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Sears DM, Bejeck A, Kilpatrick L, Griggs N, Farmer L, Jackson B, Janek H, Waddimba AC. Leadership development as a novel strategy to mitigate burnout among female physicians. PLoS One 2025; 20:e0319895. [PMID: 40100847 PMCID: PMC11918409 DOI: 10.1371/journal.pone.0319895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2024] [Accepted: 02/08/2025] [Indexed: 03/20/2025] Open
Abstract
BACKGROUND Female physicians are more likely to experience burnout and less likely to hold leadership positions. Effective interventions are needed to support women physicians in the workforce. OBJECTIVE To determine if a shared learning, social-based leadership development program will impact burnout and career trajectory for female physicians. DESIGN Cohort study. SETTING Multispecialty healthcare system and state medical society members. PARTICIPANTS Burnout and Engagement surveys were emailed to 5000 physicians within the Baylor Scott & White Health System (BSWH). The external control group consisted of 516 female physicians within the Texas Medical Association (TMA) and not associated with BSWH. Internal controls included both male (670) and female physicians (240) who did not participate in the program. INTERVENTION The Women Leaders in Medicine (WLiM) program included twice-annual in person summits and support programs throughout the 2-year study period. MEASUREMENTS The Maslach Burnout Index (MBI) was utilized to evaluate burnout. Surveys were conducted at three separate points and included interest in leadership, intent to retain current employment, and open comments. RESULTS Participants in WLiM had decreased frequency of high emotional exhaustion (mean 2.9 decreased to 2.5), decreased occurrence of high depersonalization (mean 1.6 decreased to 1.3), and improved levels of personal accomplishment (mean 4.7 improved to 5.1) and leadership aspiration (mean 7.4 to 7.8). Intention to stay went from 4.0 to 4.1. CONCLUSIONS Burnout can be improved, and leadership aspirations fostered with a group leadership development in a cohort of female physicians.
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Affiliation(s)
- Dawn M. Sears
- North Texas VA Medical Center, Dallas University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
| | - Alexis Bejeck
- Department of Internal Medicine, Scott and White Medical Center, Baylor Scott and White Health, Temple, Texas, United States of America
| | - Laurel Kilpatrick
- Department of Internal Medicine, Scott and White Medical Center, Baylor Scott and White Health, Temple, Texas, United States of America
| | - Nicole Griggs
- North Texas VA Medical Center, Dallas University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
| | - Lindsey Farmer
- Department of Internal Medicine, UTHealth McGovern Medical School, Houston, Texas, United States of America
| | - Brittany Jackson
- Department of Anesthesiology, Vanderbilt University, Nashville, Tennessee, United States of America
| | - Hania Janek
- North Texas VA Medical Center, Dallas University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
| | - Anthony C. Waddimba
- Department of Surgery, Baylor University Medical Center, Baylor Scott and White Health, Dallas, Texas, United States of America
- Baylor Scott and White Research Institute, Baylor Scott and White Health, Dallas, Texas, United States of America
- Department of Medical Education, Texas A&M College of Medicine, Dallas, Texas, United States of America
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Wojda PJ. Physician Burnout: The Making of a Crisis. HEALTH CARE ANALYSIS 2025; 33:15-34. [PMID: 39543017 DOI: 10.1007/s10728-024-00496-w] [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] [Accepted: 11/01/2024] [Indexed: 11/17/2024]
Abstract
This essay places contemporary efforts to understand and respond to the crisis of physician burnout in historical perspective, proposing that the origins of such efforts lie in nineteenth century concerns over "nervous exhaustion," well before the term "physician burnout" was coined by social scientists in the early 1970s. Only very recently, however, have physician-scholars started to bring more sophisticated tools to bear in conceptualizing the problem, moving from a "systems approach" to the most recent efforts to frame the issue as a problem of corporate culture. The essay proposes that these different approaches to physician burnout illustrate the changing self-images of the medical profession over the last century and a half. Because such self-images are embedded in normative assumptions, contextualizing physician burnout in these terms reveals the crisis to be as much social and political as professional.
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Affiliation(s)
- Paul J Wojda
- Department of Thoelogy, University of St. Thomas (Minnesota), 2115 Summit Avenue, JRC109A, St. Paul, MN, 55105, USA.
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Aluce LM, Cooper JJ, Emlet LL, Cohen ER, Ostrowski SJ, Wood GJ, Vermylen JH. Bringing competency-based communication training to scale: A multi-institutional virtual simulation-based mastery learning curriculum for Emergency Medicine residents. MEDICAL TEACHER 2025; 47:505-512. [PMID: 38803304 DOI: 10.1080/0142159x.2024.2345267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 04/16/2024] [Indexed: 05/29/2024]
Abstract
PURPOSE Serious illness communication skills are essential for physicians, yet competency-based training is lacking. We address scalability barriers to competency-based communication skills training by assessing the feasibility of a multi-center, virtual simulation-based mastery learning (vSBML) curriculum on breaking bad news (BBN). METHODS First-year emergency medicine residents at three academic medical centers participated in the virtual curriculum. Participants completed a pretest with a standardized patient (SP), a workshop with didactics and small group roleplay with SPs, a posttest with an SP, and additional deliberate practice sessions if needed to achieve the minimum passing standard (MPS). Participants were assessed using a previously published BBN assessment tool that included a checklist and scaled items. Authors compared pre- and posttests to evaluate the impact of the curriculum. RESULTS Twenty-eight (90%) of 31 eligible residents completed the curriculum. Eighty-nine percent of participants did not meet the MPS at pretest. Post-intervention, there was a statistically significant improvement in checklist performance (Median= 93% vs. 53%, p < 0.001) and on all scaled items assessing quality of communication. All participants ultimately achieved the MPS. CONCLUSIONS A multi-site vSBML curriculum brought all participants to mastery in the core communication skill of BBN and represents a feasible, scalable model to incorporate competency-based communication skills education in a widespread manner.
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Affiliation(s)
- Laurie M Aluce
- Instructor of Medicine and Emergency Medicine, Department of Medicine and Department of Emergency Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Julie J Cooper
- Department of Emergency Medicine, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA
- Academic Faculty, Department of Emergency Medicine, ChristianaCare, Newark, DE, USA
| | - Lillian Liang Emlet
- Department of Critical Care Medicine and Department of Emergency Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
- VA Pittsburgh Healthcare System, Pittsburgh, PA, USA
| | - Elaine R Cohen
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Simon J Ostrowski
- Department of Emergency Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Gordon J Wood
- Department of Medicine and Department of Medical Education, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Julia H Vermylen
- Department of Medicine and Department of Medical Education, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Ichikura K, Watanabe K, Moriya R, Chiba H, Inoue A, Arai Y, Shimazu A, Fukase Y, Tagaya H, Tsutsumi A. Online vs. face-to-face interactive communication education using video materials among healthcare college students: a pilot non-randomized controlled study. BMC MEDICAL EDUCATION 2024; 24:746. [PMID: 38987794 PMCID: PMC11238445 DOI: 10.1186/s12909-024-05742-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 07/03/2024] [Indexed: 07/12/2024]
Abstract
BACKGROUND This study aimed to examine whether online interactive communication education using video materials was as effective as face-to-face education among healthcare college students. METHODS The participants were healthcare college students who were enrolled in study programs to obtain national medical licenses. They participated in lectures and exercises on healthcare communication, both online (n = 139) and face-to-face (n = 132). Listening skills, understanding, and confidence in healthcare communication were assessed using a self-assessed tool. RESULTS From the two-way ANOVA result, the interaction effects between group (online, face-to-face) and time (Time 1, Time 2, Time 3) were not statistically significant. The main effect of time increased significantly from Time1 to Time 3 on understanding of communication with patients (Hedges'g = 0.51, 95%CI 0.27-0.75), confidence in communication with patients (g = 0.40, 95%CI 0.16-0.64), and confidence in clinical practice (g = 0.49, 95%CI 0.25, 0.73), while the score of listening skills had no significant change (Hedges'g = 0.09, 95%CI - 0.03 to 0.45). CONCLUSIONS The results show that online communication education with video materials and active exercises is as effective in improving students' confidence as face-to-face. It will be necessary to modify the content of this educational program to improve skills as well as confidence in communication. TRIAL REGISTRATION Not Applicable.
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Affiliation(s)
- Kanako Ichikura
- Department of Health Science, Kitasato University School of Allied Health Sciences, 1-15-1 Kitazato, Minami-ku, Sagamihara, Kanagawa, 252-0373, Japan.
- Kitasato University Graduate School of Medical Sciences, 1-15-1 Kitazato, Minami-ku, Sagamihara, Kanagawa, 252-0373, Japan.
| | - Kazuhiro Watanabe
- Department of Public Health, Kitasato University School of Medicine, 1-15-1 Kitazato, Minami- ku, Sagamihara, Kanagawa, 252-0374, Japan
| | - Rika Moriya
- Department of Medical Education, Kitasato University School of Medicine, 1-15-1 Kitazato, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan
| | - Hiroki Chiba
- Department of Medical Education, Kitasato University School of Medicine, 1-15-1 Kitazato, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan
| | - Akiomi Inoue
- Institutional Research Center, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, 807-8555, Japan
| | - Yumi Arai
- Department of Patient Safety and Hospital Administration, Kitasato University Hospital, 1-15-1 Kitazato, Minami-ku, Sagamihara, Kanagawa, 252-0375, Japan
| | - Akihito Shimazu
- Faculty of Policy Management, Keio University, 5322, Endo, Fujisawa, Kanagawa, 252-0882, Japan
| | - Yuko Fukase
- Department of Health Science, Kitasato University School of Allied Health Sciences, 1-15-1 Kitazato, Minami-ku, Sagamihara, Kanagawa, 252-0373, Japan
- Kitasato University Graduate School of Medical Sciences, 1-15-1 Kitazato, Minami-ku, Sagamihara, Kanagawa, 252-0373, Japan
| | - Hirokuni Tagaya
- Department of Health Science, Kitasato University School of Allied Health Sciences, 1-15-1 Kitazato, Minami-ku, Sagamihara, Kanagawa, 252-0373, Japan
- Kitasato University Graduate School of Medical Sciences, 1-15-1 Kitazato, Minami-ku, Sagamihara, Kanagawa, 252-0373, Japan
| | - Akizumi Tsutsumi
- Department of Public Health, Kitasato University School of Medicine, 1-15-1 Kitazato, Minami- ku, Sagamihara, Kanagawa, 252-0374, Japan
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Kk A, At J, Lø P, Jd L, L L, S EN, S T, Lh J. Effects of on-site Supportive Communication Training (On-site SCT) on doctor-patient communication in oncology: Study protocol of a randomized, controlled mixed-methods trial. BMC MEDICAL EDUCATION 2024; 24:522. [PMID: 38730382 PMCID: PMC11088166 DOI: 10.1186/s12909-024-05496-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 04/30/2024] [Indexed: 05/12/2024]
Abstract
BACKGROUND The quality of communication in oncology significantly impacts patients' health outcomes, as poor communication increases the risk of unnecessary treatment, inadequate pain relief, higher anxiety levels, and acute hospitalizations. Additionally, ineffective communication skills training (CST) is associated with stress, low job satisfaction, and burnout among doctors working in oncology. While acknowledging the importance of effective communication, the specific features of successful CST remain uncertain. Role-play and recorded consultations with direct feedback appear promising for CST but may be time-consuming and face challenges in transferring acquired skills to clinical contexts. Our aim is to bridge this gap by proposing a novel approach: On-site Supportive Communication Training (On-site SCT). The concept integrates knowledge from previous studies but represents the first randomized controlled trial employing actual doctor-patient interactions during CST. METHODS This randomized multicenter trial is conducted at three departments of oncology in Denmark. Doctors are randomized 1:1 to the intervention and control groups. The intervention group involves participation in three full days of On-site SCT facilitated by a trained psychologist. On-site SCT focuses on imparting communication techniques, establishing a reflective learning environment, and offering emotional support with a compassionate mindset. The primary endpoint is the change in percentage of items rated "excellent" by the patients in the validated 15-item questionnaire Communication Assessment Tool. The secondary endpoints are changes in doctors' ratings of self-efficacy in health communication, burnout, and job satisfaction measured by validated questionnaires. Qualitative interviews will be conducted with the doctors after the intervention to evaluate its relevance, feasibility, and working mechanisms. Doctors have been actively recruited during summer/autumn 2023. Baseline questionnaires from patients have been collected. Recruitment of new patients for evaluation questionnaires is scheduled for Q1-Q2 2024. DISCUSSION This trial aims to quantify On-site SCT efficacy. If it significantly impacts patients/doctors, it can be a scalable CST concept for clinical practice. Additionally, qualitative interviews will reveal doctors' insight into the most comprehensible curriculum parts. TRIAL REGISTRATION April 2023 - ClinicalTrials.gov (NCT05842083). April 2023 - The Research Ethics Committee at the University of Southern Denmark (23/19397).
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Affiliation(s)
- Antonsen Kk
- Department of Oncology, Vejle Hospital, University Hospital of Southern Denmark, Vejle, Denmark.
- Department of Regional Health Research, University of Southern Denmark, Vejle, Denmark.
| | - Johnsen At
- Department of Oncology and Palliative Care, Zealand University Hospital, Roskilde/Naestved, Denmark
| | - Poulsen Lø
- Department of Oncology, Aalborg University Hospital, Aalborg, Denmark
| | - Lyhne Jd
- Department of Oncology, Vejle Hospital, University Hospital of Southern Denmark, Vejle, Denmark
- Department of Regional Health Research, University of Southern Denmark, Vejle, Denmark
| | - Lund L
- Department of Regional Health Research, University of Southern Denmark, Vejle, Denmark
- Center for Shared Decision Making, Vejle Hospital, University Hospital of Southern Denmark, Vejle, Denmark
| | - Eßer-Naumann S
- Department of Oncology and Palliative Care, Zealand University Hospital, Roskilde/Naestved, Denmark
| | - Timm S
- Department of Oncology, Vejle Hospital, University Hospital of Southern Denmark, Vejle, Denmark
- Department of Regional Health Research, University of Southern Denmark, Vejle, Denmark
| | - Jensen Lh
- Department of Oncology, Vejle Hospital, University Hospital of Southern Denmark, Vejle, Denmark
- Department of Regional Health Research, University of Southern Denmark, Vejle, Denmark
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Abstract
Communication skills training is a core competency for neonatal-perinatal medicine (NPM) fellows, yet many neonatology fellowship programs do not have formal communication skills curricula. Since the late 1990s, experiential learning that includes role-play and simulation has become the standard for communication training. NPM fellows who receive simulation-based communication skills training report greater comfort with difficult conversations in the NICU. Most communication skills studies in neonatology focus on antenatal counseling, with some studies regarding family meetings and end of life conversations. Published examples for simulation-based communication skills curricula exist, with ideas for adapting them to meet the needs of local resources.
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Affiliation(s)
- Sara Munoz-Blanco
- Department of Pediatrics, Division of Neonatology and Pediatric Palliative Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA.
| | - Renee Boss
- Department of Pediatrics, Division of Neonatology and Pediatric Palliative Medicine, Berman Institute of Bioethics, Johns Hopkins School of Medicine, Baltimore, MD, USA
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Yacoubian A, Demerouti E, Degheili JA, El Hajj A. A survey-based study about burnout among postgraduate medical trainees: implications for leaders in healthcare management. Front Public Health 2023; 11:1209191. [PMID: 37501948 PMCID: PMC10369186 DOI: 10.3389/fpubh.2023.1209191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 06/27/2023] [Indexed: 07/29/2023] Open
Abstract
Introduction The goal of the study is to assess burnout among postgraduate medical trainees, evaluate the association with sociodemographic features and offer potential wellness strategies for leaders responsible for their education, training, management, and wellbeing. Methods The Oldenburg Burnout Inventory was used. The web-based, voluntary, and anonymous survey was sent to postgraduate medical trainees from various specialties and all years of training in a tertiary medical center in Beirut, Lebanon. Additional questions were added after the survey regarding reporting channels for burnout and possible interventions for wellbeing. Results The total number of valid responses are 188. The prevalence rates of high burnout are 37.2% for disengagement and 51.1% for exhaustion. There is a significant difference between the mean of exhaustion and gender (p = 0.003). There is a significant difference between the mean of disengagement and year of training (p = 0.017). There is a significant difference between the mean of exhaustion and year of training (p = 0.029). There is a significant difference between the frequency of disengagement and year of training (p = 0.027). Conclusion The study reveals how postgraduate medical training program is impacted by the existing challenges from social, health, and financial standpoint, along with the instabilities encountered such as multiple wars and port blast in 2020 and how these variables aggravate burnout. Burnout severely impacts the education and training of PGMT and promoting wellbeing can help reverse the process. Findings contribute to establishing effective strategic interventions for leaders in healthcare management to adopt.
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Affiliation(s)
- Aline Yacoubian
- Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Evangelia Demerouti
- Dept. Industrial Engineering & Innovation Sciences, Eindhoven University of Technology, Eindhoven, Netherlands
| | - Jad A. Degheili
- Department of Urology, Children's Hospital of Eastern Ontario (CHEO), Ottawa, ON, Canada
| | - Albert El Hajj
- Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon
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Somboonviboon D, Wittayawisawasakul Y, Wacharasint P. Prevalence and Risk Factors of Burnout Syndrome during COVID-19 Pandemic among Healthcare Providers in Thailand. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2023; 2023:5719241. [PMID: 37288116 PMCID: PMC10243951 DOI: 10.1155/2023/5719241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 01/03/2023] [Accepted: 02/24/2023] [Indexed: 06/09/2023]
Abstract
Objective To study prevalence, risk factors, and consequences of the COVID-19 pandemic related to Burnout syndrome (BOS) among Thai healthcare providers (HCPs) during the COVID-19 pandemic. Methods We performed a cross-sectional study among HCPs, involved in caring for patients during the pandemic in two periods (1st period, May-Jun 2021, and 2nd period, Sep-Oct 2021). Data were distributed using electronic questionnaires. BOS was defined if respondents exhibited a high level of at least one domain in the Maslach Burnout Inventory criteria. The primary outcome was prevalence of BOS. Results Altogether, 2,027 and 1,146 respondents were enrolled in the 1st and 2nd periods, respectively. Most respondents were female (73.3, 68.2%). The top three job positions were physicians (49.2, 58.9%), nurses (41.2, 30.6%), and nursing assistants (4.8, 6.5%), respectively. No difference was found in overall prevalence of Burnout syndrome during the 1st and 2nd periods (73 vs. 73.5%, p=0.80). Using multivariate analysis, significant risk factors for Burnout syndrome in both periods were (1) living with family (odds ratio (OR) 1.3 and 1.5), (2) tertiary care hospital (OR 1.92 and 2.13), (3) nurse (OR 1.38 and 2.29), (4) nursing assistant (OR 0.92 and 4.81), (5) salary ≤40,000 THB (OR 1.53 and 1.53), (6) >20 patients per shift (OR 1.55 and 1.88), (7) >6 shifts after hours monthly (OR 1.26 and 1.49), and (8) ≤1 rest day weekly (OR 1.3 and 1.4). Conclusion We found a high prevalence of Burnout syndrome among Thai HCPs during the pandemic. Knowing those risk factors may provide a strategy to BOS during the pandemic.
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Affiliation(s)
- Dujrath Somboonviboon
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Phramongkutklao Hospital, Bangkok, Thailand
| | - Yingvitch Wittayawisawasakul
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Phramongkutklao Hospital, Bangkok, Thailand
| | - Petch Wacharasint
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Phramongkutklao Hospital, Bangkok, Thailand
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Mlaba PC, Ginindza TG, Hlongwana KW. The Prevalence of Compassion Fatigue among Oncology Healthcare Professionals in Three Public Healthcare Facilities in Kwazulu-Natal, South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5412. [PMID: 37048026 PMCID: PMC10093869 DOI: 10.3390/ijerph20075412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 03/15/2023] [Accepted: 04/04/2023] [Indexed: 06/19/2023]
Abstract
Compassion fatigue (CF) is a serious global challenge among healthcare professionals dealing with diseases with poor health outcomes in clinical settings. Chronic exposure to the suffering of others is inevitable in the oncology setting and remains one of the main contributors to CF. Therefore, this study determined the prevalence of CF among oncology healthcare professionals (OHPs) in three public healthcare facilities in KwaZulu-Natal, South Africa. This cross-sectional descriptive study was conducted among 73 OHPs using the Professional Quality of Life Scale version 5 questionnaire, and the data were analysed using the Statistical Package for Social Sciences. More than half (56.2%) of the participants reported average scores for CF, with 43.8% of them scoring low. The participants from Inkosi Albert Luthuli Central Hospital had the highest CF mean score (26.8) compared to those from Addington Hospital (21.2) and Greys Hospital (22.9). Female OHPs had a higher mean score (24.3) for CF, compared to their male counterparts (20.6). The CF scores were positively correlated with older age and longer work experience of the OHPs. The prevalence of CF among OHPs was average, compared to those reported by other local and international studies. Nevertheless, these results cannot be taken lightly, given the straining effects of unmanaged CF on the healthcare system generally and on patient care in particular. The results of this study can potentially contribute to policy development and the planning of intervention strategies towards the effective management of CF among OHPs.
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Affiliation(s)
- Phindile C. Mlaba
- Discipline of Public Health Medicine, School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban 4001, South Africa
- Cancer & Infectious Diseases Epidemiology Research Unit (CIDERU), College of Health Sciences, University of KwaZulu-Natal, Durban 4001, South Africa
| | - Themba G. Ginindza
- Discipline of Public Health Medicine, School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban 4001, South Africa
- Cancer & Infectious Diseases Epidemiology Research Unit (CIDERU), College of Health Sciences, University of KwaZulu-Natal, Durban 4001, South Africa
| | - Khumbulani W. Hlongwana
- Discipline of Public Health Medicine, School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban 4001, South Africa
- Cancer & Infectious Diseases Epidemiology Research Unit (CIDERU), College of Health Sciences, University of KwaZulu-Natal, Durban 4001, South Africa
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Martins BNFL, Migliorati CA, Ribeiro AC, Martins MD, Brandão TB, Lopes MA, Alves CG, Santos-Silva AR. The barriers dentists face to communicate cancer diagnosis: self-assessment based on SPIKES protocol. Med Oral Patol Oral Cir Bucal 2023; 28:e191-e198. [PMID: 36565222 PMCID: PMC9985943 DOI: 10.4317/medoral.25650] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 10/03/2022] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND This study aimed to characterize the barriers faced by Brazilian dentists to deliver bad news (DBN) about oral and oropharyngeal cancer diagnoses to patients by using a questionnaire based on the guidelines of the SPIKES protocol. MATERIAL AND METHODS This was an observational cross-sectional study. The questionnaire contained 27 questions based on the SPIKES protocol, which were answered in the SurveyMonkey platform. RESULTS A total of 186/249 dentists answered the questionnaire. The main specialties reported were 36.02% oral medicine, 21.5% oral pathology, and 9.13% oral and maxillofacial surgery. A total of 44.6% expressed concern about the patient's emotional reactions, and 46.24% of respondents had never participated in any specific training to communicate bad news. CONCLUSIONS The lack of training and low confidence in dealing with patients' emotional reactions dentists were considered the greatest barriers to DBNs. Moreover, most dentists who participated in the survey believe that a protocol to guide the communication of bad news would be useful for clinical practice. For those protocols to be used by dentists, training is critical for these protocols to be incorporated by professionals.
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Affiliation(s)
- B-N-F-L Martins
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas Av. Limeira, 901, Areão, Piracicaba 13414-903, SP, Brazil
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Youssef D, Youssef J, Abou-Abbas L, Kawtharani M, Hassan H. Prevalence and correlates of burnout among physicians in a developing country facing multi-layered crises: a cross-sectional study. Sci Rep 2022; 12:12615. [PMID: 35871153 PMCID: PMC9308770 DOI: 10.1038/s41598-022-16095-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 07/04/2022] [Indexed: 02/07/2023] Open
Abstract
AbstractBurnout among physicians is a serious concern that cultivates its seeds during their education. This study assessed the prevalence of burnout among Lebanese physicians and explored its correlates and the combined effects of the pandemic and the economic crisis on burnout. A web-based cross-sectional study was conducted in December 2020 using a snowball sampling technique. Moderate and high levels of burnout hit 90.7% of the physicians where personal, work-related, and client-related burnout were detected among 80.4%, 75.63%, and 69.6% of them respectively. A strong association was found between the higher level of burnout and female gender, younger age, being single, having a dependent child, living with an elderly or a family member with comorbidities, and insufficient sleeping hours. Physicians’ specialties, working in a public health facility, limited years of professional experience, lack of previous experience in a pandemic, and extensive working hours were also associated with increased burnout. Furthermore, low income, working in the frontline, higher threat perception, and fear of COVID-19 were contributing to higher burnout. The combined effect of threat perception and financial hardship significantly increased burnout levels. The alarming burnout level detected among physicians urges health authorities to take prompt actions to enhance the physicians’ well-being.
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van Meurs J, Wichmann AB, van Mierlo P, van Dongen R, van de Geer J, Vissers K, Leget C, Engels Y. Identifying, exploring and integrating the spiritual dimension in proactive care planning: A mixed methods evaluation of a communication training intervention for multidisciplinary palliative care teams. Palliat Med 2022; 36:1493-1503. [PMID: 36305616 PMCID: PMC9749014 DOI: 10.1177/02692163221122367] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Patients receiving palliative care value attention given to their spiritual needs. However, these needs often remain unexplored as healthcare professionals lack the skills to identify and explore them and to integrate this information into care plans. AIM To evaluate the effects of an interactive communication training intervention for palliative care teams in order to identify and explore the spiritual dimension and integrate it in patients' care plans. DESIGN A mixed methods pre-post study, including self-assessment questionnaires, evaluation of videos with simulated consultations (applied competence) and medical record review (implementation). SETTING/PARTICIPANTS Three palliative care teams including nurses (N = 21), physicians (N = 14) and spiritual caregivers (N = 3). RESULTS The questionnaires showed an improvement on 'Patient and family-centred communication' of the End-of-life professional caregiver survey (+0.37, p < 0.01; the 8-item S-EOLC (+0.54, p < 0.01) and regarding the Spiritual Care Competence Scale, on the three subscales used (+0.27, p < 0.01, +0.29, p < 0.01 and +0.32, p < 0.01). Video evaluations showed increased attention being paid to patient's aims and needs. The medical record review showed an increase in anticipation on the non-somatic dimension (OR: 2.2, 95% CI: 1.2-4.3, p < 0.05) and, using the Mount Vernon Cancer Network assessment tool, addressing spiritual issues (OR: 10.9, 95% CI: 3.7-39.5, p < 0.001). CONCLUSIONS Our training intervention resulted in increased palliative care professionals' competence in identifying and exploring patients' spiritual issues, and their integration in multidimensional proactive palliative care plans. The intervention directly addresses patients' spiritual concerns and adds value to their palliative care plans.
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Affiliation(s)
- Jacqueline van Meurs
- Department of Spiritual and Pastoral Care & Department of Anaesthesiology, Pain and Palliative Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Anne B Wichmann
- Department of Anaesthesiology, Pain and Palliative Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Patricia van Mierlo
- Department of Geriatrics & Centre of Supportive and Palliative Care, Rijnstate Arnhem, The Netherlands
| | - Robert van Dongen
- Department of Pain Management and Palliative Care, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands and Department of Anaesthesiology, Pain and Palliative Care, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Joep van de Geer
- Chaplain at Academic Hospice Demeter, Bilthoven and Policy Advisor Spiritual Care in Palliative Care at Agora, The Netherlands
| | - Kris Vissers
- Department of Anaesthesiology, Pain and Palliative Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Carlo Leget
- Department of Care and Welfare, University of Humanistic Studies, Utrecht, The Netherlands
| | - Yvonne Engels
- Department of Anaesthesiology, Pain and Palliative Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands
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Karnieli-Miller O, Pelles S, Meitar D. Position paper: Teaching breaking bad news (BBN) to undergraduate medical students. PATIENT EDUCATION AND COUNSELING 2022; 105:2899-2904. [PMID: 35710469 DOI: 10.1016/j.pec.2022.05.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 05/29/2022] [Accepted: 05/30/2022] [Indexed: 06/15/2023]
Abstract
Sharing new medical information that is perceived as seriously effecting people's lives, i.e., breaking bad news (BBN) is important in caring for patients and relatives and is challenging for healthcare professionals. Optimal BBN requires incorporation and implementation of multiple professional competencies acquired gradually throughout years of training. The BBN encounter has implications for all participants: the patient, family members, their close social environments, and the deliverer of the news. Due to these implications and the accountability involved, medical schools invest educational resources in helping medical students develop this competency. The current paper summarizes literature, research, and teaching experiences while suggesting practical guidelines for designing and teaching a BBN course to undergraduate students. The following principles lie behind the recommendations: stepwise spiral continuity of exposure to and teaching of communication skills in various contexts while focusing on BBN in the advanced clinical years; relating the developing skills to broader humanistic studies; enhancing awareness of self-perspectives and beliefs regarding BBN; connecting to patients' and family members experiences and needs; providing a BBN protocol and opportunities for structured experiential learning followed by reflection and feedback; using observation and reflection to address gaps between theory and real-life practice; and creating continuity of learning about BBN through undergraduate, graduate, and continuing medical education. Applying this learning process can help enhance the management of these difficult conversations to improve patients' care during these difficult, life-changing encounters, and physicians' well-being.
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Affiliation(s)
- Orit Karnieli-Miller
- Department of Medical Education, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Sharon Pelles
- Department of Medical Education, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Oncology, Tel Aviv Medical Center, Tel Aviv, Israel
| | - Dafna Meitar
- Mandel School for Educational Leadership, Jerusalem, Israel; Medical College of Wisconsin, Wisconsin, USA
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Donisi V, Perlini C, Mazzi MA, Rimondini M, Garbin D, Ardenghi S, Rampoldi G, Montelisciani L, Antolini L, Strepparava MG, Del Piccolo L. Training in communication and emotion handling skills for students attending medical school: Relationship with empathy, emotional intelligence, and attachment style. PATIENT EDUCATION AND COUNSELING 2022; 105:2871-2879. [PMID: 35715300 DOI: 10.1016/j.pec.2022.05.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 05/23/2022] [Accepted: 05/25/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To describe the Emoty-Com training, its impact on medical students' attitudes towards doctors' emotions and to explore the association between students' empathy, emotional intelligence (EI), and attachment style (AS) with post-training performance scores. METHODS The 16-hour Emoty-Com training was delivered to all second-year medical students of Verona and Milan (Italy) Universities. At pre-training, students filled out three questionnaires assessing empathy, AS and EI and responded to three questions on attitudes towards doctors' emotions in the doctor-patient encounter. The same three questions and a final evaluation test were proposed at post-training. RESULTS 264 students participated in the study. The training reduced students' worry about managing emotions during doctor-patient relationships. Gender was associated with specific subscales of empathy, EI, and AS. Final performance scores were associated with students' attitudes towards emotions but not with empathy, EI, and AS. CONCLUSION The Emoty-Com training increased students' self-efficacy in handling their own emotions during consultations. Students' performance scores were related to their attitude towards doctors' emotions in clinical encounters. PRACTICE IMPLICATIONS The Emoty-Com training suggests ways to teach and evaluate emotion-handling skills for medical students. Possible links between empathy, EI, AS, and the attitudes towards doctors' emotions during the years of education are highlighted.
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Affiliation(s)
- Valeria Donisi
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Cinzia Perlini
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Maria Angela Mazzi
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Michela Rimondini
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Davide Garbin
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Stefano Ardenghi
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, MB, Italy
| | - Giulia Rampoldi
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, MB, Italy
| | - Laura Montelisciani
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, MB, Italy
| | - Laura Antolini
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, MB, Italy
| | - Maria Grazia Strepparava
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, MB, Italy; Department of Mental Health, Clinical Psychology Unit, San Gerardo Hospital, ASST-Monza, Monza, MB, Italy
| | - Lidia Del Piccolo
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
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Burnout Syndrome among Otorhinolaryngologists during the COVID-19 Pandemic. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58081089. [PMID: 36013556 PMCID: PMC9415072 DOI: 10.3390/medicina58081089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 08/07/2022] [Accepted: 08/09/2022] [Indexed: 11/17/2022]
Abstract
Background and Objectives: To determine the prevalence of burnout syndrome among otorhinolaryngologists in Lithuania and investigate associations with sociodemographic and professional factors during the COVID-19 pandemic. Materials and Methods: Burnout was measured using the validated Lithuanian version of the Maslach Burnout Inventory. Demographic characteristics and professional characteristics were collected utilizing an anonymous questionnaire. Results: Eighty otorhinolaryngologists (ORL group) and 30 information technology professionals (the control group) were enrolled in this study. A high level of professional burnout in at least one of the subscales was observed in 82.5% of the ORL group subjects. Depersonalization and burnout syndrome were more frequently detected with increasing age in the ORL group (r = 0.2, p < 0.04). Greater satisfaction with salary and working environment resulted in a lower burnout incidence (r = 0.31, p = 0.001). Conclusions: During the COVID-19 pandemic, the incidence of burnout syndrome has been high among Lithuanian otorhinolaryngologists. Demographic and professional characteristics are significantly related to burnout syndrome among Lithuanian otorhinolaryngologists.
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Hasan F, Pabari R, Wilejto M. Training for Wellness in Pediatric Oncology: A Focus on Education and Hidden Curricula. Curr Oncol 2022; 29:5579-5584. [PMID: 36005178 PMCID: PMC9406305 DOI: 10.3390/curroncol29080440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 08/01/2022] [Accepted: 08/02/2022] [Indexed: 11/16/2022] Open
Abstract
Pediatric oncologists have the privilege of caring for children and families facing serious, often life-threatening, illnesses. Providing this care is emotionally demanding and associated with significant risks of stress and burnout for oncologists. Traditional approaches to physician burnout and wellbeing have not emphasized the potential roles of education and training in mitigating this stress. In this commentary, we discuss the contribution that education, particularly in the areas of palliative and psychosocial oncology, can make in preparing oncologists for the work that they do. We argue that by adequately providing oncologists with the skills they need for their work, we can reduce their risk of burning out. We also discuss the importance of paying attention to hidden and formal curricula to ensure that messages provided in formal education programs are supported by informal training experiences.
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Affiliation(s)
- Fyeza Hasan
- Division of Haematology/Oncology, Department of Paediatrics, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
- Correspondence:
| | - Reena Pabari
- Division of Haematology/Oncology, Department of Paediatrics, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
| | - Marta Wilejto
- Division of Hematology/Oncology, Department of Pediatrics, London Health Sciences Center, London, ON N6A 5W9, Canada
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Omar AS, Labib A, Hanoura SE, Rahal A, Kaddoura R, Chughtai TS, Karic E, Shaikh MS, Hamad WJ, ElHassan M, AlHashemi A, Khatib MY, AlKhulaifi A. Impact of Extracorporeal Membrane Oxygenation Service on Burnout Development in Eight Intensive Care Units. A National Cross-Sectional Study. J Cardiothorac Vasc Anesth 2022; 36:2891-2899. [PMID: 35300897 DOI: 10.1053/j.jvca.2022.02.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 01/25/2022] [Accepted: 02/11/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVES This study aimed at investigating the effects of an extracorporeal membrane oxygenation (ECMO) service on Burnout syndrome (BOS) development in the intensive care unit (ICU). DESIGN The authors conducted a cross-sectional descriptive study. SETTINGS Eight ICUs within 5 tertiary hospitals in 1 country. PARTICIPANTS Intensive care practitioners (nurses, physicians, and respiratory therapists). INTERVENTION Using an online questionnaire, the Maslach Burnout Inventory Human Services Survey for Medical Personnel. In addition, demographic variables, workload, salary satisfaction, and caring for COVID-19 patients were assessed. Participants were divided based on working in an ICU with ECMO (ECMO-ICU) and without (non-ECMO-ICU) ECMO service, and burnout status (burnout and no burnout). MEASUREMENTS AND MAIN RESULTS The response rate for completing the questionnaire was 36.4% (445/1,222). Male patients represented 53.7% of the participants. The overall prevalence of burnout was 64.5%. The overall burnout prevalence did not differ between ECMO- and non-ECMO-ICU groups (64.5% and 63.7, respectively). However, personal accomplishment (PA) score was significantly lower among ECMO-ICU personnel compared with those in a non-ECMO-ICU (42.7% v 52.6, p = 0.043). Significant predictors of burnout included profession (nurse or physician), acquiring COVID-19 infection, knowing other practitioners who were infected with COVID-19, salary dissatisfaction, and extremes of workload. CONCLUSION Burnout was equally prevalent among participants from ECMO- and non-ECMO-ICU, but PA was lower among participants in the ICU with an ECMO service. The reported high prevalence of burnout, and its predictors, requires special attention to try to reduce its occurrence.
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Affiliation(s)
- Amr Salah Omar
- Department of Cardiothoracic Surgery/Cardiac ICU Section, Heart Hospital, Hamad Medical Corporation, Doha, Qatar; Department of Critical Care Medicine, Beni Suef University, Beni Suef, Egypt; Weill Cornell Medical College-Qatar, Doha, Qatar.
| | - Ahmed Labib
- Weill Cornell Medical College-Qatar, Doha, Qatar; Department of Medicine, Medical Intensive Care Unit (MICU), Hamad General Hospital, Doha, Qatar
| | - Samy Elsayed Hanoura
- Department of Cardiothoracic Surgery/Cardiac ICU Section, Heart Hospital, Hamad Medical Corporation, Doha, Qatar; Weill Cornell Medical College-Qatar, Doha, Qatar; Alazhar University, department of anesthesia, Cairo, Egypt
| | - Alaa Rahal
- Department of Clinical Pharmacy, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Rasha Kaddoura
- Department of Clinical Pharmacy, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | | | - Edin Karic
- Department of Critical Care, Al Wakra Hospital, Doha, Qatar
| | | | | | - Mawahib ElHassan
- Department of Cardiology, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | | | | | - Abdulaziz AlKhulaifi
- Department of Cardiothoracic Surgery/Cardiac ICU Section, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
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18
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The Association Between Factors Promoting Nonbeneficial Surgery and Moral Distress: A National Survey of Surgeons. Ann Surg 2022; 276:94-100. [PMID: 33214444 PMCID: PMC9635854 DOI: 10.1097/sla.0000000000004554] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To assess the prevalence of moral distress among surgeons and test the association between factors promoting non-beneficial surgery and surgeons' moral distress. SUMMARY BACKGROUND DATA Moral distress experienced by clinicians can lead to low-quality care and burnout. Older adults increasingly receive invasive treatments at the end of life that may contribute to surgeons' moral distress, particularly when external factors, such as pressure from colleagues, institutional norms, or social demands, push them to offer surgery they consider non-beneficial. METHODS We mailed surveys to 5200 surgeons randomly selected from the American College of Surgeons membership, which included questions adapted from the revised Moral Distress Scale. We then analyzed the association between factors influencing the decision to offer surgery to seriously ill older adults and surgeons' moral distress. RESULTS The weighted adjusted response rate was 53% (n = 2161). Respondents whose decision to offer surgery was influenced by their belief that pursuing surgery gives the patient or family time to cope with the patient's condition were more likely to have high moral distress (34% vs 22%, P < 0.001), and this persisted on multivariate analysis (odds ratio 1.44, 95% confidence interval 1.02-2.03). Time required to discuss nonoperative treatments or the consulting intensivists' endorsement of operative intervention, were not associated with high surgeon moral distress. CONCLUSIONS Surgeons experience moral distress when they feel pressured to perform surgery they believe provides no clear patient benefit. Strategies that empower surgeons to recommend nonsurgical treatments when they believe this is in the patient's best interest may reduce nonbeneficial surgery and surgeon moral distress.
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Chênevert D, Brown TL, Pomey MP, Benomar N, Colombat P, Fouquereau E, Loiselle CG. Investigating a Participatory Intervention in Multidisciplinary Cancer Care Teams Using an Integrative Organizational Model: A Study Protocol. Front Psychol 2022; 13:798863. [PMID: 35592179 PMCID: PMC9113022 DOI: 10.3389/fpsyg.2022.798863] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 03/30/2022] [Indexed: 12/03/2022] Open
Abstract
Multidisciplinary teams encounter many challenges that can lead to higher levels of distress and burnout. This trend is acutely prevalent among multidisciplinary cancer care teams who frequently contend with increased task complexity and numbers of patients. Resilience is emerging as a critical resource that may optimize team members’ psychological health and wellbeing, work efficiency, and organizational agility, while reducing burnout. Accordingly, the proposed study aims to implement and evaluate a promising participatory interventional approach that fosters team resilience. Specifically, the effects of the intervention on participating team members will be compared to a control group of non-participating team members. This intervention’s core components include skills training, patient-centered meetings, talking spaces, and an agile problem-solving approach. The proposed study also seeks to determine whether enhanced resilience improves team mental health status and organizational outcomes. A participatory interventional approach will be implemented and assessed at three-time intervals [i.e., pre-intervention deployment (N = 375), 12 months post-deployment (N = 236), and 24 months post-deployment (N = 146)] across five cancer care teams in three Quebec healthcare institutions. A mixed methods design will be used that includes observations, semi-structured interviews, focus groups, and self-report questionnaires. Direct observation will document team functioning and structural resources (e.g., meetings, conflict management, and leadership). Semi-structured interviews will explore participants’ experience with activities related to the participatory interventional approach, its perceived benefits and potential challenges. Focus groups will explore participants’ perceptions of their team’s resilience and the effectiveness of the intervention. Questionnaires will assess support, recognition, empowerment, organizational justice, individual resilience, psychological safety, work climate, team resilience, workplace burnout, engagement, quality of work life, wellbeing, and organizational citizenship behaviors, and sociodemographic variables. Moreover, objective measures including absenteeism and staff turnover will be obtained via human resource records. Structural equation modeling will be used to test the study’s hypotheses. The proposed protocol and related findings will provide stakeholders with quantitative and qualitative data concerning a participatory interventional approach to optimize team effectiveness. It will also identify critical factors implicated in favorable organizational outcomes in connection with multidisciplinary cancer care teams. Expected results and future directions are also presented herein.
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Affiliation(s)
- Denis Chênevert
- Department of Human Resources, HEC Montreal, Montreal, QC, Canada.,Healthcare Management Hub, HEC Montreal, Montreal, QC, Canada.,Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC, Canada.,Unité de Soutien SSA, Université de Sherbrooke, Campus de Longueuil, Longueuil, QC, Canada
| | - Tyler L Brown
- Department of Oncology, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Marie-Pascale Pomey
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC, Canada.,Department of Management, Evaluation and Health Policy, School of Public Health, Université de Montréal, Montreal, QC, Canada.,Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Nadia Benomar
- Healthcare Management Hub, HEC Montreal, Montreal, QC, Canada
| | - Philippe Colombat
- Qualipsy EE 1901, Department of Psychology, Université de Tours, Tours, France
| | - Evelyne Fouquereau
- Qualipsy EE 1901, Department of Psychology, Université de Tours, Tours, France
| | - Carmen G Loiselle
- Department of Oncology, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada.,Ingram School of Nursing, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada.,Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada.,Segal Cancer Centre, Jewish General Hospital, Montreal, QC, Canada
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Patell R, Maddaleni G, Dodge L, Buss M, Freed J. Communication Skills Training for Internal Medicine Residents Using a Brief Animated Video. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022; 37:379-386. [PMID: 32661936 DOI: 10.1007/s13187-020-01825-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Patient communication courses are time-intensive, making incorporation into residency curricula challenging. Using a short video could be an efficient means to teach residents communication skills. We created a 4-min animated video focused on the "ask more and summarize technique". Residents rotating on the inpatient oncology and palliative care service received a video link with a survey (S1) on the tool and its projected utility. A second survey (S2) was sent upon rotation completion to assess the utility of the technique. A 6-month follow up e-mail was sent to determine retention of skills. A total of 52/106 residents responded to S1 and 32/52 to S2. Median age was 28 years and 86% were PGY-1. On S1, 95% enjoyed the format, and 95% thought the narration was an effective learning tool and 90% that the animation was effective. A majority (87%) felt the tool would be useful. On comparing self-reported acquisition of skills for paired survey responses, there was a significant increase in asking more regarding patient questions (p = 0.04) but not summarizing back responses (p = 0.1). This tool was reported to be useful in a variety of settings including explaining prognoses, unrealistic patient expectations, upset patients, and patients with fear or anxiety. A 6-month follow up survey (n = 22) showed that almost all the respondents continued to report using the skills learned. A short video is a brief and effective tool that can be incorporated into a busy clinical curriculum to teach residents communication skills in the areas of cancer and palliative care.
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Affiliation(s)
- Rushad Patell
- Division of Hematology and Hematologic Malignancies, Beth Israel Deaconess Medical Center (East Campus), Shapiro Clinical Center 9th Floor, 330 Brookline Avenue, Boston, MA, 02215-5400, USA
| | - Geeda Maddaleni
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Laura Dodge
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Mary Buss
- Section of Palliative Care, Division of General Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Jason Freed
- Division of Hematology and Hematologic Malignancies, Beth Israel Deaconess Medical Center (East Campus), Shapiro Clinical Center 9th Floor, 330 Brookline Avenue, Boston, MA, 02215-5400, USA.
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Ercolani G, Varani S, Ostan R, Franchini L, Yaaqovy AD, Pannuti R, Biasco G, Bruera E. Tackling the Pandemic a Year Later: Burnout Among Home Palliative Care Clinicians. J Pain Symptom Manage 2022; 63:e349-e356. [PMID: 34973353 PMCID: PMC8730739 DOI: 10.1016/j.jpainsymman.2021.12.027] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 12/21/2021] [Accepted: 12/22/2021] [Indexed: 12/12/2022]
Abstract
CONTEXT The COVID-19 pandemic strongly challenged healthcare workers, disrupting their work routine and impacting on their professional life. A previous investigation explored levels of burnout and psychological morbidity among palliative care professionals (PCPs) during COVID-19 first wave. OBJECTIVE To update data about burnout and psychological morbidity among PCPs after a year of COVID-19 pandemic. METHODS The same questionnaires on burnout (Maslach Burnout Inventory, MBI) and psychological morbidity (General Health Questionnaire 12 items, GHQ-12) were administered a year after. Differences in MBI and GHQ-12 scores obtained in the two studies (COVID2020 and COVID2021), as well as distributions of PCPs showing burnout symptoms and psychological morbidity were analyzed and compared. We also explored the association between the three dimensions of burnout and socio-demographic and professional characteristics. RESULTS The sample consisted of 145 PCPs (59% physicians and 41% nurses). Response rate (70.4%) was quite similar to the previous study (73.2%). No differences were observed in the frequency of burnout between COVID2021 and COVID2020; the PCPs in COVID2021 reported marginally higher level of EE (P = .049) and this result is confirmed in physicians (P = .010) while no difference was observed in nurses (P = .326). In addition, the percentage of cases showing psychological morbidity significantly decreased. CONCLUSION Our findings show stable levels of burnout and decreasing levels of psychological morbidity among PCPs one year after the onset of the COVID-19 pandemic. However, more research is needed to detail the significance of emotional exhaustion dimension, a variable influenced by the survey.
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Affiliation(s)
- Giacomo Ercolani
- Training and Research Department (G.E., S.V., R.O., L.F., R.P.), National Tumor Assistance (ANT), Bologna, Italy
| | - Silvia Varani
- Training and Research Department (G.E., S.V., R.O., L.F., R.P.), National Tumor Assistance (ANT), Bologna, Italy.
| | - Rita Ostan
- Training and Research Department (G.E., S.V., R.O., L.F., R.P.), National Tumor Assistance (ANT), Bologna, Italy
| | - Luca Franchini
- Training and Research Department (G.E., S.V., R.O., L.F., R.P.), National Tumor Assistance (ANT), Bologna, Italy
| | - Ahikam David Yaaqovy
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna (A.D.Y., G.B.), Bologna, Italy
| | - Raffaella Pannuti
- Training and Research Department (G.E., S.V., R.O., L.F., R.P.), National Tumor Assistance (ANT), Bologna, Italy
| | - Guido Biasco
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna (A.D.Y., G.B.), Bologna, Italy
| | - Eduardo Bruera
- Department of Palliative Care (E.B.), Rehabilitation and Integrative Medicine, Huston, Texas
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Omar AS, Hanoura S, Labib A, Kaddoura R, Rahhal A, Al-Zubi MM, Galvez RD, Shiju S, Al Jonidi MJ, Ragab H, Al Hashemi AA, Alumlla A. Burnout among Respiratory Therapists and Perception of Leadership: A Cross Sectional Survey Over Eight Intensive Care Units. J Intensive Care Med 2022; 37:1553-1562. [DOI: 10.1177/08850666221086208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Burnout syndrome (BOS) is a job-related stress disorder featured by three main cardinal manifestations: emotional exhaustion (EE), reduced personal accomplishment (PA), and depersonalization (DP). Aim We aimed to report the prevalence of burnout and the impact of leadership and work condition on the burnout among respiratory therapists (RT) are front-line practitioners in many critical settings. Methods We surveyed RT in eight intensive care units (ICU) at five tertiary hospitals, under one medical corporation, using three instruments: the Maslach Burnout Inventory Human Services Survey for Medical Personnel, Condition of Work Effectiveness Questionnaire (CWEQ), and Leadership behaviours scale. We used a group of other health care practitioners (ie, physicians and nurses) as the control group. Results Of a sampling frame of 1222 ICU practitioners, 445 (36.4%) responded with completed surveys. Eighty-four (17.3%) and 361 (82.7%) participants were in the RT and the control group, respectively. The overall burnout score was significantly lower in the RT group (53.6% vs. 67%, p = 0.02). The EE and DP scores were significantly lower in the RT group [(26.2% vs. 37.7, p = 0.048) and (9.5% vs. 19.9%, p = 0.025), respectively], but the PA score did not show significant difference between the groups. A significant negative relationship was found between CWEQ score and both EE and DP scores (rs = −0. 0.557, p < 0.001) and (rs = −0.372, p < 0.001), respectively, while a significant positive correlation was found between CWEQ and the PA score (rs = 0.225, p < 0.042). A significant negative relationship was found between the leadership attitude and EE scores (rs = −0.414, p < 0.001). Conclusion The results of this study suggest a high burnout rate among RT. The reported rate was significantly correlated to work conditions and leadership behaviours. Organizational efforts should be directed to combating burnout through the identification and adequate management of the key precipitating factors. ClinicalTrials.gov Identifier: NCT04620005
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Affiliation(s)
- Amr Salah Omar
- Department of Cardiothoracic Surgery/Cardiac Anaesthesia & ICU, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
- Department of Critical Care Medicine, Beni Suef University, Beni Suef, Egypt
- Weill Cornell Medical College-Qatar, Doha, Qatar
| | - Samy Hanoura
- Department of Cardiothoracic Surgery/Cardiac Anaesthesia & ICU, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
- Weill Cornell Medical College-Qatar, Doha, Qatar
- Department of Anesthesia and intensive care, Al-Azhar University, Cairo, Egypt
| | - Ahmed Labib
- Weill Cornell Medical College-Qatar, Doha, Qatar
- Department of Medicine, Medical Intensive Care Unit (MICU), Hamad General Hospital, Doha, Qatar
| | - Rasha Kaddoura
- Pharmacy Department, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Alaa Rahhal
- Pharmacy Department, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Mohammed Mousa Al-Zubi
- Department of Critical Care (surgical & medical) and Operating theater, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Ruzzel Dorado Galvez
- Department of the Office of Chief, HMC Corporate, Hamad Medical Corporation, Doha, Qatar
| | - Shiny Shiju
- Department of Critical Care (surgical & medical) and Operating theater, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | | | - Hany Ragab
- Department of Cardiothoracic Surgery/Cardiac Anaesthesia & ICU, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | | | - Abdelwahid Alumlla
- Department of Cardiothoracic Surgery/Cardiac Anaesthesia & ICU, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
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McNeil MJ, Ehrlich BS, Wang H, Vedaraju Y, Bustamante M, Dussel V, Friedrich P, Garcia Quintero X, Gillipelli SR, Gomez Garcia W, Graetz DE, Kaye EC, Metzger ML, Sabato Danon CV, Devidas M, Baker JN, Agulnik A. Physician Perceptions of Palliative Care for Children With Cancer in Latin America. JAMA Netw Open 2022; 5:e221245. [PMID: 35258577 PMCID: PMC8905380 DOI: 10.1001/jamanetworkopen.2022.1245] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
IMPORTANCE The World Health Organization (WHO) designates early integration of palliative care as an ethical responsibility in the treatment of children with serious illness. Although structural barriers may influence provision of pediatric palliative care (PPC) for children with cancer in resource-limited settings, underlying physician perceptions may also impede early integration of PPC in cancer care. OBJECTIVE To investigate perceptions among physicians in Latin America about the integration of palliative care for children with cancer. DESIGN, SETTING, AND PARTICIPANTS This survey study used the Assessing Doctors' Attitudes on Palliative Treatment (ADAPT) survey, which was developed for physicians who care for children with cancer and was initially distributed in Eurasia. The survey was modified for use in Latin America, including translation into Spanish and adaptation for cultural context. The survey was distributed between August 21, 2020, and January 31, 2021, to physicians treating children with cancer in 17 Latin American countries. Each country had a specific survey distribution method based on guidance of local experts. MAIN OUTCOMES AND MEASURES The ADAPT survey evaluated physicians' understanding of palliative care principles, comfort in addressing patient and family suffering, and identification of barriers to PPC integration for children with cancer. Univariate and multivariable linear regression analyses were used to assess factors associated with physicians' knowledge about and comfort with PPC practice and whether independent physician variables were associated with survey response alignment with WHO guidance on PPC. Open-ended questions were analyzed qualitatively to supplement the quantitative data. RESULTS A total of 874 physicians from 17 countries participated, with an overall response rate of 39.9% (874 of 2193) and a median country response rate of 51.4% (range, 23.7%-100%). Most respondents were aged 35 years or older (577 [66.0%]), and 594 (68.0%) identified as female. Most physicians (486 [55.6%]) had no formal PPC training, and 303 (34.7%) had no access to PPC experts for consultation. Physician perspectives on PPC were generally aligned with WHO guidance (mean [SD] alignment, 83.0% [14.1%]; range among respondents, 24.0%-100%). However, only 438 respondents (50.1%) felt comfortable addressing physical symptoms of patients receiving PPC, 295 (33.8%) felt comfortable addressing emotional symptoms, and 216 (24.7%) felt comfortable addressing grief and bereavement needs of the patient's family. A total of 829 participants (94.8%) desired further education and training in PPC. CONCLUSION AND RELEVANCE Although physicians' perspectives aligned well with WHO guidance for PPC, this survey study identified opportunities for improving physician training in symptom management and emotional support for children with cancer and their families. These findings may inform the development of targeted interventions to improve the quality of PPC for children with cancer in Latin America.
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Affiliation(s)
- Michael J. McNeil
- Department of Global Pediatric Medicine, St Jude Children’s Research Hospital, Memphis, Tennessee
- Division of Quality of Life and Palliative Care Department of Oncology, St Jude Children’s Research Hospital, Memphis, Tennessee
| | - Bella S. Ehrlich
- Department of Global Pediatric Medicine, St Jude Children’s Research Hospital, Memphis, Tennessee
- Brown University School of Medicine, Providence, Rhode Island
| | - Huiqi Wang
- Department of Global Pediatric Medicine, St Jude Children’s Research Hospital, Memphis, Tennessee
| | - Yuvanesh Vedaraju
- Department of Global Pediatric Medicine, St Jude Children’s Research Hospital, Memphis, Tennessee
| | | | - Veronica Dussel
- Center for Research and Implementation in Palliative Care, Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina
| | - Paola Friedrich
- Department of Global Pediatric Medicine, St Jude Children’s Research Hospital, Memphis, Tennessee
| | - Ximena Garcia Quintero
- Department of Global Pediatric Medicine, St Jude Children’s Research Hospital, Memphis, Tennessee
- Fundación Valle de Lilli, Cali, Colombia
| | - Srinithya R. Gillipelli
- Department of Global Pediatric Medicine, St Jude Children’s Research Hospital, Memphis, Tennessee
- Baylor College of Medicine, Houston, Texas
| | - Wendy Gomez Garcia
- Oncology Unit, Dr Robert Reid Cabral Children’s Hospital, Santo Domingo, Dominican Republic
| | - Dylan E. Graetz
- Department of Global Pediatric Medicine, St Jude Children’s Research Hospital, Memphis, Tennessee
| | - Erica C. Kaye
- Division of Quality of Life and Palliative Care Department of Oncology, St Jude Children’s Research Hospital, Memphis, Tennessee
| | - Monika L. Metzger
- Department of Global Pediatric Medicine, St Jude Children’s Research Hospital, Memphis, Tennessee
| | | | - Meenakshi Devidas
- Department of Global Pediatric Medicine, St Jude Children’s Research Hospital, Memphis, Tennessee
| | - Justin N. Baker
- Division of Quality of Life and Palliative Care Department of Oncology, St Jude Children’s Research Hospital, Memphis, Tennessee
| | - Asya Agulnik
- Department of Global Pediatric Medicine, St Jude Children’s Research Hospital, Memphis, Tennessee
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Brünahl CA, Hinding B, Eilers L, Höck J, Hollinderbäumer A, Buggenhagen H, Reschke K, Schultz JH, Jünger J. Implementing and optimizing a communication curriculum in medical teaching: Stakeholders' perspectives. PLoS One 2022; 17:e0263380. [PMID: 35130309 PMCID: PMC8820607 DOI: 10.1371/journal.pone.0263380] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 01/18/2022] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE The relevance of communication in medical education is continuously increasing. At the Medical Faculty of Hamburg, the communication curriculum was further developed and optimized during this project. This article aims to describe the stakeholders' perceived challenges and supporting factors in the implementation and optimization processes. METHODS The initial communication curriculum and its development after a one-year optimization process were assessed with a curricular mapping. A SWOT analysis and group discussions were carried out to provide information on the need for optimization and on challenges the different stakeholders faced. RESULTS The curricular mapping showed that the communication curriculum is comprehensive, coherent, integrated and longitudinal. In both the implementation and the project-related optimization processes, support from the dean, cooperation among all stakeholders and structural prerequisites were deemed the most critical factors for successfully integrating communication content into the curriculum. CONCLUSION The initiative and support of all stakeholders, including the dean, teachers and students, were crucial for the project's success. PRACTICE IMPLICATIONS Although the implementation of a communication curriculum is recommended for all medical faculties, their actual implementation processes may differ. In a "top-down" and "bottom-up" approach, all stakeholders should be continuously involved in the process to ensure successful integration.
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Affiliation(s)
- Christian Andreas Brünahl
- The German National Institute for state examinations in Medicine, Pharmacy and Psychotherapy (IMPP), Mainz, Germany
- Institute and Outpatients Clinic for Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Barbara Hinding
- The German National Institute for state examinations in Medicine, Pharmacy and Psychotherapy (IMPP), Mainz, Germany
| | - Leonie Eilers
- The German National Institute for state examinations in Medicine, Pharmacy and Psychotherapy (IMPP), Mainz, Germany
| | - Jennifer Höck
- Institute and Outpatients Clinic for Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Anke Hollinderbäumer
- Rudolf Frey Lernklinik, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Holger Buggenhagen
- Rudolf Frey Lernklinik, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Kirsten Reschke
- University Clinic for Nephrology and Hypertension, Diabetology and Endocrinology, University Hospital Magdeburg, Magdeburg, Germany
| | - Jobst-Hendrik Schultz
- Department of General Internal Medicine and Psychosomatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Jana Jünger
- The German National Institute for state examinations in Medicine, Pharmacy and Psychotherapy (IMPP), Mainz, Germany
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Ghazwani EY. Prevalence and Determinants of Burnout Among Palliative Care Clinicians in Saudi Arabia. Front Public Health 2022; 9:834407. [PMID: 35127634 PMCID: PMC8810484 DOI: 10.3389/fpubh.2021.834407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 12/27/2021] [Indexed: 11/13/2022] Open
Abstract
Background Palliative care is in dire necessity than ever before due to aging populations and the prevalence of cancer and other chronic diseases associated with aging. Objective To assess the prevalence and risk factors associated with burnout among palliative care clinicians in Saudi Arabia. Methods A cross-sectional study conducted in 2018 covering all palliative care centers of Saudi Arabia and included 44 palliative care physicians (26 males and 18 females). The level of burnout was measured using Maslach Burnout Inventory's (MBI) 22 point scale questionnaire which assesses emotional exhaustion, depersonalization, and reduced personal accomplishment, the three dimensions of burnout syndrome. Pearson correlation and binary logistic analysis were performed using SPSS to find out factors influencing burnout considering P-value of <0.05 as significant. Results Eight participants (18.2%) had experienced emotional exhaustion and 11 (25%) had experienced depersonalization and detachment, and reduced personal accomplishment, each. Job title and availability of some administrative departments, supporting health care staff, and pain relief medications have shown significant impact of level of burnout. However, the prevalence of the burnout dimensions did not differ significantly according to the palliative care physicians' other characteristics. Conclusions This is amongst the first survey to assess the prevalence of burnout among palliative care physicians in Saudi Arabia. Although, some variables have shown significantly high level in the burnout domains, yet, the overall prevalence of burnout is low among palliative care physicians in Saudi Arabia. The availability of hospitals services such as administrative departments, supporting health care staff, and pain relief drugs have shown significant impact on burnout.
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26
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Vincent A, Urben T, Becker C, Beck K, Daetwyler C, Wilde M, Gaab J, Langewitz W, Hunziker S. Breaking bad news: A randomized controlled trial to test a novel interactive course for medical students using blended learning. PATIENT EDUCATION AND COUNSELING 2022; 105:105-113. [PMID: 33994021 DOI: 10.1016/j.pec.2021.05.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 04/07/2021] [Accepted: 05/03/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Breaking bad news (BBN) is challenging for physicians and patients and specific communication strategies aim to improve these situations. This study evaluates whether an E-learning assignment could improve medical students' accurate recognition of BBN communication techniques. METHODS This randomized controlled trial was conducted at the University of Basel. After a lecture on BBN, 4th year medical students were randomized to an intervention receiving an E-learning assignment on BBN or to a control group. Both groups then worked on an examination video and identified previously taught BBN elements shown in a physician-patient interaction. The number of correctly, misclassified and incorrectly identified BBN communication elements as well as missed opportunities were assessed in the examination video. RESULTS We included 160 medical students (55% female). The number of correctly identified BBN elements did not differ between control and intervention group (mean [SD] 3.51 [2.50] versus 3.72 [2.34], p = 0.58). However, the mean number of inappropriate BBN elements was significantly lower in the intervention than in the control group (2.33 [2.57] versus 3.33 [3.39], p = 0.037). CONCLUSIONS Use of an E-learning tool reduced inappropriate annotations regarding BBN communication techniques. PRACTICE IMPLICATIONS This E-learning might help to further advance communication skills in medical students.
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Affiliation(s)
- Alessia Vincent
- Medical Communication and Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland; Division of Clinical Psychology and Psychotherapy, Faculty of Psychology, University of Basel, Basel, Switzerland
| | - Tabita Urben
- Medical Communication and Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland
| | - Christoph Becker
- Medical Communication and Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland; Emergency Department, University Hospital Basel, Basel, Switzerland
| | - Katharina Beck
- Medical Communication and Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland
| | | | - Michael Wilde
- Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Jens Gaab
- Division of Clinical Psychology and Psychotherapy, Faculty of Psychology, University of Basel, Basel, Switzerland
| | - Wolf Langewitz
- Medical Communication and Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland; Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Sabina Hunziker
- Medical Communication and Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland; Faculty of Medicine, University of Basel, Basel, Switzerland.
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Loh JMI, Saleh A. Lashing out: emotional exhaustion triggers retaliatory incivility in the workplace. Heliyon 2022; 8:e08694. [PMID: 35036596 PMCID: PMC8749205 DOI: 10.1016/j.heliyon.2021.e08694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 08/21/2021] [Accepted: 12/27/2021] [Indexed: 11/27/2022] Open
Abstract
Incivility in the workplace is a growing problem in many workplaces that can detrimentally affect employees and organisations. Despite this increasing problem, the current literature on incivility lacks an integrated theoretical model to explain engaged and retaliated incivility in the workplace. To address this gap, we tested a model which incorporated both Spiral Theory of Incivility with Conservation of Resource Theory to explain the underlying processes involve in the relationship between engaged and retaliatory workplace incivility. Specifically, retaliatory incivility was hypothesised as an influencing factor, work withdrawal and job dissatisfaction as consequences, and emotional exhaustion as a moderator. A total of 875 employees in multinational organisations across three countries were panel surveyed. The overall result from the Structural Equation Modelling (SEM) indicated that the fit indices for the proposed model fulfilled all recommended levels. Importantly, emotional exhaustion was found to be the trigger point in the negative spiral of workplace incivility. Theoretical implications and practical considerations were discussed.
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Affiliation(s)
- Jennifer M I Loh
- University of Canberra, Canberra Business School, Bruce Campus, Canberra, Australia
| | - Abu Saleh
- University of Canberra, Canberra Business School, Bruce Campus, Canberra, Australia
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Morelli E, Mulas O, Caocci G. Patient-Physician Communication in Acute Myeloid Leukemia and Myelodysplastic Syndrome. Clin Pract Epidemiol Ment Health 2021; 17:264-270. [PMID: 35444710 PMCID: PMC8985469 DOI: 10.2174/1745017902117010264] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 08/09/2021] [Accepted: 08/17/2021] [Indexed: 11/22/2022]
Abstract
Introduction An effective communication is an integral part of the patient-physician relationship. Lack of a healthy patient-physician relationship leads to a lower level of patient satisfaction, scarce understanding of interventions and poor adherence to treatment regimes. Patients need to be involved in the therapeutic process and the assessment of risks and perspectives of the illness in order to better evaluate their options. Physicians, in turn, must convey and communicate information clearly in order to avoid misunderstandings and consequently poor medical care. The patient-physician relationship in cancer care is extremely delicate due to the complexity of the disease. In cancer diagnosis, the physician must adopt a communicative approach that considers the psychosocial factors, needs and patient's preferences for information,which in turn all contribute to affect clinical outcomes. Search Strategy and Methods This review was conducted using the Preferred Reporting Items for Systematic and Meta-analyses (PRISMA) statement. We included studies on the importance of physician-patient communication in Acute Myeloid Leukaemia and Myelodysplastic Syndrome care. We searched PubMed, Web of Sciences, Scopus, Google scholar for studies published from December 1 st , 2020 up to March 1 st , 2021. Using MeSH headings, we search for the terms "Physician and patient communication AND Acute Myeloid leukemia" or "Myelodysplastic syndrome" or "Doctor" or "Clinician", as well as variations thereof . Purpose of the Review This review examines the progress in communication research between patient and physician and focuses on the impact of communication styles on patient-physician relationshipin hematologic cancers, including Acute Myeloid Leukaemia and Myelodysplastic Syndromes.
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Affiliation(s)
- Emanuela Morelli
- Hematology and CTMO, Businco Hospital, ARNAS “G. Brotzu”, Cagliari, Italy
| | - Olga Mulas
- Hematology and CTMO, Businco Hospital, ARNAS “G. Brotzu”, Cagliari, Italy
| | - Giovanni Caocci
- Hematology and CTMO, Businco Hospital, ARNAS “G. Brotzu”, Cagliari, Italy
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Dorough RJM, Adamuti-Trache M, Siropaides CH. Association of Medical Student Characteristics and Empathy After a Communication Workshop. J Patient Exp 2021; 8:23743735211065273. [PMID: 34926804 PMCID: PMC8671654 DOI: 10.1177/23743735211065273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Medical education values patient-centered communication skills of responding to patient's emotions, however, guidance is limited on how to provide a well-rounded curriculum. This study examines the effect of a 90-minute communication workshop on the level of empathy of the 116 medical students who participated in the workshop. We used three psychometric categories from the Jefferson Scale of Empathy (JSE) as dependent variables. We conducted mixed analysis of variance (ANOVA) analyses to determine the change in empathy scores after the workshop, the main effects for gender and medical specialty, and their interaction with time. We found an increase in perspective taking and compassionate care scales, although no changes on walking in patients' shoes scale. Female and people-oriented specialty students scored higher on all scales. Some gender-specialty groups showed an empathy decrease: people-oriented specialty females on compassionate care scale and people-oriented and other specialty males on walking in patients' shoes scale. We concluded that communication training requires a multidimensional approach to target various areas of building empathy. Standardization of training should be embedded with empathy development within medical education curriculum.
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Kheradmand A, Mahjani M, Pirsalehi A, Fatemizadeh S, Moshari M, Ziaie S, Fatemizadeh S, Khoshgoui B. Mental Health Status among Healthcare Workers during COVID-19 Pandemic. IRANIAN JOURNAL OF PSYCHIATRY 2021; 16:250-259. [PMID: 34616458 PMCID: PMC8452830 DOI: 10.18502/ijps.v16i3.6250] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 12/24/2020] [Accepted: 02/09/2021] [Indexed: 12/28/2022]
Abstract
Objective: COVID-19, which is an international concern by far, had fundamental impacts on mental health of medical staff. Healthcare workers are the high-risk group to endure the emotional outcomes brought about by the outbreak. This study assesses the mental consequences of healthcare workers during the acute phase of COVID-19 pandemic in Tehran. Method: We conducted a cross-sectional study on healthcare workers from two tertiary referral hospitals in Tehran province. A total of 222 of the staff participated in the study. Our questionnaires comprised Impact of Event Scale-Revised (IES-R) and 12-item General Health Questionnaire (GHQ-12), which were handed to participants to obtain data on their general mental problems in addition to the psychological impacts of the evolving virus on this particular group. Epidemiologic and sociodemographic information of participants, level of perceiving exposure to disease, and underlying diseases of each of them were gathered during the recruitment period. Results: Results showed high probabilities (98.2%) in mental disorders among healthcare workers. Since our study was done during the initial phase of the pandemic, development of mental issues due to the newly emerged infectious virus was expected. However, we recorded mild (41.4%) to moderate (31.5%) impact of this novel virus. The possibility of having mental problems was much higher in females, assistant nurses, individuals with lower education, and those who provided care for COVID-19 patients. Conclusion: COVID-19 has brought about increased distress among healthcare workers. Noticeably, the forefront group in combating this virus bear the most emotional complications. Thus, efforts should be taken into practice to provide proper psychological support for this vulnerable group.
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Affiliation(s)
- Ali Kheradmand
- Department of Psychiatry, Taleghani Hospital Research Development Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahsa Mahjani
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Pirsalehi
- Department of Internal Medicine, Taleghani Hospital Research Development Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Somayeh Fatemizadeh
- Department of Internal Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Moshari
- Department of Anesthesiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shadi Ziaie
- Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sima Fatemizadeh
- Department of Clinical Psychology, Central Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Banafshe Khoshgoui
- Taleghani Hospital Research Development Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Papadakos CT, Stringer T, Papadakos J, Croke J, Embleton A, Gillan C, Miller K, Weiss A, Wentlandt K, Giuliani M. Effectiveness of a Multiprofessional, Online and Simulation-Based Difficult Conversations Training Program on Self-Perceived Competence of Oncology Healthcare Provider Trainees. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2021; 36:1030-1038. [PMID: 32140967 DOI: 10.1007/s13187-020-01729-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Effective communication between healthcare providers (HCPs) and patients is important for HCP well-being, patient engagement, and health outcomes. Yet, HCPs do not receive adequate communication skills training and report feeling unprepared for difficult conversations. A needs assessment of 64 cancer HCP trainees in Toronto, Canada, found that a majority of trainees rated themselves with low competency in communication skills to support patients through difficult conversations, while nearly all rated these skills as important to their practice. A blended multiprofessional communications program was developed including online theoretical learning and reflective practice in addition to in-person simulation with standardised patient actors. Since communication skills mastery is highly unlikely to occur at the termination of a single training program, the goal of the program was to stimulate participants' motivational beliefs about difficult conversations communication skills in order to deepen their commitment to learning and mastery. The motivational beliefs assessed included self-efficacy (self-perceived competence), intent to use techniques learned, and confidence in task mastery. After completing the course, participants' self-perceived competence in dealing with difficult conversations significantly increased by an average of 25 points (p < 0.001) on a rating scale of 1-100 (n = 40). Participants' intent to use techniques did not change significantly and remained high with an overall average of 89 points. After the course, participants rated their confidence in mastering techniques learned at an average score of 71 points. Multiprofessional, simulation-based training is an effective way to improve HCP trainees' motivational beliefs around having difficult conversations.
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Affiliation(s)
- Christine Tina Papadakos
- Department of Cancer Education, Princess Margaret Cancer Centre, Toronto, Canada
- Patient Education, Cancer Care Ontario, Toronto, Canada
| | - Tylar Stringer
- Department of Cancer Education, Princess Margaret Cancer Centre, Toronto, Canada
| | - Janet Papadakos
- Department of Cancer Education, Princess Margaret Cancer Centre, Toronto, Canada
- Patient Education, Cancer Care Ontario, Toronto, Canada
- Cancer Health Literacy Research Centre, Cancer Education, Princess Margaret Cancer Centre, Toronto, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| | - Jennifer Croke
- Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Canada
- Department of Radiation Oncology, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Anne Embleton
- Practice Based Education, Collaborative Academic Practice, Princess Margaret Cancer Centre, Toronto, Canada
| | - Caitlin Gillan
- Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Canada
- Department of Radiation Oncology, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Kim Miller
- Department of Supportive Care, Division of Psychosocial Oncology, Princess Margaret Cancer Centre, Toronto, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Andrea Weiss
- Department of Supportive Care, Division of Palliative Care, Princess Margaret Cancer Centre, Toronto, Canada
- Department of Family and Community Medicine, Division of Palliative Care, University of Toronto, Toronto, Canada
| | - Kirsten Wentlandt
- Department of Supportive Care, Division of Palliative Care, Princess Margaret Cancer Centre, Toronto, Canada
- Department of Family and Community Medicine, Division of Palliative Care, University of Toronto, Toronto, Canada
| | - Meredith Giuliani
- Department of Cancer Education, Princess Margaret Cancer Centre, Toronto, Canada.
- Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Canada.
- Department of Radiation Oncology, Faculty of Medicine, University of Toronto, Toronto, Canada.
- Undergraduate Medical Education, Faculty of Medicine, University of Toronto, Toronto, Canada.
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Alabi RO, Hietanen P, Elmusrati M, Youssef O, Almangush A, Mäkitie AA. Mitigating Burnout in an Oncological Unit: A Scoping Review. Front Public Health 2021; 9:677915. [PMID: 34660505 PMCID: PMC8517258 DOI: 10.3389/fpubh.2021.677915] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 08/24/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: The purpose of this study was to provide a scoping review on how to address and mitigate burnout in the profession of clinical oncology. Also, it examines how artificial intelligence (AI) can mitigate burnout in oncology. Methods: We searched Ovid Medline, PubMed, Scopus, and Web of Science, for articles that examine how to address burnout in oncology. Results: A total of 17 studies were found to examine how burnout in oncology can be mitigated. These interventions were either targeted at individuals (oncologists) or organizations where the oncologists work. The organizational interventions include educational (psychosocial and mindfulness-based course), art therapies and entertainment, team-based training, group meetings, motivational package and reward, effective leadership and policy change, and staff support. The individual interventions include equipping the oncologists with adequate training that include-communication skills, well-being and stress management, burnout education, financial independence, relaxation, self-efficacy, resilience, hobby adoption, and work-life balance for the oncologists. Similarly, AI is thought to be poised to offer the potential to mitigate burnout in oncology by enhancing the productivity and performance of the oncologists, reduce the workload and provide job satisfaction, and foster teamwork between the caregivers of patients with cancer. Discussion: Burnout is common among oncologists and can be elicited from different types of situations encountered in the process of caring for patients with cancer. Therefore, for these interventions to achieve the touted benefits, combinatorial strategies that combine other interventions may be viable for mitigating burnout in oncology. With the potential of AI to mitigate burnout, it is important for healthcare providers to facilitate its use in daily clinical practices. Conclusion: These combinatorial interventions can ensure job satisfaction, a supportive working environment, job retention for oncologists, and improved patient care. These interventions could be integrated systematically into routine cancer care for a positive impact on quality care, patient satisfaction, the overall success of the oncological ward, and the health organizations at large.
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Affiliation(s)
- Rasheed Omobolaji Alabi
- Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Department of Industrial Digitalization, School of Technology and Innovations, University of Vaasa, Vaasa, Finland
| | | | - Mohammed Elmusrati
- Department of Industrial Digitalization, School of Technology and Innovations, University of Vaasa, Vaasa, Finland
| | - Omar Youssef
- Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Department of Pathology, University of Helsinki, Helsinki, Finland
| | - Alhadi Almangush
- Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Department of Pathology, University of Helsinki, Helsinki, Finland
- University of Turku, Institute of Biomedicine, Pathology, Turku, Finland
| | - Antti A. Mäkitie
- Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Department of Otorhinolaryngology – Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institute and Karolinska University Hospital, Stockholm, Sweden
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Holden CL, Jeanfreau MM. Are Perfectionistic Standards Associated with Burnout? Multidimensional Perfectionism and Compassion Experiences Among Professional MFTs. CONTEMPORARY FAMILY THERAPY 2021; 45:207-217. [PMID: 34456467 PMCID: PMC8379052 DOI: 10.1007/s10591-021-09605-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2021] [Indexed: 11/29/2022]
Abstract
The current study addressed the role that perfectionism plays among professionals in this field of marriage and family therapy (MFT). Specifically, this study provides information about PS (personal standards) perfectionism and EC (evaluative concerns) and their relationship with both compassion satisfaction and compassion fatigue. The sample included 247 marriage and family therapists who answered demographic questions along with completing the professional quality of life scale (ProQOL; as reported by Stamm, B. H. (2009). Professional Quality of Life: Compassion Satisfaction and Fatigue Version 5 (ProQOL). Retrieved from http://www.proqol.org/ProQol_Test.html; Stamm in The concise ProQOL manual, ProQOL.org, 2010;) and the multidimensional perfectionism scale (MPS; Hewitt and Flett, Journal of Personality and Social Psychology 60:456–470, 1991). Results indicated three significant findings: (1) higher levels of both self-oriented and socially oriented perfectionism are correlated with higher levels of both burnout and secondary traumatic stress; (2) as years of work as an MFT increase, level of burnout decreases; and (3) women demonstrated statistically significantly higher scores in PS perfectionism than men. Limitations, implications, and future directions are discussed.
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Affiliation(s)
- C L Holden
- School of Child and Family Sciences, The University of Southern Mississippi, 118 College Drive #5035, Hattiesburg, MS 39406 USA
| | - M M Jeanfreau
- School of Child and Family Sciences, The University of Southern Mississippi, 118 College Drive #5035, Hattiesburg, MS 39406 USA
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Bui S, Pelosi A, Mazzaschi G, Tommasi C, Rapacchi E, Camisa R, Binovi C, Leonardi F. Burnout and Oncology: an irreparable paradigm or a manageable condition? Prevention strategies to reduce Burnout in Oncology Health Care Professionals. ACTA BIO-MEDICA : ATENEI PARMENSIS 2021; 92:e2021091. [PMID: 34212933 PMCID: PMC8343755 DOI: 10.23750/abm.v92i3.9738] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 05/11/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND Burnout is a stress-induced occupational related syndrome, characterized by Emotional Exhaustion (EE), feeling of depersonalization (DP) and low sense of professional accomplishment (PA). The aim of this study is to analyse the effectiveness of interventions in decreasing health professionals Burnout as well as work and life-style risk factors. Methods: A survey in Medical Oncology Department in the University Hospital of Parma was conducted using the validated Maslach Burnout Inventory (MBI) and two additional questionnaires exploring lifestyle and work factors. An 8-months intervention involved fortnight meetings by facilitators, incorporated elements of reflection, shared experiences and managing emotions. Six months after the end of the intervention a second survey was performed among the participants using MBI and the same questionnaires mentioned above. Results: EE resulted the most problematic score in Day Hospital: after the 8-month intervention we described a significant decreasing in EE score especially for Day Hospital operators (from 16.7 to 10.9) and a considerable reduction in DP score. In the Oncology Ward a correlation between lack of collaboration among different health categories and DE score was detected; in the Day Hospital the absence of solid working teams was related to higher EE scores. Conclusion: The Oncology professional health care personnel are at the greatest risk of Burnout. Our study in Oncology Department shows that specific intervention should be used to prevent and reduce Burnout. Effective personal health care strategies should be incorporated into routine oncology care to prevent and treat Burnout.
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Affiliation(s)
- Simona Bui
- azienda ospedaliero universitario di Parma.
| | | | | | | | | | | | - Cinzia Binovi
- Medical Oncology Unit, University Hospital of Parma.
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Stephens E, William L, Lim LL, Allen J, Zappa B, Newnham E, Vivekananda K. Complex conversations in a healthcare setting: experiences from an interprofessional workshop on clinician-patient communication skills. BMC MEDICAL EDUCATION 2021; 21:343. [PMID: 34126985 PMCID: PMC8204413 DOI: 10.1186/s12909-021-02785-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 06/03/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Communication is pivotal to the effective care and treatment of patients in our health care systems. Despite this understanding, clinicians are not sufficiently educated to confidently conduct complex discussions with patients. Communication skills workshops have been shown to be an effective educational format to improve clinician skills. However, despite the increasing interprofessional focus within modern medicine, there have been few studies looking at interprofessional communication workshops. METHODS A qualitative study was conducted to assess how an interprofessional communication skills workshop affected the communication skills of clinicians at a tertiary health service. Pre- and post-workshop surveys were undertaken by participants, followed by focus group interviews eight-weeks post workshop. RESULTS Clinicians were able to incorporate learnt communication skills into their daily practice. This was associated with an improvement in confidence of clinicians in having complex discussions, in addition to a reduction in the burden of having complex discussions. Participants responded positively to the interdisciplinary format, reporting benefits from the learning experience that translated into daily practice. CONCLUSION Clinicians' communication skills in conducting complex clinician-patient conversations can be improved by participation in interprofessional communication skills workshops. We identified that the interprofessional aspect of the workshops not only improved interprofessional understanding and relationships, but also developed increased self-awareness during complex discussions, and reduced the sense of burden felt by clinicians.
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Affiliation(s)
- Edward Stephens
- Eastern Health, Arnold Street, Box Hill, Victoria, Australia.
| | - Leeroy William
- Eastern Health, Arnold Street, Box Hill, Victoria, Australia
| | - Lyn-Li Lim
- Eastern Health, Arnold Street, Box Hill, Victoria, Australia
| | - Judy Allen
- Eastern Health, Arnold Street, Box Hill, Victoria, Australia
| | - Bernadette Zappa
- Eastern Health Cancer Services, Eastern Health, Arnold Street, Box Hill, Victoria, Australia
| | - Evan Newnham
- Eastern Health, Arnold Street, Box Hill, Victoria, Australia
| | - Kitty Vivekananda
- Monash University, Level 1 Learning and Teaching Building, 19 Ancora Imparo Way, Clayton, Victoria, Australia
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Hua J, Howell JL, Sweeny K, Andrews SE. Outcomes of Physicians' Communication Goals During Patient Interactions. HEALTH COMMUNICATION 2021; 36:847-855. [PMID: 31992094 DOI: 10.1080/10410236.2020.1719321] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
During healthcare visits, physicians may set communication goals such as providing their patient with information about treatment; however, no recommendations exist regarding which goals physicians should prioritize during their often-brief interactions with patients. Two studies examined five communication goals (providing information, reducing distress, increasing patient satisfaction, increasing patient adherence, and encouraging hope) in the context of physician-patient interactions and their relationship with patient and physician outcomes. In Study 1, audio-recordings of physician-patient interactions were coded by research assistants for goal-related content. In Study 2, patients reported their physician's use of each goal during the interaction. In both studies, patients and physicians reported visit outcomes. Within-study meta-analyses suggested that the goal of reducing distress, but not the other goals, was consistently related to improved outcomes in Study 1. All goals were related to improved outcomes in Study 2. We then computed sample-size-weighted meta-analytic effects of each goal on each outcome across both studies. These results suggested that all of the goals had similar-sized positive relationships with patient and physician outcomes across studies. These findings suggest that physicians should generally approach consultations with communication goals in mind, but prioritizing efforts to reduce distress may be particularly beneficial.
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Affiliation(s)
- Jacqueline Hua
- Department of Psychological Sciences, University of California, Merced
| | - Jennifer L Howell
- Department of Psychological Sciences, University of California, Merced
| | - Kate Sweeny
- Department of Psychology, University of California, Riverside
| | - Sara E Andrews
- Department of Psychology, University of California, Riverside
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Khechine W, Ezzaairi F, Sahli J, Belaid I, Daldoul A, Zaied S, Chabchoub I, Ammar N, Hochlaf M, Ben Fatma L, Ben Ahmed S. Burn-out of the Medical Oncology Health Care Professionals
and Associated Factors in Tunisia. PSYCHO-ONCOLOGIE 2021. [DOI: 10.3166/pson-2020-0134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Introduction: Burn-out is defined as a syndrome of emotional exhaustion, depersonalization and diminished self-achievement that affects individuals exposed to chronic occupational stress. Physicians and caregivers faced with the death of their patients, such as oncology, are particularly vulnerable to this syndrome.
Objectives: To evaluate the burn-out of medical professionals in medical oncology, to research the predisposing factors and to analyze the functional complaints and the behavior of the staff associated with this syndrome.
Methods: A descriptive and analytical cross-sectional study among medical oncology professionals practicing in public hospitals in the Tunisian territory who exercise more than two years in oncology; with the Maslach Burnout Inventory (MBI).
Results: Our study population was predominantly female (81%). 53% are doctors and 47% are paramedical health care professionals. A high degree of emotional exhaustion, depersonalization and personal achievement were found in 63%, 53% and 59% in our population, respectively. With 21% global high burn-out. The female sex was associated with high emotional exhaustion and low personal accomplishment as well as global burn-out. This burn-out was attributed to factors associated with working conditions and professional climate, mainly: overwork, poor organization of service, lack of resources and time, lack of recognition, lack of communication, lack of respect, conflicts with colleagues, report unsatisfactory salary effort and aggressions by patients and their families. Functional complaints and health care professional’s behavior associated with burn-out were: feelings of sadness, blockage, and irritability, sleep disorders, unexplained pain, epigastralgia, addictive behaviors, psychotropic consumption, suicidal thoughts, decreased performance and desire for a job transfer.
Conclusions: By its impact on professionals, burn-out in medical oncology represents a major threat to the quality of health care. Its etiologies, although complex and intricate, are well known. Its prevention and its support are possible, but involve mobilization at all levels.
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Søvold LE, Naslund JA, Kousoulis AA, Saxena S, Qoronfleh MW, Grobler C, Münter L. Prioritizing the Mental Health and Well-Being of Healthcare Workers: An Urgent Global Public Health Priority. Front Public Health 2021; 9:679397. [PMID: 34026720 PMCID: PMC8137852 DOI: 10.3389/fpubh.2021.679397] [Citation(s) in RCA: 344] [Impact Index Per Article: 86.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 04/12/2021] [Indexed: 12/27/2022] Open
Abstract
The COVID-19 pandemic has had an unprecedented impact on health systems in most countries, and in particular, on the mental health and well-being of health workers on the frontlines of pandemic response efforts. The purpose of this article is to provide an evidence-based overview of the adverse mental health impacts on healthcare workers during times of crisis and other challenging working conditions and to highlight the importance of prioritizing and protecting the mental health and well-being of the healthcare workforce, particularly in the context of the COVID-19 pandemic. First, we provide a broad overview of the elevated risk of stress, burnout, moral injury, depression, trauma, and other mental health challenges among healthcare workers. Second, we consider how public health emergencies exacerbate these concerns, as reflected in emerging research on the negative mental health impacts of the COVID-19 pandemic on healthcare workers. Further, we consider potential approaches for overcoming these threats to mental health by exploring the value of practicing self-care strategies, and implementing evidence based interventions and organizational measures to help protect and support the mental health and well-being of the healthcare workforce. Lastly, we highlight systemic changes to empower healthcare workers and protect their mental health and well-being in the long run, and propose policy recommendations to guide healthcare leaders and health systems in this endeavor. This paper acknowledges the stressors, burdens, and psychological needs of the healthcare workforce across health systems and disciplines, and calls for renewed efforts to mitigate these challenges among those working on the frontlines during public health emergencies such as the COVID-19 pandemic.
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Affiliation(s)
| | - John A Naslund
- Department of Global Health and Social Medicine and Harvard Medical School, Boston, MA, United States
| | | | - Shekhar Saxena
- Department of Global Health and Population, School of Public Health, Harvard University, Boston, MA, United States
| | | | - Christoffel Grobler
- Faculty of Health Sciences, School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
| | - Lars Münter
- Danish Committtee for Health Education, Copenhagen, Denmark
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Franchini L, Varani S, Ostan R, Bocchi I, Pannuti R, Biasco G, Bruera E. Home palliative care professionals perception of challenges during the Covid-19 outbreak: A qualitative study. Palliat Med 2021; 35:862-874. [PMID: 33829909 DOI: 10.1177/02692163211008732] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Home palliative care services have played an essential role during the first wave of the SARS-CoV-2 outbreak by providing symptom control, drug procurement, and psychological support for frail patients and their families unable to leave their homes. AIM To understand how home palliative care professionals were affected by the outbreak, describing changes and challenges in their daily work as well as their reactions to the Covid-19 pandemic in Italy. DESIGN Qualitative study conducted using telephone semi-structured interviews, with thematic analysis. SETTING/PARTICIPANTS Thirty home care professionals working for an Italian non-profit organization which provides home palliative care for cancer patients and their families. RESULTS Three main themes were identified. The first theme showed both patient-related and practice-related challenges participants faced in their daily work, requiring the implementation of different communication methods and patient and family education on risk prevention. The second theme showed the perception of increased responsibility and being the only landmark for family played a decisive role in participants' positive attitude. The third theme highlighted the participants' perception of the critical role of a home care setting in this emergency situation. CONCLUSIONS The first wave of the Covid-19 pandemic brought many challenges and stressors for home palliative care professionals. On the other side, they reported a satisfaction with their critical role in carrying out their work with patients at risk.
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Affiliation(s)
| | | | - Rita Ostan
- National Tumor Assistance (ANT), Bologna, Italy
| | | | | | | | - Eduardo Bruera
- Department of Palliative Care, Rehabilitation and Integrative Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Mulder MB, Sussman MS, Eidelson SA, Gross KR, Buzzelli MD, Batchinsky AI, Schulman CI, Namias N, Proctor KG. Heart Rate Complexity in US Army Forward Surgical Teams During Pre Deployment Training. Mil Med 2021; 185:e724-e733. [PMID: 32722768 DOI: 10.1093/milmed/usz434] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 06/28/2019] [Accepted: 07/04/2019] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION For trauma triage, the US Army has developed a portable heart rate complexity (HRC) monitor, which estimates cardiac autonomic input and the activity of the hypothalamic-pituitary-adrenal (HPA) axis. We hypothesize that autonomic/HPA stress associated with predeployment training in U.S. Army Forward Surgical Teams will cause changes in HRC. MATERIALS AND METHODS A prospective observational study was conducted in 80 soldiers and 10 civilians at the U.S. Army Trauma Training Detachment. Heart rate (HR, b/min), cardiac output (CO, L/min), HR variability (HRV, ms), and HRC (Sample Entropy, unitless), were measured using a portable non-invasive hemodynamic monitor during postural changes, a mass casualty (MASCAL) situational training exercise (STX) using live tissue, a mock trauma (MT) STX using moulaged humans, and/or physical exercise. RESULTS Baseline HR, CO, HRV, and HRC averaged 72 ± 11b/min, 5.6 ± 1.2 L/min, 48 ± 24 ms, and 1.9 ± 0.5 (unitless), respectively. Supine to sitting to standing caused minimal changes. Before the MASCAL or MT, HR and CO both increased to ~125% baseline, whereas HRV and HRC both decreased to ~75% baseline. Those values all changed an additional ~5% during the MASCAL, but an additional 10 to 30% during the MT. With physical exercise, HR and CO increased to >200% baseline, while HRV and HRC both decreased to 40 to 60% baseline; these changes were comparable to those caused by the MT. All the changes were P < 0.05. CONCLUSIONS Various forms of HPA stress during Forward Surgical Team STXs can be objectively quantitated continuously in real time with a portable non-invasive monitor. Differences from resting baseline indicate stress anticipating an impending STX whereas differences between average and peak responses indicate the relative stress between STXs. Monitoring HRC could prove useful to field commanders to rapidly and objectively assess the readiness status of troops during STXs or repeated operational missions. In the future, health care systems and regulatory bodies will likely be held accountable for stress in their trainees and/or obliged to develop wellness options and standardize efforts to ameliorate burnout, so HRC metrics might have a role, as well.
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Affiliation(s)
- Michelle B Mulder
- Dewitt Daughtry Department of Surgery Divisions of Trauma, Burns, & Surgical Critical Care, Ryder Trauma Center, University of Miami Miller School of Medicine, Miami, FL 33136
| | - Matthew S Sussman
- Dewitt Daughtry Department of Surgery Divisions of Trauma, Burns, & Surgical Critical Care, Ryder Trauma Center, University of Miami Miller School of Medicine, Miami, FL 33136
| | - Sarah A Eidelson
- Dewitt Daughtry Department of Surgery Divisions of Trauma, Burns, & Surgical Critical Care, Ryder Trauma Center, University of Miami Miller School of Medicine, Miami, FL 33136
| | - Kirby R Gross
- U.S. Army Trauma Training Detachment, Ryder Trauma Center, University of Miami Miller School of Medicine, Miami, FL 33136
| | - Mark D Buzzelli
- U.S. Army Trauma Training Detachment, Ryder Trauma Center, University of Miami Miller School of Medicine, Miami, FL 33136
| | - Andriy I Batchinsky
- Extracorporeal Life Support Capability Area, Battlefield Health & Trauma Center for Human Integrative Physiology, U.S. Army Institute of Surgical Research, 3698 Chambers Pass, Bldg 3611, JBSA Fort Sam Houston, TX 78234-6315.,The Geneva Foundation, Tacoma, WA 98402
| | - Carl I Schulman
- Dewitt Daughtry Department of Surgery Divisions of Trauma, Burns, & Surgical Critical Care, Ryder Trauma Center, University of Miami Miller School of Medicine, Miami, FL 33136.,U.S. Army Trauma Training Detachment, Ryder Trauma Center, University of Miami Miller School of Medicine, Miami, FL 33136
| | - Nicholas Namias
- Dewitt Daughtry Department of Surgery Divisions of Trauma, Burns, & Surgical Critical Care, Ryder Trauma Center, University of Miami Miller School of Medicine, Miami, FL 33136
| | - Kenneth G Proctor
- Dewitt Daughtry Department of Surgery Divisions of Trauma, Burns, & Surgical Critical Care, Ryder Trauma Center, University of Miami Miller School of Medicine, Miami, FL 33136.,U.S. Army Trauma Training Detachment, Ryder Trauma Center, University of Miami Miller School of Medicine, Miami, FL 33136
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Mion G, Hamann P, Saleten M, Plaud B, Baillard C. Psychological impact of the COVID-19 pandemic and burnout severity in French residents: A national study. THE EUROPEAN JOURNAL OF PSYCHIATRY 2021. [DOI: 10.1016/j.ejpsy.2021.03.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Exploring the Impact of Primary Care Physician Burnout and Well-Being on Patient Care: A Focus Group Study. J Patient Saf 2021; 16:e278-e283. [PMID: 33215893 DOI: 10.1097/pts.0000000000000438] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
OBJECTIVES The aims of the study were (1) to explore whether primary care physicians (general practitioners [GPs]) perceive burnout and well-being to impact on the quality and safety of patient care and (2) to determine potential mechanisms behind these associations. METHOD Five focus groups with 25 practicing GPs were conducted in England, either in the participants' practice or in a private meeting room outside of their workplace.An interview schedule with prompts was followed with questions asking how participants perceive GP burnout and poor well-being could impact on patient care delivery. Audio recordings were transcribed verbatim and analyzed using thematic analysis. RESULTS General practitioners believed that poor well-being and burnout affect the quality of care patients receive through reducing doctors' abilities to empathize, to display positive attitudes and listening skills, and by increasing the number of inappropriate referrals made. Participants also voiced that burnout and poor well-being can have negative consequences for patient safety, through a variety of mechanisms including reduced cognitive functioning and decision-making abilities, a lack of headspace, and fatigue. Furthermore, it was suggested that the relationship between well-being/burnout and mistakes is likely to be circular. CONCLUSIONS Further research is needed to ascertain the validity of these perceptions. If found, physicians, healthcare organizations, and policy makers should examine how they can improve physician well-being and prevent burnout, because this may be a route to ensure high-quality and safe patient care.
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Abusanad A, Bensalem A, Shash E, Mula-Hussain L, Benbrahim Z, Khatib S, Abdelhafiz N, Ansari J, Jradi H, Alkattan K, Jazieh AR. Burnout in oncology: Magnitude, risk factors and screening among professionals from Middle East and North Africa (BOMENA study). Psychooncology 2021; 30:736-746. [PMID: 33427352 DOI: 10.1002/pon.5624] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 01/04/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Burnout (BO) among oncology professionals (OP) is increasingly being recognized. Early recognition and intervention can positively affect the quality of care and patient safety. This study investigated the prevalence, work and lifestyle factors affecting BO among OPs in the Middle East and North Africa (MENA). METHODS An online survey was conducted among MENA OPs between 10 February and 15 March 2020, using the validated Maslach Burnout Inventory of emotional exhaustion (EE), depersonalization (DP) and personal accomplishment (PA), including questions regarding demography/work-related factors and attitudes towards oncology. Data were analysed to measure BO prevalence and risk factors and explore a screening question for BO. RESULTS Of 1054 respondents, 1017 participants (64% medical oncologists, 77% aged less than 45 years, 55% female, 74% married, 67% with children and 40% practiced a hobby) were eligible. The BO prevalence was 68% with high levels of EE and DP (35% and 57% of participants, respectively) and low PA scores (49%). BO was significantly associated with age less than 44 years, administrative work greater than 25% per day and the thought of quitting oncology (TQ). Practising a hobby, enjoying oncology communication and appreciating oncology work-life balance were associated with a reduced BO score and prevalence. North African countries reported the highest BO prevalence. Lack of BO education/support was identified among 72% of participants and TQ-predicted burnout in 77%. CONCLUSIONS This is the largest BO study in MENA. The BO prevalence was high and several modifiable risk factors were identified, requiring urgent action. TQ is a simple and reliable screening tool for BO.
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Affiliation(s)
- Atlal Abusanad
- Department of Medical Oncology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Assia Bensalem
- Oncology Department, CHU Dr Benbadis, Constantine, Algeria
| | - Emad Shash
- Department of Medical Oncology, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Layth Mula-Hussain
- Radiation Oncology Department, University of Ottawa, Ottawa, Ontario, Canada
| | - Zineb Benbrahim
- Faculty of Medicine and Pharmacy of Fez, University Sidi Mohammed Ben Abdellah
| | - Sami Khatib
- Department of Oncology, Private Sector, Amman, Jordan
| | - Nafisa Abdelhafiz
- Department of Oncology, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Jawaher Ansari
- Department of Medical Oncology, Tawam Hospital, Al Ain, United Arab Emirates
| | - Hoda Jradi
- Public Health Faculty, Department of public health, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Khaled Alkattan
- Thoracic surgery department, King Faisal Specialist Hospital and Research Center (KFSH-RC), Alfaisal University, Riyadh, Saudi Arabia
| | - Abdul R Jazieh
- Department of Oncology, King Abdulaziz Medical City, Riyadh, Saudi Arabia
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Varani S, Ostan R, Franchini L, Ercolani G, Pannuti R, Biasco G, Bruera E. Caring Advanced Cancer Patients at Home During COVID-19 Outbreak: Burnout and Psychological Morbidity Among Palliative Care Professionals in Italy. J Pain Symptom Manage 2021; 61:e4-e12. [PMID: 33249082 PMCID: PMC7691143 DOI: 10.1016/j.jpainsymman.2020.11.026] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 11/19/2020] [Accepted: 11/20/2020] [Indexed: 12/16/2022]
Abstract
CONTEXT Providing palliative care (PC) at home for patients with advanced cancer has become essential during the COVID-19 emergency. Nevertheless, the home PC professionals (PCPs) faced a challenging situation because of increased number of discharged patients, reduced availability of health-care facilities, and physical/relational barriers between them and patients. OBJECTIVES This study aimed to investigate the impact of COVID-19 pandemic on burnout and psychological morbidity among home PCPs in Italy. METHODS One hundred and ninety-eight PC physicians and nurses working in home assistance in Italy were invited to participate. The results obtained by the investigation conducted during the COVID-19 emergency (COVID2020) were compared with data collected in 2016 in the same setting (BURNOUT2016). The questionnaires (socio-demographics, Maslach Burnout Inventory and General Health Questionnaire-12) were the same for both the surveys. The PCPs participating in COVID2020 survey (n = 145) were mostly the same (70%) who participated in the BURNOUT2016 study (n = 179). RESULTS One hundred and forty-five PCPs participated in the study (response rate 73.2%). During the COVID-19 emergency, home PCPs presented a lower burnout frequency (P < .001) and higher level of personal accomplishment than in 2016 (P = .047). Conversely, the risk for psychological morbidity was significantly higher during the pandemic (P < .001). CONCLUSIONS In the age of COVID-19, the awareness of being at the forefront of containing the pandemic along with the sense of responsibility toward their high-risk patients may arouse PCPs' psychological distress, but, on the other hand, this condition may improve their sense of professional satisfaction and personal accomplishment.
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Affiliation(s)
| | - Rita Ostan
- National Tumor Assistance (ANT), Bologna, Italy
| | | | | | | | - Guido Biasco
- University of Bologna & Academy of the Sciences of Palliative Medicine, Bologna, Italy
| | - Eduardo Bruera
- Department of Palliative Care, Rehabilitation and Integrative Medicine, Houston, Texas
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Becker NDC, Carlos da Rocha A, Follador FAC, Wendt GW, Ferreto LED, Fortes PN, Amorim JPA. Burnout Syndrome in Brazilian Medical Doctors: A Cross-Sectional Examination of Risk and Protective Factors. FRONTIERS IN HEALTH SERVICES 2021; 1:760034. [PMID: 36926482 PMCID: PMC10012636 DOI: 10.3389/frhs.2021.760034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 10/12/2021] [Indexed: 11/13/2022]
Abstract
Objectives: This investigation sought to identify the prevalence of Burnout Syndrome (BS) among Brazilian medical doctors (BS) and the associations with risk factors and protective factors. Methods: Out of 206 registered MD from a medium-sized municipality, 121 were enrolled in this cross-sectional study. Convenience sampling was used. Based on Cohen's f 2, a power of 98% and a 0.05 alpha was achieved. MD responded to sociodemographic questions and to the Portuguese-version of the Maslach Burnout Inventory-Human Services Survey (MBI). Risk and protective factors linked with BS were examined with regression analyses. Results: The age of the participants ranged from 25 to 69 years (M = 40.89; SD = 10.13) and 73.6% were male. The prevalence of BS was 7.5%. Differential aspects were related to BS. For instance, while not reporting satisfaction with the institution (β = 16.16, p < 0.001) and not practicing physical exercise (β = 7.39, p = 0.014) were associated with higher scores in the BS composite score, those who did not intend to change their careers (β = -17.15, p < 0.001) and participants who saw mental health specialists (β = -8.99, p = 0.007) scored lower, accounting for nearly a half of the BS composite score (R 2 = 46%). Conclusion: The prevalence of BS in this study falls within the range previously reported among healthcare professionals (i.e., 2.6-11.8%). Moreover, data suggested that commitment with the occupation and with the participant's own mental health could boost reactions against the deleterious effects of the BS. In this sense, organizations can develop strategies for preventing BS, a process that is known to be chronic and, to some extent, preventable.
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Affiliation(s)
- Natalia Dalla Costa Becker
- Department of Health Sciences, Postgraduate Program in Applied Health Sciences, Francisco Beltrão, Western Paraná State University, Paraná, Brazil
| | - Adilson Carlos da Rocha
- Department of Social Sciences, Francisco Beltrão, Western Paraná State University, Paraná, Brazil
| | - Franciele Aní Caovilla Follador
- Department of Health Sciences, Postgraduate Program in Applied Health Sciences, Francisco Beltrão, Western Paraná State University, Paraná, Brazil
| | - Guilherme Welter Wendt
- Department of Health Sciences, Faculty of Medicine Francisco Beltrão, Western Paraná State University, Paraná, Brazil
| | - Lirane Elize Defante Ferreto
- Department of Health Sciences, Postgraduate Program in Applied Health Sciences, Francisco Beltrão, Western Paraná State University, Paraná, Brazil
| | - Paulo Nunes Fortes
- Department of Health Sciences, Faculty of Medicine Francisco Beltrão, Western Paraná State University, Paraná, Brazil
| | - João Paulo Arruda Amorim
- Department of Health Sciences, Postgraduate Program in Applied Health Sciences, Francisco Beltrão, Western Paraná State University, Paraná, Brazil
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Leiss U, Schiller A, Fries J, Voitl P, Peyrl A. Self-Care Strategies and Job Satisfaction in Pediatricians: What We Can Do to Prevent Burnout-Results of a Nationwide Survey. Front Pediatr 2021; 9:722356. [PMID: 34532304 PMCID: PMC8438418 DOI: 10.3389/fped.2021.722356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 08/06/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction: Working in the clinical field can be a demanding experience. While reports indicate escalating burnout rates among physicians, further investigation about what physicians can do to prevent burnout is necessary. Our objective was to assess self-care levels among pediatricians and the correlation with job satisfaction in order to subsequently identify protective factors. Methods: In this nationwide, cross-sectional study, a web-based survey was distributed to all Austrian pediatricians via a mailing list of the Austrian Society of Pediatrics. Self-care was measured with a modified Professional Self-Care Scale (PSCS), which consisted of nine items on a four-point Likert scale (from 1, "totally disagree," to 4, "totally agree"). Additional items addressed job satisfaction, peer support, and access to professional coaching. Results: The survey was distributed to 1,450 mailing list contacts, a total of 309 Austrian pediatricians completed the survey (21%). "Family" (M = 3.3) and "Friends" (M = 3.1) were the most highly rated self-care strategies. We found significant differences between pediatricians under 35 years and those aged 50 years and above (z = -4.21, p < 0.001). Peer support appeared to impact job satisfaction substantially. We found differences between pediatricians who frequently talk to colleagues about difficult situations, those who sometimes do so, and those who never do (p < 0.001), with a linear trend indicating increased job satisfaction with more frequent peer support (p < 0.001). Conclusions: Among all self-care strategies, a stable network of family and friends was highest rated, followed by balanced nutrition. Younger, male pediatricians working in hospital showed to be a vulnerable group with regard to overall self-care. Moreover, higher self-care values were found among those pediatricians who reported to receive peer support on a regular basis. We suggest combined organizational and individual interventions to promote pediatricians' well-being. Organizations should provide the possibility to select a well-balanced diet as well as space and time to consume food and cultivate a work environment that enables communication among peers and facilitates professional coaching. On the personal level, we want to encourage pediatricians to talk to trusted colleagues in challenging clinical situations and to consider working with a professional coach.
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Affiliation(s)
- Ulrike Leiss
- Department of Pediatrics, Medical University of Vienna, Vienna, Austria.,Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Andrea Schiller
- Department of Pediatrics and Neonatology, St. Josef Hospital Vienna, Vienna, Austria
| | - Jonathan Fries
- Department of Pediatrics, Medical University of Vienna, Vienna, Austria.,Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria.,Department of Developmental and Educational Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Peter Voitl
- First Vienna Medical Care Center, Vienna, Austria
| | - Andreas Peyrl
- Department of Pediatrics, Medical University of Vienna, Vienna, Austria.,Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
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Communication in Palliative Care. Respir Med 2021. [DOI: 10.1007/978-3-030-81788-6_9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Franceschi E, Brandes AA. Burnout in medical oncology during the COVID-19 pandemic. Expert Rev Anticancer Ther 2020; 21:351-353. [PMID: 33353446 DOI: 10.1080/14737140.2021.1866549] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Enrico Franceschi
- Medical Oncology Department, Azienda USL/IRCCS Istituto Delle Scienze Neurologiche Di Bologna, Bologna, Italia
| | - Alba A Brandes
- Medical Oncology Department, Azienda USL/IRCCS Istituto Delle Scienze Neurologiche Di Bologna, Bologna, Italia
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Soltan MR, Al-Hassanin SA, Soliman SS, Gohar SF. Workplace-related stress among oncologists: Egyptian single-centered observational study. MIDDLE EAST CURRENT PSYCHIATRY 2020. [DOI: 10.1186/s43045-020-00026-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Abstract
Background
The oncologists are facing more challenges than ever before in their work with cancer patients. The aim of the study is to assess the level of work-related stress among oncology clinicians and to compare it with non-oncologists. Thirty oncologists working at clinical oncology department at Menoufia University hospitals, Egypt, were compared to an equal number of non-oncologists matched for the same gender and work duration. After consent, all the participants were interviewed using a structured questionnaire to collect background information and the workplace stress scale (WSS) was used to ascertain their stress level.
Results
The percentage distribution of different grades of WSS among the two groups did not show any significant difference (P = 0.84). Gender had no significant association to the mean score of WSS (P > 0.05). All the juniors (residents) in this study with work duration ≤ 3 years had significantly higher levels of WSS than seniors (> 3 years), P < 0.001. Among oncologists or non-oncologists, juniors showed significantly higher levels of WSS than seniors (P = 0.003 and < 0.001 respectively). However, junior oncologists had no significant difference than junior non-oncologists and seniors in both groups did not show any significant difference regarding the mean score of WSS.
Conclusion
All the workers within the two groups had experienced work-related stress. However, there was no statistically significant difference among them regarding the different grades of work place stress scale.
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De Hert S. Burnout in Healthcare Workers: Prevalence, Impact and Preventative Strategies. Local Reg Anesth 2020; 13:171-183. [PMID: 33149664 PMCID: PMC7604257 DOI: 10.2147/lra.s240564] [Citation(s) in RCA: 282] [Impact Index Per Article: 56.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 10/13/2020] [Indexed: 11/23/2022] Open
Abstract
Approximately, one in three physicians is experiencing burnout at any given time. This may not only interfere with own wellbeing but also with the quality of delivered care. This narrative review discusses several aspects of the burnout syndrome: prevalence, symptoms, etiopathogenesis, diagnosis, impact, and strategies on how to deal with the problem.
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Affiliation(s)
- Stefan De Hert
- Department of Anesthesiology and Perioperative Medicine, Ghent University Hospital, Ghent University, Ghent, Belgium
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