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Miranda-Mendizabal A, Castellví P, Vilagut G, Alayo I, Almenara J, Ballester L, Echeburúa E, Gabilondo A, Gili M, Mortier P, Piqueras JA, Roca M, Auerbach RP, Bruffaerts R, Kessler RC, Alonso Caballero J. Suicidal ideation risk among LGB Spanish university students: The role of childhood and adolescence adversities and mental disorders. J Affect Disord 2024; 353:52-59. [PMID: 38417714 DOI: 10.1016/j.jad.2024.02.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 02/21/2024] [Accepted: 02/23/2024] [Indexed: 03/01/2024]
Abstract
BACKGROUND Childhood/adolescence adversities and mental disorders are higher among LGB youths. AIMS To evaluate the role of childhood maltreatment, bullying, and mental disorders on the association between sexual orientation and suicidal ideation (SI); and the role of mental disorders on the association between sexual orientation discrimination and SI. METHODS Baseline and 12-month follow-up online surveys of Spanish first-year university students (18-24-year-olds). Multivariable logistic regression models assessed the effects of childhood/adolescence adversities and mental disorders in the relationship between sexual orientation, discrimination and SI. RESULTS A total of 1224 students were included (16.4 % LGBs). Risk factors of lifetime SI were sexual orientation (OR 2.4), any bullying (OR 2.4), any childhood maltreatment (OR 4.0), and any mental disorders (OR 3.8). Final model Area Under the Curve (AUC) 0.78. Among homosexual and bisexual students, discrimination showed increased risk of 12-month SI (OR 2.2), but this effect was no longer statistically significant when any 12-month mental disorder was added (OR 7.8). Final model AUC 0.72. LIMITATIONS Sample of interest was relatively small. But it was similar to comparable studies and statistical adjustments have been performed. Assessment of mental disorders and SI was not based on clinical assessment. However, validated scales showing good diagnostic agreement with clinical judgement were used. CONCLUSIONS Childhood/adolescence adversities and mental disorders interact in the association between sexual orientation and SI. Mental disorders may mediate the association between sexual orientation discrimination and SI. Further research using larger samples and causal modelling approach assessing the mediators of SI risk among LGBs is needed.
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Affiliation(s)
- Andrea Miranda-Mendizabal
- Teaching, Research & Innovation Unit, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Spain; Mental Health Networking Biomedical Research Centre (CIBERSAM), Madrid, Spain; Health Services Research Group, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain.
| | - Pere Castellví
- Department of Medicine, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Gemma Vilagut
- Health Services Research Group, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Itxaso Alayo
- Health Services Research Group, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain; Carrer Dr. Antoni Pujadas 42, 08830 Sant Boi de Llobregar, Spain; Department of Health & Experimental Sciences, Pompeu Fabra University (UPF), Barcelona, Spain
| | | | - Laura Ballester
- Health Services Research Group, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | - Andrea Gabilondo
- Outpatient Mental Health Care Network, Osakidetza-Basque Health Service, Biodonosti Health Research Institute, San Sebastian, Spain
| | - Margalida Gili
- Institut Universitari d'Investigació en Ciències de la Salut (IUNICS-IDISPA), University of Balearic Islands (UIB), Palma de Mallorca, Spain
| | - Philippe Mortier
- Health Services Research Group, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
| | - José Antonio Piqueras
- Department of Health Psychology, Miguel Hernández University of Elche (UMH), Alicante, Spain
| | - Miquel Roca
- Institut Universitari d'Investigació en Ciències de la Salut (IUNICS-IDISPA), University of Balearic Islands (UIB), Palma de Mallorca, Spain
| | - Randy P Auerbach
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA
| | - Ronny Bruffaerts
- Universitair Psychiatrisch Centrum, KU Leuven (UPC-KUL), Leuven, Belgium
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Jordi Alonso Caballero
- Health Services Research Group, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Department of Health & Experimental Sciences, Pompeu Fabra University (UPF), Barcelona, Spain.
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Fond G, Lucas G, Boyer L. Prevalence and factors associated with gender incongruence in French healthcare professionals: results from a nationwide survey. Public Health 2024; 228:51-54. [PMID: 38271859 DOI: 10.1016/j.puhe.2023.12.028] [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: 10/09/2023] [Revised: 11/08/2023] [Accepted: 12/20/2023] [Indexed: 01/27/2024]
Abstract
OBJECTIVES The objective of this study was to explore gender incongruence among French healthcare professionals and its associated factors. STUDY DESIGN Nationwide online cross-sectional survey. METHODS Healthcare professionals were recruited from May 2, 2021, to June 30, 2021, through social networks, professional networks, and email invitations. A multivariate regression model was used to analyze the association between gender incongruence and socio-demographic, professional, mental health, and addiction behavior factors. RESULTS The study included 10,325 healthcare professionals, indicating a prevalence of gender incongruence at 2.6% (95% confidence interval [CI]: 2.3-2.9%). In multivariate analyses, we found that healthcare professionals with gender incongruence, when compared to their counterparts, exhibited the following characteristics: they were more frequently male (adjusted odds ratio [aOR] = 1.88, 95% CI: [1.42-2.48], p < 0.001), less frequently physicians (aOR = 0.18, 95%CI: [0.11-0.29], p < 0.001), health executives (aOR = 0.51 [0.34-0.77], p = 0.001), nurses (aOR = 0.47, 95%CI: [0.33-0.68], p < 0.001), and other allied professionals (aOR = 0.33, 95%CI [0.23-0.49], p < 0.001) than nurse assistants, they consumed antidepressants more frequently (aOR = 1.52, 95%CI: [1.02-2.26], p = 0.041) and were more likely to be tobacco smokers (aOR = 1.34 (1.02-1.77), p = 0.035). We did not observe any significant associations with age, hazardous drinking, sustained bullying at the work place, or sexual-orientation-based discrimination (all p > 0.05). CONCLUSIONS Gender incongruence should be taken into account at the management, colleague, or institution levels. We found that the professionals reporting gender incongruence consumed more antidepressants and smoked more, which may indicate a certain level of distress that warrants further investigation. PROTOCOL REGISTRATION IRB n°C08/21.01.06.93911, CNIL. The protocol was published DOI: 10.1016/j.encep.2021.06.001. TRIAL AND PROTOCOL REGISTRATION The protocol was published DOI: 10.1016/j.encep.2021.06.001.
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Affiliation(s)
- G Fond
- Assistance Publique des Hôpitaux de Marseille, Aix-Marseille University, CEReSS-Health Service Research and Quality of Life Center, 27, boulevard Jean - Moulin, 13005 Marseille, France; Fondation FondaMental, Créteil, France.
| | - G Lucas
- Assistance Publique des Hôpitaux de Marseille, Aix-Marseille University, CEReSS-Health Service Research and Quality of Life Center, 27, boulevard Jean - Moulin, 13005 Marseille, France
| | - L Boyer
- Assistance Publique des Hôpitaux de Marseille, Aix-Marseille University, CEReSS-Health Service Research and Quality of Life Center, 27, boulevard Jean - Moulin, 13005 Marseille, France; Fondation FondaMental, Créteil, France
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Meeks LM, Conrad SS, Nouri Z, Moreland CJ, Hu X, Dill MJ. Patient And Coworker Mistreatment Of Physicians With Disabilities. Health Aff (Millwood) 2022; 41:1396-1402. [DOI: 10.1377/hlthaff.2022.00502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Lisa M. Meeks
- Lisa M. Meeks, University of Michigan, Ann Arbor, Michigan
| | - Sarah S. Conrad
- Sarah S. Conrad, Association of American Medical Colleges, Washington, D.C
| | - Zakia Nouri
- Zakia Nouri, Association of American Medical Colleges
| | | | - Xiaochu Hu
- Xiaochu Hu, Association of American Medical Colleges
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FOND G, FERNANDES S, LUCAS G, Greenberg N, BOYER L. Depression in healthcare workers: results from the nationwide AMADEUS survey. Int J Nurs Stud 2022; 135:104328. [PMID: 35952535 PMCID: PMC9359895 DOI: 10.1016/j.ijnurstu.2022.104328] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 07/15/2022] [Accepted: 07/16/2022] [Indexed: 10/31/2022]
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Reece-Nguyen T, Afonso AM, Vinson AE. Burnout, Mental Health, and Workplace Discrimination in Lesbian, Gay, Bisexual, Transgender, Queer/Questioning, Intersex, and Asexual Anesthesiologists. Anesthesiol Clin 2022; 40:245-255. [PMID: 35659398 DOI: 10.1016/j.anclin.2022.01.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Increasing attention is being paid to both anesthesiologist well-being and commitments to diversity, equity, and inclusion. Sexual minorities (ie, members of the lesbian, gay, bisexual, transgender, queer/questioning, intersex, and asexual [LGBTQIA] communities) face many challenges in society and the workplace, including mental health conditions, discrimination, and increased risk for burnout. In this review, we outline the current state of mental health conditions and burnout in sexual minority individuals, discrimination and harassment faced both in society and the workplace, and steps that workplaces can take to become more inclusive and welcoming.
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Affiliation(s)
- Travis Reece-Nguyen
- Department of Anesthesiology, Perioperative, and Pain Medicine, Division of Pediatric Anesthesiology, Stanford Medicine, 453 Quarry Road, MC: 5663, Stanford, CA 94305, USA
| | - Anoushka M Afonso
- Department of Anesthesiology & Critical Care, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, C-336, New York, NY 10065, USA
| | - Amy E Vinson
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital and Harvard Medical School, 300 Longwood Avenue, Bader 3, Boston, MA 02115, USA.
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Peel JK, Flexman AM, Cygler J, Kirkham KR, Lorello GR. Standing out or fitting in: A latent projective content analysis of discrimination of women and 2SLGBTQ+ anesthesiologists and providers. J Clin Anesth 2022; 80:110884. [PMID: 35597003 DOI: 10.1016/j.jclinane.2022.110884] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 05/08/2022] [Accepted: 05/11/2022] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Discrimination toward sex and gender minority anesthesiologists and anesthesia trainees exists. Potential reasons for this discrimination are unclear and incompletely characterized. This study sought to better understand what discrimination looks like for sex and gender minorities in anesthesiology and the culture within anesthesiology that allows this discrimination to occur. MATERIALS AND METHODS With institutional research ethics board approval and informed consent, we performed a qualitative analysis of free-text responses from a previously-published internet-based cross-sectional survey distributed to Canadian anesthesiology residents, fellows, and staff. The purpose of this survey was to characterize intersections between respondent gender or sexuality with experiences of discrimination in the workplace. Separate analysis of qualitative and quantitative components of this survey was planned a priori, and the quantitative component was published elsewhere. Free-text responses were independently coded by two researchers and subsequently synthesized into emerging themes using latent projective content analysis sensitized by Butler's theory of performativity. RESULTS Out of 490 free-text responses from 171 respondents [140 (81.9%) identifying as heterosexual], two themes emerged: i) fitting in: performativity reinforcing the status quo, and ii) standing out: performativity as a means of disruptive social change. Power structures were observed to favour individuals who "fit in" with the normative performances of gender and/or sexuality. DISCUSSION Our study illuminates how individuals whose performances of gender and sexuality "fit in" with those expected normative performances reinforce a workplace culture that advantages them, whereas individuals whose performances of gender and sexuality "stand out" disproportionately experience discrimination. The dismantling of bias and discrimination in the anesthesiology workplace requires individuals (a) who are empowered within their workplace because they "fit in" with the majority; (b) who recognize discrimination toward communities of their peers and/or colleagues; and (c) who actively choose to "stand out".
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Affiliation(s)
- John K Peel
- University of Toronto, Department of Anesthesiology and Pain Medicine, Toronto, ON, Canada
| | - Alana M Flexman
- The University of British Columbia, Department of Anesthesiology, Pharmacology and Therapeutics, Vancouver, BC, Canada
| | - Jeremy Cygler
- University of Toronto, Department of Medicine, Toronto, ON, Canada
| | - Kyle R Kirkham
- University of Toronto, Department of Anesthesiology and Pain Medicine, Toronto, ON, Canada; University Health Network - Toronto Western Hospital, Department of Anesthesia and Pain Management, Toronto, ON, Canada
| | - Gianni R Lorello
- University of Toronto, Department of Anesthesiology and Pain Medicine, Toronto, ON, Canada; University Health Network - Toronto Western Hospital, Department of Anesthesia and Pain Management, Toronto, ON, Canada; The Wilson Centre, University Health Network, Toronto, ON, Canada; Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada.
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Dyrbye LN, West CP, Sinsky CA, Trockel M, Tutty M, Satele D, Carlasare L, Shanafelt T. Physicians' Experiences With Mistreatment and Discrimination by Patients, Families, and Visitors and Association With Burnout. JAMA Netw Open 2022; 5:e2213080. [PMID: 35587344 PMCID: PMC9121189 DOI: 10.1001/jamanetworkopen.2022.13080] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 04/01/2022] [Indexed: 11/30/2022] Open
Abstract
Importance Burnout is common among physicians and is associated with suboptimal patient outcomes. Little is known about how experiences with patients, families, and visitors differ by physician characteristics or contribute to the risk of burnout. Objective To examine the occurrence of mistreatment and discrimination by patients, families, and visitors by physician characteristics and the association between such interactions and experiencing burnout. Design, Setting, and Participants This cross-sectional survey was conducted from November 20, 2020, to March 23, 2021, among US physicians. Exposures Mistreatment and discrimination were measured using items adapted from the Association of American Medical College's Graduation Questionnaire with an additional item querying respondents about refusal of care because of the physicians' personal attributes; higher score indicated greater exposure to mistreatment and discrimination. Main Outcomes and Measures Burnout as measured by the Maslach Burnout Inventory. Results Of 6512 responding physicians, 2450 (39.4%) were female, and 369 (7.2%) were Hispanic; 681 (13.3%) were non-Hispanic Asian, Native Hawaiian, or Pacific Islander; and 3633 (70.5%) were non-Hispanic White individuals. Being subjected to racially or ethnically offensive remarks (1849 [29.4%]), offensive sexist remarks (1810 [28.7%]), or unwanted sexual advances (1291 [20.5%]) by patients, families, or visitors at least once in the previous year were common experiences. Approximately 1 in 5 physicians (1359 [21.6%]) had experienced a patient or their family refusing to allow them to provide care because of the physician's personal attributes at least once in the previous year. On multivariable analyses, female physicians (OR, 2.33; 95% CI, 2.02-2.69) and ethnic and racial minority physicians (eg, Black or African American: OR, 1.59; 95% CI, 1.13-2.23) were more likely to report mistreatment or discrimination in the previous year. Experience of mistreatment or discrimination was independently associated with higher odds of burnout (vs score of 0 [no mistreatment], score of 1: OR, 1.27; 95% CI, 1.04-1.55; score of 2: OR, 1.70; 95% CI, 1.38-2.08; score of 3: OR, 2.20; 95% CI, 1.89-2.57). There was no difference in the odds of burnout by gender after controlling for experiencing mistreatment and discrimination score and other demographic factors, specialty, practice setting, work hours, and frequency of overnight call. Conclusions and Relevance In this study, mistreatment and discrimination by patients, families, and visitors were common, especially for female and racial and ethnic minority physicians, and associated with burnout. Efforts to mitigate physician burnout should include attention to patient and visitor conduct.
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Affiliation(s)
- Liselotte N. Dyrbye
- Mayo Clinic, Rochester, Minnesota
- now with University of Colorado School of Medicine, Denver
| | | | | | - Mickey Trockel
- Psychiatry and Behavioral Sciences, Stanford School of Medicine, Stanford, California
| | | | - Daniel Satele
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
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Lucas G, Colson S, Boyer L, Gentile S, Fond G. Work environment and mental health in nurse assistants, nurses and health executives: results from the AMADEUS study. J Nurs Manag 2022; 30:2268-2277. [PMID: 35332585 DOI: 10.1111/jonm.13599] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 03/13/2022] [Accepted: 03/17/2022] [Indexed: 11/28/2022]
Abstract
AIM To explore work environment and mental health in nurse assistants, nurses and health executives in a national large-scale study. BACKGROUND We have data for physicians but not for other healthcare workers categories. METHODS 6935 participants were recruited between 2021 May and June by professional mailings and professional networks. RESULTS All professional categories reported high rates of high psychological demand (>90%), low social support (>60%) burnout (50 to 60%), exposure to potentially morally injurious events (>40%) depression (approximately 30%). Surgery nurses reported the highest exposure to potentially morally injurious events. Major depression was identified in approximately 30% of participants in all categories but less than 10% reported consuming antidepressants. 31 to 49% of participants reported sleep disorders and 16 to 21% reported consuming regularly hypnotics. Physicians reported high hazardous drinking behavior and nurse assistant high smoking rates. CONCLUSIONS AND IMPLICATIONS FOR NURSING MANAGEMENT Our results suggest that preventing burnout and depression in healthcare workers is a priority. To reach this goal, nursing managers could develop some interventions to reduce psychological demand and increase personal accomplishment and social support between colleagues, prevent sustained bullying at the workplace and health risk behaviors. These interventions should be further developed and evaluated.
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Affiliation(s)
- Guillaume Lucas
- AP-HM, Faculté des Sciences Médicales et Paramédicales, Aix Marseille Université, EA3279-CEReSS, Marseille Cedex, France
| | - Sébastien Colson
- AP-HM, Faculté des Sciences Médicales et Paramédicales, Aix Marseille Université, EA3279-CEReSS, Marseille Cedex, France
| | - Laurent Boyer
- AP-HM, Faculté des Sciences Médicales et Paramédicales, Aix Marseille Université, EA3279-CEReSS, Marseille Cedex, France.,Fondation FondaMental, Créteil, France
| | - Stéphanie Gentile
- AP-HM, Faculté des Sciences Médicales et Paramédicales, Aix Marseille Université, EA3279-CEReSS, Marseille Cedex, France
| | - Guillaume Fond
- AP-HM, Faculté des Sciences Médicales et Paramédicales, Aix Marseille Université, EA3279-CEReSS, Marseille Cedex, France.,Fondation FondaMental, Créteil, France
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Lucas G, Colson S, Boyer L, Gentile S, Fond G. [Influence of the work environment on burn-out and depression in nurses]. REVUE DE L'INFIRMIERE 2022; 71:34-35. [PMID: 35090629 DOI: 10.1016/j.revinf.2021.11.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Burn out is defined as a state of psychological exhaustion in the face of an unfavourable work environment. In the health sector, this includes, among other things, an excessive care burden, the lack of autonomy or control over work, the vicious circle of absenteeism, the lack of support, moral and sexual harassment, discrimination or the Covid-19 health crisis. Burn-out also increases the risk of depression among care workers.
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Affiliation(s)
- Guillaume Lucas
- École des sciences infirmières, faculté des sciences médicales et paramédicales, Aix-Marseille université, 27 boulevard Jean-Moulin, 13385 Marseille cedex 5, France.
| | - Sébastien Colson
- École des sciences infirmières, faculté des sciences médicales et paramédicales, Aix-Marseille université, 27 boulevard Jean-Moulin, 13385 Marseille cedex 5, France
| | - Laurent Boyer
- Centre de recherche sur les services de santé et la qualité de vie, faculté des sciences médicales et paramédicales, Aix-Marseille université, 27 boulevard Jean-Moulin, 13005 Marseille, France; Fondation FondaMental, pôle de psychiatrie, hôpital Albert-Chenevier, 40 rue de Mesly, 94000 Créteil, France
| | - Stéphanie Gentile
- Centre de recherche sur les services de santé et la qualité de vie, faculté des sciences médicales et paramédicales, Aix-Marseille université, 27 boulevard Jean-Moulin, 13005 Marseille, France
| | - Guillaume Fond
- Centre de recherche sur les services de santé et la qualité de vie, faculté des sciences médicales et paramédicales, Aix-Marseille université, 27 boulevard Jean-Moulin, 13005 Marseille, France; Fondation FondaMental, pôle de psychiatrie, hôpital Albert-Chenevier, 40 rue de Mesly, 94000 Créteil, France
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Risk factors for burnout and depression in healthcare workers: The national AMADEUS study protocol. Encephale 2021; 48:247-253. [PMID: 34666893 DOI: 10.1016/j.encep.2021.06.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 05/23/2021] [Accepted: 06/04/2021] [Indexed: 11/21/2022]
Abstract
CONTEXT Burnout is an international phenomenon defined as a state of professional exhaustion. It can lead to depression and have major economic and organizational impacts. Previous studies of healthcare professionals in France have focused on physicians, but none to date have explored other healthcare professions. OBJECTIVES The main objective of our study is to determine the prevalence of burnout among healthcare workers. The secondary objectives are to explore the associations of burnout with professional and psycho-social factors and the risk of depression, professional harassment, sexual harassment, sexual-orientation based discrimination, consumption of antidepressants, anxiolytics and also the lifestyle of the individual: smoking, alcohol consumption, coffee consumption, physical activity and sleep quality. MATERIALS AND METHODS The survey will take the form of a voluntary and anonymous online questionnaire carried out on the FramaForm1® platform and will be disseminated via social networks, professional networks and mailings. STUDY POPULATION Senior doctors, interns, directors of care, nurses, head nurses and senior head nurses, physiotherapists and occupational therapists, dieticians, radiology technicians, laboratory technicians, psychologists, nurses' aides, auxiliary nurses and midwives will be included. COLLECTED DATA Burnout will be measured with the Maslach Inventory burnout (MBI) questionnaire, work environment with the Karasek questionnaire and anxiety, depression risk with the Center for Epidemiologic Studies- Depression (CES-D), physical activity with the Global Physical Activity Questionnaire (GPAQ) and sleep quality with the Pittsburgh Sleep Quality Index (PSQI). ETHICS This protocol has been accepted by the ethical committee (IRB n°C08/21.01.06.93911, CNIL). EXPECTED RESULTS Based on international studies, we expect a high rate of burnout with disparities according to profession, socio-demographic data, seniority and type of service. We also expect a significant rate of untreated depression. This study will provide evidence for policy makers to implement collective strategies to reduce burnout and depression in the different populations studied.
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