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Stouder A, Ayars CL. Burnout, Personal, and Occupational Factors as Predictors of Physician Assistant Faculty Intent to Leave After the COVID-19 Pandemic. J Physician Assist Educ 2024:01367895-990000000-00133. [PMID: 38595214 DOI: 10.1097/jpa.0000000000000579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
INTRODUCTION This study addressed whether burnout, personal, or occupational factors predicted physician assistant (PA) faculty intent to leave and established a new postpandemic national benchmark for PA faculty burnout and intent to leave. METHODS In spring 2023, a nonexperimental, cross-sectional survey was emailed to 2031 PA faculty drawn from program faculty listings and the PA Education Association member database. Descriptive statistics were used to describe the sample, and a multiple regression analysis was conducted to analyze the predictive ability of the independent variables on intent to leave. RESULTS The response rate was 30% (609 of 2031), with 496 responses (24.4%) included in the analysis. The sample reflected the population of PA faculty. The regression model significantly predicted intent leave (P < .001). The adjusted R2 was 0.46, indicating the combination of independent variables predicted 46% of the variance in PA faculty intent to leave. Significant predictors included emotional exhaustion and identifying as multiracial (P < .001), control and values (P < .01), and depersonalization, fairness, rewards, and clinical year faculty role (P < .05). The sample had moderate levels of burnout and experienced burnout at higher rates than in prepandemic studies. Physician assistant faculty in administrative leadership roles had the highest levels of burnout and intent to leave. Despite this, PA faculty intent to leave measures were similar to prepandemic levels. DISCUSSION Several of the predictive variables were related to well-being and social-emotional aspects of the workplace. These findings have implications for institutional policies and practices that support faculty well-being and workplace culture to enhance retention.
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Affiliation(s)
- April Stouder
- April Stouder, EdD, MHS, PA-C, is an associate professor, associate program director of Duke Physician Assistant Program, Durham, North Carolina
- Candace L. Ayars, PhD, is an associate professor, A.T. Still University, College of Graduate Health Studies, Kirksville, Missouri
| | - Candace L Ayars
- April Stouder, EdD, MHS, PA-C, is an associate professor, associate program director of Duke Physician Assistant Program, Durham, North Carolina
- Candace L. Ayars, PhD, is an associate professor, A.T. Still University, College of Graduate Health Studies, Kirksville, Missouri
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Ma Y, Xie T, Zhang J, Yang H. The prevalence, related factors and interventions of oncology nurses' burnout in different continents: A systematic review and meta-analysis. J Clin Nurs 2023; 32:7050-7061. [PMID: 37492975 DOI: 10.1111/jocn.16838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 06/01/2023] [Accepted: 07/14/2023] [Indexed: 07/27/2023]
Abstract
BACKGROUND Burnout is a significant occupational problem among oncology nurses, affecting their physical and mental health and the quality of medical care. Besides, there is a gradually increasing trend that we should pay more attention to. OBJECTIVES To investigate the prevalence, influencing factors and interventions of oncology nurses' burnout among different continents. DESIGN Systematic review and meta-analysis. DATA SOURCES English literature in PubMed, EMBASE, MEDLINE/EBSCOhost, CINAHL Complete and Web and of Science were searched before 1 March 2022. RESULTS Twenty studies included 5904 oncology nurses in this review. Meta-analysis was performed in 19 of the studies. First, the pooled mean scores estimate for emotional exhaustion (EE) was 22.13 (95% CI: 19.69-24.58), depersonalization (DP) was 6.89 (95% CI: 5.67-8.10) and personal accomplishment (PA) was 32.86 (95% CI: 29.34-36.37). A high level of burnout was defined as a high level of EE (score ≥ 27), a high level of DP (score ≥ 10), and a low level of PA (score ≤ 33). Of these, 36.40% of nurses reported high EE, 28.26% reported high DP and 28.68% reported low levels of PA. Furthermore, there are differences in the prevalence, influencing factors and intervention measures of burnout among oncology nurses in different regions. The highest pooled mean scores for EE and DP were found in Asia. And the highest pooled mean scores for PA were found in the Americas. The factors that influence burnout among Asian oncology nurses are mostly personal-related factors such as empathy and personality traits, while the factors that influence burnout among European oncology nurses are work-related factors. This review included three intervention studies from Europe and the Americas, with fewer intervention studies on burnout in oncology nurses in Asia. CONCLUSION Oncology nurses in Asia had the highest pooled mean scores for EE and DP, and the highest mean scores for the PA pool in the Americas. There are regional differences in the prevalence and factors influencing burnout among oncology nurses, but there are few interventions for it. Therefore, future interventions should be developed to address the differences that exist in different regions. RELEVANCE TO CLINICAL PRACTICE Burnout among oncology nurses in different regions is a concern, and this review may provide a reference for managers to target interventions to alleviate burnout among oncology nurses.
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Affiliation(s)
- Yao Ma
- Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Tian Xie
- Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China
| | - Jian Zhang
- Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China
| | - Hui Yang
- Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China
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Zhang F, Lin C, Li X, Li M, Jia R, Guo X, Bai H. The relationships between burnout, general wellbeing, and psychological detachment with turnover intention in Chinese nurses: a cross-sectional study. Front Public Health 2023; 11:1216810. [PMID: 37546331 PMCID: PMC10399590 DOI: 10.3389/fpubh.2023.1216810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 06/30/2023] [Indexed: 08/08/2023] Open
Abstract
Background It is critical to minimize nurse turnover to improve the quality of care and patient safety. In-depth investigation is required to better understand the factors related to nurses' turnover intentions. Aim This study aimed to determine the relationships between burnout, general wellbeing, and psychological detachment with turnover intention among nurses in China. Methods A cross-sectional survey using convenience sampling was conducted in one hospital in China between January 2023 and March 2023. A total of 536 nurses were surveyed using the General Wellbeing Schedule (GWB), the Maslach Burnout Inventory scale (MBI), the Psychological Detachment scale, and the Turnover Intention scale. The collected data were analyzed using SPSS 26.0 statistical software. The chi-square test and binary logistic regression analysis were used to explore the factors related to turnover intention. Results Our data demonstrated that the turnover intention scores were 13 (10, 15.75), with 56% of nurses exhibiting a high level of turnover intention. Binary logistic regression analysis results indicated that being on a contract (OR = 4.385, 95% CI = 2.196-8.754), working in the pediatrics (OR = 2.392, 95% CI = 1.267-4.514) or obstetrics (OR = 2.423, 95% CI = 1.145-5.126) department, and experiencing burnout (OR = 1.024, 95% CI = 1.008-1.041) were associated with a heightened level of turnover intention. Conversely, organizational satisfaction (OR = 0.162, 95% CI = 0.033-0.787) and general wellbeing (OR = 0.967, 95% CI = 0.946-0.989) were identified as factors that hindered the intention to leave. Conclusions Findings from this study suggest that nurses were employed on a contract basis, working in pediatric or obstetric departments, expressing dissatisfaction with the organization, reporting low general wellbeing, and experiencing high levels of burnout that require special attention. The identification of these risk factors can inform targeted interventions and support programs aimed at improving the wellbeing and retention of nurses in these settings.
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Affiliation(s)
- Fengzhi Zhang
- Department of Nursing, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Chunhui Lin
- Department of Nursing, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiaoxue Li
- Department of Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Manman Li
- Department of Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ruolin Jia
- Department of Reproduction, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiaoli Guo
- Department of Administration Office, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Hua Bai
- Department of Infection Control, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Graham LJ, Hite A, Harris J, Belcher G. Silent Conversations: Goals of Care and End-of-Life Quality in Relapsed High-Risk Leukemia. J Adv Pract Oncol 2023; 14:380-387. [PMID: 37576364 PMCID: PMC10414529 DOI: 10.6004/jadpro.2023.14.5.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2023] Open
Abstract
Background Advanced practice providers (APPs) affect high-quality health care through leadership, evidence-based practice implementation, and quality improvement projects. When planning solutions to clinical problems, leadership must solicit APP input to promote success. Hematology patients are more likely to receive poor-quality end-of-life (EOL) care than those with solid tumors. Regardless of disease, aggressive EOL care is increasing despite evidence that it is often inconsistent with patients' goals of care (GOC). Data regarding this phenomenon in hematology specifically is lacking. The distorted association of "end of life" with "goals of care" has "silenced" crucial goals discussions in patients with relapsed or refractory high-risk leukemia, which raises concerns for the provision of care that is inconsistent with patients' values and preferences. Hematologists may possess certain traits and distinct barriers leading to what one might call an aversion to GOC discussions in the inpatient setting. Aims (1) Quantify hematologists' rate of participation in a GOC pathway initiative during two separate months. (2) Explore the hematologists' definition of and barriers to having GOC discussions. Design This is a mixed-methods, explanatory sequential design (follow-up explanations variant). Sample Quantitative: Hematology inpatient admissions during two nonconsecutive months in 2021. Qualitative: Eighteen leukemia hematologists from one dedicated cancer center. Results During the 2 months, an average of 36% of admissions met the criteria for GOC pathway initiation, 19% of those had an appropriate initiation order, and < 1% had a properly documented and billed GOC discussion. Nine hematologists responded to a SurveyMonkey poll with two questions. All nine included clinical situation and communication in their definition of GOC discussions. Time limitations and prognostic uncertainty were the two most reported barriers. Discussion The findings demonstrate that the apprehension of hematologists to have GOC conversations is similarly seen in the APPs' reluctance to initiate a pathway intended to lead to GOC conversations. The percentage of eligible inpatient admissions meeting the specified criteria was similar between the 2 months; however, the number of appropriate referrals and documented or billed GOC discussions was higher in the earlier month, demonstrating temporal decline. Further research inquiry is needed to explore causation of this phenomenon.
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Affiliation(s)
| | - Amy Hite
- From Pittsburg State University, Pittsburg, Kansas
| | | | - Greg Belcher
- From Pittsburg State University, Pittsburg, Kansas
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Estephan L, Pu C, Bermudez S, Waits A. Burnout, mental health, physical symptoms, and coping behaviors in healthcare workers in Belize amidst COVID-19 pandemic: A nationwide cross-sectional study. Int J Soc Psychiatry 2023:207640231152209. [PMID: 36748178 PMCID: PMC9908523 DOI: 10.1177/00207640231152209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND Healthcare workers are vulnerable to burnout, especially during the COVID-19 pandemic in the low resource settings. Belize is a small Central American developing country known for its chronic healthcare worker shortage and this is the first study to assess burnout prevalence and its associated factors among healthcare workers in Belize. AIM To evaluate the prevalence of burnout and its associated factors in HCWs in Belize covering multiple domains (mental health, physical symptoms, and coping behaviors) during the COVID-19 pandemic. METHODS A cross-sectional survey that was developed and validated by a panel of experts was delivered online to all the healthcare workers in Belize from September to November 2021. Burnout was assessed using Copenhagen Burnout Inventory. Depression and anxiety screening was carried out using the Patient Health Questionnaire - 2 (PHQ-2) and Generalized Anxiety Disorder 2-item (GAD-2). Burnout associated factors were estimated using logistic regression models. FINDINGS Of the total of 263 participants, 27.76% had overall burnout: 56.65% had personal, 54.37% had work-related, and 19.39% had patient-related burnout. Burnout was positively associated with anxiety (OR: 3.14 [1.67, 5.92]), depression (OR: 4.45 [2.30, 8.61]), intentions of quitting their jobs (OR: 2.59 [1.49, 4.51]), health status worsening (OR: 2.21 [1.26, 3.87]), multiple physical symptom presentation (OR: 1.19, [1.10, 1.29]), and use of multiple maladaptive coping behaviors (OR: 1.66, [1.30, 2.12]). INTERPRETATION Healthcare workers in Belize showed substantial levels of burnout which were significantly associated with using maladaptive coping behaviors, presenting multiple physical symptoms, quitting their jobs, health status worsening, and other mental health issues. These findings should be used to develop and implement programs such as regular health check-ups, health promotion awareness campaigns, and worker recruitment strategies which would improve the working conditions, quality of life, and psychological well-being of our healthcare workers.
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Affiliation(s)
- Lila Estephan
- International Health Program, National Yang Ming Chiao Tung University, Taipei
| | - Christy Pu
- International Health Program, National Yang Ming Chiao Tung University, Taipei.,Institute of Public Health, National Yang Ming Chiao Tung University, Taipei
| | - Selma Bermudez
- Epidemiology Unit, Karl Heusner Memorial Hospital Authority, Belize City, Belize
| | - Alexander Waits
- International Health Program, National Yang Ming Chiao Tung University, Taipei.,Institute of Public Health, National Yang Ming Chiao Tung University, Taipei
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Huang SS, Chen CY, Kau K, Tsai JM, Tsay SL. Key determinates of job satisfaction for acute care nurse practitioners in Taiwan. BMC Nurs 2023; 22:6. [PMID: 36604678 PMCID: PMC9814220 DOI: 10.1186/s12912-022-01156-x] [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: 02/18/2022] [Accepted: 12/19/2022] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Taiwan is a super-aged society, and the shortage of hospital doctors; nurse practitioners (NPs) became vital healthcare providers to fulfill the healthcare demands of the population. The purpose of this study was to explore the key determinates of job satisfaction for NPs in acute care practices using significant practice variables, such as empowerment and burnout. METHODS Participants of this descriptive survey study were recruited from a national sample of NPs with membership in the Taiwan Association of Nurse Practitioners. The data were collected utilizing an online questionnaire based on demographic and practice variables, the Misener Nurse Practitioner Job Satisfaction Scale (MNPJSS), the Condition for Work Effectiveness Questionnaire II (CWEQ II), and the Copenhagen Burnout Inventory (CBI). A total of 1,211 NPs completed the online survey. A multiple regression model with the stepwise selection was used to explore job satisfaction. RESULTS The mean overall satisfaction score indicated that the level of satisfaction was between slightly dissatisfied and slightly satisfied. Regression results indicated that formal power, work-related burnout, access to information, and needed resources were critical components of job satisfaction, and accounted for 63% of the variance. Moreover, NPs who were married, had a higher annual salary, worked only during the day shift, and had lower patients-related burnout showed better job satisfaction. CONCLUSIONS This study provides evidence for healthcare organizations to formulate policies to strengthen NP job satisfaction. Empowerment and burnout are vital factors in NPs' job satisfaction. Healthcare organizations have an obligation to implement policies to empower NPs in practice and provide interventions to mitigate burnout. Implementing these changes will improve job satisfaction and with it the quality of patient care.
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Affiliation(s)
- Sheng-Shiung Huang
- grid.445025.20000 0004 0532 2244College of Nursing and Health Sciences, Da-Yeh University, Changhua, Taiwan
| | - Cheng-Yuan Chen
- grid.412094.a0000 0004 0572 7815National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan
| | - Kevin Kau
- grid.19188.390000 0004 0546 0241Academic Writing Education Center, National Taiwan University, Taipei, Taiwan
| | - Jung-Mei Tsai
- grid.413593.90000 0004 0573 007XDepartment of Nursing, Mackay Memorial Hospital, Taipei, Taiwan ,grid.445025.20000 0004 0532 2244Department of Nursing, Da-Yeh University, Changhua, Taiwan
| | - Shiow-Luan Tsay
- grid.445025.20000 0004 0532 2244College of Nursing and Health Sciences, Da-Yeh University, Changhua, Taiwan
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El-Ibiary SY, Salib M, Lee KC. Assessment of Areas of Worklife Among Pharmacy Educators. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2022; 86:8671. [PMID: 34815212 PMCID: PMC10159459 DOI: 10.5688/ajpe8671] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 11/15/2021] [Indexed: 05/06/2023]
Abstract
Objective. To assess in pharmacy academicians the six domains of worklife (community, control, fairness, reward, workload, values) that have been associated with burnout and poor job satisfaction.Methods. We aimed to assess the Areas of Worklife Survey (AWS) among a sample of pharmacy academicians attending a national meeting to evaluate personal, environmental, or workplace factors that may influence the worklife environment. Data were analyzed using SPSS, descriptive statistics were identified, and Kruskal-Wallis and Pearson correlations were performed.Results. The participant response rate was 40% (n=49/121 attendees). Eighty-eight percent of participants reported working more than 40 hours per week. Mean AWS scores ranged from 2.7 to 3.9 (whereby 1 indicated a strong mismatch between person and work environment and 5 indicated a strong match). The workload and fairness domains had the lowest reported scores, whereas control had the highest. Higher mean scores were reported for control and reward in those with a mentor and for fairness in those having a hobby.Conclusion. Participants gave the lowest ratings to two worklife areas, workload and fairness. Developing targeted interventions, such as in mentorship, hobbies, and transparency in the work setting, may be important for preventing burnout in pharmacy academicians. Further studies in a larger population may help to determine factors associated with the areas of worklife that received low ratings.
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Affiliation(s)
| | | | - Kelly C Lee
- University of California, San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences, San Diego, California
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de Cordova PB, Johansen ML, Grafova IB, Crincoli S, Prado J, Pogorzelska-Maziarz M. Burnout and intent to leave during COVID-19: A cross-sectional study of New Jersey hospital nurses. J Nurs Manag 2022; 30:1913-1921. [PMID: 35478365 PMCID: PMC9115191 DOI: 10.1111/jonm.13647] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 03/09/2022] [Accepted: 04/25/2022] [Indexed: 12/26/2022]
Abstract
Aim The aim of this work is to examine staffing, personal protective equipment (PPE) adequacy and physical exhaustion that contributed to burnout and intent to leave among hospital nurses during the first peak of the COVID‐19 pandemic. Background Burnout is associated with adverse nurse and patient outcomes. Identifying the magnitude of burnout that occurred during the pandemic can prepare managers for the long‐term mental health effects on nurses. Methods A cross‐sectional, electronic survey was administered to examine perceptions of burnout and intent to leave among all New Jersey hospital nurses from October 6 to October 26, 2020. Results A total of 3030 nurses responded with 64.3% reporting burnout and 36.5% reporting intent to leave the hospital within a year. There was a significant association between high levels of burnout and intent to leave (χ2 = 329.4; p = .001). There was no association between staffing and burnout; however, reporting inadequate PPE (OR = 1.77 [95% CI: 1.34–2.34]) and physical exhaustion (OR = 3.89 [95% CI: 3.19–4.76]) remained predictors of burnout among nurses. Conclusion Inadequate PPE and physical exhaustion coupled with short staffing contributed to burnout and intent to leave. Implications for Nursing Management Managers should continue to utilize evidence‐based mental health interventions and advocate within their nursing professional organizations for relief funds to reduce burnout.
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Affiliation(s)
- Pamela B de Cordova
- Rutgers, the State University of New Jersey, Division of Nursing Science - School of Nursing, Division of Nursing Science, School of Nursing, Newark, New Jersey, USA.,New Jersey Collaborating Center for Nursing (NJCCN), Newark, New Jersey, USA
| | - Mary L Johansen
- Rutgers, the State University of New Jersey, Division of Nursing Science - School of Nursing, Division of Nursing Science, School of Nursing, Newark, New Jersey, USA
| | - Irina B Grafova
- Rutgers, the State University of New Jersey, Division of Entry to Baccalaureate Nursing, School of Nursing, Newark, New Jersey, USA
| | - Suzanne Crincoli
- New Jersey Collaborating Center for Nursing (NJCCN), Newark, New Jersey, USA
| | - Joseph Prado
- Rutgers, the State University of New Jersey, Minority Biomedical Research Support Program (MBRS), Newark, New Jersey, USA
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Abstract
Poor practice environments contribute to burnout, but favorable environments containing support, resources, autonomy, and optimal relations with colleagues may prevent burnout. Compared to all nurse practitioners (NPs), 69% of these NPs provide primary care to patients, yet it is unknown whether the practice environment is associated with NP burnout. A study to examine environmental factors related to NP burnout was conducted. Overall, 396 NPs completed the survey and 25.3% were burnt-out. Higher scores on the professional visibility, NP-physician relations, NP-administration relations, independent practice and support subscales were associated with 51%, 51%, 58%, and 56% lower risk of NP burnout, respectively.
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A review of stress management interventions for the oncology nursing workforce: What do we know and what should we be doing differently? HEALTH PSYCHOLOGY REPORT 2021. [DOI: 10.5114/hpr.2020.100787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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