[Work stress and resident burnout, before and during the COVID-19 pandemia: An up-date]

Post-pandemic depression, anxiety, and stress: A look at the mental health of medical and administrative staff

INTRODUCTION

Research has shown how mental health among hospital staff worldwide was affected during the COVID-19 pandemic. However, evidence of the physiological status of healthcare and administrative workers at the first level of medical care post-pandemic is scant. Therefore, it is necessary to identify mental health problems among hospital staff following the COVID-19 pandemic.

OBJECTIVE

To determine the prevalence of symptoms and severity of depression, anxiety, and stress among health personnel in the primary care post-pandemic of the Institute of Social Security and Services for State Workers in Puebla.

MATERIALS AND METHODS

A cross-sectional observational study was conducted on medical and administrative staff, comprising 190 participants who worked during the pandemic. A data collection instrument and the 21 item Depression, Anxiety, and Stress Scale were used to determine the prevalence of symptoms and severity of these three mental health issues.

RESULTS

The prevalence of symptoms of depression was 20.5 %, with a moderate predominant severity index (38.5 %), anxiety was 33.2 %, with an extremely severe predominant index (36.5 %), and stress was 30.0 %, with a moderate predominant severity index (36.8 %), respectively. The nursing subgroup, within the medical area staff, exhibited a prevalence of anxiety symptoms of 44.7 %, which was statistically significant (p = 0.008).

CONCLUSION

Despite the post-pandemic period during which this study was conducted, the nursing staff was the most affected group in terms of the prevalence of symptoms of anxiety and depression. Another relevant finding was that administrative workers showed an extremely severe intensity of symptoms of depression, anxiety, and stress.

Residency Wellness: A Historical Narrative Review

INTRODUCTION

The structure of medical residency in the United States has experienced significant changes, paralleling advances in medical science and education. While these changes have enhanced medical training, they have introduced challenges, particularly in resident wellness. The well-being of residents is critical for patient care and the healthcare system. This review aims to provide an overview of the historical trends in medical residency, focusing on the evolution of resident wellness and its associated challenges.

METHODS

A narrative review was conducted, examining the evolution and challenges of medical residency with an emphasis on resident wellness. An exhaustive literature search on January 25, 2024 was conducted across PubMed, Web of Science, and Google Scholar. The search utilized keywords related to medical residency, wellness, and educational reforms. Articles were selected based on relevance and robust evidence, and information was organized into thematic categories for narrative synthesis.

RESULTS

The search yielded 57 publications that met the inclusion criteria. Historical trends revealed a shift from an apprenticeship model to formalized training programs, with each phase bringing unique challenges to resident wellness. The Flexner Report's influence on standardizing medical education, the rise of modern residency programs, and the recognition of burnout as a significant issue were key developments. Policy changes, technological impacts, and the COVID-19 pandemic have further shaped residency training and wellness. Studies highlight the need for interventions addressing burnout and promoting wellness, with varied approaches across specialties and institutions.

CONCLUSION

Residency burnout has been a growing concern since the 1970s, exacerbated by advancements in medicine, technology, and recent global events like the COVID-19 pandemic. Although awareness has increased, the need remains to address burnout and promote wellness during residency. Further research is warranted to develop effective interventions and adapt training to meet the evolving needs of residents.

The show must go on: fostering residents' sustainable employability in medical education - a qualitative exploration of the Resident Leadership Program

BACKGROUND

Residents' sustainable employability (SE) is threatened by high burn-out rates, sleep deficits, and career dissatisfaction. Medical education may contribute to residents' SE by providing them with opportunities to influence their employment contexts and to develop conscious self-regulation. This paper explores how residents, participating in the Resident Leadership Program (RLP), are enabled to work on, and learn about, their SE.

METHODS

The RLP took place between February and July 2021 and consisted of lectures on, and practice in, quality improvement (QI) work. SE was the theme that governed residents' QI projects. In this study, residents were interviewed individually before the program (n = 8), were observed while participating in the program (45 h) and were interviewed in three groups after the program (n = 8). The data were analysed in accordance with the 'flexible-coding' method.

RESULTS

The findings are presented in four 'acts' mirroring an unfolding play as a metaphor to show how residents' understanding of context, self-regulations, and quality improvement work-relevant to their SE-changed in the RLP. The acts include 'setting the stage', describing how residents experienced the context of medicine; 'acting the part', depicting how residents managed their employment contexts using self-regulation; 'changing the décor', elaborating on residents' QI projects; and 'growing one's role', presenting residents' take-aways from participating in the RLP that may benefit their SE. These take-aways encompassed awareness of the importance of SE, a reconsideration and/or adjustment of self-regulation, feeling better equipped to navigate employment contexts, and increased joy in work because of contributing to peers' SE through QI work.

CONCLUSIONS

Our results indicate that medical education is a fruitful environment for providing important lessons and tools for residents to work on and learn about their SE, likely benefiting their SE throughout their careers.

[Prevalence of burnout syndrome in physicians working in Spain: systematic review and meta-analysis]

OBJECTIVE

To analyze the prevalence of burnout syndrome in physicians working in Spain through a systematic review with meta-analysis METHOD: We searched PubMed/MEDLINE, Embase, and PsycINFO (up to June 2023). Observational studies conducted in Spain reporting the prevalence of burnout in physicians were included. From each study, methodological characteristics and results were extracted, and their quality was evaluated. We performed a narrative synthesis with random effects meta-analysis to calculate proportions.

RESULTS

Sixty-seven studies with 16,076 participants were included. For the primary outcome, the meta-analysis revealed a global prevalence of burnout in physicians of 24% (95%CI: 19%-29%; 46 studies; 8821 participants; I2=97%). From subgroup analysis, differences were observed depending on the diagnostic criteria used: 18% (95%CI: 13%-23%) for three dimensions of burnout, 29% (95%CI: 24%-34%) for two dimensions and 51% (95%CI: 42%-60%) for one dimension. The heterogeneity between studies could not be fully explained through additional analyses where non-statistically significant differences were found with other variables (e.g., study quality, setting, professional category or medical specialty).

CONCLUSIONS

A high prevalence of burnout syndrome was found in physicians working in Spain. These results can contribute to estimating the burden associated with burnout in physicians at a national level and to the design of future studies. Strategies appear to be necessary to prevent and mitigate this situation.

PROTOCOL REGISTRATION

Open Science Framework: https://osf.io/b2h4m/.

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

Background

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

Methodology

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

Results

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

Discussion

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