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Health Care Worker Burnout During the COVID-19 Pandemic in HIV Clinics in Guangxi, China: A Cross-sectional Analysis of Risk and Protective Factors. J Assoc Nurses AIDS Care 2022; 33:311-332. [PMID: 35025823 DOI: 10.1097/jnc.0000000000000318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
ABSTRACT Dual epidemics of coronavirus disease 2019 (COVID-19) and HIV cause burnout among HIV health care workers. Guided by a socioecological framework, we investigated risk and protective factors of their burnout in Guangxi, China based on an online survey (N = 1,029) from April to May 2020. Descriptive and bivariate analyses and hierarchical regression were conducted. COVID-19-related stressors (B = 0.648 [0.482-0.816], p < .001), challenges while delivering HIV services (B = 0.236 [0.174-0.298], p < .001), and working in province/city-level institutes (B = 2.302, [0.828-3.776], p =.002) were risk factors. Protective factors were resilience (B = -0.596 [-0.687 to -0.504], p < .001), workplace social support (B = -0.410 [-0.717 to -0.044], p =.03), and institutional responsiveness to COVID-19 (B = -0.138 [-0.205 to -0.071], p < .001), respectively. Burnout-related interventions may benefit from promoting resilience, creating a supportive work environment, and strengthening institutional response to public health emergencies.
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Sales JM, Piper K, Riddick C, Getachew B, Colasanti J, Kalokhe A. Low provider and staff self-care in a large safety-net HIV clinic in the Southern United States: Implications for the adoption of trauma-informed care. SAGE Open Med 2019; 7:2050312119871417. [PMID: 31467676 PMCID: PMC6704408 DOI: 10.1177/2050312119871417] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 08/01/2019] [Indexed: 11/29/2022] Open
Abstract
Objective: This mixed-methods needs assessment study examined self-care practices among providers, staff, and administrators at an HIV clinic and identified barriers and facilitators to strengthening self-care services in this setting. Methods: Surveys (n = 31) and qualitative interviews (n = 23) were conducted with staff, providers, and administrators at a large, safety-net HIV clinic. Results: Surveys indicated an overall absence of formal self-care services including resources to manage stress, opportunities to debrief, and formal mechanisms to voice concerns. Based on interviews with staff and providers, deficiencies in self-care services included support for dealing with complex patients, formal mechanisms for feedback, and time for self-care. Administrators recognized the need for more support, acknowledged that opportunities for employees to voice concerns were lacking, and felt that implementing multi-disciplinary team meetings could improve morale and reduce stress and burnout. Conclusion: This assessment revealed a need to enhance self-care in safety-net HIV services. Adoption of trauma-informed care, which includes activities to strengthen self-care, could reduce workplace burnout.
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Affiliation(s)
- Jessica M Sales
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Kaitlin Piper
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Clara Riddick
- Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Betelihem Getachew
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Jonathan Colasanti
- Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.,Division of Infectious Diseases, School of Medicine, Emory University, Atlanta, GA, USA
| | - Ameeta Kalokhe
- Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.,Division of Infectious Diseases, School of Medicine, Emory University, Atlanta, GA, USA
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Kerr ZY, Miller KR, Galos D, Love R, Poole C. Challenges, coping strategies, and recommendations related to the HIV services field in the HAART era: a systematic literature review of qualitative studies from the United States and Canada. AIDS Patient Care STDS 2013; 27:85-95. [PMID: 23336722 DOI: 10.1089/apc.2012.0356] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Qualitative research methods have been utilized to study the nature of work in the HIV services field. Yet current literature lacks a Highly Active Anti-Retroviral Treatment (HAART) era compendium of qualitative research studying challenges and coping strategies in the field. This study systematically reviewed challenges and coping strategies that qualitative researchers observed in the HIV services field during the HAART era, and their recommendations to organizations. Four online databases were searched for peer-reviewed research that utilized qualitative methods, were published from January 1998 to February 2012, utilized samples of individuals in the HIV services field; occurred in the U.S. or Canada, and contained information related to challenges and/or coping strategies. Abstracts were identified (n=846) and independently read and coded for inclusion by at least two of the four first authors. Identified articles (n=26) were independently read by at least two of the four first authors who recorded the study methodology, participant demographics, challenges and coping strategies, and recommendations. A number of challenges affecting those in the HIV services field were noted, particularly interpersonal and organizational issues. Coping strategies were problem- and emotion-focused. Summarized research recommendations called for increased support, capacity-building, and structural changes. Future research on challenges and coping strategies must provide up-to-date information to the HIV services field while creating, implementing, and evaluating interventions to manage current challenges and reduce the risk of burnout.
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Affiliation(s)
- Zachary Y. Kerr
- Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina-Chapel Hill, Chapel Hill, North Carolina
| | - Katye R. Miller
- Student Wellness Center, Office of Student Life, The Ohio State University, Columbus, Ohio
| | - Dylan Galos
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Randi Love
- Division of Health Behavior/Health Promotion, College of Public Health, The Ohio State University, Columbus, Ohio
| | - Charles Poole
- Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina-Chapel Hill, Chapel Hill, North Carolina
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Kerr ZY, Grafsky EL, Miller K, Love R. Stressors and coping strategies for HIV-test counselors giving rapid HIV-test results: an exploratory qualitative study. AIDS Patient Care STDS 2011; 25:483-91. [PMID: 21745119 DOI: 10.1089/apc.2011.0085] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Stress has been extensively researched in the HIV services field. Yet, research regarding stress related to HIV-test counseling has solely focused on stressors related to giving results, even though stress on the HIV test counselor can occur at many points within a counseling session. This exploratory, qualitative study examines the stressors faced and coping mechanisms utilized by HIV-test counselors at AIDS service organizations (ASOs) during rapid HIV-test counseling sessions. Forty-two HIV test counselors were interviewed regarding HIV-test counseling sessions in which they provided preliminary-positive/reactive, negative/nonreactive, and invalid results. Regardless of the test result, HIV test counselors faced stressors, including giving HIV test results; dealing with emotions; difficult clients; self-doubt; and systemic stressors. Most stress was managed through social support, preparatory coping strategies, respite, and putting things into perspective. Despite the exploratory nature of the study, the findings suggest that strengthening support bases and improving current training standards will increase the well-being of HIV test counselors.
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Affiliation(s)
- Zachary Y Kerr
- Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina-Chapel Hill, 27599-7435, USA.
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Abstract
AIM The aim of this study was to examine the level of burnout and factors that contribute to burnout in hospital nurses in the People's Republic of China. BACKGROUND While burnout among hospital nurses has been widely researched in western countries, little research has investigated burnout among hospital nurses in China. METHOD A translated version of the Maslach Burnout Inventory-Human Services Survey was used to measure burnout in 249 randomly selected nurses from various wards of a large teaching hospital in Beijing, China. Questionnaire packs were sent to the hospital wards where selected nurses worked. One hundred and twenty-eight nurses returned the completed questionnaire. The response rate was 51%. RESULTS The results showed moderate levels of Emotional Exhaustion and Personal Accomplishment, and low levels of Depersonalization. Age, years of experience and professional title had a significant positive relationship with Emotional Exhaustion and Personal Accomplishment. Older, married nurses with more personal responsibilities and in a more senior position experienced higher levels of Emotional Exhaustion. CONCLUSION The findings suggest that burnout is a significant issue for nurses in China. IMPLICATIONS FOR NURSING MANAGEMENT The results of this study indicate that working environment factors such as relationships with coworkers and managers may contribute to or mitigate burnout. There is a need to address personal and professional support, life-work balance, personal accomplishment and educational programmes to reduce burnout in nurses working in China.
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Affiliation(s)
- Frances Lin
- School of Nursing and Midwifery Gold Coast, Griffith University, Queensland, Australia.
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Hillhouse JJ, Adler CM, Walters DN. A simple model of stress, burnout and symptomatology in medical residents: A longitudinal study. PSYCHOL HEALTH MED 2010. [DOI: 10.1080/135485000106016] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Abstract
Prior research findings about caregiving for persons with HIV/AIDS indicate that caregiving impacts nurses in three separate domains: personal self as a nurse in practice; interactions with the nurse's family members, friends, and colleagues; and interactions with persons with HIV/AIDS. However the impact caregiving for persons with HIV/AIDS has on rural nurses has not been extensively explored. A qualitative study of rural registered nurses' experiences of caring for persons with HIV/AIDS was conducted to determine how caregiving affects registered nurses in rural areas. Content analysis was used to analyze rural registered nurses' written comments about their experiences of caring for persons with HIV/AIDS. Themes identified from the nurses' accounts of instances of caregiving were the perceived risk of acquiring the virus, a lack of concern about HIV/AIDS, and a need for ongoing continued education about the care of persons with HIV/AIDS.
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Affiliation(s)
- Iris L Mullins
- College of Health and Social Services, School of Nursing, New Mexico State University, Box 30001, MSC 3185, Las Cruces, NM 88003-8001, USA.
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Munro I, Edward KL. The lived experience of gay men caring for others with HIV/AIDS: Resilient coping skills. Int J Nurs Pract 2008; 14:122-8. [DOI: 10.1111/j.1440-172x.2008.00675.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Hughes BM. Psychology, hospitalization and some thoughts on medical training. EUROPEAN JOURNAL OF PSYCHOTHERAPY & COUNSELLING 2001. [DOI: 10.1080/13642530110040109] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Shoptaw S, Stein JA, Rawson RA. Burnout in substance abuse counselors. Impact of environment, attitudes, and clients with HIV. J Subst Abuse Treat 2000; 19:117-26. [PMID: 10963923 DOI: 10.1016/s0740-5472(99)00106-3] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Due to associations between acquired immunodeficiency sydnrome (AIDS) and substance abuse, many substance abuse treatment counselors have clients with human immunodeficiency virus (HIV)/AIDS. We assess the contribution of various hypothesized predictors of burnout among 134 substance abuse counselors working with clients with HIV/AIDS. Counselors reported practice-related variables, including support from coworkers and supervisors, caseload, percentage of HIV-positive clients, and whether they worked at a methadone clinic, and personal characteristics of job efficacy and education. The three burnout dimensions were emotional exhaustion, depersonalization, and personal accomplishment. Emotional exhaustion was significantly predicted by less support, less efficacy, and working in a methadone clinic. Depersonalization was predicted by less efficacy, less support, and working in a methadone clinic. Personal accomplishment was predicted by having a lower percentage of clients with HIV/AIDS, and more efficacy, support, and education. We present empirically based suggestions for interventions that can prevent or limit burnout.
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Affiliation(s)
- S Shoptaw
- Matrix Center, 12304 Santa Monica Boulevard, Suite, 90025, Los Angeles, CA, USA.
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Kalichman SC, Gueritault-Chalvin V, Demi A. Sources of occupational stress and coping strategies among nurses working in AIDS care. J Assoc Nurses AIDS Care 2000; 11:31-7. [PMID: 10826302 DOI: 10.1016/s1055-3290(06)60274-4] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Nurses working in AIDS care experience high rates of occupational stress and therefore are vulnerable to emotional exhaustion and occupational burnout. This study surveyed 499 members of the Association of Nurses in AIDS Care regarding their work-related stress experiences and coping strategies for managing stress. Qualitative analyses identified a hierarchical structure of occupational stress, with two supraclusters representing workplace and patient care-related stress and eight specific subclusters of stressors: institutions, personnel, biohazards, death, informing patients, challenging patients, families, and treatment dilemmas. Analyses showed that nurses experiencing stress from their workplace were significantly more likely to use wishful thinking, planful problem solving, and avoidance as coping strategies, whereas stress originating from patient care was more likely to be dealt with using positive appraisal and acceptance. Interventions designed to assist nurses in managing occupational stress and to prevent occupational burnout must include the sources of work-related stress among nurses in AIDS care.
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Affiliation(s)
- S C Kalichman
- Center for AIDS Intervention Research (CAIR), Medical College of Wisconsin, Milwaukee 53226, USA.
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Schaufeli WB, Van Dierendonck D. A cautionary note about the cross-national and clinical validity of cut-off points for the Maslach Burnout Inventory. Psychol Rep 1995; 76:1083-90. [PMID: 7480470 DOI: 10.2466/pr0.1995.76.3c.1083] [Citation(s) in RCA: 129] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
In the present study, burnout scores of three samples, as measured with the Maslach Burnout Inventory, were compared: (1) the normative American sample from the test-manual (N = 10,067), (2) the normative Dutch sample (N = 3,892), and (3) a Dutch outpatient sample (N = 142). Generally, the highest burnout scores were found for the outpatient sample, followed by the American and Dutch normative samples, respectively. Slightly different patterns were noted for each of the three components. Probably sampling bias, i.e., the healthy worker effect, or cultural value patterns, i.e., femininity versus masculinity, might be responsible for the results. It is concluded that extreme caution is required when cut-off points are used to classify individuals by burnout scores; only nation-specific and clinically derived cut-off points should be employed.
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Affiliation(s)
- W B Schaufeli
- Department of Psychology, Utrecht University, The Netherlands
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Bennett L, Duke J. Research note: decision-making processes, ethical dilemmas and models of care in HIV/AIDS health care provision. SOCIOLOGY OF HEALTH & ILLNESS 1995; 17:109-119. [PMID: 11654309 DOI: 10.1111/1467-9566.ep10934498] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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