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Kim S, Tak SH. A Conceptual Analysis of Psychological Burnout Among Nurses Providing Terminal Care. J Adv Nurs 2025. [PMID: 40372078 DOI: 10.1111/jan.17056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2024] [Revised: 04/13/2025] [Accepted: 05/06/2025] [Indexed: 05/16/2025]
Abstract
AIM To analyse the concept of psychological burnout among nurses in the context of terminal care. DESIGN Concept analysis. METHODS The study was conducted according to the eightstep conceptual analysis procedure suggested by Walker and Avant. DATA SOURCES Articles published in English or Korean between January 2014 and 2024 were reviewed in March 2024. A total of eight search engines were used for the literature review, including PubMed, Cumulative Index of Nursing and Allied Health Literature (CINAHL) and PsycINFO. A total of 19 articles were finally selected for the analysis based on criteria. RESULTS The attributes of psychological burnout among nurses providing terminal care are depletion of energy, emotional numbness, disengagement, sense of powerlessness and emotional repression. Seven antecedents and six consequences of the concept were identified in this study. CONCLUSION The result of this study provides a foundation for the development of tailored interventions and further research related to the occurrence of psychological burnout among nurses providing terminal care. Additionally, considering the characteristics of terminal care, we suggest additional studies to confirm the attributes of burnout in this context across various cultural and religious backgrounds. IMPLICATION FOR THE PROFESSION AND/OR PATIENT CARE This study helps clarify the concept of psychological burnout among nurses in terminal care and informs the development of various interventions, educational programmes and related policies. PATIENT OR PUBLIC CONTRIBUTION No patients or public contribution.
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Affiliation(s)
- Sunjung Kim
- College of Nursing, Seoul National University, Seoul, Republic of Korea
| | - Sunghee H Tak
- Research Institute of Nursing Science, College of Nursing, Seoul National University, Seoul, Republic of Korea
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Romão ME, Setti I, Alfano G, Barello S. Exploring risk and protective factors for burnout in professionals working in death-related settings: A scoping review. Public Health 2025; 241:1-11. [PMID: 39929133 DOI: 10.1016/j.puhe.2025.01.038] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2024] [Revised: 01/10/2025] [Accepted: 01/30/2025] [Indexed: 03/17/2025]
Abstract
OBJECTIVES This study aimed to explore the published literature on risk and protective factors associated with burnout among professionals working in death-related settings. STUDY DESIGN Scoping Review. METHODS This review adopted the JBI guidelines for Scoping Reviews and followed the PRISMA-ScR guidelines. A comprehensive search strategy has been implemented across PubMed, CINAHL, PsycINFO, Web of Science, and Scopus databases. Grey literature was not included in this review. Eligible studies encompassed descriptions of risk or protective factors associated with burnout in professionals working in death scenarios. Two independent researchers screened titles and abstracts and subsequently conducted full-text assessments based on predefined inclusion criteria. Relevant data have been systematically extracted and tabulated. The findings were thematically organized and qualitatively summarized, with potential visual aids such as graphs and tables. RESULTS The studies highlighted risk and protective factors for burnout among death-related professions, such as demographic and personal factors, work-related factors, and psychological and social factors. CONCLUSIONS This study summarizes the current knowledge about burnout among professionals working in death scenarios. Further research is necessary for the development of prevention programs destined for this population.
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Affiliation(s)
- Mateus Eduardo Romão
- Work and Health Psychology Lab, Department of Brain and Behavioral Sciences, University of Pavia, Italy.
| | - Ilaria Setti
- Work and Health Psychology Lab, Department of Brain and Behavioral Sciences, University of Pavia, Italy
| | - Giorgia Alfano
- Work and Health Psychology Lab, Department of Brain and Behavioral Sciences, University of Pavia, Italy
| | - Serena Barello
- Work and Health Psychology Lab, Department of Brain and Behavioral Sciences, University of Pavia, Italy; Unit of Applied Psychology, IRCCS Mondino Foundation, Pavia, Italy
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Safiye T, Mahmutović E, Biševac E, Zimonjić V, Dubljanin D, Kovačević A, Nenezić N, Radlović A, Salihagić Z, Ajdinović A, Minić S, Šaćirović E, Uzelac J, Dolićanin Z, Dubljanin J. Factors Associated with Burnout Syndrome in Serbian Healthcare Workers During the COVID-19 Pandemic. Healthcare (Basel) 2025; 13:106. [PMID: 39857132 PMCID: PMC11765227 DOI: 10.3390/healthcare13020106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2024] [Revised: 12/23/2024] [Accepted: 01/06/2025] [Indexed: 01/27/2025] Open
Abstract
Background/Objectives: The COVID-19 pandemic imposed immense stress on healthcare systems worldwide, significantly affecting the mental well-being of healthcare workers (HCWs). This study examined the sociodemographic, occupational, and COVID-19-related predictors of burnout syndrome among Serbian HCWs. Methods: A cross-sectional survey of 400 doctors and nurses utilized the Maslach Burnout Inventory to assess emotional exhaustion, depersonalization, and personal accomplishment. Sociodemographic, work-related, and COVID-19-related data were collected via a questionnaire. Results: Key predictors of emotional exhaustion included female gender, inadequate rest, sleep disturbances, and frontline COVID-19 work. Depersonalization was associated with fewer children, temporary employment, and COVID-19 frontline duties. Conversely, older age, religiosity, larger households, and a higher socioeconomic status positively correlated with personal accomplishment. Conclusions: These findings emphasize the urgent need for targeted interventions, including improved working conditions and mental health support, to reduce burnout and enhance HCWs' well-being during medical crises.
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Affiliation(s)
- Teodora Safiye
- Department of Psychology, State University of Novi Pazar, 36300 Novi Pazar, Serbia
| | - Elvis Mahmutović
- Department of Biomedical Sciences, State University of Novi Pazar, 36300 Novi Pazar, Serbia; (E.M.); (E.B.); (Z.S.); (A.A.); (S.M.); (E.Š.); (Z.D.)
| | - Emir Biševac
- Department of Biomedical Sciences, State University of Novi Pazar, 36300 Novi Pazar, Serbia; (E.M.); (E.B.); (Z.S.); (A.A.); (S.M.); (E.Š.); (Z.D.)
| | - Velida Zimonjić
- Quality Assurance Office, State University of Novi Pazar, 36300 Novi Pazar, Serbia;
| | - Draško Dubljanin
- Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia; (D.D.); (A.K.); (A.R.); (J.D.)
- Department of Pulmonology, University Clinical Hospital Center Zvezdara, 11120 Belgrade, Serbia
| | - Andreja Kovačević
- Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia; (D.D.); (A.K.); (A.R.); (J.D.)
- Department of Cardiopulmonary Rehabilitation, Institute for Rehabilitation Belgrade, 11000 Belgrade, Serbia
| | - Nemanja Nenezić
- Department of Medical Studies Ćuprija, Academy of Educational and Medical Vocational Studies Kruševac, 35230 Ćuprija, Serbia;
| | - Aleksandar Radlović
- Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia; (D.D.); (A.K.); (A.R.); (J.D.)
| | - Zerina Salihagić
- Department of Biomedical Sciences, State University of Novi Pazar, 36300 Novi Pazar, Serbia; (E.M.); (E.B.); (Z.S.); (A.A.); (S.M.); (E.Š.); (Z.D.)
| | - Aldina Ajdinović
- Department of Biomedical Sciences, State University of Novi Pazar, 36300 Novi Pazar, Serbia; (E.M.); (E.B.); (Z.S.); (A.A.); (S.M.); (E.Š.); (Z.D.)
| | - Slaviša Minić
- Department of Biomedical Sciences, State University of Novi Pazar, 36300 Novi Pazar, Serbia; (E.M.); (E.B.); (Z.S.); (A.A.); (S.M.); (E.Š.); (Z.D.)
| | - Elma Šaćirović
- Department of Biomedical Sciences, State University of Novi Pazar, 36300 Novi Pazar, Serbia; (E.M.); (E.B.); (Z.S.); (A.A.); (S.M.); (E.Š.); (Z.D.)
| | - Jovana Uzelac
- Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia;
| | - Zana Dolićanin
- Department of Biomedical Sciences, State University of Novi Pazar, 36300 Novi Pazar, Serbia; (E.M.); (E.B.); (Z.S.); (A.A.); (S.M.); (E.Š.); (Z.D.)
| | - Jakša Dubljanin
- Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia; (D.D.); (A.K.); (A.R.); (J.D.)
- General Hospital Atlas, 11000 Belgrade, Serbia
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Gonçalves F, Gaudêncio M, Paiva I, Castelo Branco M, Viana J. Burnout and Professional Quality of Life Assessment in Portuguese Healthcare Professionals Working in Oncology and Palliative Care: A Cross-Sectional Study. Healthcare (Basel) 2024; 13:26. [PMID: 39791633 PMCID: PMC11719651 DOI: 10.3390/healthcare13010026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2024] [Revised: 12/21/2024] [Accepted: 12/24/2024] [Indexed: 01/12/2025] Open
Abstract
INTRODUCTION/BACKGROUND Burnout is a three-dimensional syndrome characterized by exhaustion that appears when the professional is constantly exposed to a stressful work environment, as well as depersonalization and lower personal accomplishment. Professional quality of life at work can be defined as the satisfaction degree that a person feels when being or going to their workplace. OBJECTIVE To evaluate burnout and professional quality of life in healthcare professionals working in oncology and palliative care. MATERIAL AND METHODS A cross-sectional, observational, and descriptive study was carried out in a convenience sample of 337 healthcare professionals from a Portuguese Oncology Hospital. The assessment tools were a sociodemographic questionnaire, the Maslach Burnout Inventory (MBI), and the Professional Quality of Life-version 5 (proQOL-5) scales. Statistical analysis was performed using the IBM SPSS® Statistics program (significance level of 95% (p ≤ 0.05)). RESULTS The majority of professionals were female (84%), with a median age of 41 years. Most professionals work in oncological care services (76.8%), with an average of 40 h a week. There were no statistically significant differences in MBI and ProQOL dimensions between the two groups studied (professionals working in oncology vs. palliative care). In the sample and group of professionals working with palliative patients, it was observed that lower levels of compassion satisfaction were related to higher levels of emotional exhaustion (p < 0.001). On the other hand, higher levels of satisfaction correlated with a greater sense of personal accomplishment (p < 0.001); higher levels of secondary traumatic stress were related to a greater tendency towards emotional exhaustion (p < 0.001) and depersonalization (p = 0.031). DISCUSSION AND CONCLUSIONS Working in oncology and palliative care may predispose one to the onset of burnout related to contact with distress and suffering. With this study, the authors intend to demonstrate that both scales (MBI and ProQOL) are complementary in the analysis of the prevalence of burnout and professional quality of life, particularly in the context of oncology and palliative care. The risk of compassion fatigue and burnout highlights the need to develop coping strategies to minimize this risk and improve the quality of life and bonding of health professionals.
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Affiliation(s)
- Florbela Gonçalves
- Faculty of Health Sciences, University of Beira Interior, 6201-001 Covilha, Portugal;
- Institute of Oncology Francisco Gentil Coimbra, 3000-075 Coimbra, Portugal;
| | | | - Ivo Paiva
- Health Sciences Research Unit, Nursing, Nursing School of Coimbra, 3000-232 Coimbra, Portugal;
| | - Miguel Castelo Branco
- Faculty of Health Sciences, University of Beira Interior, 6201-001 Covilha, Portugal;
| | - Joaquim Viana
- Department of Anesthesiology, Coimbra Hospital and Universitary Center, 3004-561 Coimbra, Portugal;
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Gonçalves F, Gaudencio M, Castelo Branco M, Viana J. Burnout and attachment in oncology and palliative care healthcare professionals. BMJ Support Palliat Care 2024; 14:e2843-e2855. [PMID: 38388210 DOI: 10.1136/spcare-2023-004694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 02/05/2024] [Indexed: 02/24/2024]
Abstract
OBJECTIVES Examine the prevalence of burn-out in health professionals working in a hospital dedicated to patients with cancer. Explore the relationship between attachment style and burn-out in healthcare professionals working in Oncology and Palliative Care. METHODS Cross-sectional descriptive and correlational study with a sample of 337 health professionals working in a tertiary hospital dedicated to oncology care. The evaluation protocol included a sociodemographic questionnaire, two burn-out (Copenhagen Burnout Inventory (CBI) and Maslach Burnout Inventory) and attachment (Adult Attachment Scale) scales. Statistical analysis was performed by IBM SPSS Statistics V.25. The tests were performed at a significance level of 5%. RESULTS In the sample, there is a predominance of professionals working in oncology services (76,8%). Comparing professionals who work in oncology services and palliative care, it appears that just over half have high levels of personal burn-out, however the groups do not differ significantly (53.5% vs 56.8%, p=0.619); the same is observed in work-related (p=0.626) and patient-related burn-out (p=0.672). The number of hours per week in which one has the perception that is exposed to suffering is positively correlated with personal, work-related burn-out and exhaustion (p<0.05). Correlating the two burn-out scales in the sample, it is observed that higher levels of personal, work-related and patient-related burn-out are associated with higher levels of emotional exhaustion and depersonalisation, as well as lower levels of personal accomplishment (p<0.001). Considering the correlation between the burn-out dimensions and attachment scale, it appears that high levels of exhaustion, depersonalisation, personal, work-related and patient-related burn-out were associated with higher levels of anxiety (p<0.001). Similar results were found in the palliative care professionals sample. CONCLUSIONS The constant exposure to the suffering of others places high emotional demands on oncology and palliative care professionals, making them vulnerable to burn-out. Burn-out is a multifactorial process, that involves individual characteristics with environmental effects. There are no significant differences between Oncology and Palliative Care professionals. Higher levels of personal, work-related and patient-related burn-out are associated with higher levels of anxiety. These results suggest that an anxious attachment style increases the risk of burn-out . In the sample, the most important predictor of burn-out was the number of hours per week exposed to suffering. In order to prevent burn-out, there is a growing evidence that suggests mindfulness, exercise, high-quality sleep and pursuit of happiness can improve burn-out in healthcare professionals. This work brings the advantage of using two burn-out assessment scales (particularly CBI scale), in addition to trying to correlate the level of burn-out and attachment in professionals exposed to suffering.
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Affiliation(s)
- Florbela Gonçalves
- Universidade da Beira Interior Faculdade de Ciencias da Saude, Covilha, Portugal
- Instituto Portugues de Oncologia de Coimbra Francisco Gentil EPE, Coimbra, Coimbra, Portugal
| | - Margarida Gaudencio
- Instituto Portugues de Oncologia de Coimbra Francisco Gentil EPE, Coimbra, Coimbra, Portugal
| | | | - Joaquim Viana
- Centro Hospitalar e Universitario de Coimbra EPE, Coimbra, Coimbra, Portugal
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Helaß M, Maatouk I. An estimate of burnout prevalence among oncology nurses. BMC Nurs 2024; 23:758. [PMID: 39407158 PMCID: PMC11479565 DOI: 10.1186/s12912-024-02421-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2024] [Accepted: 10/08/2024] [Indexed: 10/20/2024] Open
Abstract
BACKGROUND Registered nurses (RNs) in oncology must cope with the suffering of patients, the inevitability of death and their own transience. This poses a possible risk for the development of burnout, which can result in low job satisfaction and ultimately an increased intention to leave the job. Our aim was to assess psychological distress in registered nurses working in oncology. OBJECTIVE AND METHOD A cross-sectional survey with the Oldenburger Burnout Inventory was presented to nurses within the German Cancer Society. It collected data on psychological distress via two subscales, exhaustion and disengagement. Socio-demographic data were assessed. RESULTS Among 83 participating nurses, we found a prevalence of high disengagement in 17 oncology nurses (20.48%) and high exhaustion (MExh>2.5 = burnout) in 44 (53.00%). Looking at the highest values of both scales, 18.08% of respondents were at high risk for psychological distress. There was a low correlation between disengagement and age (r = 0.331, p < 0.01). The risk of high disengagement among nurses older than 50 (n = 9, 52.94%) was three times higher than for those who were 50 or younger (n = 8, 47.06%) (RR = 8.642, 95% CI: 1.475-5.749, p < 0,01). CONCLUSION This survey highlights a high rate of burnout among German oncology nurses. Interventions should be developed, implemented, and delivered in an age-appropriate manner. To ensure high-quality care and patient safety, oncology nurses should be offered preventive mental healthcare services later in their careers. CLINICAL TRIAL REGISTRATION NUMBER The study was registered with the German Clinical Trials Register (DRKS500018851).
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Affiliation(s)
- Madeleine Helaß
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany.
| | - Imad Maatouk
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany
- Department of Internal Medicine II, Section of Psychosomatic Medicine, Psychotherapy and Psychooncology, Julius-Maximilian University Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany
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Ramaci T, Santisi G, Curatolo K, Barattucci M. Perceived organizational support moderates the effect of job demands on outcomes: Testing the JD-R model in Italian oncology nurses. Palliat Support Care 2024; 22:1338-1346. [PMID: 38766714 DOI: 10.1017/s1478951524000890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
OBJECTIVES The research aimed to test the job demands-resources (JD-R) model on a sample of Italian oncology workers, and the role of perceived organizational support (POS) as a moderator of the effects of JD on outcomes (job satisfaction and burnout [BO]). METHODS Based on the JD-R model, a correlational study was designed to investigate the relationships between JD, POS as a job resource, self-esteem (as a personal resource), and job outcomes (BO and job satisfaction); the research involved a sample of oncology nurses (N = 235) from an Italian public hospital, who completed a questionnaire during working hours. Relationships between variables were investigated with multiple regressions and moderation analysis. RESULTS Results confirmed that JD predict both BO and job satisfaction; POS is a weak predictor of job outcomes, but its mediator role in the JD-outcomes relationship was confirmed: the more the nurses perceive a supportive organization, the weaker the positive relationship between JD and BO. SIGNIFICANCE OF RESULTS Findings are consistent with other contributions that highlighted that organizational job resources may attenuate the adverse effect of JD on positive and negative outcomes: POS may play a central role in employee well-being and health, acting as a possible moderator, and somehow defusing the positive association between JD and outcomes.
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Affiliation(s)
- Tiziana Ramaci
- Faculty of Human and Social Sciences, Kore University of Enna, Enna, Italy
| | - Giuseppe Santisi
- Department of Educational Sciences, University of Catania, Catania, Italy
| | - Krizia Curatolo
- Faculty of Human and Social Sciences, Kore University of Enna, Enna, Italy
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Duan Y, Huang J, Yu R, Lin F, Liu Y. Evaluation of the effect of death education based on the Peace of Mind Tea House: a randomized controlled trial of nursing trainees at Xiamen University, China. BMC Nurs 2024; 23:597. [PMID: 39183284 PMCID: PMC11346280 DOI: 10.1186/s12912-024-02188-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 07/16/2024] [Indexed: 08/27/2024] Open
Abstract
BACKGROUND There are few studies on death education models for nursing students in China. It is of great significance to construct a model of nursing students' death education combined with clinical practice. This study aims to evaluate the effect of death education on nursing students based on the Peace of Mind Tea House. METHODS The randomized controlled trial commenced from February 7 to March 18, 2021,featuring a two-month intercession at a hospital situated in Xiamen, China. The research subjects were chosen using a convenient sampling approach with nursing students from the hospital's internship program. Ninety-two participants were enrolled, with 46 in each group. Thirteen participants were lost to follow-up, corresponding to 14% of the total study population. The samples were then allocated randomly into either the intervention group or the control group. In addition to their hospital internship, the intervention group participated in six death education courses that focused on cognitive, emotional, and motor skills as well as the "Peace of Mind Tea House" program. Control participants will undergo regular internships. Before and two weeks after the course, both groups were evaluated for death anxiety, attitude towards death, and the meaning of life to assess the intervention's effectiveness. RESULTS In the fear of death item of the Death Attitude Scale and the meaning of life section, the post-test score minus the pre-test score of the intervention group were 2.50 ± 3.90 (p = 0.011), and 8.90 ± 11.07 (p = 0.035), respectively. During the communication and sharing session of the reassurance card activity, 41 participants (95.3%) found the activity meaningful. CONCLUSION Our data analysis demonstrates that nursing students have accepted and acknowledged the Peace of Mind Tea House-based education on death, which positively impacted their attitudes towards deathand the meaning of life. The content of death education should be integrated with traditional culture, and a new model of death education should be constructed with the Heart to Heart cards as its core. This research presents proof of the efficacy of implementing appropriate death education for nursing students, and provides a successful intervention plan to alleviate their future death anxiety and develop a positive outlook on death. TRIAL REGISTRATION This study was approved by the Ethical Committee of Xiamen University School of Medicine (No. XDYX202304K21)(Date:18/01/2021). Written consent to participate was obtained from all the students.
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Affiliation(s)
- Ying Duan
- Department of Nursing, School of Medicine, Xiamen University, Xiangan Campus, Fujian, 361102, Xiamen, China
| | - JianMei Huang
- Zhangzhou Health Vocational College, Zhangzhou, China
| | - Rong Yu
- Gastrointestinal Surgery, Zhongshan Hospital Xiamen University, Xiamen, China
| | - Feng Lin
- Nursing Department, Zhongshan Hospital Xiamen University, Xiamen, China
| | - Yang Liu
- Department of Nursing, School of Medicine, Xiamen University, Xiangan Campus, Fujian, 361102, Xiamen, China.
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Uno A. How Views on Death and Time Perspectives Relate to Palliative Care Nurses' Attitudes Toward Terminal Care? OMEGA-JOURNAL OF DEATH AND DYING 2024; 88:1031-1050. [PMID: 34872421 DOI: 10.1177/00302228211055269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study's purpose was to explore how palliative care nurses' views on death and time perspectives are related to their terminal care attitudes. A questionnaire survey-consisting of the Death Attitude Inventory, Experiential Time Perspective Scale, and the Japanese version of the Frommelt Attitudes Toward Care of the Dying Scale-was administered to 300 individuals. Cluster analysis was conducted to categorize the way nurses perceive death, which revealed four types: Avoidant, middle, accepting, and indifferent. As a result of the analysis of variance on the terminal care attitudes, based on the types of views on death and time attitudes, it was found that the middle and accepting types, as well as the adaptive formation of time attitudes, were related to positive terminal care attitudes. In conclusion, more effective improvements in attitudes toward terminal care can be expected by incorporating time perspective, in addition to the conventional approaches focusing on death.
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Affiliation(s)
- Akari Uno
- Graduate School of Education, Tohoku University, Sendai, Japan
- Japan Society for the Promotion of Science Research Fellow, Japan
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Cantero-García M, Llorente M, Gómez-Martínez S, González-Moreno J. Attitudes toward death and burnout syndrome in geriatrics and gerontology healthcare personnel. Rev Esp Geriatr Gerontol 2023; 58:101422. [PMID: 37897943 DOI: 10.1016/j.regg.2023.101422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 09/14/2023] [Accepted: 09/25/2023] [Indexed: 10/30/2023]
Abstract
INTRODUCTION Geriatric and gerontology healthcare workers are associated with a series of psychosocial risks such as death, bereavement and illness, and this implies a significant emotional and work overload, which can lead to negative attitudes toward death. OBJECTIVE The aims of this study were to assess attitudes toward death, the level of burnout and the relationship between geriatrics and gerontology professionals. METHOD A correlational, cross-sectional study was conducted, in which the 42 participants in the sample completed an online questionnaire including the Revised Profile of Attitudes to Death (PAM-R) and the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). RESULTS The results obtained show that the predominant attitude toward death in the sample is that of neutral acceptance, and with regard to burnout syndrome, moderate average levels are found in the dimensions of emotional exhaustion and personal accomplishment, but a low level of depersonalisation. CONCLUSION Healthcare workers with attitudes of greater fear of death or acceptance of escape tend to experience higher levels of emotional exhaustion and depersonalisation, as do those with an attitude of death avoidance, who also have lower personal fulfillment.
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Affiliation(s)
- María Cantero-García
- Universidad a Distancia de Madrid (UDIMA), Madrid, Spain; Universidad Internacional de Valencia, Área de salud, Spain.
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Yu J, Soh KL, He L, Wang P, Soh KG, Cao Y. The Experiences and Needs of Hospice Care Nurses Facing Burnout: A Scoping Review. Am J Hosp Palliat Care 2023; 40:1029-1039. [PMID: 36400563 DOI: 10.1177/10499091221141063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/19/2023] Open
Abstract
AIM Explore the existing literature on the experience and needs of palliative nurses facing job burnout. BACKGROUND On a global scale, with the increase of aging, the number of people in need of palliative care has increased significantly, which has a huge impact on the professional pressure of palliative nurses. Existing literature focuses on examining palliative care from the perspective of patients, but palliative nurses also face the threats to physical and mental health caused by job burnout. EVALUATION A systematic literature search has been carried out in the following databases as of October 2021:PubMed, EMBASE, CINAHL, Web of Science, and Scopus. The Cochrane Library and Joanna Briggs Institute Library were also searched to confirm if there are any available systematic reviews on the subject. Manually searched the reference list of included papers. KEY ISSUES Seventeen studies were included in this review. Five key issues in the palliative care nurse's experience: (1) psychological harm, (2) physical symptoms, (3) negative emotions, (4) Burnout caused by communication barriers, and (5) Lack of experience. Two key issues in the needs of palliative care nurses: (1) social support, and (2) training and education. CONCLUSION The pressure of facing death for a long time and controlling the symptoms of patients has a very important impact on the mental and physical health of palliative nurses. Nursing staff have needed to be satisfied, and it is essential to provide support and help relieve the pressure on palliative nurses.
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Affiliation(s)
- Jiaxiang Yu
- Department of Nursing, University Putra Malaysia, Serdang, Malaysia
| | - Kim Lam Soh
- Department of Nursing, University Putra Malaysia, Serdang, Malaysia
| | - Liping He
- Department of Nursing, University Putra Malaysia, Serdang, Malaysia
| | - Pengpeng Wang
- Department of Nursing, University Putra Malaysia, Serdang, Malaysia
| | - Kim Geok Soh
- Department of Sport Studies, Faculty of Educational Studies, Putra Malaysia University, Serdang, Malaysia
| | - Yingjuan Cao
- Department of Nursing, Qilu Hospital of Shandong University, Jinan, China
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Koh Li Yen T, Yung SH, Chia SC, Chia TY, Koh Yong Hwang M, Patinadan PV, Wong TY. Coda and Catharsis: Exploring the Emotional Challenges and Coping of Junior Palliative Physicians Through Cinematic Reflection. OMEGA-JOURNAL OF DEATH AND DYING 2023:302228231194215. [PMID: 37542455 DOI: 10.1177/00302228231194215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/07/2023]
Abstract
Background: There has been little research on reflective tools for junior doctors, whom may have encountered challenges working in palliative care whereby grief and losses are high. This is a qualitative study aiming to firstly explore the emotional challenges of junior doctors and secondly whether the movie is an effective reflective tool. Setting/participants: 32 junior doctors rotating through the palliative care unit were recruited and underwent a combined movie screening with a focus group discussion after. Results: Emotional challenges highlighted were (1) lifting the veil of death (2) impeded call of action (3) manifesting inner fatigue. Majority found the movie relatable to their clinical practice and felt that the focus group discussion was helpful. Conclusion: Junior doctors do have certain emotional challenges during their palliative care posting. Having a movie session combined with a focus group discussion is a reasonable method to help them reflect about their challenges.
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Affiliation(s)
- Tessa Koh Li Yen
- Palliative Medicine Tan Tock Seng Hospital, Tan Tock Seng Hospital, Singapore
| | - Sek Hwee Yung
- Palliative Medicine Tan Tock Seng Hospital, Tan Tock Seng Hospital, Singapore
| | - Siew Chin Chia
- Palliative Medicine Tan Tock Seng Hospital, Tan Tock Seng Hospital, Singapore
| | - T-Yunn Chia
- Palliative Medicine Tan Tock Seng Hospital, Dover Park Hospice, Singapore
| | | | - Paul Victor Patinadan
- Palliative Medicine Tan Tock Seng Hospital, Nanyang Technological University, Singapore
| | - Teck Yee Wong
- Palliative Medicine Tan Tock Seng Hospital, Tan Tock Seng Hospital, Singapore
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13
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Zulueta Egea M, Prieto-Ursúa M, Bermejo Toro L, Jodar Anchía R. Quality of palliative nursing care: Meaning, death anxiety, and the mediating role of well-being. Palliat Support Care 2023; 21:205-213. [PMID: 35139982 DOI: 10.1017/s1478951521001954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND There is increasing concern regarding the quality of palliative nursing care. However, despite the growing number of studies identifying related variables, there is still a paucity of studies analyzing models of how these variables interrelate. OBJECTIVE The study aimed to identify the role played in the quality of palliative care of nursing professionals by the variables meaning and death anxiety and to investigate the mediating role of psychological well-being and engagement. METHOD 176 palliative nursing professionals participated, selected by non-probabilistic convenience sampling using the snowball method. A simple mediation analysis and a multiple mediator model were performed in parallel, and data were collected using a paper and online questionnaire between January and May 2018. RESULTS Well-being mediated the impact of meaning (indirect effect = 0.096, SE = 0.044, 95% confidence interval (CI): 0.028, 0.213) and death anxiety (indirect effect = -0.032, SE = 0.013, 95% CI: -0.064, -0.010) on the quality of care. Engagement, on the other hand, only mediated the impact of meaning (indirect effect = 0.185, SE = 0.085, 95% CI: 0.035, 0.372), while the indirect effect of death anxiety with the quality of care through engagement was not statistically significant (indirect effect = 0.008, SE = 0.009, 95% CI: -0.004, 0.032). SIGNIFICANCE OF RESULTS Death anxiety is not directly related to the quality of care, but rather has an effect through psychological well-being, a variable acting as a mediator between the two. The effect of meaning on the quality of care is explained by the mediation of both engagement and psychological well-being, and its impact on the quality of care is thereby mediated by more variables than death anxiety.
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Affiliation(s)
- Mar Zulueta Egea
- Nursing, Centro Universitario de Ciencias de la Salud San Rafael-Nebrija, Madrid, Spain
| | - María Prieto-Ursúa
- Psychology Department and Clinical Unit of Psychology (UNINPSI), Comillas Pontifical University - Cantoblanco Campus, Comunidad de Madrid, Spain
| | - Laura Bermejo Toro
- Psychology Department and Clinical Unit of Psychology (UNINPSI), Comillas Pontifical University - Cantoblanco Campus, Comunidad de Madrid, Spain
| | - Rafa Jodar Anchía
- Psychology Department and Clinical Unit of Psychology (UNINPSI), Comillas Pontifical University - Cantoblanco Campus, Comunidad de Madrid, Spain
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14
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Omidi Z, Khanjari S, Salehi T, Haghani S. Association between burnout and nurses' quality of life in neonatal intensive care units: During the COVID-19 pandemic. JOURNAL OF NEONATAL NURSING : JNN 2023; 29:144-148. [PMID: 35475268 PMCID: PMC9021044 DOI: 10.1016/j.jnn.2022.04.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 04/12/2022] [Indexed: 05/13/2023]
Abstract
BACKGROUND Neonatal intensive care unit (NICUs) nurses could suffer from job stress and burnout, which could cause increased turnover rates and decreased Quality of Life (QoL) among nurses. PURPOSE To determine the association between burnout and nurses' QoL in NICUs. STUDY DESIGN This correlational study was performed in 2020 on 140 nurses working in NICUs. The Maslach burnout and WHO Quality of Life-BREF was used to collect data. RESULTS There is a positive association between personal accomplishment and all dimensions of QoL (r = 0.40 to 0.56) and a negative association between emotional exhaustion, depersonalization of burnout and all dimensions of QoL (r = -0.47 to -0.79). CONCLUSION It is suggested that several interventions must be taken to prevent burnout and increased QoL in NICU nurses. The findings could provide scientific evidence for managers and encourage evidence-based decision-making to reduce burnout and improve the QoL of nurses especially during the Covid-19 pandemic.
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Affiliation(s)
- Zahra Omidi
- Student of Neonatal Intensive Care Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Sedigheh Khanjari
- Dept. of Pediatrics. Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Tahmineh Salehi
- Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Shima Haghani
- Biostatistics Nursing Care Research Center, Iran University of Medical Sciences, Tehran, Iran
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15
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Zhang Y, Guan C, Jiang J, Zhu C, Hu X. Mediating effect of resilience on the relationship between perceived social support and burnout among Chinese palliative nurses. J Clin Nurs 2022. [PMID: 36101490 DOI: 10.1111/jocn.16532] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 08/17/2022] [Accepted: 08/31/2022] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To detect the mediating effect of resilience on the relationship between perceived social support and burnout in Chinese palliative nurses. BACKGROUND Palliative nurses are a group that is vulnerable to burnout. Perceived social support may contribute to decreasing palliative nurses' burnout and facilitating their personal resilience, and resilience may be associated with lower levels of burnout. However, these relationships were unclear in the Chinese context. DESIGN A cross-sectional design. METHODS The STROBE guideline was performed to report this study. A mixed sampling method including convenience sampling and stratified sampling was used to recruit participants, and a total of 319 palliative nurses completed the Nursing Burnout Scale, the Perceived Social Support Scale and the Connor-Davidson Resilience Scale from May 2021 to September 2021. Influencing factors were primarily identified using independent-sample t tests and one-way ANOVA. Bootstrap method was used to detect the mediating effect of resilience. RESULTS The level of burnout in palliative nurses (23.4 ± 7.68) was higher than that of general nurses in China. Education level, health condition and monthly income were influencing factors of burnout. Resilience was detected as a mediator in the relationships between perceived social support and dimensions of burnout. CONCLUSIONS Chinese palliative nurses experience a relatively high level of burnout, which may be influenced by several sociodemographic variables. Resilience could mediate the effect of perceived social support on the dimensions of burnout. Problem-oriented and palliative-tailored strategies should be developed to further address burnout in Chinese palliative nurses. RELEVANCE TO CLINICAL PRACTICE Nurse managers and policy makers should support nurse ongoing education, adopt health-promoting interventions and optimise salary systems. In addition, perceived social support resources and resilience training programmes are also warranted. PATIENT OR PUBLIC CONTRIBUTION All participants were invited to complete the informed consent form and paper questionnaires. Human resource managers helped us collect some subjective data through the personnel management system. Nurse managers of palliative units conducted regular staff meetings to promote the data collection process.
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Affiliation(s)
- Yalin Zhang
- West China School of Nursing, Sichuan University/Department of Nursing, West China Hospital, Sichuan University, Chengdu, China
| | - Chang Guan
- West China School of Nursing, Sichuan University/Department of Nursing, West China Hospital, Sichuan University, Chengdu, China
| | - Jianjun Jiang
- Department of Palliative Medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Chuanmei Zhu
- Department of Outpatient, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaolin Hu
- West China School of Nursing, Sichuan University/Department of Nursing, West China Hospital, Sichuan University, Chengdu, China
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16
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Xiang-Zi J, Jia-Yuan Z. Mindfulness exercises reduce death anxiety and burnout in intensive care nurses. DEATH STUDIES 2022; 47:600-605. [PMID: 36016467 DOI: 10.1080/07481187.2022.2113480] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Intensive care units (ICUs) nurses experience a high level of death anxiety. Interventions that reduce death anxiety are needed. We conducted a nonrandomized study with 66 ICU nurses. The 34 in the intervention group received an 8-week tailored mindfulness-based intervention and the 32 in the control group received no intervention. Both groups completed pre and post-tests of death anxiety and burnout. At post-test, the levels of death anxiety and job burnout in the intervention group were significantly lower than the control group. Mindfulness-based intervention can reduce the death anxiety level and burnout of ICU nurses.
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Affiliation(s)
- Ji Xiang-Zi
- Department of Management, Suzhou Industrial Park Institute of Service Outsourcing, Suzhou, China
| | - Zhang Jia-Yuan
- Department of Nursing, Harbin Medical University, Daqing, China
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17
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The Association of Life Events Outside the Workplace and Burnout: A Cross-Sectional Study on Nursing Assistants. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159342. [PMID: 35954702 PMCID: PMC9368059 DOI: 10.3390/ijerph19159342] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 07/20/2022] [Accepted: 07/26/2022] [Indexed: 01/27/2023]
Abstract
Background: Burnout, by definition, is related to adverse chronic workplace stressors. Life events outside the workplace have been associated with an increased risk of psychiatric morbidity. However, it is unknown whether life events outside the workplace increase the severity of burnout. Purpose: The aim of the study was to investigate the association between burnout and life events outside the workplace in nursing assistants. Methods: In an observational, cross-sectional, single-site study of 521 nursing assistants at a university hospital, we assessed burnout with the Maslach Burnout Inventory-Human Services Survey, and life events with the Social Readjustment Rating Scale. We constructed equations of multiple linear regression analyses that included each burnout subscale as the dependent variable and a domain of life events as the independent variable. Results were adjusted for potential confounders, including gender, no religion or faith, years of work, and depression. Results: An increase in the number of life events in the domain of personal changes or difficulties (e.g., personal injury or illness, sexual difficulties, change in recreation, church activities, social activities, sleeping habits, eating habits and revision of personal habits) was associated with increased severity of emotional exhaustion. An increase in the number of life events in the domain of changes in familial situation and in the domains of death of relatives or friends were associated with increased severity of depersonalization. Those associations were independent of work-related life events and other potential confounders. Conclusions: Life events outside the workplace may increase the levels of burnout in nursing assistants.
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18
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Brian Nyatanga B. Healthcare professionals who provide palliative care require support to reduce symptoms of burnout. Evid Based Nurs 2022; 25:ebnurs-2020-103377. [PMID: 35393295 DOI: 10.1136/ebnurs-2020-103377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2022] [Indexed: 06/14/2023]
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19
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Celano T, Harris S, Sawyer AT, Hamilton T. Promoting Spiritual Well-Being Among Nurses. NURSE LEADER 2022; 20:188-192. [PMID: 35280339 PMCID: PMC8899437 DOI: 10.1016/j.mnl.2021.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 08/04/2021] [Accepted: 08/09/2021] [Indexed: 11/26/2022]
Abstract
Health care organizations are facing the fallout from inadequate nurse staffing in addition to the emotional and spiritual tolls of the COVID-19 pandemic. Organizations must strategically differentiate themselves by novel methods of recruitment and retention, including care of the nurse as a whole person. Tactical strategies can be implemented by nurse leaders to promote the spiritual well-being of the nursing workforce. These strategies include incorporating spirituality and soft skills into nursing orientation, developing and providing interventions to support spiritual well-being, and implementing methods to provide spiritual care of patients by nurses.
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20
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Sapeta P, Centeno C, Belar A, Arantzamendi M. Adaptation and continuous learning: integrative review of coping strategies of palliative care professionals. Palliat Med 2022; 36:15-29. [PMID: 34554042 PMCID: PMC8793319 DOI: 10.1177/02692163211047149] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Coping is essential to manage palliative care professionals' challenges. The focus has been on the effects of coping mechanism; however, little is known about coping itself in palliative care. AIM To synthesise evidence of coping strategies in palliative care professionals, and how different strategies play roles over time. DESIGN Systematically conducted integrative review. DATA SOURCES PubMed; CINAHL; Medline; PsycINFO and B-ON were searched (1996-2021) combining 'coping' AND 'palliative care'. A predefined data extraction sheet was developed to report data. Two researchers performed constant comparative analysis using Nvivo®. RESULTS Thirty-one studies were included. Four main strategies with recurrent reference to time were found: (a) proactive coping, involving activities to achieve self-confidence and control situations and emotions; (b) self-care based coping, including self-protection and self-awareness activities, with behavioural disconnection; (c) self-transformation coping, involving activities to accept limits; and (d) encountering deep professional meaning, is a coping mechanism based on meaning, frequently considering the deepest meaning of work. The dynamic and influencing factors were training, team interaction, professional motivation and family. They were usually protective factors, though sometimes they represented risk factors. The emotional burden associated with healthcare and systemic stressors were always risk factors. An explanatory model describes a complex and dynamic process, in which everyday strategies and more introspective strategies are combined. CONCLUSIONS The model showed a process of adaptation and learning to persevere in palliative care. It changes over time under factors and strategies, and evolves in a personal and professional transformation, parallel to the working life. It would be worth assessing coping in healthcare professionals who chose to leave palliative care and to investigate the reasons they did so and their coping mechanisms.
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Affiliation(s)
- Paula Sapeta
- Escola Superior de Saúde Dr. Lopes Dias, Instituto Politécnico de Castelo Branco, Castelo Branco, Portugal
| | - Carlos Centeno
- Institute for Culture and Society, ATLANTES, Universidad de Navarra, Pamplona, Navarra, Spain
- IdISNA – Instituto de Investigación Sanitaria de Navarra, Medicina Paliativa, Pamplona, Navarra, Spain
- Clínica Universidad de Navarra, Pamplona, Navarra, Spain
| | - Alazne Belar
- Institute for Culture and Society, ATLANTES, Universidad de Navarra, Pamplona, Navarra, Spain
- IdISNA – Instituto de Investigación Sanitaria de Navarra, Medicina Paliativa, Pamplona, Navarra, Spain
| | - María Arantzamendi
- Institute for Culture and Society, ATLANTES, Universidad de Navarra, Pamplona, Navarra, Spain
- IdISNA – Instituto de Investigación Sanitaria de Navarra, Medicina Paliativa, Pamplona, Navarra, Spain
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21
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Alsalhe TA, Chalghaf N, Guelmami N, Azaiez F, Bragazzi NL. Occupational Burnout Prevalence and Its Determinants Among Physical Education Teachers: A Systematic Review and Meta-Analysis. Front Hum Neurosci 2021; 15:553230. [PMID: 34955783 PMCID: PMC8695498 DOI: 10.3389/fnhum.2021.553230] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 05/26/2021] [Indexed: 11/23/2022] Open
Abstract
Burnout can be defined as an occupational syndrome resulting from poorly managed chronic workplace stress. It is characterized by three dimensions: feelings of energy depletion or exhaustion; increased mental distance from one's job, or feelings of negativism or cynicism related to one's job; and reduced professional efficacy. Teachers are among the human service professionals particularly vulnerable to occupational burnout. Teaching is a highly demanding and challenging task, in that requires constant confrontation with different stakeholders (students and their parents, administrators). Among teachers, physical education teachers have been particularly understudied even though a recently published systematic review has found that they are exposed to high levels of stress. To better explore burnout syndrome among physical education teachers, the present systematic review was undertaken, searching up to six languages. Fifty-six studies were included in the present review. The reported rate of high emotional exhaustion ranged from 11.52 to 60.6%, according to the single study. Pooling together 12 studies and totaling 2,153 physical education teachers, the prevalence rate of high emotional exhaustion was computed to be 28.6 [95% CI 21.9–35.8]. The reported rate of high depersonalization ranged from 3.6 to 45.2%, according to the single study. Pooling together 11 studies and totaling 2,113 physical education teachers, the prevalence rate of high depersonalization was computed to be 14.5% [95% CI 8.0–22.4]. The reported rate of low personal accomplishment ranged from 13.63 to 55.6%, according to the single study. Pooling together 12 studies and totaling 2,153 physical education teachers, the prevalence rate of low personal accomplishment was computed to be 29.5% [95% CI 23.8–35.4]. The reported rate of overall burnout ranged from 10.0 to 51.6%, according to the single study. Pooling together 7 studies and totaling 1,101 physical education teachers, the prevalence rate of overall burnout was computed to be 23.9% [95% CI 13.6–36.0]. No evidence of publication bias could be found, both visually inspecting the funnel plot and conducting the Egger's linear regression test. Burnout imposes a significant burden among physical education teachers. Based on the information contained in the present systematic review and meta-analysis, tailored interventions could be designed to mitigate such a burden. However, due to the limitations of the studies included in the present systematic review and meta-analysis, further research in the field is urgently warranted. Systematic Review Registration:https://osf.io/69ryu/, identifier: 10.17605/OSF.IO/69RYU.
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Affiliation(s)
- Tariq A Alsalhe
- College of Sport Sciences and Physical Activity, King Saud University, Riyadh, Saudi Arabia
| | - Nasr Chalghaf
- Group for the Study of Development and Social Environment (GEDES), Faculty of Human and Social Science of Sfax, Sfax, Tunisia.,Higher Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Noomen Guelmami
- Group for the Study of Development and Social Environment (GEDES), Faculty of Human and Social Science of Sfax, Sfax, Tunisia.,Higher Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Fairouz Azaiez
- Group for the Study of Development and Social Environment (GEDES), Faculty of Human and Social Science of Sfax, Sfax, Tunisia.,Higher Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Nicola Luigi Bragazzi
- Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DINOGMI), Genoa University, Genoa, Italy.,Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics, York University, Toronto, ON, Canada
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22
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Xie L, Li Y, Ge W, Lin Z, Xing B, Miao Q. The relationship between death attitude and professional identity in nursing students from mainland China. NURSE EDUCATION TODAY 2021; 107:105150. [PMID: 34560392 DOI: 10.1016/j.nedt.2021.105150] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 08/31/2021] [Accepted: 09/12/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Professional identity reduces the risk of job burnout in nurses, and attitudes towards death might be a factor affecting nurses' professional identity. Little research has been conducted to directly investigate the relationship between professional identity and death attitudes in nursing students. In addition, there are cultural differences in the formation of death attitudes. It is necessary to explore attitudes towards death in Chinese nursing students and investigate the relationship between death attitudes and professional identity. OBJECTIVES To investigate the relationship between professional identity and death attitudes in nursing students in mainland China. DESIGN A cross-sectional study. PARTICIPANTS A total of 2119 nursing students from mainland China were included in this survey. METHODS The survey was conducted online. The questionnaire included the Chinese version of the Professional Identification Scale and the Chinese version of the Death Attitude Profile - Revised to measure the nursing students' professional identity and attitudes towards death. The survey also collected the participants' age, gender, institution type, place of residence and self-assessed health state. RESULTS The professional identity of the nursing students (average scores: 33.68 ± 5.12) from mainland China was above an intermediate level, and their attitudes towards death were positive overall (escape acceptance: 3.37 ± 0.96, approach acceptance: 3.36 ± 0.79, fear of death: 2.88 ± 0.77, death avoidance: 2.74 ± 0.84, neutral acceptance: 2.29 ± 0.77). Among the nursing students, professional identity was correlated with attitudes towards death. Specifically, professional identity was positively correlated with approach acceptance (p < 0.001), escape acceptance (p < 0.001) and neutral acceptance (p < 0.001) but negatively correlated with fear of death (p < 0.001) and death avoidance (p < 0.001). The nursing students with relatively low professional identity showed stronger death anxiety than those with relatively high professional identity (p < 0.001). CONCLUSION The outcome of this study suggests that education on life and death and internship experience in palliative care contribute to the development of a high level of professional identity in nursing work.
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Affiliation(s)
- Lin Xie
- School of Clinical Medicine, Hangzhou Normal University, Hangzhou 311121, China.
| | - Yanjuan Li
- Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou 310007, China.
| | - Wenjie Ge
- School of Nursing, Hangzhou Normal University, Hangzhou 311121, China.
| | - Ze Lin
- Institute of Psychological Sciences, Hangzhou Normal University, Hangzhou 311121, China.
| | - Bingyu Xing
- School of Nursing, Hangzhou Normal University, Hangzhou 311121, China.
| | - Qunfang Miao
- School of Clinical Medicine, Hangzhou Normal University, Hangzhou 311121, China.
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23
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Diehl E, Rieger S, Letzel S, Schablon A, Nienhaus A, Escobar Pinzon LC, Dietz P. Burdens, resources, health and wellbeing of nurses working in general and specialised palliative care in Germany - results of a nationwide cross-sectional survey study. BMC Nurs 2021; 20:162. [PMID: 34488742 PMCID: PMC8419389 DOI: 10.1186/s12912-021-00687-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 08/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Palliative care in Germany is divided into general (GPC) and specialised palliative care (SPC). Although palliative care will become more important in the care sector in future, there is a large knowledge gab, especially with regard to GPC. The aim of this study was to identify and compare the burdens, resources, health and wellbeing of nurses working in GPC and SPC. Such information will be helpful for developing prevention programs in order to reduce burdens and to strengthen resources of nurses. METHODS In 2017, a nationwide cross-sectional survey was conducted. In total, 437 nurses in GPC and 1316 nurses in SPC completed a questionnaire containing parts of standardised instruments, which included parts of the Copenhagen Psychosocial Questionnaire (COPSOQ), the Patient Health Questionnaire (PHQ-2), the Resilience Scale (RS-13) Questionnaire, a single question about back pain from the health survey conducted by the Robert Koch Institute as well as self-developed questions. The differences in the variables between GPC and SPC nurses were compared. RESULTS SPC nurses reported higher emotional demands as well as higher burdens due to nursing care and the care of relatives while GPC nurses stated higher quantitative demands, i.e. higher workload. SPC nurses more often reported organisational and social resources that were helpful in dealing with the demands of their work. Regarding health, GPC nurses stated a poorer health status and reported chronic back pain as well as a major depressive disorder more frequently than SPC nurses. Furthermore, GPC nurses reported a higher intention to leave the profession compared to SPC nurses. CONCLUSIONS The findings of the present study indicate that SPC could be reviewed as the best practice example for nursing care in Germany. The results may be used for developing target group specific prevention programs for improving health and wellbeing of nurses taking the differences between GPC and SPC into account. Finally, interventional and longitudinal studies should be conducted in future to determine causality in the relationship of burdens, resources, health and wellbeing.
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Affiliation(s)
- Elisabeth Diehl
- Institute of Occupational, Social and Environmental Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Obere Zahlbacher Str. 67, 55131 Mainz, Germany
| | - Sandra Rieger
- Institute of Occupational, Social and Environmental Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Obere Zahlbacher Str. 67, 55131 Mainz, Germany
| | - Stephan Letzel
- Institute of Occupational, Social and Environmental Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Obere Zahlbacher Str. 67, 55131 Mainz, Germany
| | - Anja Schablon
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Centre Hamburg-Eppendorf, Building W38, Martinistraße 52, 20246 Hamburg, Germany
| | - Albert Nienhaus
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Centre Hamburg-Eppendorf, Building W38, Martinistraße 52, 20246 Hamburg, Germany
- Department for Occupational Medicine, Hazardous Substances and Health Science, Institution for Accident Insurance and Prevention in the Health and Welfare Services (BGW), Pappelallee 33/35/37, 22089 Hamburg, Germany
| | - Luis Carlos Escobar Pinzon
- Institute of Occupational, Social and Environmental Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Obere Zahlbacher Str. 67, 55131 Mainz, Germany
- Federal Institute for Occupational Safety and Health (BAuA), Nöldnerstr. 40-42, 10317 Berlin, Germany
| | - Pavel Dietz
- Institute of Occupational, Social and Environmental Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Obere Zahlbacher Str. 67, 55131 Mainz, Germany
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24
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Dijxhoorn AFQ, Brom L, van der Linden YM, Leget C, Raijmakers NJ. Healthcare Professionals' Work-Related Stress in Palliative Care: A Cross-Sectional Survey. J Pain Symptom Manage 2021; 62:e38-e45. [PMID: 33864848 DOI: 10.1016/j.jpainsymman.2021.04.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 04/06/2021] [Accepted: 04/08/2021] [Indexed: 01/12/2023]
Abstract
CONTEXT Providing palliative care can lead to work-related stress and ultimately to burnout. The need for palliative care will further increase due to population aging and people living longer with life-threatening diseases. Therefore, a healthy palliative care workforce is vital. OBJECTIVES This study aims to get insight into the experienced work-related stress among healthcare professionals providing palliative care in the Netherlands and their strategies and needs in relation to maintaining a healthy work-life balance. METHODS A cross-sectional online survey among members of the Dutch Association for Palliative Care Professionals was conducted between February and March 2020. Burnout was assessed by the validated Burnout Assessment Tool. Self-constructed questions assessed strategies and needs of healthcare professionals providing palliative care regarding work-related stress. RESULTS In total 179 eligible respondents responded (response rate 54%). Respondents were mostly female (79%) and older than 50 years (66%). Most respondents were nurses (47%) and physicians (39%). Two-thirds of respondents (69%) experienced a median level of burnout and 2% a (very) high level. Furthermore, 7% had been on sick leave due to burnout. Although healthcare professionals engage on average in 3.7 coping activities, a quarter (23%) felt that these activities were not sufficient to maintain balanced. Respondents feel a need for activities aimed at the team and organisation level such as feeling emotionally safe within their team. CONCLUSION Symptoms of burnout are quite prevalent among healthcare professionals providing palliative care in the Netherlands. Healthcare professionals have a need for team and organisation approaches to maintain a healthy work-life balance.
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Affiliation(s)
- Anne-Floor Q Dijxhoorn
- Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands; Netherlands Association for Palliative Care (PZNL), Utrecht, The Netherlands; Centre of Expertise in Palliative Care, Leiden University Medical Centre, Leiden, The Netherlands.
| | - Linda Brom
- Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands; Netherlands Association for Palliative Care (PZNL), Utrecht, The Netherlands
| | - Yvette M van der Linden
- Centre of Expertise in Palliative Care, Leiden University Medical Centre, Leiden, The Netherlands
| | - Carlo Leget
- University of Humanistic Studies, Utrecht, The Netherlands
| | - Natasja Jh Raijmakers
- Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands; Netherlands Association for Palliative Care (PZNL), Utrecht, The Netherlands
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25
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Fear of death and its relationship to resilience in nursing students: A longitudinal study. Nurse Educ Pract 2021; 55:103175. [PMID: 34450400 DOI: 10.1016/j.nepr.2021.103175] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 07/19/2021] [Accepted: 08/14/2021] [Indexed: 12/15/2022]
Abstract
AIM Taking a corpus of nursing students enrolled in the 2017-2021 nursing degree, we aim to analyse how students' levels of resilience and fear of death evolve in the first three years of the degree and whether there are differences between students based on age and gender. In addition, we aim to describe the relationship between resilience and fear of death. BACKGROUND Throughout their training, nursing students will encounter situations of grief and death that may generate reactions of rejection, anxiety and emotional imbalance. Recognising and controlling these emotions through specialised training in end-of-life care and fostering resilience is essential. DESIGN Comparative, correlational and longitudinal study. METHODS Our corpus comprised 100 nursing students who were followed through the first three years of their training. Data were collected using a sociodemographic questionnaire, the Collet-Lester Fear of Death Scale and the Resilience Scale. RESULTS The corpus reported medium-high levels of fear of death overall. Patterns were similar for all academic years: fear of other people's death was invariably the highest scoring subscale; and while individual dimensions of the Collet-Lester scale correlated directly and significantly with each other they were found to be inversely related to student age. High levels of resilience were recorded and were highest in the final year. CONCLUSIONS In this sample of student nurses, fear of death and resilience do not appear to be related to each other. Nursing education must include training specifically targeted at increasing levels of resilience and decreasing fear of death to improve end-of-life care.
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Nwanya M, Rowberry D. The importance of understanding burnout: an oncology nurse perspective. ACTA ACUST UNITED AC 2021; 30:S8-S14. [PMID: 34037439 DOI: 10.12968/bjon.2021.30.10.s8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The challenges presented by the global COVID-19 pandemic have intensified the stressors placed on nurses, leading to burnout. Oncology nurse burnout is likely to be an increasingly significant issue for cancer services as the true cost of the pandemic is revealed. Delays in diagnosis and treatment of cancers are reported widely, inevitably leading to poor prognosis and more aggressive treatments for patients. Gaining a better understanding of oncology nurse burnout, its prevalence and causes as well as strategies to reduce or prevent it will help to improve patient care and support staff wellbeing during and after the pandemic. Methodology: A search of the literature related to oncology nurse burnout, covering North America and Europe over 5 years (August 2014-January 2020), resulted in 31 articles for review. None of the studies were carried out in the UK, suggesting a need for robust investigations into oncology nurse burnout in the British health service. Summary: The prevalence of burnout among oncology nurses before the COVID-19 outbreak appeared to be high and is likely to have increased as a result of the pandemic. However, the studies investigating oncology nurse burnout are small and cross-sectional, with low-quality methods. The literature suggests the major causes of burnout arise in the workplace, particularly aspects of the environment that prevent nurses from working according to their values. Although burnout is frequently attributed to workplace factors, interventions remain focused on individuals' coping mechanisms and rarely on the workplace factors that are known to cause it.
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27
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Lenzo V, Sardella A, Maisano Branca G, Bordino V, Aragona M, Garipoli C, Schimmenti A, Quattropani MC. The interplay between burnout risk and attachment styles among palliative care practitioners. PSYCHODYNAMIC PRACTICE 2021. [DOI: 10.1080/14753634.2021.1922305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Vittorio Lenzo
- Department of Social and Educational Sciences of the Mediterranean Area, University for Foreigners “Dante Alighieri” of Reggio Calabria, Reggio Calabria, Italy
| | - Alberto Sardella
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Giuliana Maisano Branca
- Medical Oncology Unit with Hospice, Department of Human Pathology “G. Barresi”, University of Messina, Messina, Italy
| | - Valentina Bordino
- Palliative Home Care Service, Sisifo - Consortium of Social Cooperatives, Catania, Italy
| | - Marcello Aragona
- Medical Oncology Unit with Hospice, Department of Human Pathology “G. Barresi”, University of Messina, Messina, Italy
| | - Claudia Garipoli
- Medical Oncology Unit with Hospice, Department of Human Pathology “G. Barresi”, University of Messina, Messina, Italy
| | - Adriano Schimmenti
- Faculty of Human and Social Sciences, UKE – Kore University of Enna, Enna, Italy
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28
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Holbert E, Dellasega C. De-stressing From Distress: Preliminary Evaluation of a Nurse-Led Brief Debriefing Program. Crit Care Nurs Q 2021; 44:230-234. [PMID: 33595969 DOI: 10.1097/cnq.0000000000000356] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
In critical care units, distressing events related to patient and family-centered care can influence job dissatisfaction and emotional distress.1-8 Strategies for processing difficult incidents are limited, creating a need for standardized real-time debriefing tools. This study evaluated an innovative nurse-led program that was developed and piloted in one acute care unit of a large academic medical center. An evidence-based practice nurse-led debriefing process provided a sequential process for facilitation of an interdisciplinary group after the occurrence of a distressing event. Throughout a 2-year period, 104 real-time debriefings (>380 staff participation) took place. Emergent situations precipitated the most debriefings followed by disruptive patient/family behavior. Over 80% of the participants affirmed the debriefing process was beneficial, assisted them in coping with the traumatic event, and recommended this type of debriefing to others. These results show that members of an interdisciplinary team will engage in a brief (∼10 minute) nurse-led debriefing program when offered the opportunity to do so, and that this intervention was successful beyond the acute care unit where it originated.
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29
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Cagnazzo C, Filippi R, Zucchetti G, Cenna R, Taverniti C, Guarrera ASE, Stabile S, Federici I, Monti M, Pirondi S, Testoni S, Fagioli F. Clinical research and burnout syndrome in Italy - only a physicians' affair? Trials 2021; 22:205. [PMID: 33712055 PMCID: PMC7953807 DOI: 10.1186/s13063-021-05158-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 02/27/2021] [Indexed: 11/10/2022] Open
Abstract
Background The burnout phenomenon has been extensively investigated among health care professionals, particularly focusing on physicians and nurses. However, literature concerning burnout in clinical research is poor and often neglects the other professional categories involved. Methods In March 2019, all members of Italian Group of Clinical Research Coordinator were invited to participate to a web survey, consisting of three sections: general information and workload; Maslach Burnout Inventory (MBI) test; subjective perception of oneself’s work stress and possible causes. Results The majority of respondents felt a form of distress. The main source was contract type (31.2%), followed by workload (20.5%) and lack of skills recognition (17.8%). Results from MBI test confirmed the interviewees’ subjective perception: an intermediate level of emotional exhaustion (19.1 points) and a very high sense of reduced professional achievement (26.8 points) were observed. Both depersonalization and sense of reduced professional achievement showed weak to moderate correlations with emotional exhaustion. Emotional exhaustion was associated with contract type with high significance. Conclusion It is necessary to act on those qualitative factors that are greatly increasing the level of perceived stress, jeopardizing the quality of clinical research coordinators work and significantly amplifying the phenomenon of migration towards the private sector. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-021-05158-z.
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Affiliation(s)
- Celeste Cagnazzo
- Unità di Ricerca e Sviluppo Clinico SC Oncoematologia Pediatrica, AOU Città della Salute e della Scienza, Presidio Ospedaliero Infantile Regina Margherita, Piazza Polonia 94, 10126, Turin, Italy. .,Dipartimento di Scienze della Sanità Pubblica e Pediatriche, Università degli Studi di Torino, Turin, Italy. .,Gruppo Italiano Data Manager - CRC, Meldola, FC, Italy.
| | - Roberto Filippi
- Oncologia Medica 1, AOU Città della Salute e della Scienza, Presidio Molinette, Turin, Italy
| | - Giulia Zucchetti
- Unità di Ricerca e Sviluppo Clinico SC Oncoematologia Pediatrica, AOU Città della Salute e della Scienza, Presidio Ospedaliero Infantile Regina Margherita, Piazza Polonia 94, 10126, Turin, Italy.,Dipartimento di Scienze della Sanità Pubblica e Pediatriche, Università degli Studi di Torino, Turin, Italy
| | - Rosita Cenna
- Unità di Ricerca e Sviluppo Clinico SC Oncoematologia Pediatrica, AOU Città della Salute e della Scienza, Presidio Ospedaliero Infantile Regina Margherita, Piazza Polonia 94, 10126, Turin, Italy.,Dipartimento di Scienze della Sanità Pubblica e Pediatriche, Università degli Studi di Torino, Turin, Italy
| | - Cristiana Taverniti
- Gruppo Italiano Data Manager - CRC, Meldola, FC, Italy.,Oncologia Medica 1, AOU Città della Salute e della Scienza, Presidio Molinette, Turin, Italy
| | - Agata Sue Ellen Guarrera
- Gruppo Italiano Data Manager - CRC, Meldola, FC, Italy.,Terapie Cellulari e Medicina Trasfusionale, AOU Careggi, Florence, Italy
| | - Stefano Stabile
- Gruppo Italiano Data Manager - CRC, Meldola, FC, Italy.,SC Oncologia Falck, Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Irene Federici
- Gruppo Italiano Data Manager - CRC, Meldola, FC, Italy.,Clinica di Ematologia, AOU Ospedali Riuniti Umberto I, G.M. Lancisi, G. Salesi, Ancona, Italy
| | - Manuela Monti
- Gruppo Italiano Data Manager - CRC, Meldola, FC, Italy.,Biostatistics and Clinical Trials Unit, IRCCS Istituto Scientifico Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, FC, Italy
| | - Sara Pirondi
- Gruppo Italiano Data Manager - CRC, Meldola, FC, Italy.,UOSD Oncologia, AUSL Modena Area Sud Ospedale di Sassuolo (MO), Modena, Italy
| | - Sara Testoni
- Gruppo Italiano Data Manager - CRC, Meldola, FC, Italy.,Biostatistics and Clinical Trials Unit, IRCCS Istituto Scientifico Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, FC, Italy
| | - Franca Fagioli
- Unità di Ricerca e Sviluppo Clinico SC Oncoematologia Pediatrica, AOU Città della Salute e della Scienza, Presidio Ospedaliero Infantile Regina Margherita, Piazza Polonia 94, 10126, Turin, Italy.,Dipartimento di Scienze della Sanità Pubblica e Pediatriche, Università degli Studi di Torino, Turin, Italy
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30
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Sumner RC, Kinsella EL. Grace Under Pressure: Resilience, Burnout, and Wellbeing in Frontline Workers in the United Kingdom and Republic of Ireland During the SARS-CoV-2 Pandemic. Front Psychol 2021; 11:576229. [PMID: 33584412 PMCID: PMC7874970 DOI: 10.3389/fpsyg.2020.576229] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 12/04/2020] [Indexed: 12/14/2022] Open
Abstract
The coronavirus pandemic has necessitated extraordinary human resilience in order to preserve and prolong life and social order. Risks to health and even life are being confronted by workers in health and social care, as well as those in roles previously never defined as "frontline," such as individuals working in community supply chain sectors. The strategy adopted by the United Kingdom (UK) government in facing the challenges of the pandemic was markedly different from other countries. The present study set out to examine what variables were associated with resilience, burnout, and wellbeing in all sectors of frontline workers, and whether or not these differed between the UK and Republic of Ireland (RoI). Individuals were eligible if they were a frontline worker (in health and social care, community supply chain, or other emergency services) in the UK or RoI during the pandemic. Part of a larger, longitudinal study, the participants completed an online survey to assess various aspects of their daily and working lives, along with their attitudes toward their government's handling of the crisis, and measurement of psychological variables associated with heroism (altruism, meaning in life, and resilient coping). A total of 1,305 participants (N = 869, 66.6% from the UK) provided sufficient data for analysis. UK-based workers reported lower wellbeing than the RoI-based participants. In multivariate models, both psychological and pandemic-related variables were associated with levels of resilience, burnout, and wellbeing in these workers, but which pandemic-related variables were associated with outcomes differed depending on the country. The judgment of lower timeliness in their government's response to the pandemic appeared to be a key driver of each outcome for the UK-based frontline workers. These findings provide initial evidence that the different strategies adopted by each country may be associated with the overall wellbeing of frontline workers, with higher detriment observed in the UK. The judgment of the relatively slow response of the UK government to instigate their pandemic measures appears to be associated with lower resilience, higher burnout, and lower wellbeing in frontline workers in the UK.
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Affiliation(s)
- Rachel C Sumner
- HERA Lab, School of Natural & Social Sciences, University of Gloucestershire, Cheltenham, United Kingdom
| | - Elaine L Kinsella
- Department of Psychology, RISE Lab, Health Research Institute, Centre for Social Issues Research, University of Limerick, Limerick, Ireland
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31
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Diehl E, Rieger S, Letzel S, Schablon A, Nienhaus A, Escobar Pinzon LC, Dietz P. The relationship between workload and burnout among nurses: The buffering role of personal, social and organisational resources. PLoS One 2021; 16:e0245798. [PMID: 33481918 PMCID: PMC7822247 DOI: 10.1371/journal.pone.0245798] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 01/07/2021] [Indexed: 01/11/2023] Open
Abstract
Workload in the nursing profession is high, which is associated with poor health. Thus, it is important to get a proper understanding of the working situation and to analyse factors which might be able to mitigate the negative effects of such a high workload. In Germany, many people with serious or life-threatening illnesses are treated in non-specialized palliative care settings such as nursing homes, hospitals and outpatient care. The purpose of the present study was to investigate the buffering role of resources on the relationship between workload and burnout among nurses. A nationwide cross-sectional survey was applied. The questionnaire included parts of the Copenhagen Psychosocial Questionnaire (COPSOQ) (scale 'quantitative demands' measuring workload, scale 'burnout', various scales to resources), the resilience questionnaire RS-13 and single self-developed questions. Bivariate and moderator analyses were performed. Palliative care aspects, such as the 'extent of palliative care', were incorporated to the analyses as covariates. 497 nurses participated. Nurses who reported 'workplace commitment', a 'good working team' and 'recognition from supervisor' conveyed a weaker association between 'quantitative demands' and 'burnout' than those who did not. On average, nurses spend 20% of their working time with palliative care. Spending more time than this was associated with 'burnout'. The results of our study imply a buffering role of different resources on burnout. Additionally, the study reveals that the 'extent of palliative care' may have an impact on nurse burnout, and should be considered in future studies.
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Affiliation(s)
- Elisabeth Diehl
- Institute of Occupational, Social and Environmental Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Sandra Rieger
- Institute of Occupational, Social and Environmental Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Stephan Letzel
- Institute of Occupational, Social and Environmental Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Anja Schablon
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Albert Nienhaus
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department for Occupational Medicine, Hazardous Substances and Health Science, Institution for Accident Insurance and Prevention in the Health and Welfare Services (BGW), Hamburg, Germany
| | - Luis Carlos Escobar Pinzon
- Institute of Occupational, Social and Environmental Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
- Federal Institute for Occupational Safety and Health (BAuA), Berlin, Germany
| | - Pavel Dietz
- Institute of Occupational, Social and Environmental Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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Dijxhoorn AFQ, Brom L, van der Linden YM, Leget C, Raijmakers NJ. Prevalence of burnout in healthcare professionals providing palliative care and the effect of interventions to reduce symptoms: A systematic literature review. Palliat Med 2021; 35:6-26. [PMID: 33063609 DOI: 10.1177/0269216320956825] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND In recent years there has been increasing attention for the prevalence and prevention of burnout among healthcare professionals. There is unclarity about prevalence of burnout in healthcare professionals providing palliative care and little is known about effective interventions in this area. AIM To investigate the prevalence of (symptoms of) burnout in healthcare professionals providing palliative care and what interventions may reduce symptoms of burnout in this population. DESIGN A systematic literature review based on criteria of the PRISMA statement was performed on prevalence of burnout in healthcare professionals providing palliative care and interventions aimed at preventing burnout. DATA SOURCES PubMed, PsycInfo and Cinahl were searched for studies published from 2008 to 2020. Quality of the studies was assessed using the method of Hawkers for systematically reviewing research. RESULTS In total 59 studies were included. Burnout among healthcare professionals providing palliative care ranged from 3% to 66%. No major differences in prevalence were found between nurses and physicians. Healthcare professionals providing palliative care in general settings experience more symptoms of burnout than those in specialised palliative care settings. Ten studies reported on the effects of interventions aimed at preventing burnout. Reduction of one or more symptoms of burnout after the intervention was reported in six studies which were aimed at learning meditation, improving communication skills, peer-coaching and art-therapy based supervision. CONCLUSION The range of burnout among healthcare professionals providing palliative care varies widely. Interventions based on meditation, communication training, peer-coaching and art-therapy based supervision have positive effects but long-term outcomes are not known yet.
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Affiliation(s)
- Anne-Floor Q Dijxhoorn
- Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.,Netherlands Association for Palliative Care (PZNL), Utrecht, The Netherlands.,Centre of Expertise in Palliative Care, Leiden University Medical Centre, Leiden, Zuid-Holland, The Netherlands
| | - Linda Brom
- Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.,Netherlands Association for Palliative Care (PZNL), Utrecht, The Netherlands
| | - Yvette M van der Linden
- Centre of Expertise in Palliative Care, Leiden University Medical Centre, Leiden, Zuid-Holland, The Netherlands
| | - Carlo Leget
- University of Humanistic Studies, Utrecht, The Netherlands
| | - Natasja Jh Raijmakers
- Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.,Netherlands Association for Palliative Care (PZNL), Utrecht, The Netherlands
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Burnout in Palliative Care Nurses, Prevalence and Risk Factors: A Systematic Review with Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207672. [PMID: 33096682 PMCID: PMC7589426 DOI: 10.3390/ijerph17207672] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 10/17/2020] [Accepted: 10/19/2020] [Indexed: 01/21/2023]
Abstract
Palliative care nurses are exposed to hard situations, death, and duel feelings in their daily practice. These, and other work stressors, can favor burnout development. Thus, it is important to analyze the prevalence and risk factors of burnout in palliative care nurses and estimate its prevalence. A systematic review and meta-analysis was done with quantitative primary studies. n = 15 studies were included with n = 6 studies including information for the meta-analysis. The meta-analytic prevalence estimation of emotional exhaustion was 24% (95% CI 16–34%), for depersonalization was 30% (95% CI 18–44%) and for low personal accomplishment was 28% with a sample of n = 693 palliative care nurses. The main variables related with burnout are occupational variables followed by psychological variables. Some interventions to improve working conditions of palliative care nurses should be implemented to reduce burnout.
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Musetti A, Schianchi A, Caricati L, Manari T, Schimmenti A. Exposure to animal suffering, adult attachment styles, and professional quality of life in a sample of Italian veterinarians. PLoS One 2020; 15:e0237991. [PMID: 32853290 PMCID: PMC7451658 DOI: 10.1371/journal.pone.0237991] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 08/06/2020] [Indexed: 11/19/2022] Open
Abstract
Contextual and individual risk factors of veterinarians’ professional quality of life are being debated. Research suggests that attachment styles are relevant predictors of professional quality of life; however, their role in work-related well-being of veterinarians is yet to be ascertained. In the present study, self-report measures on exposure to animal suffering, adult attachment styles, and professional quality of life were administered to 1,445 Italian veterinarians (70% females) aged 24 to 74 years old; sociodemographic information and information on workload were also collected. Female gender, higher levels of ordinary workload, on-call hours per week, exposure to animal suffering, together with fearful and preoccupied attachment styles were significantly associated with lower levels of veterinarians’ quality of life. This suggests that work-related factors may combine with individual psychological features in promoting or disadvantaging the professional quality of life of veterinarians. Implications of these findings for promoting veterinarians’ quality of life and directions for future research are discussed.
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Affiliation(s)
- Alessandro Musetti
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Parma, Italy
- * E-mail:
| | | | - Luca Caricati
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Parma, Italy
| | - Tommaso Manari
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Parma, Italy
| | - Adriano Schimmenti
- Faculty of Human and Social Sciences, UKE - Kore University of Enna, Cittadella Universitaria, Enna, Italy
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Undergraduate Nursing Students' Perception of End-of-Life Care Education Placement in the Nursing Curriculum. J Hosp Palliat Nurs 2020; 21:E12-E18. [PMID: 30893289 DOI: 10.1097/njh.0000000000000533] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Nursing students, who have been receiving the End-of-Life Nursing Education Consortium (ELNEC) Core training throughout their Bachelor of Science in Nursing program, have a unique perspective of the benefits of this training. In addition, they have insight as to where an online ELNEC module series specifically for undergraduate nursing students would best be integrated within the curriculum. This study used a mixed methods strategy to evaluate students' opinions on the placement of end-of-life care education within the curriculum and their experience of having received ELNEC training previously throughout their program. Senior-level nursing student opinions on the placement of the ELNEC modules within the curriculum were equally divided, with one-third suggesting placement at the sophomore level, one-third suggesting placement at the junior level, and one-third suggesting placement at the senior level. Students also offered a recommendation for an end-of-life care simulation integration into the Bachelor of Science in Nursing curriculum. Students who have been receiving ELNEC training integrated throughout the curriculum reported feeling comfortable with providing end-of-life care after graduation. Themes extracted from students' suggestions on improving end-of-life care education were as follows: (1) The quality and consistency of instruction needs to be enhanced, (2) palliative care education should be delivered using various methods, and (3) methods to assess education on palliative care should be improved. Students reported that ELNEC training helped them to gain insight into the key elements in palliative care, to understand the differences and similarities between palliative care and hospice, and to understand the nurse's role in palliative care and hospice.
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36
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Diehl E, Rieger S, Letzel S, Schablon A, Nienhaus A, Escobar Pinzon LC, Dietz P. Health and intention to leave the profession of nursing - which individual, social and organisational resources buffer the impact of quantitative demands? A cross-sectional study. BMC Palliat Care 2020; 19:83. [PMID: 32552671 PMCID: PMC7298824 DOI: 10.1186/s12904-020-00589-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 06/08/2020] [Indexed: 01/02/2023] Open
Abstract
Background The aim of this study was to analyse the buffering effect of individual, social and organisational resources on health and intention to leave the profession in the context of burden due to quantitative job demands. Methods In 2017, a cross-sectional survey was carried out anonymously among nurses in palliative care in Germany. One thousand three hundred sixteen nurses responded to the questionnaire (response rate 38.7%), which contained, amongst others, questions from the German version of the Copenhagen Psychosocial Questionnaire (COPSOQ). Moderator analyses were conducted to investigate the buffering effect of different resources on health (‘self-rated health’ and ‘burnout’) and ‘intention to leave’ in the context of quantitative demands. Results ‘Self-rated health’ was significantly buffered by the resources ‘recognition through salary’ (p = 0.001) and ‘good working team’ (p = 0.004). Additionally, buffering effects of the resources ‘workplace commitment’ and ‘good working team’ on ‘burnout’ (p = 0.001 and p = 0.006, respectively) as well as of the resources ‘degree of freedom’, ‘meeting relatives after death of patients’, ‘recognition from supervisor’ and ‘possibilities for development’ on ‘intention to leave’ (p = 0.014, p = 0.012, p = 0.007 and p = 0.036, respectively) were observed. Conclusions The results of our study can be used to develop and implement job (re) design interventions with the goal of reducing the risk of burnout and enhancing job satisfaction among nurses in palliative care. This includes for example adequate payment, communication training and team activities or team events to strengthen the team as well as the implementation of some rituals (such as meeting relatives after the death of patients). As our study was exploratory, the results should be confirmed in further studies.
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Affiliation(s)
- Elisabeth Diehl
- Institute of Occupational, Social and Environmental Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Obere Zahlbacher Str, 67 55131, Mainz, Germany.
| | - Sandra Rieger
- Institute of Occupational, Social and Environmental Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Obere Zahlbacher Str, 67 55131, Mainz, Germany
| | - Stephan Letzel
- Institute of Occupational, Social and Environmental Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Obere Zahlbacher Str, 67 55131, Mainz, Germany
| | - Anja Schablon
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Albert Nienhaus
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.,Department for Occupational Medicine, Hazardous Substances and Health Science, Institution for Accident Insurance and Prevention in the Health and Welfare Services (BGW), Hamburg, Germany
| | - Luis Carlos Escobar Pinzon
- Institute of Occupational, Social and Environmental Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Obere Zahlbacher Str, 67 55131, Mainz, Germany.,Federal Institute for Occupational Safety and Health (BAuA), Berlin, Germany
| | - Pavel Dietz
- Institute of Occupational, Social and Environmental Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Obere Zahlbacher Str, 67 55131, Mainz, Germany
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Death Self-efficacy, Attitudes Toward Death and Burnout Among Oncology Nurses: A Multicenter Cross-sectional Study. Cancer Nurs 2020; 45:E388-E396. [PMID: 32511153 DOI: 10.1097/ncc.0000000000000839] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND To effectively care for dying patients, nurses need to possess death self-efficacy-the state of having both a range of skills and capabilities to provide care to dying patients and confidence in one's ability to do so. A paucity of death self-efficacy may lead to burnout. OBJECTIVES The aims of this study are to clarify oncology nurses' death self-efficacy and to explore its relationships with attitudes toward death and burnout. METHODS A cross-sectional study was performed in 7 cancer hospitals across mainland China between June and July 2019. Oncology nurses completed an online survey consisting of the Death Self-efficacy Scale, Death Attitude Profile-Revised Scale, and Maslach Burnout Inventory. RESULTS The 755 oncology nurses completing the survey reported low death self-efficacy and high levels of burnout. Those who had more years of clinical experience, had the highest professional rank, talked death quite often, and have received palliative care trainings, doing no shift work, scored higher on death self-efficacy. Death self-efficacy was positively correlated with positive attitudes toward death and negatively correlated with levels of burnout. The multiple regression analysis showed that death self-efficacy and attitudes toward death were independent, significant predictors of oncology nurses' burnout. CONCLUSIONS Chinese oncology nurses are not well prepared to care for dying cancer patients and cope with death-related issues. IMPLICATIONS FOR PRACTICE Improvement in death self-efficacy among oncology nurses is necessary, especially for those who are young, are unmarried, are doing shift work, and never received palliative care training. Enhanced death self-efficacy may be realized through self-reflective practice and palliative care education.
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Lenzo V, Bordino V, Bonanno GA, Quattropani MC. Understanding the role of regulatory flexibility and context sensitivity in preventing burnout in a palliative home care team. PLoS One 2020; 15:e0233173. [PMID: 32421730 PMCID: PMC7233554 DOI: 10.1371/journal.pone.0233173] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Accepted: 04/29/2020] [Indexed: 02/07/2023] Open
Abstract
Although burnout syndrome has been investigated in depth, studies specifically focused on palliative home care are still limited. Moreover, there is still a lack of evidence regarding the interplay between emotional flexibility and sensitivity to context in preventing burnout in home care settings. For these reasons, the aims of this study were to examine burnout symptoms among practitioners specializing in palliative home care and to investigate the role of regulatory flexibility and sensitivity to context in understanding burnout. An exploratory cross-sectional design was adopted. A convenience sample (n = 65) of Italian specialist palliative care practitioners participated in this study. Participants were recruited between February and April 2019 from two palliative home care services that predominantly cared for end-of-life cancer patients. The Italian version of the Maslach Burnout Inventory (MBI), the Flexible Regulation of Emotional Expression (FREE) scale (a measure of emotional flexibility), and the Context Sensitivity Index (CSI) (a measure of sensitivity to context) were administered. Analyses of variance were conducted using the three MBI factors as dependent variables and profession as an independent variable. Subsequently, three identical analyses of covariance were conducted with age, work experience, flexibility and sensitivity to context as covariates. The results showed a low burnout risk for all three of the MBI factors, and there were no gender differences. An ANOVA revealed a significant effect of profession type and age on the emotional exhaustion factor of the MBI, and an ANCOVA indicated that these effects persisted after covariates were accounted for. The results also showed a significant effect of the FREE score on emotional exhaustion. These findings can help explain the differential contributions of profession type and age to the burnout symptoms investigated. In addition, the emotional flexibility component, as an aspect of resilience, represents a significant and specific factor of emotional exhaustion. Interventions to prevent burnout must consider these relationships.
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Affiliation(s)
- Vittorio Lenzo
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
- * E-mail:
| | - Valentina Bordino
- Palliative home care services, Sisifo—Consortium of Social Cooperatives, Catania, Italy
| | - George A. Bonanno
- Teachers College, Columbia University, New York, NY, United States of America
| | - Maria C. Quattropani
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
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Socaciu AI, Ionut R, Barsan M, Ungur AP, Rajnoveanu AG. Burnout in Gastroenterology Unit Nurses. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17093115. [PMID: 32365748 PMCID: PMC7246650 DOI: 10.3390/ijerph17093115] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 04/24/2020] [Accepted: 04/27/2020] [Indexed: 12/14/2022]
Abstract
(1) Background: Burnout syndrome is a significant problem in nursing professionals but may be dependent on the type of care that they provide. The objectives of our study are to identify and explore risk factors associated with burnout among gastroenterology nurses. Identifying the risk factors involved is an essential element for prevention programs. (2) Methods: We performed an analytical descriptive cross-sectional study. Burnout was measured using an adapted version of the Maslach Burnout Inventory (MBI) questionnaire. Strength of association between burnout scores and risk factors was calculated using Fischer’s exact test; (3) Results: Our subjects were all female nurses. Work-related risk factors, such as an increased workload and a large number of night shifts have been associated with burnout in nurses, together with a lack of physical activity. We found no significant associations with sociodemographic factors; (4) Conclusions: Gastroenterology nurses are affected by high levels of emotional exhaustion. Work-related risk factors and a sedentary lifestyle result in a greater prevalence of burnout. In this category of healthcare workers, preventive actions are needed. The physical activity outside work could be a protective factor for burnout, and an exercise program could contribute to the effectiveness of well-established burnout intervention programs.
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Guo Q, Zheng R. Assessing oncology nurses’ attitudes towards death and the prevalence of burnout: A cross-sectional study. Eur J Oncol Nurs 2019; 42:69-75. [DOI: 10.1016/j.ejon.2019.08.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 07/29/2019] [Accepted: 08/01/2019] [Indexed: 10/26/2022]
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Rawlings D, Devery K, Poole N. Improving quality in hospital end-of-life care: honest communication, compassion and empathy. BMJ Open Qual 2019; 8:e000669. [PMID: 31259290 PMCID: PMC6567943 DOI: 10.1136/bmjoq-2019-000669] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 05/14/2019] [Accepted: 05/16/2019] [Indexed: 11/03/2022] Open
Abstract
Background With over half of expected deaths occurring in acute hospitals, and a workforce not trained to care for them, good quality end-of-life care in these settings is hard to achieve. The National Consensus Statement on Essential Elements for Safe and High-Quality End-of-Life Care has been translated into e-learning modules by the End of Life Essentials project, and this study aims to demonstrate how clinicians interpret the Consensus Statement in their day-to-day practice by answering the question at the end of each module: 'Tomorrow, the one thing I can change to more appropriately provide end-of-life care is…'. Methods The modules were developed by a palliative care educator with the support of a peer review group and were piloted with 35 health professionals. Pre-post module evaluation data were collected and during a 10-month period from 2016 to 2017 a total of 5181 individuals registered for the project accessing one or more of the six modules. The data from 3201 free-text responses to the post hoc practice change question have been analysed, and themes generated. Findings Five themes are derived from the data: communication, emotional insight, professional mindset, person-centred care and professional practice. Conclusion Learners who have completed End of Life Essentials have shared the ways they state they can change their practice tomorrow which may well be appreciated as a clinical response to the work by the Australian Commission on Safety and Quality in Health Care in leading and coordinating national improvements in quality and safety in healthcare in Australia. While intent cannot guarantee practice change, theory on intention-behaviour relations indicate that intentions have a strong association with behaviour. This indicates that the modules have the ability to influence end-of-life care in acute hospitals.
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Affiliation(s)
- Deb Rawlings
- Palliative and Supportive Services, Flinders University, Adelaide, South Australia, Australia
| | - Kim Devery
- Palliative and Supportive Services, Flinders University Faculty of Medicine, Nursing and Health Sciences, Adelaide, South Australia, Australia
| | - Naomi Poole
- Director, Partnering with Consumers, Australian Commission on Safety and Quality in Health Care, Sydney, New South Wales, Australia
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Gurdogan EP, Kınıcı E, Aksoy B. The relationship between death anxiety and attitudes toward the care of dying patient in nursing students. PSYCHOL HEALTH MED 2019; 24:843-852. [DOI: 10.1080/13548506.2019.1576914] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Eylem Pasli Gurdogan
- Department of Nursing, Trakya University Faculty of Health Sciences, Edirne, Turkey
| | - Ezgi Kınıcı
- Department of Nursing, Trakya University Faculty of Health Sciences, Edirne, Turkey
| | - Berna Aksoy
- Department of Nursing, Trakya University Faculty of Health Sciences, Edirne, Turkey
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Correlates of perceived death competence: What role does meaning-in-life and quality-of-life play? Palliat Support Care 2019; 17:550-560. [DOI: 10.1017/s1478951518000937] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjectiveUnderstanding factors that are associated with more adaptive death attitudes and competencies can inspire future health-promoting palliative care strategies and inform approaches to training and development for health professionals. The potential importance of meaning, purpose, quality, and values in life for promoting adaptive death attitudes has been highlighted, but there is limited research in this area, particularly in relation to death competence. The purpose of this cross-sectional study was to develop an understanding of demographic and life-related factors associated with perceived death competence, such as meaning in life and quality of life.MethodDuring the course enrollment period of a Massive-Online-Open-Course about death and dying, 277 participants completed questionnaires on death competence, meaning in life, quality of life, and sociodemographic background.ResultFindings indicated that greater presence of meaning in life, quality of life, age, death experience, and carer experience were each statistically significant unique predictors of death competence scores. Life-related variables were more strongly associated with death competence than demographic variables. Bereavement experience and experience caring for the dying was associated with greater death competence, but there were no differences on death competence between health professionals and the general community. Above all other factors, the presence of meaning in life was the strongest predictor of higher perceived competence in coping with death.Significance of resultsThe findings demonstrate important interconnections between our attitudes about life and death. Knowledge of factors associated with poorer death competence may help identify those at risk of greater distress when facing death, and might prove useful additions to bereavement risk assessments. Understanding factors associated with greater death competence in health professionals and volunteers may help predict or prevent burnout and compassion fatigue, and help identify who would benefit from additional training and support. Future longitudinal studies including both health professionals and the general community are needed to determine the effect adaptive attitudes toward meaning in life can potentially have on bolstering subsequent adaptive coping and competence regarding death and dying.
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A Multicentre Study of Burnout Prevalence and Related Psychological Variables in Medical Area Hospital Nurses. J Clin Med 2019; 8:jcm8010092. [PMID: 30650557 PMCID: PMC6351959 DOI: 10.3390/jcm8010092] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Revised: 01/11/2019] [Accepted: 01/14/2019] [Indexed: 11/16/2022] Open
Abstract
Background: Nursing burnout is an important problem that affects nurses’ wellness, the quality of care and the health institutions. Study aims were to estimate levels of burnout; to determine the phase of burnout experienced by nurses in the medical area; to analyse the relationship between burnout and personality and psychological factors. Methods: Quantitative, cross-sectional, multicentre study. Hospitals from eight cities were included. The study sample was n = 301 nurses, working in the medical area of hospitals in the Andalusian Health Service during the second semester of 2017. Sociodemographic, occupational and personality variables were studied using the Revised NEO Personality Inventory together with the Educational-Clinical Questionnaire: Anxiety and Depression, and burnout was measured by the Maslach Burnout Inventory. Results: Almost 40% of the nurses presented high levels of burnout. The three burnouts (emotional exhaustion, depersonalisation and personal accomplishment) presented statistically significant correlations with the personality factors of neuroticism, extraversion, openness, agreeableness and conscientiousness, and also with the scores recorded for anxiety and depression. Multiple linear regression models showed agreeableness and depression to be statistically significant predictors of all dimensions of the syndrome. Conclusion: Hospital nurses working in the medical area in Andalusia experience high levels of burnout.
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Ezenwaji IO, Eseadi C, Okide CC, Nwosu NC, Ugwoke SC, Ololo KO, Oforka TO, Oboegbulem AI. Work-related stress, burnout, and related sociodemographic factors among nurses: Implications for administrators, research, and policy. Medicine (Baltimore) 2019; 98:e13889. [PMID: 30653094 PMCID: PMC6370177 DOI: 10.1097/md.0000000000013889] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 11/12/2018] [Accepted: 12/05/2018] [Indexed: 11/29/2022] Open
Abstract
This study examined work-related stress and burnout symptoms with respect to related sociodemographic factors among nurses in Nigeria.A representative sample of nurses (N = 393) was randomly selected from hospitals in Southeast Nigeria to take part in this cross-sectional, correlational study from June to December 2017. Participants received questionnaires by mail, which measured work stress and burnout symptoms, respectively. Data collected were analyzed using bivariate correlations and multiple regression analyses.Among the sociodemographic factors investigated, sex was significantly correlated with work-related stress. The sociodemographic factors were not significantly associated with burnout symptoms. Stepwise multiple regression procedure produced a model that contained four sociodemographic factors and explained 4.5% of the variance in nurses' work stress scores and 0.8% of the variance in nurses' burnout scores. Age, work environment, and work experience did not make significant contributions to the prediction of work-related stress among the nurses. Finally, sex, age, work environment, and work experience did not make significant contributions to the prediction of burnout among the nurses.Nurses' sociodemographic factors, which included sex, age, work environment and work experience accounted for only a small proportion of variance in nurses' work stress and burnout in Southeast Nigeria. The study also furthers our awareness that sex is significantly linked to work-related stress among the nurses in Southeast Nigeria. Thus, the implications of the study for administrators, research, and policy were discussed.
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Affiliation(s)
| | | | - Charity C. Okide
- Department of Adult Education & Extra-mural Studies, University of Nigeria Nsukka, Enugu State
| | | | | | - Kennedy O. Ololo
- Department of Sociology/Psychology/Criminology & Security Studies, Alex-Ekwueme Federal University, Ndufu Alike Ikwo, Ebonyi State, Nigeria
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Autocompetencia para el trabajo en final de vida. Versión española de la Self-Competence in Death Work Scale. ENFERMERIA CLINICA 2019; 29:3-9. [DOI: 10.1016/j.enfcli.2018.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 08/25/2018] [Accepted: 10/17/2018] [Indexed: 11/18/2022]
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Levels of Burnout and Risk Factors in Medical Area Nurses: A Meta-Analytic Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15122800. [PMID: 30544672 PMCID: PMC6313576 DOI: 10.3390/ijerph15122800] [Citation(s) in RCA: 115] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 12/05/2018] [Accepted: 12/07/2018] [Indexed: 01/27/2023]
Abstract
Research findings concerning burnout prevalence rate among nurses from the medical area are contradictory. The aim of this study was to analyse associated factors, to determine nurse burnout levels and to meta-analyse the prevalence rate of each burnout dimension. A systematic review, with meta-analysis, was conducted in February 2018, consulting the next scientific databases: PubMed, CUIDEN, CINAHL, Scopus, LILACS, PsycINFO and ProQuest Health & Medical Complete. In total, 38 articles were extracted, using a double-blinded procedure. The studies were classified by the level of evidence and degrees of recommendation. The 63.15% (n = 24) of the studies used the MBI. High emotional exhaustion was found in the 31% of the nurses, 24% of high depersonalisation and low personal accomplishment was found in the 38%. Factors related to burnout included professional experience, psychological factors and marital status. High emotional exhaustion prevalence rates, high depersonalisation and inadequate personal accomplishment are present among medical area nurses. The risk profile could be a single nurse, with multiple employments, who suffers work overload and with relatively little experience in this field. The problem addressed in this study influence the quality of care provided, on patients’ well-being and on the occupational health of nurses.
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Parola V, Coelho A, Romero ÁA, Peiró RP, Blanco-Blanco J, Apóstolo J, Gea-Sánchez M. The construction of the health professional in palliative care contexts: a scoping review on caring for the person at the end of life. Porto Biomed J 2018; 3:e10. [PMID: 31595242 PMCID: PMC6726306 DOI: 10.1016/j.pbj.0000000000000010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 05/04/2018] [Indexed: 11/29/2022] Open
Abstract
AIM The aim of the study was to map of the literature on the elements contributing to the construction of the health care professional in the context of palliative care. METHODS Scoping review based on Arksey and O'Malley framework. PubMed, Embase, CINAHL, Scopus databases, and gray literature were the sources searched (2005-2015), completed by reference searching, hand searching, and expert consultations. Primary studies focusing on different professionals working in palliative care units or hospice centers were eligible for inclusion. RESULTS From a total of 3632 articles, 22 met the inclusion criteria. The content of the studies was described and classified in 5 elements: (i) construction and application of the concept of care; (ii) psychosocial effects that the daily care produces; (iii) working conditions that influence the caregiving provided; (iv) knowledge mobilized in the provision of care; and (v) strategies adopted by health care professionals to build relationships. Data about nurses, physicians, and psychologists were found, but no data were found about social workers. Gaps identified in the publications were as follows: relationship competencies and strategies adopted; the real needs from educational programs; and the view of other professionals. CONCLUSIONS Key elements identified in the concept of the construction of the health care professional should be addressed in future interventions: prevention of emotional exhaustion, depersonalization, and achievement of a greater personal accomplishment. In addition, none of the articles retrieved offered the different perspectives of all the disciplines in a multidisciplinary team.
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Affiliation(s)
- Vitor Parola
- Abel Salazar Biomedical Sciences Institute, University of Porto, Porto
- Nursing School of Coimbra, Health Sciences Research Unit: Nursing, Portugal Centre for Evidence-Based Practice: A JBI Centre of Excellence, Coimbra, Portugal
| | - Adriana Coelho
- Abel Salazar Biomedical Sciences Institute, University of Porto, Porto
- Nursing School of Coimbra, Health Sciences Research Unit: Nursing, Portugal Centre for Evidence-Based Practice: A JBI Centre of Excellence, Coimbra, Portugal
| | - Álvaro A Romero
- Faculty of Nursing and Physiotherapy, GESEC, Lleida University, Lleida, Spain
| | - Roland P Peiró
- Faculty of Nursing and Physiotherapy, GESEC, Lleida University, Lleida, Spain
| | - Joan Blanco-Blanco
- Faculty of Nursing and Physiotherapy, GESEC, Lleida University, Lleida, Spain
| | - João Apóstolo
- Nursing School of Coimbra, Health Sciences Research Unit: Nursing, Portugal Centre for Evidence-Based Practice: A JBI Centre of Excellence, Coimbra, Portugal
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Cañadas-De la Fuente GA, Ortega E, Ramirez-Baena L, De la Fuente-Solana EI, Vargas C, Gómez-Urquiza JL. Gender, Marital Status, and Children as Risk Factors for Burnout in Nurses: A Meta-Analytic Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E2102. [PMID: 30257449 PMCID: PMC6209972 DOI: 10.3390/ijerph15102102] [Citation(s) in RCA: 117] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 09/18/2018] [Accepted: 09/22/2018] [Indexed: 12/19/2022]
Abstract
The correlation between the burnout syndrome and sociodemographic variables in nursing professionals has been widely studied though research results are contradictory. The aim of this study was to assess the impact of gender, marital status, and children on the dimensions of the burnout syndrome (emotional exhaustion, depersonalization, and personal accomplishment) in nursing professionals, as measured with the Maslach Burnout Inventory. The search was performed in May 2018 in the next databases: CINAHL, CUIDEN, Dialnet, Psicodoc, ProQuest Platform, OVID Platform, and Scopus with the search equation ("Maslach Burnout Inventory" OR "MBI") AND "nurs*", without using any search restriction. The sample was n = 78 studies: 57 studies for gender; 32 for marital status; 13 for having children. A statistically significant relation between depersonalization and gender (r = 0.078), marital status (r = 0.047), and children (r = 0.053) was found. A significant relation was also found between emotional exhaustion and children (r = 0.048). The results showed that being male, being single or divorced, and not having children were related to the highest levels of burnout in nurses. Moreover, these relations could be accentuated by the influence of moderator variables (age, seniority, job satisfaction, etc.), which, in combination with the previously mentioned significant relations, should be evaluated in the design burnout risk profiles for nursing professionals.
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Affiliation(s)
| | - Elena Ortega
- Faculty of Psychology, University of Almería, Carretera Sacramento S.N., 04120 La Cañada, Almería, Spain.
| | - Lucia Ramirez-Baena
- Brain, Mind and Behaviour Research Center (CIMCYC), University of Granada, Campus Universitario de Cartuja S.N., 18011 Granada, Spain.
| | - Emilia I De la Fuente-Solana
- Brain, Mind and Behaviour Research Center (CIMCYC), University of Granada, Campus Universitario de Cartuja S.N., 18011 Granada, Spain.
| | - Cristina Vargas
- Faculty of Psychology, University of Valencia, Avenida de Blasco Ibáñez N. 13, 46010 Valencia, Spain.
| | - Jose Luis Gómez-Urquiza
- Faculty of Health Sciences, University of Granada, Avenida de la Ilustración N. 60, 18016 Granada, Spain.
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