Relationship between job burnout, psychosocial factors and health care-associated infections in critical care units

Factors affecting the quality of working life among nurses caring for Syrian refugee camps in Jordan

OBJECTIVES

The global refugee crisis, exacerbated by the Syrian war, has placed tremendous strain on Jordan's healthcare system and infrastructure, notably impacting nurses working in refugee camps. The aim to identify factors influencing nurses' Quality of life at work (QWL) and understand their significance in crisis healthcare environments.

METHODOLOGY

A cross-sectional study was conducted in multiple healthcare facilities within Syrian refugee camps. A convenient sample of 166 nurses participated, and data were collected using the Brook's Quality of Nursing Work Life Survey. Data analysis included descriptive and inferential (one-way ANOVA) statistics. Significance level was set at 0.05.

RESULTS

Nurses in this study generally reported a moderate QWL, with an average score of 152.85, indicating that their overall work experience falls into the moderate range. The study found that nurses perceived their work-life/home-life balance (mean score 25.79), work design (mean score 35.71), work context (mean score 71.37), and work world (mean score 19.96) at levels indicative of moderate satisfaction. There were no statistically significant differences in QWL among participating nurses, suggesting that factors other than demographic characteristics may play a more influential role in determining nurses' QWL in the unique context of refugee caregiving.

CONCLUSION

This study underscores that working within refugee healthcare missions and recommends targeted interventions to enhance their well-being.

Mental health, psychological distress and burnout in Australian dental practitioners

BACKGROUND

Dental practitioners are known to experience a high level of stress, but little is known about the mental health of Australian dental practitioners. The aim of this study was to investigate the prevalence of mental health conditions among Australian dental practitioners.

METHODS

A cross sectional survey of 1483 Australian dental practitioners was carried out from October to December 2021. Participants reported aspects of mental health including depression, anxiety disorder, burnout (Sydney Burnout Measure) and psychological distress (Kessler Psychological Distress Scale and General Health Questionnaire 12).

RESULTS

Self-reported psychological distress was high, with 32.0% rated as having moderate or severe psychological distress and 59.4% a high likelihood of minor (or more severe) psychological distress. One in four participants (24.8%) were classified as likely to be experiencing burnout, with 25.9% reporting ever having a diagnosis of depression, 11.4% a current diagnosis of depression, 23.1% ever having a diagnosis of anxiety disorder and 12.9% a current diagnosis of anxiety disorder.

CONCLUSION

Australian dental practitioners reported a high burden of psychological distress, burnout and mental health issues, suggesting a need for education and programmes to support their mental health and wellbeing. © 2023 Australian Dental Association.

Australian dental practitioners experience of burnout

BACKGROUND

The aim of this study was to investigate factors associated with burnout in Australian dental practitioners.

METHODS

A cross-sectional survey of 1483 Australian dental practitioners was conducted from Oct to Dec 2021. Participants reported burnout using the Sydney Burnout Measure, and aspects of mental health including psychological distress, depression, and anxiety disorders. Predictors of burnout were explored using a generalized linear model with a stepped approach including demographic, health and risk factor variables.

RESULTS

One in four participants were classified as likely to be experiencing burnout. Burnout was associated with working in a regional/rural location (β = 2.82, p < 0.001), an academic/non-clinical role (β = 5.01, p = 0.037), more years of experience as a dental practitioner (β = 0.08, p = 0.022), a current diagnosis of depression (β = 2.38, p = 0.049), moderate/severe psychological distress (β = 7.16, p < 0.001), poor self-rated physical health (β = 5.84, p < 0.001) and increasing alcohol consumption (β = 0.17, p = 0.020). Participants who scored high on resilience (β = -0.23, p = 0.002) or perfectionism (β = -0.24, p < 0.001) had lower burnout scores.

CONCLUSION

Australian dental practitioners appear to be at high risk of burnout which may impact on their health and wellbeing and ability to deliver patient care. There is a need for support services to manage burnout and education to address workplace and environmental factors that may contribute to burnout.

The Mediating Role of Emotion Management, Self-Efficacy and Emotional Intelligence in Clinical Nurses Related to Negative Psychology and Burnout

Objective

To explore the influence of negative psychology and burnout in clinical nurses, and to analyse the mediating role between self-efficacy and emotional intelligence in emotion management.

Methods

From January 2022 to December 2022, 12,704 clinical nurses from 32 general hospitals in Hunan Province were selected as research participants by convenience sampling. Negative psychology, emotion management, self-efficacy, emotional intelligence and burnout in clinical nurses were measured, and structural equation models were constructed to explore their impact on burnout in clinical nurses.

Results

Clinical nurses' negative psychology had a positive effect on burnout (β=0.60, 95% CI: 0.63-0.66), emotional intelligence (β=-0.08, 95% CI: -0.10, -0.06) and the self-efficacy of emotion management (β=-0.60, 95% CI: -0.05, -0.03) on burnout. Moreover, emotional intelligence and emotion management self-efficacy played a mediating role between negative psychology and burnout in nurses.

Conclusion

Clinical nurses' negative psychology had a positive impact on burnout, and emotional intelligence and the self-efficacy of emotion management could alleviate the influence of negative psychology on burnout among nurses. Nurses' emotional intelligence and emotion management self-efficacy can be improved through practical training to help them cope with emotionally loaded situations and reduce stress responses.

Psychopathological Factors Associated With Burnout in Intensive Care Nurses: A Cross-Sectional Study

BACKGROUND

Although previous studies have separately revealed that parameters such as anxiety, depression, and secondary traumatic stress (STS) are associated with burnout, there is still a limited understanding of the relationship between anxiety, depression, and STS and burnout in intensive care unit (ICU) nurses.

AIMS

To investigate the relationship between levels of burnout, anxiety, depression, and STS in ICU nurses.

METHODS

A cross-sectional study was conducted with ICU nurses (N = 164) from a university hospital in eastern Turkey. The participants completed the anxiety, depression, STS, and burnout scales along with the descriptive characteristics form. The data were analyzed using descriptive statistics, correlation, and logistic regression analysis.

RESULTS

The mean scores for STS, anxiety, depression, and burnout were 40.60 ± 13.77, 17.14 ± 12.90, 13.28 ± 9.75 and 41.39 ± 14.87, respectively. The results showed that, in the ICU nurses, anxiety, depression, and STS components explained 61% of emotional exhaustion, 38% of depersonalization, and 13% of personal accomplishment.

CONCLUSIONS

While the present findings supported the paradigm that burnout in ICU nurses is associated with STS, anxiety, and depression, they also revealed some details about the psychopathological factors associated with burnout. These details were as follows: (1) individuals who resorted to avoidance as a component of STS on a high level were more likely to experience emotional exhaustion and depersonalization, (2) individuals with severe depressive symptoms were more likely to experience a decrease in their personal accomplishment, and (3) individuals with anxiety symptoms were more likely to experience both emotional exhaustion and personal accomplishment.

What are the essential components to implement individual-focused interventions for well-being and burnout in critical care healthcare professionals? A realist expert opinion

Background

This study aimed to determine what, how, and under what circumstances individual-focused interventions improve well-being and decrease burnout for critical care healthcare professionals.

Method

This realist approach, expert opinion interview, was guided by the Realist And Meta-narrative Evidence Synthesis: Evolving Standards II (RAMESES II) guidelines. Semi-structured interviews with critical care experts were conducted to ascertain current and nuanced information on a set of pre-defined individual interventions summarized from a previous umbrella review. The data were appraised, and relationships between context, mechanisms, and outcomes were extracted, which created theory prepositions that refined the initial program theory.

Results

A total of 21 critical care experts were individually interviewed. By understanding the complex interplay between organizational and personal factors that influenced intervention uptake, it was possible to decipher the most likely implementable intervention for critical care healthcare professionals. The expert recommendation suggested that interventions should be evidence-based, accessible, inclusive, and collaborative, and promote knowledge and skill development. Unique mechanisms were also required to achieve the positive effects of the intervention due to the presence of contextual factors within critical care settings. Mechanisms identified in this study included the facilitation of self-awareness, self-regulation, autonomy, collaboration, acceptance, and inclusion (to enable a larger reach to different social groups).

Conclusion

This validation of a theoretical understanding of intervention that addressed well-being and burnout in critical care healthcare professionals by expert opinion demonstrated essential mechanisms and contextual factors to consider when designing and implementing interventions. Future research would benefit by piloting individual interventions and integrating these new theoretical findings to understand better their effectiveness for future translation into the "real-world" setting.

The life history narrative of clinical nurses with more than 30 years of experience

BACKGROUND

The nurses with long-term careers in clinical settings shows a clear declining trend. Recording the specific period in Korea's nursing history is also important from a historical perspective. The aim of this study was to analyze the life history narrative of clinical nurses who have been in service for more than 30 years and to explore the strength and structure of their experience that enabled them to retain their long-term careers.

METHODS

This study conducted qualitative research with a life history narrative. For data collection, biographical-narrative interview through in-depth personal interviews with six participants. The participants were clinical nurses who had worked at a general hospital for more than 30 years. The interviews were conducted in three sessions per participant, each session lasting 90-180 min. Qualitative thematic analysis was used to analyze the data.

RESULTS

The narrative of their life stories were analyzed by dividing them into "Dimensions," "Turnings" and "Adaptations". The dimensions were categorized into individual and career dimensions. Turning points were empirical and environmental conditions that posed a threat to their career retention as nurse clinicians. Adaptations were illustrated individual methods and social interactions. Twenty-four themes were derived from the 94 thematic statements. After the abstract, four comprehensive categories emerged. The core theme for retaining long-term careers, with "Finding value in myself" comprising four themes: "acknowledgement and support from families," "healthy relationship at work," "trusting myself'," and "accumulation of small achievements."

CONCLUSIONS

The life narratives of participants reveal a close connection with and relationship between the changes in the social aspects, the fields of healthcare and nursing, their individual predispositions, family recognition, and organizational support at that time in Korea. The healthy interpersonal relationships in work place are the most important condition in maintaining the long-term work of nurses. The experience of nurses in one era may not be able to represent experiences in another era, so an in-depth study exploring the social context seems to be necessary. There is a need for policies and changes in the field that can keep the lives of professional women working as nurses proudly.

Are human resource managers with good listening competency more likely to avoid job burnout?

BACKGROUND

Listening is an important responsibilities of human resource managers, whether it will bring role stress to human resource managers, or lead to the risk of job burnout. This study aims to analyze the impact of listening competency on job burnout among human resource managers, and examine the mediating effect of role stress.

METHODS

This study adopted a cross-sectional method to randomly select 500 human resource managers from China's top ten human resource management cities to conduct an online questionnaire survey, and 232 valid samples were obtained. Descriptive statistical and one-way ANOVA were used to explore the status of job burnout among human resource managers in China. Correlation analysis, multiple linear regression and mediating effect analysis were employed to test the relationship between listening competency and job burnout, as well as the mediating effect of role stress.

RESULTS

(1) 34.5% of the respondents reported mild burnout, while 3.0% respondents showed serious burnout. Emotional exhaustion was the most serious. (2) Those are good at listening could easily avoid job burnout. Among them, listening skills were conducive to reducing the degree of depersonalization of human resource managers, and empathy was more conducive to improving their personal sense of accomplishment. (3) The role stress had a significant mediating role in the relationship between listening competency and job burnout. Which means that listening competency can avoid job burnout by reducing role stress of human resource managers.

CONCLUSIONS

This study revealed the current situation of job burnout among human resource managers in China, and explored the influence of listening competency on job burnout. This study enriched the research content of job burnout, and provided references for preventing and intervening job burnout of human resource managers.

Ergonomic Risk-prone Activities toward Nurses in the Intensive Care and Emergency Room

BACKGROUND: Nurses have the risk of ergonomic hazards in providing nursing care, especially with increasingly dynamic health services such as during Coronavirus disease-19 pandemic like today. AIM: The aim of the study was to evaluate activities prone to produce ergonomic risks during the implementation of nursing care in intensive care and emergency room (ER) of a hospital in Riau, Indonesia. METHODOLOGY: This study was conducted by observing the routine activities conducted by the nurses and using similar task group techniques equipped with Rapid Entire Body Assessment instrument. Those observed activities were obtained from 17 intensive care room nurses and ten ER nurses. There were six activities observed in the intensive care room: Bathing, transferring the patient, wounds dressing, taking blood samples for the AGDA examinations, as well as inserting the intravenous needle and electrocardiograms. Meanwhile, there were two activities observed in the ER: Transferring the patient and inserting the intravenous needle. RESULTS: The highest ergonomic risks activity in the intensive care room was bathing the patient with a total score of 13. At the ER, the highest risk score was transferring the patient with a total score of 12. Both activities were at level 4, indicating a high-risk condition. Thus, examinations and changes should be immediately initiated. CONCLUSION: The results are significant to be paid attention by the related parties at the hospital to facilitate some improvements immediately. In addition, the ergonomic approaches that can be suggested to the nurses are regular stretching, physical exercises, and applying ergonomic principles while working.

Burnout, Self-Efficacy, and Resilience in Haitian Nurses: A Cross-Sectional Study

Purpose of Study: Though nursing burnout is a global problem, research on nurse burnout in Haiti is scarce. In a context of multiple personal, social, and environmental challenges, this study assessed burnout and associated factors among Haitian nurses. Design of Study: A multi-site cross-sectional study. Methods: A survey in French and Haitian Creole was conducted in five Haitian hospitals using forward and back translated scales measuring burnout (emotional exhaustion [EE], depersonalization [DP], personal accomplishment [PA]), self-efficacy, nursing work environment, resilience, and demographics. Findings: Haitian nurses (N = 179) self-reported moderate EE (M = 21, SD = 11.18), low DP (Mdn = 2.0, range = 29), and high personal accomplishment (Mdn = 41.0, range = 33). General self-efficacy (M = 32.31, SD = 4.27) and resilience (M = 26.68, SD = 5.86) were high. Dissatisfaction with salary, autonomy, and staffing were evident. Conclusions: It is noteworthy that burnout was lower than expected given the scarce resource, difficult socio-politico-economic environment. High levels of self-efficacy and resilience likely mitigated a higher level of burnout. Adaptation enables these nurses to manage their critical conditions and practice holistic nursing, which may inspire hope among nurses in similar contexts.

Gender and occupational role differences in work-related post-traumatic stress symptoms, burnout and global functioning in emergency healthcare workers

OBJECTIVES

To explore gender and occupational role impact on work-related Post-Traumatic Stress Symptoms, Post-Traumatic Stress Disorder, burnout and global functioning in a sample of emergency healthcare workers.

DESIGN

A cross-sectional study.

PARTICIPANTS/SETTING

126 healthcare workers of the Emergency Department, including Intensive Care Unit, Emergency Room and Emergency Medicine, of a major University Hospital in central Italy were recruited.

MAIN OUTCOME MEASURES

Participants were assessed by means of the: Trauma and Loss Spectrum-Self Report (TALS-SR) to explore Post-Traumatic Stress Spectrum Symptoms, Professional Quality of Life (ProQOL) Scale to assess Compassion Satisfaction, Burnout and Compassion Fatigue and Work and Social Adjustment Scale (WSAS) to measure global functioning.

RESULTS

The present findings showed females were more prone to develop Post-Traumatic Stress Symptoms, particularly re-experiencing (p = .010) and hyperarousal (p = .026) symptoms and medical doctors reporting higher Burnout (p < .001) and lower Compassion Satisfaction (p = .009) mean scores than nurses. Higher levels of functioning impairment emerged amongst medical doctors rather than nurses, in both social (p = .029) and private (p = .020) leisure activities. Linear correlations highlighted relationships between the TALS-SR, ProQOL and WSAS scores. Finally, medical doctor status was significantly associated with lower Compassion Satisfaction (p = .029) and higher Burnout (p = .015).

CONCLUSION

Our results highlight high post-traumatic stress symptoms and burnout levels in emergency healthcare workers with a relevant impact of female gender and occupational role, supporting the need for preventive strategies, also in light of the current COVID-19 pandemic.

Prevalence, Risk Factors and Burnout Levels in Intensive Care Unit Nurses: A Systematic Review and Meta-Analysis

Nursing is considered to be an at-risk profession of burnout due to daily exposure to difficult situations such as death and pain care. In addition, some units such as the intensive care unit (ICU), can be stressful due to high levels of morbidity and mortality and ethical dilemmas. Burnout causes a deterioration in quality of care, increasing the risk of mortality in patients due to poor performance and errors in the healthcare environment. The aim of this study was to analyse the levels, prevalence and related factors of burnout in ICU nurses. A systematic review and meta-analysis were carried out in the Medline, Scopus and CINAHL databases. Fifteen articles were found for the systematic review and four for the meta-analysis. With a sample of n = 1986 nurses, the meta-analytic estimate prevalence for high emotional exhaustion was 31% (95% CI, 8-59%), for high depersonalization was 18% (95% CI, 8-30%), and for low personal accomplishment was 46% (95% CI, 20-74%). Within the dimensions of burnout, emotional exhaustion had a significant relationship with depression and personality factors. Both sociodemographic factors (being younger, single marital status, and having less professional experience in ICU) and working conditions (workload and working longer hours) influence the risk of burnout syndrome.

The influence of mobile phone addiction and work procrastination on burnout among newly graduated Chinese nurses

PURPOSE

The study was conducted to explore the relationship between mobile phone addiction, work procrastination, and burnout among newly graduated nurses.

DESIGN AND METHODS

A cross-sectional survey involving 220 newly graduated nurses in China was conducted from June to July 2020.

FINDINGS

Approximately 60.9% of newly graduated nurses experienced occupational burnout; 72.7% of newly graduated nurses were characterized by moderate or greater procrastination and mobile phone addiction was at a moderate level. Mobile phone addiction and work procrastination were significant factors leading to emotional exhaustion and cynicism. Work procrastination was also an independent predictor of reduced professional efficacy.

PRACTICE IMPLICATIONS

Reducing the level of mobile phone addiction and work procrastination among newly graduated nurses might be effective for burnout prevention.

Addressing Burnout Syndrome From a Critical Care Specialty Organization Perspective

BACKGROUND

Health care specialty organizations are an important resource for their membership; however, it is not clear how specialty societies should approach combating stress and burnout on an organizational scale.

OBJECTIVE

To understand the prevalence of burnout syndrome in American Thoracic Society members, identify specialty-specific risk factors, and generate strategies for health care societies to combat burnout.

METHODS

Cross-sectional, mixed-methods survey in a sample of 2018 American Thoracic Society International Conference attendees to assess levels of burnout syndrome, work satisfaction, and stress.

RESULTS

Of the 130 respondents, 69% reported high stress, 38% met burnout criteria, and 20% confirmed chaotic work environments. Significant associations included sex and stress level; clinical time and at-home electronic health record work; and US practice and at-home electronic health record work. There were no significant associations between burnout syndrome and the selected demographics. Participants indicated patient care as the most meaningful aspect of work, whereas the highest contributors to burnout were workload and electronic health record documentation. Importantly, most respondents were unaware of available resources for burnout.

CONCLUSIONS

Health care specialty societies have access to each level of the health system, creating an opportunity to monitor trends, disseminate resources, and influence the direction of efforts to reduce workplace stress and enhance clinician well-being.

Relationship between nurse burnout, patient and organizational outcomes: Systematic review

BACKGROUND

Burnout, characterized by emotional exhaustion, depersonalization, and decreased personal accomplishments, poses a significant burden on individual nurses' health and mental wellbeing. As growing evidence highlights the adverse consequences of burnout for clinicians, patients, and organizations, it is imperative to examine nurse burnout in the healthcare system.

OBJECTIVE

The purpose of this review is to systematically and critically appraise the current literature to examine the associations between nurse burnout and patient and hospital organizational outcomes.

DESIGN AND DATA SOURCES

A systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses was conducted. PubMed, CINAHL, PsychInfo, Scopus, and Embase were the search engines used. The inclusion criteria were any primary studies examining burnout among nurses working in hospitals as an independent variable, in peer-reviewed journals, and written in English. The search was performed from October 2018 to January 2019 and updated in January and October 2020.

RESULTS

A total of 20 studies were included in the review. The organizational-related outcomes associated with nurse burnout were (1) patient safety, (2) quality of care, (3) nurses' organizational commitment, (4) nurse productivity, and (5) patient satisfaction. For these themes, nurse burnout was consistently inversely associated with outcome measures.

CONCLUSIONS

Nurse burnout is an occupational hazard affecting nurses, patients, organizations, and society at large. Nurse burnout is associated with worsening safety and quality of care, decreased patient satisfaction, and nurses' organizational commitment and productivity. Traditionally, burnout is viewed as an individual issue. However, reframing burnout as an organizational and collective phenomenon affords the broader perspective necessary to address nurse burnout. Tweetable abstract: Not only nurse burnout associated w/ worsening safety & quality of care, but also w/ nurses' organizational commitment and productivity. Reframing burnout, as an organizational & collective phenomenon is necessary.

How does innovative technology impact nursing in infectious diseases and infection control? A scoping review

Aim

Considering the increasing number of emerging infectious diseases, innovative approaches are strongly in demand. Additionally, research in this field has expanded exponentially. Thus, faced with this diverse information, we aim to clarify key concepts and knowledge gaps of technology in nursing and the field of infectious diseases.

Design

This scoping review followed the methodology of scoping review guidance from Arksey and O’Malley.

Methods

Six databases were searched systematically (PubMed, Web of Science, IEEE Explore, EBSCOhost, Cochrane Library and Summon). After the removal of duplicates, 532 citations were retrieved and 77 were included in the analysis.

Results

We identified five major trends in technology for nursing and infectious diseases: artificial intelligence, the Internet of things, information and communications technology, simulation technology and e‐learning. Our findings indicate that the most promising trend is the IoT because of the many positive effects validated in most of the reviewed studies.

Mobile phone addiction and its association with burnout in Chinese novice nurses: A cross-sectional survey

AIM

To explore the levels of mobile phone addiction and burnout and their relationships among novice nurses.

DESIGN

A cross-sectional investigation design.

METHODS

Questionnaires were distributed to 400 novice nurses in five public hospitals in China. A total of 366 participants completed the survey. Data collected in 2020 were analysed by using descriptive statistics, an independent t test and Pearson's correlation analysis.

RESULTS

The results showed that the frequency of nursing adverse events was associated with higher level of mobile phone addiction in novice nurses, and 52.46% of the participants (N = 366) presented a high level of occupational burnout. Moreover, the results indicated that there was a positive correlation between the novice nurses' mobile phone addiction level and burnout (r = .33, p < .01).

CONCLUSION

The level of mobile phone addiction may affect nursing adverse events and nurses' burnout. Education on novice nurses' mobile phone use seems necessary to ensure patient safety and burnout prevention.

IMPACT

Findings of this study expanded important knowledge about mobile phone addiction and its potential influence on nursing safety and nurse burnout and may place significant implications to staff nurse management and in-service education.

Impact of burnout, secondary traumatic stress and compassion satisfaction on hand hygiene of healthcare workers during the COVID-19 pandemic

Aim

To assess the prevalence of burnout, secondary traumatic stress, and compassion satisfaction and explore their impacts on self‐reported hand hygiene among medical aid teams in the COVID‐19 period in Wuhan, China.

Design

Cross‐sectional study.

Method

A total of 1,734 healthcare workers from 17 medical aid teams were surveyed. The survey included burnout, secondary traumatic stress and compassion satisfaction measured by the professional quality of life scale and self‐reported hand hygiene. Data were collected between 5–7 March 2020. Multiple regression analyses were performed.

Results

Burnout and secondary trauma stress were at low and average levels, and compassion satisfaction was at average and high levels. Burnout was negatively associated with hand hygiene, while compassion satisfaction was positively associated. Hospital administrators should pay attention to burnout and compassion satisfaction to improve infection control behaviours. Management of healthcare workers in our study may be constructive in emerging infectious diseases.

Psychological capital, well-being, and patient safety attitudes of nurses and midwives: A cross-sectional survey

Nursing and midwifery are unarguably stressful endeavors requiring high levels of psychological capital and coping strategies. The impact of the work environment on patient safety outcomes suggests that high nurse/midwife stress may be associated with more adverse patient events. The purpose of this study was to explore the psychological capital of clinical nurses and midwives and identify explanatory factors (including psychological capital, well-being, and health-related behaviors) contributing to attitudes to patient safety. A descriptive web- and paper-based survey comprising a convenience sample of nurses and midwives in acute health facilities in Sydney, Australia, was performed (October 2018 and April 2019). Variables included psychological capital, psychological well-being, work culture, and attitudes to patient safety. Descriptive statistics were performed and a regression model was specified (a statistical significance of P < 0.05 was set a priori). Psychological capital, depression score, and work engagement had a significant effect on patient safety perceptions when controlling for other factors. The findings suggest that nurse and midwife well-being is an important consideration when striving to improve patient safety.

Prevalence of burnout among intensivists in mainland China: a nationwide cross-sectional survey

BACKGROUND

Burnout has gained increasing attention worldwide; however, there is a lack of relevant research in China. This study investigated the prevalence and factors associated with burnout in physicians of the intensive care unit (ICU) in mainland China.

METHODS

This cross-sectional multicenter study included critical care physicians from all provinces in mainland China (except Tibet). A self-administered survey questionnaire was conducted. It included three parts: demographic information, lifestyle and work information, and the Maslach Burnout Inventory. The levels of burnout were calculated. The factors independently associated with burnout were analyzed by logistic regression.

RESULTS

Finally, 1813 intensivists participated in the survey. The participation rate was 90.7%. The prevalence of burnout and severe burnout was 82.1% (1489/1813) and 38.8% (704/1813), respectively. According to the logistic regression analysis, "difficulty in making treatment decisions" was independently associated with burnout [OR = 1.365, CI (1.060, 1.757)]. "Higher number of children" [OR = 0.714, CI (0.519, 0.981)] and higher "income satisfaction" [OR = 0.771, CI (0.619, 0.959)] were independent protective factors against severe burnout.

CONCLUSIONS

The burnout rate in ICU physicians in China is high. Difficult treatment decisions, the number of children, and income satisfaction are independently associated with burnout rates among ICU physicians in China.

TRIAL REGISTRATION

Burnout syndrome of the Chinese personnel working in intensive care units: a survey in China, ChiCTR-EOC-17013044, registered October 19, 2017. http://www.chictr.org.cn/showproj.aspx?proj=22329 .

Impact of the coronavirus disease 2019 pandemic on critical care healthcare workers' depression, anxiety, and stress levels

Aim

The aim of the study was to determine levels of depression, anxiety, and stress symptoms and factors associated with psychological burden amongst critical care healthcare workers in the early stages of the coronavirus disease 2019 pandemic.

Methods

An anonymous Web-based survey distributed in April 2020. All healthcare workers employed in a critical care setting were eligible to participate. Invitations to the survey were distributed through Australian and New Zealand critical care societies and social media platforms. The primary outcome was the proportion of healthcare workers who reported moderate to extremely severe scores on the Depression, Anxiety, and Stress Scale-21 (DASS-21).

Results

Of the 3770 complete responses, 3039 (80.6%) were from Australia. A total of 2871 respondents (76.2%) were women; the median age was 41 years. Nurses made up 2269 (60.2%) of respondents, with most (2029 [53.8%]) working in intensive care units. Overall, 813 (21.6%) respondents reported moderate to extremely severe depression, 1078 (28.6%) reported moderate to extremely severe anxiety, and 1057 (28.0%) reported moderate to extremely severe stress scores. Mean ± standard deviation values of DASS-21 depression, anxiety, and stress scores amongst woman vs men was as follows: 8.0 ± 8.2 vs 7.1 ± 8.2 (p = 0.003), 7.2 ± 7.5 vs 5.0 ± 6.7 (p < 0.001), and 14.4 ± 9.6 vs 12.5 ± 9.4 (p < 0.001), respectively. After adjusting for significant confounders, clinical concerns associated with higher DASS-21 scores included not being clinically prepared (β = 4.2, p < 0.001), an inadequate workforce (β = 2.4, p = 0.001), having to triage patients owing to lack of beds and/or equipment (β = 2.6, p = 0.001), virus transmission to friends and family (β = 2.1, p = 0.009), contracting coronavirus disease 2019 (β = 2.8, p = 0.011), being responsible for other staff members (β = 3.1, p < 0.001), and being asked to work in an area that was not in the respondents' expertise (β = 5.7, p < 0.001).

Conclusion

In this survey of critical care healthcare workers, between 22 and 29% of respondents reported moderate to extremely severe depression, anxiety, and stress symptoms, with women reporting higher scores than men. Although female gender appears to play a role, modifiable factors also contribute to psychological burden and should be studied further.

Burnout Syndrome in Paediatric Oncology Nurses: A Systematic Review and Meta-Analysis

Purpose: To determine levels of burnout among paediatric oncology nurses, and the risk factors that may influence its development. Method: A literature review with meta-analysis was conducted, via a search in the PubMed, CINHAL, Scopus, ProQuest (Health and Medical Complete), Scielo and PsycINFO databases, using the search equation: "Nurs* AND burnout AND oncology AND pediatric". Results: The final sample of selected studies was of eight articles. All were quantitative studies of paediatric oncology nurses, using the Maslach Burnout Inventory, written in English or Spanish. No search restrictions were established on the year of publication. The eight studies reported moderate-high levels of burnout in each of its three dimensions. These dimensions were all related to the characteristics of the profession, in terms of complexity, shifts and workload, and to sociodemographic variables such as marital status, work experience, age and gender. The prevalence meta-analytical estimation for a sample of n = 361 nurses were 37% for high emotional exhaustion, 16% for high depersonalisation and 27% for low personal fulfilment. Conclusions: Most paediatric oncology nurses present moderate-high levels of burnout. Therefore, strategies and interventions should be identified and implemented to protect these workers from the syndrome.

A cross-sectional study exploring the relationship between burnout, absenteeism, and job performance among American nurses

Background

Studies suggest a high prevalence of burnout among nurses. The aim of this study was to evaluate the relationship between burnout among nurses and absenteeism and work performance.

Methods

A national sample of U.S. nurses was sent an anonymous, cross-sectional survey in 2016. The survey included items about demographics, fatigue, and validated instruments to measure burnout, absenteeism, and poor work performance in the last month.

Results

Of the 3098 nurses who received the survey, 812 (26.2%) responded. The mean age was 52.3 years (SD 12.5), nearly all were women (94.5%) and most were married (61.9%) and had a child (75.2%). Participating nurses had a mean of 25.7 (SD 13.9) years of experience working as nurse and most held a baccalaureate (38.2%) or masters of science (37.1%) degree in nursing. A quarter worked in the inpatient setting (25.5%) and the average hours worked per week was 41.3 (SD 14.1). Overall, 35.3% had symptoms of burnout, 30.7% had symptoms of depression, 8.3% had been absent 1 or more days in the last month due to personal health, and 43.8% had poor work performance in the last month. Nurses who had burnout were more likely to have been absent 1 or more days in the last month (OR 1.85, 95% CI 1.25–2.72) and have poor work performance (referent: high performer; medium performer, OR 2.68,95% CI 1.82–3.99; poor performer, OR 5.01, 95% CI 3.09–8.14). After adjusting for age, sex, relationship and parental status, highest academic degree, practice setting, burnout, depression, and satisfaction with work-life integration, nurses who were more fatigued (for each point worsening, OR 1.22, 95% CI 1.10–1.37) were more likely to have had absenteeism while those who worked more hours (for each additional hour OR 0.98, 95% CI 0.96–1.00) were less likely to have had absenteeism. Factors independently associated with poor work performance included burnout (OR 2.15, 95% CI 1.43–3.24) and fatigue (for each point of worsening, OR 1.22, 95% CI 1.12–1.33).

Conclusions

These findings suggest burnout is prevalent among nurses and likely impacts work performance.

Evidence Relating Health Care Provider Burnout and Quality of Care: A Systematic Review and Meta-analysis

BACKGROUND

Whether health care provider burnout contributes to lower quality of patient care is unclear.

PURPOSE

To estimate the overall relationship between burnout and quality of care and to evaluate whether published studies provide exaggerated estimates of this relationship.

DATA SOURCES

MEDLINE, PsycINFO, Health and Psychosocial Instruments (EBSCO), Mental Measurements Yearbook (EBSCO), EMBASE (Elsevier), and Web of Science (Clarivate Analytics), with no language restrictions, from inception through 28 May 2019.

STUDY SELECTION

Peer-reviewed publications, in any language, quantifying health care provider burnout in relation to quality of patient care.

DATA EXTRACTION

2 reviewers independently selected studies, extracted measures of association of burnout and quality of care, and assessed potential bias by using the Ioannidis (excess significance) and Egger (small-study effect) tests.

DATA SYNTHESIS

A total of 11 703 citations were identified, from which 123 publications with 142 study populations encompassing 241 553 health care providers were selected. Quality-of-care outcomes were grouped into 5 categories: best practices (n = 14), communication (n = 5), medical errors (n = 32), patient outcomes (n = 17), and quality and safety (n = 74). Relations between burnout and quality of care were highly heterogeneous (I2 = 93.4% to 98.8%). Of 114 unique burnout-quality combinations, 58 indicated burnout related to poor-quality care, 6 indicated burnout related to high-quality care, and 50 showed no significant effect. Excess significance was apparent (73% of studies observed vs. 62% predicted to have statistically significant results; P = 0.011). This indicator of potential bias was most prominent for the least-rigorous quality measures of best practices and quality and safety.

LIMITATION

Studies were primarily observational; neither causality nor directionality could be determined.

CONCLUSION

Burnout in health care professionals frequently is associated with poor-quality care in the published literature. The true effect size may be smaller than reported. Future studies should prespecify outcomes to reduce the risk for exaggerated effect size estimates.

PRIMARY FUNDING SOURCE

Stanford Maternal and Child Health Research Institute.

Burnout syndrome in intensive care professionals: relationships with health status and wellbeing

OBJECTIVES

To determine the predictive models that include the dimensions of burnout that are predictors for physical/mental health, and subjective/psychological wellbeing perceived in intensive care professionals; to analyse the relationships between burnout syndrome, health status and wellbeing experienced by these professionals; and to establish sociodemographic differences in the variables evaluated.

METHOD

A correlational and cross-sectional study was conducted. A total of 52 critical care professionals, mainly nurses, were recruited from an intensive care unit of Madrid. All participants were assessed with the questionnaires: Maslach Burnout Inventory-Human Services Survey, Short Form-12 Health Survey, Satisfaction With Life Scale, Positive and Negative Affect Schedule, and Psychological Well-Being Scales.

RESULTS

No significant sociodemographic differences were found. High levels in the three burnout dimensions were associated with poor physical/mental health and subjective/psychological wellbeing. High scores in emotional exhaustion and depersonalization, and low in personal accomplishment negatively predicted subjective and psychological well-being scales. The self-acceptance scale had the highest predictive validity. Emotional exhaustion was the only burnout dimension that negatively predicted physical and mental health.

CONCLUSIONS

Health status and levels of subjective/psychological wellbeing can be negatively influenced by the burnout syndrome experienced by intensive care professionals. As a result, the implementation of programmes to prevent and treat this syndrome is needed. These preventive interventions can positively impact not only the health and wellbeing of these professionals, but can also improve their ability to practice effectively, improve healthcare quality and patient security, and reduce the economic costs of health institutions. It is therefore imperative to implement burnout preventive programmes for intensive care professionals from universities to health institutions.

Association between burnout and sense of coherence among speech and language therapists: an exploratory study in Italy

Background and aim:

Job burnout has been recognized as a serious occupational hazard among professionals, such as health care professionals. The sense of coherence (SoC) is deemed to be a personal resource capable of reducing the impact of job stressors and, consequently, the experience of job burnout. The purpose of this study was to investigate the relationship between SoC and job burnout among speech and language therapists.

Materials and methods:

A descriptive and cross-sectional analysis was carried out through an online self-reported questionnaire. A total of 217 Italian speech and language therapists were involved in the study. The Anova test, T-test and logistic regression were performed to study the association between SoC and job burnout.

Results:

The Anova test showed that job tenure was not associated to job burnout. The T-test showed that speech and language therapists having a low SoC exhibited significantly higher emotional exhaustion, higher cynicism, and lower professional efficacy (t=-7.190 d.f.=215 p<.001) when compared to those having a high SoC. Finally, the odds ratio showed that low SoC was associated with high emotional exhaustion (OR=11.86; 95% CI=5.52-25.49; p<0.05), low SoC was associated with high cynicism (OR=4.41, CI=2.50-7.80; p<0.05), and low SoC was associated with low personal efficacy (OR=4.70; CI=2.59-8.52; p<0.05).

Conclusion:

Our results are in line with previous studies which showed that SoC is a fundamental personal resource which may activate workers’ reaction to various stressors, thus reducing the experience of burnout. (www.actabiomedica.it)

Self-evaluation and professional status as predictors of burnout among nurses in Jordan

The aim of this study is to evaluate the contribution of self-evaluation, professional status and several demographic factors in predicting burnout among nurses in Jordan. This study was performed on a stratified convenience sample of 350 nurses from 6 hospitals. Modified versions of burnout inventory, self-evaluation scale, and professional status scale were developed, validated and used in this study. Burnout, self-evaluation, and professional status are all found to be at moderate levels. Furthermore, self-evaluation and professional status are found to be important predictors of burnout. On the other hand, although type of hospital and educational level are found to be associated with the level of burnout, overall none of the studied demographic factors was found to be a significant predictor of burnout among nurses in Jordan.

Psychosocial risks, burnout and intention to quit following the introduction of new software at work

BACKGROUND

Despite a rich literature on association between psychosocial factors, the demand-control-support (DCS) model and burnout, there are few integrated frameworks encompassing the DCS model, burnout and intention to quit, particularly in a technological context.

OBJECTIVE

This manuscript examines the relationships between psychosocial risks, the demand-control-support (DCS) model, burnout syndrome and intention to quit following the introduction of new software at work.

METHODS

Data was collected from agents and advisors working at a Canadian university and using newstudy management software. An online questionnaire was sent via the university's internal mail. Finally, 112 people completed the online survey for a response rate of 60.9% .

RESULTS

The results of structural equation modeling show that psychological demands, decision latitude and social support are associated with burnout. It is also clear that burnout, in particular depersonalization and emotional exhaustion, is positively associated with intention to quit.

CONCLUSIONS

The few studies that raise the negative consequences of technology on quality of life in the workplace, and particularly on health, have not succeeded in establishing a direct link between a deterioration of health and the use of technology. This is due to the fact that there are few epidemiological studies on the direct consequences of the use of ITC on health.

A Phenomenological Study of Italian Students' Responses to Professional Dilemmas: A Cross-Cultural Comparison

Phenomenon: Medical professionalism is a complex construct, based in social and cultural influences, yet little research has been done to show how culture influences the behaviors and attitudes of medical students. We presented Italian students with the same professional dilemmas used in a previous Canadian and Taiwanese cross-cultural study to look for similarities and differences and detect elements of Italian culture that influenced how students responded to dilemmas. The aim was to provide medical educators with some insights into students' behavioral strategies and feelings when faced with a professional dilemma. Approach: Using Giorgi's method, we performed a phenomenological analysis of 15 interviews of Italian medical students who responded to standardized video scenarios representing professional dilemmas. These videos were used in Canada and Taiwan and were translated into Italian. All students were from the same degree course, at Year 6, and were recruited on a voluntary basis at the beginning of the Internal Medicine course. Interview transcripts were anonymized before analysis. Findings: Scenarios were perceived as realistic and easy to envision in Italy. Four themes emerged: establishing priority among principles, using tactics to escape the dilemma, defending the self, and defending the relationships. When compared with previous studies, we noted that Italian students did not mention the principles of reporting inappropriate behavior, seeking excellence, or following senior trainees' advice. Insights: This is the first cross-cultural study of professionalism that involves a Mediterranean country and the observed differences could be interpreted as expressions of Italian cultural traits: distrust toward authority and a cooperative rather than competitive attitude. These findings have practical implications for educators to design and run curricula of professionalism with culturally appropriate topics. They highlight the need for more cross-cultural research.

Millennial managers: exploring the next generation of talent

PURPOSE

While considerable scholarly attention has been given to "millennials" (those born between 1981 and 1997), little is known of this generation's ability to influence healthcare organizations and managerial roles in particular. This paper aims to clarify why millennials enter the healthcare management field and how their motivations correlate with preferences for working in various healthcare sectors and with various patient populations.

DESIGN/METHODOLOGY/APPROACH

Survey data were collected from 107 millennials pursuing bachelor degrees in healthcare management by using a modified version of the multidimensional work motivation scale. Further data were collected on millennials' preferences for working in various healthcare sectors and with various patient populations. Correlational analyses were conducted to examine the relationship between types of motivation and workplace preferences. Cross-cultural differences were also examined within this generational set.

FINDINGS

Results indicate a significant positive relationship between intrinsic motivation and preferences for working on the payer side of the industry and within finance and IT functions. Findings also reveal a significant positive relationship between prosocial motivation and preferences for working with more vulnerable patient populations. Variance in work motivation among cultural sub-sets of millennials suggests different upbringings, or alternatively, cultural relativity of the motivational constructs themselves.

RESEARCH LIMITATIONS/IMPLICATIONS

Despite offering key insights into the next generation of healthcare managers, this study is limited by a sample of millennials from one large, metropolitan university in the USA and thus may not represent the views of all millennials.

PRACTICAL IMPLICATIONS

To select, retain and develop the next generation of healthcare managers, it is incumbent upon organizations to better understanding millennials' motivations and preferences.

ORIGINALITY/VALUE

This study is the first of its kind to illuminate the motivations and preferences that underpin a key and growing segment of the healthcare workforce. Millennials, now the largest and most diverse generation on the planet, are poised to change the landscape of health care.

The role of autonomy and social support in the relation between psychosocial safety climate and stress in health care workers

Background

Health care workers are exposed to psychosocial work factors. Autonomy and social support are psychosocial work factors that are related to stress, and are argued to largely result from the psychosocial safety climate within organisations. This study aimed to assess to what extent the relation between psychosocial safety climate and stress in health care workers can be explained by autonomy and social support.

Methods

In a cross-sectional study, psychosocial safety climate, stress, autonomy, co-worker support, and supervisor support were assessed using questionnaires, in a sample of health care workers (N = 277). Linear mixed models analyses were performed to assess to what extent social support and autonomy explained the relation between psychosocial safety climate and stress.

Results

A lower psychosocial safety climate score was associated with significantly higher stress (B = −0.21, 95% CI = −0.27 – -0.14). Neither co-worker support, supervisor support, nor autonomy explained the relation between psychosocial safety climate and stress. Taken together, autonomy and both social support measures diminished the relation between psychosocial safety climate and stress by 12% (full model: B = −0.18, 95% CI = −0.25 – -0.11).

Conclusions

Autonomy and social support together seemed to bring about a small decrease in the relation between psychosocial safety climate and stress in health care workers. Future research should discern whether other psychosocial work factors explain a larger portion of this relation.

Trial registration

This study was registered in the Netherlands National Trial Register, trial code: NTR5527.

Burnout and health among critical care professionals: The mediational role of resilience

OBJECTIVES

To analyse the mediational role of resilience in relationships between burnout and health in critical care professionals; to determine relationships among resilience level, three burnout dimensions, and physical/mental health; and to establish demographic differences in psychological variables evaluated.

DESIGN

Cross-sectional study.

PARTICIPANTS/SETTING

A total of 52 critical care professionals, mainly nurses, were recruited from an intensive care unit of Madrid (Spain).

METHOD

All participants were assessed with the questionnaires 10-item Connor-Davidson Resilience Scale, Maslach Burnout Inventory-Human Services Survey, and Short Form-12 Health Survey.

RESULTS

No demographic differences were found. Three burnout dimensions were negatively associated with mental health and resilience. Mediational analyses revealed resilience mediated 1) the relationships between emotional exhaustion and depersonalisation with mental health (partial mediations) and 2) the relationship between personal accomplishment and mental health (total mediation).

CONCLUSIONS

Resilience minimises and buffers the impact of negative outcomes of workplace stress on mental health of critical care professionals. As a result, resilience prevents the occurrence of burnout syndrome. Resilience improves not only their mental health, but also their ability to practice effectively. It is therefore imperative to develop resilience programs for critical care nurses in nursing schools, universities and health centres.

Factors influencing new graduate nurse burnout development, job satisfaction and patient care quality: a time-lagged study

AIM

To test a hypothesized model linking new graduate nurses' perceptions of their manager's authentic leadership behaviours to structural empowerment, short-staffing and work-life interference and subsequent burnout, job satisfaction and patient care quality.

BACKGROUND

Authentic leadership and structural empowerment have been shown to reduce early career burnout among nurses. Short-staffing and work-life interference are also linked to burnout and may help explain the impact of positive, empowering leadership on burnout, which in turn influences job satisfaction and patient care quality.

DESIGN

A time-lagged study of Canadian new graduate nurses was conducted.

METHODS

At Time 1, surveys were sent to 3,743 nurses (November 2012-March 2013) and 1,020 were returned (27·3% response rate). At Time 2 (May-July 2014), 406 nurses who responded at Time 1 completed surveys (39·8% response rate). Descriptive analysis was conducted in SPSS. Structural equation modelling in Mplus was used to test the hypothesized model.

RESULTS

The hypothesized model was supported. Authentic leadership had a significant positive effect on structural empowerment, which in turn decreased both short-staffing and work-life interference. Short-staffing and work-life imbalance subsequently resulted in nurse burnout, lower job satisfaction and lower patient care quality 1 year later.

CONCLUSION

The findings suggest that short-staffing and work-life interference are important factors influencing new graduate nurse burnout. Developing nurse managers' authentic leadership behaviours and working with them to create and sustain empowering work environments may help reduce burnout, increase nurse job satisfaction and improve patient care quality.

A study of job stress and burnout and related factors in the hospital personnel of Iran

INTRODUCTION

Job stress has become one of the main factors in reducing efficiency and the loss of human resources that may cause physical and psychological adverse effects in employees. Hospital personnel are facing different stressful events, such as birth, pain and death, in a single day. Hence, identifying the job stress rates and related factors may be effective in offering proper strategies. Therefore, the present research was done to study the rate of job stress and burnout in hospital personnel and compare some of the related factors in hospitals personnel of Yazd, Iran.

METHODS

This cross-sectional study was conducted on 306 hospital personnel (Male: 114, Female: 192) in Yazd in 2015-16. The data were collected using a demographic questionnaire, Maslach Burnout Inventory (MBI), and Hospital Stress (HSS-35). SPSS-16 software and Pearson-product moment correlation and independent-samples t-test were used for data analysis.

RESULTS

The mean job stress score was above average. The mean burnout dimensions that were above average included emotional exhaustion (21.7 ± 7.27), depersonalization (9.61 ± 3.74) and personal accomplishment (26.80 ± 6.17). While Pearson correlation revealed a significant positive relationship between job stress, emotional exhaustion, and depersonalization, there was a negative relationship between job stress and personal accomplishment (p < 0.01). Independent-samples t-test results showed that the rate of job stress, emotional exhaustion, and depersonalization in males is higher than females, married people have more emotional exhaustion than single ones, and, finally, health staff have more job stress than administrative staff. At the same time, the administrative staff and females have better personal accomplishment than other groups (p < 0.05).

CONCLUSION

Since the rate of job stress in hospital personnel is worrying and it has adverse effects on personnel health, effective strategies on physical and mental health, such as employment support and stress management training, seem crucial to enhance physical and psychological health of hospital personnel.