1
|
Liang L, Hu Y, Fei J, Yuan T, Gao R, Yue J, Song Q, Zhao X, Mei S. Association between burnout and post-traumatic stress disorder among frontline nurse during COVID-19 pandemic: A moderated mediation analysis. J Clin Nurs 2024; 33:1076-1083. [PMID: 38041239 DOI: 10.1111/jocn.16916] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 05/29/2023] [Accepted: 10/11/2023] [Indexed: 12/03/2023]
Abstract
AIMS AND OBJECTIVES The aim of this study was to investigate the relationship between burnout and post-traumatic stress disorder (PTSD) among frontline nurses who went to assist the epidemic situation in Wuhan, China, during the outbreak in 2020. The study also explored the mediating role of depression and the moderating role of age in the main relationship. BACKGROUND The relationship between burnout and PTSD in nurse has rarely been investigated in the context of the COVID-19 pandemic. Understand the relationship between these variables can provide empirical evidence for developing interventions and protocols that improve the health of nurses in future public health emergencies. DESIGN An online cross-sectional survey of targeted local 327 nurses who went to assist the COVID-19 epidemic situation in Wuhan during the initial outbreak. METHODS This study was conducted in August 2020, the burnout scale, the PTSD scale and the depression scale were used to survey participants. The moderated mediation model was used to test research hypotheses. RESULTS Burnout could affect the PTSD symptoms in nursing staffs and depression could mediate this relationship. Age moderated the relationship between burnout/depression and PTSD, and the effects was strong and significant among younger participants in the relationship between burnout and PTSD. CONCLUSIONS Burnout was identified as a core risk factor of PTSD in nurses. Depression and age played significant roles in the relationship between burnout and PTSD. RELEVANCE TO CLINICAL PRACTICE PTSD, as a symptom that manifests after experiencing a stressful event, should be a key concern among frontline healthcare professionals. This study suggests that PTSD in nurses can be further reduced by reducing burnout. Attention should also be paid to the PTSD status of nurses of different age groups. PATIENT OR PUBLIC CONTRIBUTION Patients and the public were not involved in the design and implementation of this study. Frontline nurses completed an online questionnaire for this study.
Collapse
Affiliation(s)
- Leilei Liang
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Yuanchao Hu
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Junsong Fei
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Tongshuang Yuan
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Ren Gao
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Jingyi Yue
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Qianqian Song
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Xixi Zhao
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Songli Mei
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, Jilin Province, China
| |
Collapse
|
2
|
Younes S, Hallit S, Mohammed I, El Khatib S, Brytek-Matera A, Eze SC, Egwu K, Jabeen R, Pavlović N, Salameh P, Cherfane M, Akel M, Haddad C, Choueiry R, Fekih-Romdhane F, Iskandar K. Moderating effect of work fatigue on the association between resilience and posttraumatic stress symptoms: a cross-sectional multi-country study among pharmacists during the COVID-19 pandemic. Biopsychosoc Med 2024; 18:4. [PMID: 38374107 PMCID: PMC10875825 DOI: 10.1186/s13030-024-00300-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 01/01/2024] [Indexed: 02/21/2024] Open
Abstract
INTRODUCTION In the context of the COVID-19 pandemic, pharmacists, despite their vital contributions, have faced significant challenges that have impacted their mental well-being, potentially leading to the development of Post-Traumatic Stress symptoms (PTSS). The aim of this study was to investigate the role of work-related fatigue as a potential moderator in the relationship between pharmacists' resilience and their likelihood of experiencing PTSS during the COVID-19 pandemic. METHODS A cross-sectional survey was conducted online in eight countries from January to December 2021, including Brazil, Lebanon, Nigeria, Pakistan, Poland, Serbia, and Tunisia. The mediation analysis was conducted using PROCESS MACRO (an SPSS add-on) v3.4 model 1, taking work fatigue as a moderator in the association between resilience and PTSS. RESULTS A total of 442 pharmacists were enrolled in this study (mean age = 33.91 ± 10.36 years) with 59.5% of them being females. The results were adjusted over country, gender, working in contact with COVID-19, working patients, working mandatory hours, working voluntary hours, age, household crowding index and number of months engaged in COVID-19. The interactions resilience by physical (Beta = 0.02; p = .029), mental (Beta = 0.02; p = .040) and emotional (Beta = 0.03; p = .008) work fatigue were significantly associated with PTSS; for pharmacists with low to moderate levels of physical (Beta = - 0.33; p < .001 and Beta = - 0.21; p = .001), mental (Beta = - 0.29; p < .001 and Beta = - 0.18; p = .006) and emotional (Beta = - 0.31; p < .001 and Beta = - 0.17; p = .008) work fatigue, higher resilience was significantly related to lower PTSS levels. However, for pharmacists with high levels of physical/mental/emotional work fatigue, the association between resilience and PTSS became non-significant. CONCLUSION This study highlights the complex relationship between work-related fatigue, resilience, and PTSS in pharmacists. It emphasizes the need to address work-related fatigue for pharmacists' psychological well-being during crises, offering insights for tailored support and interventions.
Collapse
Affiliation(s)
- Samar Younes
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, Lebanese International University, Beirut, Lebanon
- Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban (INSPECT- LB), Beirut, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
- Applied Science Research Center, Applied Science Private University, Amman, Jordan
| | - Irfan Mohammed
- Department of Restorative Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - Sarah El Khatib
- Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban (INSPECT- LB), Beirut, Lebanon
- Department of Health Sciences, Faculty of Public Health, Lebanese University, Tripoli, Lebanon
| | - Anna Brytek-Matera
- Eating Behavior Laboratory (EAT Younes et al. BioPsychoSocial Medicine, Institute of Psychology, University of Wroclaw, Wroclaw, Poland
| | | | - Kenneth Egwu
- Faculty of Pharmaceutical Sciences, University of Nigeria, Nsukka, Nigeria
| | - Rawshan Jabeen
- Department of Research & Development, Children's Hospital Karachi, Karachi, Pakistan
| | - Nebojša Pavlović
- Department of Pharmacy, Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, Novi Sad, 21000, Serbia
| | - Pascale Salameh
- Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban (INSPECT- LB), Beirut, Lebanon
- Gilbert and Rose Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
- Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
- Faculty of Pharmacy, Lebanese University, Hadat, Lebanon
| | - Michelle Cherfane
- Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban (INSPECT- LB), Beirut, Lebanon
- Gilbert and Rose Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
| | - Marwan Akel
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, Lebanese International University, Beirut, Lebanon
- Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban (INSPECT- LB), Beirut, Lebanon
| | - Chadia Haddad
- Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban (INSPECT- LB), Beirut, Lebanon
- Gilbert and Rose Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
- School of Health Sciences, Modern University for Business and Science, Beirut, Lebanon
| | - Randa Choueiry
- Department of Medicinal Sciences, Faculty of Medicine, Lebanese University, Beirut, Lebanon
| | - Feten Fekih-Romdhane
- Department of Psychiatry "Ibn Omrane", Razi Hospital, Manouba, 2010, Tunisia
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Katia Iskandar
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, Lebanese International University, Beirut, Lebanon.
- Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban (INSPECT- LB), Beirut, Lebanon.
- Institut supérieur de santé publique de l'université Saint-Joseph de Beyrouth, campus des sciences médicales, rue de Damas, BP 11-5076, Riad El Solh, Beyrouth, 1107 2180, Lebanon.
- Faculty of Public Health-Section 2 (CERIPH), Lebanese University, Fanar, 90656, Lebanon.
| |
Collapse
|
3
|
Rigas N, Kyritsis Z, Dagla M, Soldatou A, Orovou E, Tzitiridou-Chatzopoulou M, Eskitzis P, Antoniou E. Post-Traumatic Stress Disorder Symptoms among Pediatric Healthcare Workers. NURSING REPORTS 2024; 14:115-127. [PMID: 38251188 PMCID: PMC10801477 DOI: 10.3390/nursrep14010010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 12/30/2023] [Accepted: 01/04/2024] [Indexed: 01/23/2024] Open
Abstract
Post-traumatic stress disorder symptoms related to work in pediatric departments aremajor public health problems, as they directly affect health organizations, healthcare workers, and, due to the poor quality of care, the patients as well. The post-traumatic symptoms that a healthcare worker may experience are related to intrusion, avoidance, negative changes in cognition and mood, and changes in arousal and reactivity. The aim of the present investigation was to identify risk factors that contribute to the development of PTSD in pediatric healthcare workers, in order to implement necessary workplace measures. A sample of four hundred and forty-five pediatric workers at seven Greek public hospitals consented to participate in the survey. Socio-demographic data and a post-traumatic checklist (5th edition) were used to diagnose post-traumatic stress disorder. According to the results, risk factors for the development of post-traumatic symptoms include medical or nursing errors, threats to a child's life, and incidents of workplace bullying. More specifically, 25.2% of the participants had a provisional PTSD diagnosis, 72.8%of the sample experienced an incident involving a medical or nursing error in their workplace related to the treatment or care of a child, 56% experienced an incident involving a child's death or a threat to a child's life due to a serious illness or injury, and 55.5% experienced an incident of workplace bullying. In addition, it was found that having a university-level education, master's, or PhD, working in a circular shift, being assigned to a department by management rather than the worker, and dissatisfaction with salary were associated with post-traumatic stress disorder. The high rates of PTSD symptoms among participants highlight the need for prevention and management measures to protect and support the mental health of workers in pediatric departments. We propose frequent evaluations of the mental health of employees, more time for rest, incentives for professional development, utilization of their specializations and specialties, support from mental health specialists when symptoms are diagnosed, and the option for employees to change departments if they wish or if they show symptoms of mental trauma.
Collapse
Affiliation(s)
- Nikolaos Rigas
- Department of Midwifery, University of West Attica, 12243 Athens, Greece; (M.D.); (E.A.)
| | - Zacharias Kyritsis
- Department of Mathematics, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Maria Dagla
- Department of Midwifery, University of West Attica, 12243 Athens, Greece; (M.D.); (E.A.)
| | - Alexandra Soldatou
- Faculty of Medicine, National and Kapodistrian University of Athens, 15772 Athens, Greece;
| | - Eirini Orovou
- Department of Midwifery, University of Western Macedonia, 50200 Ptolemaida, Greece; (E.O.); (M.T.-C.); (P.E.)
| | | | - Panagiotis Eskitzis
- Department of Midwifery, University of Western Macedonia, 50200 Ptolemaida, Greece; (E.O.); (M.T.-C.); (P.E.)
| | - Evangelia Antoniou
- Department of Midwifery, University of West Attica, 12243 Athens, Greece; (M.D.); (E.A.)
| |
Collapse
|
4
|
Serrano-Ibáñez ER, Corrás T, Del Prado M, Diz J, Varela C. Psychological Variables Associated With Post-Traumatic Stress Disorder in Firefighters: A Systematic Review. TRAUMA, VIOLENCE & ABUSE 2023; 24:2049-2066. [PMID: 35521996 PMCID: PMC10486174 DOI: 10.1177/15248380221082944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Firefighters are repeatedly exposed to work-related potential traumatic events and have an increased risk of developing post-traumatic stress disorder (PTSD). However, the mechanisms implicated in this relationship are not clear. The aim of this study was to analyse the risk and protective factors related to the development of PTSD in firefighters. According to PRISMA, a systematic review of scientific literature was conducted in Web of Science, PsycINFO, Scopus, PubMed and the Cochrane Central Register of Controlled Trials. Quality in Prognosis Studies (QUIPS) was used as the methodological quality indicator of the selected articles (PROSPERO reference CRD42020213009). Prognostic studies involving active firefighters with presence of post-traumatic symptomatology, presenting original findings, and written in Spanish or English were included. A total of 1768 potentially eligible articles were identified. According to the inclusion criteria, 87 articles were selected to evaluate the full text. Finally, 19 articles were included, comprising 12,298 active firefighters. There is high heterogeneity in the variables evaluated in the different studies. Taking the data for which this review has found more evidence (moderate support), operational stress, job duration, burnout, expressive suppression and rumination could be risk factors of PTSD, and belongingness and dispositional mindfulness could be protective factors. Other variables with weak support (e.g. resilience) were analysed. This review analyses the available literature, highlighting its scarcity for future research on the subject. Due to repeated trauma exposure, it is important to continue investigations and bear these variables in mind for the prevention of PTSD in firefighters.
Collapse
Affiliation(s)
| | - Tania Corrás
- Área de Psicología, Universidad Isabel I, Burgos, España
| | | | - Javier Diz
- Área de Psicología, Universidad Isabel I, Burgos, España
| | - Carmen Varela
- Área de Psicología, Universidad Isabel I, Burgos, España
| |
Collapse
|
5
|
Pergol-Metko P, Staniszewska A, Metko S, Sienkiewicz Z, Czyzewski L. Compassion Fatigue and Perceived Social Support among Polish Nurses. Healthcare (Basel) 2023; 11:healthcare11050706. [PMID: 36900712 PMCID: PMC10001227 DOI: 10.3390/healthcare11050706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/22/2023] [Accepted: 02/23/2023] [Indexed: 03/06/2023] Open
Abstract
BACKGROUND Social support has a vital role in preventing traumatic stress in nurses. Nurses are regularly exposed to contact with violence, suffering, and death. The situation worsened during the pandemic because they were also faced with the possibility of infection SARS-CoV-2 and death from COVID-19. Many nurses are faced with increased pressure, stress, and other adverse effects on their mental health. The study aimed to measure the relationship between compassion fatigue and perceived social support in polish nurses. METHODS The study was conducted on 862 professionally active nurses in Poland using the CAWI method (Computer-Assisted Web Interview). The professional Quality of Life scale (ProQOL) and the Multidimensional Scale of Perceived Social Support (MSPSS) were used for collecting the data. StatSoft, Inc. (2014) was used for data analysis. For comparisons between the groups: Mann-Whitney U test, ANOVA Kruskal-Wallis test, and multiple comparisons (post-hoc). The relationships between variables were tested using Spearman's rho, Tau Kendall, and the chi-square test. RESULTS The research showed the presence of compassion satisfaction, compassion fatigue, and burnout in the group of Polish hospital nurses. A higher level of perceived social support was associated with lower compassion fatigue (r = -0.35; p < 0.001). A higher level of social support was associated with higher job satisfaction (r = 0.40; p < 0.001). The study also found that a higher level of social support was associated with a lower risk of burnout (r = -0.41; p < 0.001). CONCLUSIONS Preventing compassion fatigue and burnout should be a priority for healthcare managers. Notably, an essential predictor of compassion fatigue is that Polish nurses often work overtime. It is necessary to pay more attention to the crucial role of social support in preventing compassion fatigue and burnout.
Collapse
Affiliation(s)
- Paulina Pergol-Metko
- Department of Development of Nursing and Social & Medical Sciences, Medical University of Warsaw, 02-091 Warsaw, Poland
- Correspondence:
| | - Anna Staniszewska
- Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, 02-091 Warsaw, Poland
| | | | - Zofia Sienkiewicz
- Department of Development of Nursing and Social & Medical Sciences, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Lukasz Czyzewski
- Department of Geriatric Nursing, Medical University of Warsaw, 02-091 Warsaw, Poland
| |
Collapse
|
6
|
Liu Y, Zou L, Yan S, Zhang P, Zhang J, Wen J, Mao J, Li L, Wang Y, Fu W. Burnout and post-traumatic stress disorder symptoms among medical staff two years after the COVID-19 pandemic in Wuhan, China: Social support and resilience as mediators. J Affect Disord 2023; 321:126-133. [PMID: 36280200 PMCID: PMC9585849 DOI: 10.1016/j.jad.2022.10.027] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 10/01/2022] [Accepted: 10/18/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Evidence on the relationship between burnout and post-traumatic stress disorder (PTSD) is limited. We aimed to evaluate the association between burnout and PTSD symptoms among medical staff two years after the coronavirus disease 2019 (COVID-19) pandemic in Wuhan, China, and explore the mediating roles of social support and psychological resilience. METHODS A multicenter survey was conducted online from January to March 2022 among healthcare professionals from six general hospitals. Hierarchical linear regression was used to detect the predictors of PTSD symptoms. Structural equation modeling (SEM) was used to analyze the pathways from burnout to PTSD symptoms. RESULTS Hierarchical linear regression showed that burnout, social support, and psychological resilience were significant predictors of PTSD symptoms among medical staff. In the SEM, the standardized total effect of burnout on PTSD symptoms was 0.336(bias-corrected 95 % confidence interval [0.303, 0.367], P < 0.001). Social support and psychological resilience partially mediated the relationship between burnout and PTSD symptoms (indirect effects accounted for 22.3 % of the total effect). LIMITATIONS Owing to the cross-sectional design, only clues to causal explanations can be provided. CONCLUSIONS Burnout has significant direct and indirect effects on PTSD symptoms. Furthermore, social support and psychological resilience might be effective ways to reduce the impact of burnout on PTSD symptoms in medical staff after a major public health outbreak.
Collapse
Affiliation(s)
- Yifang Liu
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Li Zou
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Shijiao Yan
- Department of Emergency Medicine, Hunan Provincial People's Hospital/The First Affiliated Hospital, Hunan Normal University, Changsha, Hunan, China,School of Public Health, Hainan Medical University, Haikou, China
| | - Pu Zhang
- Department of Cardiology, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - Jun Zhang
- Department of Endocrinology, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - Jing Wen
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jing Mao
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Longti Li
- Department of Nursing, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - Ying Wang
- Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wenning Fu
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| |
Collapse
|
7
|
Ham E, Seto MC, Rodrigues NC, Hilton NZ. Workplace stressors and PTSD among psychiatric workers: The mediating role of burnout. Int J Ment Health Nurs 2022; 31:1151-1163. [PMID: 35574982 DOI: 10.1111/inm.13015] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/26/2022] [Indexed: 11/28/2022]
Abstract
Critical workplace events (e.g., assaults), chronic stressors, burnout, and work conditions all affect nurse well-being. The present study investigated associations among these sources of stress and posttraumatic stress disorder (PTSD) symptoms in psychiatric nurses, hypothesizing that burnout would mediate the paths between workplace stressors and PTSD. Surveys were completed by 611 psychiatric nurses or allied health staff working on inpatient units in three psychiatric hospitals. Participants reported on critical events and chronic stressors specific to providing psychiatric care and completed the Maslach Burnout Inventory (MBI), Areas of Worklife Survey (AWS) (work conditions), and PTSD Checklist for DSM-5. Data were analysed using structural equation modelling. Burnout had a direct relation to PTSD symptoms and partially mediated the effect of exposure to critical events, but not chronic stressors, on PTSD symptoms. Chronic stressors related to patients' disturbing behaviour (e.g., flooding room, eating non-food items) had a direct effect on PTSD symptoms, but those related to resisting care (e.g., screaming constantly, physically resisting care) had no significant association. Worklife conditions had a negative direct effect on Burnout and indirect effect on PTSD, whereby participants reporting poorer alignment of work conditions with their expectations had higher Burnout and PTSD symptom scores. Different sources of workplace stress have different relations to PTSD symptoms, and Burnout has both direct and mediation effects. Interventions aimed at reducing patients' aggressive and disturbing acts and improving healthcare providers' burnout and worklife factors in hospitals may all be needed to reduce PTSD among psychiatric staff.
Collapse
Affiliation(s)
- Elke Ham
- Waypoint Centre for Mental Health Care, Penetanguishene, ON, Canada
| | - Michael C Seto
- University of Ottawa's Institute of Mental Health Research, Ottawa, Canada
| | | | - N Zoe Hilton
- Waypoint Centre for Mental Health Care, Penetanguishene, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, Canada
| |
Collapse
|
8
|
Chin DL, Kyung M, Li J, Phelps S, Hong O. The short form effort-reward imbalance: Measure of occupational stress for firefighters. Am J Ind Med 2022; 65:492-499. [PMID: 35411620 DOI: 10.1002/ajim.23355] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 03/01/2022] [Accepted: 03/22/2022] [Indexed: 11/11/2022]
Abstract
PURPOSE The original effort-reward imbalance (ERI) questionnaire has been widely used as a measure of occupational stress. The need for brief measurement of psychosocial stress at work has risen. This study examined the psychometric properties of a 16-item short form ERI (S-ERI) questionnaire. METHODS A cross-sectional study was conducted with a convenience sample of 247 career firefighters in the United States. An internet-based survey contained the S-ERI questionnaire, and assessed perceived health, demographics, and work characteristics. Internal consistency was tested by item-total correlation and Cronbach's α coefficients. Factorial validity was assessed by confirmatory factor analysis (CFA), and criterion validity was examined by testing the S-ERI's association with perceived health, controlling for other factors. RESULTS The study participants were primarily young and mid-aged White males (mean age = 42 years, 75% White non-Hispanic, 93% males). The S-ERI questionnaire showed satisfactory internal consistency, with Cronbach α coefficients above 0.80 for all three scales: effort 0.82, reward 0.83, and overcommitment 0.81. CFA showed all the S-ERI components had a good fit (goodness-of-fit index = 0.99, comparative fit index = 0.92, root mean square error of approximation = 0.06). In terms of criterion validity, significantly increased odds ratios (ORs) for perceived health (those indicating they were less healthy) were found in firefighters in the lowest tertile of reward (OR = 7.06, 95% confidence interval [CI]: 2.86-17.43), and highest tertile of overcommitment (OR = 2.29, 95% CI: 1.00-5.22), after controlling for other factors. CONCLUSION The S-ERI questionnaire is a reliable and valid measure to assess occupational stress. We recommend the use of S-ERI as a measure of occupational stress when initiating efforts to improve firefighters' wellness.
Collapse
Affiliation(s)
- Dal Lae Chin
- Occupational and Environmental Health Nursing Graduate Program, School of Nursing, University of California San Francisco, San Francisco, California, USA
| | - MinJung Kyung
- Occupational and Environmental Health Nursing Graduate Program, School of Nursing, University of California San Francisco, San Francisco, California, USA
| | - Jian Li
- Department of Environmental Health Sciences, Fielding School of Public Health, School of Nursing, University of California Los Angeles, Los Angeles, California, USA
| | - Stephanie Phelps
- Occupational and Environmental Health Nursing Graduate Program, School of Nursing, University of California San Francisco, San Francisco, California, USA
| | - OiSaeng Hong
- Occupational and Environmental Health Nursing Graduate Program, School of Nursing, University of California San Francisco, San Francisco, California, USA
| |
Collapse
|
9
|
Yang BJ, Yen CW, Lin SJ, Huang CH, Wu JL, Cheng YR, Hsieh CC, Hsiao FH. Emergency nurses' burnout levels as the mediator of the relationship between stress and posttraumatic stress disorder symptoms during COVID-19 pandemic. J Adv Nurs 2022; 78:2861-2871. [PMID: 35307874 PMCID: PMC9111628 DOI: 10.1111/jan.15214] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 01/06/2022] [Accepted: 01/22/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Bey-Jing Yang
- Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan.,Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Ching-Wei Yen
- Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan
| | - Shou-Ju Lin
- Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan
| | - Chien-Hua Huang
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Jhong-Lin Wu
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Yih-Ru Cheng
- Clinical Psychology Center, National Taiwan University Hospital, Taipei, Taiwan
| | - Chia-Chen Hsieh
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Fei-Hsiu Hsiao
- Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan.,School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
| |
Collapse
|
10
|
Student Burnout and PTSD Symptoms: The Role of Existential Anxiety and Academic Fears on Students during the COVID 19 Pandemic. DEPRESSION RESEARCH AND TREATMENT 2022; 2022:6979310. [PMID: 35096425 PMCID: PMC8796705 DOI: 10.1155/2022/6979310] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 12/25/2021] [Accepted: 01/17/2022] [Indexed: 12/02/2022]
Abstract
It is well known that student burnout is a serious mental health problem, caused by chronic stress related to the educational area. However, in the COVID 19 pandemic, young people have to struggle with additional threats that affect their overall functioning and perception of the world. The main purpose of this study was to investigate the mediating effects of existential anxiety and academic fears on the relationship between academic burnout and posttraumatic stress disorder symptoms. The findings confirmed that academic burnout, existential anxiety, and academic fear were significantly associated with higher posttraumatic symptoms. Existential anxiety and academic fear played a mediating role in the association between academic burnout and posttraumatic stress disorder symptoms. In conclusion, it is considered that student burnout and anxiety indicators are important risk factors for the trauma experienced by students and may increase its symptoms.
Collapse
|
11
|
Dyal MAA, Smith TD, DeJoy DM, Moore BA. Occupational Stress and Burnout in the Fire Service: Examining the Complex Role and Impact of Sleep Health. Behav Modif 2021; 46:374-394. [PMID: 34433285 DOI: 10.1177/01454455211040049] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The occupational stress inherent in firefighting poses both physiological and psychological risks to firefighters that have been found to possess a reciprocal nature. That is, the nature of these relationships in terms of indicator and impact are elusive, especially as it relates to sleep health (e.g., quality, quantity, hygiene, etc.) as a specific physiological risk and burnout as a specific psychological risk. A series of mediation models were assessed to examine the reciprocal relationships between occupational stress, burnout, and sleep health in a sample of 161 career firefighters. The mediation models confirmed reciprocity among the variables in so much that relationships were best described by the underlying mechanism at work. Comprehensive assessments of both subjective and objective markers of sleep health should be incorporated into firefighter research to supplement behavioral health assessments and interventions, especially related to burnout and occupational stress.
Collapse
Affiliation(s)
| | - Todd D Smith
- Indiana University, School of Public Health - Bloomington, USA
| | | | | |
Collapse
|
12
|
Giménez Lozano JM, Martínez Ramón JP, Morales Rodríguez FM. Doctors and Nurses: A Systematic Review of the Risk and Protective Factors in Workplace Violence and Burnout. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3280. [PMID: 33810020 PMCID: PMC8004742 DOI: 10.3390/ijerph18063280] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 03/12/2021] [Accepted: 03/15/2021] [Indexed: 12/14/2022]
Abstract
The present study aims analyze the risk factors that lead to high levels of burnout among nurses and physicians and the protective factors that prevent them. Thus, it is also intended to explore the possible correlation between physical and verbal violence produced at work and the symptoms derived from burnout. Methods: The search was carried out on the Scopus, PubMed and Web of Science databases between 2000 and 2019 (on which date the bibliographic search ends). Descriptive studies estimating the prevalence of workplace violence and risk and protective factors and burnout were included. An adapted version of the Downs and Black quality checklist was used for article selection. 89.6 percent of the studies analysed were in the health sector. There is a significant correlation between burnout symptoms and physical violence at work. On the one hand, the risk factors that moderate this correlation were of structural/organisational type (social support, quality of the working environment, authoritarian leadership, little autonomy or long working days, etc.) and personal type (age, gender, nationality or academic degree, etc.). On the other hand, protective factors were the quality of the working environment, mutual support networks or coping strategies. The results were analysed in-depth and intervention strategies were proposed.
Collapse
Affiliation(s)
- Jose Miguel Giménez Lozano
- Department of Educational and Developmental Psychology, Faculty of Psychology, Campus Universitario de Cartuja, University of Granada, 18071 Granada, Spain;
| | - Juan Pedro Martínez Ramón
- Department of Developmental and Educational Psychology, Campus of Espinardo, University of Murcia, 30100 Murcia, Spain;
| | - Francisco Manuel Morales Rodríguez
- Department of Educational and Developmental Psychology, Faculty of Psychology, Campus Universitario de Cartuja, University of Granada, 18071 Granada, Spain;
| |
Collapse
|
13
|
Vinnikov D, Romanova Z, Kapanova G, Raushanova A, Kalmakhanov S, Zhigalin A. Testosterone and occupational burnout in professional male firefighters. BMC Public Health 2021; 21:397. [PMID: 33622299 PMCID: PMC7903594 DOI: 10.1186/s12889-021-10446-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 02/15/2021] [Indexed: 11/10/2022] Open
Abstract
Background Very little is known about the biologic predictors of the occupational burnout in firefighters. The aim of this study was to characterize testosterone profile of active firefighters and quantify its association with three domains of the occupational burnout. Methods We enrolled 100 firefighters (median age 28 (interquartile range (IQR) 9.8) years with 5 (IQR 9) years in service) of three fire departments in Almaty, Kazakhstan. Demographics, smoking status, health-related quality of life (HRQL) and burnout scores of Maslach Burnout Inventory were assessed using a questionnaire, while total blood testosterone was measured in venous blood. Logistic regression models were used to quantify the association of blood testosterone with each burnout domain in the adjusted for confounders models. Results The median blood testosterone level was 14 (IQR 3.5) nmol/l and was only predicted by age (beta − 0.14, p < 0.01, 79% power). There were no differences in blood testosterone levels between occupational groups (Group 1 (firefighters), 14.6 (IQR 3.4); Group 2 (fire truck drivers), 14.7 (IQR 5.6); Group 3 (shift commanders, division heads, department managers and engineers), 14 (IQR 4.1) nmol/l, Kruskal-Wallis p = 0.32) or departments. Testosterone could not predict EX or CY, but had a negative association with PE score reflecting more burnout (odds ratio 1.18 (95% confidence interval 1.01;1.38)), adjusted for age, mental component of HRQL and education. Conclusions Firefighters with higher testosterone may develop burnout in PE earlier, and this should be considered for proper work placement within the rescue system.
Collapse
Affiliation(s)
- Denis Vinnikov
- al-Farabi Kazakh National University, 71 al-Farabi avenue, Almaty, Kazakhstan, 050040. .,Peoples' Friendship University of Russia (RUDN University), 6 Miklukho-Maklaya street, Moscow, Russian Federation, 117198.
| | - Zhanna Romanova
- al-Farabi Kazakh National University, 71 al-Farabi avenue, Almaty, Kazakhstan, 050040
| | - Gulnara Kapanova
- al-Farabi Kazakh National University, 71 al-Farabi avenue, Almaty, Kazakhstan, 050040
| | - Aizhan Raushanova
- al-Farabi Kazakh National University, 71 al-Farabi avenue, Almaty, Kazakhstan, 050040
| | | | - Alexander Zhigalin
- National Research Tomsk State University, 36 Lenin avenue, Tomsk, Russian Federation, 634050.,Federal Research Center of Fundamental and Translational Medicine, 2 Timakov Street, Novosibirsk, Russian Federation, 630117
| |
Collapse
|
14
|
Johnson SU, Ebrahimi OV, Hoffart A. PTSD symptoms among health workers and public service providers during the COVID-19 outbreak. PLoS One 2020; 15:e0241032. [PMID: 33085716 PMCID: PMC7577493 DOI: 10.1371/journal.pone.0241032] [Citation(s) in RCA: 134] [Impact Index Per Article: 33.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 10/07/2020] [Indexed: 11/30/2022] Open
Abstract
In the frontline of the pandemic stand healthcare workers and public service providers, occupations which have proven to be associated with increased mental health problems during pandemic crises. This cross-sectional, survey-based study collected data from 1773 healthcare workers and public service providers throughout Norway between March 31, 2020 and April 7, 2020, which encompasses a timeframe where all non-pharmacological interventions (NPIs) were held constant. Post-traumatic stress disorder (PTSD), anxiety and depression were assessed by the Norwegian version of the PTSD checklist (PCL-5), General Anxiety Disorder -7, and Patient Health Questionnaire-9 (PHQ-9), respectively. Health anxiety and specific predictors were assessed with specific items. Multiple regression analysis was used for predictor analysis. A total of 28.9% of the sample had clinical or subclinical symptoms of PTSD, and 21.2% and 20.5% were above the established cut-offs for anxiety and depression. Those working directly in contrast to indirectly with COVID-19 patients had significantly higher PTSD symptoms. Worries about job and economy, negative metacognitions, burnout, health anxiety and emotional support were significantly associated with PTSD symptoms, after controlling for demographic variables and psychological symptoms. Health workers and public service providers are experiencing high levels of PTSD symptoms, anxiety and depression during the COVID-19 pandemic. Health workers working directly with COVID-19 patients have significantly higher levels of PTSD symptoms and depression compared to those working indirectly. Appropriate action to monitor and reduce PTSD, anxiety, and depression among these groups of individuals working in the frontline of pandemic with crucial societal roles should be taken immediately.
Collapse
Affiliation(s)
- Sverre Urnes Johnson
- Department of Psychology, University of Oslo, Oslo, Norway
- Modum Bad Psychiatric Hospital, Vikersund, Norway
| | - Omid V. Ebrahimi
- Department of Psychology, University of Oslo, Oslo, Norway
- Modum Bad Psychiatric Hospital, Vikersund, Norway
| | - Asle Hoffart
- Department of Psychology, University of Oslo, Oslo, Norway
- Modum Bad Psychiatric Hospital, Vikersund, Norway
| |
Collapse
|
15
|
A Relational Model for Stress: A Systematic Review of the Risk and Protective Factors for Stress-Related Diseases in Firefighters. PSYCH 2020. [DOI: 10.3390/psych2010008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Firefighters are considered a high-risk group for the development of PTSD and other stress-related diseases. More than the exposure to potentially traumatic events, personal and occupational characteristics have been pointed out as interfering in the perception of stress, which may lead to the emergence of mental and physical symptoms. This study aimed to analyze the relationship between the main factors that contribute to stress-related diseases in firefighters. A systematic review was conducted in order to identify original articles focusing on risk and protective factors for stress in this population. Personality traits, training, experience in extreme situations and social and organizational support influence the perception of stress and, consequently, the choice of coping strategies, which may protect against or potentiate the stress reactions. The findings of this study allow us to draw a relational model that represents the dynamics among the factors related to stress in firefighters. The development of PTSD and other stress-related diseases depends on a host of pre-trauma and post-trauma factors and, although training is an important protective factor, being prepared to face extreme situations does not mean being immune to traumatic stress.
Collapse
|