Burnout among physicians

Psychological Health and Wellness and the Impact of a Supportive Text Messaging Program (Wellness4MDs) Among Physicians and Medical Learners in Canada: Protocol for a Longitudinal Study

BACKGROUND

Burnout, anxiety, and depression continue to affect physicians, postgraduate medical trainees, and medical students globally and in Canada particularly after the COVID-19 pandemic.

OBJECTIVE

The primary goal of this project is to design, implement, monitor, and evaluate a daily supportive SMS text messaging program (Wellness4MDs, Global Psychological e-Health Foundation). The program aims to reduce the prevalence and severity of burnout, anxiety, and depression symptoms among physicians, postgraduate medical trainees, and medical students in Canada.

METHODS

This longitudinal study represents a multistakeholder, mixed methods, multiyear implementation science project. Project evaluation will be conducted through a quantitative prospective longitudinal approach using a paired sample comparison, a naturalistic cross-sectional controlled design, and satisfaction surveys. Prevalence estimates for psychological problems would be based on baseline data from self-completed validated rating scales. Additional data will be collected at designated time points for paired comparison. Outcome measures will be assessed using standardized rating scales, including the Maslach Burnout Inventory for burnout symptoms, the 9-item Patient Health Questionnaire for depression symptoms, the 7-item Generalized Anxiety Disorder scale for anxiety symptoms, and the World Health Organization-Five Well-Being Index.

RESULTS

The project launched in the last quarter of 2023, and program evaluation results will become available within 36 months. The Wellness4MDs program is expected to reduce the prevalence and severity of psychological problems among physicians in Canada and achieve high subscriber satisfaction.

CONCLUSIONS

The results from the Wellness4MDs project evaluation will provide key information regarding the effectiveness of daily supportive SMS text messages and links to mental health resources on these mental health parameters in Canadian physicians, postgraduate trainees, and medical students. Information will be useful for informing policy and decision-making concerning psychological interventions for physicians in Canada.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/44368.

Work-related stressors and psychological distress predict career change ideation among Lithuanian healthcare workers

OBJECTIVES

The study aimed to assess the mental health and well-being of Lithuanian healthcare workers by gathering demographic information, identifying common stressors affecting the work environment, evaluating mental health, and exploring directions for psychosocial care. Additionally, the research explored the prevalence of considering a career change among respondents.

MATERIAL AND METHODS

The study included 1618 responders who completed an online survey in December 2021 - January 2022. Participants included in this study: physicians, nurses, residents and other healthcare workers. It evaluated their demographics, most common stressors affecting their work environment and mental health on the Depression, Anxiety and Stress Scale - 21 (DASS-21) scale. Lastly, all responders asked if they had considered changing their occupation to a non-medical job. Univariate analysis was performed using χ2 and Student's t test, and binary logistic regression evaluated career change predictors.

RESULTS

Career change was considered by 1081 (66.8%) responders. The main career change predictors were poor working conditions (OR 1.91, p < 0.001), direct contact with patients (OR 1.84, p < 0.001), lack of career perspectives (OR 1.95, p < 0.001), mobbing (OR 1.67, p = 0.001) and exhaustion (OR 1.51, p = 0.005). After evaluating DASS-21 scores, it was found that 23% of respondents had severe and extremely severe depression symptoms, 27.4% severe and extremely severe anxiety, and 21.4% had severe and extremely severe stress levels.

CONCLUSIONS

Lithuanian healthcare workers are in high distress and have poor mental health. They are in need psychosocial assistance to avoid burnout and staff loss. Int J Occup Med Environ Health. 2024;37(3):287-99.

The Prevalence and Predictors of Burnout Among Resident Doctors in Enugu State, South East Nigeria: A Mixed Method Study

BACKGROUND

Burnout in the health care industry is a potential hazard that has reached epidemic proportions mostly among doctors in practice and training. Burnout has enormous consequences on doctors, patients, and health care institutions.

AIM

This study aimed to determine the prevalence and predictors of burnout among resident doctors in Enugu State, Nigeria.

METHODS

This was a mixed-method study of 420 resident doctors in tertiary hospitals in Enugu State, Nigeria. Data were collected using Oldenburg Burnout Inventory and in-depth interviews of chief resident doctors of selected departments. Data were analyzed using IBM statistical package 23.0 and Nvivo 11. Test of significance was set at 0.05.

RESULTS

The mean age of participants was 34.11 ± 5.08 years. The prevalence of burnout groups among resident doctors was 84.3% in the burnout group, 4.8% in the disengagement group, 6.9% in the exhaustion group, and 4.0% in the non-burnout group. Gender (OR = 1.861, C.I = 1.079-3.212), duration of training (OR = 1.740, C.I = 1.008-3.005), and working hours (OR = 2.982, C.I = 1.621-5.487) were the predictors of burnout; only working hours (OR = 0.279, C.I = 0.091-0.0862) was the predictor of disengagement; and gender (OR = 0.248, C.I = 0.107-0.579) was the predictor of exhaustion. Heavy workloads, long working hours, migration, poor working environment, job insecurity, poor remuneration, and management style were identified factors of burnout.

CONCLUSION

There was high prevalence of burnout among resident doctors, predicted by gender, duration of training, and working hours. Interventions are needed to reduce burnout, prevent the "brain drain", and improve resident doctors' overall well-being.

Caring for the Caregivers: Improving Mental Health among Health Professionals Using the Behavioral Health Professional Workforce Resilience ECHO Program

Behavioral health professionals are at high risk for burnout and poor mental health. Our objective was to understand the impact of the Behavioral Health Providers Workforce Resiliency (BHPWR) ECHO Program on the resilience and burnout of participating behavioral health professionals. We assessed the first two years (March 2022 to March 2024) of the BHPWR ECHO, a national program operating from the University of New Mexico (N = 1585 attendees), using a mixed-methods design. We used a retrospective pre/post survey (n = 53 respondents) and focus interviews with 1-3 participants (n = 9 participants) to assess for changes in knowledge and confidence and assess changes in burnout and resilience. We found that participants increased their knowledge of how to respond when (1) their workload was more than they could manage, (2) they felt that they lacked control, (3) their work did not feel rewarding, and (4) they were experiencing compassion fatigue. They increased their confidence in (1) building a support system and (2) using the wellness tools taught in the course. Respondents were less burnt out (score: 26.0 versus 17.8, p < 0.01) and more resilient (29.9 versus 34.9, p < 0.01) compared to when they started attending the program. Tele-mentoring programs like the BHPWR ECHO Program may improve wellness among health care professionals.

Health Workers' Mindfulness-Based Stress Reduction and Resilience During COVID-19 Pandemic

Background

Research indicates that a significant number of healthcare workers accounted for all confirmed Coronavirus disease 2019 (COVID-19) cases, and many of the infected healthcare workers were asymptomatic. During the COVID-19 outbreak, a considerable number of people in Taiwan contracted the disease. Therefore, health workers in Taiwan often experienced lack of medical resources, and this problem is worse for outer island areas. In terms of stress and mental health, this study investigated the effect of poor healthcare capacity and high workload on health workers during the COVID-19 pandemic. This study also explored mindfulness-based stress reduction and resilience in health workers.

Methods

This study conducted an in-depth interview to investigate stress perceived by health workers in a hospital located on an outer island of Taiwan as well as their mental health and stress relieving strategies.

Results

It was found that during the COVID-19 outbreak, some common sources of stress for health workers included exposure to infectious diseases, heavy workloads, facing ethical dilemma in clinical decision-making, and unfamiliar problems from the pandemic. These types of stress cause worries, anxiety, and depression in health workers, which affects their mental and physical health as well as their patient-care performance.

Conclusion

This study proposed that mindfulness-based stress reduction and protecting mental health are important for health workers.

Burnout in Graduate Medical Education: Uncovering Resident Burnout Profiles Using Cluster Analysis

Background

Burnout is common among residents and negatively impacts patient care and professional development. Residents vary in terms of their experience of burnout. Our objective was to employ cluster analysis, a statistical method of separating participants into discrete groups based on response patterns, to uncover resident burnout profiles using the exhaustion and engagement sub-scales of the Oldenburg Burnout Inventory (OLBI) in a cross-sectional, multispecialty survey of United States medical residents.

Methods

The 2017 ACGME resident survey provided residents with an optional, anonymous addendum containing 3 engagement and 3 exhaustion items from the OBLI, a 2-item depression screen (PHQ-2), general queries about health and satisfaction, and whether respondents would still choose medicine as a career. Gaussian finite mixture models were fit to exhaustion and disengagement scores, with the resultant clusters compared across PHQ-2 depression screen results. Other variables were used to demonstrate evidence for the validity and utility of this approach.

Results

From 14 088 responses, 4 clusters were identified as statistically and theoretically distinct: Highly Engaged (25.8% of respondents), Engaged (55.2%), Disengaged (9.4%), and Highly Exhausted (9.5%). Only 2% of Highly Engaged respondents screened positive for depression, compared with 8% of Engaged respondents, 29% of Disengaged respondents, and 53% of Highly Exhausted respondents. Similar patterns emerged for the general query about health, satisfaction, and whether respondents would choose medicine as a career again.

Conclusion

Clustering based on exhaustion and disengagement scores differentiated residents into 4 meaningful groups. Interventions that mitigate resident burnout should account for differences among clusters.

Study of the Relationship between Sensory Processing Sensitivity and Burnout Syndrome among Speech and Language Therapists

BACKGROUND

Burnout syndrome can arise due to either situational factors such as working conditions, or dispositional factors such as certain temperaments, like a high sensory processing sensitivity. We aim to address the relative absence of studies on speech-language therapists and seek to determine the role of high sensitivity for these healthcare workers in relation to burnout syndrome.

METHOD

The sample consisted of 602 female speech-language pathologists who anonymously completed a questionnaire measuring burnout (ProQOL 5th edition) and sensory processing sensitivity (HSPS-FR).

RESULTS

The results revealed that 77.41% of the participants reported moderate or high burnout scores. Furthermore, the analyses revealed that highly sensitive participants are more vulnerable to burnout than others.

CONCLUSION

This study highlights the negative impact of high sensory processing sensitivity on burnout. However, according to the kind of sensitivity, we discuss the way in which highly sensitive caregivers can master this sensitivity in order to use it as a strength in their professions and to spare themselves from suffering deleterious effects, such as compassion fatigue and/or burnout.

Burnout syndrome among healthcare professionals in the Fako division, Cameroon: Impact of physical activity and sleep quality

Objectives

Burnout syndrome (BOS) is an affection mostly resulting from chronic job-related stress. Many studies have identified job-related and non-job-related factors associated with BOS. Our aim of this study was to assess the level of BOS in private and public hospital healthcare providers in Fako division, Cameroon and evaluate the impact of physical activity and sleep quality (SQ).

Methods

The study was carried out in five randomly selected hospitals in Fako Division over a three-month period. Consenting doctors, nurses and laboratory technicians were recruited using consecutive sampling methods. Sociodemographic and professional characteristics were collected using a structured questionnaire. BOS was assessed using the Maslach Burnout Inventory Human Services Survey (MBI-HSS). Sleep quality (SQ) and physical activity (PA) were assessed using the Pittsburgh Sleep Quality Index (PSQI) and Global Physical Activity Questionnaire (GPAQ) respectively. Odd ratios and 95% confidence intervals were calculated and a statistical significance was set for p-value < 0.05.

Results

The mean age was 32 ± 6 years and 70.9% female. BOS prevalence was 66.3% with 71.4% in females and 53.9% in males (p = 0.002). Of the 232 participants with BOS, 65.7%, 52% and 53.7% had moderate to high emotional exhaustion, depersonalization and decreased personal accomplishment, respectively. Moderate to high PA as well as poor SQ were not significantly associated with BOS while longer sleep duration (>8 h) was associated with a greater odd of BOS.

Conclusions

The prevalence of BOS was high among healthcare professionals. While PA showed no protective effects, high sleep duration could increase its risk.

Examining the relationship between long working hours and the use of prescription sedatives among U.S. workers

OBJECTIVES

The prevalence of long working hours has been accompanied by a corresponding rise in sleep disorders. Sedative-hypnotic agents (SHAs), have been reported as the second most commonly misused drug class in the U.S. The key objective of this study was to examine the relationship between working hours on the use of sleep aids and medications with sedative properties.

METHODS

The 2010-2019 Medical Expenditure Panel Survey data was utilized. SHAs and medications with sedative related properties (MSRPs) were identified. Furthermore, we employed different regression models ranging from multivariable linear regression, Tobit regression, Heckman regression, and multivariable logistic regression, to ensure consistency, robustness, and reliability of associations.

RESULTS

Overall, a sample of 81,518 observations of full-time workers was analyzed. Working 56hours or more per week was significantly associated (p < 0.05) with an increased odds of using SHAs and MSRPs by 13% (Adjusted Odds Ratio, aOR =1.13, 95% Confidence Interval, CI=1.01:1.26) and 9% (aOR=1.09, 95% CI=1.03:1.16), respectively more than that among those who worked fewer hours. Females in our study had a higher likelihood (aOR=1.11, 95% CI=1.05:1.19) of using SHAs when compared to males. Also, professional services had the highest likelihood (aOR=1.31, 95% CI=1.14:1.50) of using SHAs.

CONCLUSION

We found that long working hours were significantly associated with an elevated use of SHAs and MSRPs among U.S. workers. Specifically, female workers and individuals working in professional services had the highest likelihood of using sleep medications.

Relationship of Burnout and Extra-Curricular Activities among Dental Students: An Original Research

Introduction

"Burnout syndrome (BS)" is a work-associated condition which is frequently observed in medical professionals, especially students. Extra-curricular activities (ECAs) are one of the coping techniques that students employ to deal with stress and exhaustion.

Goal

The study's goal is to evaluate dental students' levels of burnout and how it correlates with their participation in ECAs.

Materials and Procedures

In South India, a dentistry school conducted a cross-sectional questionnaire research with its students. Both the regular and supplemental batches of students from the first year through the fifth year (internship) were included. The "Maslach Burnout Inventory Student Survey", which has 15 items in three areas-"Emotional Fatigue (EE), Cynicism (CY), & Professional Efficacy (PE)"-was used to assess burnout. A 5-point Likert scale was used to grade each response. Poisson log linear model and the Mann-Whitney U test were employed. The threshold for statistical significance was 5 out of 100.

Results

Four hundred participants were finalized after the criteria. Over 80% of the participants were women students as in accordance with the routine proportion of the dental students. The participants' average age was 22.1 ± 12 years. Burnout was seen in nearly 20% of subjects. Significant variation was seen for all the three domains of the burnout when they were compared against the ECA (P = 0.019(EE), 0.003(CY), and 0.005(PE)).

Conclusion

It is safe to say that among the participants, burnout is a common occurrence. There is a need for early detection of burnout in dental students and prompt, efficient management.

Burnout syndrome among nurses at a military medical academy in Serbia

OBJECTIVES

Healthcare workers are the professional group at higher risk of burnout than others. It is the underlying reason for medical errors and the general decrease in quality of patient care and is related to poor patient-healthcare worker relationships. Healthcare workers who work with military personnel have specificities compared to healthcare workers who work only with civilians.

METHODS

A cross-sectional study among 171 nurses at the Military Medical Academy was conducted. The questionnaire consisted of items regarding socio-demographic and socioeconomic characteristics, lifestyle characteristics, workplace environment, workplace stress, strategies of stress management, symptoms and signs of workplace-related stress, and the Serbian version of the Maslach Burnout Inventory.

RESULTS

The prevalence of burnout was 46.2%. The multivariate logistic regression analysis showed that the burnout was associated with stating that they would not choose the same profession again (OR = 4.54, 95% CI: 1.53-14.50) and with not being interested in the work (OR = 4.86, 95% CI: 1.58-14.92).

CONCLUSION

The prevalence of burnout is relatively high among nurses at the Medical Military Academy in Belgrade and is associated with factors in the work environment.

Are early career family physicians prepared for practice in Canada? A qualitative study

BACKGROUND

In Canada, the College of Family Physicians of Canada (CFPC) introduced Competency Based Medical Education to prepare and train family medicine residents to be competent to enter and adapt to the independent practice of comprehensive family medicine. Despite its implementation, the scope of practice is narrowing. This study aims to understand the degree to which early career Family Physicians (FPs) are prepared for independent practice.

METHOD

A qualitative design was used for this study. A survey and focus groups were conducted with early-career FPs who completed residency training in Canada. The survey and focus groups examined the degree of preparedness of early career FPs in relation to 37 core professional activities identified by the CFPC's Residency Training Profile. Descriptive statistics and qualitative content analysis were conducted.

RESULTS

Seventy-five participants from across Canada participated in the survey, and 59 participated in the focus groups. Early career FPs reported being well prepared to provide continuous and coordinated care for patients with common presentations and deliver various services to different populations. FPs were also well prepared to manage the electronic medical record, participate in team-based care, provide regular and after-hours coverage, and assume leadership and teaching roles. However, FPs reported being less prepared for virtual care, business management, providing culturally safe care, delivering specific services in emergency care hospitals, obstetrics, self-care, engaging with the local communities, and conducting research activities.

CONCLUSIONS

Early career FPs do not feel fully prepared for practice in all 37 core activities in the Residency Training Profile. As part of the introduction of the three-year program by the CFPC, the postgraduate family medicine training should consider providing more exposure to learning opportunities and developing curricula in the areas where FPs are unprepared for practice. These changes could facilitate the production of a FP workforce better prepared to manage the dynamic and complex challenges and dilemmas faced in independent practice.

Ten Traits of Great Physicians! And Tips to Help You Improve

There are certain traits that differentiate great doctors from good doctors. This article will discuss some of these traits along with tips you can incorporate to go from good to great. By applying these tips, I hope you will enhance your ability to practice medicine and improve your patients' experience.

Medical students' coping with stress and its predictors: a cross-sectional study

Objectives

To analyse stress coping styles of medical students at different time points of medical education and to identify predictors of functional coping.

Methods

A cross-sectional study was conducted among medical students (N = 497, 361 women and 136 men) before year one (n = 141), after year one (n = 135) and after year five (n = 220). Students answered the Brief Coping Orientation to Problems Experienced Inventory, the Work-Related Behaviour and Experience Patterns, the Perceived Medical School Stress Instrument and the Maslach Burnout Inventory. Multiple regression was used to examine factors associated with functional coping.

Results

Single factor ANOVA indicated a significant difference for functional coping between the time points (F (2, 494) = 9.52, p < .01), with fifth-year students scoring significantly higher than students before or after year one. There was a significant difference in dysfunctional coping (F (2, 494) = 12.37, p < .01), with students before year one and after year five scoring higher than those after year one. Efficacy (β = 0.15, t (213) = 4.66, p < .01), emotional distancing (β = 0.04, t (213) = 3.50, p < .01) and satisfaction with life (β = 0.06, t (213) = 4.87, p < .01) were positive predictors of functional coping.

Conclusions

Scores for both functional and dysfunctional coping vary during medical education. The reasons for low coping scores after year one require further explanation. These findings represent a starting point for investigations into how to promote functional coping during early medical education.

Burnout among Residents: Prevalence and Predictors of Depersonalization, Emotional Exhaustion and Professional Unfulfillment among Resident Doctors in Canada

BACKGROUND

Burnout in the medical profession has garnered a lot of attention over recent years. It has been reported across all specialties and all stages of medical education; however, resident doctors in particular are at risk for burnout throughout their years of training. This study was aimed at evaluating the prevalence and correlates of burnout among resident doctors in Alberta.

METHODS

Through a descriptive cross-sectional study design, a self-administered questionnaire was used to gather data from resident doctors at two medical schools in Alberta, Canada. The Maslach Burnout Inventory was used as the assessment tool. Chi-squared and multivariate binary logistic regression analyses were used.

RESULTS

Overall burnout prevalence among residents was 58.2%, and for professional fulfilment index, it was 56.7% for work exhaustion and interpersonal disengagement and 83.5% for lack of professional fulfillment. Working more than 80 h/week (OR = 16.437; 95% CI: 2.059-131.225), being dissatisfied (OR = 22.28; 95% CI: 1.75-283.278) or being neither satisfied nor dissatisfied with a career in medicine (OR = 23.81; 95% CI: 4.89-115.86) were significantly associated with high depersonalization. Dissatisfaction with efficiency and resources (OR = 10.83; CI: 1.66-70.32) or being neither satisfied nor dissatisfied with a career in medicine (OR = 5.14; CI: 1.33-19.94) were significantly associated with high emotional exhaustion. Working more than 80 h/week (OR = 5.36; CI: 1.08-26.42) and somewhat agreeing that the residency program has enough strategies aimed at resident well-being in place (OR = 3.70; CI: 1.10-12.46) were significantly associated factors with high work exhaustion and interpersonal disengagement. A young age of residents (≤30 years) (OR = 0.044; CI: 0.004-0.445) was significantly associated with low professional fulfillment.

CONCLUSION

Burnout is a serious occupational phenomenon that can degenerate into other conditions or disrupt one's professional performance. Significant correlates were associated with high rates of burnout. Leaders of medical schools and policymakers need to acknowledge, design, and implement various strategies capable of providing continuous effective mental health support to improve the psychological health of medical residents across Canada.

Burnout, work engagement and work hours - how physicians' decision to work less is associated with work-related factors

BACKGROUND

According to new estimates, the health care sector will suffer a shortage of physicians in primary and specialty care. In this context, work engagement and burnout are two constructs that have gained attention recently. The aim of this study was to investigate how these constructs are related to work hour preference.

METHOD

The present study was based on the baseline survey of the long-term study of physicians with different specialties, in which 1,001 physicians took part (response rate: 33.4%). Burnout was measured using the Copenhagen Burnout Inventory adapted for health care professionals; work engagement was assessed using the Utrecht Work Engagement scale. Data analyses included regression and mediation models.

RESULTS

Overall, 297 out of 725 physicians were planning to cut down work hours. Several reasons - such as burnout - are discussed. According to multiple regression analyses desire to work less hours was significantly linked to all three dimensions of burnout (p < 0.001), as well as work engagement (p = 0.001). In addition, work engagement significantly mediated the relationship between the burnout dimensions on work hour reduction (patient-related: b = - 0.135, p < 0.001; work-related: b = - 0.190, p < 0.001; personal: b = - 0.133, p < 0.001 ).

DISCUSSION

Physicians tending to reduce work hours exhibited different levels of work engagement as well as burnout (personal, patient- and work-related). Moreover, work engagement influenced the relationship between burnout and work hour reduction. Therefore, interventions that increase work engagement may positively impact negative effects of burnout on work hour changes.

From hospital to home following a lower limb amputation: A focus group study of healthcare professionals' views and experiences with transitioning

INTRODUCTION

Patients undergoing major lower limb amputation often have multiple comorbidities, requiring care from numerous healthcare professionals (HCPs). Furthermore, they may experience physical, medical and practical challenges post-amputation. Patients with complex needs are particularly vulnerable during care transitions and may benefit from integrated care models.

AIM

This study aimed to explore HCPs' views and experiences regarding the transition process after implementing an integrated care model for patients with lower limb amputation.

METHODS

We conducted two focus groups with 13 HCPs from a Danish hospital and three surrounding districts; all working in the Safe Journey programme. The interviews were analysed using thematic analysis.

RESULTS

Three themes were created: 1) becoming a team across sectors, 2) continuity of care as a driver for patient safety and 3) challenges in achieving safe transitions. The Safe Journey programme facilitated the construction of an interdisciplinary team, cross-sectoral communication and professional relations, increasing HCPs' sense of improved patient safety and care continuity. However, HCPs experienced an increased workload, including coordination and at-home patient visits.

CONCLUSIONS

HCPs found the Safe Journey programme to be valuable for patients undergoing major lower limb amputation and promotive of cross-sectoral professional relations, communication, continuity and patient safety. However, the programme was time- and resource-consuming compared to conventional models.

Perspectives of medical students on future work-life balance in Japan: A qualitative study using postlecture comments

Background

Recently, work-life balance (WLB) has grown in popularity among medical professionals, and an increasing number of institutions are including WLB lectures into medical school curricula. In Japan, medical student lectures concerning WLB were given in at least 50% of universities. However, with these changes in social awareness, it is not fully clear how current medical students view WLB. The purpose of this study is to explore how Japanese medical students think about their future WLB from the perspective of constructivism.

Method

We used one of the present authors' work career and life cycle as an example of a physician's career in a lecture for medical students on community medicine in 2020. Students were asked to remark on their thoughts on the talk and their views on future WLB, and we analyzed their comments qualitatively to understand the current male and female medical students' perspectives on future WLB.

Result

We used the feedback of 119 participants (71 males and 48 females). Most students, regardless of gender, thought WLB was essential, but the factors they mentioned as being connected to WLB mirrored the continuing traditional notions of gender-based division of labor and doctors' fixed-job image. Male students' views, on the other hand, were more varied, reflecting recent generational shifts.

Conclusions

For the improved WLB in medical doctors, it would be required to tackle the problem from several angles, including not just increasing support for WLB but also fostering an awareness of the essence of WLB in pregraduate medical school.

Self-compassion training to improve well-being for surgical residents

CONTEXT

Burnout remains prevalent among surgical residents. Self-compassion training may serve to improve their well-being.

OBJECTIVE

To evaluate the impact on well-being of a self-compassion program modified for surgical residents.

DESIGN

This is a 3-year, mixed-methods study using pre-post surveys and focus groups to identify areas for programmatic improvement and the subsequent impact of the modifications.

SETTING

A single academic institution.

PARTICIPANTS

Surgical residents participating in a self-compassion program.

INTERVENTIONS

A self-compassion program adapted from a larger course to fit the needs of surgical residents.

MAIN OUTCOME MEASURES

Themes relating to the program's strengths and weaknesses were identified through participant focus groups. Well-being was assessed through validated measurement tools, including The Maslach Burnout Inventory (MBI), Patient Health Questionnaire-9, Perceived Stress Scale, and Spielberger State-Trait Anxiety Inventory-6.

RESULTS

95 residents participated in the self-compassion program, of which 40 residents completed both surveys (total response rate: 42%). All participants demonstrated severe burnout pre-program, based on scores of at least one of the MBI subscales. Emotional exhaustion scores improved post-program, with larger improvements seen after program modifications (2018: 58% vs 2020: 71%). Focus group findings demonstrated that residents need a safe and distraction-free space to practice self-compassion, and program engagement improved following modifications.

Leadership Inequity, Burnout, and Lower Engagement of Women in Medicine

Gender parity has been reached in graduation rates from medical school, yet women in medicine continue to face obstacles in promotion, compensation and opportunities, leading to leadership inequity, higher burnout and lower engagement. These complex issues with gender are just one aspect of the wide challenges related to diversity, equity and inclusion among medical professionals. While there are no "one size fits all" approaches, psychologists are well positioned to lead efforts related to promoting leadership equity, reducing burnout and raising engagement because of their training in communication skills, programmatic development and empathetic listening. This paper details several evidence-based efforts in which psychologists can lead in these ongoing issues for women in medicine.

Job Satisfaction, Well-Being, and Burnout among Ophthalmology Educators

Purpose  This article assesses the prevalence of burnout among ophthalmology educators and identifies opportunities to improve well-being in this population. Methods  The research team conducted a cross-sectional study using an institutional review board-exempt survey addressing the domains of the Maslach Burnout Inventory, intent to leave, and interest in wellness activities. Survey participants included ophthalmology residency program directors (PDs) and associate PDs (APDs) who are members of the Association of University Professors of Ophthalmology (AUPO). Analysis involved a top-box approach. Results  Surveys were sent to 175 members with a response rate of 38.9%. Percentages of survey respondents reporting either (1) "never" or (2) "less than a few times per year" when asked to self-assess for certain manifestations of burnout are as follows: "considering residents as impersonal objects" (95.2%), "becoming more callous towards people" (90.3%), and "becoming emotionally hardened" (80.6%). Approximately 65% of ophthalmology educators reported never considering or rarely considering leaving their position in the year prior to completing the survey. For wellness promotion among AUPO educators, the greatest interest was in small group mentoring sessions (85%) and webinars on wellness-related topics (70%). Conclusion  The prevalence of burnout symptoms among ophthalmology educators compares favorably to educators from other specialties. Ophthalmology PDs and APDs demonstrate a greater degree of personal accomplishment than do their cohorts within other specialties, suggesting a decreased likelihood of burnout onset among ophthalmology educators. Furthermore, our study's job satisfaction data reveal a high degree of satisfaction among ophthalmology PDs and APDs.

Burnout among Physicians at Medical Departments in Benghazi-Libya

Background Burnout syndrome is recognized as a global issue, and as medical practice is stressful, healthcare workers are found to be burnt out and exhausted very soon, which is reflected negatively on the medical staff well-being, patients' outcome, and the overall organizational performance.

Aim This study is planned to assess the magnitude of burnout among physicians in Benghazi-Libya.

Methods This cross-sectional study was carried out in 2020 on a total of 150 physicians working at different departments of internal medicine in Benghazi-Libya. The Maslach Burnout Inventory collection instrument was used to assess the three components of burnout syndrome: emotional exhaustion, depersonalization, and reduced personal accomplishment. High scores in emotional exhaustion and depersonalization and low scores in personal accomplishment are indicative of high burnout. The statistical analyses of the data were performed using the SPSS version 21. The level of statistical significance was considered as p-value less than 0.05.

Results 60% of the respondents were females and 40% were males. About 14.7% had high emotional exhaustion, 92% had high depersonalization, and 87.3% had low personal accomplishment scores. Statistical analysis showed no significant relationship between gender and burnout. Alternatively, a significant association was found between degree certificate and emotional exhaustion, as moderate- and high-level burnout were more prevalent among MBCHB participants than those with masters and board degrees. No association was found between degree certificate and depersonalization or personal accomplishment.

Conclusion Burnout is prevalent among internal medicine doctors in Benghazi, with the newly graduated medical personnel scoring higher rates of burnout than doctors with higher degrees. No relationship was found between gender and burnout.

Prevalence and correlates of burnout among physicians in a developing country facing multi-layered crises: a cross-sectional study

Burnout among physicians is a serious concern that cultivates its seeds during their education. This study assessed the prevalence of burnout among Lebanese physicians and explored its correlates and the combined effects of the pandemic and the economic crisis on burnout. A web-based cross-sectional study was conducted in December 2020 using a snowball sampling technique. Moderate and high levels of burnout hit 90.7% of the physicians where personal, work-related, and client-related burnout were detected among 80.4%, 75.63%, and 69.6% of them respectively. A strong association was found between the higher level of burnout and female gender, younger age, being single, having a dependent child, living with an elderly or a family member with comorbidities, and insufficient sleeping hours. Physicians’ specialties, working in a public health facility, limited years of professional experience, lack of previous experience in a pandemic, and extensive working hours were also associated with increased burnout. Furthermore, low income, working in the frontline, higher threat perception, and fear of COVID-19 were contributing to higher burnout. The combined effect of threat perception and financial hardship significantly increased burnout levels. The alarming burnout level detected among physicians urges health authorities to take prompt actions to enhance the physicians’ well-being.

Impact of Burnout on Daily Activities from an Occupational Therapy Perspective: A Serial Mediation Model with the IDA Scale

BACKGROUND

Burnout syndrome is one of the most frequent health complications among workers. Acknowledging the work perspective as something basic and essential in a person's life means that this disorder can have huge implications in their most basic daily activities.

METHODS

A cross-sectional, quantitative observational design was conducted with data from Spanish workers. A serial mediation model was applied to study the relationship between daily activities and burnout syndrome. For this purpose, the IDA scale was developed.

CONCLUSIONS

The results show us that peoples' work situation has an impact on their daily life. There is quantitative evidence of the impact on daily life occupations and how it further decreases the levels of health and well-being of the person, on their independence and, consequently, on their quality of life.

Mental Health of Nurses Working in a Judicial Psychiatry Hospital during the COVID-19 Pandemic in Italy: An Online Survey

The onset of this new pandemic has highlighted the numerous critical issues at the organizational level, which involve both national healthcare and the judicial system. For this reason, nurses working in prisons may exhibit a poor quality of life, mainly related to their high level of work stress. This cross-sectional survey aimed to assess the emotional state of nurses working in the Judicial Psychiatry Hospital of Barcellona PG (Messina, Italy) during the COVID-19 pandemic. Data collection occurred twice: from 1 April to 20 May 2020 (i.e., during the Italian lockdown) and from 15 October to 31 December 2021 (during the second wave). At baseline, the 35 enrolled nurses presented medium to high levels of stress. At T1, they had a reduction in perceived personal achievement (MBI-PR p = 0.01), an increase in emotional exhaustion (MBI-EE p < 0.001), and stress (PSS p = 0.03), as well as anxiety (STAI Y1/Y2 p < 0.001). Most participants underlined the high usability of the online system (SUS: 69.50/SD 19.9). We also found increased stress, anxiety, and burnout risk in nursing staff. The study clearly demonstrates that the first year of the COVID-19 pandemic in Italy caused a worsening of mental health among nurses working in prisons. We believe that monitoring the mental state of healthcare professionals is fundamental to improving their quality of life and healthcare services.

Prevalence of Psychopathological Symptoms and Their Determinants in Four Healthcare Workers' Categories during the Second Year of COVID-19 Pandemic

Highly stressful situations, such as the current COVID-19 pandemic, induce constant changes in the mental state of people who experience them. In the present study, we analyzed the prevalence of some psychological symptoms and their determinants in four different categories of healthcare workers during the second year of the pandemic. A total of 265 physicians, 176 nurses, 184 other healthcare professionals, and 48 administrative employees, working in different Italian healthcare contexts, answered a questionnaire including variables about their mental status and experience with the pandemic. The mean scores for anxiety and depressive symptoms measured more than one year after the onset of the pandemic did not reach the pathological threshold. In contrast, post-traumatic and burnout symptoms tended toward the critical threshold, especially in physicians. The main determinant of psychological distress was perceived stress, followed by job satisfaction, the impact of COVID-19 on daily work, and a lack of recreational activities. These results increase the knowledge of which determinants of mental distress would be important to act on when particularly stressful conditions exist in the workplace that persist over time. If well-implemented, specific interventions focused on these determinants could lead to an improvement in employee well-being and in the quality of care provided.

Risk perception and affective state on work exhaustion in obstetrics during the COVID-19 pandemic

A multicenter cross-sectional survey study involving four Italian University Hospitals was performed to test the hypothesis that negative affect and positive affect (affective dimensions) mediate the association between risk perception (perceived risk of infection and death; cognitive dimensions) and the feeling of work exhaustion (WE) among obstetrics healthcare providers (HCPs) during the Coronavirus Disease 2019 (COVID-19) pandemic. Totally, 570 obstetrics HCPs were invited to complete the 104-item IPSICO survey in May 2020. A theoretical model built on the tested hypothesis was investigated by structural equation modelling. The model explained 32.2% of the WE variance. Only negative affect mediated the association between cognitive dimensions and WE and also the association between WE and psychological well-being before the pandemic, experiences of stressful events, female gender, and dysfunctional coping. Non-mediated associations with WE were observed for work perceived as a duty, experience of stressful events, support received by colleagues, and the shift strategy. Only previous psychological well-being, support by colleagues, and shift strategies were inversely associated with WE. Based on study results, monitoring negative than positive affect appears superior in predicting WE, with practical implications for planning psychological interventions in HCPs at the individual, interpersonal, and organizational levels.

The relationship between school burnout, sense of school belonging and academic achievement in preclinical medical students

The purpose of the study was to evaluate the relationship between school burnout, sense of school belonging, and academic achievement in medical students. This cross-sectional study was performed with students at the Ondokuz Mayıs University Medical Faculty (Samsun, Turkey) between 1 and 31 May 2019. Six hundred one (71.0%) first, second, and third-year students were included in the study. A questionnaire was employed as the data collection method. The questionnaire consisted of two parts. The first part consisted of questions investigating sociodemographic information produced by the authors by scanning the literature. The second part consisted of the School Burnout Inventory and the Psychological Sense of School Membership Scale. The relationship between the sense of school belonging, school burnout, and academic achievement was evaluated using structural equation modeling. The structural equation modeling analysis determined that school burnout played a mediating role in the relationship between the sense of school belonging and academic achievement in preclinical medical students. As the sense of belonging to the school increases in preclinical medical students, academic achievement increases. School burnout in preclinical medical students increases as a sense of school belonging decreases. Academic achievement among preclinical medical students decreases as school burnout levels increase. Increasing the sense of school belonging can be effective in preventing school burnout and increasing academic achievement.

A Multi-Center Study on the Negative Psychological Impact and Associated Factors in Chinese Healthcare Workers 1 Year After the COVID-19 Initial Outbreak

Objectives: The study aimed at analyzing the prevalence of five psychological outcomes (depression, anxiety, stress, post-traumatic stress disorder (PTSD), and suicidal ideation) among Chinese healthcare workers (HCWs), and measured the total possible negative psychological impact 1 year after the COVID-19 initial outbreak. Methods: A cross-sectional nationwide multi-center study was performed between November 2020 and March 2021 in China. A self-report questionnaire was applied, and three psychological scales were used. Binary logistic regression was performed to analyze the risk factors associated with each psychological outcome. Results: The findings demonstrated that the COVID-19 pandemic had a negative psychological impact on HCWs, which was still evident 1 year after the initial outbreak. Nurses showed higher depression and anxiety than other HCWs. Female gender, passive coping, long working hours, having a chronic disease, and experiencing violence, among other factors, were all risk factors for psychological impairment. Conclusion: Developing and promoting programs to improve mental health among HCWs, and identifying those who might need psychological support is still relevant 1 year after the initial outbreak.

Mindfulness as a tool for reducing stress in healthcare professionals: An umbrella review

BACKGROUND: Health care providers (HCPs) and health care students experience a huge amount of stress due to high workloads and pressure to perform and are likely to develop anxiety, depression and burnout. OBJECTIVE: The objective was to carry out an umbrella review of systematic and narrative reviews on the effectiveness of mindfulness-based interventions in reducing stress and improving well-being in HCPs and health care students. METHODS: Systematic and narrative reviews that examined the impact of mindfulness-based interventions on HCPs and healthcare students’ perceived stress were identified through a systematic search of three electronic databases: PubMed, Scopus and Web of Science. RESULTS: Fifteen articles were included in the analysis: eleven systematic and four narrative reviews. Studies’ quality varied from critically low to high. The different interventions showed positive results in reducing stress in both HCPs and students, with mindfulness-based stress reduction (MBSR) course having the major impact. CONCLUSIONS: MBSR techniques and other Mindfulness Based Interventions resulted to be potentially effective in reducing stress. However, despite the vast amount of data collected by the studies and the promising results, several limitations affected the validity of the studies. Therefore, more research that considers the critical aspects of this field is required, in order to provide more reliable results.

Stress in Medical Students: PRIMES, an Italian, Multicenter Cross-Sectional Study

Medical students (MSs) are healthcare workers and must also cope with education-related stressors. This study aims to assess factors associated with perceived stress in Italian MSs. A cross-sectional study was conducted in 12 Italian medical schools (MSCs) in November 2018. A questionnaire assessed socio-demographic characteristics, habits, opinions about MSC, and concerns about the future. Stress was assessed with the PSS-10. Descriptive and univariable tests were performed. A linear model was fitted to find associations of the PSS-10 score with characteristics. There were 2513 collected questionnaires. Median PSS-10 score was 18 (IQR 11). Median age was 22 (IQR 4) and 61% of the sample was female. Female gender, being part of a sexual minority, poor financial situation, competitive atmosphere, having hobbies, resting, and sleeping hindered by MSC were characteristics associated with higher PSS-10 scores. Current relationship, good family relationship, and no concerns about the future were protective factors. Being part of sexual minorities had greater effects in students not living away from home, while in the other group it was not having satisfying friendships. Medical students suffer higher levels of stress than the general population, and many MSC stressors are associated. Living away from home modifies risk and protective factors, offering the possibility to tailor group-specific interventions.

Occupational stressors in healthcare workers in France

OBJECTIVES

To describe psychosocial constraints and mental health of hospital workers, and to identify the psychosocial constraints significantly associated with mental health difficulties, especially in two groups: caregivers and other hospital workers.

METHOD

Data about working conditions and health status collected by the Evrest National observatory in 2018-2019 during occupational health consultation were used. Psychosocial constraints and mental health among caregivers, other hospital workers and non-hospital workers were described.

RESULTS

There were 1251 hospital workers (843 caregivers, 408 other hospital workers) and 25 129 other workers. Intensity and working time (time pressure, extra working time, missing or shortening a meal), and ethical dilemmas (not having the means to ensure high-quality work, too rapidly handling a procedure that would require more painstaking care) were significantly more reported by the caregivers than by the other hospital workers (50.8% vs 44.2%, 43.4% vs 32.5%, 47.2% vs 17.2%, 21.4% vs 16.4% and 41.5% vs 29.0% respectively). Prevalence of psychological distress was not significantly higher for caregivers (12.3%) than for other hospital workers (12.4%) but was significantly higher than for other workers (7.3%). For caregivers, factors significantly associated with psychological distress were time pressure (Odds Ratio adjusted on sociodemographic factors (OR) = 2.33 CI95% [1.35-4.04]), "difficulties to reconcile private life and work life" (OR = 2.95 [1.54-5.69]), "work not recognized in the professional setting" (OR = 1.89 [1.08-3.31]) and "fear of losing one's job" (OR = 2.98 [1.53-5.8]). For other hospital workers, they were "difficulties to reconcile private life and work life (OR = 2.76 [1.04-7.30]), "insufficient possibilities of mutual aid" (OR = 2.85 [1.24-6.53] and "not having the means to ensure high-quality work" (OR = 3.42 [1.62-7.21]).

CONCLUSION

Factors significantly associated with psychological distress were not the same for caregivers and other hospital workers, nor were they the most frequently reported. Detailed description of the constraints according to group of workers could help to develop a high-priority preventive program regarding psychosocial risk factors.

Using nominal group technique among resident physicians to identify key attributes of a burnout prevention program

PURPOSE

To identify preferred burnout interventions within a resident physician population, utilizing the Nominal Group Technique. The results will be used to design a discrete choice experiment study to inform the development of resident burnout prevention programs.

METHODS

Three resident focus groups met (10-14 participants/group) to prioritize a list of 23 factors for burnout prevention programs. The Nominal Group Technique consisted of three steps: an individual, confidential ranking of the 23 factors by importance from 1 to 23, a group discussion of each attribute, including a group review of the rankings, and an opportunity to alter the original ranking across participants.

RESULTS

The total number of residents (36) were a representative sample of specialty, year of residency, and sex. There was strong agreement about the most highly rated attributes which grouped naturally into themes of autonomy, meaning, competency and relatedness. There was also disagreement on several of the attributes that is likely due to the differences in residency specialty and subsequently rotation requirements.

CONCLUSION

This study identified the need to address multiple organizational factors that may lead to physician burnout. There is a clear need for complex interventions that target systemic and program level factors rather than focus on individual interventions. These results may help residency program directors understand the specific attributes of a burnout prevention program valued by residents. Aligning burnout interventions with resident preferences could improve the efficacy of burnout prevention programs by improving adoption of, and satisfaction with, these programs. Physician burnout is a work-related syndrome characterized by emotional exhaustion, depersonalization, and a sense of reduced personal accomplishment [1]. Burnout is present in epidemic proportions and was estimated to occur in over 50 percent of practicing physicians and in up to 89 percent of resident physicians pre-COVID 19. The burnout epidemic is growing; a recent national survey of US physicians reported an 8.9 percent increase in burnout between 2011 and 2014 [2]. Rates of physician burnout have also increased [3] during the COVID-19 pandemic with a new classification of "pandemic burnout" experienced by over 52 percent of healthcare workers as early as June of 2020 [4]. Physician burnout can lead to depression, suicidal ideation, and relationship problems that may progress to substance abuse, increased interpersonal conflicts, broken relationships, low quality of life, major depression, and suicide [5-7]. The estimated rate of physician suicide is 300-400 annually [8-10].

Work fatigue among Lebanese physicians and students during the COVID-19 pandemic: validation of the 3D-Work Fatigue Inventory (3D-WFI) and correlates

Background

Work fatigue is a work-related condition that affects physicians’ health, work attitude safety and performance. Work fatigue affects not only medical workers but can also leave a negative impact on patients. With the burden of the COVID-19 pandemic as well as the economic crisis Lebanese doctors have been facing in the last 2 years, the aim of our study was to validate the 3D-Work Fatigue Inventory (3D-WFI) among Lebanese physicians and assess the rate and correlates of work fatigue (physical, mental and emotional).

Methods

A cross-sectional study was undertaken through an anonymous self-administered questionnaire between October 2020 and January 2021. The SPSS AMOS software v.24 was used to conduct confirmatory factor analysis (CFA). To validate the 3D-WFI, multiple indices of goodness-of-fit were described: the Relative Chi-square (χ2/df) (cut-off values:< 2–5), the Root Mean Square Error of Approximation (RMSEA) (close and acceptable fit are considered for values < 0.05 and < 0.11 respectively), the Tucker Lewis Index (TLI) and the Comparative Fit Index (CFI) (acceptable values are ≥0.90).

Results

A total of 401 responses was collected; 66.1, 64.8 and 65.1% respondents had an intermediate to high level of emotional, mental and physical work fatigue respectively. The fit indices obtained in the CFA of the 3D-WFI items fitted well: CFI =0.98, TLI =0.98, RMSEA = 0.05; 95% CI 0.046–0.063; pclose = 0.20) and χ²(136) = 295.76. The correlation coefficients between the three factors (Factor 1 = Physical work fatigue, Factor 2 = Mental work fatigue, Factor 3 = Emotional work fatigue) were adequate as well: Factor 1-Factor 2 (r = 0.70), Factor 1-Factor 3 (r = 0.52) and Factor 2-Factor 3 (r = 0.65). In addition, feeling pressured by long working hours during the pandemic, having more hours of night duty per month, more stressful events in life, and higher depression were significantly associated with more physical and mental work fatigue. Higher depression and having more stressful events in life were significantly associated with more emotional work fatigue.

Conclusion

Work fatigue in Lebanese physicians seems to be associated with higher level of everyday stress, high work load and depression. Hospitals and local health authorities can use these results for early interventions that aim to reduce work fatigue and ensure the wellbeing of Lebanese physicians.

A Comparative Cross-Sectional Study Assessing the Psycho-Emotional State of Intensive Care Units' Physicians and Nurses of COVID-19 Hospitals of a Russian Metropolis

Working in intensive care units (ICUs) is stressful and potentially leads to various psycho-emotional disorders. Today, this issue represents a serious concern to the healthcare sector and affects the quality of healthcare provided. This study aimed to assess and compare the psycho-emotional state in COVID-19 and non-COVID-19 hospitals' ICU healthcare workers (HCWs). From January to July 2021, we conducted an anonymous cross-sectional web survey of ICU physicians and nurses (N = 1259) of various hospitals in a metropolis with a population of over 10 million people. The statistical distributions of non-COVID-19 ICU HCWs showed the following results: emotional exhaustion levels (low 14.6%, average 30.8%, and high 54.6%); depersonalization levels (low 11.6%, average 16.5%, and high 71.9%); and reduced personal accomplishment levels (low 23.5%, average 40.3%, and high 36.2%). The statistical distributions of COVID-19 ICU HCWs showed the following results: emotional exhaustion levels (low 16.5%, average 31.5%, and high 52%); depersonalization levels (low 7.4%, average 9.4%, and high 83.1%); and reduced personal accomplishment levels (low 25.4%, average 45.4%, and high 29.1%). This study found a strong correlation between emotional exhaustion, aggression, and depersonalization in non-COVID-19 ICU HCWs and also found a correlation between their age, aggression, emotional exhaustion, and occupational stress.

The Prevalence of Burnout and Its Associated Factors Among Surgical Specialists in Kuwait Ministry of Health Hospitals

Background

Workplace burnout is a state of emotional exhaustion (EE), depersonalization of others (DP), and low personal accomplishment (PA) owing to workplace stressors. This study aimed to assess the prevalence of burnout and its associated factors among surgical specialists in Kuwait.

Methods

This cross-sectional study assessed the prevalence of burnout among 489 surgeons in practice at Kuwait Ministry of Health (MOH). Data were collected using a self-administered questionnaire. Burnout was assessed using the Maslach Burnout Inventory, which defines burnout as having a high score of EE or DP, or a low score of PA; with severe burnout involving all. The associations between burnout or severe burnout with sociodemographic and occupational characteristics were assessed using multivariate binary logistic regression to adjust for potential confounders.

Results

Prevalence estimates for burnout and severe burnout were 76.9% (95% Confidence Interval = 72.9–80.7%) and 14.0% (11.0–17.5%), respectively. The prevalence estimates for high EE, high DP, and low PA scores were 44.7, 43.1, and 47.2%, respectively. The prevalence of burnout and severe burnout was highest among neurosurgeons. Burnout was lowest among otolaryngology surgeons and severe burnout was lowest among cardiothoracic surgeons. After adjustment, burnout was associated with younger age, lower income, and more on-calls per month. The four most common sources of stress included less family time, verbal assault, case overload, and highly complicated cases.

Conclusion

The prevalence of burnout among surgeons in Kuwait MOH hospitals is high. Occupational health programs should use these findings to design and implement interventions that can treat and prevent burnout in this population.

Physicians' Health-Related Quality of Life and Its Associated Factors During COVID-19 Pandemic in Jordan: A Cross-Sectional Study

Healthcare workers worldwide have been exposed to extraordinary stress during COVID-19 pandemic. This study aimed to investigate health-related quality of life (HRQoL) level and its health and occupational associated factors among Jordanian physicians during COVID-19 pandemic. A cross-sectional design using an online survey was adopted targeting physicians at different Jordanian hospitals. The study survey included demographics, HRQoL measured by 12-item Short Form health survey (SF-12) mental and physical components, physicians' evaluation of work conditions during COVID-19, Neck Disability Index (NDI), Depression Anxiety Stress Scale (DASS 21), and International Physical Activity Questionnaire (IPAQ). Descriptive analyses were conducted to summarize primary data. Factors associated with HRQoL were determined using a multiple variable regression analysis. In total, 326 physicians successfully completed the survey, 44.2% were males with mean age of 32.08 (±6.93). SF-12 mental component mean was 52.13 (±20.84) and physical component mean was 69.24 (±18.1). Physicians HRQoL level was significantly associated with levels of stress (β = -0.23, 95% CI -1.05 to -0.27), depression (β = -0.22, 95% CI -1.09 to -0.28), neck disability (β = -0.30, 95% CI -1.08 to -0.57), health self-evaluation (β = 0.14, 95% CI 1.66-7.87), sleep self-evaluation (β = 0.09, 95% CI 0.16-3.58), and physical activity level (β = 0.09, 95% CI 0.00-0.001). Jordanian physicians' level of HRQoL was relatively low during COVID-19. Healthcare facilities administrators should take into consideration factors associated with physicians' HRQoL level when planning for future healthcare emergencies.

Reassessing the most popularly suggested measurement models and measurement invariance of the Maslach Burnout Inventory - human service survey among Vietnamese healthcare professionals

BACKGROUND

Despite its popularity, Maslach Burnout Inventory-Human Service Survey (MBI-HSS)'s factorial structure has been subject to considerable debate, and its measurement invariance (MI) is seldomly examined. This cross-sectional study aims at reassessing the most popularly suggested structures of this instrument, namely the 20- and 22-item three-factor model on Vietnamese healthcare professionals. It also examines the MI of MBI-HSS across genders, occupations, and mental health conditions.

METHOD

Self-administered questionnaires were sent out to 1500 doctors and nurses working at 15 hospitals in big cities in Vietnam in September and October 2020, and 1162 valid questionnaires were collected. The questionnaire consists of three sets of questions covering (1) demographic information of participants; (2) MBI-HSS questionnaire; and (3) The 21-item version of the Depression-Anxiety-Stress Scale. MBI-HSS scale was validated on Vietnamese sample for the first time; therefore, we used the repeated forward-backward procedure to translate this scale into Vietnamese. To examine which model best fits the data, a series of Confirmatory Factor Analysis (CFA) was used to test the model fit of correlated three-factor model, second-order hierarchical model, and bi-factor model. The reliability of the MBI-HSS was assessed using Cronbach's α coefficients. Then, multiple-group CFA (MGCFA) was applied to determine whether the MBI-HSS has a similar structure between groups different in gender, occupation, and mental health condition.

RESULTS

Our findings confirmed that the 22-item MBI-HSS best fit the data, and this scale measures three distinct but related aspects of burnout, including Emotional Exhaustion, Depersonalization, and Personal Accomplishment. The MI of MBI-HSS across genders and occupations was also confirmed. However, data did not fit well with group at risk for common mental health disorders. It can be concluded that the Vietnamese version of MBI-HSS is a valid measure to assess burnout level of healthcare professionals in Vietnam who are not at risk for mental health disorders.

OUP accepted manuscript

Aims

The European Association of Cardiovascular Imaging Scientific Initiatives Committee conducted a global survey to evaluate the impact of the 2019 coronavirus disease (COVID-19) pandemic on the mental well-being of cardiac imaging specialists.

Methods and results

In a prospective international survey performed between 23 July 2021 and 31 August 2021, we assessed the mental well-being of cardiac imaging specialists ∼18 months into the COVID-19 pandemic. One-hundred-and-twenty-five cardiac imaging specialists from 34 countries responded to the survey. More than half described feeling anxious during the pandemic, 34% felt melancholic, 27% felt fearful, and 23% respondents felt lonely. A quarter of respondents had increased their alcohol intake and more than half reported difficulties in sleeping. Two-thirds of respondents described worsening features of burnout during the past 18 months, 44% considered quitting their job. One in twenty respondents had experienced suicidal ideation during the pandemic. Despite these important issues, the majority of participants (57%) reported having no access to any formal mental health support at work.

Conclusion

The survey has highlighted important issues regarding the mental well-being of cardiac imaging specialists during the COVID-19 pandemic. This is a major issue in our sub-specialty, which requires urgent action and prioritization so that we can improve the mental health of cardiovascular imaging specialists.

The mediating role of residents' wellbeing between program leadership and quality of care: A cross-sectional study

BACKGROUND

Research has shown that organizational leadership and support affect organizational outcomes in several sectors, including healthcare. However, less is known about how organizational leadership might influence the wellbeing of clinical trainees as well as the quality of their patient care practices.

OBJECTIVES

This study examined the mediating effects of burnout and engagement between program director-resident relationship quality and residents' reported quality of care, and the moderating effect of perceived departmental support.

METHODS

The authors conducted a cross-sectional study in September 2020, using a 41-item questionnaire, among 20 residency programs in an academic medical center in Lebanon. Measures included program director-resident relationship quality, perceived departmental support, burnout subcomponents, engagement, and self-reported quality of care. Ordinary least squares regression was used to conduct parallel mediation and moderated mediation analyses using SPSS macro-PROCESS, to assess the strength and direction of each of the proposed associations.

RESULTS

A total of 95/332 (28.6%) residents responded. Results revealed that program director-resident relationship quality had a significant indirect effect on residents' suboptimal patient care practices and attitudes towards patients, through at least one of the wellbeing dimensions (p < .05). Perceived departmental support did not play a dominant role over program director-resident relationship quality, and thus did not influence any of the mediated relationships.

CONCLUSION

Our study adds a new dimension to the body of literature suggesting that program director-resident relationship quality plays an important role in promoting residents' wellbeing and achieving important clinical health outcomes. Such findings imply that the quality of program director-resident relationship could be an important component of residents' wellbeing and patient safety. If further research confirms these associations, it will become imperative to determine what interventions might improve the quality of relationships between program directors and residents.

Mindfulness-Based Interventions to Reduce Burnout in Primary Healthcare Professionals: A Systematic Review and Meta-Analysis

Mindfulness-based interventions (MBIs) are reported by experimental studies as practical approaches to reduce burnout in primary healthcare professionals (PHCP). However, to date, no research has synthesized the evidence to determine the overall effects of MBIs for reducing burnout in PHCP. We conducted a systematic review and meta-analysis to analyze the effects of MBIs to reduce burnout in PHCP. We searched articles in the PubMed/MEDLINE, Web of Science, Cochrane, and Scopus databases from inception to September 2021 using MeSH terms: "mindfulness", "burnout", and "primary healthcare". Two reviewers extracted the data and assessed the risk of bias. We used a random-effects meta-analysis to calculate the standardized mean differences (SMD) and mean differences (MD) with 95% confidence intervals (CI) of emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA) domains of burnout. Of 61 records, ten were included (n = 417). Overall, the studies were rated as having a high risk of bias and limited quality evidence. MBIs significantly reduced EE (SMD = -0.54, 95%CI: -0.72 to -0.36; MD = -5.89, 95%CI: -7.72 to -4.05), DP (SMD = -0.34, 95%CI: -0.52 to -0.17; MD = -1.96, 95%CI: -2.96 to -0.95), and significantly increased PA (SMD = 0.34, 95%CI: 0.17 to 0.52; MD = 2.05, 95%CI: 1.04 to 3.06). Although further high-quality research is needed, our findings support the implementation of MBIs for reducing burnout in PHCP.

Burnout prevalence among European physicians: a systematic review and meta-analysis

PURPOSE

Our objective was to assess burnout prevalence rates among physicians practicing in Europe (regardless of their specialty) taking into account the main approaches used to define burnout with the Maslach Burnout Inventory (MBI) tool.

METHODS

A systematic review was carried out from 2006 to 2018. A keyword request was obtained using the PubMed/Medline, Web of Science and Banque de Données en Santé Publique search engine. Studies written in English measuring burnout with the MBI tool among a population of practicing European physicians were selected. Data were extracted and classified according to burnout's definition provided by the authors. Three definitions using the MBI dimensions were considered: tri-, bi- and unidimensional definition. A meta-analysis was then performed on burnout prevalence rates according to the dimensional definition of burnout.

RESULTS

From 2378 search results, we selected 56 studies including from up to 41 European countries. Depending upon the study, physicians' burnout prevalence rates ranged from 2.5% to 72.0%. The pooled prevalence rate of burnout was estimated at 7.7% [5.3-10.4%] with the tridimensional definition, 19.7% [13.5-26.3%] with the bidimensional definition and 43.2% [29.0-57.6%] with the unidimensional definition.

CONCLUSION

Burnout pooled prevalence among physicians varies from single to fivefold depending on the method employed to assess burnout with the MBI tool. Medical community should determine a standardized method to assess burnout prevalence rates to best evaluate this phenomenon.

Prevalence of burnout syndrome and associated factors in university professors working in Salvador, state of Bahia

INTRODUCTION:

Burnout syndrome is a phenomenon characterized by chronic emotional exhaustion that can lead to physical, psychological, and social consequences. Because they need to support themselves financially, university professors have accepted increasingly longer working hours and accumulated duties, resulting in greater exposure to factors that may induce the onset of mental disorders such as burnout syndrome.

OBJECTIVES:

This cross-sectional epidemiological study aimed to determine the prevalence of burnout syndrome and predisposing factors in university professors working in Salvador, Brazil.

METHODS:

The sample consisted of 210 participants. The Maslach Burnout Inventory adapted for teachers, the gold standard for detecting burnout syndrome, and a sociodemographic questionnaire were administered to identify variables that may influence the development of burnout. Then, the data were compiled in Excel and analyzed with the aid of GraphPad Prism.

RESULTS:

The prevalence of burnout was 41% (n = 86). A stratified data analysis showed that being under 40 years of age, being single, being childless, teaching natural sciences, and working at several institutions are risk factors for developing burnout syndrome.

CONCLUSIONS:

The prevalence of burnout syndrome in university professors was 41%. Professors who were young, single, childless, taught natural sciences, and worked at more than one institution were found to be more likely to develop burnout syndrome.

Physician burnout: prevention strategies

Burnout syndrome is a response to occupational stress that consists of emotional exhaustion, depersonalization, and reduced personal fulfillment. It may affect health care professionals, requiring due attention and the development of preventive mechanisms. The objective of this study was to identify possible ways to prevent the onset of burnout among physicians. A literature review was conducted in PubMed and SciELO databases. The search resulted in 16 articles on the subject, of which 11 conducted individual-focused interventions, four focused on the work environment, and one focused on both aspects. In conclusion, reducing burnout levels may benefit both physicians and patients, and conducting approaches focused on both the individual and the work environment is essential. However, further research on physician burnout prevention is needed.

Paving the way to reduce work-stress in rehabilitation nurses: Promising results from a pilot study

Work Stress (WS) negatively affects both nurses and the healthcare system. The aim of this exploratory study is to investigate the effect of a professional stress prevention program in order to reduce WS in nurses working in a Rehab Ward. Twenty-three nurses were enrolled in this pilot study. The professional stress prevention program was based on group meetings and individual support. At baseline, we found a high burnout risk in nurses. At the end of the meetings, we found a normalization in WS, with a higher sense of personal achievement and a greater use of functional coping strategies. Intervention on WS could be a useful way to reduce stress and anxiety, promoting more functional coping strategies to face work difficulties in nurses working in Rehab wards.

Do Orthopaedic Residency Programs Have the Least Time Between Invitation and Interview?

BACKGROUND

The cost and stress of applying to residency programs are increasing. Planning for interviews with limited lead time can cause additional burden to residency applicants.

OBJECTIVE

We sought to determine if the specialty of orthopaedics was affording the same lead time between interview invitation and interview dates as its surgical and medical counterparts.

METHODS

Dates for the first interview invitation and last possible interview were gathered for each program in orthopaedic surgery, general surgery, otolaryngology, vascular surgery, plastic surgery, neurological surgery, internal medicine, psychiatry, pediatrics, and family medicine. Interview lead time was calculated for each specialty. Mann-Whitney U and independent sample Kruskal-Wallis tests were used for nonparametric data with P < .05 considered as significant.

RESULTS

Orthopaedic surgery lead time is significantly different when compared individually and pairwise to other specialties (P < .05 for all comparisons), with a median lead time of 57 days. The next lowest lead time specialty is otolaryngology with a 70-day lead time. The specialty with the longest is pediatrics (median 106 days).

CONCLUSIONS

Residency programs (orthopaedic surgery in particular) vary widely in the amount of lead time given to schedule and attend interviews. The authors propose that interview invitations be extended into mid-October.