Burnout Syndrome in Paediatric Nurses: A Multi-Centre Study

Effects of compassion satisfaction and compassion fatigue on posttraumatic growth of psychiatric nurses: A cross-sectional study

AIMS

This study aimed to explore the effects of compassion satisfaction and compassion fatigue on the posttraumatic growth of psychiatric nurses.

BACKGROUND

Psychiatric nurses' prolonged and repeated exposure to trauma and complex situations in the work environment can lead to negative emotions such as compassion fatigue, but they also experience positive consequences such as posttraumatic growth, and the relationship between compassion fatigue and posttraumatic growth is not unclear.

METHODS

A total of 336 nurses from psychiatry departments of seven tertiary hospitals in Sichuan Province, China, were administered an online questionnaire. Participants were recruited through convenience sampling. The posttraumatic growth level was measured with the Simplified Chinese version of the Posttraumatic Growth Inventory. The Professional Quality of Life Scale-Chinese version was used to assess compassion satisfaction, burnout and secondary traumatic stress. T-test and one-way variance analysis, Pearson correlation analysis and hierarchical linear regression were used for data analysis. A STROBE checklist was used to guide the reporting of the research.

RESULTS

Psychiatric nurses' posttraumatic growth is at a low level, influenced by demographic and occupational factors, whereas compassion satisfaction, burnout and secondary traumatic stress are at a moderate level. Hierarchical regression analysis suggested that compassion satisfaction and secondary traumatic stress had a positive impact on posttraumatic growth, whereas burnout had a negative impact on posttraumatic growth.

CONCLUSIONS

Findings suggest that nursing managers should attach importance to the mental health of psychiatric nurses, improve compassion satisfaction, alleviate burnout and promote posttraumatic growth.

The impact of burnout on paediatric nurses' attitudes about patient safety in the acute hospital setting: A systematic review

BACKGROUND

Patient safety is the cornerstone of quality healthcare. Nurses have a duty to provide safe care, particularly to vulnerable populations such as paediatric patients. Demands on staff and resources are rising and burnout is becoming an increasingly prevalent occupational hazard in paediatric healthcare today. Occupational stress is a barrier to maintaining a positive patient safety culture.

PURPOSE

This paper seeks to explore the impact of burnout on paediatric nurses' attitudes about patient safety.

METHODS

A systematic review approach was used. Embase, Cochrane Library, Medline, CINAHL, and PsycINFO were the databases searched. All quantitative, primary, empirical studies, published in English, which investigated associations between burnout and attitudes to patient safety in the paediatric nursing workforce were included.

RESULTS

Four studies were eligible for inclusion. These studies examined a total of 2769 paediatric nurses. Pooled data revealed overall moderate to high levels of burnout. All studies exposed a negative association between emotional exhaustion and safety attitude scoring (r = -0.301- -0.481). Three studies demonstrated a negative association to job satisfaction (r = -0.424- -0.474). The potential link between burnout and an increased frequency of adverse events was also highlighted.

CONCLUSIONS

Burnout may negatively impact paediatric nurses' attitudes to patient safety in the acute hospital setting. Targeted interventions to tackle burnout are urgently required to protect both paediatric nurses and patients.

IMPLICATIONS

Managers and policy makers must promote nurse well-being to safeguard staff and patients. Educational interventions are required to target burnout and promote patient safety. Further research is required to investigate the long-term impact of burnout.

Intervention Programs Targeting Burnout in Health Professionals: A Systematic Review

Background

Burnout is an occupational syndrome, with a higher prevalence in professionals whose close involvement with other people is significant. There is a great diversity of professionals at risk of burnout, and therefore the implementation of intervention programs is relevant, as helping people to maintain their mental and emotional health enables them to become more meaningfully involved in their communities and become more effective and active global citizens. We aimed to review systematically the characteristics of interventions targeting burnout in health professionals.

Methods

The search was conducted in three databases: Scopus, Web of Science, and PubMed, following the PRISMA model, and 16 eligible articles were identified between 2012 and 2023.

Results

Mindfulness showed great efficacy in preventing burnout, by reducing stress levels and promoting empathy. In addition, relaxation and breathing techniques, yoga, and music therapy showed to improve burnout and occupational stress levels. Balint groups have also helped slow the progression of burnout. Implications about the need for future research to foster the promotion of well-being and mental health of health professionals are mentioned.

Conclusion

Mindfulness, relaxation and breathing techniques, yoga, music therapy and balint groups proved to be effective in preventing burnout.

The Mediating Role of Anxiety in the Relationship between Job Satisfaction and Psychosocial Functions of Nurses and Pediatricians in PICUs

Background

Job satisfaction refers to an individual's overall attitude towards their job. It is influenced by various factors such as work environment, job role, work-life balance, compensation, anxiety, opportunities for growth and development. However, low levels of job satisfaction can have a significant impact on an individual's mental health and overall well-being.

Objective

We contacted this study in order to assess the effect of PICU nurses' and pediatricians' job satisfaction on their psychosocial functioning and to examine the role of anxiety as a mediating factor in this relationship.

Methods

A sample of 155 nurses and pediatricians at 7 University Hospitals in Greece has consented to participate in the study. Socio-demographic data, Hamilton Rating Scale for Anxiety, Minnesota Satisfaction Questionnaire -short form and a Brief Inventory of Psychosocial Functioning were used to evaluate anxiety, job satisfaction and psychosocial functions.

Results

According to our results, participants with moderate or severe levels of anxiety showed moderate or low job satisfaction, while moderate or severe anxiety was also associated with low levels of participants' psychosocial functioning. Job satisfaction is a dynamic situation that is affected by the levels of anxiety of each worker in PICU.

Conclusion

The presence of anxiety may be related to comorbid mental health disorders since it affects the psychosocial functions of the worker. We propose a longer rest period, a change of department in case an employee wishes it or shows symptoms of increased stress or another mental health disorder, regular assessments by mental health experts for all PICU's staff and support after a diagnosis of a mental health problem.

Prevalence and levels of burnout in nursing students: A systematic review with meta-analysis

AIM

The aim of this study was to analyze burnout levels and prevalence in nursing students and to estimate prevalence levels with meta-analyses.

BACKGROUND

Nurses are one of the healthcare professionals most affect by burnout, but nursing students, during their studies, can also suffer burnout.

DESIGN

a systematic review with meta-analysis was performed.

METHODS

The search equation used in Pubmed, CINAHL and Scopus databases was "burnout AND nursing students". Quantitative primary studies including information about burnout, emotional exhaustion, depersonalization, or personal accomplishment in nursing students were included. Four meta-analysis were performed.

RESULTS

the sample was of n = 34 studies, with n = 15 studies being included in the meta-analysis with n = 2744 nursing students. Burnout prevalence was 19% (95% CI 11-28%). Regarding burnout dimensions, the most affected was high emotional exhaustion with a prevalence of 41%(95% CI 23-61%; n = 2222) followed by 27% low personal accomplishment(95% CI 9-49%; n = 2096), 25% high depersonalization (95% CI 15-36%; n = 2096).

CONCLUSIONS

Prevalence of burnout and its dimensions vary from 19% to 41%, being emotional exhaustion the main problem in nursing students. This problem may affect their future as nursing professionals, and it would be of important to prevent and to treat burnout at university levels.

Big five model personality traits and job burnout: a systematic literature review

BACKGROUND

Job burnout negatively contributes to individual well-being, enhancing public health costs due to turnover, absenteeism, and reduced job performance. Personality traits mainly explain why workers differ in experiencing burnout under the same stressful work conditions. The current systematic review was conducted with the PRISMA method and focused on the five-factor model to explain workers' burnout risk.

METHODS

The databases used were Scopus, PubMed, ScienceDirect, and PsycINFO. Keywords used were: "Burnout," "Job burnout," "Work burnout," "Personality," and "Personality traits".

RESULTS

The initial search identified 3320 papers, from which double and non-focused studies were excluded. From the 207 full texts reviewed, the studies included in this review were 83 papers. The findings show that higher levels of neuroticism (r from 0.10** to 0.642***; β from 0.16** to 0.587***) and lower agreeableness (r from - 0.12* to - 0.353***; β from - 0.08*** to - 0.523*), conscientiousness (r from -0.12* to -0.355***; β from - 0.09*** to - 0.300*), extraversion (r from - 0.034** to - 0.33***; β from - 0.06*** to - 0.31***), and openness (r from - 0.18*** to - 0.237**; β from - 0.092* to - 0.45*) are associated with higher levels of burnout.

CONCLUSIONS

The present review highlighted the relationship between personality traits and job burnout. Results showed that personality traits were closely related to workers' burnout risk. There is still much to explore and how future research on job burnout should account for the personality factors.

Profiling health professionals' personality traits, behaviour styles and emotional intelligence: a systematic review

BACKGROUND

Non-cognitive traits have been theorised to predict characteristics, career choice and outcomes of health professionals and could represent a homogenous group. This study aims to profile and compare personality traits, behaviour styles and emotional intelligence of health practitioners across a variety of professions.

METHODS

Empirical literature was systematically reviewed. A two-concept search strategy was applied to four databases (CINAHL, PubMed, Embase, ProQuest). Title/abstract and full text articles were screened against inclusion and exclusion criteria. Methodological quality was assessed using Mixed Methods Appraisal Tool. Data was synthesised narratively and meta-aggregated where feasible.

RESULTS

Three hundred twenty-one studies representing 153 assessment tools of personality (n = 83 studies), behaviour (n = 8), and emotional intelligence (n = 62) were included. Most studies (n = 171) explored personality (medicine, nursing, nursing assistants, dentistry, allied health, paramedics), revealing variation in traits across professions. Behaviour styles were least measured with only ten studies exploring these across four health professions (nursing, medicine, occupational therapy, psychology). Emotional intelligence (n = 146 studies) varied amongst professions (medicine, nursing, dentistry, occupational therapy, physiotherapy, radiology) with all exhibiting average to above-average scores.

CONCLUSION

Personality traits, behaviour styles and emotional intelligence are all key characteristics of health professionals reported in the literature. There is both heterogeneity and homogeneity within and between professional groups. The characterisation and understanding of these non-cognitive traits will aid health professionals to understand their own non-cognitive features and how these might be useful in predicting performance with potential to adapt these to enhance success within their chosen profession.

Use of the Maslach Burnout Inventory among public health care professionals: a scoping review (Preprint)

BACKGROUND

Work can be considered a source of living, well-being, and socioeconomic development. When the work environment negatively influences individuals, it may trigger emotional disturbances, behavioral problems, chronic stress conditions, and illnesses such as burnout syndrome (BS). Recently, studies on BS have increased and placed a special focus on health care professionals. The prevalence of BS among health professionals is associated with their chronic exposure to human hardship and long working hours without proper rest. These factors have contributed to greater stress and high physical and emotional exhaustion levels.

OBJECTIVE

This study aims to identify and map studies using the Maslach Burnout Inventory (MBI) scale to identify burnout syndrome in health professionals working in public health services.

METHODS

This scoping review was developed based on the Joanna Briggs Institute (JBI) Reviewers Manual and reported according to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews). A total of 6 databases were searched to identify relevant studies: Embase, LILACS, MEDLINE or PubMed, PsycInfo, Scopus, and Web of Science. Gray literature was consulted on ProQuest Dissertations and Theses Global, Google Scholar, Brazilian Digital Library of Theses and Dissertations, and Open Access Theses and Dissertations. Additionally, the reference lists were searched to retrieve studies not previously selected. The steps followed in this study were proposed by Arskey and O'Malley and Levac, Colquhoun, and O'Brien: identification of research questions, identification of potential studies, study selection, data extraction and imputation, data analyses and interpretation, and consultation with stakeholders. The detailed methodology was published in a protocol.

RESULTS

A total of 55 articles were identified after screening for eligibility criteria, published between 1999 and 2021 in 32 countries. Most reports were published in Brazil, Spain, and China. A total of 22 versions of the MBI were identified, presenting different items, scores, and cutoff points. The included studies had recommendations and implications for clinical practice. The consultation with stakeholders allowed knowledge translation for those interested in BS.

CONCLUSIONS

Studies mostly included physicians (34/55, 61.8%) and nurses (24/55, 43.6%), and the original version of MBI was predominantly used. Divergences in BS classification were highlighted, which may be related to MBI cross-cultural adaptations and applications in other countries. This study contributes to the advancement of research regarding burnout syndrome as an occupational illness since it has harmful consequences for workers, health care services, and the quality of care provided to the population.

Use of the Maslach Burnout Inventory Among Public Health Care Professionals: Protocol for a Scoping Review

BACKGROUND

Burnout syndrome is a chronic response to stressors in the workplace. It is characterized by emotional exhaustion and physical and mental burnout and may lead to high employee turnover, work absenteeism, and increased occupational accidents. Most studies use the Maslach Burnout Inventory (MBI) to identify burnout and implement preventive actions and treatments.

OBJECTIVE

This study presents a scoping review protocol to identify and map studies that used MBI to assess burnout syndrome in health care professionals working in public health services.

METHODS

This scoping review protocol follows the Joanna Briggs Institute reviewers' manual, and this protocol consists of 6 stages: identifying the research question, identifying relevant studies, study selection, data extraction and coding, analysis and interpretation of results, and consultation with stakeholders. We will conduct searches in Embase, LILACS, PubMed/MEDLINE, PsycINFO, Scopus, Web of Science databases, and gray literature. The main research question is as follows: how is MBI used to identify burnout syndrome in health care professionals working in public health services? Inclusion criteria will comprise qualitative and quantitative studies using MBI to identify burnout syndrome in health care professionals working in public health services and no restrictions in language and publication dates. Data will be extracted using a spreadsheet adapted from the Joanna Briggs Institute model. Quantitative and qualitative data will be analyzed using descriptive statistics and thematic analysis, respectively. The consultation with stakeholders will be essential for increasing the knowledge about MBI, identifying new evidence, and developing future strategies to guide public policies preventing burnout syndrome in health care professionals working in public services.

RESULTS

This protocol will guide a scoping review to identify and map studies that used MBI to identify burnout syndrome in health care professionals working in public health services. The results of this review may be useful to public health care professionals, managers, policymakers, and the general population because these findings will help understand the validated, translated, and adapted versions of MBI and domains, number of items, Likert scales, and cutoff points or the latent profile analysis most used in the literature. Furthermore, possible research gaps may be identified to guide future studies. All information regarding the stages of the scoping review favor its transparency and allow it to be methodologically replicated according to the principles of open science, thereby reducing the risk of bias and data duplication.

CONCLUSIONS

This study may reveal the multiplicity of scales described in the literature and the different forms of assessing burnout syndrome in health care professionals. This study may help to standardize the assessment of burnout syndrome in health care professionals working in public health services and contribute to the discussion and knowledge dissemination about burnout syndrome and mental health in this population.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/42338.

Personality Factors as Predictors in Burnout Level Changes for Surgical Area Nurses

Surgical area nurses provide comprehensive care to patients throughout the surgical process. Increases in life expectancy lead to the appearance and development of diseases, translating into an increase in the number of necessary interventions. Increases in the workload can be another risk factor for the development of burnout in professionals in this area. Knowledge of psychological and personality-related variables provides relevant information of level changes in the dimensions of burnout syndrome. Three logistic regression models, based on a cross-sectional study with 214 nurses working in the surgical area in the Andalusian Health Service, Spain, were built for each dimension. These models included different variables related to depression and personality, with some being significant at the population level and consequently true risk or protection factors. Friendliness, responsibility and extraversion are protection factors for the personal accomplishment dimension, whilst neuroticism is a risk factor for this dimension. Friendliness is also a protection factor for depersonalization, whilst depression is a risk factor. Finally, neuroticism, responsibility and depression are risk factors for the emotional exhaustion dimension of burnout. These findings provide relevant information that makes anticipation of this syndrome in this group easier.

Brief mindful coloring for stress reduction in nurses working in a Hong Kong hospital during COVID-19 pandemic: A randomized controlled trial

BACKGROUND

Effective interventions to promote well-being at work are required to reduce the prevalence and consequences of stress and burnout especially during the COVID-19 pandemic. This study determined the effects of mindful coloring on perceived stress levels, mental well-being, burnout, and state and trait mindfulness levels for nurses during COVID-19.

METHODS

This was a single-center, two-armed, parallel, superiority, blinded randomized controlled trial. Seventy-seven participants were randomly allocated (by computer-generated sequence) to either mindful coloring (n = 39) or waitlist control groups (n = 38). Twenty-seven nurses in the mindful coloring group and 32 in the control group were included in the full compliance per protocol analysis. The mindful coloring intervention included participants viewing a 3-minutes instructional video and coloring mandalas for at least 5 working days or 100 minutes in total during a 10-day period. Participants in both groups completed the Perceived Stress Scale (total score 0-40), short Warwick-Edinburgh Mental Well-being Scale (total score 7-35), Maslach Burnout Inventory-Human Services Survey for Medical Personnel (3 subscales), Five Facets Mindfulness Questionnaire-Short Form (total score 24-120) and Mindful Attention Awareness Scale-State version (total score 0-30) instruments. The primary outcome was the perceived stress level.

RESULTS

Baseline prevalence of moderate to high perceived stress level was high (79.2%). There was a large mindful coloring effect on reducing mean perceived stress levels (Mean difference [MD] in change between groups -3.0, 95% CI: -5.0 to -1.00; Cohen's d = 0.80). Mindful coloring may lead to a small improvement in mental well-being level (P = .08), with an improvement found in the intervention group (MD 0.9, 95% CI 0.0-1.8, P = .04) through enhanced state mindfulness (P < .001). There were no effects on changing burnout subscales or trait mindfulness levels. No adverse reactions were reported.

CONCLUSION

Coloring mandalas may be an effective low-cost brief intervention to reduce perceived stress levels through enhancing state mindfulness and it may promote mental well-being. Hospitals may promote or provide mindful coloring as a self-care and stress-relief practice for nurses during their off hours or work breaks.

Factors Influencing Pediatric Hematology/Oncology Nurse Retention: A Scoping Review

Background: Nursing staff retention is an ongoing concern within pediatric hematology/oncology settings globally. Work-related stressors cause emotional burden, psychological distress, and burnout to which nurses respond by leaving their workplace. Consequently, workplace culture and functionality are negatively impacted, quality of care reduces, and potential harm to patients increases. This paper aims to identify the "most" influencing factors for intention to leave among pediatric hematology/oncology nurses. Methods: A systematic search was undertaken on 29 July 2021 across five electronic databases, Cumulative Index to Nursing and Allied Health Literature, Joanna Briggs Institute, MEDLINE, PubMed, and Web of Science, using MeSH and keywords related to pediatric hematology/oncology nurse retention. Results: The initial search yielded 283 articles. Following abstract and full-text review, nine articles met inclusion criteria. Across all studies, strong links between health service organizational factors (e.g., unit acuity and time constraints), clinician demographics (e.g., age, education, experience, and coping mechanisms), and nursing retention within pediatric hematology/oncology settings were observed. Direct patient care and long-term relationships with pediatric hematology/oncology patients were identified as the most frequent and intense stressors, while also presenting the most rewarding aspect of the nurse's work. Discussion: Clinician burnout and retention were found to be complex and multifaceted organizational and individual issues, which most importantly evolved from accumulative exposure to specialty-specific stressors. Interventions to prevent clinician burnout and improve staff retention, therefore, need to comprise individual and organizational level strategies specific to the healthcare context.

Prevalence, Levels and Related Factors of Burnout in Nurse Managers: A Multi-Centre Study

Aims

The aims of this study are to analyse the prevalence and levels of burnout syndrome in nurse managers and to evaluate the relationship between burnout and related sociodemographic, occupational and psychological factors.

Background

Burnout syndrome, defined as an emotional response to chronic stress, is a major problem among nurse managers.

Methods

The study was conducted using a cross‐sectional survey design and data collected by the Maslach Burnout Inventory, the revised NEO Five Factor Inventory and the Educational‐Clinical Questionnaire for Anxiety and Depression. The sample population consisted of 86 nurse managers from different hospitals from the Public Health Service of Andalusia, Spain.

Results

A total of 22.4% of the participants presented high levels of emotional exhaustion, 21% experienced depersonalisation and 57.6% had little sense of personal accomplishment. Working long shifts was related to burnout. Emotional exhaustion and depersonalization were predicted by depression, while personal accomplishment was predicted by conscientiousness, agreeableness and openness.

Conclusions

A total of 34.1% of the participants presented high levels of burnout, manifested by feelings of low personal accomplishment. Psychological and occupational factors play an important role in the development of this syndrome.

Implications for Nursing Management

Nurse managers should seek to detect burnout among staff and colleagues matching the risk profile for this condition and promote interventions to prevent it.

Playing-Dumb Behavior of Trainers During Online Streaming and Trainee's Burnout Behavior: Mediating Role of Psychological Disengagement

A trainer's behavior is a crucial factor, and it can affect the cognitive engagement of trainees in parts of training and development programs; thus, playing-dumb behavior by a trainer can cause lower attachment and less interested trainees during courses. This study was planned to investigate the impact of trainers' playing-dumb behavior on trainees' burnout behavior under the mediating role of psychological disengagement in online broadcasting. This study followed a convenience sampling technique under a cross-sectional research design, and data are collected from 371 trainees through a questionnaire. This study follows structural equation modeling to model the path relationship among study constructs. Results of this study indicate the presence of a relationship between trainers' dumb behavior and its impact on trainee psychological disengagement, which leads to burnout. Findings of this study contribute to the inclusive body of knowledge pertaining to playing-dumb behavior and trainees' burnout during the course.

How to Mitigate the Negative Effect of Emotional Exhaustion among Healthcare Workers: The Role of Safety Climate and Compensation

This study examines the relationship between emotional exhaustion and job satisfaction. We further propose a safety climate and compensation as contextual variables that weaken the effect of emotional exhaustion. Survey data collected from 694 employees of a public hospital provided support for the hypothesized research model. The hierarchical multiple regression results reveal that high emotional exhaustion is negatively related to job satisfaction. In addition, the results suggest that compensation and a safety climate are moderating variables that mitigate the negative effects of emotional exhaustion. The theoretical implications and future directions are discussed.