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Küçükali H, Türkoğlu SN, Hasanli S, Dayanır Çok FN, Culpan HC, Hayran O. Comparison of the burnout among medical residents before and during the pandemic. J Psychosom Res 2023; 165:111118. [PMID: 36565658 PMCID: PMC9758755 DOI: 10.1016/j.jpsychores.2022.111118] [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] [Received: 05/30/2022] [Revised: 12/10/2022] [Accepted: 12/10/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVE This study aims to compare the level of burnout syndrome in medical residents before and during the COVID-19 pandemic and identify potential risk factors. METHODS This cross-sectional study was conducted on medical residents from three different university hospitals in Turkey in March 2021, one year after the pandemic hit Turkey. Burnout is measured by the Maslach Burnout Inventory which assesses three dimensions of it: emotional exhaustion, depersonalization, and personal accomplishment. Collected data were combined and compared with data from a previous study which was held in the same hospitals in December 2019, three months before the pandemic. RESULTS 412 medical residents from three universities participated. The mean age was 27.8 ± 2.4 and half of them were female. Compared to pre-pandemic levels, no significant differences in emotional exhaustion (pre:19.0 ± 7.6 post:18.8 ± 7.8), depersonalization (pre:7.3 ± 4.3 post:7.2 ± 4.4), and personal accomplishment (pre:20.8 ± 5.1 post:21.1 ± 5) scores were observed one year after pandemic. Adjusting for confounders, multiple linear regression models indicated that who are female, are in surgical specialty, have vulnerable cohabitant, and have more night shifts faces higher emotional exhaustion. Depersonalisation is higher among who spent more years in residency, have more night shifts, or COVID-19 outpatient duty. Females and those who have vulnerable cohabitant has lower levels of Personal Achievement. CONCLUSION This study does not support the hypothesis that pandemic increases the burnout levels. Yet it identifies a couple of pandemic related factors that are associated with burnout and confirming the association of several previously known factors.
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Affiliation(s)
- Hüseyin Küçükali
- Queen's University Belfast, Centre for Public Health, Belfast, UK; Istanbul Medipol University, School of Medicine, Department of Public Health, Istanbul, Türkiye.
| | - Sezanur Nazlı Türkoğlu
- Bezmialem Vakif University, School of Medicine, Department of Public Health, Istanbul, Türkiye.
| | - Shams Hasanli
- University of Health Sciences, Hamidiye International School of Medicine, Istanbul, Türkiye.
| | - Fatma Nur Dayanır Çok
- Dicle University, School of Medicine, Department of Public Health, Diyarbakir, Türkiye.
| | | | - Osman Hayran
- Istanbul Medipol University, School of Medicine, Department of Public Health, Istanbul, Türkiye.
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Khoche S, Maus T. The Reality of Virtual Reality in Echocardiography Education? J Cardiothorac Vasc Anesth 2023; 37:306-307. [PMID: 36428203 DOI: 10.1053/j.jvca.2022.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 11/02/2022] [Indexed: 11/09/2022]
Affiliation(s)
- Swapnil Khoche
- Department of Anesthesiology, Division of Cardiothoracic Anesthesia, Thorton Hospital, University of California-San Diego, La Jolla, CA.
| | - Timothy Maus
- Department of Anesthesiology, Division of Cardiothoracic Anesthesia, Thorton Hospital, University of California-San Diego, La Jolla, CA
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Kovács M, Muity G, Szapáry Á, Nemeskéri Z, Váradi I, Kapus K, Tibold A, Zalayné NM, Horvath L, Fehér G. The prevalence and risk factors of burnout and its association with mental issues and quality of life among hungarian postal workers: a cross-sectional study. BMC Public Health 2023; 23:75. [PMID: 36627594 PMCID: PMC9832666 DOI: 10.1186/s12889-023-15002-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 01/05/2023] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Burnout is one of the most extensively studied phenomena of the twenty-first century; which has been extensively studied among helping professions, although it can be broadened to several other types of occupation. Based on our knowledge and literature search, no similar studies have been carried out among postal workes to date. METHODS This cross-sectional questionnaire-based epidemiological study was carried out between May 2021 and January 2022 in five counties in Hungary with the recruitment of postal delivery workers focusing on (1) the prevalence of burnout among postal delivery workers; (2) including the role of demographic parameters, duration of employment as well as the presence of secondary employment; (3) and also analyzed the role of several risk factors and medical conditions; (4) and we also examined the possible association between depression, insomnia and quality of life and burnout. RESULTS Overall 1300 questionnaires were successfully delivered and 1034 responses received (response rate of 79.5%). Three hundred sixty-eight males (35.6%) and six hundred sixty-six females (64.4%) participated in our study. The prevalence of burnout was 50.8% (525/1034) in this study population (mean score 2.74 ± 0.33). Logistic regression analysis showed that female gender [OR = 2.380, 95% CI: 1.731 to 2.554], first workplace [OR = 1.891, 95% CI: 1.582 to 2.162] and working more than 30 years [OR = 1.901, 95% CI: 1.608 to 2.326] have significantly increased the likelyhood of burnout as well as the history of muscoskeletal pain [OR = 1.156, 95% CI: 1.009 to1.342], current quality of life [OR = 1.602, 95% CI: 1.473 to 1.669] and the presence of sleep disturbance [OR = 1.289, 95% CI: 1.066 to 1.716]. CONCLUSION This is the first study in Hungary to investigate the prevalence of burnout among postal workers and to explore the relationship between burnout and mental health problems. Our study underlines the clinical importance of burnout and draws attention to the need for appropriate prevention and treatment strategies.
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Affiliation(s)
- Miklós Kovács
- grid.9679.10000 0001 0663 9479Centre for Occupational Medicine, Medical School, University of Pécs, 7624 Pecs, Hungary
| | - György Muity
- Harkany Spa and Thermal Center, Harkány, 7815 Hungary
| | - Ádám Szapáry
- grid.9679.10000 0001 0663 9479Centre for Occupational Medicine, Medical School, University of Pécs, 7624 Pecs, Hungary
| | - Zsolt Nemeskéri
- grid.9679.10000 0001 0663 9479Faculty of Cultural Sciences, Education and Regional Development, University of Pécs, 7633 Pecs, Hungary
| | - Imre Váradi
- grid.9679.10000 0001 0663 9479Centre for Occupational Medicine, Medical School, University of Pécs, 7624 Pecs, Hungary
| | - Krisztián Kapus
- grid.9679.10000 0001 0663 9479Centre for Occupational Medicine, Medical School, University of Pécs, 7624 Pecs, Hungary
| | - Antal Tibold
- grid.9679.10000 0001 0663 9479Centre for Occupational Medicine, Medical School, University of Pécs, 7624 Pecs, Hungary
| | - Nikoletta Magyar Zalayné
- grid.9679.10000 0001 0663 9479Centre for Occupational Medicine, Medical School, University of Pécs, 7624 Pecs, Hungary
| | - Lilla Horvath
- grid.9679.10000 0001 0663 9479Centre for Occupational Medicine, Medical School, University of Pécs, 7624 Pecs, Hungary
| | - Gergely Fehér
- grid.9679.10000 0001 0663 9479Centre for Occupational Medicine, Medical School, University of Pécs, 7624 Pecs, Hungary ,grid.9679.10000 0001 0663 9479Department of Primary Health Care, University of Pécs, 7623 Pecs, Hungary
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Khalil MT, Rathore FA, Dy R. Wellness in residency: Addressing the neglected need in lower middle-income countries. J Pediatr Rehabil Med 2023; 16:457-462. [PMID: 37694319 PMCID: PMC10578206 DOI: 10.3233/prm-230031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 08/15/2023] [Indexed: 09/12/2023] Open
Abstract
The concept of wellness incorporates many domains, including mental, physical, social, and integrated well-being. However, it is not well understood in most lower middle-income countries (LMIC). The significance of practicing wellness during residency, focusing on the context of LMIC, is described here. Based on the authors' experiences of working in LMIC, the challenges faced during residency and the importance of prioritizing self-care and well-being is highlighted. Physician burnout is a global concern having a negative impact on patient care quality, patient satisfaction, and professionalism. Interventions to address wellness can be individual and organization-based. Individual interventions include mindfulness training, behavioral interventions, self-care practices, and support networks. Organizational interventions involve the establishment of wellness committees, introduction of wellness curricula, optimization of workflows, and creation of shared social spaces. There is a need for implementing wellness practices within residency programs in LMIC. By focusing on wellness, physicians can mitigate burnout, enhance their well-being, and improve patient care outcomes.
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Affiliation(s)
| | | | - Rochelle Dy
- Baylor College of Medicine/Texas Children’s Hospital, Houston, TX, USA
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Jesuyajolu D, Nicholas A, Okeke C, Obi C, Aremu G, Obiekwe K, Obinna I. BURNOUT AMONG SURGEONS AND SURGICAL TRAINEES: A Systematic Review and Meta-analysis of the prevalence and associated factors. SURGERY IN PRACTICE AND SCIENCE 2022. [DOI: 10.1016/j.sipas.2022.100094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Shawahna R, Maqboul I, Ahmad O, Al-Issawy A, Abed B. Prevalence of burnout syndrome among unmatched trainees and residents in surgical and nonsurgical specialties: a cross-sectional study from different training centers in Palestine. BMC MEDICAL EDUCATION 2022; 22:322. [PMID: 35473599 PMCID: PMC9041277 DOI: 10.1186/s12909-022-03386-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 04/19/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Burnout is a psychological syndrome that involves physical, mental, and emotional exhaustion. This study was conducted to determine the prevalence of burnout among unmatched trainees and residents in surgical and nonsurgical specialties in Palestine. Additionally, this study also sought to identify the associated variables and predictors of higher burnout scores. METHODS This study was conducted in a cross-sectional design using a questionnaire in the period between October 2020 and March 2021. The questionnaire collected sociodemographic characteristics of the residents and trainees in 18 different training centers/hospitals. The Copenhagen Burnout Inventory was used to determine burnout among the residents and trainees. Pearson's correlations, analysis of variance, Student's t-test, and multiple linear regressions were used to analyze the data. RESULTS The study tool was completed by 250 residents and trainees in surgical and nonsurgical specialties (response rate = 83.3%). Of all participants, 203 (81.2%) reported a moderate-severe degree of burnout in the personal domain, 188 (75.2%) reported a moderate-severe degree of burnout in the work-related domain, and 97 (38.8%) reported moderate-severe degree of burnout in the client-related domain. There was a moderate and positive correlation between personal and work-related burnout scores (Pearson's r = 0.69, p-value < 0.001), and client-related burnout scores (Pearson's r = 0.52, p-value < 0.001). Similarly, there was a moderate and positive correlation between work-related and client-related burnout scores (Pearson's r = 0.57, p-value < 0.001). The multiple linear regression model showed that higher burnout scores were predicted by being married, not having another paid employment, inability to financially support oneself, frequent consumption of tea/coffee, dissatisfied with the training/job, thinking to change the profession, and long working hours. CONCLUSION The findings of this study indicated that burnout was highly prevalent among residents and trainees in surgical and nonsurgical specialties in Palestine. Decision-makers in healthcare authorities, hospital managers, professional groups, directors of residency programs, and educators/trainers should consider addressing burnout and improving the well-being of residents and trainees in surgical and nonsurgical specialties in Palestine. Future studies are still needed to determine which interventions could be effective in reducing burnout among residents and trainees in surgical and nonsurgical specialties in Palestine.
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Affiliation(s)
- Ramzi Shawahna
- Department of Physiology, Pharmacology and Toxicology, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine.
- An-Najah BioSciences Unit, Centre for Poisons Control, Chemical and Biological Analyses, An-Najah National University, Nablus, Palestine.
| | - Iyad Maqboul
- Department of Medicine, Faculty of Medicine & Health Sciences, An-Najah National University, P.O. Box 7, Nablus, Palestine.
- An-Najah National University Hospital, Nablus, Palestine.
| | - Ola Ahmad
- Department of Medicine, Faculty of Medicine & Health Sciences, An-Najah National University, P.O. Box 7, Nablus, Palestine
| | - Afnan Al-Issawy
- Department of Medicine, Faculty of Medicine & Health Sciences, An-Najah National University, P.O. Box 7, Nablus, Palestine
| | - Batoul Abed
- Department of Medicine, Faculty of Medicine & Health Sciences, An-Najah National University, P.O. Box 7, Nablus, Palestine
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Nurikhwan PW, Felaza E, Soemantri D. Burnout and quality of life of medical residents: a mixed-method study. KOREAN JOURNAL OF MEDICAL EDUCATION 2022; 34:27-39. [PMID: 35255614 PMCID: PMC8906927 DOI: 10.3946/kjme.2022.217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 10/20/2021] [Indexed: 06/14/2023]
Abstract
PURPOSE Currently there are a limited number of comprehensive studies exploring in more depth the relationship between burnout and quality of life (QoL) of medical residents during residency training. This study aims to examine the correlation between burnout and residents' QoL and explore the factors associated with burnout in residency training. METHODS This was a mixed-method study. The first stage was a quantitative study using cross-sectional design to administer the Maslach Burnout Inventory Human Service Survey and World Health Organization Quality of Life-BREF instruments to 86 medical residents, followed with the qualitative study through 10 in-depth interviews. RESULTS Twenty-seven residents (31.4%) experienced severe emotional exhaustion (EE), 22 (25.6%) experienced severe depersonalization (DP), and 40 (46,5%) experienced low personal accomplishment (PA). Factors increasing the likelihood of experiencing burnout were being surgical residents for EE (2.65 times), dealing with difficult/rare cases for DP (1.14 points), and working hours for PA (1.03 points). The QoL was influenced by the three burnout domains, marital status, education level, gender, age, type of residency, night shift, difficult/rare cases, working hours, and number of emergency cases. Factors influencing burnout, both intrinsic and extrinsic, were identified and divided into causative and protective factors. CONCLUSION The current study has examined the relationship between burnout and QoL and identified factors affecting residents' burnout. Both intrinsic factors, such as spirituality, and extrinsic factors which include duration of shift, work facilities, and teacher-senior-junior relationships, affect burnout. Supervision and academic regulation are some of the solutions expected by the residents to minimize burnout.
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Affiliation(s)
- Pandji Winata Nurikhwan
- Department of Medical Education, Faculty of Medicine, Lambung Mangkurat University, Banjarmasin, Indonesia
| | - Estivana Felaza
- Department of Medical Education, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Diantha Soemantri
- Department of Medical Education, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
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Daryanto B, Rahmadiani N, Amorga R, Kautsarani I, Susilo H, Persada Isma SP. Burnout syndrome among residents of different surgical specialties in a tertiary referral teaching hospital in Indonesia during COVID-19 pandemic. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2022; 14:100994. [PMID: 35155847 PMCID: PMC8824714 DOI: 10.1016/j.cegh.2022.100994] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 01/22/2022] [Accepted: 02/04/2022] [Indexed: 11/25/2022] Open
Abstract
Introduction Burnout is experienced frequently by residents, especially during COVID-19 pandemic. Impacts of the pandemic on clinical workload and training program of the residents has also resulted in burnout, which may impact their clinical performance and safety. Therefore, this paper aims to assess burnout syndrome among surgical residents in Indonesia during COVID-19 pandemic. Methods A cross-sectional survey was conducted on 120 surgical residents (from orthopedics, general surgery, and urology department) of a tertiary referral teaching hospital in Malang using web-based questionnaire. Personal data form and Maslach Burnout Inventory (MBI) for medical personnel were used. There are 3 subscales of MBI: emotional exhaustion (EE), depersonalization (DP), and personal achievement (PA). Comparative and correlative analysis were performed to analyze the socio-demographic, academic, and work-related factors in relation to the subscales scores of MBI-HSS and the presence of burnout. Results Burnout were experienced by 56.67% of residents in this study. There were statistically significant association regarding burnout and marital status, residency specialty, year of residency, and working hours upon analysis of mean and classification of subscale scores of MBI with the examined factors. Conclusion This study showed that burnout is a major issue in surgical residents during COVID-19 pandemic and may be associated with certain socio-demographic, academic, and work-related factors. Further studies to identify factors contributing to burnout in residents during COVID-19 pandemic are needed. It is imperative to formulate resident-centered strategies to prevent and address burnout among residents to ensure their overall well-being during this pandemic.
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Affiliation(s)
- Besut Daryanto
- Department of Urology, Saiful Anwar General Hospital, Malang, Indonesia
| | - Nayla Rahmadiani
- Department of Anatomic Pathology, Saiful Anwar General Hospital, Malang, Indonesia
| | - Reza Amorga
- Department of Urology, Saiful Anwar General Hospital, Malang, Indonesia
| | - Intan Kautsarani
- Department of Ophthalmology, Saiful Anwar General Hospital, Malang, Indonesia
| | - Hery Susilo
- Department of Oncology Surgery, Saiful Anwar General Hospital, Malang, Indonesia
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Health-related attitudes, behaviors and burnout in intern medical officers and their effects on self-reported patient care in a developing country. Ir J Med Sci 2022; 191:2449-2455. [PMID: 34993835 PMCID: PMC8739003 DOI: 10.1007/s11845-021-02874-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 11/29/2021] [Indexed: 11/17/2022]
Abstract
Background Intern Medical Officers (IMOs) in Sri Lanka face significant challenges due to heavy patient load and scarcity of resources. Aims To assess IMOs' level of burnout, associated factors and the effects on self-reported patient care in comparison to post-intern Relief House Officers (RHOs). Methods A descriptive cross-sectional study was conducted among IMOs and RHOs in two leading tertiary care hospitals in Sri Lanka. The level of burnout was assessed using Maslach Burnout Index. The self-reported health-related attitudes, practices, level of burnout, and their associations with patient care were compared between IMOs and RHOs. Results We studied 114 participants (70 (61.4%) IMOs and 44 (38.6%) RHOs). IMOs were not involved in regular exercises (χ2(1) = 19.8, p = 0.000), skipped meals frequently (χ2(1) = 29.3, p = 0.000), and had a poor sleep quality (χ2(1) = 35.7, p = 0.000) compared to RHOs. Overall, 46.5%, 95.5%, and 86.7% of the participants were having moderate-to-high emotional exhaustion, depersonalization, and sense of poor personal achievement. The exhaustion and depersonalization levels were significantly higher among IMOs. Emotional exhaustion was significantly associated with poor sleep (U = 923.0, p = 0.014). Self-reported patient care negatively correlated with exhaustion (rs(112) = − 0.263, p = 0.005) and depersonalization (rs(112) = − 0.491, p = 0.000), while having positive attitudes correlated with better patient care (rs(112) = 0.208, p = 0.027). Conclusions The prevalence of burnout in IMOs in Sri Lanka is high, which, in turn, negatively correlates with patient care. IMOs face significant challenges in self-care, while their poor sleep perturbs daytime activities and conceivably interferes with patient care. Therefore, we recommend introduction of preventive measures to mitigate burnout in early-career physicians, particularly IMOs, to improve both self and patient care. Supplementary information The online version contains supplementary material available at 10.1007/s11845-021-02874-y.
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Pascucci T, Cardella GM, Hernández-Sánchez B, Sánchez-García JC. Systematic Review of Socio-Emotional Values Within Organizations. Front Psychol 2022; 12:738203. [PMID: 35115980 PMCID: PMC8805683 DOI: 10.3389/fpsyg.2021.738203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 11/09/2021] [Indexed: 12/02/2022] Open
Abstract
The theory of separation assumes, with provocation, that an organization cannot reconcile profits and social function. Organizations can reconcile these two, apparently contrasting, missions, by considering emotions, especially moral emotions, to create a genuine motivation for focusing on goals beyond simple economic earnings and protecting organizations or groups of people from dysfunctional attitudes and behaviors, as well as considering the important role of the stakeholder accountability. Using the PRISMA method, we created a review of records using keywords relating to a socio-emotional value within organizations, with a particular focus on the last 20 years. We used the SCOPUS database and, after removing irrelevant records, we used the VOSviewer tool to create a cluster map of different areas in this topic. Some records cite the socio-emotional value that is related to organizational and employee suffering, while other articles consider it a positive factor that improves performance and prevents problems in organizations.
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Affiliation(s)
- Tancredi Pascucci
- Cátedra de Emprendedores, Universidad de Salamanca, Salamanca, Spain
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Harvey SB, Epstein RM, Glozier N, Petrie K, Strudwick J, Gayed A, Dean K, Henderson M. Mental illness and suicide among physicians. Lancet 2021; 398:920-930. [PMID: 34481571 PMCID: PMC9618683 DOI: 10.1016/s0140-6736(21)01596-8] [Citation(s) in RCA: 79] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 04/09/2021] [Accepted: 07/01/2021] [Indexed: 12/11/2022]
Abstract
The COVID-19 pandemic has heightened interest in how physician mental health can be protected and optimised, but uncertainty and misinformation remain about some key issues. In this Review, we discuss the current literature, which shows that despite what might be inferred during training, physicians are not immune to mental illness, with between a quarter and a third reporting increased symptoms of mental ill health. Physicians, particularly female physicians, are at an increased risk of suicide. An emerging consensus exists that some aspects of physician training, working conditions, and organisational support are unacceptable. Changes in medical training and health systems, and the additional strain of working through a pandemic, might have amplified these problems. A new evidence-informed framework for how individual and organisational interventions can be used in an integrated manner in medical schools, in health-care settings, and by professional colleagues is proposed. New initiatives are required at each of these levels, with an urgent need for organisational-level interventions, to better protect the mental health and wellbeing of physicians.
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Affiliation(s)
- Samuel B Harvey
- Black Dog Institute, Faculty of Medicine, University of New South Wales, Randwick, NSW, Australia.
| | - Ronald M Epstein
- Center for Communication and Disparities Research, Department of Family Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Nicholas Glozier
- Sydney School of Medicine (Central Clinical School), Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Katherine Petrie
- Black Dog Institute, Faculty of Medicine, University of New South Wales, Randwick, NSW, Australia; School of Psychiatry, UNSW Medicine, University of New South Wales, Kensington, NSW, Australia
| | - Jessica Strudwick
- Black Dog Institute, Faculty of Medicine, University of New South Wales, Randwick, NSW, Australia
| | - Aimee Gayed
- Black Dog Institute, Faculty of Medicine, University of New South Wales, Randwick, NSW, Australia
| | - Kimberlie Dean
- School of Psychiatry, UNSW Medicine, University of New South Wales, Kensington, NSW, Australia; Justice Health and Forensic Mental Health Network, Matraville, NSW, Australia
| | - Max Henderson
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
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Kaggwa MM, Kajjimu J, Sserunkuma J, Najjuka SM, Atim LM, Olum R, Tagg A, Bongomin F. Prevalence of burnout among university students in low- and middle-income countries: A systematic review and meta-analysis. PLoS One 2021; 16:e0256402. [PMID: 34460837 PMCID: PMC8405021 DOI: 10.1371/journal.pone.0256402] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 08/05/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Burnout is common among university students and may adversely affect academic performance. Little is known about the true burden of this preventable malady among university students in low-and-middle-income countries (LMICs). OBJECTIVES This study aimed to systematically estimate the prevalence of burnout among university students in LMICs. METHODS We searched PubMed, Google Scholar, CINAHL, Web of Science, African Journals Online, and Embase from the inception of each database until February 2021. Original studies were included. No study design or language restrictions were applied. A random-effects meta-analysis was performed using STATA version 16.0. Heterogeneity and publication bias were assessed using Q-statistics and funnel plots, respectively. RESULTS Fifty-five unique articles, including a total of 27,940 (Female: 16,215, 58.0%) university students from 24 LMICs were included. The Maslach Burnout Inventory (MBI) was used in 43 studies (78.2%). The pooled prevalence of burnout was 12.1% (95% Confidence Interval (CI) 11.9-12.3; I2 = 99.7%, Q = 21,464.1, p = < 0.001). The pooled prevalence of emotional exhaustion (feelings of energy depletion), cynicism (negativism), and reduced professional efficacy were, 27.8% (95% CI 27.4-28.3; I2 = 98.17%. p = <0.001), 32.6 (95% CI: 32.0-33.1; I2: 99.5%; p = < 0.001), and 29.9% (95% CI: 28.8-30.9; I2: 98.1%; p = < 0.001), respectively. CONCLUSION Nearly one-third of university students in LMICs experience burnout. More studies are needed to understand the causes of burnout in this key population. There is a need to validate freely available tools for use in these countries.
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Affiliation(s)
- Mark Mohan Kaggwa
- Department of Psychiatry, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Jonathan Kajjimu
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Jonathan Sserunkuma
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | | | - Letizia Maria Atim
- Department of Psychiatry, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Ronald Olum
- College of Health Science, Makerere University, Kampala, Uganda
| | - Andrew Tagg
- Emergency Department, Western Hospital-Footscray, Footscray, Victoria, Australia
- School of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - Felix Bongomin
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Gulu University, Gulu, Uganda
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Johnson J, Al-Ghunaim TA, Biyani CS, Montgomery A, Morley R, O’Connor DB. Burnout in Surgical Trainees: a Narrative Review of Trends, Contributors, Consequences and Possible Interventions. Indian J Surg 2021; 84:35-44. [PMID: 34341627 PMCID: PMC8319710 DOI: 10.1007/s12262-021-03047-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 07/14/2021] [Indexed: 02/03/2023] Open
Abstract
Surgical disciplines are popular and training places are competitive to obtain, but trainees report higher levels of burnout than either their non-surgical peers or attending or consultant surgeons. In this review, we critically summarise evidence on trends and changes in burnout over the past decade, contributors to surgical trainee burnout, the personal and professional consequences of burnout and consider the evidence for interventions. There is no evidence for a linear increase in burnout levels in surgeons over the past decade but the impact of the COVID-19 pandemic has yet to be established and is likely to be significant. Working long hours and experiencing stressful interpersonal interactions at work are associated with higher burnout in trainees but feeling more supported by training programmes and receiving workplace supervision are associated with reduced burnout. Burnout is associated with poorer overall mental and physical well-being in surgical trainees and has also been linked with the delivery of less safe patient care in this group. Useful interventions could include mentorship and improving work conditions, but there is a need for more and higher quality studies.
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Affiliation(s)
- Judith Johnson
- School of Psychology, University of Leeds, Leeds, LS29JT UK
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, BD96RJ UK
- School of Public Health and Community Medicine, University of New South Wales, Sydney, 2052 Australia
| | | | - Chandra Shekhar Biyani
- Department of Urology, St James’s University Hospital, Beckett Street, Leeds, LS9 7TF UK
- Cadaveric Simulation Programme, Anatomy Department, School of Medicine, University of Leeds, Leeds, LS2 9JT UK
| | - Anthony Montgomery
- Department of Educational and Social Policy, University of Macedonia, Thessaloniki, Greece
| | - Roland Morley
- Imperial College Healthcare NHS Trust, London, W2 1NY UK
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Malik MA, Inam H, Martins RS, Janjua MBN, Zahid N, Khan S, Sattar AK, Khan S, Haider AH, Enam SA. Workplace mistreatment and mental health in female surgeons in Pakistan. BJS Open 2021; 5:6284043. [PMID: 34037208 PMCID: PMC8152181 DOI: 10.1093/bjsopen/zrab041] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 03/22/2021] [Indexed: 11/18/2022] Open
Abstract
Background Despite workplace mistreatment, which includes harassment, bullying and gender discrimination(GD)/bias, being serious problems for female surgeons, there are limited data from lower–middle-income countries like Pakistan. This study explored harassment and GD/bias experienced by female surgeons in Pakistan, and the effects of these experiences on mental health and well-being. Methods A nationwide survey was conducted between July and September 2019 in collaboration with the Association of Women Surgeons of Pakistan, an organization consisting of female surgeons and trainees in Pakistan. An anonymous online survey was emailed directly, disseminated via social media platforms (such as Facebook, Twitter and Instagram), and sent to surgical programmes in Pakistan. Results A total of 146 women surgeons responded to the survey; 67.1 per cent were trainees and the rest attending surgeons. Overall, 57.5 per cent of surgeons reported experiencing harassment, most common being verbal (64.0 per cent) and mental (45.9 per cent), but this mostly went unreported (91.5 per cent). On multivariable analysis adjusted for age and specialty, workplace harassment (odds ratio 2.02 (95 per cent c.i. 1.09 to 4.45)) and bullying (odds ratio 5.14 (95 per cent c.i. 2.00–13.17)) were significantly associated with severe self-perceived burnout, while having a support system was protective against feelings of depression (odds ratio 0.35 (95 per cent c.i. 0.16 to 0.74)). The overwhelming majority (91.3 per cent) believed that more institutional support groups were needed to help surgeons with stress reduction (78.8 per cent), receiving mentorship (74.7 per cent) and work–life balance (67.8 per cent). Conclusion Workplace mistreatment, in particular harassment and bullying, has a damaging impact on the mental well-being of female surgeons, particularly trainees. The absence of support groups in Pakistan should be urgently addressed so that surgeons, especially trainees, may cope better with potentially harmful workplace stressors.
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Affiliation(s)
- M A Malik
- Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan
| | - H Inam
- Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan
| | - R S Martins
- Medical College, Aga Khan University Hospital, Karachi, Pakistan
| | - M B N Janjua
- Department of Surgery, Howard University Hospital, Washington, DC, USA
| | - N Zahid
- Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan
| | - S Khan
- Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan
| | - A K Sattar
- Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan
| | - S Khan
- Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan
| | - A H Haider
- Medical College, Aga Khan University Hospital, Karachi, Pakistan
| | - S A Enam
- Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan
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Naji L, Singh B, Shah A, Naji F, Dennis B, Kavanagh O, Banfield L, Alyass A, Razak F, Samaan Z, Profetto J, Thabane L, Sohani ZN. Global prevalence of burnout among postgraduate medical trainees: a systematic review and meta-regression. CMAJ Open 2021; 9:E189-E200. [PMID: 33688027 PMCID: PMC8034324 DOI: 10.9778/cmajo.20200068] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Burnout among postgraduate medical trainees (PMTs) is increasingly being recognized as a crisis in the medical profession. We aimed to establish the prevalence of burnout among PMTs, identify risk and protective factors, and assess whether burnout varied by country of training, year of study and specialty of practice. METHODS We systematically searched MEDLINE, Embase, PsycINFO, the Cochrane Database of Systematic Reviews, Web of Science and Education Resources Information Center from their inception to Aug. 21, 2018, for studies of burnout among PMTs. The primary objective was to identify the global prevalence of burnout among PMTs. Our secondary objective was to evaluate the association between burnout and country of training, year of study, specialty of training and other sociodemographic factors commonly thought to be related to burnout. We employed random-effects meta-analysis and meta-regression techniques to estimate a pooled prevalence and conduct secondary analyses. RESULTS In total, 8505 published studies were screened, 196 met eligibility and 114 were included in the meta-analysis. The pooled prevalence of burnout was 47.3% (95% confidence interval 43.1% to 51.5%), based on studies published over 20 years involving 31 210 PMTs from 47 countries. The prevalence of burnout remained unchanged over the past 2 decades. Burnout varied by region, with PMTs of European countries experiencing the lowest level. Burnout rates among medical and surgical PMTs were similar. INTERPRETATION Current wellness efforts and policies have not changed the prevalence of burnout worldwide. Future research should focus on understanding systemic factors and leveraging these findings to design interventions to combat burnout. STUDY REGISTRATION PROSPERO no. CRD42018108774.
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Affiliation(s)
- Leen Naji
- Departments of Family Medicine (Naji, Singh, Kavanagh, Profetto) and of Health Research Methods, Evidence and Impact (Naji, Alyass, Samaan, Thabane), McMaster University; Michael G. DeGroote School of Medicine (Shah); Departments of Vascular Surgery (Naji) and Medicine (Dennis); Health Sciences Library (Banfield), McMaster University, Hamilton, Ont.; Li Ka Shing Knowledge Institute (Razak), St. Michael's Hospital, Toronto, Ont.; Department of Psychiatry and Behavioural Neurosciences (Samaan), McMaster University, Hamilton, Ont.; Biostatistics Unit, St. Joseph's Healthcare - Hamilton (Thabane), Hamilton, Ont.; Faculty of Medicine (Sohani), University of Toronto, Toronto, Ont.; Department of Internal Medicine (Sohani), McGill University, Montréal, Que.
| | - Brendan Singh
- Departments of Family Medicine (Naji, Singh, Kavanagh, Profetto) and of Health Research Methods, Evidence and Impact (Naji, Alyass, Samaan, Thabane), McMaster University; Michael G. DeGroote School of Medicine (Shah); Departments of Vascular Surgery (Naji) and Medicine (Dennis); Health Sciences Library (Banfield), McMaster University, Hamilton, Ont.; Li Ka Shing Knowledge Institute (Razak), St. Michael's Hospital, Toronto, Ont.; Department of Psychiatry and Behavioural Neurosciences (Samaan), McMaster University, Hamilton, Ont.; Biostatistics Unit, St. Joseph's Healthcare - Hamilton (Thabane), Hamilton, Ont.; Faculty of Medicine (Sohani), University of Toronto, Toronto, Ont.; Department of Internal Medicine (Sohani), McGill University, Montréal, Que
| | - Ajay Shah
- Departments of Family Medicine (Naji, Singh, Kavanagh, Profetto) and of Health Research Methods, Evidence and Impact (Naji, Alyass, Samaan, Thabane), McMaster University; Michael G. DeGroote School of Medicine (Shah); Departments of Vascular Surgery (Naji) and Medicine (Dennis); Health Sciences Library (Banfield), McMaster University, Hamilton, Ont.; Li Ka Shing Knowledge Institute (Razak), St. Michael's Hospital, Toronto, Ont.; Department of Psychiatry and Behavioural Neurosciences (Samaan), McMaster University, Hamilton, Ont.; Biostatistics Unit, St. Joseph's Healthcare - Hamilton (Thabane), Hamilton, Ont.; Faculty of Medicine (Sohani), University of Toronto, Toronto, Ont.; Department of Internal Medicine (Sohani), McGill University, Montréal, Que
| | - Faysal Naji
- Departments of Family Medicine (Naji, Singh, Kavanagh, Profetto) and of Health Research Methods, Evidence and Impact (Naji, Alyass, Samaan, Thabane), McMaster University; Michael G. DeGroote School of Medicine (Shah); Departments of Vascular Surgery (Naji) and Medicine (Dennis); Health Sciences Library (Banfield), McMaster University, Hamilton, Ont.; Li Ka Shing Knowledge Institute (Razak), St. Michael's Hospital, Toronto, Ont.; Department of Psychiatry and Behavioural Neurosciences (Samaan), McMaster University, Hamilton, Ont.; Biostatistics Unit, St. Joseph's Healthcare - Hamilton (Thabane), Hamilton, Ont.; Faculty of Medicine (Sohani), University of Toronto, Toronto, Ont.; Department of Internal Medicine (Sohani), McGill University, Montréal, Que
| | - Brittany Dennis
- Departments of Family Medicine (Naji, Singh, Kavanagh, Profetto) and of Health Research Methods, Evidence and Impact (Naji, Alyass, Samaan, Thabane), McMaster University; Michael G. DeGroote School of Medicine (Shah); Departments of Vascular Surgery (Naji) and Medicine (Dennis); Health Sciences Library (Banfield), McMaster University, Hamilton, Ont.; Li Ka Shing Knowledge Institute (Razak), St. Michael's Hospital, Toronto, Ont.; Department of Psychiatry and Behavioural Neurosciences (Samaan), McMaster University, Hamilton, Ont.; Biostatistics Unit, St. Joseph's Healthcare - Hamilton (Thabane), Hamilton, Ont.; Faculty of Medicine (Sohani), University of Toronto, Toronto, Ont.; Department of Internal Medicine (Sohani), McGill University, Montréal, Que
| | - Owen Kavanagh
- Departments of Family Medicine (Naji, Singh, Kavanagh, Profetto) and of Health Research Methods, Evidence and Impact (Naji, Alyass, Samaan, Thabane), McMaster University; Michael G. DeGroote School of Medicine (Shah); Departments of Vascular Surgery (Naji) and Medicine (Dennis); Health Sciences Library (Banfield), McMaster University, Hamilton, Ont.; Li Ka Shing Knowledge Institute (Razak), St. Michael's Hospital, Toronto, Ont.; Department of Psychiatry and Behavioural Neurosciences (Samaan), McMaster University, Hamilton, Ont.; Biostatistics Unit, St. Joseph's Healthcare - Hamilton (Thabane), Hamilton, Ont.; Faculty of Medicine (Sohani), University of Toronto, Toronto, Ont.; Department of Internal Medicine (Sohani), McGill University, Montréal, Que
| | - Laura Banfield
- Departments of Family Medicine (Naji, Singh, Kavanagh, Profetto) and of Health Research Methods, Evidence and Impact (Naji, Alyass, Samaan, Thabane), McMaster University; Michael G. DeGroote School of Medicine (Shah); Departments of Vascular Surgery (Naji) and Medicine (Dennis); Health Sciences Library (Banfield), McMaster University, Hamilton, Ont.; Li Ka Shing Knowledge Institute (Razak), St. Michael's Hospital, Toronto, Ont.; Department of Psychiatry and Behavioural Neurosciences (Samaan), McMaster University, Hamilton, Ont.; Biostatistics Unit, St. Joseph's Healthcare - Hamilton (Thabane), Hamilton, Ont.; Faculty of Medicine (Sohani), University of Toronto, Toronto, Ont.; Department of Internal Medicine (Sohani), McGill University, Montréal, Que
| | - Akram Alyass
- Departments of Family Medicine (Naji, Singh, Kavanagh, Profetto) and of Health Research Methods, Evidence and Impact (Naji, Alyass, Samaan, Thabane), McMaster University; Michael G. DeGroote School of Medicine (Shah); Departments of Vascular Surgery (Naji) and Medicine (Dennis); Health Sciences Library (Banfield), McMaster University, Hamilton, Ont.; Li Ka Shing Knowledge Institute (Razak), St. Michael's Hospital, Toronto, Ont.; Department of Psychiatry and Behavioural Neurosciences (Samaan), McMaster University, Hamilton, Ont.; Biostatistics Unit, St. Joseph's Healthcare - Hamilton (Thabane), Hamilton, Ont.; Faculty of Medicine (Sohani), University of Toronto, Toronto, Ont.; Department of Internal Medicine (Sohani), McGill University, Montréal, Que
| | - Fahad Razak
- Departments of Family Medicine (Naji, Singh, Kavanagh, Profetto) and of Health Research Methods, Evidence and Impact (Naji, Alyass, Samaan, Thabane), McMaster University; Michael G. DeGroote School of Medicine (Shah); Departments of Vascular Surgery (Naji) and Medicine (Dennis); Health Sciences Library (Banfield), McMaster University, Hamilton, Ont.; Li Ka Shing Knowledge Institute (Razak), St. Michael's Hospital, Toronto, Ont.; Department of Psychiatry and Behavioural Neurosciences (Samaan), McMaster University, Hamilton, Ont.; Biostatistics Unit, St. Joseph's Healthcare - Hamilton (Thabane), Hamilton, Ont.; Faculty of Medicine (Sohani), University of Toronto, Toronto, Ont.; Department of Internal Medicine (Sohani), McGill University, Montréal, Que
| | - Zainab Samaan
- Departments of Family Medicine (Naji, Singh, Kavanagh, Profetto) and of Health Research Methods, Evidence and Impact (Naji, Alyass, Samaan, Thabane), McMaster University; Michael G. DeGroote School of Medicine (Shah); Departments of Vascular Surgery (Naji) and Medicine (Dennis); Health Sciences Library (Banfield), McMaster University, Hamilton, Ont.; Li Ka Shing Knowledge Institute (Razak), St. Michael's Hospital, Toronto, Ont.; Department of Psychiatry and Behavioural Neurosciences (Samaan), McMaster University, Hamilton, Ont.; Biostatistics Unit, St. Joseph's Healthcare - Hamilton (Thabane), Hamilton, Ont.; Faculty of Medicine (Sohani), University of Toronto, Toronto, Ont.; Department of Internal Medicine (Sohani), McGill University, Montréal, Que
| | - Jason Profetto
- Departments of Family Medicine (Naji, Singh, Kavanagh, Profetto) and of Health Research Methods, Evidence and Impact (Naji, Alyass, Samaan, Thabane), McMaster University; Michael G. DeGroote School of Medicine (Shah); Departments of Vascular Surgery (Naji) and Medicine (Dennis); Health Sciences Library (Banfield), McMaster University, Hamilton, Ont.; Li Ka Shing Knowledge Institute (Razak), St. Michael's Hospital, Toronto, Ont.; Department of Psychiatry and Behavioural Neurosciences (Samaan), McMaster University, Hamilton, Ont.; Biostatistics Unit, St. Joseph's Healthcare - Hamilton (Thabane), Hamilton, Ont.; Faculty of Medicine (Sohani), University of Toronto, Toronto, Ont.; Department of Internal Medicine (Sohani), McGill University, Montréal, Que
| | - Lehana Thabane
- Departments of Family Medicine (Naji, Singh, Kavanagh, Profetto) and of Health Research Methods, Evidence and Impact (Naji, Alyass, Samaan, Thabane), McMaster University; Michael G. DeGroote School of Medicine (Shah); Departments of Vascular Surgery (Naji) and Medicine (Dennis); Health Sciences Library (Banfield), McMaster University, Hamilton, Ont.; Li Ka Shing Knowledge Institute (Razak), St. Michael's Hospital, Toronto, Ont.; Department of Psychiatry and Behavioural Neurosciences (Samaan), McMaster University, Hamilton, Ont.; Biostatistics Unit, St. Joseph's Healthcare - Hamilton (Thabane), Hamilton, Ont.; Faculty of Medicine (Sohani), University of Toronto, Toronto, Ont.; Department of Internal Medicine (Sohani), McGill University, Montréal, Que
| | - Zahra N Sohani
- Departments of Family Medicine (Naji, Singh, Kavanagh, Profetto) and of Health Research Methods, Evidence and Impact (Naji, Alyass, Samaan, Thabane), McMaster University; Michael G. DeGroote School of Medicine (Shah); Departments of Vascular Surgery (Naji) and Medicine (Dennis); Health Sciences Library (Banfield), McMaster University, Hamilton, Ont.; Li Ka Shing Knowledge Institute (Razak), St. Michael's Hospital, Toronto, Ont.; Department of Psychiatry and Behavioural Neurosciences (Samaan), McMaster University, Hamilton, Ont.; Biostatistics Unit, St. Joseph's Healthcare - Hamilton (Thabane), Hamilton, Ont.; Faculty of Medicine (Sohani), University of Toronto, Toronto, Ont.; Department of Internal Medicine (Sohani), McGill University, Montréal, Que.
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Hassan NM, Abu-Elenin MM, Elsallamy RM, Kabbash IA. Job stress among resident physicians in Tanta University Hospitals, Egypt. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:37557-37564. [PMID: 32157529 DOI: 10.1007/s11356-020-08271-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 02/28/2020] [Indexed: 06/10/2023]
Abstract
Resident physicians are the first-line health service providers, subjected to prolonged working hours, sleep deprivation and high job demands. Work stress causes reduction in productivity, suboptimal patient care and medical errors. To determine the level of stress among residents and associated factors and stressors. A cross-sectional study at Tanta University Hospitals recruited residents (n = 278), between December 2016 and February 2017. Job stress was assessed using a predesigned questionnaire. The mean age was 26.53 ± 1.35, and 46.4% were males. The majority reported they work more than 48 h/week, do not get a break during work and have a night shift periodically (87%, 83.1% and 94.2%, respectively). Only 4 (1.4%) had low stress while 169 (60.8%) had moderate and 105 (37.8%) had high stress. The study revealed a statistically significant association between high level of stress and being a single resident (p = 0.017), belonging to surgical departments (p = 0.001) and an absence of break during working hours (p = 0.001). The prime sources of stress were underpayment for the job (87.4%), serving to large number of patients (85.2%), disruption of home life due to long hours at work (83.9%), conflict of responsibilities (81.3) and complying with increasing bureaucratic procedures (78.8%) besides no available fund for research (74.8%). Medical residents experienced moderate to high level of job stress. Thus, there is a need for stress management programs during residency training period taking in consideration main sources of stress.
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Affiliation(s)
- Nadira Mansour Hassan
- Public Health & Community Medicine Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
| | - Mira M Abu-Elenin
- Public Health & Community Medicine Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Rania M Elsallamy
- Occupational Medicine in Public Health & Community Medicine Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Ibrahim A Kabbash
- Public Health & Community Medicine Department, Faculty of Medicine, Tanta University, Tanta, Egypt
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Galaiya R, Kinross J, Arulampalam T. Factors associated with burnout syndrome in surgeons: a systematic review. Ann R Coll Surg Engl 2020; 102:401-407. [PMID: 32326734 PMCID: PMC7388944 DOI: 10.1308/rcsann.2020.0040] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/12/2020] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION To date, studies have shown a high prevalence of burnout in surgeons. Various factors have been found to be associated with burnout, and it has significant consequences personally and systemically. Junior doctors are increasingly placing their own health and wellbeing as the most important factor in their decisions about training. Finding ways to reduce and prevent burnout is imperative to promote surgical specialties as attractive training pathways. METHODS The MEDLINE, PsychInfo and EMBASE databases were searched using the subject headings related to surgery and burnout. All full text articles that reported data related to burnout were eligible for inclusion. Articles which did not use the Maslach Burnout Inventory or included non-surgical groups were excluded; 62 articles fulfilled the criteria for inclusion. FINDINGS Younger age and female sex tended to be associated with higher levels of burnout. Those further in training had lower levels of burnout, while residents suffered more than their seniors. Burnout is associated with a lower personal quality of life, depression and alcohol misuse. Academic work and emotional intelligence may be protective of burnout. Certain personality types are less likely to be burnt out. Mentorship may reduce levels of burnout. CONCLUSIONS Workload and work environment are areas that could be looked at to reduce job demands that lead to burnout. Intervening in certain psychological factors such as emotional intelligence, resilience and mindfulness may help to reduce burnout. Promoting physical and mental health is important in alleviating burnout, and these factors likely have a complex interplay.
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Affiliation(s)
- R Galaiya
- Barnet, Enfield and Haringey Mental Health NHS Trust
| | - J Kinross
- Department of Surgery and Cancer, Imperial College London, UK
| | - T Arulampalam
- School of Medicine, Anglia Ruskin University, Chelmsford
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Leu S, Vuille-dit-Bille RN, Fink L, Soll C, Staerkle RF. Burnout in Swiss and Australian surgeons in training—a cross-sectional study. Eur Surg 2020. [DOI: 10.1007/s10353-020-00639-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Abstract
Objectives: To determine the prevalence and risk factors for burnout in the intensive care units (ICU) staff in Turkey. Burnout is prevelant in physicians and nurses in the ICU worldwide. Most ICU workers with burnout plan to leave their professions. Frequent replacement of ICU staff increases cost and decreases the quality of care. Prevalence and risk factors of burnout in ICU staff in Turkey are largely unknown. Methods: This is a cross-sectional study. Data were gathered using the Maslach Burnout Inventory (MBI) which was distributed during August 2018, among all 1161 ICU workers in Turkey. Results: Burnout was detected in at least one subscale in 99% of participants and in all 3 subscales in 15% of the participants. Risk factors for emotional exhaustion included female gender (odds ratio [OR]=1.87 [95% CI: 1.26-2.78]; p<0.01), alternate-day shift (OR=3.93 [95% CI: 1.66-9.30]; p<0.01), and incidence of end of life care (OR=1.01 [95% CI: 1.00-1.03]; p<0.01). For depersonalization it included alternate-day shift (OR=2.22 [95% CI: 1.15-4.26]; p<0.05), incidence of end of life care (OR=1.02 [95% CI: 1.01-1.03]; p<0.01), and for reduced personal accomplishment it included incidence of end of life care (OR=0.97 [95% CI: 0.96-0.98]; p<0.01). Conclusion: The results indicated that ICU staff in Turkey had a high rate of burnout.
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Affiliation(s)
- Gülseren Elay
- Department of Intensive Care, Dr. Ersin Arslan Research Hospital, Gaziantep, Turkey. E-mail.
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Fernando BMS, Samaranayake DL. Burnout among postgraduate doctors in Colombo: prevalence, associated factors and association with self-reported patient care. BMC MEDICAL EDUCATION 2019; 19:373. [PMID: 31619216 PMCID: PMC6794729 DOI: 10.1186/s12909-019-1810-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 09/16/2019] [Indexed: 05/25/2023]
Abstract
BACKGROUND Postgraduate doctors are prone to burnout due to occupational and educational stressors. Sri Lankan situation is unknown. This study determines burnout among postgraduate doctors in Colombo: Prevalence, associated factors, and association with self-reported patient care. METHODS A cross-sectional study was conducted among 278 postgraduate doctors from eight specialties working in Colombo district, attached to the main postgraduate training institute for medical professionals. A self-administered questionnaire was used. It comprised of the Copenhagen Burnout Inventory and an author-developed questionnaire, which was used to assess, associated factors and self-reported patient care. Prevalence of burnout was calculated. Associations were analysed using chi-square and binary logistic regression. RESULTS The response rate was 88.1% (n = 245). The prevalence of personal, work-related and client-related burnout was 41.6% (95% CI = 35.5-47.8%), 30.6% (95% CI = 24.8-36.4%), 8.9% (95% CI = 5.4-12.5%) respectively. Personal burnout was positively associated with, the trainee being a female, having a chronic disease, being involved in frequent unhealthy habits, having doctor parents, having home-work demands and having emotional demands. It was negatively associated with, having frequent healthy habits, being satisfied with skill development opportunities, and frequent use of deep studying. Work-related burnout was positively associated with, female gender, being involved in frequent unhealthy habits, having home-work demands and having emotional demands. It was negatively associated with, frequent use of deep methods of studying. Client-related burnout was positively associated with having emotional demands and negatively associated with being satisfied with training. The frequent self-reported, suboptimal patient-care practices: poor communication, poor clinical practice, poor response to patient's needs and poor communication during handing over were associated positively with client-related burnout. CONCLUSIONS Most postgraduate doctors in Colombo have high personal and work-related burnout but client-related burnout is less. The factors associated with burnout need to be addressed by the programme managers of the postgraduate courses. Preventive measures should be introduced to reduce burnout among future postgraduate trainees of Colombo.
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Majid Z, Warsi SM. Physician burnout: an acute issue for the medical community in low- and middle-income countries. Trop Doct 2019; 49:159. [PMID: 31014194 DOI: 10.1177/0049475519843053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Zain Majid
- 1 Medical Doctor, Dow Medical College, Civil Hospital, Karachi, Pakistan
| | - Syed Majid Warsi
- 2 Medical Doctor, Jinnah Postgraduate Medical Centre, Karachi, Pakistan
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Bolat MS, Yürük E, Çınar Ö, Akdeniz E, Altunrende F, Özkuvancı Ü, Tomak L, Kadıoğlu A, Müslümanoğlu AY. The prevalence of Burnout Syndrome among Turkish Urologists: Results of a Nationwide Survey. Turk J Urol 2018; 45:449-455. [PMID: 30475702 DOI: 10.5152/tud.2018.34202] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2018] [Accepted: 07/17/2018] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To investigate the prevalence of Burnout syndrome (BS) with its emotional exhausting (EE), depersonalization (DP), and personal accomplishment (PA) dimensions among Turkish urologists. MATERIAL AND METHODS A total of 2,259 certified Turkish urologists were invited by e-mail to participate in this cross-sectional survey-based study. An online survey was conducted to evaluate three dimensions of BS ie: -EE, DP and PA-and their association with socio-demographic variables of Turkish urologists using the Maslach Burnout Inventory (MBI). RESULTS Of the 2259 urologists contacted, 362 (with a mean age of 44±9.9 years) completed the survey. The mean EE, DP and PA scores were 16.8±8.7, 6.6±4.6 and 8.2±5.6, respectively. Cronbach's α reliability co-efficiencies were 0.920 for EE, 0.819 for DP and 0.803 for PA. Antidepressant drug usage was quite prevalent among participants (21.9%), and the most common comorbidity was hypertension (13%). The academic title, age, smoking status, monthly income and relationships between colleagues and employers were associated with BS (p<0.05). CONCLUSION The prevalence of BS among Turkish urologists is quite prevalent in terms of EE and DP subscales and may negatively affect the psychosocial status and well-being of the urologists. In this study, a high prevalence of BS has been reported among Turkish urologists. In conclusion the BS could become an important occupational and health problem, if it is not properly managed.
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Affiliation(s)
- Mustafa Suat Bolat
- Department of Urology, Health Sciences University, Training and Research Hospital, Samsun, Turkey
| | - Emrah Yürük
- Department of Urology, Health Sciences University, Bağcılar Training and Research Hospital, İstanbul Turkey
| | - Önder Çınar
- Department of Urology, Health Sciences University, Training and Research Hospital, Samsun, Turkey
| | - Ekrem Akdeniz
- Department of Urology, Health Sciences University, Training and Research Hospital, Samsun, Turkey
| | - Fatih Altunrende
- Department of Urology, İstanbul Bilim University School of Medicine, İstanbul, Turkey
| | - Ünsal Özkuvancı
- Department of Urology, İstanbul University School of Medicine, İstanbul, Turkey
| | - Leman Tomak
- Department of Biostatistics, Ondokuz Mayıs University School of Medicine, Samsun, Turkey
| | - Ateş Kadıoğlu
- Department of Urology, İstanbul University School of Medicine, İstanbul, Turkey
| | - Ahmet Yaser Müslümanoğlu
- Department of Urology, Health Sciences University, Bağcılar Training and Research Hospital, İstanbul Turkey
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Rodrigues H, Cobucci R, Oliveira A, Cabral JV, Medeiros L, Gurgel K, Souza T, Gonçalves AK. Burnout syndrome among medical residents: A systematic review and meta-analysis. PLoS One 2018; 13:e0206840. [PMID: 30418984 PMCID: PMC6231624 DOI: 10.1371/journal.pone.0206840] [Citation(s) in RCA: 208] [Impact Index Per Article: 34.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Burnout is a psychological syndrome that is very common among medical residents. It consists of emotional exhaustion (EE), depersonalization (DP) and reduced personal accomplishment (PA). OBJECTIVE To estimate burnout among different medical residency specialties. METHODS A systematic review with meta-analysis was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A search of bibliographic databases and grey literature was conducted, from inception to March 2018. The following databases were accessed: Embase, PubMed, Web of Science, Google Scholar and Scopus, and 3,575 studies were found. Methodological quality was evaluated by Agency for Healthcare Research and Quality Methodology Checklist for Cross-Sectional/Prevalence Study. In the final analysis, 26 papers were included. Their references were checked for additional studies, but none were included. RESULTS 4,664 medical residents were included. High DP, EE and low PA proportions were compared. Specialties were distributed into three groups of different levels of burnout prevalence: general surgery, anesthesiology, obstetrics/gynecology and orthopedics (40.8%); internal medicine, plastic surgery and pediatrics (30.0%); and otolaryngology and neurology (15.4%). Overall burnout prevalence found for all specialties was 35.7%. CONCLUSION The prevalence of burnout syndrome was significantly higher among surgical/urgency residencies than in clinical specialties. PROSPERO REGISTRATION CRD42018090270.
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Affiliation(s)
- Hugo Rodrigues
- Health Science Postgraduate Program, Universidade Federal do Rio Grande do Norte, Natal, Brazil
| | - Ricardo Cobucci
- Department of Obstetrics and Gynecology, Potiguar University, Natal, Brazil
| | - Antônio Oliveira
- Department of Pharmacy, Universidade Federal do Rio Grande do Norte, Natal, Brazil
| | - João Victor Cabral
- Medical student, Universidade Federal do Rio Grande do Norte, Natal, Brazil
| | - Leany Medeiros
- Medical resident at Family Medicine Program, Hospital Santa Marcelina, São Paulo, Brazil
| | - Karen Gurgel
- Medical resident at Obstetrics and Gynecology Program, Universidade Federal do Rio Grande do Norte, Natal, Brazil
| | - Tházio Souza
- Medical resident at Obstetrics and Gynecology Program, Universidade Federal do Rio Grande do Norte, Natal, Brazil
| | - Ana Katherine Gonçalves
- Health Science Postgraduate Program, Universidade Federal do Rio Grande do Norte, Natal, Brazil
- Department of Obstetrics and Gynecology, Universidade Federal do Rio Grande do Norte, Natal, Brazil
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25
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Lin KS, Zaw T, Oo WM, Soe PP. Burnout among house officers in Myanmar: A cross-sectional study. Ann Med Surg (Lond) 2018; 33:7-12. [PMID: 30094025 PMCID: PMC6077145 DOI: 10.1016/j.amsu.2018.07.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2017] [Revised: 05/09/2018] [Accepted: 07/05/2018] [Indexed: 11/29/2022] Open
Abstract
Background Burnout can result in a serious negative impact on a doctor's life, the quality of patient care, and the healthcare organization. This study aims to determine the prevalence of burnout and factors affecting burnout among the house officers in Myanmar. Materials and methods An exploratory cross-sectional quantitative survey study was conducted using a self-administered, web-based survey. House officers working in any of the government hospitals in Myanmar were invited to participate in the study. The survey link was distributed online via Facebook. To measure burnout, we utilised a non-proprietary single-item measure, validated to serve as a reliable substitute for the Maslach Burnout Inventory Emotional Exhaustion (MBI:EE). To measure global life satisfaction, the validated Satisfaction with Life Scale (SWLS) was used. The questions for the scales regarding the psychosocial environment were extracted from the long version of the validated Copenhagen Psychosocial Questionnaire (COPSOQ II). The scales selected were "possibilities for the development", "meaning of work", "commitment to workplace", "recognition", "social support from colleagues" and "social support from supervisors". Multiple logistic regression method was applied to determine the factors associated with burnout. Results Regarding the prevalence of burnout, out of 159 participants, 42.8% (n = 68) of the participants had no symptoms of burnout. 57.2% (n = 91) had one or more symptoms of burnout. Multivariate analysis showed that the only significant factor associated with burnout was "recognition" (OR 0.96, 95% CI: 0.94-0.97, P < 0.001). Conclusion From this study, we have determined the relatively high burnout prevalence and that recognition is the only preventive factor; increase in recognition will decrease the odds of burnout. Hence, urgent interventions are recommended to prevent undesirable effects on both health professionals and patients. Recognition for work done should always be in the heart of the health authorities and medical community in Myanmar.
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Affiliation(s)
| | - Thant Zaw
- University of Medicine 1, Yangon, Myanmar
| | - Win Min Oo
- Rheumatology Department, Royal North Shore Hospital and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Sydney, Australia
| | - Pa Pa Soe
- University of Medicine 1, Yangon, Myanmar
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Forel D, Vandepeer M, Duncan J, Tivey DR, Tobin SA. Leaving surgical training: some of the reasons are in surgery. ANZ J Surg 2018; 88:402-407. [DOI: 10.1111/ans.14393] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 12/19/2017] [Indexed: 12/01/2022]
Affiliation(s)
- Deanne Forel
- Royal Australasian College of Surgeons, Research and Evaluation, Incorporating ASERNIP-S; Adelaide South Australia Australia
| | - Meegan Vandepeer
- Royal Australasian College of Surgeons, Research and Evaluation, Incorporating ASERNIP-S; Adelaide South Australia Australia
| | - Joanna Duncan
- Royal Australasian College of Surgeons, Research and Evaluation, Incorporating ASERNIP-S; Adelaide South Australia Australia
| | - David R. Tivey
- Royal Australasian College of Surgeons, Research and Evaluation, Incorporating ASERNIP-S; Adelaide South Australia Australia
| | - Stephen A. Tobin
- Royal Australasian College of Surgeons; Melbourne Victoria Australia
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Zafar W. Response to Dr. Beas et al. J Emerg Med 2017; 52:108. [PMID: 27742401 DOI: 10.1016/j.jemermed.2016.08.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 08/31/2016] [Indexed: 06/06/2023]
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