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Chen-Xu J, Miranda Castilho B, Moura Fernandes B, Silva Gonçalves D, Ferreira A, Gonçalves AC, Ferreira Vieira M, Silva AM, Borges F, Paes Mamede M. Medical residency in Portugal: a cross-sectional study on the working conditions. FRONTIERS IN HEALTH SERVICES 2023; 3:1190357. [PMID: 38116534 PMCID: PMC10728646 DOI: 10.3389/frhs.2023.1190357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 11/07/2023] [Indexed: 12/21/2023]
Abstract
Objectives The current European crisis in human resources in health has opened the debate about working conditions and fair wages. This is the case with Resident doctors, which have faced challenges throughout Europe. In Portugal, they account for about a third of the doctors in the Portuguese National Health Service. No studies to date objectively demonstrate the working conditions and responsibilities undertaken. This study aims to quantify the residents' workload and working conditions. Methods Observational, retrospective cross-sectional study which involved a survey on the clinical and training activity of Portuguese residents, actively working in September 2020. The survey was distributed through e-mail to residents' representatives and directly to those affiliated with the Independent Union of Portuguese Doctors. The descriptive analysis assessed current workload, and logistic regression models analyzed associations with geographical location and residency seniority. Results There were a total of 2,012 participants (19.6% of invited residents). Of the residents giving consultations, 85.3% do so with full autonomy. In the emergency department, 32.1% of the residents work 24 h shifts and 25.1% work shifts without a specialist doctor present. Regarding medical training, 40.8% invest over EUR 1,500 annually. Autonomy in consultations was associated with being a Family Medicine resident (OR 4.219, p < 0.001), being a senior resident (OR 5.143, p < 0.001), and working in the Center (OR 1.685, p = 0.009) and South regions (OR 2.172, p < 0.001). Seniority was also associated with investing over EUR 1,500 in training annually (OR 1.235, p = 0.021). Conclusion Residents work far more than the contracted 40 h week, often on an unpaid basis. They present a high degree of autonomy in their practice, make a very significant personal and financial investment in medical training, with almost no time dedicated to studying during working hours. There is a need to provide better working conditions for health professionals, including residents, for the sake of the sustainability of health systems across Europe.
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Affiliation(s)
- José Chen-Xu
- Unidade de Saúde Pública, Agrupamento de Centros de Saúde Baixo Mondego, Coimbra, Portugal
- Comprehensive Health Research Centre, National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal
| | | | - Bruno Moura Fernandes
- Radiology Oncology Department, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal
| | - Diana Silva Gonçalves
- Unidade de Saúde Familiar ARS Médica, Agrupamento de Centros de Saúde Loures-Odivelas, Loures, Portugal
| | - André Ferreira
- Medical Oncology Department, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal
| | - Ana Catarina Gonçalves
- Infectious Diseases Department, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
| | - Maycoll Ferreira Vieira
- Centros de Saúde de Santana e do Caniçal, Serviço de Saúde da Região Autónoma da Madeira, EPERAM, Madeira, Portugal
| | - Andreia M. Silva
- General Surgery Department, Hospital da Horta, EPER, Açores, Portugal
| | - Fábio Borges
- Unidade de Saúde Familiar S. Miguel-O-Anjo, Agrupamento de Centros de Saúde Ave-Famalicão, Famalicão, Portugal
| | - Mónica Paes Mamede
- Anaesthesiology Department, Centro Hospitalar de Lisboa Central, Lisboa, Portugal
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Jiménez Padilla EA, Galindo Vázquez O, Jiménez Flores J, Costas Muñiz R, Meneses García A. Factors associated with the presence of fear of contagion and burnout syndrome in nursing personnel during the COVID-19 pandemic. J Res Nurs 2023; 28:418-431. [PMID: 38144962 PMCID: PMC10741272 DOI: 10.1177/17449871231202235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2023] Open
Abstract
Introduction During the COVID-19 pandemic, nursing personnel presented a higher prevalence of fear of contagion, anxiety symptoms, depression, and burnout syndrome. However, the variables associated with these conditions in Mexico are unknown. Objective To determine the clinical, sociodemographic, and psychological variables associated with fear of contracting COVID-19 and burnout syndrome in nursing personnel. Methods The study was a cross-sectional correlational study. It included 423 Mexican nursing professionals, working in public and private institutions, of different specialties aged 18-61 years (M = 36 years), the sampling was non-probabilistic by convenience. The instruments used were: COVID-19 fear scale, Maslach Burnout Inventory, Generalized Anxiety Disorder Scale-7 and Patient Health Questionnaire-9. Multinomial logistic regression models were used to analyse the results. Results The factors associated with fear of contagion were anxiety symptoms (Odds Ratio [OR]: 7.806, p < 0.05), caring for patients with COVID-19 (OR: 5.460, p < 0.05, 0.001) and mild emotional exhaustion (OR: 5.181, p < 0.05). The syndrome dimensions were: depressive symptoms (OR: 12.062; 7.667, p < 0.05), fear of contagion (OR: 4.978; 4.913; 4.921; 4.921, p < 0.01), marital status (OR: 3.404; 3.219, p < 0.05) and young age (OR: 1.064; 1.084, p < 0.05). Conclusions The factors associated with fear of contagion and burnout syndrome found were having clinical psychological symptoms, as well as being young, being single, being married and being in the health system caring for patients with COVID-19.
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Affiliation(s)
| | | | - Juan Jiménez Flores
- Full-time Professor, Faculty of Higher Studies Zaragoza, National Autonomous University of Mexico UNAM, Mexico
| | - Rosario Costas Muñiz
- Assistant, Department of Behavioral Sciences, Memorial Sloan Kettering Cancer Center MSKCC, USA
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Morita T, Muroya S, Takahashi O, Ohde S. Factors Associated with Intention to Resign among Medical Residents during the COVID-19 Pandemic in Japan: A Cross-sectional Study. JMA J 2023; 6:292-299. [PMID: 37560358 PMCID: PMC10407254 DOI: 10.31662/jmaj.2023-0004] [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: 01/17/2023] [Accepted: 04/12/2023] [Indexed: 08/11/2023] Open
Abstract
INTRODUCTION The coronavirus disease 2019 (COVID-19) pandemic has significantly affected healthcare workers' mental health worldwide, leading to the intention to resign. Japanese medical residents were no exception to the impact of COVID-19. This study aimed to illustrate how the COVID-19 pandemic affected medical residents' intention to resign. METHODS A cross-sectional study was conducted for Postgraduate Year (PGY)1-5 medical residents in Japan using an internet survey from March 11 to March 18, 2021. During this survey, the Japanese government declared a second-time state of emergency on January 7, 2021, and all restrictions were expanded nationwide until March 21, 2021. Medical residents were categorized into two groups (intention to resign group [IR] or no intention to resign group [NIR]) based on their intention to resign. Multivariate logistic regression analysis was conducted to elucidate the risk factors for the intention to resign. RESULTS 354 medical residents were enrolled in this study (response rate: 40.2%). Ninety-two medical residents (26.0 %) were categorized into IR and 262 (74.0%) into NIR. According to multivariate logistic regression analysis, those who did not have mental support at their hospital had 2.95 times greater chance of intending to resign (Adjusted odds ratio [AOR] = 2.95, 95% confidence interval (CI) [1.42-6.15]). Medical residents who engaged in patients with COVID-19 (AOR = 2.13, 95% Cl [1.08-4.18]) and PGY5 (AOR = 3.38, 95% Cl [1.51-7.56]) had a higher likelihood of intending to resign among residents in all PGY. CONCLUSIONS One in four medical residents intended to resign during the COVID-19 pandemic. Particularly, PGY5 and medical residents who treated patients with COVID-19 were found at risk of having the intention to resign. At times of crisis, such as the COVID-19 epidemic, establishing a mental health support system that targets high-risk residents is critical.
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Affiliation(s)
- Takako Morita
- Graduate School of Public Health and Clinical Epidemiology St. Luke's International University, Tokyo, Japan
| | - Saki Muroya
- Graduate School of Public Health and Clinical Epidemiology St. Luke's International University, Tokyo, Japan
| | - Osamu Takahashi
- Graduate School of Public Health and Clinical Epidemiology St. Luke's International University, Tokyo, Japan
| | - Sachiko Ohde
- Graduate School of Public Health and Clinical Epidemiology St. Luke's International University, Tokyo, Japan
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Ryan E, Hore K, Power J, Jackson T. The relationship between physician burnout and depression, anxiety, suicidality and substance abuse: A mixed methods systematic review. Front Public Health 2023; 11:1133484. [PMID: 37064688 PMCID: PMC10098100 DOI: 10.3389/fpubh.2023.1133484] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 02/09/2023] [Indexed: 04/03/2023] Open
Abstract
Introduction The World Health Organization defines burnout as a problem associated with employment, a category distinct from psychological disorders such as depression, anxiety, suicidality and disorders of substance abuse. Evaluating the association between burnout as an occupational exposure and psychological morbidity may indicate that burnout can act as an occupational risk factor for mental ill-health. The systematic review explores this relationship in physicians due to the increased risk in this population and the implications for healthcare delivery. Methods A mixed methods systematic review of the literature was conducted across Medline, Cinahl Plus, PsycInfo, Web of Science and The Cochrane Library. Databases were systematically searched using keywords relating to physician burnout and depression, anxiety, suicidality and substance abuse. Identified articles were screened for eligibility by two independent researchers. Data extraction was performed and studies assessed for risk of bias. Quantitative and qualitative results were integrated using a convergent segregated approach and results portrayed as a narrative synthesis. Results Sixty-one articles were included in the review. There was notable heterogeneity in the measurement and criteria used to define burnout limiting the assimilation of results. Despite this, all studies that measured the association between depression and burnout reported a significant association. Studies that reported association between burnout and anxiety were similarly uniformly consistent. Most studies that reported the association between burnout and suicidality indicated that a significant association exists however difficulty in measurement of suicidality may have influenced variability of results. The reported association between substance abuse and burnout was more variable, suggesting that any association is likely to be weak or influenced by other variables. Qualitative studies described the manifestations of chronic workplace stress as well as perceived links with psychological morbidity. These included lack of time for work-life balance, the contribution of professional relationships and a culture of invulnerability that exists among physicians. Conclusion The systematic review cannot conclude causality but suggests that physician burnout is associated with depression, anxiety and suicidality. Qualitative data provides insight into the nature of this association. The review indicates the need for longitudinal research and provides considerations for intervention strategies to prevent the development and progression of burnout. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020172938, identifier: CRD42020172938.
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Affiliation(s)
- Emer Ryan
- Department of Cardiothoracic Anaesthesia, Auckland City Hospital, Auckland, New Zealand
- Usher Institute, University of Edinburgh, Scotland, United Kingdom
- College of Anaesthesiologists of Ireland, Dublin, Ireland
| | - Kevin Hore
- College of Anaesthesiologists of Ireland, Dublin, Ireland
- Department of Anaesthesia, Great Ormonde Street Children's Hospital, London, United Kingdom
| | - Jessica Power
- Centre for Global Health, Trinity College, Dublin, Ireland
| | - Tracy Jackson
- Usher Institute, University of Edinburgh, Scotland, United Kingdom
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Failla G, Caminiti M, Chen-Xu J, Lo Moro G, Berselli N, Cabral Ferreira M, Malcata F, Peyre-Costa D, Croci R, Soldà G, Capodici A, Morcavallo C, Traglia F, Cedrone F, Storti I, Jaquete AA, Antinozzi M, Vasiliu A. Impact of the COVID pandemic on mental health and training opportunities of Public Health Residents from 4 European countries: A cross-sectional study. Front Public Health 2023; 11:1044171. [PMID: 36960373 PMCID: PMC10028077 DOI: 10.3389/fpubh.2023.1044171] [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: 09/14/2022] [Accepted: 02/06/2023] [Indexed: 03/09/2023] Open
Abstract
Objectives There is little evidence on the impact of the COVID-19 pandemic on Public Health Residents' (PHR) mental health (MH). This study aims at assessing prevalence and risk factors for depression, anxiety and stress in European PHR during the COVID-19 pandemic. Methods Between March and April 2021, an online survey was administered to PHR from France, Italy, Portugal and Spain. The survey assessed COVID-19 related changes in working conditions, training opportunities and evaluated MH outcomes using the Depression Anxiety Stress Scales-21. Multivariable logistic regressions were applied to identify risk factors. Results Among the 443 respondents, many showed symptoms of depression (60.5%), anxiety (43.1%) and stress (61.2%). The main outcome predictors were: female gender for depression (adjOR = 1.59, 95%CI [1.05-2.42]), anxiety (adjOR = 2.03, 95%CI [1.33-3.08]), and stress (adjOR = 2.35, 95%CI [1.53-3.61]); loss of research opportunities for anxiety (adjOR = 1.94, 95%CI [1.28-2.93]) and stress (adjOR = 1.98, 95%CI [1.26-3.11]); and COVID-19 impact on training (adjOR = 1.78, 95%CI [1.12-2.80]) for depression. Conclusions The pandemic had a significant impact on PHR in terms of depression, anxiety and stress, especially for women and who lost work-related opportunities. Training programs should offer PHR appropriate MH support and training opportunities.
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Affiliation(s)
- Giovanna Failla
- Department of Life Sciences and Public Health, Catholic University of the Sacred Heart, Rome, Italy
| | - Marta Caminiti
- Department of Public Health Sciences, University of Perugia, Perugia, Italy
| | - José Chen-Xu
- Public Health Unit, Primary Health Care Cluster Baixo Mondego, Coimbra, Portugal
| | | | - Nausicaa Berselli
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Filipa Malcata
- Public Health Unit, Primary Health Care Cluster Porto Ocidental, Porto, Portugal
| | - David Peyre-Costa
- Public Health Unit, University Hospital of Montpellier, Montpellier, France
| | - Roberto Croci
- School of Medicine, University Vita-Salute San Raffaele, Milan, Italy
| | - Giorgia Soldà
- School of Hygiene and Preventive Medicine, Department of Biomedical and Neuromotor Sciences, Public Health and Medical Statistics, University of Bologna, Bologna, Italy
| | - Angelo Capodici
- School of Hygiene and Preventive Medicine, Department of Biomedical and Neuromotor Sciences, Public Health and Medical Statistics, University of Bologna, Bologna, Italy
| | - Caterina Morcavallo
- Department of Biomedical Sciences and Human Oncology, School of Medicine, University of Bari Aldo Moro, Bari, Italy
| | - Francesco Traglia
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Fabrizio Cedrone
- Health Management of “SS. Spirito” Hospital of Pescara, Local Health Authority of Pescara, Pescara, Italy
| | - Ilaria Storti
- Department of Cardiothoracic and Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Alfonso Alonso Jaquete
- Preventive Medicine and Public Health Unit, Health Department of the Government of Cantabria, Santander, Spain
| | | | - Anca Vasiliu
- Department of Pediatrics, Global Tuberculosis Program, Baylor College of Medicine, Houston, TX, United States
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Nishizaki Y, Nagasaki K, Shikino K, Kurihara M, Shinozaki T, Kataoka K, Shimizu T, Yamamoto Y, Fukui S, Nishiguchi S, Katayama K, Kobayashi H, Tokuda Y. Relationship between COVID-19 care and burnout among postgraduate clinical residents in Japan: a nationwide cross-sectional study. BMJ Open 2023; 13:e066348. [PMID: 36639218 PMCID: PMC9842597 DOI: 10.1136/bmjopen-2022-066348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVE The relationship between the care of patients with COVID-19 and mental health among resident physicians in Japan is imperative for ensuring appropriate care of patients with COVID-19 and should be clarified. We herein assessed the relationship between the care of patients with COVID-19 and mental health among postgraduate year 1 (PGY-1) and PGY-2 resident physicians and factors associated with mental health. DESIGN This nationwide cross-sectional study analysed data obtained using the clinical training environment self-reported questionnaire. SETTING An observational study across Japan among resident physicians (PGY-1 and PGY-2) from 583 teaching hospitals. PARTICIPANTS Examinees who took the general medicine in-training examination of academic year 2020. PRIMARY AND SECONDARY OUTCOME MEASURES The Patient Health Questionnaire and Mini-Z 2.0 were used to assess mental health, and experience of caring for patients with COVID-19 was divided into three groups (none, 1-10 and ≥11). The prevalence of mental conditions in the three groups was compared using the 'modified' Poisson generalised estimating equations by adjusting for prefecture-level, hospital-level and resident-level variables. RESULTS Of the 5976 participants analysed, 50.9% were PGY-1. The prevalence of burnout was 21.4%. Moreover, 47.0% of all resident physicians had no experience in the care of patients with COVID-19. The well-experienced group accounted for only 7.9% of the total participants. A positive association was found between the number of caring patients with COVID-19 and burnout (prevalence ratio 1.25; 95% CI 1.02 to 1.53). Moreover, the shortage of personal protective equipment was identified as a major contributor to burnout (prevalence ratio 1.60; 95% CI 1.36 to 1.88). CONCLUSIONS Resident physicians who experienced more care of patients with COVID-19 had slightly greater burnout prevalence than those who did not. Approximately half of resident physicians did not participate in the care of patients with COVID-19, which posed a challenge from an educational perspective.
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Affiliation(s)
- Yuji Nishizaki
- Division of Medical Education, Juntendo University School of Medicine, Tokyo, Japan
| | - Kazuya Nagasaki
- Department of Internal Medicine, Mito Kyodo General Hospital, University of Tsukuba, Ibaraki, Japan
| | - Kiyoshi Shikino
- Department of General Medicine, Chiba University Hospital, Chiba, Japan
| | - Masaru Kurihara
- Department of Patient Safety, Nagoya University Hospital, Aichi, Japan
| | - Tomohiro Shinozaki
- Department of Information and Computer Technology, Faculty of Engineering, Tokyo University of Science, Tokyo, Japan
| | - Koshi Kataoka
- Division of Medical Education, Juntendo University School of Medicine, Tokyo, Japan
| | - Taro Shimizu
- Department of Diagnostic and Generalist Medicine, Dokkyo Medical University Hospital, Tochigi, Japan
| | - Yu Yamamoto
- Division of General Medicine, Center for Community Medicine, Jichi Medical University, Tochigi, Japan
| | - Sho Fukui
- Department of Emergency and General Medicine, Kyorin University, Tokyo, Japan
| | - Sho Nishiguchi
- Department of General Internal Medicine, Shonan Kamakura General Hospital, Kanagawa, Japan
| | - Kohta Katayama
- Division of General Internal Medicine, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Hiroyuki Kobayashi
- Department of Internal Medicine, Mito Kyodo General Hospital, University of Tsukuba, Ibaraki, Japan
| | - Yasuharu Tokuda
- Muribushi Okinawa Center for Teaching Hospitals, Okinawa, Japan
- Tokyo Foundation for Policy Research, Tokyo, Japan
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Ishikawa M. Overwork among resident physicians: national questionnaire survey results. BMC MEDICAL EDUCATION 2022; 22:729. [PMID: 36266644 PMCID: PMC9584270 DOI: 10.1186/s12909-022-03789-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 09/07/2022] [Accepted: 09/20/2022] [Indexed: 05/31/2023]
Abstract
BACKGROUND Residents experience the longest working hours among physicians. Thus, it would be beneficial to perform a nationwide survey in Japan on residents' long work hours and the background factors promoting upper limits on working hours of Japanese residents. The aim of this study was to study or assess the state of physicians' excessive work hours and its background factors using a questionnaire survey. METHODS The survey was sent to 924 hospitals. The physicians' general attributes, work hours and conditions, and employers' foundational entities were explored. Multiple logistic regression analysis was performed to elucidate the background factors for long work hours. RESULTS Of the 4306 resident physicians who responded, 67% had ≥ 60 in-hospital hours/week and 27% had ≥ 80 h/week; 51% were on-call ≥ four times/month. Many of them hoped for increased remuneration. Additionally, female (reference: male, OR: 0.65, 95% CI: 0.55-0.76), 35-40 years old (reference: 25-30 years old, OR: 1.83, 95% CI: 1.32-2.54), childlessness (reference: child, OR: 1.41, 95% CI: 1.12-1.75), surgical specialization (reference: internal medicine, OR: 2.51, 95% CI: 1.96-3.23), neurosurgical specialization (reference: internal medicine, OR: 4.38, 95% CI: 2.92-6.59) and hospitals with 200-400 physicians (reference: <100 physicians, OR: 1.82, 95% CI: 1.12-2.96) exhibited significant correlations with ≥ 80 in-hospital hours/week. CONCLUSION Understanding the factors that increase the likelihood of residents working very long hours could aid in making targeted changes to address the specific concerns. Moreover, reducing working hours to a reasonable limit can improve resident physicians' health and the quality of care they provide in their community.
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Affiliation(s)
- Masatoshi Ishikawa
- Faculty of Medicine, University of Tsukuba, 1 Chome-1-1 Tennodai, 305-8577, Tsukuba, Ibaraki, Japan.
- Research Institute, Tokyo Healthcare University, Shinagawa, Tokyo, Japan.
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AlSaif HI, Alenezi MN, Asiri M, Alshaibani KO, Alrasheed AA, Alsaad SM, Batais MA. Empathy among Saudi Residents at a Tertiary Academic Center during the COVID-19 Pandemic and Its Association with Perceived Stress. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58091258. [PMID: 36143935 PMCID: PMC9506239 DOI: 10.3390/medicina58091258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/06/2022] [Accepted: 09/07/2022] [Indexed: 11/29/2022]
Abstract
Background and Objectives: Empathy is an important attribute of a healthy doctor−patient relationship. Although multiple studies have assessed empathy in different countries, little is known about its levels among Saudi residents and its association with perceived stress. Objectives: To assess the levels of empathy and to identify if there is an association with stress in general and across the demographic and training characteristics of residents. Materials and Methods: A cross-sectional questionnaire-based study was carried out from December 2020 to March 2021 among residents training at a tertiary academic center in Riyadh, Saudi Arabia. Empathy and perceived stress were measured using the Jefferson Scale of Empathy (JSE) and the Perceived Stress Scale (PSS). Results: A total of 229 residents participated. The mean JSE score was 105.25 ± 15.35. The mean JSE scores were significantly higher among residents training in pediatrics (mean difference (MD) = 17.35, p < 0.001), family medicine (MD = 12.24, p = 0.007), and medical specialties (MD = 11.11, p = 0.012) when compared with surgical specialties and anesthesia. In addition, residents who worked 1−4 on-calls per month had a higher mean JSE score (MD = 11.23, p = 0.028) compared with those who worked 7 or more on-calls. Lastly, no correlation between empathy and perceived stress was detected in the whole sample (r = −0.007, p = 0.913); however, there was a correlation among residents training in medical specialties (r = −0.245, p = 0.025). Conclusion: Residents in our study had empathy levels comparable with Asian but lower than Western residents. We recommend qualitative studies that explore potential factors that might affect empathy among residents and studying the association between empathy and perceived stress among medical residents. Postgraduate curricula should incorporate interventions that foster a more empathetic doctor−patient relationship.
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Affiliation(s)
- Haytham I AlSaif
- Department of Family and Community Medicine, College of Medicine, King Saud University, P.O. Box 2925 (34), Riyadh 11461, Saudi Arabia
| | - Mamdouh N Alenezi
- Department of Family and Community Medicine, College of Medicine, King Saud University, P.O. Box 2925 (34), Riyadh 11461, Saudi Arabia
| | - Mohammed Asiri
- Department of Medicine, College of Medicine, King Saud University, P.O. Box 2925 (38), Riyadh 11461, Saudi Arabia
| | | | - Abdullah A Alrasheed
- Department of Family and Community Medicine, College of Medicine, King Saud University, P.O. Box 2925 (34), Riyadh 11461, Saudi Arabia
| | - Saad M Alsaad
- Department of Family and Community Medicine, College of Medicine, King Saud University, P.O. Box 2925 (34), Riyadh 11461, Saudi Arabia
| | - Mohammed A Batais
- Department of Family and Community Medicine, College of Medicine, King Saud University, P.O. Box 2925 (34), Riyadh 11461, Saudi Arabia
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Jacoby JL, Smith AB, Barraco RD, Greenberg MR, Donoghue EA, Kane BG, Macfarlan JE, Crowley LM, Weaver KR, Quinn JF. Do incoming residents vary in measures of emotional status even prior to residency training? INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2022; 13:198-204. [PMID: 35916647 PMCID: PMC9904997 DOI: 10.5116/ijme.62cb.f308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 07/11/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES To determine whether Empathy, Emotional Intelligence, and Burnout scores differ by specialty in incoming residents. METHODS This is a single-site, prospective, cross-sectional study. Three validated survey instruments, the Jefferson Scale of Physician Empathy, Maslach Burnout Inventory, and Emotional and Social Competency Inventory, were written into a survey platform as a single 125-question Qualtrics survey. Over three academic years, 2015-2017, 229 incoming residents across all specialties were emailed the survey link during orientation. Residents were grouped by incoming specialty with anonymity assured. A total of 229 responses were included, with 121 (52.8%) identifying as female. Statistical analysis was performed using the Analysis of Variance or Kruskal-Wallis test, Chi-Square or Fisher's Exact test, and Independent Samples t-test or Mann Whitney U test. A Bonferroni correction was applied for pairwise comparisons. RESULTS Family Medicine had a higher median Jefferson Scale of Physician Empathy score (127) compared to Emergency Medicine (115), (U=767.7, p=0.0330). Maslach Burnout Inventory depersonalization and personal accomplishment subcategory scores showed a significant difference between specialties when omnibus tests were performed, but pairwise comparisons with emergency medicine residents showed no differences. Differences were found in the Maslach Burnout Inventory categories of Depersonalization (χ2(8, N=229) =15.93, p=0.0434) and Personal Accomplishment level (χ2(8, N=229) =20.80, p=0.0077) between specialties. CONCLUSIONS Differences in measures of well-being exist across specialties, even prior to the start of residency training. The implication for educators of residency training is that some incoming residents, regardless of specialty, already exhibit troublesome features of burnout, and resources to effectively deal with these residents should be developed and utilized.
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Affiliation(s)
- Jeanne L. Jacoby
- Lehigh Valley Health Network, Department of Emergency and Hospital Medicine, University of South Florida Morsani College of Medicine (USF-MCOM), Schoenersville Road, Bethlehem, PA, USA
| | - Amy B. Smith
- Lehigh Valley Health Network, Department of Education, University of South Florida Morsani College of Medicine (USF-MCOM), Schoenersville Road, Bethlehem, PA, USA
| | - Robert D. Barraco
- Lehigh Valley Health Network, Department of Education, University of South Florida Morsani College of Medicine (USF-MCOM), Schoenersville Road, Bethlehem, PA, USA
| | - Marna Rayl Greenberg
- Lehigh Valley Health Network, Department of Emergency and Hospital Medicine, University of South Florida Morsani College of Medicine (USF-MCOM), Schoenersville Road, Bethlehem, PA, USA
| | - Elaine A. Donoghue
- Lehigh Valley Health Network, Department of Education, University of South Florida Morsani College of Medicine (USF-MCOM), Schoenersville Road, Bethlehem, PA, USA
| | - Bryan G. Kane
- Lehigh Valley Health Network, Department of Emergency and Hospital Medicine, University of South Florida Morsani College of Medicine (USF-MCOM), Schoenersville Road, Bethlehem, PA, USA
| | - Jennifer E. Macfarlan
- Lehigh Valley Health Network, Network Office of Research and Innovation, University of South Florida Morsani College of Medicine (USF-MCOM), Schoenersville Road, Bethlehem, PA, USA
| | - Lauren M. Crowley
- Lehigh Valley Health Network, Department of Emergency and Hospital Medicine, University of South Florida Morsani College of Medicine (USF-MCOM), Schoenersville Road, Bethlehem, PA, USA
| | - Kevin R. Weaver
- Lehigh Valley Health Network, Department of Emergency and Hospital Medicine, University of South Florida Morsani College of Medicine (USF-MCOM), Schoenersville Road, Bethlehem, PA, USA
| | - Joann Farrell Quinn
- University of South Florida Morsani College of Medicine (USF-MCOM), Tampa Campus, Tampa, FL, USA
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10
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Nagasaki K, Seo E, Maeno T, Kobayashi H. Diagnostic accuracy of the Single-item Measure of Burnout (Japanese version) for identifying medical resident burnout. J Gen Fam Med 2022; 23:241-247. [PMID: 35800639 PMCID: PMC9249940 DOI: 10.1002/jgf2.535] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 02/27/2022] [Accepted: 03/01/2022] [Indexed: 11/11/2022] Open
Abstract
Background Burnout is a psychological syndrome consisting of emotional exhaustion, cynicism, and decreased professional efficacy. The Maslach Burnout Inventory (MBI) is widely used as the standard measure. However, the MBI is lengthy and not free to use, which makes it a less than ideal tool for regularly assessing burnout. The single question burnout measure (SMB) is a novel and simple measure of burnout, which is associated well with emotional exhaustion and has sufficient diagnostic performance for burnout. This study aimed to evaluate the concurrent and convergent validity of the Japanese version of the single-item measure of burnout (SMB-J) compared with the MBI. Methods Ninety-four medical residents volunteered to complete the MBI-General Survey (MBI-GS) and the SMB-J. We assessed the concurrent (sensitivity and specificity) and convergent validity of the SMB-J compared with the MBI-GS. Results The sensitivity for identifying burnout using the SMB-J was 53.8%, and the specificity was 88.2%. The area under the receiver operating characteristic curve (AUC) was 0.71. MBI-GS scores on the subscales of Emotional Exhaustion (r = 0.509, p < 0.0001) and Cynicism (r = 0.57, p < 0.0001) strongly correlated with the SMB-J scores. Conclusions We concluded that for identifying burnout among Japanese medical residents, the psychometric properties of the SMB-J are comparable to those of the original version of the SMB. Although the SMB-J has low sensitivity to detect burnout, it is more convenient to use than the MBI.
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Affiliation(s)
- Kazuya Nagasaki
- Department of Internal MedicineMito Kyodo General HospitalUniversity of TsukubaIbarakiJapan
| | - Emiko Seo
- Center for Medical Education and TrainingUniversity of Tsukuba HospitalIbarakiJapan
| | - Tetsuhiro Maeno
- Department of General Medicine and Primary CareUniversity of Tsukuba HospitalIbarakiJapan
| | - Hiroyuki Kobayashi
- Department of Internal MedicineMito Kyodo General HospitalUniversity of TsukubaIbarakiJapan
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11
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Nishimura Y, Miyoshi T, Hagiya H, Otsuka F. Prevalence of psychological distress on public health officials amid COVID-19 pandemic. Asian J Psychiatr 2022; 73:103160. [PMID: 35594688 PMCID: PMC9098654 DOI: 10.1016/j.ajp.2022.103160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 05/04/2022] [Accepted: 05/06/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVES While the coronavirus disease 2019 (COVID-19) pandemic has led to increased burnout among frontline healthcare workers (HCWs), little research has been done regarding the potential psychological burden among public health officials who have worked tirelessly to tackle the pandemic from an administrative perspective. This study aimed to determine the prevalence of burnout, depression, and job-related stress in Japanese public health officers amid the COVID-19 pandemic. METHODS We conducted an anonymous, self-administered web-based cross-sectional survey including basic demographics, work-related questions, the Maslach Burnout Inventory, Patient Health Questionnaire-9, Utrecht Work Engagement Scale-3, and Brief Job Stress Questionnaire. 100 public health officers working in the public health centers (PHCs) in Okayama, Japan, answered the survey in December 2021 when the 5th surge in the number of COVID-19 was over. RESULTS The prevalence of burnout, depression, and job-related stress was 27%, 43%, and 62%, respectively. The multivariate logistic analysis demonstrated that females, public health nurses, and those who suffered from a lack of support from their workplaces were significantly associated with psychological distress. CONCLUSIONS While we tend to focus on mitigation plans to help alleviate burnout of frontline HCWs, more focus is needed to help public health officers, and public health nurses, in particular, to alleviate their psychological distress and job-related stress to prevent further staff shortages and secure sustainable health systems.
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Affiliation(s)
- Yoshito Nishimura
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 7008558, Japan; Department of Medicine, John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI 96813, USA.
| | - Tomoko Miyoshi
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 7008558, Japan
| | - Hideharu Hagiya
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 7008558, Japan
| | - Fumio Otsuka
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 7008558, Japan
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12
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BURNOUT SYNDROME IN DENTISTS: WORK-RELATED FACTORS. J Dent 2022; 121:104143. [DOI: 10.1016/j.jdent.2022.104143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 04/20/2022] [Accepted: 04/21/2022] [Indexed: 11/18/2022] Open
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13
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Nagasaki K, Nishizaki Y, Shinozaki T, Kobayashi H, Shimizu T, Okubo T, Yamamoto Y, Konishi R, Tokuda Y. Impact of the resident duty hours on in-training examination score: A nationwide study in Japan. MEDICAL TEACHER 2022; 44:433-440. [PMID: 34818129 DOI: 10.1080/0142159x.2021.2003764] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
PURPOSE The relationship between duty hours (DH) and the performance of postgraduate residents is needed to establish appropriate DH limits. This study explores their relationship using the General Medicine In-training Examination (GM-ITE). MATERIALS AND METHODS In this cross-sectional study, GM-ITE examinees of 2019 had participated. We analyzed data from the examination and questionnaire, including DH per week (eight categories). We examined the association between DH and GM-ITE score, using random-intercept linear models with and without adjustments. RESULTS Five thousand five hundred and ninety-three participants (50.7% PGY-1, 31.6% female, 10.0% university hospitals) were included. Mean GM-ITE scores were lower among residents in Category 2 (45-50 h; mean score difference, -1.05; p < 0.001) and Category 4 (55-60 h; -0.63; p = 0.008) compared with residents in Category 5 (60-65 h; Reference). PGY-2 residents in Categories 2-4 had lower GM-ITE scores compared to those in Category 5. University residents in Category 1 and Category 5 showed a large mean difference (-3.43; p = 0.01). CONCLUSIONS DH <60-65 h per week was independently associated with lower resident performance, but more DH did not improve performance. DH of 60-65 h per week may be the optimal balance for a resident's education and well-being.
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Affiliation(s)
- Kazuya Nagasaki
- Department of Internal Medicine, Mito Kyodo General Hospital, University of Tsukuba, Ibaraki, Japan
| | - Yuji Nishizaki
- Division Medical Education, Juntendo University School of Medicine, Tokyo, Japan
| | - Tomohiro Shinozaki
- Department of Information and Computer Technology, Faculty of Engineering, Tokyo University of Science, Tokyo, Japan
| | - Hiroyuki Kobayashi
- Department of Internal Medicine, Mito Kyodo General Hospital, University of Tsukuba, Ibaraki, Japan
| | - Taro Shimizu
- Department of Diagnostic and Generalist Medicine, Dokkyo Medical University Hospital, Tochigi, Japan
| | - Tomoya Okubo
- Research Division, National Center for University Entrance Examinations, Tokyo, Japan
| | - Yu Yamamoto
- Division of General Medicine, Center for Community Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Ryota Konishi
- Education Adviser Japan Organization of Occupational Health and Safety, Kanagawa, Japan
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14
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Ishikawa M. Relationships between overwork, burnout and suicidal ideation among resident physicians in hospitals in Japan with medical residency programmes: a nationwide questionnaire-based survey. BMJ Open 2022; 12:e056283. [PMID: 35273058 PMCID: PMC8915267 DOI: 10.1136/bmjopen-2021-056283] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES This study examined the relationships between overwork, burnout and suicidal ideation among resident physicians working in hospitals throughout Japan. DESIGN A nationwide, questionnaire-based survey. SETTING Participating hospitals (n=416) were accredited by the Japanese Medical Specialty Board to offer medical residency programmes in 19 core specialties. Surveys were conducted in October 2020. PARTICIPANTS Valid responses were obtained from 4306 physicians (response rate: 49%). OUTCOME MEASURES Items pertaining to the Japanese Burnout Scale, depressive tendencies and suicidal ideation were included in questionnaires. Multiple regression analyses were performed: suicidal ideation was the response variable; sex, age, core specialty, marital status, income, weekly working hours and workplace (ownership, number of beds, number of full-time physicians and regional classification) were explanatory variables. RESULTS Regarding the Japanese Burnout Scale, the highest score was recorded for 'sense of personal accomplishment', followed by 'emotional exhaustion' and 'depersonalization'. Increased emotional exhaustion and depersonalisation were associated with longer working hours, but there was no such trend for sense of personal accomplishment. Depressive tendencies and suicidal ideation were noted in 24.1% and 5.6% of respondents, respectively. These percentages tended to increase when respondents worked longer hours. Several factors were significantly associated with suicidal ideation: female sex (reference: male, OR: 2.08, 95% CI: 1.56 to 2.77), ≥12 million yen income (reference: <2 million yen, OR: 0.21, 95% CI: 0.05 to 0.79), ≥100 working hours/week (reference:<40 hours/week, OR: 3.64, 95% CI: 1.88 to 7.04) and 600-799 hospital beds (reference: <200 beds, OR: 0.23, 95% CI: 0.07 to 0.82). CONCLUSIONS Many Japanese residents demonstrated a tendency to experience burnout and suicidal ideation. Female sex, low income, long working hours and insufficient hospital beds were associated with suicidal ideation. To ensure physicians' health and patients' safety, it is necessary to advance workstyle reform for physicians.
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Affiliation(s)
- Masatoshi Ishikawa
- Department of Health Services Research, University of Tsukuba, Tsukuba, Ibaraki, Japan
- Tokyo Healthcare University, Gotanda, Tokyo, Japan
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15
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Nishimura Y, Miyoshi T, Sato A, Hasegawa K, Hagiya H, Kosaki Y, Otsuka F. Burnout of Healthcare Workers Amid the COVID-19 Pandemic: A Follow-Up Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111581. [PMID: 34770095 PMCID: PMC8582846 DOI: 10.3390/ijerph182111581] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 11/01/2021] [Accepted: 11/02/2021] [Indexed: 12/28/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has posed a significant challenge to the modern healthcare system and led to increased burnout among healthcare workers (HCWs). We previously reported that HCWs who engaged in COVID-19 patient care had a significantly higher prevalence of burnout (50.0%) than those who did not in November 2020 (period 1). We performed follow-up surveys in HCWs in a Japanese national university hospital, including basic demographics, whether a participant engaged in care of COVID-19 patients in the past 2 weeks, and the Maslach Burnout Inventory in February 2021 (period 2) and May 2021 (period 3). Periods 1 and 3 were amid the surges of COVID-19 cases, and period 2 was a post-surge period with a comparatively small number of COVID-19 patients requiring hospitalization. Response rates to the surveys were 33/130 (25.4%) in period 1, 36/130 (27.7%) in period 2, and 56/162 (34.6%) in period 3, respectively. While no consistent tendency in the prevalence of burnout based on variables was observed throughout the periods, the prevalence of burnout tends to be higher in periods 1 and 3 in those who engaged in COVID-19 patient care in the last 2 weeks (50.0%, 30.8%, 43.1% in period 1, 2, and 3, respectively). Given the prolonged pandemic causing stigmatization and hatred against HCWs leading to increased prevalence of burnout, high-level interventions and supports are warranted.
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Affiliation(s)
- Yoshito Nishimura
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 7008558, Japan; (T.M.); (K.H.); (H.H.); (F.O.)
- Department of Medicine, John A. Burns School of Medicine, University of Hawai’i, Honolulu, HI 96822, USA
- Correspondence:
| | - Tomoko Miyoshi
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 7008558, Japan; (T.M.); (K.H.); (H.H.); (F.O.)
| | - Asuka Sato
- Center for Graduate Medical Education, Okayama University Hospital, Okayama 7008558, Japan;
| | - Kou Hasegawa
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 7008558, Japan; (T.M.); (K.H.); (H.H.); (F.O.)
| | - Hideharu Hagiya
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 7008558, Japan; (T.M.); (K.H.); (H.H.); (F.O.)
| | - Yoshinori Kosaki
- Center for Education in Medicine and Health Sciences, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 7008558, Japan;
| | - Fumio Otsuka
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 7008558, Japan; (T.M.); (K.H.); (H.H.); (F.O.)
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Roslan NS, Yusoff MSB, Ab Razak A, Morgan K, Ahmad Shauki NI, Kukreja A, Rahmat N, Andrew CRW, Shaharudin Basri MF, Abd Mokti AS, Md Yazid NH, Ismail M, Bakit P. Training Characteristics, Personal Factors and Coping Strategies Associated with Burnout in Junior Doctors: A Multi-Center Study. Healthcare (Basel) 2021; 9:healthcare9091208. [PMID: 34574982 PMCID: PMC8472197 DOI: 10.3390/healthcare9091208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 09/03/2021] [Accepted: 09/10/2021] [Indexed: 11/16/2022] Open
Abstract
Physician burnout has been recognized as a public health crisis. However, there is a paucity of burnout studies in the context of medical internship. We assessed the prevalence and relationship between various training characteristics, personal variables, resilience, and coping with burnout in a cross-sectional study involving 837 interns from ten hospitals across Malaysian healthcare system. The instrument package included demographic questions, the Connor-Davidson Resilience Scale, Brief COPE and the Copenhagen Burnout Inventory. A total of 754 (90.1%) interns completed the inventories. We found a high prevalence of personal-related (73.3%), work-related (69.1%), and patient-related (43.4%) burnout among Malaysian interns. Multivariable analysis showed female gender (odds ratio (OR):1.50; 95% confidence interval (CI): 1.02-2.20), prior work experience (OR: 1.56; 95% CI: 1.05-2.30), and irregular spirituality routines (OR: 1.97; 95% CI: 1.30-2.99) were associated with increased odds of personal-related burnout. Irregular spirituality routines (OR: 2.24; 95% CI: 1.49-3.37) were associated with work-related burnout, while living with other people (OR: 1.77; 95% CI: 1.15-2.73) was associated with patient-related burnout. Lower resilience levels and avoidant copings were associated with personal-, work-, and patient-related burnout. Burnout prevalence among interns is high. The findings support the value of individual-targeted alongside organizational-targeted intervention in burnout reduction. As burnout is prevalent in both years of internship training, ongoing burnout prevention and wellbeing measures are deemed necessary.
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Affiliation(s)
- Nurhanis Syazni Roslan
- Department of Medical Education, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu 16150, Malaysia; (M.S.B.Y.); (M.F.S.B.)
- Correspondence:
| | - Muhamad Saiful Bahri Yusoff
- Department of Medical Education, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu 16150, Malaysia; (M.S.B.Y.); (M.F.S.B.)
| | - Asrenee Ab Razak
- Department of Psychiatry, School of Medical Sciences, Universiti Sains Malaysia and Hospital USM, Universiti Sains Malaysia, Kota Bharu 16150, Malaysia;
| | - Karen Morgan
- Perdana University-Royal College of Surgeons in Ireland School of Medicine, Perdana University, Kuala Lumpur 50490, Malaysia;
- Department of Health Psychology, Royal College of Surgeons in Ireland, D02 YN77 Dublin, Ireland
| | - Nor Izzah Ahmad Shauki
- Institute for Health Systems Research, National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia;
| | - Anjanna Kukreja
- Department of Medicine, University Malaya Medical Centre, Kuala Lumpur 59100, Malaysia;
| | - Norashidah Rahmat
- Department of Pathology, Hospital Sultanah Aminah Johor Bahru, Ministry of Health, Johor Bahru 80100, Malaysia;
| | - Chin Ri Wei Andrew
- Department of General Surgery, Hospital Queen Elizabeth, Kota Kinabalu, Ministry of Health, Kota Kinabalu 88200, Malaysia;
| | - Muhammad Fikri Shaharudin Basri
- Department of Medical Education, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu 16150, Malaysia; (M.S.B.Y.); (M.F.S.B.)
| | | | - Nur Haziyah Md Yazid
- Hospital Tunku Azizah, Jalan Raja Muda Abdul Aziz, Kampung Baru, Ministry of Health, Kuala Lumpur 50300, Malaysia;
| | - Munirah Ismail
- Institute for Health Management, National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia; (M.I.); (P.B.)
| | - Pangie Bakit
- Institute for Health Management, National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia; (M.I.); (P.B.)
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17
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Nagasaki K, Shikino K, Nishimura Y, Kuriyama A, Nonaka S, Izumiya M, Makiishi T. Translation, Cultural Adaptation, and Validation of the Mini-Z 2.0 Survey among Japanese Physicians and Residents. Intern Med 2021; 60:2405-2411. [PMID: 33612686 PMCID: PMC8381173 DOI: 10.2169/internalmedicine.6749-20] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objective The Mini-Z 2.0 is a new, simple, and nonproprietary tool for assessing physician well-being and burnout. To date, a non-English version of the Mini-Z 2.0 survey has not been validated. Therefore, we aimed to develop a Japanese version of the Mini-Z 2.0 and to evaluate its validity and reliability using survey data from physicians affiliated with an internal medicine academic society. Methods The Mini-Z 2.0 survey was translated into Japanese using a forward-backward translation method. The participants belonged to the American College of Physicians' Japan Chapter. The translated version of the Mini-Z 2.0 survey was distributed to participants using an electronic mailing list. Convergent validity was assessed between burnout and other items using Pearson's product-moment statistic. Structural validity was evaluated using an exploratory factor analysis and confirmatory factor analysis, and reliability was assessed using internal consistency. Results Of the 1,255 physicians and medical residents contacted, 283 responded (22.5%). Burnout was present in 34.6% of the participants, with 48.8% reporting high stress levels. Convergent validity was demonstrated, with satisfactory correlations between burnout and satisfaction, value alignment, work control, and stress. An exploratory factor analysis identified two factors (i.e., Well-Being and Relationships and Work-Related Stressors); however, the three models evaluated using the confirmatory factor analysis revealed a poor fit. Cronbach's alpha for the sample was 0.80. Conclusion The Japanese version of the Mini-Z 2.0 demonstrated good internal consistency and convergent validity. Despite its inadequate structural validity, it can be used to measure physician well-being and related workplace conditions in Japan.
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Affiliation(s)
- Kazuya Nagasaki
- Department of Internal Medicine, Mito Kyodo General Hospital, University of Tsukuba, Japan
| | - Kiyoshi Shikino
- Department of General Medicine, Chiba University Hospital, Japan
| | - Yoshito Nishimura
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan
| | - Akira Kuriyama
- Emergency and Critical Care Center, Kurashiki Central Hospital, Japan
| | | | - Masashi Izumiya
- Department of Medical Education Studies, International Research Center for Medical Education, Graduate School of Medicine, The University of Tokyo, Japan
| | - Tetsuya Makiishi
- Department of General Medicine, Faculty of Medicine, Shimane University, Japan
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18
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Abstract
Objective We examined the prevalence of burnout among resident doctors and its relationship with specific stressors. Method We conducted a nationwide, online, cross-sectional survey in Japan with 604 resident doctors in 2018-2019. Materials Participants completed the Maslach Burnout Inventory-General Survey to evaluate burnout and provided details of their individual factors and working environmental factors. Chi-square tests and t-tests were conducted for categorical and continuous variables, respectively. The association between burnout and resident-reported causes of stress, ways of coping with stress, number of times patient-safety incidents were likely to occur, and individuals who provide support when in trouble was analyzed using logistic regression analyses after controlling for confounding variables. Results A total of 28% met the burnout criteria, 12.2% were exhausted, 2.8% were depressed, and 56.9% were healthy. After adjusting for sex, postgraduate years, type of residency program, marital status, number of inpatients under residents' care, number of working hours, number of night shifts, number of days off, and resident-reported causes of stress - excessive paperwork [odds ratio (OR): 2.24, 95% confidence interval (CI): 1.32-3.80], excessive working hours (OR: 2.75, 95% CI: 1.24-6.04), low autonomy (OR: 3.92, 95% CI: 2.01-7.65), communication problems at the workplace (OR: 2.24, 95% CI: 1.05-4.76), complaints from patients (OR: 6.62, 95% CI: 1.21-36.1), peer competition (OR: 2.22, 95% CI: 1.25-3.93), and anxiety about the future (OR: 2.13, 95% CI: 1.28-3.56) - were independently associated with burnout. The burnout group had more reported patient-safety incidents that were likely to occur per year (>10) (OR: 2.65, 95% CI: 1.01-6.95) and a lack of individuals who could provide support when in trouble (OR: 1.83, 95% CI: 1.01-3.34) than the non-burnout group. Conclusion This study described the prevalence of burnout among residents who responded to our survey. We detected an association between burnout and resident-reported causes of stress, patient-safety incidents, and a lack of individuals who provide support when in trouble. Further interventional studies targeting ways to reduce these concerns are warranted.
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Affiliation(s)
- Takahiro Matsuo
- Department of Infectious Diseases, St. Luke's International Hospital, Japan
| | - Osamu Takahashi
- Department of General Internal Medicine, St. Luke's International Hospital, Japan
- Graduate School of Public Health, St. Luke's International University, Japan
| | | | - Hiroko Arioka
- Department of General Internal Medicine, St. Luke's International Hospital, Japan
| | - Daiki Kobayashi
- Department of General Internal Medicine, St. Luke's International Hospital, Japan
- Graduate School of Public Health, St. Luke's International University, Japan
- Department of Community-Based Medicine, Fujita Health University, Japan
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Nishizawa T, Yoshida S, Toyoshima O, Matsuno T, Irokawa M, Arano T, Ebinuma H, Suzuki H, Kanai T, Koike K. Risk Factors for Prolonged Hospital Stay after Endoscopy. Clin Endosc 2021; 54:851-856. [PMID: 33721977 PMCID: PMC8652156 DOI: 10.5946/ce.2020.292] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 12/30/2020] [Indexed: 01/21/2023] Open
Abstract
Background/Aims The recovery room used after endoscopy has limited capacity, and an efficient flow of the endoscopy unit is desired. We investigated the duration of hospital stay after endoscopy and the risk factors for prolonged hospital stay among outpatients.
Methods We retrospectively studied consecutive patients who underwent esophagogastroduodenoscopy or colonoscopy at the Toyoshima Endoscopy Clinic. We collected data on age, sex, body weight, midazolam and pethidine dosage, respiratory depression during endoscopy, and duration of hospital stay after endoscopy (scope out to check out). Risk factors for prolonged hospital stay (>100 minutes) were identified using multiple logistic regression analysis.
Results We enrolled 3,898 patients, including 3,517 (90.2%) patients tested under sedation and 381 (9.8%) patients tested without sedation. Overall, 442 (11.3%) patients had prolonged stay (>100 min). The mean time difference between sedation group and non-sedation group was 44.2 minutes for esophagogastroduodenoscopy and 39.1 minutes for colonoscopy. Age (odds ratio [OR], 1.025; 95% confidence interval [CI], 1.014−1.036), female sex (OR, 1.657; 95% CI, 1.220−2.249), and midazolam dose (OR, 1.019; 95% CI, 1.013−1.026) were independently associated with prolonged hospital stay after esophagogastroduodenoscopy, with similar results for colonoscopy.
Conclusions Old age, female sex, and midazolam dose were independent risk factors for prolonged hospital stay after endoscopy.
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Affiliation(s)
- Toshihiro Nishizawa
- Gastroenterology, Toyoshima Endoscopy Clinic, Tokyo, Japan.,Department of Gastroenterology and Hepatology, International University of Health and Welfare, Narita Hospital, Narita, Japan
| | - Shuntaro Yoshida
- Gastroenterology, Toyoshima Endoscopy Clinic, Tokyo, Japan.,Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Osamu Toyoshima
- Gastroenterology, Toyoshima Endoscopy Clinic, Tokyo, Japan.,Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tatsuya Matsuno
- Gastroenterology, Toyoshima Endoscopy Clinic, Tokyo, Japan.,Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masataka Irokawa
- Gastroenterology, Toyoshima Endoscopy Clinic, Tokyo, Japan.,Gastroenterology, Sanraku Hospital, Tokyo, Japan
| | - Toru Arano
- Gastroenterology, Toyoshima Endoscopy Clinic, Tokyo, Japan.,Gastroenterology, The Fraternity Memorial Hospital, Tokyo, Japan
| | - Hirotoshi Ebinuma
- Department of Gastroenterology and Hepatology, International University of Health and Welfare, Narita Hospital, Narita, Japan
| | - Hidekazu Suzuki
- Department of Gastroenterology and Hepatology, Tokai University School of Medicine, Isehara, Japan
| | - Takanori Kanai
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Kazuhiko Koike
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Burnout of Healthcare Workers amid the COVID-19 Pandemic: A Japanese Cross-Sectional Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052434. [PMID: 33801349 PMCID: PMC7967555 DOI: 10.3390/ijerph18052434] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 02/22/2021] [Accepted: 02/24/2021] [Indexed: 12/22/2022]
Abstract
The coronavirus disease 2019 (COVID-19) global pandemic has drastically changed how we live and work. Amid the prolonged pandemic, burnout of the frontline healthcare professionals has become a significant concern. We conducted a cross-sectional survey study to provide data about the relationship between the COVID-19 pandemic and the prevalence of burnout in healthcare professionals in Japan. Healthcare workers in a single Japanese national university hospital participated in the survey, including basic demographics, whether a participant engaged in care of COVID-19 patients in the past 2 weeks and the Maslach Burnout Inventory. Of those, 25.4% fully answered the survey; 33.3% were doctors and 63.6% were nurses, and 36.3% engaged in care of COVID-19 patients in the past 2 weeks. Compared to those belonging to General Medicine, those in Emergency Intensive Care Unit were at higher risk of burnout (odds ratio (OR), 6.7; 95% CI, 1.1–42.1; p = 0.031). Of those who engaged in care of COVID-19 patients, 50% reported burnout while 6.1% did not (OR 8.5, 95% CI; 1.3–54.1; p = 0.014). The burnout of healthcare workers is a significant concern amid the pandemic, which needs to be addressed for sustainable healthcare delivery.
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Nimer A, Naser S, Sultan N, Alasad RS, Rabadi A, Abu-Jubba M, Al-Sabbagh MQ, Jaradat KM, AlKayed Z, Aborajooh E, Daradkeh S, Abufaraj M. Burnout Syndrome during Residency Training in Jordan: Prevalence, Risk Factors, and Implications. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1557. [PMID: 33562100 PMCID: PMC7914676 DOI: 10.3390/ijerph18041557] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 02/02/2021] [Accepted: 02/03/2021] [Indexed: 12/13/2022]
Abstract
Burnout syndrome is common among healthcare professions, including resident physicians. We aimed to assess the prevalence of burnout among resident physicians in Jordan, and a secondary aim was to evaluate the risk factors associated with the development of burnout syndrome in those residents, including gender, working hours, psychological distress, training sector, and specialty. In this cross-sectional study, 481 residents were recruited utilizing multistage stratified sampling to represent the four major health sectors in Jordan. Data were collected using an online questionnaire, where the Copenhagen Burnout Inventory (CBI) was used to assess the prevalence of burnout. The prevalence, group differences, and predictors of burnout were statistically analyzed using STATA 15. Overall, 373 (77.5%) residents were found to have burnout. Factors associated with higher levels of burnout were psychological stress (β = 2.34, CI = [1.88-2.81]), longer working hours (β = 4.07, CI = [0.52-7.62], for 51-75 h a week, β = 7.27, CI = [2.86-11.69], for 76-100 h a week and β = 7.27, CI = [0.06-14.49], for >100 h a week), and obstetrics/gynecology residents (β = 9.66, CI = [3.59-15.73]). Conversely, medical sub-specialty residents, as well as private and university hospital residents, had lower burnout levels. We concluded that decreasing the workload on residents, offering psychological counseling, and promoting a safety culture for residents might help in mitigating burnout consequences.
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Affiliation(s)
- Abdullah Nimer
- School of Medicine, The University of Jordan, Amman 11942, Jordan; (A.N.); (S.N.); (N.S.); (R.S.A.); (A.R.); (M.A.-J.)
| | - Suzan Naser
- School of Medicine, The University of Jordan, Amman 11942, Jordan; (A.N.); (S.N.); (N.S.); (R.S.A.); (A.R.); (M.A.-J.)
| | - Nesrin Sultan
- School of Medicine, The University of Jordan, Amman 11942, Jordan; (A.N.); (S.N.); (N.S.); (R.S.A.); (A.R.); (M.A.-J.)
| | - Rawand Said Alasad
- School of Medicine, The University of Jordan, Amman 11942, Jordan; (A.N.); (S.N.); (N.S.); (R.S.A.); (A.R.); (M.A.-J.)
| | - Alexander Rabadi
- School of Medicine, The University of Jordan, Amman 11942, Jordan; (A.N.); (S.N.); (N.S.); (R.S.A.); (A.R.); (M.A.-J.)
| | - Mohammed Abu-Jubba
- School of Medicine, The University of Jordan, Amman 11942, Jordan; (A.N.); (S.N.); (N.S.); (R.S.A.); (A.R.); (M.A.-J.)
| | - Mohammed Q. Al-Sabbagh
- Medical internship, Jordan University Hospital, The University of Jordan, Amman 11942, Jordan;
| | - Khaldoon M. Jaradat
- Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman 11942, Jordan;
| | - Zaid AlKayed
- Department of Psychiatry, Jordan University Hospital, The University of Jordan, Amman 11942, Jordan;
| | - Emad Aborajooh
- Department of General Surgery and Anesthesia, Faculty of Medicine, Mutah University, Kerak 61710, Jordan;
| | - Salam Daradkeh
- Department of General Surgery, Jordan University Hospital, The University of Jordan, Amman 11942, Jordan;
| | - Mohammad Abufaraj
- Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman 11942, Jordan;
- Department of Urology, Medical University of Vienna, 1090 Vienna, Austria
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Kodama T, Ida Y, Miura H. A Nationwide Survey on Working Hours and Working Environment among Hospital Dentists in Japan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17239048. [PMID: 33291636 PMCID: PMC7730468 DOI: 10.3390/ijerph17239048] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 12/01/2020] [Accepted: 12/02/2020] [Indexed: 11/16/2022]
Abstract
Sustainable human resource is one of the main issues in healthcare delivery and the way hospital dentists work has a significant impact on oral and dental healthcare services. This study is the first large-scale nationwide survey aiming to investigate the working hours including the working environment among hospital dentists in Japan. A total of 2914 hospital dentists responded to self-administered questionnaires from general hospitals (GHs) and medical educational institutions (MEIs) across the country. Among full-time dentists, the younger generation (i.e., those in their 20s and 30s) of both male and female dentists working in GHs engage in over 40 h of in-hospital clinical practice per week, apart from their self-learning hours. In contrast, the middle-aged dentists (i.e., those in their 40s and 50s) at MEIs work for more than 50 h on average due to the added teaching and research responsibilities. In a multiple logistic regression model using "more than 60 h of work per week" as the dependent variable, higher ORs (Odds Ratios) were found in males (OR = 1.83, 95%CI 1.50-2.22), MEIs (OR = 1.92, 1.52-2.42), and individuals specializing in dental and oral surgery (OR = 1.85, 1.47-2.32). Task-shifting was requested by 22.6% of the respondents for preventive care and dental guidance. Only a few male dentists experienced taking a parental leave and the peak distribution of working hours was shorter for females working in GHs. The support for child-rearing in the work environment is still insufficient and a consensus on the involvement of male dentists in childcare is needed.
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Affiliation(s)
- Tomoko Kodama
- Department of International Health and Collaboration, National Institute of Public Health, Wako 351-0197, Japan
- Correspondence: ; Tel.: +81-48-458-6150
| | - Yusuke Ida
- Healthcare Executive Program, Graduate School of Medicine, the University of Tokyo, Tokyo 113-0033, Japan;
| | - Hiroko Miura
- Division of Disease Control and Epidemiology, School of Dentistry, Health Sciences University of Hokkaido, Hokkaido 061-0293, Japan;
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Jean WC, Ironside NT, Felbaum DR, Syed HR. The Impact of Work-Related Factors on Risk of Resident Burnout: A Global Neurosurgery Pilot Study. World Neurosurg 2020; 138:e345-e353. [DOI: 10.1016/j.wneu.2020.02.115] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 02/18/2020] [Accepted: 02/19/2020] [Indexed: 01/08/2023]
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Grover S, Sahoo S, Bhalla A, Avasthi A. Burnout in medical professionals working in a tertiary care hospital: A re-analysis of the data. JOURNAL OF MENTAL HEALTH AND HUMAN BEHAVIOUR 2019. [DOI: 10.4103/jmhhb.jmhhb_63_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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