Relation and effect of resilience on burnout in nurses: A literature review and meta-analysis

Burnout combating strategies, triggers, implications, and self-coping mechanisms among nurses working in Saudi Arabia: a multicenter, mixed methods study

BACKGROUND

The World Health Organization (WHO) has defined burnout as an occupational phenomenon resulting from unsuccessfully managed chronic workplace stress. The well-being of healthcare professionals is the foundation for the health of patients and organizations. In Saudi Arabia, nursing plays a pivotal role in the healthcare sector, with both local and expatriate nurses taking part in various clinical and high-pressure services. However, rapid growth in healthcare facilities, staff shortages, and patient loads are adversely impacting stress levels among nurses.

METHODS

This study used a mix of research methods to survey 1,747 nurses (with a 90% response rate) from three major hospitals (King Fahad Medical City, King Saud Medical City, and King Faisal Specialist Hospital and Research Center), two smaller hospitals (Prince Mohammed Bin Abdulaziz Hospital and Al Habib Medical Group (HMG)-Al Suwaidi Hospital branch), and five primary healthcare centers, selecting participants randomly. Survey questionnaires collected data to evaluate the significance of the proposed burnout-combating strategies in relation to nursing administration, workload, and hospital administration responsibilities. Qualitative data were gathered through semi-structured interviews with 90 nurses to investigate and explore burnout triggers, implications, and coping mechanisms.

FINDINGS

A majority of the nurses (87.9%) indicated that assessing their needs and listening to their feedback could help them manage and prevent burnout. In comparison, 89.7% believed that their leaders should enhance the work environment and conditions, while 87% suggested adjusting the nurse-to-patient ratio to improve patient satisfaction. Conversely, 6.8% of the participants held a negative perception that each additional patient per nurse was associated with an increase in the mortality rate, whereas 3.4% felt that granting nurses more control over their schedules and conducting departmental meetings to discuss health could help alleviate work pressure. We identified three themes: factors that trigger burnout symptoms, the implications of burnout, and suggested coping mechanisms. Additionally, they highlighted the prevalence and likelihood of burnout triggers, implications, and coping strategies, providing critical insights for nurse leaders, workload management, and hospital administrators.

CONCLUSION

Nurse leaders, along with workload management strategies and hospital administrators, play a crucial role in mitigating and overcoming burnout. Establishing a healthy work environment is recognized as the most effective strategy for combating burnout, followed by implementing mental health education and training programs to enhance adaptive and cognitive resilience, promote health improvement, and strengthen resistance to burnout. Further research is needed to evaluate the effectiveness of these coping strategies for other healthcare professionals and to explore how cultural diversity, religious beliefs, and social factors may influence burnout triggers, consequences, and the development of self-coping mechanisms.

IMPLICATIONS FOR PRACTICE

Healthcare leaders should remain vigilant and prioritize strengthening resilience in hospital settings. Changes in institutional policies are essential to upholding suitable staffing ratios to reduce workload stress, implementing equitable scheduling practices to enhance work-life balance, and ensuring consistent, uninterrupted breaks to promote mental and physical rejuvenation. Organizations must implement policies that directly address the factors contributing to burnout.

CLINICAL TRIAL NUMBER

Not applicable.

Shift Type and Resilience Training Effect on Nurse Outcomes

BACKGROUND

Nursing shift work disrupts circadian rhythms, negatively impacting physical and mental health. Night shift workers face the added challenge of shift work disorder. Resilience training may help mitigate these effects and improve perceived organizational support.

OBJECTIVE

We aimed to examine the effect of the Community Resilience Model® training on outcomes (ie, perception of organizational support, resilience, burnout, distress, and intention to leave) among shift workers at an academic medical center while exploring differences in demographics, work characteristics, and outcomes by shift type (day vs night).

METHODS

Training was offered to all nursing roles. Work characteristics, demographics, and nurse outcomes were collected via an online survey. Binomial logistic regressions were conducted for all outcomes.

RESULTS

Of our sampling (N = 878), 52.6% were nurse staff, 23% usually worked night shifts, and 28% attended training. Night shift workers reported significantly lower perceptions of organizational support (P = .03) and resilience (P = .005). Over 55% of night shift workers reported burnout compared to 45% of day shift workers. Sixty-three percent of night and 51% of day shift workers were distressed (P = .002). Training attendees reported significantly higher perceptions of organizational support. Participants reporting higher perceived organizational support also reported less burnout, distress, and intention to leave.

CONCLUSION

Participants in resilience training rated higher perceptions of organizational support, particularly among night shift workers, who reported lower support, resilience, and higher burnout and distress. These results suggest that resilience training may benefit night shift workers by enhancing support and reducing negative outcomes.

Resilience enhancement interventions for disaster rescue workers: a systematic review

Resilience is defined as the ability of individuals to adapt to stress and adversity. In recent years, the concept of resilience in the context of disaster, particularly that of disaster rescue workers, has received considerable attention from academic researchers, disaster response organizations, and policymakers involved in disaster management. This systematic review aimed to identify interventions designed to enhance the resilience of disaster rescue workers. A systematic search was conducted from inception to January 31, 2024, in ten electronic databases: ISI Web of Science, Scopus, PubMed, MEDLINE (Ovid), Embase, Cochrane Library, CINAHL, PILOTS, PsycInfo, and the CNKI. A manual search of the reference lists of the included articles and an author search were conducted to identify additional relevant literature. A total of 22 studies that aimed to enhance resilience among disaster rescue workers were included in this review. These interventions focused on resilience-related knowledge and skills, stress and energy management, coping strategies, mindfulness, and psychological first aid. The duration of these interventions ranged from 1 to 24 h within 8 weeks, with sessions conducted in-person or online in group formats. Individual resilience, coping, social support, mindfulness, and burnout improvements were reported. The most common types of interventions were psychoeducation, followed by mindfulness-based training. However, the methodological quality of these interventions was generally sub-optimal. A well-designed intervention study is needed to enhance the resilience of disaster rescue workers.

Cultivating Resilience: Meta-Analysis of Mindfulness-Based Training for Nurse Stress and Burnout Mitigation

PURPOSE

The current meta-analysis sought to evaluate the effectiveness of mindfulness-based training (MBT) in alleviating stress and burnout among nurses, providing critical insights for their support and management in clinical environments.

METHOD

A literature review was conducted from April 15 to June 20, 2024, across various databases. Inclusion criteria were randomized controlled trials (RCTs) that examined the influence of MBT on stress and burnout in nurses. A meta-analysis was performed to synthesize results.

RESULTS

Ten RCTs, involving 912 nurses, were included, with 455 individuals participating in MBT. Aggregated data revealed that MBT reduced stress levels (standardized mean difference [SMD] = -0.99, 95% confidence interval [CI] [-1.38, -0.60]; p < 0.001) and job burnout (SMD = -0.45, 95% CI [-0.76, -0.14]; p = 0.005) among nurses. In addition, Egger's regression test did not detect any publication bias within the consolidated findings.

CONCLUSION

Results of our investigation underscore the high efficacy of MBT in mitigating stress and burnout among nursing professionals. Although our data suggest that MBT offers a promising short-term strategy for addressing these challenges, further research is needed to assess the durability of its effects and sustainability of its benefits. [Journal of Psychosocial Nursing and Mental Health Services, xx(x), xx-xx.].

Predictors of nurses' work-related mental health during the COVID-19 pandemic: a paired follow-up study

Nurses are essential pillars of society, providing care for the sick. It is crucial for society to ensure that nurses have favorable working conditions, as they face a heightened risk of negative psychological conditions such as depression, anxiety, stress, and emotional exhaustion due to the demanding nature of their work. The strain on healthcare staff, particularly during the COVID-19 pandemic, has underscored these challenges. This study aimed to identify predictors of work-related mental health issues in nurses' work environments. In 2017, a questionnaire was distributed to 9,219 Swedish nurses, with 4,962 responses received. The questionnaire was redistributed during the pandemic in 2020, and 3,107 nurses responded. However, due to missing data and some nurses previously reporting a mental health diagnosis, only 2,030 questionnaires were included in the study. Among these, 143 nurses reported experiencing work-related mental health problems. The data was analyzed by logistic regression analysis, and 6 out of the 24 statements investigated were statistically significant (p < 0.05), i.e., there was a longitudinal association between nurses' work situation and their mental health problems. The six statements were "I do not feel I get enough rest/recuperation between work shifts", "The work pace in my daily work is too high", "I do not feel I have enough support from my coworkers", "I do not experience joy in my daily work", "I do not feel like my daily work is meaningful", and "I do not get enough opportunities at work to utilize my skills and knowledge".

Conclusions

This study revealed that work pace, recovery, support from colleagues, joy, meaningfulness, and development opportunities at work are particularly important for nurses' mental health. Actions in those areas are needed for nurses to have a sustainable work situation.

Assessing the Impact of Burnout on Nurse Safety Behaviors and Patient Safety Competence: A Latent Profile Analysis Study

Aim: This study examines the association between burnout, nurse safety behaviors, and patient safety competency among nurses working in cancer hospitals using person-centered and variable-centered methodologies. Background: Burnout is prevalent among nurses worldwide, with cancer hospital nurses exhibiting high levels of burnout. Burnout correlates with a higher incidence of adverse events and diminished patient safety. Nurse safety behaviors and patient safety competency play protective roles in ensuring patient safety. Methods: This study used a cross-sectional online survey and included 2092 eligible nurses, with 95.0% being female. We invited nurses from cancer hospitals in 12 provinces in China to complete an online survey from April to June 2023. Through the online Questionnaire Star platform, invited nurses provided demographic information and completed the Maslach Burnout Inventory, the Nurse Safety Behaviors Scale, and the Patient Safety Competency Scale. Latent profile analysis was used to identify heterogeneous characteristics of nurse burnout. Results: From a person-centered perspective, nurse burnout was categorized into three latent profiles: "high achievement stable type" (70.3%), "high-efficiency contradictory type" (6.6%), and "high-pressure adaptive type" (23.1%). From a variable-centered perspective, patient safety competency partially mediated the relationship between burnout profiles and nurse safety behaviors. Conclusion: This study identified three heterogeneous latent profiles of burnout among cancer hospital nurses and highlighted the significant impact of excessive working hours and lack of safety training on burnout across different job titles and income levels. Additionally, it verified the mediation effect of patient safety competency between burnout profiles and nurse safety behaviors. Future treatments should focus on high-risk populations by offering improved safety training and suitable work schedules to reduce burnout. Furthermore, personalized measures to enhance nurses' safety competencies should be adopted to improve burnout and safety behaviors. This study integrates person-centered and variable-centered methods, offering new insights and underscoring the critical role of safety in mitigating burnout.

Psychological resilience as a mediator between nurse faculty support and student nurses' clinical adjustment: Implications for nursing education

BACKGROUND

Nurse faculty play a critical role in shaping the clinical experience of student nurses through their support and guidance during clinical placements. However, despite this evidence, the mechanism by which nurse faculty support contributes to effective clinical adjustment in students remains unexplored.

PURPOSE

This study examined the intermediary role of psychological resilience in the relationship between nurse faculty support and clinical adjustment among student nurses.

METHODS

This correlational study involved 506 student nurses from nursing schools in the Philippines. Three standardized scales were used to collect data, including the Nurse Faculty Support Scale (NFSS), Clinical Adjustment Scale - Student Nurse Version (CAS-SN), and the Brief Resilient Scale (BRS).

RESULTS

Students perceived high levels of nurse faculty support, moderate to high levels of resilience, and an overall positive clinical adjustment. Nurse faculty support had a direct and positive effect on clinical adjustment (β = 0.406, p < .001). Psychological resilience partially mediated (β = 0.0321, p < .05) the relationship between nurse faculty support and clinical adjustment.

CONCLUSION

Adequate nurse faculty support was associated with increased psychological resilience in student nurses, which, in turn, enhances their adjustment in the clinical area. Fostering supportive relationships and implementing resilience-building strategies within nurse education programs can contribute to students' successful adaptation to the demands of clinical practice.

Community-based health programme for nurses and midwives: A mixed methods evaluation

AIM

To evaluate a community-based psychological health and well-being programme for nurses and midwives.

DESIGN

Mixed methods programme evaluation.

METHODS

Four studies were included: observational descriptive study (cross-sectional survey) of the health, well-being and experiences of previous programme participants (Study 1); observational exploratory prospective cohort study (longitudinal survey) of health, well-being and experiences of participants who engaged in the programme from 2020 to 2023 (Study 2); qualitative descriptive study (interviews) of experiences and perceptions of nurses and midwives who have engaged with the programme as participants or clinicians (Study 3); observational descriptive study (cross-sectional survey) of experiences and perceptions of programme stakeholders (Study 4). Surveys included validated measures. Data were collected online. Descriptive, repeated measures and thematic analyses were conducted.

RESULTS

One-hundred and fifteen participants completed Study 1: 20% (n = 23) reported stress in the severe-to-extremely severe category; 22% (n = 25) reported psychological distress in the moderate-to-severe category. Thirty-one programme participants were followed in Study 2: the effect of the programme on participant well-being over time was not significant. Sixteen programme participants and eight programme clinicians were interviewed (Study 3). Experiences of nurses and midwives engaging with the programme were highly positive and strong attributes of the programme included (1) shared professional experience of clinicians and participants which supported a common language and facilitated understanding, and (2) effective programme leadership, and autonomy and flexibility in the clinicians' role which enabled and supported a positive working experience. Thirty-nine broader stakeholders participated in a cross-sectional survey (Study 4). All stakeholders reported high satisfaction with the programme. Participants considered the programme being 'by nurses and midwives, for nurses and midwives' critical to the programme's success and value.

CONCLUSIONS

The community-based psychological health and well-being programme developed, led and delivered by nurses and midwives, for nurses and midwives, was a highly valued resource.

IMPACT

Levels of stress and burnout in the health workforce are high. A community-based psychological health and well-being programme for nurses and midwives was found to be an important and highly valued resource for nurses and midwives. A programme delivered by nurses and midwives, for nurses and midwives, was considered critical to programme success. Programme leadership, and autonomy and flexibility in the programme clinicians' roles, facilitated and supported a positive working experience for programme clinicians.

IMPLICATIONS FOR THE PROFESSION AND PATIENT CARE

Quality and safety in patient care is directly impacted by the well-being of nurse and midwives. A community-based psychological health and well-being programme for nurses and midwives was found to be an important and highly valued resource for nurses and midwives.

REPORTING METHOD

Survey findings were reported according to STROBE (von Elm et al. in Lancet, 370:1453-1457, 2007) and qualitative findings according to COREQ (Tong et al. in International Journal for Quality in Health Care, 19(6):349-357, 2007).

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Development and psychometric testing of the psychological capital questionnaire for nurses

BACKGROUND

Psychological capital (PsyCap) is a positive internal resource for individuals, playing a crucial role in mental health. Evaluating nurses' psychological capital is important for understanding their mental well-being, as they face unique occupational stressors. However, existing PsyCap questionnaires are developed for various other professions such as enterprise employees, teachers, patients, teenagers, and civil servants, making them less suitable for the nursing profession. The main aim of this study is to develop and validate a Psychological Capital Questionnaire specifically tailored to the nursing occupation in Chinese clinical settings.

METHODS

This is a multi-stage, cross-sectional study conducted between March 2022 and May 2023. Preliminary items of the scale were generated through a literature review, theoretical research, and the Delphi method. The final questionnaire was validated through two rounds of data collection. In the first stage, 236 nurses were selected using purposive sampling for item analysis, exploratory factor analysis (EFA)and reliability testing. In the second stage, data were collected from 494 nurses using convenience sampling to conduct confirmatory factor analysis (CFA).

RESULTS

The final questionnaire contains 30 items, with six factors extracted by EFA, accounting for 77.59% of the total variance. The confirmatory factor analysis showed good model fit, with the following indices: χ²/df = 4.052, GFI = 0.836, CFI = 0.938, TLI = 0.926, NFI = 0.919, RMSEA = 0.079, RMR = 0.030. The reliability measures were high, with a Cronbach's α of 0.976, split-half coefficient of 0.976, and test-retest reliability of 0.941 and 0.963.

CONCLUSIONS

The Psychological Capital Questionnaire for Nurses exhibits strong psychometric properties, making it a valuable tool for assessing the psychological capital of nurses in Chinese clinical settings.

Relationship between psychological capital and nursing burnout: A systematic review and meta-analysis

AIM

This systematic review and meta-analysis aimed to analyze studies that examined the relationship between psychological capital and burnout in registered nurses.

BACKGROUND AND INTRODUCTION

Registered nurses are subject to high rates of burnout, with negative consequences on health, well-being, and quality of care. Psychological capital could be an important element in preventing or reducing this condition.

METHODS

This research is based on the Joanna Briggs Institute Guidelines and Preferred Reporting Items for systematic reviews and meta-analysis. A total of 180 studies on psychological capital and burnout were retrieved from Web of Science, Scopus, PubMed, Medline, and PsycINFO. The articles were written in English, Spanish, French, and Portuguese. Then, 23 studies were included in several meta-analyses (random-effects models) performed with the R statistical program.

RESULTS

Analysis of the 23 studies revealed that psychological capital and burnout are significantly correlated. The Psychological Capital Questionnaire (PCQ) and the Maslach Burnout Inventory (MBI) were the most used scales to measure psychological capital and burnout, respectively. The meta-analyses showed an inverse correlation between psychological capital and burnout (r = -0.44, 95% CI [-0.51, -0.36], n = 6092), and emotional exhaustion (r = -0.32, 95% CI [-0.42, -0.21], n = 3349).

CONCLUSION

This review provides evidence of the negative relationship between psychological capital and burnout in registered nurses. Therefore, enhancing psychological capital is an effective strategy to prevent and reduce burnout in nurses.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

Psychological capital is a personal resource open to development over time and susceptible to interventions aimed at promoting optimism, efficacy, hope, and resilience. In that sense, training aimed at improving psychological capital, as a protective mechanism to prevent and reduce burnout and emotional exhaustion, should be considered together with organizational measures to promote nurses' health and well-being.

Organizational resilience and primary care nurses' work conditions and well-being: a multilevel empirical study in China

Resilience is crucial for a health system to better prevent and respond to public health threats and provide high-quality services. Despite the growing interest in the concept of resilience in health care, however, there is little empirical evidence of the impact of organizational resilience, especially in primary care settings. As the largest professional group in primary care, primary care nurses are taking more and more responsibilities during their daily practice, which influences both their work conditions and well-being. This study aims to examine the association between organizational resilience and primary care nurses' working conditions and well-being. Using a convenience sampling approach, we recruited 175 primary care nurses from 38 community health centres (CHCs) in four cities in China. Organizational resilience was operationalized as comprising two domains: adaptive capacity and planning capacity, and measured using a 16-item scale. The primary care nurses' working condition indicators comprised variables of psychological safety, organizational commitment, professional commitment, and self-directed learning; well-being indicators included depression and burn-out. Hierarchical linear regression models were built for analysis. We found that the sampled CHCs have a relatively high level of organizational resilience. The organizational resilience was positively associated with the four indicators of working conditions: psychological safety (β = 0.04, P < 0.01), organizational commitment (β = 0.38, P < 0.01), professional commitment (β = 0.39, P < 0.01), and self-directed learning (β = 0.28, P < 0.01). However, organizational resilience was not significantly associated with the two well-being indicators. Furthermore, we found that the adaptive capacity has stronger association compared with planning capacity. Therefore, primary care manager should build resilient organizations, especially the adaptive capacity, in order to enhance primary care nurses' psychological safety, commitment and learning behaviours. Further studies should also be conducted to understand the link between organizational resilience and primary care nurses' well-being.

Nurse Burnout and Patient Safety, Satisfaction, and Quality of Care: A Systematic Review and Meta-Analysis

Importance

Occupational burnout syndrome is characterized by emotional exhaustion, depersonalization, and a diminished sense of personal accomplishment and is prevalent among nurses. Although previous meta-analyses have explored the correlates of nurse burnout, none have estimated their association with health care quality and safety and patient morbidity and mortality.

Objective

To evaluate the magnitude and moderators of the association between nurse burnout and patient safety, patient satisfaction, and quality of care.

Data Source

The Web of Science, Scopus, MEDLINE, Embase, PsycINFO, CINAHL, and ProQuest databases were searched from January 1, 1994, to February 29, 2024.

Study Selection

Two reviewers independently identified studies that reported a quantifiable association between nurse burnout and any of the outcomes of patient safety, patient satisfaction, or quality of health care.

Data Extraction and Synthesis

The PRISMA 2020 guideline was followed. Two reviewers independently extracted the standardized mean difference (SMD) (Cohen d) estimates for a random-effects meta-analysis. Subgroup analyses and meta-regressions were conducted using prespecified variables.

Main Outcomes and Measures

Any measure of patient safety, patient satisfaction, or quality of health care previously associated with nurse burnout.

Results

A total of 85 studies (81 cross-sectional and 4 longitudinal) involving 288 581 nurses from 32 countries (mean [SD] age, 33.9 (2.1) years; 82.7% female; mean [SD] burnout prevalence rate with study-specific ascertainments, 30.7% [9.7%]) were included. Nurse burnout was associated with a lower safety climate or culture (SMD, -0.68; 95% CI, -0.83 to -0.54), lower safety grade (SMD, -0.53; 95% CI, -0.72 to -0.34), and more frequent nosocomial infections (SMD, -0.20; 95% CI, -0.36 to -0.04), patient falls (SMD, -0.12; 95% CI, -0.22 to -0.03), medication errors (SMD, -0.30; 95% CI, -0.48 to -0.11), adverse events or patient safety incidents (SMD, -0.42; 95% CI, -0.76 to -0.07), and missed care or care left undone (SMD, -0.58; 95% CI, -0.91 to -0.26) but not with the frequency of pressure ulcers. Nurse burnout was also associated with lower patient satisfaction ratings (SMD, -0.51; 95% CI, -0.86 to -0.17) but not with the frequencies of patient complaints or patient abuse. Finally, nurse burnout was associated with lower nurse-assessed quality of care (SMD, -0.44; 95% CI, -0.57 to -0.30) but not with standardized mortality rate. The associations were consistent across nurses' age, sex, work experience, and geography and persistent over time. For patient safety outcomes, the association was smaller for the low personal accomplishment subcomponent of burnout than for emotional exhaustion or depersonalization, as well as for nurses with a college education.

Conclusions and Relevance

In this systematic review and meta-analysis, nurse burnout was found to be associated with lower health care quality and safety and lower patient satisfaction. This association was consistent across nurse and study characteristics.

Resilience after adversity: an umbrella review of adversity protective factors and resilience-promoting interventions

Introduction

Resilience is the dynamic adaptive process of maintaining or recovering mental health from stressors, such as trauma, challenging life circumstances, critical transitions, or physical illnesses. Resilience after adversity can be fostered through protective factors and the implementation of interventions that promote resilience. Hence, it is essential to investigate both protective and vulnerable factors to reduce the negative effects of unfavorable life events and increase resilience through positive risk-response interventions.

Objective

To assess the effect of previous adversity, protecting factors, and resilience-promoting interventions to possess resilience after adversity in a global context.

Methods

The study included English language articles sourced from PubMed, Embase, Scopus, Web of Sciences, the Cochrane Database of Systematic Reviews, Scopus, and Google Scholar published before 15 April 2024. These articles reported the effect of adversity, protecting factors, and/or resilience-promoting interventions to possess resilience after adversity in a global context without a population age limitation. The quality of the included studies was assessed using the Assessment of Multiple Systematic Reviews. A weighted inverse-variance random-effects model was applied to find the pooled estimates. The subgroup analysis, heterogeneity, publication bias, and sensitivity analysis were also assessed.

Results

A total of 44 articles (n = 556,920 participants) were included in this umbrella review. From the random-effects model analysis, the pooled effect of adversity on the development of resilience was 0.25 (p < 0.001). The pooled effects of adversity-protective factors and resilience-promoting interventions after adversity were 0.31 (p < 0.001) and 0.42 (p < 0.001), respectively. The pooled effects of specific adversity protective factors were 0.26, 0.09, 0.05, 0.34, 0.23, and 0.43 for the availability of support, cognitive ability, community cohesion, positive self-perception, religious involvement, and self-regulation, respectively. The pooled effects of specific resilience-promoting interventions were 0.30, 0.21, 0.51, and 0.52 for cognitive behavior therapy (CBT) interventions, mindfulness-based interventions, mixed interventions, and resilience-promoting interventions, respectively.

Conclusion

The findings of this umbrella review revealed that people who experienced early adversity can develop resilience later in life. The study highlights the need to consider adversity protective factors, such as availability of support (family, friends, and school), cognitive ability, community cohesion, positive self-perception, religious involvement, and self-regulation, and resilience-promoting interventions, including CBT interventions, mindfulness-based interventions, and mixed interventions, to enhance resilience promotion programs.

Burnout and Well-Being in Trainees: Findings From a National Survey of US Obstetrics and Gynecology Residents

Background Despite national attention on resident well-being, challenges persist. Effective solutions require greater understanding of personal and program factors. Objective To explore burnout, resilience, self-reported mental health, and perceptions of the learning environment in a national sample of obstetrics and gynecology (OB/GYN) residents. Methods An observational cross-sectional survey of OB/GYN residents taking the January 2022 national in-training examination included an abbreviated 2-item Maslach Burnout Inventory, a short version of the Connor-Davidson Resilience Scale, and subjective experience of other factors. Kruskal-Wallis and chi-square tests explored differences in outcomes and associations between variables. Results Among 5761 residents taking the examination, 3741 (64.9%) participated, with 2425 of 3741 (64.8%) reporting burnout, 2138 (57.2%) depression, 2651 (70.9%) anxiety, and 147 (3.9%) suicidal ideation. Women fared worse than men in terms of burnout (2105 of 3147, 66.9% vs 281 of 496, 56.7%, P<.001), depression (1843 of 3147, 58.6% vs 256 of 496, 51.6%, P=.004), anxiety (2318 of 3147, 73.7% vs 294 of 496, 59.3%, P<.001), and resilience (5.9±2.1 vs 6.2±2.1, P=.006). More nonbinary residents considered leaving residency (17 of 49, 34.7% vs 676 of 3147, 21.5% [women] and 108 of 496, 21.8% [men], P=.008). Race-based differences were seen in depression, suicidal ideation, and thoughts of leaving residency. Increased binge drinking was reported with increasing postgraduate year. Among 614 residents reporting that well-being was not a priority in their program, 539 of 614 (87.8%) reported burnout, 469 of 614 (76.4%) depression, and 508 of 614 (82.7%) anxiety. Conclusions Residents report high rates of mental health concerns, and these are worse among women, gender nonconforming individuals, Black residents, and those who perceive well-being is not a priority in their training program.

Past the tipping point: Understanding and addressing burnout among nursing students

Burnout is a widespread concern in healthcare, with nurses bearing a disproportionate burden among healthcare professionals. This epidemic of occupational stress has also affected nursing students, who face the external demands inherent in the profession. In this call-to-action paper, we conducted an extensive literature review exploring strategies aimed at mitigating burnout among nursing students, and offer recommendations for academic institutions, healthcare leaders, research funders, and political leaders, including both the civil service and elected leaders to support the advancement and sustainability of the nursing profession and its workforce.

Research hotspots and trends in healthcare workers' resilience: A bibliometric and visualized analysis

Background

The resilience of healthcare workers has gained increasing attention, yet comprehensive studies focusing on recent trends and developments are scarce. We conducted an extensive bibliometric analysis from inception to 2023 to address this gap.

Methods

Publications on healthcare workers' resilience were extracted from the Web of Science Core Collection database. Bibliometric analysis was conducted with CiteSpace, VOSviewer, and Scimago Graphica, focusing on annual publications, country/region, institution, journal, author, keyword analysis, and reference co-citation analysis related to resilience in healthcare workers.

Results

The analysis included 750 documents, revealing a general upward trend in publications across 67 countries/regions, 1,251 institutions, and 3,166 authors. The USA and China emerged as the top contributors, with 192 and 168 publications, respectively. Based on keyword analysis and reference co-citation analysis, the focus areas include the Resilience Scale, the impact of the COVID-19 pandemic on HCWs and their resilience, and nurse resilience.

Conclusion

This study highlights the growing interest in healthcare workers' resilience by using bibliometric and visualization techniques for effective analysis. This paper will enhance scholars' understanding of the dynamic evolution of healthcare workers' resilience and identify emerging research topics.

The association between problematic internet use and burnout: A three-level meta-analysis

BACKGROUND

Burnout has received considerable attention in recent years because of the adverse consequences for people. Theoretical perspectives propose that problematic internet use is a significant potential risk for burnout. Despite a plethora of studies showing a positive association between problematic internet use and burnout, there remains a contentious debate regarding the extent and direction of this association.

METHODS

This study aims to perform a three-level meta-analysis to evaluate the strength of the relationship between problematic internet use and burnout through a quantitative synthesis of eligible studies published until April 2023.

RESULTS

A total of 42 studies with 54,121 participants and 103 effect sizes were identified. The results indicated a positive, moderate, and significant association between problematic internet use and burnout. Furthermore, the subgroup analysis found that this association was moderated by population, dimension of burnout, and the measure of burnout, however, some study features (i.e., region, type of problematic internet use, gender, and publication year) could not explain the heterogeneity across individual studies.

LIMITATIONS

Studies included in the current meta-analysis mainly used cross-sectional designs, which limited the potential to make inferences on the causal relationship between problematic internet use and burnout.

CONCLUSIONS

Individuals with problematic internet use have exhibited higher levels of burnout. Overall, these findings develop a deeper understanding of this association between problematic internet use and burnout and have implications for the direction of future research and interventions.

Assessment of burnout, resilience, and thriving among academic health professionals: findings from an international study

Introduction

Burnout, resilience, and thriving significantly impact academics, particularly in health professions, where responsibilities are extensive. This study aimed to explore these constructs among academic health professionals, examining sociodemographic and work-related factors influencing these outcomes.

Methods

A cross-sectional study was conducted among academic health professionals via web-based professional networks from August 2022 to February 2023. Validated tools were used, and descriptive and inferential statistics were applied.

Results

505 participants were included, predominantly female (63%), with a mean age of 38.15 ± 9.6 years. High burnout was reported by 10.9%, 13.7% experienced exhaustion, and 6.3% were disengaged. Resilience and thriving were moderate at 59.2 and 51.9%, respectively. Age correlated negatively with burnout (r = -0.131, p = 0.003) but positively with resilience (r = 0.178, p < 0.001). Females reported higher exhaustion (p = 0.014), while males showed greater resilience (p = 0.016). Instructors exhibited lower resilience compared to assistant professors (p < 0.001) and associate professors (p < 0.001). Those at public universities reported higher exhaustion than those at private universities (p < 0.001).

Conclusion

Variable levels of burnout, resilience, and thriving were observed among academic health professionals, influenced by sociodemographic and work-related factors. Interventions targeting resilience and thriving may mitigate burnout risk and enhance engagement among academics in health professions.