital Medicine, Children's Hospital of Colorado, Aurora, CO, USA
| | - Jan E Leonard
- Pediatric Emergency Medicine, Children's Hospital of Colorado, Aurora, CO, USA
| | - Sonja I Ziniel
- Pediatric Hospital Medicine, Children's Hospital of Colorado, Aurora, CO, USA.,Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA
| | - Joseph A Grubenhoff
- Pediatric Emergency Medicine, Children's Hospital of Colorado, Aurora, CO, USA
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Armant A, Ollierou F, Gauvin J, Jeoffrion C, Cougot B, Waelli M, Moret L, Beauvivre K, Fleury-Bahi G, Berrut G, Tripodi D. Psychosocial and Organizational Processes and Determinants of Health Care Workers' (HCW) Health at Work in French Public EHPAD (Assisted Living Residences): A Qualitative Approach Using Grounded Theory. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147286. [PMID: 34299739 PMCID: PMC8304826 DOI: 10.3390/ijerph18147286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 06/22/2021] [Accepted: 07/03/2021] [Indexed: 11/29/2022]
Abstract
In a context marked by negative health indicators that make structural aspects more salient, this paper aimed at understanding and explaining the processes and determinants at work that positively and negatively interfere with the professionals’ health in the French public nursing home environment. To this purpose, the qualitative approach by grounded theory was chosen. In total, 90 semi-structured interviews were recorded and 43 were transcribed; in addition, 10 observations of 46 participations in meetings and working groups were carried out in four public service and hospital establishments. Our results indicate that the role of health workers, its definition, and its execution are fundamental to the understanding of their health at work. Two protective and constructive processes are involved in the maintenance and development of the professionals’ health in this work, with considerable confrontations with death and suffering: individual and collective control of emotional and cognitive commitment, and the development of resources for formation, information, and cooperation. Nonetheless, they are jeopardized when a lasting imbalance is generated between the work’s demands and the available resources. This leads to a loss spiral in organizational, inter-individual, and individual resources that makes it difficult to sustain work.
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Affiliation(s)
- Anne Armant
- Work and Health Innovation Research Laboratory, Department of Occupational Medicine and Environmental Health, Nantes University Hospital, F 44093 Nantes, France; (A.A.); (F.O.); (J.G.); (B.C.); (K.B.)
- Laboratoire de Psychologie des Pays de la Loire LPPL-EA 4638, Department of Psychology, University of Nantes, F 44000 Nantes, France;
| | - Florian Ollierou
- Work and Health Innovation Research Laboratory, Department of Occupational Medicine and Environmental Health, Nantes University Hospital, F 44093 Nantes, France; (A.A.); (F.O.); (J.G.); (B.C.); (K.B.)
| | - Jules Gauvin
- Work and Health Innovation Research Laboratory, Department of Occupational Medicine and Environmental Health, Nantes University Hospital, F 44093 Nantes, France; (A.A.); (F.O.); (J.G.); (B.C.); (K.B.)
| | - Christine Jeoffrion
- Laboratoire Inter-Universitaire de Psychologie, Personnalité, Cognition et Changement Social LIP/PC2S—EA 4145, Université of Grenoble Alpes, F 38058 Grenoble, France;
| | - Baptiste Cougot
- Work and Health Innovation Research Laboratory, Department of Occupational Medicine and Environmental Health, Nantes University Hospital, F 44093 Nantes, France; (A.A.); (F.O.); (J.G.); (B.C.); (K.B.)
- Qualité de Vie et Santé Psychologique (QualiPsy) EE1901, UFR Arts et Sciences Humaines, University of Tours, F 37000 Tours, France
| | - Mathias Waelli
- Management des Organisation en Santé MOS, EA 7348, Ecole des Hautes Etudes en Santé Publique EHESP, F 35043 Rennes, France;
| | - Leila Moret
- Methods in Patients-Centered Outcomes and Health Research-SPHERE, UMR INSERM U 1246–EA 4275, 22 Bd Bénoni Goullin, University of Nantes, F 42200 Nantes, France;
| | - Kristina Beauvivre
- Work and Health Innovation Research Laboratory, Department of Occupational Medicine and Environmental Health, Nantes University Hospital, F 44093 Nantes, France; (A.A.); (F.O.); (J.G.); (B.C.); (K.B.)
- Laboratoire de Psychologie des Pays de la Loire LPPL-EA 4638, Department of Psychology, University of Nantes, F 44000 Nantes, France;
| | - Ghozlane Fleury-Bahi
- Laboratoire de Psychologie des Pays de la Loire LPPL-EA 4638, Department of Psychology, University of Nantes, F 44000 Nantes, France;
| | - Gilles Berrut
- Gerontology Department, Pôle Hospitalo-Universitaire Gérontologie, Nantes University Hospital, F 44093 Nantes, France;
| | - Dominique Tripodi
- Work and Health Innovation Research Laboratory, Department of Occupational Medicine and Environmental Health, Nantes University Hospital, F 44093 Nantes, France; (A.A.); (F.O.); (J.G.); (B.C.); (K.B.)
- Laboratoire de Psychologie des Pays de la Loire LPPL-EA 4638, Department of Psychology, University of Nantes, F 44000 Nantes, France;
- Correspondence:
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