Professional burnout of nurses and the level of rationing of nursing care: an observational preliminary study

BACKGROUND

Nurses are one of the professional groups most exposed to experiencing professional burnout. Professional burnout has a negative impact on the quality of nursing care, including causing care rationing. Therefore, it is very important to understand the determinants of both professional burnout and care rationing, as well as their mutual relationships. The aim of the study was to understand the impact of professional burnout among nurses on the level of rationing of nursing care.

METHODS

The study was conducted among 100 nurses at the Głogów County Hospital (Poland) from November 14, 2011, to November 18, 2022. The following Polish version of the standardized research tools were utilized: the Basel Extent of Rationing of Nursing Care- Revised (BERNCA-R) questionnaire and the Oldenburg Burnout Inventory (OLBI). Additionally, a survey designed by the authors was employed.

RESULTS

The BERNCA-R significantly correlates (p < 0.05) and positively (r > 0) with OLBI (disengagement), resulting in a higher degree of care rationing. The average overall BERNCA-R score was 1.56 points (SD = 0.62), indicating that the frequency of care rationing among respondents ranged from "never" to "rarely." Among participants in the OLBI questionnaire, 63% of respondents had a moderate level of work exhaustion, 36% had a high level of work exhaustion, and 1% had a low level of work exhaustion. In turn, 58% of respondents had a moderate level of disengagement, 38% had a high level of disengagement, and 4% had a low level of disengagement. Moreover, a statistically significant association with the BERNCA-R score concerning the workplace (ward) and participation in training on preventing professional burnout was shown.

CONCLUSIONS

The rationing of nursing care was found to be at a low level. The higher the level of disengagement, the greater the level of care rationing was observed. In conservative units, nurses demonstrated a higher level of care rationing. Nurses' expectations regarding the reduction of professional burnout include, among other things, higher remuneration, an increase in the number of staff, and an improvement in the work atmosphere.

Unfinished nursing care in intensive care units and the mediating role of the association between nurse working environment, and quality of care and nurses' wellbeing

OBJECTIVES

Unfinished care refers to the situation in which nurses are forced to delay or omit necessary nursing care. The objectives was: 1) to measure the prevalence of unfinished nursing care in intensive care units during the COVID-19 pandemic; 2) to examine whether unfinished nursing care has a mediating role in the relationship between nurse working environment and nurse-perceived quality of care and risk of burnout among nurses.

DESIGN

A national cross-sectional survey.

SETTING

Seventy-five intensive care units in Belgium (December 2021 to February 2022).

MAIN OUTCOME MEASURES

The Practice Environment Scale of the Nursing Work Index was used to measure the work environment. The perception of quality and safety of care was evaluated via a Likert-type scale. The risk of burnout was assessed using the Maslach Burnout Inventory scale.

RESULTS

A total of 2,183 nurse responses were included (response rate of 47.8%). Seventy-six percent of nurses reported at least one unfinished nursing care activity during their last shift. The staffing and resource adequacy subdimension of the Practice Environment Scale of the Nursing Work Index had the strongest correlation with unfinished nursing care. An increase in unfinished nursing care led to significantly lower perceived quality and safety of care and an increase in high risk of burnout. Unfinished nursing care appears to be a mediating factor for the association between staffing and resource adequacy and the quality and safety of care perceived by nurses and risk of burnout.

CONCLUSIONS

Unfinished nursing care, which is highly related to staffing and resource adequacy, is associated with increased odds of nurses being at risk of burnout and reporting a lower level of perceived quality of care.

IMPLICATIONS FOR CLINICAL PRACTICE

The monitoring of unfinished nursing care in the intensive care unit is an important early indicator of problems related to adequate staffing levels, the well-being of nurses, and the perceived quality of care.

[Shortage of nurses in Spain: from the global case to particular situation. SESPAS Report 2024]

The nursing shortage is a multi-causal phenomenon that affects all countries and currently a global concern. The shortage of nurses jeopardizes the sustainability of health systems and the population health outcomes. Spain has historically had no difficulties in attracting new generations of nurses. The shortage of nurses is caused by the precarious working conditions and lack of professional development that have led to episodes of high international migration and abandonment of the profession. In this paper we focus on the evolution of different indicators of the working conditions of non-specialist nurses, who make up the bulk of the profession. These indicators allow us to analyse the abandonment of the profession, the duration of contracts, their full-time or part-time dedication and the excessive hiring. We have analysed the effect of COVID-19 and the labour reform on these indicators. COVID-19 reduced the abandonment of the profession and is currently at its lowest level, it has also accelerated the need to improve working conditions by increasing the percentage of permanent contracts and reducing the multiplicity of contracts in the same month. The labour reform has helped reduce the percentage of temporary contracts until reaching around 80% of the total contracts, and has reduced the number of nurses in Spain with more than one contract in the same month to below 3000 nurses on a sustained basis.

Systematic Review and Meta-Analysis of Randomized Trials Testing Interventions to Reduce Physician Burnout

BACKGROUND

Physicians deal with intense professional pressures, which may contribute to increasing burnout. We sought to evaluate the efficacy of interventions designed to reduce burnout in physicians, physicians-in-training, and other health care professionals.

METHODS

We searched PubMed and Embase (through January 6, 2023) and reference lists. We included all randomized studies assessing an intervention designed to reduce professional burnout in physicians and other health care personnel. We adhered to the PRISMA reporting guidelines. We abstracted data on study and participant characteristics, study outcomes, and study quality. We used a random-effects model to pool mean differences in burnout change (pre- and post-intervention) between intervention and control arms.

RESULTS

Thirty-one of the 38 eligible studies (81.6%) used the Maslach Burnout Inventory (MBI) questionnaire to assess burnout. When comparing the intervention and control groups, the mean difference in the emotional exhaustion component of the MBI was -1.11 (95% confidence interval [CI], -2.14 to -0.09; I2: 74.5%; 20 studies); the mean difference in the depersonalization component of the MBI was -0.32 (95% CI, -0.63 to -0.01; I2: 54.2%; 17 studies); and the mean difference in the personal accomplishment component of the MBI was 1.11 (95% CI, -0.21 to 2.43; I2: 94.3%; 16 studies).

CONCLUSIONS

Studies testing interventions to decrease physician burnout led to significant numerical improvements in some domains of burnout, but it is unlikely that these changes result in meaningful changes in clinical burnout. Further, the limited follow-up time, biased assessments, and heterogeneity in intervention efficacy suggest that a more nuanced understanding of the causes of burnout is needed to develop more effective interventions.

Effects of internet-based, psychosocial, and early medical interventions on professional burnout in health care workers: Systematic literature review and meta-analysis

Background

The prevalence of professional burnout increased among healthcare workers during the coronavirus 2019 (COVID-19) pandemic, with negative effects on their mental health. Consequently, research interest in methods to decrease the prevalence of burnout and reduce the effects of burnout on healthcare workers has increased. Objective: This study was designed to evaluate the effects of Internet-based, psychosocial, and early medical interventions on professional burnout among healthcare workers.

Methodology

This systematic review and meta-analysis involved 8004 articles identified from four databases: Cochrane, Web of Science, PubMed/Medline, and clinical trials.

Results

Four articles were included in the systematic review, of which two could be meta-analyzed. The pooled effect of the group of interventions compared to control conditions was not statistically significant.

Discussion

Evaluating therapeutic effectiveness requires more clinical trials that allow its evaluation. Although we did not find improvements in the three intervention categories, the methodological heterogeneity in each intervention and the need for a standardized intervention guide for managing and decreasing professional burnout, subject to the evaluation of its impact, are highlighted.

Need and benefit of communication training for NICU nurses

Objectives

To assess the effects of a new communication course for neonatal intensive care unit (NICU) nurses on nurses' confidence in communicating with families, and to explore communication-related issues experienced by the nurses and their relationship to burnout.

Study design

Twenty-nine nurses participated in an interactive course based on communication cases from the NICU. Participants' experience of communication with parents was assessed. They completed the Maslach Burnout Inventory. Self-reported communication skills were assessed before and after the course and at four-month follow-up.

Results

Only one nurse reported previous nursing-related communication training. High burnout scores were associated with communication-related difficulties, especially lack of time for communication. The course improved participants' confidence in their communication skills in challenging situations, including those where parents express distress or ask questions the nurse cannot answer. Participants found the course highly interesting, useful and necessary for their work.

Conclusion

Interactive, learner-centered training addressing issues specific to communication at the NICU was effective and highly appreciated.

Innovation

The course centered on a unique variety of reality-based communication cases from the NICU, relevant to the nurses' work and stimulating their reflection. An innovative feature was the emphasis on nurses' perspective and the importance of communication for their coping.

Screening for psychosocial risks among physicians in a pediatric hospital

Over the past decades, productivity practices at hospital resulted in staff overload and burnout. Prompted by physicians' complaints, this study assessed the level of psychosocial risk among senior pediatricians in a university hospital. The survey used the checklist of Quebec's National Institute of Public Health that comprises two six-indicator parts: "Context" and "Key Components" of the Organization. The psychosocial risk level was evaluated by a physician-psychologist duo during interviews of homogeneous groups of workers. The indicators were scored, tabulated, and discussed. The survey led to a substantial qualitative and quantitative clarification of physicians' working conditions, claims, and needs. Regarding Context, the staff reported mainly: (a) cumbersome organization and norms vs. limited human resources (lack of stability, incentives, and promotions); (b) absenteeism and presenteeism; (c) reluctance to seek care or advice for fear of discredit; (d) presence of verbal violence; (e) self-imposed harsh returns-to-work; (f) work-life conflicts and difficult mental disconnection from work. Regarding the Key Components, the staff reported mainly: (a) work overload (physical, mental, psychological, and relational/social), continuous stress, and perceived exhaustion; (b) low job satisfaction and insufficient recognition; (c) inconstant support by their superiors; (d) poor job relationships and colleagues' support; (e) occasional participation and lack of real autonomy and/or strategy sharing. The survey succeeded in underlining concerning issues that required the immediate attention of occupational physicians and managers. It proved the method feasible and valuable in the medical context despite a high diversity of staff functions and degrees.

A mixed-methods exploration of nurse loneliness and burnout during COVID-19

AIM

This study investigated the phenomenon of nurse loneliness as a potential contributor to burnout.

BACKGROUND

Nurse wellbeing is critical for safe and efficient healthcare delivery. However, evidence indicates nurses' wellbeing is at risk. The levels of burnout, the most commonly measured symptom of suboptimal wellbeing, are rising and may relate to a largely unexplored phenomenon: loneliness.

METHODS

A mixed-methods approach was used to investigate burnout and loneliness in direct-care nurses in four diverse hospitals in the midwestern and southeastern United States. Burnout and loneliness were measured, prevalence was estimated, and correlation was examined. Interpretive descriptive inquiry and analysis was used to develop a richer understanding of nurse loneliness in the context of burnout. While this study did not explicitly explore the impact of the global pandemic, data was collected in late 2021 and early 2022, during the Delta variant wave.

RESULTS

In the study population (n = 117), rates of burnout are high and positively correlate with loneliness. Qualitative interviews (n = 11) revealed that nurses feel unseen, emotionally detached from their work, and dehumanized. However, social connection with peers is protective and nurses still report a strong sense of devotion to the profession and solidarity with peers.

CONCLUSIONS

This study offers insight into nurse loneliness, highlighting the importance of social connectedness to improve nurse wellbeing.

Mentorship and self-efficacy are associated with lower burnout in physical therapists in the United States: a cross-sectional survey study

PURPOSE

This study investigated the prevalence of burnout in physical therapists in the United States and the relationships between burnout and education, mentorship, and self-efficacy.

METHODS

This was a cross-sectional survey study. An electronic survey was distributed to practicing physical therapists across the United States over a 6-week period from December 2020 to January 2021. The survey was completed by 2,813 physical therapists from all states. The majority were female (68.72%), White or Caucasian (80.13%), and employed full-time (77.14%). Respondents completed questions on demographics, education, mentorship, self-efficacy, and burnout. The Burnout Clinical Subtypes Questionnaire 12 (BCSQ-12) and self-reports were used to quantify burnout, and the General Self-Efficacy Scale (GSES) was used to measure self-efficacy. Descriptive and inferential analyses were performed.

RESULTS

Respondents from home health (median BCSQ-12=42.00) and skilled nursing facility settings (median BCSQ-12=42.00) displayed the highest burnout scores. Burnout was significantly lower among those who provided formal mentorship (median BCSQ-12=39.00, P=0.0001) compared to no mentorship (median BCSQ-12=41.00). Respondents who received formal mentorship (median BCSQ-12=38.00, P=0.0028) displayed significantly lower burnout than those who received no mentorship (median BCSQ-12=41.00). A moderate negative correlation (rho=-0.49) was observed between the GSES and burnout scores. A strong positive correlation was found between self-reported burnout status and burnout scores (rrb=0.61).

CONCLUSION

Burnout is prevalent in the physical therapy profession, as almost half of respondents (49.34%) reported burnout. Providing or receiving mentorship and higher self-efficacy were associated with lower burnout. Organizations should consider measuring burnout levels, investing in mentorship programs, and implementing strategies to improve self-efficacy.

THE DENTAL PROFESSION EXPERIENCES HIGH PREVALENCE RATES OF BURNOUT AND EMOTIONAL EXHAUSTION

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION

Moro JDS, Soares JP, Massignan C, Oliveira LB, Ribeiro DM, Cardoso M, Canto GL, Bolan M. Burnout syndrome among dentists: a systematic review and meta-analysis. J Evid Based Dent Pract. 2022 Sep;22(3):101,724. doi: 10.1016/j.jebdp.2022.101724. Epub 2022 Apr 2. PMID: 36162888 SOURCE OF FUNDING: University funds.

TYPE OF STUDY/DESIGN

Systematic review with meta-analysis.

Technostress as source of physician burnout: An exploration of the associations between technology usage and physician burnout

BACKGROUND

The cause of physician burnout is multifactorial. Health care systems pressures, excessive workloads, fatigue, poor self-care, administrative burdens, work hours, technological advancements, and work-home life conflicts, are all prominent themes throughout the literature. To date, little is known about whether, and to what extent, stressors related to the use of information and communication technology (ICT) use, other than electronic health records, outside of working hours, contribute to physician burnout.

PURPOSE

The purpose of this study was to explore whether work related ICT use outside of working hours is associated with physician burnout.

METHOD

A cross-sectional survey delivered online using The Maslach Burnout Inventory (MBI), a Physician Technology Usage Scale (PTUS) (and 7 personal characteristics questions. Data were analyzed using bivariate correlations, analysis of variance (ANOVA) and t-tests, and multiple linear regression.

RESULTS

Of 2,108 participants invited to complete the survey, 403 responded to and completed the survey (19% response rate). Results identified two significant factors associated with physician burnout: work related technology use outside of working hours, and the number of years in practice.

CONCLUSION

This research highlights the need for additional in-depth research into areas such as: 1. work-home life issues and how the use of technology outside of work hours may affect or be affected by burnout; 2. physician age and experience and burnout; 3. The differences between specialties and whether and how specialty-specific factors are related to burnout.

Burnout among Brazilian Dentists during the COVID-19 Pandemic: A Cross-sectional Study

Background

This article identifies the factors associated with burnout among dentists in the state of Bahia, Brazil, during the COVID-19 pandemic.

Methods

A cross-sectional study, conducted between November 2020 and February 2021, of 251 dentists, selected by snowball sampling. Sociodemographic, occupational, and epidemiological information was collected in an electronic form. Burnout was evaluated through the Maslach Burnout Inventory; anxiety through the Beck Anxiety Inventory; and quality of life through the WHOQol-BREF questionnaire. Multiple linear regression was used to identify factors associated with variations in levels of the three burnout dimensions.

Results

The mean levels of the burnout dimensions were: Emotional Exhaustion: 28.9 ± 8.9 (SD); Depersonalization = 8.2 ± 6.3; and Personal Accomplishment: 28.0 ± 6.2. The proportion of professionals with high Emotional Exhaustion (≥ 30 cut-off score), high Depersonalization (≥ 12 cut-off score), and low Personal Accomplishment (≤ 33 cut-off score) were 43.4%, 26.3% and 81.3%, respectively. Burnout components were associated with high anxiety; lower levels of the physical, psychological, social relations, and environmental dimensions of quality of life; less time working as a dentist; increased alcohol consumption during the pandemic, feeling safe when using personal protective equipment, and support from work fellows.

Conclusion

The dentists investigated showed moderate levels of Emotional Exhaustion and Depersonalization, and very low levels of Personal Accomplishment. The prevention and mitigation of burnout syndrome among dentists during a pandemic should consider several factors, such as quality of life, amount of time in the profession, use of personal protective equipment, support from fellow dentists, and alcohol consumption.

Middle Eastern nurses' views/experiences of work and well-being with the support measures during past disease outbreaks and COVID-19: a qualitative systematic review

BACKGROUND

The potential psychological health impact of pandemics on nurses has been increasingly widely recognised, as have recommendations to establish support measures for nurses' well-being. Despite the availability of support measures significant number of nurses still experienced burnout and mental distress during Covid-19. Few efforts have been made in the wider literature to understand how nurses experience well-being support or how they perceive it affects their well-being during pandemics. In the Middle East, understanding and exploring well-being support measures during pandemics from nurses' perspectives has not received significant attention.

OBJECTIVE

To investigate nurses' perspectives and experiences of well-being support measures during prior pandemics and the Covid-19 pandemic in the Middle East.

METHODS

A systematic qualitative review was undertaken utilising the JBI model as a framework. Searches were carried out in databases comprised CINAHL, MEDLINE, NUsearch Library of Nottingham University and Google Scholar. Moreover, a manual search through reference lists for relevant studies were carried out.

DATA EXTRACTION AND SYNTHESIS

Eleven studies were included in the review. The findings from the included qualitative studies were extracted using the JBI-QARI data extraction tool for qualitative research. The results were synthesised using a meta-synthesis in line with the JBI approach.

RESULTS

The included studies yielded an aggregate of 111 findings and were categorised into 14 categories, followed by four synthesised findings. These were: [1] nurses experienced challenges during MERS, yet different strategies were implemented by leaders and nurses to manage these challenges; [2] some well-being support measures were unfulfilled during Covid-19; [3] additional aspects compounded negatively on nurses' well- being; and [4] nurses showed maturity during Covid-19.

CONCLUSION

In comparison to prior health emergencies, well-being support measures during Covid-19 were not sufficiently adopted. Nurse policymakers and managers should consider these support measures to correspond with nurses' needs and explore the contextual factors that affect their implementation.

TRIAL REGISTRATION

PROSPERO (CRD42022344005).

The prevalence of professional burnout among dentists: a systematic review and meta-analysis

Professional burnout refers to mental weariness caused by occupational stress. However, there is a lack of systematic studies on the prevalence of professional burnout among dentists. The purpose of this study was to investigate the prevalence of professional burnout among dentists. Databases including PubMed, PsycINFO, Embase, Cochrane, and Web of Science were systematically searched from inception to 28 October 2021. The random-effects model and forest plots were used to assess the pooled prevalence of professional burnout among dentists. A total of 15 studies with a total of 6038 study subjects were included in the meta-analysis, and the overall professional burnout among dentists was 13% (95%CI: 6-23). Subgroup analysis suggested a high prevalence of burnout in Europe, and the least in the Americas. The pooled burnout prevalence in cross-sectional surveys was significantly lower than that in longitudinal studies. In addition, the overall burnout prevalence in the last decade was significantly lower than that of a decade ago. This meta-analysis demonstrated that the prevalence of burnout was relatively low among dentists, and there was a downward trend. Therefore, it is important to continue to pay close attention to the mental health of dentists and effectively prevent and treat professional burnout to better maintain the provision of health care services.

Burnout in South Asian rheumatologists in the COVID-19 pandemic: an online survey

Physician burnout is recognized as a global crisis and an epidemic. However, burnout in rheumatology is an understudied phenomenon. We explored the prevalence of physician burnout among rheumatologists from South Asia in the peri-pandemic period (2021-2022). Rheumatologists from Asian countries were invited to participate in an anonymized, validated, and pilot-tested e-survey via social media platforms from December 2021 to April 2022. Demographic information, social aspects (marital status, income, vacation time, daily exercise), substance abuse, EHR (electronic health record) use, and years in practice were obtained. In addition, burnout was estimated using Maslach Burnout Inventory-Human Services Survey for Medical Personnel (MBI-HSS) in three domains: emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA), and intergroup comparisons were made using independent t test and one-way ANOVA using SPSS v27. Of 146 respondents who participated in the survey, 134 belonged to Asian nations. The highest number of respondents was from Pakistan (56/134, 38.36%), followed by India (49/134, 33.56%). Slightly more respondents were male, 75 (51.4%), than females, 71 (48.6%). Over two-thirds of our respondents (99/134, 67.8%) reported burnout in at least one domain. Notably, we found statistically significant increased depersonalization scores in males. (P < 0.05). Females scored significantly higher on the following items: #5 (I feel I treat some patients as if they were impersonal objects), item# 10 (I've become more insensitive toward people since I took this job and item#22 (I feel patients blame me for some of their problems) (P < 0.05). We found differences in monthly salaries among South Asian (1484 ± 2717 USD) and non-South Asian respondents (5672 ± 8874 USD) (P < 0.01). A substantial proportion of rheumatologists in our survey report burnout, suggesting a felt need to introduce organizational measures to prevent and mitigate burnout and preserve the rheumatology workforce.

The deployment of temporary nurses and its association with permanently-employed nurses' outcomes in psychiatric hospitals: a secondary analysis

Aims

This study's objective was to investigate possible associations between the frequency of temporary nurse deployments and permanently-employed nurses' outcomes including staffing levels in Swiss psychiatric hospitals.

Background

Faced with widespread nursing shortages, some nursing managers frequently deploy temporary nurses to meet their staffing needs. While various studies have investigated the relationships between temporary nurses' deployment and permanently-employed nurse outcomes, few anywhere, and none in Switzerland, have explored such deployments' relationships with permanently-employed nurses' job satisfaction, burnout, or intent to leave their organization or profession. Furthermore, especially in psychiatric hospitals, research on temporary nurse deployments and their association with permanently-employed nurses' outcomes remains scarce.

Methods

This secondary analysis is based on the Match^RN Psychiatry study, which included 79 psychiatric units and 651 nurses. Using descriptive analyses and linear mixed modeling, we assessed the frequency of temporary nurses' deployment and its association with four permanently-employed nurse outcomes: staffing levels, job satisfaction, burnout, and intention to leave their organization or profession.

Results

Roughly one-quarter of the studied units reported frequently deploying temporary nurses. Nonetheless, no differences in nurse staffing levels were found. Regarding permanently-employed nurses' outcomes, we identified slightly higher levels of intention to leave the profession (beta = 0.18; 95% CI [0.03-0.33]) and burnout (beta = 0.19; 95% CI [0.4-0.33]) on units where temporary nurses were frequently deployed.

Conclusion

Deploying temporary nurses appears to help units maintain adequate staffing levels. However, additional research will be necessary to better understand whether working conditions are the common cause of temporary nurses' deployment and permanently-employed nurse outcomes. Until more information is available, unit managers should consider alternatives to deploying temporary nurses.

The Association between Occupational Burnout and Spiritual Well-being in Emergency Nurses: A Cross-Sectional Study

Objective

This study evaluated the occupational burnout (OB) and spiritual well-being (SWB) of emergency nurses as well as the associations between these variables.

Method

This cross-sectional study was conducted in six hospitals and emergency medical centers affiliated with Ardebil University of Medical Sciences (Ardebil, Iran), in 2020. Data were collected via socio-demographic, Spiritual Well-Being Scale (SWBS), and Maslach Burnout Inventory (MBI) questionnaires.

Results

This study included 239 emergency department nurses. The mean age of the participants was 34.4±6.4 years. The mean of existential well-being and religious well-being was 40.3±8.7 and 41.0±9.2, respectively. The results indicated that moderate (P=0.007) and severe (P<0.001) personal accomplishment was a positive and significant predictor of the SWB in emergency department nurses.

Conclusion

Proper planning and provision of suitable educational programs in the dimension of the SWB of nurses prevent the creation and continuation of OB and increase the self-efficacy and job satisfaction of emergency medical staff, resulting in better patient care.

Factors Affecting Psychological Burnout in Nurses Caring for Terminal Cancer Patients

Purpose

This study aimed to investigate the impacts of end-of-life care competency and ethical dilemmas on psychological burnout in nurses who care for terminal cancer patients.

Methods

A cross-sectional study of 160 nurses who cared for terminal cancer patients was conducted. The participants were recruited from the hospice-palliative care wards, hematology or oncology wards, or intensive care units of three general hospitals in a single metropolitan area. Data were collected using a self-administered survey to assess end-of-life care competency, ethical dilemmas, psychological burnout, and general sociodemographic characteristics. Data were analyzed using descriptive statistics, the independent t-test, analysis of variance, Pearson correlation coefficients, and hierarchical linear regression analysis using SPSS for Windows (version 26.0).

Results

Psychological burnout was significantly correlated with end-of-life care competency (r=-0.23, P=0.003) but not with ethical dilemmas. The results of the hierarchical linear regression analysis indicated that end-of-life care competency (β=-0.280, P=0.010) and ethical dilemmas (β=0.275, P=0.037) were significant predictors of psychological burnout, after adjusting for age, religious status, clinical experience, and unit type.

Conclusion

The current study's findings demonstrate that end-of-life care competency and ethical dilemmas are crucial factors that affect psychological burnout in nurses who care for terminal cancer patients. Substantive education programs must be developed to improve nurses' competencies in end-of-life care and ethical dilemmas to decrease psychological burnout.

Burnout among Emergency Nurses during COVID-19 Pandemic at Hail Governmental Hospitals in the Kingdom of Saudi Arabia

Background

Nurses' burnout is an extended response to stressors at work, which leads to a negative self-concept and reduces the professional outcome. This study aimed to evaluate the level of burnout among emergency nurses during the COVID-19 pandemic.

Methods

This cross-sectional study was conducted from October 2021 to December 2021. A total of 77 emergency nurses from King Khalid hospital 42 (54.5%), and King Salman Specialist hospital 35 (45.5%) in Hail city of Saudi Arabia, were selected using a convenient sampling method and included in the study. A self-administered questionnaire consisted of the socio-demographics data sheet, and the Copenhagen Burnout Inventory (CBI) tool to evaluate nurses' burnout.

Results

The overall rate of burnout among the studied nurses was moderate, with mean scores of 39±10. The highest rate was for personal burnout with mean scores of 41.4±16.5, while the lowest score was for client-related burnout with mean scores of 37.8±10.5. The total burnout mean scores for all dimensions of CBI are higher in divorced (46.7), older age (44.5), nursing technicians (43.4), low years of experience (42.5), lower educational level (41.9), non-Saudi (41.0), and males (40.5).

Conclusion

The prevalence of burnout among nurses in government hospitals in Hail city was moderate, which should be considered. No statistically significant association were found between socio-demographic variables and the mean scores of CBI. Therefore, it is necessary to investigate the factors associated with the occurrence of burnout, provide a training program to reduce it, and improve the mental and physical health of the emergency nurses.

Factors associated with burnout syndrome in Colombian dental specialists

OBJECTIVE

To establish the factors associated with burnout syndrome in dental specialists working in the city of Bucaramanga and its metropolitan area.

METHODS

A cross-sectional study was conducted in which the validated version of the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) questionnaire was applied to 117 dental specialists. The variables analysed were the scores obtained in the three dimensions of the instrument - sociodemographic and job-related characteristics, professional environment, and habits. Spearman's correlation coefficient and the Mann Whitney or Kruskal-Wallis U test were used in the bivariate analysis, and a logistic regression was performed in the multivariate analysis. A value of p < 0.05 was considered statistically significant. Each participant accepted their inclusion in the study after the Informed Consent process was done.

RESULTS

The average age was 44.0 ± 7.8 years, and 57.3% were women. It was observed that 3.4%, 4.3% and 4.3% of respondents scored highly in emotional exhaustion, depersonalisation and lack of personal achievement, respectively. Cigarette smoking presented a direct association with the dimensions of depersonalisation (p = 0.031) and lack of personal achievement (p = 0.025). On the other hand, having completed the postgraduate degree 10 years or more ago showed a negative association in these two dimensions (p = 0.049 and p = 0.045, respectively).

CONCLUSIONS

The results suggest that burnout syndrome is not a frequent problem in dental specialists who work in Bucaramanga and its metropolitan area. However, it is important to keep in mind that a relationship was observed between the syndrome and smoking, and the years after graduating in the specialty.

Professional quality of life in pediatric services: A cross-sectional study

OBJECTIVE

Determine the quality of working life among the different pediatric nursing professionals, taking into account socio-demographic and work context factors, and the relationship of Burnout, compassion satisfaction and compassion fatigue between different job positions.

METHOD

Cross-sectional descriptive observational study carried out between January-March 2019 at the national territory. The professional quality of life was measured with ProQOL IV and sociodemographic characteristics were recorded. The data was encoded in Microsoft Office Excel, and analyzed with SPPS considering statistically significant differences p &lt; 0.05.

RESULTS

A total of 68 nurses were included in the study. The results obtained show less satisfaction due to compassion in those professionals who have a permanent employment contract, as well as those who carry out their work in hospitalization positions compared to those in the oncology area. In our sample there are very high levels of compassion fatigue, in addition we observed a significant relationship between compassion fatigue and religious belief, being higher in believing professionals.

CONCLUSIONS

It's necessary to identify associated factors in the professional quality of life to propose intervention strategies and improvement conditions, requiring greater involvement of health institutions to improve the professional quality of life in pediatric nursing.

Prevalence of burnout and related factors in nursing faculty members: a systematic review

PURPOSE

The current study aimed to identify the prevalence of burnout and related factors in nursing faculty members through a systematic review of the literature.

METHODS

A comprehensive search of electronic databases, including Scopus, PubMed, Web of Science, Iranmedex, and Scientific Information Database was conducted via keywords extracted from Medical Subject Headings, including burnout and nursing faculty, for studies published from database inception to April 1, 2022. The quality of the included studies in this review was assessed using the appraisal tool for cross-sectional studies.

RESULTS

A total of 2,551 nursing faculty members were enrolled in 11 studies. The mean score of burnout in nursing faculty members based on the Maslach Burnout Inventory (MBI) was 59.28 out of 132. The burnout score in this study was presented in 3 MBI subscales: emotional exhaustion, 21.24 (standard deviation [SD]=9.70) out of 54; depersonalization, 5.88 (SD=4.20) out of 30; and personal accomplishment, 32.16 (SD=6.45) out of 48. Several factors had significant relationships with burnout in nursing faculty members, including gender, level of education, hours of work, number of classroom, students taught, full-time work, job pressure, perceived stress, subjective well-being, marital status, job satisfaction, work setting satisfaction, workplace empowerment, collegial support, management style, fulfillment of self-expectation, communication style, humor, and academic position.

CONCLUSION

Overall, the mean burnout scores in nursing faculty members were moderate. Therefore, health policymakers and managers can reduce the likelihood of burnout in nursing faculty members by using psychosocial interventions and support.

The impact of COVID-19 on the wellbeing of the UK nursing and midwifery workforce during the first pandemic wave: A longitudinal survey study

BACKGROUND

The specific challenges experienced by the nursing and midwifery workforce in previous pandemics have exacerbated pre-existing professional and personal challenges, and triggered new issues. We aimed to determine the psychological impact of the COVID-19 pandemic on the UK nursing and midwifery workforce and identify potential factors associated with signs of post-traumatic stress disorder.

METHODS

A United Kingdom national online survey was conducted at three time-points during the first wave of the COVID-19 pandemic between April and August 2020 (T1 and T2 during initial wave; T3 at three-months following the first wave). All members of the UK registered and unregistered nursing and midwifery workforce were eligible to participate. The survey was promoted via social media and through organisational email and newsletters. The primary outcome was an Impact of Events Scale-Revised score indicative of a post-traumatic stress disorder diagnosis (defined using the cut-off score ≥33). Multivariable logistic regression modelling was used to assess the association between explanatory variables and post-traumatic stress disorder.

RESULTS

We received 7840 eligible responses (T1- 2040; T2- 3638; T3- 2162). Overall, 91.6% participants were female, 77.2% were adult registered nurses, and 28.7% were redeployed during the pandemic. An Impact of Events Scale-Revised score ≥33 (probable post-traumatic stress disorder) was observed in 44.6%, 37.1%, and 29.3% participants at T1, T2, and T3 respectively. At all three time-points, both personal and workplace factors were associated with probable post-traumatic stress disorder, although some specific associations changed over the course of the pandemic. Increased age was associated with reduced probable post-traumatic stress disorder at T1 and T2 (e.g. 41-50 years at T1 odds ratio (OR) 0.60, 95% confidence interval (CI) 0.42-0.86), but not at T3. Similarly, redeployment with inadequate/ no training was associated with increased probable post-traumatic stress disorder at T1 and T2, but not at T3 (T1 OR 1.37, 95% CI 1.06-1.77; T3 OR 1.17, 95% CI 0.89-1.55). A lack of confidence in infection prevention and control training was associated with increased probable post-traumatic stress disorder at all three time-points (e.g. T1 OR 1.48, 95% CI 1.11-1.97).

CONCLUSION

A negative psychological impact was evident 3-months following the first wave of the pandemic. Both personal and workplace are associated with adverse psychological effects linked to the COVID-19 pandemic. These findings will inform how healthcare organisations should respond to staff wellbeing needs both during the current pandemic, and in planning for future pandemics.

Prevalence of Burnout Syndrome and Associated Variables in Mexican Medical Specialists

OBJECTIVE

To determine the prevalence of burnout syndrome and the associated variables in medical specialists in Mexico.

METHODS

Observational, descriptive and cross-sectional study, by means of a census of 540 medical specialists from three Regional Hospitals. Using their identification card and self-administered Maslach Burnout Inventory-Human Services questionnaire, descriptive statistics and inferential analysis were performed using SPSS 15.0 and Epi-infoV6.1.

RESULTS

There was a 90.0% response in the specialists studied. Burnout was detected in 45.9%. There were significant differences in variables: being female; under 40 years of age; without a stable partner, and less than 15 years together; a working couple; childless; clinical specialty; less than 10 years of professional and current employment, and accumulated work day. A negative correlation was found in burnout with emotional exhaustion, and with depersonalisation. It was positive with a lack of personal fulfilment at work.

CONCLUSIONS

Burnout is common (45.9%) in specialist physicians. The average levels of the subscales are close to normal. Emotional exhaustion and depersonalisation behave inversely proportional to the total score of the syndrome, and directly proportional to the lack of personal fulfilment in the work with burnout.

COVID-19's Impact on Cancer Care: Increased Emotional Stress in Patients and High Risk of Provider Burnout

BACKGROUND

COVID-19's precise impact on cancer patients and their oncologic care providers remains poorly understood. This study aims at comparatively analyzing COVID-19's effect on cancer care from both patient and provider perspectives.

METHODS

A multi-institutional survey was developed to assess COVID-19-specific concerns regarding treatment, safety, and emotional stress through 5-point Likert-type prompts and open-ended questions before and during the pandemic. Wilcoxon signed-rank and rank-sum tests were used to analyze before/during answers for providers and patients independently. Open-ended responses were assessed using inductive thematic analysis.

RESULTS

The survey was completed by 104 (69.3%) patients and 50 (50%) providers. Patients demonstrated a significant change in only 1 of 15 Likert prompts. Most significant were increased concern regarding susceptibility to infection [z = 2.536, p = 0.011] and concerns regarding their cancer outcome [z = 4.572, p < 0.001]. Non-physician providers demonstrated significant change in 8 of 13 Likert prompts, whereas physicians had all 13 Likert prompts change in the COVID-19 setting. Physicians believed care to be more poorly planned [z = -3.857, p ≤ 0.001], availability of protective personal equipment to be more limited [z = -4.082, p < 0.001], and were significantly concerned infecting family members [z = 4.965, p < 0.001].

CONCLUSIONS

While patients had more difficulty coping with their cancer, they did not perceive significant differences in their actual treatment. This suggests the need for a renewed focus on patients coping with cancer. Among providers, physicians more than any other provider group had a strong negative perception of COVID-19's impact on healthcare, suggesting the need for novel approaches to target physician burnout.

Exploring factors which contribute to the resilience of nurses working in the neonatal care unit: A grounded theory study

OBJECTIVES

This study aimed to produce a theoretical model to understand factors which affect the resilience of neonatal nurses. Nurses experience high levels of burnout due to the occupational stress they are exposed to. Burnout negatively affects both staff and patient outcomes, and in this population would likely affect the establishment of crucial early caregiver-infant relationships in the neonatal unit. Research suggests that increasing nurses' resilience can protect them against burnout, thus understanding factors that affect resilience in this population is critical.

RESEARCH METHODOLOGY

The study adopted a constructivist grounded theory design.

SETTING AND PARTICIPANTS

All participants were qualified registered nurses employed on a permanent basis in a Level 3 neonatal unit. Thirteen registered nurses attended one individual semi-structured interview. A constructivist grounded theory approach was used to analyse the subsequent verbatim transcripts.

FINDINGS

The resulting model identified that individuals working as nurses in the neonatal unit function within different systemic contexts: the nursing team; the family unit; the broader neonatal team; the National Health Service and their world outside the unit. Each context presents different practical, emotional and ethical challenges. These challenges are navigated through a combination of contextual, interpersonal and intrapersonal strategies.

CONCLUSIONS

The model is contextually embedded and extends existing literature pertaining to resilience of healthcare staff in other contexts. Suggestions are made in terms of adaptations to the organisational, social and individual contexts to benefit nursing resilience. Implications of the findings are also considered within the context of the ongoing Covid-19 pandemic.

Anxiety, health-related quality of life, and symptoms of burnout in frontline physicians during the COVID-19 pandemic

Background

COVID-19 pandemic caused increased workload and stress for health professionals involved in the care of such patients. We aimed to describe the health-related quality of life, and burnout in frontline physicians diagnosed with anxiety during the COVID-19 pandemic.

Methods

This was a cross-sectional study conducted during the first-wave phase of COVID-19, from September to October 2020. Questionnaires were sent electronically to 450 physicians from State of Bahia, assessing symptoms of anxiety, health-related quality of life (HRQOL) and burnout syndrome. For the categorical variables, the Pearson's chi-square test was used and difference between means was compare using the Mann-Whitney test. was Groups with and without anxiety symptoms were compared using prevalence ratios (PR). Pearson's correlation measured the correlation between WHOQOL-BREF and MBI (Maslach Burnout Inventory) domains. The Fisher r-to-z transformation was used to assess the significance of the difference between two correlation coefficients. The significance level was <0.05.

Results

Out of the 450 physicians, 223 (49,6%) completely answered the questionnaire and 38 (17%) showed symptoms of anxiety. Physicians with anxiety had higher scores in emotional exhaustion (EE) (38.31 ± 8.59 vs 25.31±0.87; p = 0.0001) and depersonalization (DP) (9.0 ± 5.6 vs 5.9 ± 5.3; p = 0.001) domains, and lower scores in personal accomplishment (PA) (32.1 ± 8.2 vs 36.3 ± 7.6; p = 0.004), than those without anxiety. All correlations between WHOQOL-BREF domains and MBI in physicians without anxiety were significant (p = 0.01).

Conclusion

Physicians with anxiety showed more emotional exhaustion, less personal accomplishment, and lower quality of life. All domains of WHOQOL BREF were correlated with all MBI domains among physicians without anxiety. Differences in correlation according to anxiety were remarkable in psychological HOQOL BREF domain and emotional exhaustion and depersonalization MBI domains. The effect of anxiety leading to poorer levels of perceived health needs to be further investigated.

Caring for patients displaying agitated behaviours in the intensive care unit - A mixed-methods systematic review

BACKGROUND

Patient agitation is common in the intensive care unit (ICU), with consequences for both patients and health professionals if not managed effectively. Research indicates that current practices may not be optimal. A comprehensive review of the evidence exploring nurses' experiences of caring for these patients is required to fully understand how nurses can be supported to take on this important role.

OBJECTIVES

The aim of this study was to identify and synthesise qualitative and quantitative evidence of nurses' experiences of caring for patients displaying agitated behaviours in the adult ICU.

METHODS

A mixed-methods systematic review was conducted. MEDLINE, CINAHL, PsycINFO, Web of Science, Emcare, Scopus, ProQuest, and Cochrane Library were searched from database inception to July 2020 for qualitative, quantitative, and mixed-methods studies. Peer-reviewed, primary research articles and theses were considered for inclusion. A convergent integrated design, described by Joanna Briggs Institute, was utilised transforming all data into qualitative findings before categorising and synthesising to form the final integrated findings. The review protocol was registered with PROSPERO CRD42020191715.

RESULTS

Eleven studies were included in the review. Integrated findings include (i) the strain of caring for patients displaying agitated behaviours; (ii) attitudes of nurses; (iii) uncertainty around assessment and management of agitated behaviour; and (iv) lack of effective collaboration and communication with medical colleagues.

CONCLUSIONS

This review describes the challenges and complexities nurses experience when caring for patients displaying agitated behaviours in the ICU. Findings indicate that nurses lack guidelines together with practical and emotional support to fulfil their role. Such initiatives are likely to improve both patient and nurse outcomes.

Hospital ethical climate associated with the professional quality of life among nurses during the early stage of COVID-19 pandemic in Wuhan, China: A cross-sectional study

Objectives

To describe the professional quality of life and explore its associated factors among nurses coming from other areas of China to assist with the anti-epidemic fight in Wuhan and especially examine whether the hospital ethical climate was independently associated with nurses’ professional quality of life.

Methods

A cross-sectional online survey was conducted from March 2020 to April 2020. The nurses working in Wuhan from the other parts of China were the target population. The Professional Quality of Life Scale version 5, the Hospital Ethical Climate Survey, and a basic information sheet were used to collect data. Descriptive statistics, t-test, ANOVA, Pearson correlation, and multiple linear regression analysis were used to analyze the data.

Results

In total, 236 nurses participated in this study, and 219 valid questionnaires were analyzed. The average age of the participants was 31.2 ± 5.0 years. Most nurses were female (176/219; 80.4%) and married (145/219; 66.2%). In term of professional quality of life, nurses reported moderate (129/219; 58.9%) to high (90/219; 41.1%) levels of compassion satisfaction, low (119/219; 54.3%) to moderate (100/219; 45.7%) levels of burnout, and low (67/219; 36.0%) to high (10/219; 4.6%) levels of secondary traumatic stress. Regarding hospital ethical climate, nurses reported moderately high hospital ethical climates with an average score of 4.46. After controlling for socio-demographic characteristics, the multiple linear regression models showed that the hospital ethical climate subscale of “relationship with physicians” was independently associated with the compassion satisfaction (β = 0.533, P < 0.01) and burnout (β = −0.237, P < 0.05); the hospital ethical climate subscale of “relationship with peers” (β = −0.191, P < 0.01) was independently associated with the secondary traumatic stress.

Conclusions

During the early stage of the pandemic, nurses demonstrated moderate to high level of compassion satisfaction, low to moderate level of burnout, and all nurses experienced secondary traumatic stress. Nurses perceived a high level of hospital ethical climate, and the perceived hospital ethical climate played an important role in promoting nurses’ professional quality of life during a life-threatening infectious disease pandemic.

Posttraumatic stress disorder and professional burnout among local government staff seven years after the Wenchuan earthquake in China: A longitudinal study

Although local government staff are crucial in post-quake reconstruction, their long-term psychological and professional consequences remain unclear. This longitudinal study investigated changes of posttraumatic stress disorder (PTSD) and professional burnout over seven years, and their underlying relationship. The study assessed 250 staff at one year (T_1y) after the earthquake, and 162 (64.8 %) were followed up at seven years (T_7y). PTSD and professional burnout were assessed with the Short Screening Scale for DSM-IV PTSD and the burnout subscale of Professional Quality of Life Scale (ProQOL), respectively, at both time points. Longitudinal changes in PTSD and burnout were examined and cross-lagged panel analyses were conducted to test the relationship between PTSD and burnout. The rates of positive cases of PTSD screening were 23.2 % at T_1y and 11.1 % at T_7y. The percentages of moderate burnout were 61.7 % at T_1y and 23.5 % at T_7y. Scores of PTSD (z = -5.70, p < 0.001) and burnout (t = 10.07, p < 0.001) from T_1y to T_7y decreased. The cross-lagged analysis indicated that burnout at T_1y predicted PTSD at T_7y (β = 0.19, p = 0.025). In conclusion, the Wenchuan earthquake has long-lasting negative effects on local government staff, although they can recover over time. Interventions to reduce professional burnout after disaster may does be beneficial to decrease the risk of PTSD in the long run.

Burnout profiles among French workers in health units for inmates: results of the EHCAU study

BACKGROUND

Health care personnel who work in penitentiary environments are at risk of burnout due to a variety of factors. Latest research have brought forward a classification system consisting of five burnout profiles on a continuum between engagement and burnout. The objective of this study was to measure the prevalence of these profiles among professionals working in French health units providing health services for inmates according to the three levels of care and to investigate their characteristics to propose appropriate management and prevention approaches.

METHODS

This study involved a cross-sectional analysis of data from the Evaluation of Health CAre in Units for inmates (EHCAU) study, a multicentric cohort study of professionals practising in health units for inmates in eastern France. Burnout was assessed by the Maslach Burnout Inventory (MBI) at the levels of emotional exhaustion, depersonalization and personal accomplishment. Job conditions and characteristics were measured using the Karasek Job Content Questionnaire and the Effort-Reward Imbalance Questionnaire. Data on sociodemographic characteristics and self-reported health status were also collected. Differences between MBI profiles were identified using Fisher's exact test and the Wilcoxon test.

RESULTS

Of the 350 professionals surveyed, 150 responded (42.9%). The most frequent profiles were ineffective (36.9%) and engagement (34.8%). The burnout (7.8%), overextended (15.6%) and disengaged (5.0%) profiles made up the remaining quarter. Significant differences in the burnout profiles were observed in regard to professional occupation (p = 0.01), irregular eating hours (p = 0.04), history of complaint procedures (p = 0.05), anxiety (p < 0.0001), depression (p < 0.0001) and the mental component of self-reported quality of life (p < 0.0001).

CONCLUSIONS

These results confirm that special attention should be given to professionals working in these challenging settings. The results have important implications for theory and research and for more customized approach interventions.

TRIAL REGISTRATION

ID RCB: 2018-A03029-46.

Digital scribe utility and barriers to implementation in clinical practice: a scoping review

Electronic health records (EHRs) allow for meaningful usage of healthcare data. Their adoption provides clinicians with a central location to access and share data, write notes, order labs and prescriptions, and bill for patient visits. However, as non-clinical requirements have increased, time spent using EHRs eclipsed time spent on direct patient care. Several solutions have been proposed to minimize the time spent using EHRs, though each have limitations. Digital scribe technology uses voice-to-text software to convert ambient listening to meaningful medical notes and may eliminate the physical task of documentation, allowing physicians to spend less time on EHR engagement and more time with patients. However, adoption of digital scribe technology poses many barriers for physicians. In this study, we perform a scoping review of the literature to identify barriers to digital scribe implementation and provide solutions to address these barriers. We performed a literature review of digital scribe technology and voice-to-text conversion and information extraction as a scope for future research. Fifteen articles met inclusion criteria. Of the articles included, four were comparative studies, three were reviews, three were original investigations, two were perspective pieces, one was a cost-effectiveness study, one was a keynote address, and one was an observational study. The published articles on digital scribe technology and voice-to-text conversion highlight digital scribe technology as a solution to the inefficient interaction with EHRs. Benefits of digital scribe technologies included enhancing clinician ability to navigate charts, write notes, use decision support tools, and improve the quality of time spent with patients. Digital scribe technologies can improve clinic efficiency and increase patient access to care while simultaneously reducing physician burnout. Implementation barriers include upfront costs, integration with existing technology, and time-intensive training. Technological barriers include adaptability to linguistic differences, compatibility across different clinical encounters, and integration of medical jargon into the note. Broader risks include automation bias and risks to data privacy. Overcoming significant barriers to implementation will facilitate more widespread adoption.

Supplementary information

The online version contains supplementary material available at 10.1007/s12553-021-00568-0.

Burnout syndrome in pediatric urology: A perspective during the COVID-19 pandemic - Ibero-American survey

INTRODUCTION

Burnout syndrome is a major cause of decreased life quality, mental health, and productivity for physicians. It is strongly related to work overload and has been a scarcely studied topic in pediatric urology. During the COVID-19 pandemic, authorities' recommendations have led to big changes in pediatric urology practice worldwide. This study aimed to evaluate the level of burnout in Ibero-American pediatric urologists (IPUs) during this pandemic.

MATERIAL AND METHODS

A cross-sectional study was conducted by applying an electronic survey during the COVID-19 pandemic peak to members of the two major associations of pediatric urology in Ibero-America (the Ibero-American Society of Pediatric Urology [SIUP] and the Brazilian School of Pediatric Urology [BSPU]) to evaluate demographic, pre-pandemic, and pandemic data. Burnout levels were assessed using the Copenhagen Burnout Inventory (CBI) questionnaire.

RESULTS

A response rate of 40% was obtained (182 out of 455 IPU respondents). Participants were from 14 different countries in Ibero-America and 75.4% were male. Data showed that during the pandemic there was a significant decrease in weekly workload, that is: > 40 h per week (h/w) (91.4%-44.6%, p < 0.001); and >6 h/w (94.9%-45.1%%, p < 0.001) in operating room time (ORT). Personal (Pe-BO), work-related (W-BO), and patient-related (Pa-BO) burnout levels among IPUs were 26.3%, 22.3%, and 7.4%, respectively (Summary table). An important difference by gender was seen, with women suffering more from the syndrome (odds ratio of 2.67 [95% confidence interval, 1.285.58; p = 0.013] for Pe-BO and OR of 3.26 [95% CI, 1.52-7.01; p = 0.004] for W-BO).

CONCLUSION

A significant decrease in workload for IPU during the pandemic was observed, as well as a low level of burnout syndrome during this time. However, the predominance of burnout in women found in this study is notable.

[Predictive factors for burnout and work engagement levels among doctors and nurses: a systematic review.]

BACKGROUND

Healthcare professionals are often subjected to demanding working conditions, and both burnout and work engagement are psychological reactions that develop when personality traits interact with the characteristics of the work. The objective of this study was to analyse the factors that influence burnout and work engagement levels among healthcare professionals.

METHODS

A systematic review of articles published between January 2015 and October 2020 was conducted in the Pubmed, Scopus, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, and ScienceDirect electronic databases, following the PRISMA format. Methodological quality was assessed through the critical evaluation tools for non-randomised studies by the Joanna Briggs Institute (JBI).

RESULTS

A total of 27 studies were included in this review. Moderate levels of work engagement and low levels of burnout were observed among healthcare professionals. Job demands (work overload, shift type, negative events, type of service, etc.) and personal, situational, and organisational resources (psychological capital, social support, ability to express emotions, personal values, feeling self-fulfilled, among others) may be factors that influence work engagement and burnout levels.

CONCLUSIONS

The results provide implications for the design, assessment and effectiveness of workplace interventions towards reducing the risk of burnout and improving work engagement levels among healthcare professionals.

Factors Associated With Burnout Syndrome in Colombian Dental Specialists

OBJECTIVE

To establish the factors associated with burnout syndrome in dental specialists working in the city of Bucaramanga and its metropolitan area.

METHODS

A cross-sectional study was conducted in which the validated version of the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) questionnaire was applied to 117 dental specialists. The variables analysed were the scores obtained in the three dimensions of the instrument - sociodemographic and job-related characteristics, professional environment, and habits. Spearman's correlation coefficient and the Mann Whitney or Kruskal-Wallis U test were used in the bivariate analysis, and a logistic regression was performed in the multivariate analysis. A value of p<0.05 was considered statistically significant. Each participant accepted their inclusion in the study after the Informed Consent process was done.

RESULTS

The average age was 44.0±7.8 years, and 57.3% were women. It was observed that 3.4%, 4.3% and 4.3% of respondents scored highly in emotional exhaustion, depersonalisation and lack of personal achievement, respectively. Cigarette smoking presented a direct association with the dimensions of depersonalisation (p=0.031) and lack of personal achievement (p=0.025). On the other hand, having completed the postgraduate degree 10 years or more ago showed a negative association in these two dimensions (p=0.049 and p=0.045, respectively).

CONCLUSIONS

The results suggest that burnout syndrome is not a frequent problem in dental specialists who work in Bucaramanga and its metropolitan area. However, it is important to keep in mind that a relationship was observed between the syndrome and smoking, and the years after graduating in the specialty.

A unitary caring science resilience-building model: Unifying the human caring theory and research-informed psychology and neuroscience evidence

Resilience is the psychological capability to recover from difficulties quickly. Healthcare professionals are especially vulnerable to job-related stress and burnout. Unitary Caring Science is the framework for Watson's Human Caring Theory, providing a philosophy of practice in healthcare. With the high rates of clinician burnout and psychological issues, it will be significant to unify the human caring theory with research-informed psychological and neuroscience evidence to develop clinicians' resilience-building strategies. The purpose of this article is to introduce a Unitary Caring Science Resilience Model and explain the science behind the core strategies based on Unitary Caring Science philosophy and the psychological and neuroscience research. This model includes six strategies: Embracing loving-kindness for self and others; Nurturing interpersonal and intersubjective connections/relations; Deepening a creative use of self and sense of belonging; Balancing self-learning, self-awareness, and an evolved self-consciousness; Valuing forgiveness and releasing negativity; Inspiring and maintaining faith-hope. The caring-theory guided resilience-building strategies are proven to alleviate the depletion of clinicians' energy and emotions. Healthcare practices are challenging but rewarding. Clinicians can be emotionally, psychologically, and physically exhausted if they always consider themselves 'giving' and 'doing' institutional tasks without a sense of purpose or fulfillment. The practice can be rewarding if it becomes more aligned with clinicians' value to serve humanity. Through the unitary caring science resilience strategies, clinicians can build resilience as an antidote to clinician burnout and depletion.

Development and validation of the Short Professional Quality of Life Scale based on versions IV and V of the Professional Quality of Life Scale

Background

This research presents a short version of the Professional Quality of Life (ProQOL) scale, one of the most frequently used questionnaires in the arena of applied healthcare investigation. It measures burnout (BO), compassion fatigue (CF), and compassion satisfaction (CS).

Methods

A 9-item version of the ProQOL was developed. In Study 1, this short version, which used items from version IV of the ProQOL, was administered to 817 palliative care professionals from Spain, Argentina, and Brazil. In Study 2, the same nine items, but this time from version V of the ProQOL, were administered to 296 Spanish palliative care professionals.

Results

Study 1: The Short ProQOL showed an adequate internal structure, and invariance across the countries studied (χ²(106) = 185.620 (p < 0.001), CFI = .929, RMSEA = 0.058 [0.044, 0.072], SRMR = 0.081). Argentinians showed higher levels of BO (mean difference = 0.172, p = 0.042, Cohen’s d = 0.168), whereas Brazilians showed higher levels of CF (Mean difference = 0.384, p = 0.002, Cohen’s d = 0.352). Study 2: the Short ProQOL again showed adequate internal structure and reliability (χ²(24) = 134.504 (p < 0.001); CFI = 0.953; RMSEA = 0.126 [0.106, 0.147]; SRMR = 0.063), and was related to coping with death, self-compassion, and self-care.

Conclusions

The Short ProQOL could help facilitate the application of harmonizing measurements and its use for cross-cultural comparisons and occupational health monitoring was satisfactory.

Quality improvement of end‑of‑life decision-making and communication in the ICU : Effect on clinicians' burnout and relatives' distress

PURPOSE

End-of-life (EOL) decision-making is stressful. We conducted a quality improvement initiative to EOL decision-making and reduce stress for clinicians and patients' relatives.

METHODS

A before-after study running from 2010-2014 at four interdisciplinary intensive care units (ICU) in a German university hospital was performed. Between periods, a multifaceted intervention was implemented to improve timeliness, clinician involvement, and organisational support. Consecutive patients with severe sepsis and therapy limitations were included. Relatives were interviewed by telephone after 90 days to assess their psychological symptoms. Clinician burnout was assessed by staff surveys in each period.

RESULTS

Participation in the pre- and postintervention period was 84/145 and 90/159 among relatives, and 174/284 and 122/297 among ICU clinicians. Staff judged intervention elements as mostly helpful, but implementation of intervention elements was heterogeneous. From pre- to postintervention, relatives' risk of posttraumatic stress, depression and anxiety did not change (all p ≥ 0.464). Clinicians' risk of burnout increased (29% vs. 41%, p = 0.05). Relatives were highly satisfied in both periods (median of 9 vs. 9.2 on a 1-10 scale each). Attendings involved residents and nurses more often (both p ≤ 0.018). Nurses more often had sufficient information to talk with relatives (41% vs. 62%, p = 0.002). Time to first EOL decision as well as barriers and facilitators of EOL decision-making did not change.

CONCLUSIONS

The intervention may have increased involvement in EOL decision-making, but was accompanied by an increased risk of clinician burnout maybe due to lack of improving communication skills and organisational support. More research is needed to understand which interventions can decrease clinician burnout.

The Prevalence of Occupational Burnout Among Ophthalmologists: A Systematic Review and Meta-Analysis

OBJECTIVE

To investigate the prevalence of occupational burnout among ophthalmologists in order to better understand the mental and physical well-being of eye physicians and surgeons in the professional workplace.

STUDY DESIGN

A systematic review and meta-analysis.

METHODS

Online computer databases MEDLINE, EMBASE, CINAHL, and ProQuest Dissertations and Theses were searched systematically and thoroughly. Conferences held through Association for Research in Vision and Ophthalmology, American Academy of Ophthalmology, and Canadian Society of Ophthalmology were searched. Studies were screened using Covidence software. Data on reported burnout prevalence was extracted. STATA 15.0 was used to conduct meta-analysis.Synthesis: Our search strategy identified 318 records from online databases and 11 records from grey literature search, which were screened at 2-levels. Title and abstracts of each record were screened resulting in 24 records moving to full-text screening. Total of 9 records were utilized for quantitative analysis in the data extraction stage. Our results indicated significant professional burnout among ophthalmologists (ES = 0.41; CI: [0.26, 0.56]) with significant emotional exhaustion (ES = 0.43; CI: [0.33, 0.53]), depersonalization (ES = 0.29; CI: [0.13, 0.46]), and a low sense of personal accomplishment (ES = 0.36; CI: [0.08, 0.63]).

CONCLUSIONS

Significant occupational burnout among ophthalmologists is concerning because burnout can have a negative effect on the physical and mental health of eye physicians and surgeons. It could impact productivity, cutbacks in work hours, or lead to early retirement from the profession. Contributing factors in ophthalmologist burnout including work overload need to be addressed in a timely manner.

Prevalence of Burnout Syndrome and Associated Variables in Mexican Medical Specialists

OBJECTIVE

To determine the prevalence of burnout syndrome and the associated variables in medical specialists in Mexico.

METHODS

Observational, descriptive and cross-sectional study, by means of a census of 540 medical specialists from three Regional Hospitals. Using their identification card and self-administered Maslach Burnout Inventory-Human Services questionnaire, descriptive statistics and inferential analysis were performed using SPSS 15.0 and Epi-infoV6.1.

RESULTS

There was a 90.0% response in the specialists studied. Burnout was detected in 45.9%. There were significant differences in variables: being female; under 40 years of age; without a stable partner, and less than 15 years together; a working couple; childless; clinical specialty; less than 10 years of professional and current employment, and accumulated work day. A negative correlation was found in burnout with emotional exhaustion, and with depersonalisation. It was positive with a lack of personal fulfilment at work.

CONCLUSIONS

Burnout is common (45.9%) in specialist physicians. The average levels of the subscales are close to normal. Emotional exhaustion and depersonalisation behave inversely proportional to the total score of the syndrome, and directly proportional to the lack of personal fulfilment in the work with burnout.

[Impact of SARS-CoV-2 (Covid-19) on the mental health of healthcare professionals: a systematic review.]

BACKGROUND

In times of this global pandemic situation, population's mental health is compromised, especially in those groups that are at the forefront of defence against the virus such as healthcare professionals. The objective of this study was to analyze the impact of the SARS-CoV-2 outbreak on healthcare professionals' mental health.

METHODS

A systematic review was carried out following the PRISMA format in Pubmed, Scopus, Web of Science, CINAHL, PsycINFO and ScienceDirect electronic databases between January and May 2020. Methodological quality was evaluated using the Joanna Briggs Institute (JBI) critical appraisal tools for non-randomized studies.

RESULTS

A total of 13 studies were included in this review. Professionals' mental health and mental functions were compromised, being especially affected those professionals on the front line of battle against the virus. However, these stats were below the general population data. Although there is wide variability of results, medium-high levels of anxiety (26,5%-44,6%), depression (8,1%-25%), concern and insomnia are detected (23,6%-38%). Paradoxically, stress levels were below expectations (3,8%-68,3%).

CONCLUSIONS

The mental well-being of health professionals working on the front line is compromised in times of pandemic by presenting medium-high levels of anxiety, depression, nervousness and insomnia, and, to a lesser extent, stress.

Burnout syndrome in university professors and academic staff members: psychometric properties of the Copenhagen Burnout Inventory-Brazilian version

The aims of this study were to evaluate the psychometric properties of the Copenhagen Burnout Inventory–Brazilian version (CBI-Br) in a sample of university professors and academic staff members of Brazilian public universities, to estimate the level of burnout syndrome (BS) among these workers, and to assess the associations of BS with demographic and occupational determinants of the syndrome. A total of 676 workers participated in the study. Confirmatory factor analysis results supported a three-factor model with 18 items and an acceptable overall fit. Adequate convergent and discriminant validity of the CBI-Br’s factors were observed, as well as adequate reliability of the instrument for the sample. In conclusion, the results of this study provide evidence of the validity and reliability of the CBI-Br for the measurement of BS in Brazilian university professors and academic staff members. In addition, the CBI-Br may be an important tool for the diagnosis of psychosocial risks related to BS in the academic environment.

Fifteen minutes may decrease nursing burnout: A discussion paper

Burnout is a global concern for nurses with broad implications for the health of staff and patients. Efforts to foster resilience that have been successful in other disciplines have yet to be applied in nursing. As employers have become more responsible for the wellbeing of their employees, leveraging these successes in other disciplines could be a straightforward way to improve the wellbeing of the nursing workforce through reducing burnout. Specifically using a paid pre-shift 15 minute program grounded in mindfulness may decrease burnout through improving resilience.

The relationship between menopausal symptoms and burnout. A cross-sectional study among nurses

Background

Despite the growing presence of menopausal women in workplaces, studies aimed at exploring the link between menopausal symptoms and job well-being are scarce. In the interest of addressing this gap, the present study aimed to explore whether menopausal symptoms might contribute to increased levels of burnout and whether this relationship can be moderated by social or personal resources.

Method

The study design was cross-sectional and non-randomized. Ninety-four menopausal nurses completed a self-report questionnaire including scales aimed at measuring menopausal symptoms, burnout, social (i.e., support from superiors and colleagues) and personal (i.e., self-efficacy, resilience, and optimism) resources. Moderated regression analyses were performed to test study hypotheses.

Results

Whereas menopausal symptoms were associated significantly with emotional exhaustion, no social or personal resources were found to moderate this relationship. Regarding depersonalization, our study indicated that it was affected by menopausal symptoms only among nurses who reported low social support (from superiors and colleagues), optimism, and resilience.

Conclusion

The present study highlights the importance of organizations that employ a growing number of menopausal women to seek solutions at the individual and social levels that help these women deal with their menopausal transition while working.

Comparison of stress and burnout among anesthesia and surgical residents in a tertiary care teaching hospital in North India

Objective:

The residents undergoing training at hospitals in our country face challenges in terms of infrastructure and high workload with undefined working hours. The aim of the study was to compare the stress and burnout levels in trainee doctors doing residency in surgical fields and anesthesia at a tertiary care academic center in North India.

Materials and Methods:

A comparative, observational study was conducted in a tertiary care teaching hospital in North India. After Ethics Committee approval, 200 residents (100 each from surgical branches and anesthesia) were required to fill a questionnaire with information about age, sex, year of residency, marital status, and the Perceived Stress Scale-10, and Burnout Clinical Subtype Questionnaire-12. Burnout and perceived stress were compared between residents of anesthesia and surgical specialties.

Results:

Residents of both surgical and anesthesia branches scored high in perceived stress, namely 21 and 18, respectively. The score was significantly higher in surgical residents (P = 0.03) and increased progressively with the year of residency. The majority of residents (90% surgical, 80% anesthesia) felt that they were being overloaded with work. However, only 20%–30% of respondents felt that there was lack of development of individual skills and still fewer (<10%) reported giving up in view of difficulties.

Conclusion:

There is high level of stress and overload dimension of burnout among the residents of anesthesia and surgical branches at our tertiary care academic institution and the surgical residents score marginally higher than anesthesia residents.

Prevalence and associated factors of burnout among Debre Berhan University medical students: a cross-sectional study

BACKGROUND

Burnout, a measure of professional distress, is more common among medical professionals. About half of medical students have this problem. However, little is known about the burnout status of medical students in Ethiopia. Therefore, the aim of this study was to assess the prevalence and associated factors of burnout among medical students of Debre Berhan University (DBU).

METHODS

A cross-sectional study was conducted on randomly selected 151 medical students of DBU. Burnout was assessed using the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). Participants were reported as having burnout if they scored ≥27 on Emotional Exhaustion (EE), ≥13 on Depersonalization (DP) sub-scales, and ≤ 31 on Personal Accomplishment (PA) sub-scale of the MBI-HSS. EpiData version 3.1 was used for data entry while SPSS version 20 and STATA version 13 for windows were used for data analysis. Both univariable and multivariable binary logistic regression analyses were conducted. The degree of association between variables was assessed using odds ratio (OR) with 95% confidence interval (CI) at two-tailed p-value of < 0.05.

RESULT

Of 144 medical students took part, 34.0% had symptoms of burnout. Regarding domains of burnout, 61.8% scored high on EE, 47.9% scored high on DP and 59.7% scored low on PA. Dissatisfaction with practice lecturer (AOR = 3.8, 95% CI (1.3, 11.6)), moderate social support (AOR = 0.2, 95% CI (0.1, 0.8)), and satisfaction with their education (AOR = 0.1 95% CI (0.0, 0.7)) were associated with burnout.

CONCLUSION

More than one-third of medical students at DBU had burnout. Individual and organizational level interventions targeting students who had poor social support, dissatisfied by their lecturer at the hospitals and their education are recommended.

Violence and burnout in health care emergency workers in Santiago, Chile: A survey-based cross-sectional study

Shortage of quantitative studies regarding health risks for emergency services workers is a concern for Chilean's occupational health organizations.

OBJECTIVE

To explore the incidence of violence and burnout in emergency services of the Metropolitan Region of Chile, and associations with workers' characteristics and workplace conditions.

METHODS

A cross-sectional study was carried out from January to August 2016. A self-reported questionnaire explored about frequency and seriousness of violence episodes and about symptoms of burnout with the Maslach Burnout Inventory.

RESULTS

Of the 565 workers participating, 71% (95% CI 66.7-74.5) said violence episodes occurred at least once a week; 71.3% (95% CI 67.3-75.0) were victims of some aggression in the previous 12 months. Patients companions, relatives or friends arose as the main aggressors and the severity of the episodes was considered slight or moderate by more than 50% of participants. Fifty-seven respondents (10.5%, CI 95% 8.1-13.5) classified as having a burnout syndrome. Having been a victim of violence was associated to high emotional exhaustion (OR_adj = 1.7, 95% CI: 1.1-2.8) and depersonalization (OR_adj = 2.0, 95% CI 1.3-3.3).

CONCLUSIONS

Violence is a problem in the emergency departments of Chile's Metropolitan Region. Burnout is also present and independently associated to violence.

The benefits of mindfulness-based interventions on burnout among health professionals: A systematic review

OBJECTIVE

Healthcare professional burnout affects performance and has a negative impact on healthcare as a whole. Mindfulness-based Interventions (MIs), developed over the last 30 years, are increasingly used by healthcare professionals to reduce the risk of burnout. Yet the impact of MIs on burnout remains to be clarified. This review aimed to summarize and evaluate the existing literature on the potential benefits of MIs to minimize burnout risk.

METHODS

We conducted a systematic review of the literature, reporting according to the PRISMA standards. PubMed, Psychinfo, Web of Science and Science Direct databases were screened for original articles. Articles in English assessing an MI in combination with burnout measures were included up to September 2018.

RESULTS

Thirty-four articles were included. Only four randomised controlled trials concluded to burnout improvement after several weeks of MIs (11,8%). In the remaining five randomised controlled trials, results did not reach statistical significance. Of the four controlled, non-randomised studies, three showed significant improvements on burnout. Twenty-one studies did not report a controlled trial design. Overall the results appeared to be widely heterogeneous and several methodological concerns arose from the review.

CONCLUSION

This review shows the overall insufficient level of evidence offered by the literature assessing the effects of MIs on burnout in health professional populations. However, some studies have reported promising results and future research should address methodological issues and define more precise contexts of interventions and target populations that could benefit from MIs.

The Effect of Emotional Intelligence on Work-Related Psychological Health Among Anglican Clergy in Wales

This study explores the effect of emotional intelligence (assessed by the Schutte Emotional Intelligence Scale) on work-related psychological health (assessed by the two scales of the Francis Burnout Inventory) among 364 Anglican clergy serving in the Church in Wales (264 clergymen, 93 clergywomen, and 7 who did not disclose their sex). After controlling for personal factors (sex and age) and for personality dimensions (extraversion, neuroticism, and psychoticism), the data suggested that higher levels of emotional intelligence enhanced work-related psychological health both in terms of lowering negative affect (emotional exhaustion in ministry) and in terms of increasing positive affect (satisfaction in ministry). These findings suggest that there may be benefits in professional development programmes designed to develop emotional intelligence among clergy.