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Guo F, Han R, Luo T, Jin S, Yan Y, Wang J, Sun X, Gao C. Psychological Distress Was Still Serious Among Anesthesiologists Under the Post COVID-19 Era. Psychol Res Behav Manag 2022; 15:777-784. [PMID: 35368423 PMCID: PMC8974417 DOI: 10.2147/prbm.s357566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 03/12/2022] [Indexed: 12/04/2022] Open
Abstract
Purpose This study aims to evaluate the psychological status and the attitudes toward the novel coronavirus disease 2019 (COVID-19) vaccine among anesthesiologists. We expected to analyze related factors and offer them some strategies to prevent and manage psychological issues under the post COVID-19 era. Methods Based on the Checklist for Reporting Results of Internet E-Surveys (CHERRIES), an online survey was designed and conducted among anesthesiologists in Shaanxi, China. Participants were asked to complete a validated questionnaire voluntarily. The following tests were performed: Depression, Anxiety and Stress Scale (DASS-21), Primary Care Post-traumatic Stress Disorder Screen (PC-PTSD), and the attitudes toward COVID-19 vaccine. Results A total of 795 anesthesiologists completed the survey, the majority of them were female, young and middle-aged, well educated, and married. The prevalence of depression, anxiety, and stress in this sample were 26.5%, 35.5%, and 19.9%, respectively. Longer daily working time, concomitant basic chronic disease, and COVID-19 exposure were extracted as risk factors for the psychological symptoms, while vaccination, elder age, and married status were negatively associated with them. An unsatisfied vaccination rate (71.9%) which might be linked with inadequate awareness and perception of the COVID-19 vaccine was also detected in this study. Conclusion Anesthesiologists are still under rising pressure of psychological symptoms in the post COVID-19 era. It is imperative to afford continuous psychological support to them and ensure their mental health and professional performance.
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Affiliation(s)
- Fei Guo
- Department of Anesthesiology, The Second Affiliated Hospital of Air Force Medical University, Xi’an, People’s Republic of China
| | - Ruili Han
- Department of Anesthesiology, The Second Affiliated Hospital of Air Force Medical University, Xi’an, People’s Republic of China
| | - Ting Luo
- Department of Obstetrics and Gynecology, The Second Xiangya Hospital of Central South University, Changsha, People’s Republic of China
| | - Shengyang Jin
- Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Yuting Yan
- Department of Anesthesiology, The Second Affiliated Hospital of Air Force Medical University, Xi’an, People’s Republic of China
| | - Jun Wang
- Department of Anesthesiology, Shaanxi Provincial Armed Police Hospital, Xi’an, People’s Republic of China
| | - Xude Sun
- Department of Anesthesiology, The Second Affiliated Hospital of Air Force Medical University, Xi’an, People’s Republic of China
| | - Changjun Gao
- Department of Anesthesiology, The Second Affiliated Hospital of Air Force Medical University, Xi’an, People’s Republic of China
- Correspondence: Changjun Gao; Xude Sun, Department of Anesthesiology, The Second Affiliated Hospital of Air Force Medical University, Xi’an, 710038, People’s Republic of China, Tel +86-13379227869; +86-13891905550, Fax +86-029-84777439, Email ;
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Khan FA, Shamim MH, Ali L, Taqi A. Evaluation of Job Stress and Burnout Among Anesthesiologists Working in Academic Institutions in 2 Major Cities in Pakistan. Anesth Analg 2019; 128:789-795. [PMID: 30883424 DOI: 10.1213/ane.0000000000004046] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Work stress is an integral part of anesthetic practice and has been a subject of many studies. Persistent stress can lead to burnout. There is limited published literature from lower- and middle-income countries where job stressors may be different from high-income countries. The aim of this study was to find out the level of burnout in a cohort of anesthesiologists working in academic institutions in 2 major cities of Pakistan, a low middle income country. We conducted an anonymous survey based on the Maslach Burnout Inventory scale with 3 major components: emotional exhaustion; depersonalization; and burnout in personal achievement. The demographic and other work-related details were collected in a standardized manner. Our response rate was 74.5%. Seventy-seven percent of the participants were residents and 23% consultants. Gender distribution was 66.9% males and 33.1% females. Thirty-nine percent (95% CI, 34.8%-44.1%) showed moderate- to high-level emotional exhaustion, 68.4% (95% CI, 63.9%-72.7%) showed a moderate to high level of depersonalization, and 50.3% (95% CI, 45.6%-55.07%) showed a moderate to high level of burnout in personal achievements. On multivariable analysis, anesthesia not being the primary career choice was significantly associated with all 3-dimensional scales for the whole cohort. Factors significantly associated with emotional exhaustion were Lahore as city of work, >2 nights on call per week, and >40 h/wk work inside the operating room. Depersonalization burnout was again associated with Lahore as city of work, >40 h/wk work inside the operating room, and personal achievement burnout with >2 on-call nights per week. No association was observed for gender, marital status, or having children. In conclusion, a high rate of burnout was identified in anesthesiologists working in 2 major cities in Pakistan. Some new associated factors such as initial choice of specialty and city of work were highlighted. Based on these findings, preventive and coping strategies need to be introduced at institutional and national levels.
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Affiliation(s)
- Fauzia A Khan
- From the Department of Anaesthesiology, Faculty of Health Sciences, Medical College, Aga Khan University, Karachi, Pakistan
| | | | - Liaqat Ali
- Department of Anaesthesia, Allama Iqbal Medical College, Lahore, Pakistan
| | - Arshad Taqi
- Department of Anaesthesia, Rashid Lateef Medical College, Lahore, Pakistan
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Loh LWW, Lee JSE, Goy RWL. Exploring the impact of overnight call stress on anaesthesiology senior residents’ perceived ability to learn and teach in an Asian healthcare system: A qualitative study. TRENDS IN ANAESTHESIA AND CRITICAL CARE 2019. [DOI: 10.1016/j.tacc.2019.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Kim DD, Kimura Jr A, Pontes DKL, Oliveira MLS, Cumino DO. Evaluation of anesthesiologists' knowledge about occupational health: Pilot study. BMC Anesthesiol 2018; 18:193. [PMID: 30567562 PMCID: PMC6300909 DOI: 10.1186/s12871-018-0661-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 12/03/2018] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND An anesthesiologists' work presents with numerous occupational risks owing to the large amount of time spent inside the operating room where constant noise, anesthetic vapors, ionizing radiation, infectious agents, and psychological stress are present. Herein, we evaluated anesthesiologists' knowledge about occupational health. METHODS A cross-sectional study was conducted to assess 158 anesthesiologists from a tertiary hospital on their knowledge about occupational health using a structured questionnaire. RESULTS The survey revealed a lack of knowledge on the forms of prevention of occupational accidents (74.6% did not know how to act in case of a fire during surgery, 56% failed to identify the post-anesthesia care unit as the place with the highest contamination by inhalation anesthetics, and 42.7% failed to identify all personal protective equipment) and a surprisingly high rate of lack of observance of preventive measures (30.3% washed their hands before touching every patient, 52.5% did not use gloves during intravenous access, and 88.6% used protective equipment against ionizing radiation). CONCLUSIONS Despite improvements in safety standards in healthcare facilities, our research showed lack of knowledge about major topics on occupational health by physicians. Improving safety awareness is an important goal of training programs and continued medical education.
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Affiliation(s)
- Daniel Dongiu Kim
- Department of Anesthesiology, Irmandade da Santa Casa de Misericordia de Sao Paulo, Rua Dr. Cesario Motta Jr, 112, Sao Paulo, SP Brazil
| | - Aldemar Kimura Jr
- Department of Anesthesiology, Irmandade da Santa Casa de Misericordia de Sao Paulo, Rua Dr. Cesario Motta Jr, 112, Sao Paulo, SP Brazil
| | - Dayanne Karla Lopes Pontes
- Department of Anesthesiology, Irmandade da Santa Casa de Misericordia de Sao Paulo, Rua Dr. Cesario Motta Jr, 112, Sao Paulo, SP Brazil
| | - Maycon Luiz Silva Oliveira
- Department of Anesthesiology, Irmandade da Santa Casa de Misericordia de Sao Paulo, Rua Dr. Cesario Motta Jr, 112, Sao Paulo, SP Brazil
| | - Debora Oliveira Cumino
- Department of Anesthesiology, Irmandade da Santa Casa de Misericordia de Sao Paulo, Rua Dr. Cesario Motta Jr, 112, Sao Paulo, SP Brazil
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Spence J, Smith D, Wong A. Stress and burnout in anesthesia residency: an exploratory case study of peer support groups. QUALITATIVE RESEARCH IN MEDICINE & HEALTHCARE 2018. [DOI: 10.4081/qrmh.2018.7417] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Stress and burnout are alarmingly prevalent in anesthesiologists, with the highest risk occurring during anesthesia residency training. To better understand this phenomenon, we conducted a mixed methods case study of our anesthesia training program to explore the residents’ accounts of stress and burnout and the potential value of peer support groups. Eight out of thirty eight residents participated in nine monthly peer support group (PSG) meetings followed by a focus group interview about stress and burnout in training and the value of PSG. We compared the participants’ mean pre-and post-PSG Maslach Burnout Inventory® (MBI) and Perceived Stress Scale® (PSS) and analysed the focus group interview for recurring themes. We captured the perspectives of twenty seven out of thirty residents who did not participate in support groups (non-participants) through an online survey on stress and burnout. We found evidence of a high prevalence of stress and burnout from the MBI and PSS scores and survey responses. Analysis of the focus group interview showed that the specific stressors of anesthesia training included: an individually-based model of training that predisposes to isolation from peers, an over-reliance on the quality of the faculty-resident relationship and the critical, high stakes nature of the profession. Residents strongly endorsed the value of PSG in decreasing isolation, enhancing validation, and support through the sharing of experiences. Lack of dedicated time and integration into the training program were major barriers to PSG participation. These barriers need to be overcome in order to fully realize its role in mitigating stress and burnout.
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Sousa ARC, Mourão JIDB. Burnout in anesthesiology. BRAZILIAN JOURNAL OF ANESTHESIOLOGY (ENGLISH EDITION) 2018. [PMID: 30025945 PMCID: PMC9391711 DOI: 10.1016/j.bjane.2018.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Sousa ARC, Mourão JIDB. [Burnout in anesthesiology]. Rev Bras Anestesiol 2018; 68:507-517. [PMID: 30025945 DOI: 10.1016/j.bjan.2018.04.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 02/07/2018] [Accepted: 04/03/2018] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Burnout is a chronic condition caused by high levels of stress and anesthesiology is a stressful medical specialty with more vulnerability to burnout. The aim of this study is to review the characteristics and impact of burnout in anesthesiology. CONTENTS In this review, the stressors and risk factors, manifestations, assessment, complications, management and prevention of burnout as well as the inconsistent research found in the state-of-art are approached. CONCLUSIONS Anesthesiologists are in a high-risk group to develop burnout, with different manifestations and consequences such as suicide or medical errors. Although there is no specific treatment yet, there are a lot of helpful measures to cope this condition. Prevention is considered an important step in order to reduce the prevalence of burnout.
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Affiliation(s)
| | - Joana Irene de Barros Mourão
- Universidade do Porto, Faculdade de Medicina, Porto, Portugal; Centro Hospitalar São João, EPE, Departamento de Anestesiologia, Porto, Portugal
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Impact of disruptions on anaesthetic workflow during anaesthesia induction and patient positioning: A prospective study. Eur J Anaesthesiol 2018; 33:581-7. [PMID: 27227550 DOI: 10.1097/eja.0000000000000484] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Work disruption in operating rooms hinders flow of patients and increases chances of error. Previous studies have largely considered the types of disruption occurring in operating rooms, but have not analysed systematically the objective impact of disruption. OBJECTIVE The objective was to evaluate the impact of disruption on time efficiency in preoperative anaesthetic work in the operating room and to link disruption to failures in co-ordination of care. DESIGN Prospective, cross-sectional and observational study. SETTING Disruptions were evaluated in operating rooms of five hospitals across three countries: Australia (one community hospital, one teaching hospital); Thailand (two community hospitals); China (one teaching hospital). PARTICIPANTS The preoperative phase of anaesthesia induction/patient positioning of 64 surgical patients across specialities was prospectively evaluated (Australia = 33; Thailand = 12; China = 10). Further, interviews were carried out with 16 consultant anaesthetists and surgeons and 13 senior operating room nurses involved in the care of these patients. MAIN OUTCOME MEASURES Disruptions were identified by trained observers in real time during the preoperative phase; four types of care co-ordination problems were identified from the interviews with senior anaesthetists, surgeons and nurses, and linked to the disruptions. Descriptive analyses of time efficiency were performed. RESULTS Complete data were available from 55 cases. Good inter-observer agreement was obtained across measurements (range 74 to 92%). An average of three disruptions per case during the preoperative phase, were observed (range 2 to 9). 'Disruption types': disruptive staff activities were associated with most timewasting (median = 1 min per case, range 0 min 0 s to 4 min 45 s per case). 'Care co-ordination problems': co-ordination lapses within the operating room team, and between them and the preoperative team were associated with most timewasting (median = 1 min per case, range 0 min 0 s to 5 min 0 s per case). CONCLUSION The study quantifies time inefficiencies affecting anaesthetic work during the preoperative phase. Work disruption wastes time and is preventable.
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Röing M, Holmström IK, Larsson J. A Metasynthesis of Phenomenographic Articles on Understandings of Work Among Healthcare Professionals. QUALITATIVE HEALTH RESEARCH 2018; 28:273-291. [PMID: 28715988 DOI: 10.1177/1049732317719433] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Phenomenography is a qualitative research method based on the assumption that almost any phenomenon will be understood by a group of people in a limited number of ways. Our aim in this article was to identify the different ways work can be understood by healthcare professionals. In a world where the delivery of healthcare is continually changing, a metasynthesis of phenomenographic articles on healthcare professionals' understandings can provide knowledge about the focus and meaning of work for these individuals today. Our metaethnographic synthesis of 14 selected phenomenographic articles identified five different ways of understanding work, ranging from a limited to an all the more comprehensive view on patients and their needs. This range of understandings reveals problem areas and challenges facing healthcare professionals today. The possibility exists as well that limited understandings of work may be negative consequences of current demands for efficiency and all the more limited healthcare resources.
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Affiliation(s)
| | - Inger K Holmström
- 1 University of Uppsala, Uppsala, Sweden
- 2 Mälardalen University, Västerås, Sweden
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10
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Zhang HF, Li FX, Lei HY, Xu SY. Rising sudden death among anaesthesiologists in China. Br J Anaesth 2017; 119:167-169. [PMID: 28974077 DOI: 10.1093/bja/aex167] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- H-F Zhang
- Zhujiang Hospital of Southern Medical University, China
| | - F-X Li
- Zhujiang Hospital of Southern Medical University, China
| | - H-Y Lei
- Zhujiang Hospital of Southern Medical University, China
| | - S-Y Xu
- Zhujiang Hospital of Southern Medical University, China
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11
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Howe PW, Kumar K. A qualitative exploration of anesthesia trainees' experiences during transition to a children's hospital. Paediatr Anaesth 2017; 27:263-270. [PMID: 27878890 DOI: 10.1111/pan.13064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/31/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND The stresses of starting a new job can make anyone feel tired and inefficient. In health care, this may impair the ability to learn at a time when there is most to learn, and increase the risk of error in a context where errors may lead to patient harm. AIM The aim of this study was to understand issues which influence anesthesia trainees' transition to a pediatric setting. METHODS This qualitative study utilized in-depth semi-structured interviews to gather data from 31 anesthesia trainees who had commenced work at a tertiary children's hospital between 4 and 6 weeks previously. Data were examined using thematic analysis. RESULTS Two key themes were identified: feeling ineffective, which appeared to have both a cognitive component (feeling disoriented) and an emotional component (feeling useless), and feeling anxious or afraid. Trainees found the pediatric environment highly unfamiliar, which made them feel disoriented, inefficient, and at times incompetent. Many experienced difficulty identifying a useful role in a highly specialized area of practice, leading to loss of identity as an expert clinician. Many described an ever-present fear of making an anesthetic error or being unable to manage a rapidly evolving clinical situation. Some trainees developed a negative mindset, which was reinforced by subsequent perceived failures. Overall, these experiences impeded trainees' ability to concentrate and learn. CONCLUSIONS The impact of disorientation and anxiety on anesthesia trainees as they adapt to a highly specialized clinical environment such as a children's hospital should not be underestimated. Study findings illustrate the importance of helping new trainees to feel less afraid, more useful, and more realistic in assessing their own performance during the transition period.
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Affiliation(s)
- Peter W Howe
- Department of Anaesthesia, Royal Children's Hospital, Melbourne, Vic, Australia
| | - Koshila Kumar
- Flinders University Rural Clinical School, Flinders University, Adelaide, SA, Australia
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Evain JN, Zoric L, Mattatia L, Picard O, Ripart J, Cuvillon P. Residual anxiety after high fidelity simulation in anaesthesiology: An observational, prospective, pilot study. Anaesth Crit Care Pain Med 2016; 36:205-212. [PMID: 27867134 DOI: 10.1016/j.accpm.2016.09.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 08/30/2016] [Accepted: 09/26/2016] [Indexed: 11/18/2022]
Abstract
BACKGROUND High fidelity simulation (HFS) in anaesthesiology intentionally provides stress on students, but anxiety may be detrimental if it goes on through debriefing. The primary goal of this study was to estimate the proportion of students with significant anxiety remaining after debriefing (residual anxiety [RA]). Secondary goals were to evaluate the instructors' ability to estimate students' RA and to identify potential risk factors for high RA. SUBJECTS AND METHODS Following IRB approval and informed consent, data from a cohort of subjects were prospectively collected by an independent expert. State-anxiety after debriefing (RA) was prospectively measured using the State-Trait Anxiety Inventory (a score varying from 20 to 80/80). RA was considered significant when≥36/80. Instructors simultaneously estimated the levels of subjects' RA via a visual analogue scale. Data about subjects, stress during scenarios (including continuous heart rate monitoring), and debriefings (including DASH© quality scores) were also collected. RESULTS Seventy study subjects (30 residents, 26 nurses and 14 anaesthetists) were enrolled during 52 HFS sessions. As concerns the primary endpoint, RA was≥36/80 in 15 subjects (21%; 95% CI: 13-32). The median RA was 30/80 [25-35]. For secondary endpoints, the instructors' estimations poorly correlated with measurements: rho=0.36 (P<0.01); limits of agreement: -16 and 22. Subjects with RA≥36/80 had significantly higher trait-anxiety (P<0.01). An easy scenario (P=0.04) and low quality debriefing (P=0.04) were associated with higher RAs. CONCLUSION Most students experienced low anxiety after debriefing. Instructors seem to be unable to reliably estimate students' RA. Students with an anxious personality are more likely to be anxious after debriefing.
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Affiliation(s)
- Jean-Noël Evain
- Division anesthésie réanimation urgences douleur, groupe hospitalo-universitaire Carémeau, CHU de Nîmes, 30900 Nîmes, France; Centre de simulation médicale SIMHU-Nîmes, groupe hospitalo-universitaire Carémeau, CHU de Nîmes, 30900 Nîmes, France.
| | - Lana Zoric
- Division anesthésie réanimation urgences douleur, groupe hospitalo-universitaire Carémeau, CHU de Nîmes, 30900 Nîmes, France; Centre de simulation médicale SIMHU-Nîmes, groupe hospitalo-universitaire Carémeau, CHU de Nîmes, 30900 Nîmes, France
| | - Laurent Mattatia
- Division anesthésie réanimation urgences douleur, groupe hospitalo-universitaire Carémeau, CHU de Nîmes, 30900 Nîmes, France; Centre de simulation médicale SIMHU-Nîmes, groupe hospitalo-universitaire Carémeau, CHU de Nîmes, 30900 Nîmes, France
| | - Olivier Picard
- Division anesthésie réanimation urgences douleur, groupe hospitalo-universitaire Carémeau, CHU de Nîmes, 30900 Nîmes, France; Centre de simulation médicale SIMHU-Nîmes, groupe hospitalo-universitaire Carémeau, CHU de Nîmes, 30900 Nîmes, France
| | - Jacques Ripart
- Division anesthésie réanimation urgences douleur, groupe hospitalo-universitaire Carémeau, CHU de Nîmes, 30900 Nîmes, France; Centre de simulation médicale SIMHU-Nîmes, groupe hospitalo-universitaire Carémeau, CHU de Nîmes, 30900 Nîmes, France
| | - Philippe Cuvillon
- Division anesthésie réanimation urgences douleur, groupe hospitalo-universitaire Carémeau, CHU de Nîmes, 30900 Nîmes, France; Centre de simulation médicale SIMHU-Nîmes, groupe hospitalo-universitaire Carémeau, CHU de Nîmes, 30900 Nîmes, France
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Work stress and satisfaction in relation to personality profiles in a sample of Dutch anaesthesiologists. Eur J Anaesthesiol 2016; 33:800-806. [DOI: 10.1097/eja.0000000000000524] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Gouin A, Damm C, Wood G, Cartier S, Borel M, Villette-Baron K, Boet S, Compère V, Dureuil B. Evolution of stress in anaesthesia registrars with repeated simulated courses: An observational study. Anaesth Crit Care Pain Med 2016; 36:21-26. [PMID: 27338521 DOI: 10.1016/j.accpm.2016.02.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Revised: 02/20/2016] [Accepted: 02/23/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND AND OBJECTIVE High-fidelity medical simulation is a source of stress for participants. The aim of this study was to assess if repeated simulated courses decrease perceived stress and/or physiological stress level and increase performance in anaesthesiology registrars. METHOD Fourteen anaesthesiology specialty registrars participated individually in three successive sessions of crisis simulation in the operating room. Participants' perceived stress levels were measured by self-assessment (simple numerical scale from 0 to 10 [0=no stress, 10=maximum stress]) and physiological stress was estimated via the maximal heart rate measured by a Holter system). Technical and non-technical performances were also assessed. Data are expressed as medians with interquartile ranges and extremes (median (IQR [Min-Max])). RESULTS Between the first and third session, simulation repetition was associated with a decrease in perceived stress (9 (8-10 [5-10]) versus 7 (5-8 [2-9]) from session 1 to session 3 respectively, P=0.02), whereas physiological stress assessed by the maximum heart rate remained unchanged (130 beats per minute (116-141 [85-170]) and 123 beats per minute (115-136 [88-166]) between sessions 1 and 3 respectively). There was also a significant inverse correlation between perceived stress levels experienced by registrars during the session and non-technical performance (P=0.008). CONCLUSION We observed a reduction in perceived stress levels experienced by registrars while physiological stress was unchanged with repeating simulation sessions combining simulated practice and debriefing. Learning through simulation could improve perceived stress management in critical situations.
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Affiliation(s)
- Antoine Gouin
- Department of Anaesthesiology and Surgical Intensive Care, Rouen University Hospital and University of Rouen, 1, rue de Germont, 76000 Rouen, France.
| | - Cédric Damm
- Department of Anaesthesiology and Surgical Intensive Care, Rouen University Hospital and University of Rouen, 1, rue de Germont, 76000 Rouen, France.
| | - Grégory Wood
- Department of Anaesthesiology and Surgical Intensive Care, Rouen University Hospital and University of Rouen, 1, rue de Germont, 76000 Rouen, France.
| | - Sébastien Cartier
- Department of Anaesthesiology and Surgical Intensive Care, Rouen University Hospital and University of Rouen, 1, rue de Germont, 76000 Rouen, France.
| | - Marie Borel
- Department of Anaesthesiology and Surgical Intensive Care, AP-HP Groupe hospitalier Pitié-Salpêtrière, 75013 Paris, France.
| | - Karen Villette-Baron
- Department of Anaesthesiology and Surgical Intensive Care, Rouen University Hospital and University of Rouen, 1, rue de Germont, 76000 Rouen, France.
| | - Sylvain Boet
- Department of Anaesthesiology; The Ottawa Hospital Research Institute; University of Ottawa Skills and Simulation Centre (uOSSC) of The Ottawa Hospital & The Academy for Innovation in Medical Education, University of Ottawa, 501, Smyth Road, Ottawa, K1H 8L6, ON, Canada.
| | - Vincent Compère
- Department of Anaesthesiology and Surgical Intensive Care, Rouen University Hospital and University of Rouen, 1, rue de Germont, 76000 Rouen, France.
| | - Bertrand Dureuil
- Department of Anaesthesiology and Surgical Intensive Care, Rouen University Hospital and University of Rouen, 1, rue de Germont, 76000 Rouen, France.
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Roberts MJ, Gale TCE, McGrath JS, Wilson MR. Rising to the challenge: acute stress appraisals and selection centre performance in applicants to postgraduate specialty training in anaesthesia. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2016; 21:323-339. [PMID: 26271681 DOI: 10.1007/s10459-015-9629-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Accepted: 08/05/2015] [Indexed: 06/04/2023]
Abstract
The ability to work under pressure is a vital non-technical skill for doctors working in acute medical specialties. Individuals who evaluate potentially stressful situations as challenging rather than threatening may perform better under pressure and be more resilient to stress and burnout. Training programme recruitment processes provide an important opportunity to examine applicants' reactions to acute stress. In the context of multi-station selection centres for recruitment to anaesthesia training programmes, we investigated the factors influencing candidates' pre-station challenge/threat evaluations and the extent to which their evaluations predicted subsequent station performance. Candidates evaluated the perceived stress of upcoming stations using a measure of challenge/threat evaluation-the cognitive appraisal ratio (CAR)-and consented to release their demographic details and station scores. Using regression analyses we determined which candidate and station factors predicted variation in the CAR and whether, after accounting for these factors, the CAR predicted candidate performance in the station. The CAR was affected by the nature of the station and candidate gender, but not age, ethnicity, country of training or clinical experience. Candidates perceived stations involving work related tasks as more threatening. After controlling for candidates' demographic and professional profiles, the CAR significantly predicted station performance: 'challenge' evaluations were associated with better performance, though the effect was weak. Our selection centre model can help recruit prospective anaesthetists who are able to rise to the challenge of performing in stressful situations but results do not support the direct use of challenge/threat data for recruitment decisions.
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Affiliation(s)
- Martin J Roberts
- Collaboration for the Advancement of Medical Education Research and Assessment (CAMERA), Plymouth University Peninsula Schools of Medicine and Dentistry, Portland Square, Drake Circus, Plymouth, PL4 8AA, UK.
| | - Thomas C E Gale
- Collaboration for the Advancement of Medical Education Research and Assessment (CAMERA), Plymouth University Peninsula Schools of Medicine and Dentistry, Portland Square, Drake Circus, Plymouth, PL4 8AA, UK
- Department of Anaesthesia, Plymouth Hospitals NHS Trust, Plymouth, UK
| | - John S McGrath
- Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
- University of Exeter Medical School, Exeter, UK
| | - Mark R Wilson
- College of Life and Environmental Sciences, University of Exeter, Exeter, UK
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Psychological distress, burnout and personality traits in Dutch anaesthesiologists. Eur J Anaesthesiol 2016; 33:179-86. [DOI: 10.1097/eja.0000000000000375] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Transtornos mentais e do comportamento relacionados ao trabalho em médicos anestesiologistas. Braz J Anesthesiol 2015; 65:504-10. [DOI: 10.1016/j.bjan.2013.03.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Accepted: 03/20/2013] [Indexed: 11/21/2022] Open
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Andrade GO, Dantas RAA. Work-related mental and behaviour disorders in anesthesiologists. Braz J Anesthesiol 2015; 65:504-10. [PMID: 26614149 DOI: 10.1016/j.bjane.2013.03.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Accepted: 03/20/2013] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Anaesthesiology is a specialty whose specificity of the working process results in high levels of stress as an inevitable condition - a particularly worrying situation in the daily life of these professionals. OBJECTIVES This study, based on data from national and international literature, aims to discuss the basis of the occurrence of mental and behavioural disorders or of psychopathological injuries (psychological distress) related to working activity in anesthesiologists. METHOD A literature review was conducted, with papers selected from Medline and Lilacs databases, published between 2000 and 2012 in Portuguese, English and Spanish, and addressing the possible association between occupational hazards of the anaesthesiologist profession and mental health problems and psychic distress. Twenty-six publications were listed. RESULTS Several aspects of the anesthesiologist's work are important points to better understand the relationship between mental health at work and working organization. Poor temporal structuring of work, conflictuous interpersonal relationships and poor control over the activity itself may be mentioned as illness enhancers. CONCLUSION The working organization, when not appropriate, is an important occupational risk factor for the life and mental health of workers, mainly of professionals focused on the care of people. This paper focuses on anesthesiologists, who are constantly exposed to stressful and anxiogenic factors.
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Affiliation(s)
- Gabriela Oliveira Andrade
- Departamento de Medicina Preventiva e Social da Universidade Federal da Bahia (UFBA), Salvador, BA, Brazil.
| | - Rosa Amélia Andrade Dantas
- Universidade Federal da Bahia (UFBA), Salvador, BA, Brazil; Universidade Federal de Sergipe (UFS), São Cristóvão, Sergipe, Brazil
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Bauer J, Groneberg DA. [Stress and job satisfaction in the discipline of inpatient anesthesiology : results of a web-based survey]. Anaesthesist 2014; 63:32-40. [PMID: 24402510 DOI: 10.1007/s00101-013-2275-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Revised: 11/06/2013] [Accepted: 11/12/2013] [Indexed: 10/25/2022]
Abstract
BACKGROUND How do physicians in the specialty of anesthesiology perceive the working conditions regarding stress and job satisfaction? The health system in Germany has been confronted with a rapidly changing framework over the last 20 years: For example, an increased influence of economic patterns on the workflow and the medical decision of physicians has been established forcing them to always take the economic aspects into account. Moreover, a new generation (generation Y) of physicians with other requirements of the work place, meaning mainly a demand for a better work-life balance, has gained a foothold in hospitals. These changes make it very important to investigate the status quo of current working conditions. AIM Working conditions in hospitals in the specialty of anesthesiology is the main issue investigated in this study. METHODS For this study 1,321 completed online-questionnaires from physicians in hospitals with the specialty of anesthesiology were analyzed. The questionnaire was based on the stress theory, the effort-reward-imbalance model (ERI) and the job-demand-control model (JDC).The items used in the questionnaire were taken from the ERI questionnaire and the short questionnaire on work analysis (KFZA). By calculating a certain ratio of several items (according to the stress theory), the prevalence of distress could be measured. In addition the overall job satisfaction in the field of anesthesiology was measured and analyzed. RESULTS In this study 47.0 % (95 %-CI: 44.3-49.7 %) of all respondents showed signs of distress. Simultaneously, 61.8 % (95 %-CI: 59.2-64.5 %) were very satisfied with the job situation. Regarding gender, female physicians perceived a lower control of the work situation whereas male physicians perceived a much higher decision level. This led to a higher prevalence of distress in the group of female physicians regarding the JDC model (odds ratio, OR: 1.54, 95 %-CI: 1.19-2.01). Regarding age, the prevalence of distress increased from 36.5 % in the respondents under 35 years old to 50.7 % in those 35-59 years old (OR: 1.79, 95 %-CI: 1.38-2.32). Looking at the different functional positions in the hospital, senior doctors showed a much higher prevalence of distress (52.8 %) than junior doctors (OR: 1.57, 95 %-CI: 1.21-2.05). Analyzing job satisfaction with respect to the functional position, the highest significant proportion was shown by senior doctors (65.8 %). CONSEQUENCES This study revealed a high prevalence of unfavorable working conditions for anesthetists in hospitals. Taking the forthcoming shortage of qualified physicians in German hospitals into account, these results have to be considered as a cause for concern. Constant unfavorable working conditions have a negative effect on the mental and physical health of employees. Sooner or later a migration of qualified physicians abroad could be the consequence. To prevent a future shortage of qualified physicians and to make the hospital work place more appealing, working conditions have to be adapted to current needs and expectations of employees. The focus should be put on balanced working conditions according to stress models shown in this study.
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Affiliation(s)
- J Bauer
- Institut für Arbeitsmedizin, Sozialmedizin und Umweltmedizin, Goethe-Universität, Theodor-Stern-Kai 7, 60329, Frankfurt a. M., Deutschland,
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Orena EF, Caldiroli D, Cortellazzi P. Does the Maslach Burnout Inventory correlate with cognitive performance in anesthesia practitioners? A pilot study. Saudi J Anaesth 2013; 7:277-82. [PMID: 24015130 PMCID: PMC3757800 DOI: 10.4103/1658-354x.115351] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background: Chronic stress is a common condition among health-care operators, anesthetists in particular. It is known to cause cognitive weakening and pathological outcomes, as the Burnout syndrome. Nevertheless, the impact of clinicians’ health on their performance has received limited attention thus far. Our pilot study, aims at evaluating the influence of burnout on the cognitive performance in a population of anesthesia practitioners. Methods: In 18 practitioners we assessed attention by means of reaction times (RTs), pre- and post-shift, with a five-subtest computerized neuropsychological battery. RTs were controlled for the situational anxiety with the State-Trait Anxiety Inventory X1. The burnout level was evaluated with the Maslach Burnout Inventory (MBI). The three MBI sub-scores (emotional exhaustion, depersonalization and professional achievement) were combined to obtain two groups according to the burnout score (high and low). Results: Anesthetists showed a significantly worse performance in the fifth test post-shift (P=0.041) than pre-shift. The high-score burnout group reacted slower than the low-score burnout group in three of the five cognitive subtests, without reaching a statistical significance. Nevertheless, our effect size, which is independent from the sample size, is very large (d=1.165). Conclusion: We found that in a population of health-care operators, burnout may affect the cognitive and potentially, the working performance. Qualitative and quantitative measurements should be integrated to ensure a better management of burnout and its consequences in workplaces.
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Affiliation(s)
- Eleonora Francesca Orena
- Department of Neurosurgery, O. U. of Neuroanesthesia and Intensive Care, IRCCS Neurological Institute C. Besta of Milan, Italy
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Norris EM, Lockey AS. Human factors in resuscitation teaching. Resuscitation 2011; 83:423-7. [PMID: 22120456 DOI: 10.1016/j.resuscitation.2011.11.001] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2011] [Revised: 10/30/2011] [Accepted: 11/02/2011] [Indexed: 02/07/2023]
Abstract
INTRODUCTION There is an increasing interest in human factors within the healthcare environment reflecting the understanding of their impact on safety. The aim of this paper is to explore how human factors might be taught on resuscitation courses, and improve course outcomes in terms of improved mortality and morbidity for patients. The delivery of human factors training is important and this review explores the work that has been delivered already and areas for future research and teaching. METHOD Medline was searched using MESH terms Resuscitation as a Major concept and Patient or Leadership as core terms. The abstracts were read and 25 full length articles reviewed. RESULTS Critical incident reporting has shown four recurring problems: lack of organisation at an arrest, lack of equipment, non functioning equipment, and obstructions preventing good care. Of these, the first relates directly to the concept of human factors. Team dynamics for both team membership and leadership, management of stress, conflict and the role of debriefing are highlighted. Possible strategies for teaching them are discussed. CONCLUSIONS Four strategies for improving human factors training are discussed: team dynamics (including team membership and leadership behaviour), the influence of stress, debriefing, and conflict within teams. This review illustrates how human factor training might be integrated further into life support training without jeopardising the core content and lengthening the courses.
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Affiliation(s)
- Elizabeth M Norris
- Grandes Maisons Road, St Sampson's Medical Practice, Guernsey, Channel Islands GY2 4JS, United Kingdom.
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