Age, Sex, and Profession Difference Among Health Care Workers With Burnout and Metabolic Syndrome in Taiwan Tertiary Hospital-A Cross-Section Study

Background

This cross-sectional study aimed to analyze the association between burnout, work-related factors and metabolic syndrome (MetS) among various health-care workers (HCWs) at a tertiary hospital in Taiwan.

Methods

Relevant demographic data were obtained through written questionnaires. Information about psychosocial and work conditions, including assigned department, working hours, shifts, and sleep condition, was obtained. Burnout was evaluated according to the Chinese version of Maslach Burnout Inventory-Health Services Survey. MetS was analyzed according to the criteria of the National Cholesterol Education Program of Taiwan-Treatment Panel for Adults III.

Results

A total of 1,055 non-doctor/nurse and 2,078 doctor/nurse staff with a median age of 45.2 and 36.1 years participated in this study. The incidence of burnout was nearly 6.42 and 6.68% and that of MetS was 31.4 and 13.5% in non-doctor/nurse and doctor/nurse staff, respectively. The results showed that burnout induced a higher Odds ratio (OR) of MetS in the doctor/nurse group (OR = 1.96, p = 0.01). Other factors, such as night shift and seniority (>10 years), led to a higher OR of MetS, but a decreased risk was observed based on seniority (2-4 years). Further, young female participants and young doctors/nurses with burnout had a higher OR of MetS compare to other groups (OR = 2.43 and 2.32, p < 0.05).

Conclusion

The study results suggested positive relationship between burnout and MetS in young female staffs and young doctors/nurses. For doctor/nurse staff with higher seniority or more night shifts, strategies are needed to prevent burnout and MetS.

The prevalence of nurse burnout and its association with telomere length pre and during the COVID-19 pandemic

Background

Burnout is a work-related stress syndrome characterized by emotional exhaustion, depersonalization, and reduced personal accomplishment. Nurse burnout is related to nurses’ deteriorating mental health and poorer patient care quality and thus, is a significant concern in healthcare. The Coronavirus Disease 2019 (COVID-19) pandemic has swept the world and distressed the healthcare systems. Because of the body’s stress mechanism, it is vital to examine the current prevalence of nurse burnout and understand it at a biological level, using an epigenetic biomarker, telomere length.

Purpose

To determine the prevalence of burnout among nurses in the Peri-Operative and Labor & Delivery settings pre and during the COVID-19 pandemic and to examine the effects of burnout on absolute telomere length.

Methods

This is a cross-sectional study assessing the prevalence of nurses’ burnout and the relationships between nurses’ burnout and telomere length. Due to the COVID-19 pandemic, we had to stop the study during the mid of data collection. Even though the study was not designed to capture changes before and during the pandemic, we analyzed two groups’ data before and during the pandemic. The study took place in a US hospital. Nurses in the hospital’s Operating Room, Post-Anesthesia Care Unit, and Labor & Delivery Unit participated in the study. Maslach Burnout Inventory survey and nurses’ demographics were administered online. Telomere length was measured via finger-prick blood.

Results

146 nurses participated in the study, with 120 participants’ blood samples collected. The high-level burnout rate was 70.5%. Correlation analysis did not reveal a direct correlation between nurse burnout and telomere length. However, in a multiple regression analysis, the final model contained the burnout subscale of emotional exhaustion, years as an RN, and work unit’s nursing care quality. There was a low degree of departure from normality of the mean absolute telomere length in the pre-pandemic group and a substantial degree of departure in the during-pandemic group.

Conclusions

Nurse burnout is a prevalent phenomenon in healthcare, and this study indicates that nurses currently experience high levels of burnout. Nurses’ cellular biomarker, telomere length, is shorter in the group of nurses during the COVID-19 pandemic than before. Appropriate measures should be implemented to decrease nurses’ burnout symptoms and improve nurses’ psychological and physical health. Nurses, especially those younger than 60, report higher burnout symptoms, particularly emotional exhaustion. This study indicates the need for intervention to promote nurses’ health during the pandemic and beyond. If not appropriately managed, nurse burnout may continue to be a significant issue facing the healthcare system.

Mindful Self-Care Practice of Nurses in Acute Care: A Multisite Cross-Sectional Survey

Consistent mindful self-care practices mitigate professional burnout and improve resilience to enable nurses provide safe and effective patient care. This study determined the levels and the influencing factors of mindful self-care of nurses in acute care settings. Data were collected from a convenience sample of 258 nurses from seven acute care hospitals using the 36-item Mindful Self-Care Scale. Data were analyzed using descriptive and correlation analyses. Nurses' mindful self-care scores were low, and female nurses had higher levels of mindful self-care than male nurses. Statistically significant negative correlations were found between nurses' mindful self-care levels and their age and clinical experience. Nurses' engagement in mindful self-care is low which may negatively affect their interactions with and care of patients and their families. Therefore, a need exists to develop and evaluate more clinical-based personal and organizational strategies to enhance the mindful self-care practices of nurses.

Burnout among healthcare providers in the complex environment of the Middle East: a systematic review

BACKGROUND

Burnout is a syndrome characterized by emotional exhaustion, increased depersonalization, and a diminished sense of personal accomplishment due to chronic emotional stress at work. Burnout impacts job satisfaction, job performance, vulnerability to illnesses, and interpersonal relationships. There is a gap in the systematic data on the burden of burnout among healthcare professionals from different sectors of healthcare in Middle Eastern countries. Our objective was to examine the burden of burnout among healthcare providers in the Middle East, how it was assessed, which sectors were included, and what interventions have been used.

METHODS

Articles were found through a systematic review of search results including PubMed, Web of Science (Thomson Reuters), and PsycINFO (EBSCO) using search terms reflecting burnout in Middle Eastern countries among populations of healthcare providers. Studies were included if they examined a quantitative measure of burnout among healthcare providers in the Middle East.

RESULTS

There were 138 articles that met our inclusion criteria for this systematic review. Studies focused on burnout in the Middle East among physicians (N = 54 articles), nurses (N = 55), combined populations of healthcare workers (N = 22), and medical students (N = 7). The Maslach Burnout Inventory was the most common tool to measure burnout. Burnout is common among physicians, nurses, and other healthcare professionals, with prevalence estimates predominantly ranging between 40 and 60%. Burnout among healthcare providers in the Middle East is associated with characteristics of their work environments, exposure to violence and terror, and emotional distress and low social support.

CONCLUSIONS

Burnout is highly prevalent among healthcare providers across countries in the Middle East. Previous studies examining burnout in this region have limitations in their methodology. More thoroughly developed epidemiologic studies of burnout are necessary. Health system strengthening is needed in a region that has endured years of ongoing conflict, and there is an urgency to design and implement programs that tackle burnout among health professionals.

Potential correlates of burnout among general practitioners and residents in Hungary: the significant role of gender, age, dependant care and experience

BACKGROUND

Burnout is increasingly prevalent among general practitioners (GPs) in Hungary, which may lead to functional impairment and, subsequently, to poor quality of patient care. However, little is known about potential predictors of burnout among GPs. The aim of this study was to explore psychosocial correlates of burnout among GPs and residents in Hungary.

METHODS

We collected socio-demographic and work-related data with self-administered questionnaires in a cross-sectional study among GPs (N = 196) and residents (N = 154). We assessed burnout with the Maslach Burnout Inventory Human Services Survey (MBI-HSS) and calculated the mean level of burnout and the proportion of physicians suffering from low, intermediate and high degree of burnout. To identify potential socio-demographic and work-related correlates of burnout among physicians, we determined Spearman's and Mann-Whitney U correlation coefficients and conducted stepwise linear regression analyses. We deployed Mann-Whitney U test to explore gender disparity in the level of burnout between female and male physicians and between general practitioners and residents.

RESULTS

The prevalence of moderate to high level emotional exhaustion, depersonalisation, and impaired personal accomplishment was 34.7, 33.5 and 67.8% as well as 41.0, 43.1, and 71.1% among GPs and residents, respectively. Residents reported significantly lower level of personal accomplishment vs GPs. We identified a significantly higher level of depersonalization among male physicians compared to female physicians. Age correlated negatively with emotional exhaustion and depersonalization and positively with personal accomplishment among GPs. Dependant care was positively associated with burnout among female GPs. Female residents were more likely to report depersonalization. High workload was positively correlated with depersonalization among female GPs. Younger age emerged as the strongest predictor of emotional exhaustion. Male gender and fewer years of experience predicted depersonalization best, and male gender showed a significant predictive relationship with low personal accomplishment.

CONCLUSION

We identified specific socio-demographic and work-related correlates of burnout, which may guide the development of specific and effective organizational decisions to attenuate occupational stress and subsequent burnout as well as functional impairment among GPs, and thus, may improve the quality of patient care.

Preventing and Alleviating Compassion Fatigue Through Self-Care: An Educational Workshop for Nurses

Though various authors have refined and described the concept of compassion fatigue (CF), the overarching features, predisposing factors, and potential consequences remain relatively consistent. Available literature demonstrates that caregivers caring for patients who are chronically ill and/or traumatized are at highest risk for developing CF. Potential consequences for unmitigated CF include physical, emotional, and work-related consequences, all of which can have negative effects on the quality and safety of care and degree of engagement with one’s employer. CF is further exacerbated by exposure to cumulative, unresolved stress and neglect of one’s own emotional needs over time. Caregivers must be knowledgeable on CF’s risk factors, symptoms, and management strategies to decrease its incidence and negative impacts. This article details the creation, execution, and evaluation of an evidence-based practice change project implemented with the goal of increasing knowledge needed to prevent, identify, and alleviate CF in high-risk nurses. The project involved a series of educational workshops containing information on CF’s risk factors, symptoms, and consequences, with a strong emphasis on self-awareness, self-care, and stress management. Pre- and postknowledge tests showed a significant increase in knowledge was achieved via the workshops, and qualitative surveys indicated a high level of participant satisfaction with the program contents, format, and impact.

Experience of nurses caring for child with hematopoietic stem cell transplantation in general pediatric ward: a descriptive phenomenological approach

BACKGROUND

Most studies on hematopoietic stem cell transplantation (HSCT) have focused on patients, survivors, or their family members, such as siblings and parents. Little attention has been paid to nurses caring for HSCT pediatric patients and in particular in a Taiwanese context.

OBJECTIVE

The objective of this study was to explore nurses' lived experience caring for HSCT children in isolation within a general pediatric ward.

METHOD

A Husserlian phenomenological approach informed the exploration of the meaning and essence of the nurses' caring experience. Data were collected using semistructured interviews.

RESULTS

Twelve nurses were interviewed. Analysis of interviews yielded 3 main themes: being worried about ruining transplantation success, feeling loss of control in handling suffering, and reflecting upon the value of HSCT.

CONCLUSIONS

Nurses felt the stress of caring for HSCT children because of the heavy workload and the pressure of responsibility. Witnessing the suffering of patients/families was particularly stressful. However, nurses were helped to overcome this stress by looking at the value and meaning of HSCT.

IMPLICATIONS FOR PRACTICE

Nurses need practical support from nursing leaders in terms of carefully organizing patient care, controlling the nurse-to-patient ratio, and offering a safe work environment by providing systematic formal training on HSCT and receiving proper supervision. Understanding and learning are gained from nurses who are able to seek meaning from HSCT through appreciating every caregiving effort and through valuing how their nursing role contributes to the quality of patients' care.

Methodological considerations when translating "burnout"

No study has systematically examined how researchers address cross-cultural adaptation of burnout. We conducted an integrative review to examine how researchers had adapted the instruments to the different contexts. We reviewed the Content Validity Indexing scores for the Maslach Burnout Inventory-Human Services Survey from the 12-country comparative nursing workforce study, RN4CAST. In the integrative review, multiple issues related to translation were found in existing studies. In the cross-cultural instrument analysis, 7 out of 22 items on the instrument received an extremely low kappa score. Investigators may need to employ more rigorous cross-cultural adaptation methods when attempting to measure burnout.

Burnout levels of hemodialysis nurses

BACKGROUND

Previous studies have found significant stressors experienced by nurses working in hemodialysis units. The purpose of this study was to determine the burnout levels of hemodialysis nurses working in hemodialysis units and their relation with some sociodemographic variables.

METHODS

The study was conducted between July 2012 and Sept 2012 in hemodialysis units of four hospitals, including one university, one public and two private hospitals, in the province of Erzurum. The population of the study consisted of 32 nurses rendering service in hemodialysis units of the related hospitals. Information forms, which were prepared by researchers in accordance with the literature, and aimed at determining the personal characteristics of nurses and Maslach Burnout Inventory were used for the data collection.

RESULTS

Examining mean scores obtained by nurses from the Maslach Burnout Inventory, it is observed that they scored 17.07 ± 8.29 from subscale of emotional exhaustion, 5.89 ± 4.13 from subscale of depersonalization and 20.64 ± 4.10 from subscale of personal accomplishment.

CONCLUSION

The results of the study revealed that nurses working in hemodialysis units experience a medium-level burnout in terms of subscales of emotional exhaustion, depersonalization, and a high-level burnout in terms of the subscale of personal accomplishment.

Children's lived experiences of hematopoietic stem cell transplantation

Although hematopoietic stem cell transplantation is a valuable treatment in many life-threatening pediatric disorders, a large number of children who receive hematopoietic stem cell transplantation are faced with a variety of physical and psychological problems throughout this process. In this study, we explored the lived experiences of these children during their treatment to provide a better understanding of their main concerns, emotions, and expectations. The participants were six children, aged between 6 and 17 years, who underwent hematopoietic stem cell transplantation. Data were collected through individual, in-depth, and semistructured interviews. Using interpretive phenomenological analysis, the findings revealed that the children experienced "transplantation rejoicing" in this "difficult passage", which was associated with "deepening of family ties". Awareness of these experiences, feelings, and concerns can help in the development of more professional interventions to provide children with holistic care during their hospitalization.

Organizational features of workplace and job engagement among Swiss healthcare workers

The aim of this study was to determine the engagement level among healthcare workers in a Swiss hospital, identifying organizational predictors that could affect it. A four-part survey (a demographic questionnaire, Maslach Burnout Inventory-General Survey, Areas of Worklife Scale, and the General Health Questionnaire) was completed by 206 nurses and physicians. With regards to organizational predictors of job engagement, energy was primarily influenced by workload, involvement by values, and efficacy by reward. Moreover, we found that engagement might affect psychophysical health conditions: better health generally corresponds to higher levels of engagement. These results confirm that engagement is influenced by organizational variables and that engaged employees are generally more healthy and efficient. Therefore, interventions to minimize the impact of work stressors and to improve engagement are needed. Effective management of excessive workload, higher levels of autonomy, and greater job support are vital to limit psychological problems of healthcare workers.