Prevalence of and factors associated with burnout among health care professionals in Arab countries: a systematic review

Burnout, Depression, and Stress in Emergency Department Nurses and Physicians and the Impact on Private and Work Life: A Systematic Review

Objectives

In today's fast-paced world, work-related stress is a prevalent problem, particularly among health care professionals in high-pressure environments such as emergency departments (EDs). This stress can lead to mental health disorders, such as depression and burnout, affecting job performance, patient care, and the quality of professional and private life. This systematic review aimed to investigate the prevalence of burnout, depression, and stress among ED nurses and physicians and the impact of these conditions on personal and professional quality of life (QoL).

Methods

The systematic literature search covered PubMed, PsycINFO, Embase, and grey literature databases. Articles were included if they were published in English or German by 31 January 2020, focused on ED physicians or nurses, and examined burnout, depression, or stress and its impact on professional or personal QoL. Quality assessment of the included studies was performed using a modified version of the Newcastle-Ottawa Scale.

Results

The systematic search resulted in 893 articles, of which 11 met the inclusion criteria. All reviewed studies had a cross-sectional study design and were of low to moderate quality. Depression, burnout, and stress were prevalent among ED physicians, ranging from 15.5% to 19.3%, 18% to 71.4%, and 19.5% to 22.7%, respectively. These were associated with lower job satisfaction in ED physicians, while findings in ED nurses also showed a considerable rate of burnout with an inverse association with compassion satisfaction. Burnout and stress were significantly associated with intentions to quit emergency medicine in ED physicians, whereas no association was found for depression. In addition, burnout showed a negative relationship to work-life balance and QoL, while higher stress levels were associated with lower life satisfaction in ED physicians.

Conclusion

Our review underlines the high prevalence of stress, depression, and burnout among ED health care professionals and their potential negative impact on private and professional life, emphasizing the need for targeted support and interventions to enhance resilience, reduce stress, and prevent the onset or deterioration of mental health diseases. This, in turn, can contribute to maintaining and strengthening the already limited human resources in EDs, ensuring the quality of patient care, and strengthening health care systems.

Revolutionizing Primary Healthcare in Jordan: A Software Engineering Approach to General Practitioner Integration

This paper examines the pervasive issues of stress and burnout among healthcare specialists in Jordan, which are intensified by the current system allowing patients unrestricted access to specialized clinics. Our comprehensive analysis includes an examination of systemic, technological, and cultural barriers that currently hinder effective healthcare delivery. This was done with a mixed-methods approach: gathering quantitative data reported by the World Health Organization and World Bank, and qualitative insights from stakeholder interviews. Based on our findings, we propose a restructured care pathway where general practitioners (GPs) serve as the primary contact point for patients. This model aims to distribute healthcare demands more evenly, thereby alleviating the pressure on specialists. We also explore the integration of health information systems to improve processes. The implementation of this GP-centric model demonstrates potential benefits in our pilot studies, including reduced wait times, improved patient satisfaction, and decreased burnout rates among specialists. The paper concludes with strategic recommendations for nationwide policy adjustments to foster a more sustainable and equitable healthcare system in Jordan.

Prevalence and associated factors of burnout syndrome among selected health care professionals at University Hospitals of Sidama Region and Southern, Ethiopia 2023

BACKGROUND

Health professionals are burn out syndrome prone occupational group. In Ethiopia there are limited evidences about burnout syndrome and work related determinant factors resulting in Burnout syndrome. Therefore, this study aimed to determine the prevalence of burnout syndrome and associated factors of burnout syndrome among health professionals working in university hospitals found in Sidama region and Southern Ethiopia 2023.

METHODS

An institution based multi-center cross-sectional study was conducted on 362 health professionals working in three university hospital from February 15 to February 30, 2023. Study participants were recruited using Simple random sampling technique. A standard self-administered Maslach Burn out Inventory questionnaire were used to collect data. Data entered into Epi-info version 7.2.5.0 and exported to stata version 17 for analysis. Multivariate logistic regression was used to identify factors associated with burnout syndrome and adjusted odds ratio with a 95% confidence interval were used to describe factors associated significantly. Variables with a P value of less than 0.05 were considered statistically significant.

RESULT

A total of 362 health professionals were enrolled in the study with a response rate of 100%. The prevalence of burnout syndrome among health professionals was found to be 198 (54.7%) with a 95% CI of 49.51-59.77%. Alcohol dependence (AOR = 6.41, 95% CI = 2.37- 17.29), Sleep problem (AOR = 3.88, 95% CI = 2.33-6.46), poor social support (AOR = 4.71, 95% CI = 2.21-10.01) and intermediate social support (AOR = 2.41, 95% CI = 1.07-5.42) were factors significantly associated with burnout syndrome.

CONCLUSION

This study revealed that a high proportion of health professionals working in university hospitals of sidama and southern part of Ethiopia suffer from burnout syndrome. Alcohol dependence, sleep problem, getting poor and intermediate social support were significantly associated predictor variable with burnout syndrome.

RECOMMENDATION

Higher officials of university hospitals and human resource department should design strategies to reduce alcohol dependence, promote healthy sleep habit and advocate strong social support among health professionals.

Examining shift duration and sociodemographic influences on the well-being of healthcare professionals in the United Arab Emirates: a cross-sectional study

Objective

Providing quality healthcare is an essential part of the healthcare system. The high workload and night work associated with healthcare providing may result in work-life imbalance among healthcare professionals (HCPs) and in degradation in the quality of care.

Methods

This cross-sectional study aimed to assess the effects of sociodemographic characteristics and shift work on HCPs' well-being in four large hospitals in the United Arab Emirates using a validated questionnaire.

Results

Responses from 526 participants indicated that 79.2% of them were under the age of 40, 70.2% were females and 50.2% were single or divorced. Responses indicated that many HCPs reported engaging in unhealthy behaviors such as consuming energy drinks (37.3%), smoking (14.2%) and taking stimulant pills (5.7%) with males being more susceptible to these practices compared to females. Results also showed that participants perceived their overall health rate, on the average, to be moderate with one third of participants indicating to be overweight. Moreover, results showed that many participants reported having blood pressure issues (16%), diabetes (8.6%) and/or heart diseases (2.7%), with females more prone to these diseases than males. Another important finding was that most respondents reported sleeping significantly less than the recommended duration and taking too long time to fall asleep. Finally, results revealed that HCPs on 12-h shifts indicated having greater satisfaction but tend to experience more exhaustion levels and worsened health indicators than those on 8-h shifts.

Conclusion

HCPs work has adverse effects on their well-being especially when combined with working at night. Healthcare implications of the results as well as recommendations to improve the well-being of HCPs based on the findings are given at the end.

Towards a National System-Level Intervention: Characterization of Burnout Among Trainees of Saudi Postgraduate Healthcare Professions Programs

BACKGROUND/OBJECTIVES

High levels of burnout among healthcare professionals and trainees represent a global problem with identified profound impacts. The collection of national data for better characterization of this problem can guide more needs-sensitive targeted interventions. We aimed to identify the prevalence of burnout, the associated factors, and their impacts among trainees of Saudi postgraduate healthcare professions training programs.

METHODS

We conducted an anonymous, cross-sectional survey of 11,500 Saudi Commission for Health Specialties trainees from February to May 2019. The survey included items for socio-demographic data, physical health, and work-related items. We used validated instruments to measure burnout (Maslach Burnout Inventory), stress (Perceived Stress Scale), and depression (Patient Health Questionnaire-9).

RESULTS

A total of 6606 postgraduate trainees from different healthcare professions responded (mean age of 28.8 ± 3 years). Fifty-six percent reported burnout symptoms. Burnout was lower among female trainees (aOR, 0.73; 95% CI, 0.65-0.82) and higher in trainees working ≥40 h/week (aOR, 1.19; 95% CI, 1.03-1.37) and doing ≥six on-call shifts/month (aOR, 1.18; 95% CI, 1.03-1.37). Harassment and discrimination increased the risk of burnout by 57% and 60% (aOR = 1.57, 95% CI: 1.36-1.80 and aOR, 1.60; 95% CI, 1.38-1.86), respectively. Burnout trainees had 3.57 adjusted odds to report major depression (95% CI 3.11-4.09), were 1.25 times more likely to report major stress (95% CI 1.36-1.80), and were 1.8 times more likely to complain of sleep disorders (95% CI 1.60-2.04).

CONCLUSION

This study identified several personal and work-related risk factors and impacts of burnout among our postgraduate trainees. The findings were helpful in guiding the expansion of the national Da'em well-being and prevention of burnout program efforts to a targeted system-level intervention.

Burnout Among ICU and Non-ICU Healthcare Professionals in Saudi Arabia: A Comparative Cross-Sectional Analysis

Purpose

Burnout syndrome is a significant concern among healthcare workers, particularly in the high-stress environment of ICUs. This study evaluates and compares the levels of burnout among healthcare workers in the ICU and non-ICU settings and to assess the influence of sociodemographic characteristics.

Materials and Methods

A cross-sectional survey was conducted using MBI questionnaire, which measures emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA).

Results

Among 844 participants (51.7% female), most were aged 25-34 (41.9%), single (46.7%), and worked in non-ICU settings (61.8%). They predominantly worked in governmental hospitals, with 1-4 years of experience (46.8%), managing 6-10 patients per shift (36.5%), and working 16-20 shifts monthly (75.8%). ICU staff reported significantly higher EE (21 [18] vs 11.5 [15], p ≤ 0.0001) and DP (17 [19] vs 8 [12], p ≤ 0.0001), and lower PA (35 [19] vs 42.5 [12], p ≤ 0.0001). Post-hoc analysis showed ICU workers were significantly more prone to moderate (Adj. Resid. = 3.57, p< 0.001) and severe EE (Adj. Resid. = 5.20, p < 0.001). In the DP domain, they were more likely to experience severe DP (Adj. Resid. = 9.22, p< 0.001). Severe burnout in PA was also more likely among ICU staff (Adj. Resid. =5.67, p< 0.001). Nurses and RTs reported higher EE and DP. Married ICU staff had lower EE (OR: 0.453) but higher DP (OR: 1.623). Factors like 6-8 years of experience, 8-hour shifts, and fewer monthly shifts were associated with reduced EE and higher PA, while additional jobs were linked to increased DP.

Conclusion

ICU healthcare workers experienced significant burnout compared to non-ICUs staff, with nurses and RTs being the most affected. Sociodemographic factors such as marital status, years of experience, shift duration, and holding additional jobs increased burnout risk. These findings underscore the need for targeted interventions in high-stress environments like the ICU.

The Relationship Between Staffing, Nurses' Emotional Exhaustion, and Adverse Patient Events in Critical Care Units in Sultanate of Oman

Background: Ensuring safe practices remains a top priority for healthcare policymakers. However, limited evidence has examined the link between individual, work-related factors, and patient safety within critical care units in Oman. Aim: To assess the relationship between staffing levels, job-related emotional exhaustion, and adverse patient events among nurses working in critical care units. Design: A cross-sectional study was conducted to collect data from critical care nurses in Oman. Nurses were recruited using a stratified proportional sampling method. Results: A total of 694 critical care nurses participated in the study. More than half (64.1%) of the critical care nurses experienced higher levels of emotional exhaustion. Significant predictors of adverse patient events included nurse staffing level (r = 0.09, p < 0.001), emotional exhaustion (β = 0.25, p < 0.001), hospital type (being affiliated with nonteaching hospitals) (p=0.021), and nationality (β = -0.15, p < 0.001). Conclusion: The occurrence of nurse-reported adverse events was associated with several key variables, including nurse staffing levels, emotional exhaustion, hospital type, and nationality. Implications for Nursing Management: To improve patient safety, healthcare policymakers should prioritize optimizing nurse staffing levels and implement strategies to reduce emotional exhaustion, particularly in nonteaching hospitals and among specific nurse demographics.

Recognizing and addressing burnout among healthcare workers in rural Nepal: a proof-of-concept study using Kern's six-step theoretical framework

INTRODUCTION

Healthcare provider burnout is highly prevalent and has negative consequences. However, many healthcare workers in LMICs, including Nepal, rarely recognize or ameliorate it. This problem is worse in rural settings. Competency-focused interventions that are developed using theoretical frameworks can address this gap.

METHODS

We used Kern's framework of curriculum development to create, refine, and assess a theory-driven intervention tailored to the needs and constraints of rural healthcare workers in Nepal. During the first phase, we conducted a targeted needs assessment using an online survey among nine rural primary care physicians working in Charikot Hospital. We then developed learning objectives for knowledge, attitude, and skills domains based on the World Health Organization (WHO) definition of burnout. Then, we created animated educational videos designed to meet the learning objectives. We then implemented the educational intervention with rural physicians and assessed their knowledge, attitudes, and feedback. During the second phase, we further developed the intervention based on findings from the first phase and assessed acceptability, feasibility, and preliminary impact using pre- and post-intervention questionnaires and key informant interviews.

RESULTS

In the first phase, nine physicians participated in the targeted needs assessment, and eight responded to the post-intervention assessment. In the second phase, 18 attendees completed the pre-intervention burnout assessment, and 16 completed both the pre-test and post-test questionnaires. On the pre-test, correct answers across questions ranged from 31-88%, while on the post-test, participants responded correctly 88-100% of the time. Related-samples Wilcoxon signed-rank test showed a statistically significant difference (P = 0.007) in the post-test scores on the knowledge domain. Qualitative results showed burnout as an unrecognized and unreported issue, and its drivers included stigma and feelings of helplessness. Participants praised the interventions and reported that they translated learned skills into practice.

CONCLUSION

In this proof-of-concept study, we found that educational interventions developed using a theory-driven framework to meet the unique needs of rural healthcare workers are acceptable and feasible. Future studies can test the intervention impact in well-powered trials to support scale-up efforts to identify and address burnout.

The relationship between self-determination and burnout: Mental health outcomes in medical residents

BACKGROUND

Burnout is a pervasively increasing threat to personal and professional wellbeing and performance. It is yet understudied in relation to basic psychological needs (BPN), especially in at-risk population such as medical residents. This study intends to explore the differential relationship between various aspects of burnout including depersonalization (DP), emotional exhaustion (EE) and lack of personal achievement (PA) and subsets of BPN satisfaction or frustration namely autonomy, relatedness, and competence, with the framework of the Self-Determination Theory (SDT) in healthcare.

MATERIALS

A total of 110 medical residents in various Lebanese hospitals were included. Demographics and standardized scales were used to measure basic psychological need satisfaction and frustration (BPNSFS), burnout (MBI), depression and anxiety (PHQ-4). Residents were also asked about subjective evaluation of academic training and level of impact by ongoing crises (COVID-19 pandemic, Beirut port explosion and financial breakdown).

RESULTS

Result point to alarming prevalence of burnout and mental distress in our sample. It also indicates a differential correlation between gender, financial security and various subsets of burnout. It lastly points to association of DP with overall satisfaction scale (Beta = 0.342, p = 0.001) and PHQ-4 scores (Beta = -0.234, p = 0.017), while feeling burdened to attend lectures and having been physically affected by the Beirut blast correlated with a sense of PA (Beta = 0.332, p = 0.010, Beta = 0.187, p = 0.041 respectively) and PHQ-4 (Beta = 0.341, p = 0.000), interacting with COVID-19 patients (Beta = 0.168, p = 0.020) and feeling protected in the working environment (Beta = -.231, p = 0.002) showed a significant association with EE.

DISCUSSION

Within the SDT framework, this study highlights the complex interplay between collective crises, subjective evaluations or work conditions and other demographics with aspects of burnout in medical residents. It mostly points to the need address this at an individual but also an institutional level to buffer distress in future healthcare providers.

Association of burnout and working environment conditions in respiratory care professionals in Saudi Arabia: a cross-sectional study

Introduction

Burnout is a pervasive issue in healthcare, and it impacts both the wellbeing of healthcare professionals and the quality of patient care. This study examines factors associated with burnout and working environment among respiratory therapists in Saudi Arabia.

Methods

A structured questionnaire was used to collect data from respiratory therapists. We collected 315 questionnaires including burnout assessment. Multinomial logistic regression was used to assess the relationship between various variables and the likelihood of experiencing severe burnout and personal achievement problems.

Results

Marital status was a significant predictor of severe burnout (p = 0.001), with single individuals having 8.2 times higher odds than married individuals. Working longer than 44 h per week was associated with a 19.3-fold increase in the odds of severe personal achievement issues compared to those working 40-44 h per week (p < 0.001). Age, gender, living arrangements, education, employment status, and salary level were not significant predictors of severe burnout or personal achievement issues.

Conclusion with discussion

The findings highlight that marital status and extended working hours are significantly associated with increased burnout among respiratory therapists in Saudi Arabia. These results underscore the importance of social support networks and work-life balance in mitigating burnout risks within this profession.

Mental health interventions affecting university faculty: a systematic review and meta-analysis

BACKGROUND

While there is growing evidence highlighting the prevalence of mental health concerns among university faculty, few studies have examined mental health interventions in this population. The objective of this systematic review and meta-analysis was to collect and critically appraise the available evidence about the effectiveness of interventions designed to improve the mental health of faculty.

METHODS

A systematic search was conducted by searching PubMed, EMBASE, Scopus, Web of Science, and CINAHL to identify relevant studies published in English language from January 1st, 2000 until October 1st, 2023. The search focused on studies done on academic faculty to describe interventions or support programs aimed at improving mental health outcomes, with comparison of mental health data before and after the intervention and an improvement in mental health as study outcome. A random effect meta-analysis method was used to estimate the effectiveness of interventions on faculty mental health.

RESULTS

Ten publications with 891 participants from 2,217 retrieved records were included. The random effect model showed substantial heterogeneity (I2 = 84.8%, 95% CI: 73.8 - 91.2%, p < 0.001). The pooled SMD was - 1.41 (95% CI: -2.81-0.004) showing a large effect, and it significantly favors the use of intervention for reducing mental health issues among faculty members. The effect size estimates for all included studies ranged from small to large, showing the positive effect of intervention on faculty mental health. Multimodal inference analysis showed that, of the many studied factors for faculty mental health, the region was the most important predictor of intervention effectiveness. However, when the significance of quantitative moderators was tested using meta-regression, age (p = 0.9491) and duration of intervention (p = 0.1284) were not statistically significant.

CONCLUSION

Interventions aimed at enhancing the mental health of university faculty were overall significant; however, individual studies showed heterogeneous results. Making efforts to enhance the mental health of faculty is crucial and has been proven effective; nevertheless, the existing evidence necessitates further research in this area. For interventions to be effective, it is imperative to tailor them to the specific environment and to the unique characteristics of faculty members.

PROSPERO REGISTRATION NUMBER

CRD42023490388.

Prevalence of burnout syndrome among anesthesiologists, anesthesia technicians, and intensive care unit nurses in Palestinian hospitals: a cross-sectional study

BACKGROUND

Burnout syndrome is marked by three primary domains: emotional exhaustion, depersonalization, and low personal accomplishment. This study assessed the prevalence of burnout syndrome among anesthesiologists, anesthesia technicians, and intensive care unit (ICU) nurses in Palestinian hospitals. In addition, this study also sought to assess associations and identify the factors that can predict higher burnout among anesthesiologists, anesthesia technicians, and ICU nurses.

METHODS

This study was conducted in a cross-sectional design using a questionnaire between October 2023 and December 2023. The questionnaire collected the demographic variables of the healthcare providers, their living conditions, lifestyle, working conditions, job satisfaction, and intention to change the profession. The healthcare providers were included from 12 different hospitals. Burnout syndrome was assessed using the Maslach Burnout Inventory-Human Services Survey for Medical Personnel (MBI-HSS-MP).

RESULTS

A total of 250 healthcare providers were invited to participate in this study, of those, 212 completed the questionnaire, giving a response rate of 84.8%. Of the healthcare providers, 72 (34.0%) were anesthesiologists, 41 (19.3%) were anesthesia technicians, and 99 (46.7%) were ICU nurses. Of all healthcare providers, 151 (71.2%) reported emotional exhaustion, 125 (59%) reported depersonalization and 145 (68.4%) reported a lack of personal achievement based on the MBI-HSS-MP criteria for burnout. Multiple linear regression showed that higher emotional exhaustion scores could be predicted by the number of working hours per day (p-value = 0.039) and higher depersonalization scores could be predicted by having children (p-value = 0.001). On the other hand, lower personal achievement scores could be predicted by having children (p-value = 0.006), not owning a car (p-value = 0.036), and having more night shifts (p-value = 0.049).

CONCLUSIONS

The findings of this study indicated that burnout syndrome was prevalent among anesthesiologists, anesthesia technicians, and ICU nurses in Palestinian hospitals. Healthcare authorities and professional bodies should consider designing interventions to reduce burnout and improve the psychological well-being of anesthesiologists, anesthesia technicians, and ICU nurses. Further studies are required to identify the most effective interventions for reducing burnout among anesthesiologists, anesthesia technicians, and ICU nurses in Palestine.

The aftermath of COVID-19: generalized anxiety disorder and burnout among radiology practitioners and interns in Saudi Arabia

Background

The coronavirus disease (COVID-19) pandemic has presented unprecedented stressors and difficulties for healthcare professionals. This study explored the prevalence of generalized anxiety disorders and burnout among radiology practitioners and interns in various hospitals in Saudi Arabia after the end of the COVID-19 global public health emergency.

Methods

A cross-sectional survey of 230 radiology practitioners and interns was conducted between October and November 2023. This study utilized the Generalized Anxiety Disorder 7-item (GAD-7) scale and Maslach Burnout Inventory-Human Services Survey for Medical Personnel (MBI-HSS-MP) 22-item questionnaire, employing a non-probability convenience sampling method. The average scores of the individual components constituting the GAD-7 scale and each burnout scale were calculated, and statistical analyses were conducted using the Mann-Whitney U and Kruskal-Wallis H nonparametric tests.

Results

Of 382 radiology practitioners and interns, 230 (60.2%) responded to the survey. Notably, 42.6% of the participants reported experiencing GAD. Regarding burnout, 82.3% were at moderate-to-high risk for emotional exhaustion, 93.5% for depersonalization, and 52.1% for personal achievement. The 31-40 years age group showed significantly higher burnout rates (p = 0.001) compared with the other age groups. Those with more than three years of experience had notably higher emotional exhaustion scores (p = 0.002) and a nearly significant increase in depersonalization scores (p = 0.051) than those with less experience.

Discussion

Our study revealed that 42.6% of radiology practitioners and interns experienced GAD, with the majority facing significant burnout. Furthermore, our research indicates a decline in GAD levels among radiology practitioners and interns compared with the peak COVID-19 pandemic period. It also showed a significant increase in both the incidence and severity of burnout, surpassing pre-pandemic levels in a comparable cohort. These findings emphasize the pressing challenges of GAD and burnout among healthcare workers, especially radiology professionals.

The Impact of Intensive Care Unit Nurses' Burnout Levels on Turnover Intention and the Mediating Role of Psychological Resilience

BACKGROUND

This study aims to investigate the relationship between burnout levels among intensive care unit (ICU) nurses, turnover intention, and the mediating role of psychological resilience.

METHODS

This survey design was used to collect data from 228 ICU nurses from hospitals in Turkey. The study utilized self-report questionnaires to measure burnout levels, turnover intention, and psychological resilience. The data were analyzed through structural equation modeling.

RESULTS

In the study, a positive relationship between burnout and turnover intention and burnout and psychological resilience is significant (p ≤ 0.001). However, psychological resilience was not found to have a mediating role, indicating that other factors or variables may play a more substantial role in the relation found between burnout and turnover intention. Also, the research model's Standardized Root Mean Square Residual is expected to be less than 0.10 for the model to have an acceptable fit.

CONCLUSION

The findings suggest that levels of burnout among ICU nurses may have significant consequences on turnover intention. However, promoting resilience cannot help diminish the negative effects of burnout on turnover intention. The findings highlight the importance of burnout levels in nursing by synthesizing findings from the previous literature. Then, focusing on the concepts of turnover intention and psychological resilience, it explains the importance of these concepts in the Intensive Care Unit nurses and their relationships with each other.

Burnout among medical residents, coping mechanisms and the perceived impact on patient care in a low/ middle income country

BACKGROUND

Burnout is a syndrome that result from chronic workplace stress and it characterized by emotional exhaustion, depersonalization and low personal accomplishments. Studies report higher burnout levels in medical personnel compared to the general population. Workplace burnout has been directly linked to medical errors and negative coping strategies such as substance abuse. The aims of this study were to assess the level of burnout in medical residents, evaluate their impressions about coping mechanisms and assess perceived impact on patient care in a low/ middle income country setting.

METHODS

This was a cross sectional, mixed methods survey carried out at Aga Khan University, Nairobi Kenya. The Maslach Burnout Inventory - Human Services Survey was used to assess the level of burnout. High-risk scores for each subscale are defined as > 27 in emotional exhaustion, > 10 in depersonalization, and < 33 in personal accomplishment. Overall high risk of burnout was defined as high-risk scores in 2 or more of the 3 categories. Categorical variables were analysed using descriptive statistics and reported as frequency counts and corresponding percentages. Chi-square test was applied to test for association of burnout and the categorical variables. P value of < 0.05 was considered statistically significant. To assess the impressions on patient care and evaluate the coping mechanisms employed in the context of burnout residents participated in four focus group discussions reaching thematic saturation.

RESULTS

95 out of 120 residents consented to participate in the study, 47.3% of whom had a high risk of burnout. A significant association was found between gender and burnout risk with more female residents having high risk of burnout compared to their male counterparts; 58.0% and 35.6% respectively (P value 0.029). Residents in paediatrics and child health had the greatest risk of burnout (8 out of 10) compared to those in other programmes (P value of 0.01). Thematic analysis from focus group discussions revealed that main sources of stress included departmental conflict and struggle to balance work and other aspects of life. All focus group discussions revealed that burnout and stress are associated with negative coping mechanisms. Respondents reported that when under stress, they felt more likely to make medical errors.

CONCLUSION

This study reported high risk of burnout among post graduate residents which is consistent with other global studies. The sources of stress cited by residents were mostly related to the workplace and many perceived sub-optimal patients care resulted from burnout. This highlights a need for preventive measures such as wellness programs within the training programmes.

TRIAL REGISTRATION NUMBER

Not applicable.

Burnout and predictive factors among medical students: a cross-sectional survey

BACKGROUND

Burnout is a growing problem in medical education, and is usually characterised by three dimensions: emotional exhaustion, cynicism, and reduced professional efficacy. Currently, the majority of burnout studies have been conducted in western high-income countries, overshadowing findings from low- and middle-income countries. Our objective is to investigate burnout and its associated predictive factors in Morocco, aiming to guide intervention strategies, while also assessing differences between the preclinical and clinical years.

METHODS

A cross-sectional, self-administered online survey assessing burnout dimensions and its main determinants was distributed among medical students at Université Mohammed VI des Sciences et de la Santé (UM6SS, Casablanca, Morocco). Descriptive analyses involved computing mean scores, standard deviations and Pearson correlations. Further, t-tests were performed to check for significant differences in burnout dimensions across the preclinical and clinical learning phase, and stepwise linear regression analyses were conducted using a backward elimination method to estimate the effects of the selected variables on the three burnout dimensions.

RESULTS

A t-test assessing the difference in cynicism found a significant difference between students at the preclinical phase and the clinical phase, t(90) = -2.5, p = 0.01. For emotional exhaustion and reduced professional efficacy no significant difference was observed. A linear regression analysis showed that emotional exhaustion was significantly predicted by workload, work-home conflict, social support from peers and neuroticism. Cynicism was predicted by the learning phase, workload, meaningfulness and neuroticism; and reduced professional efficacy by neuroticism only.

CONCLUSIONS

Our findings suggest a potential gradual increase in cynicism during medical education in Morocco. Conducting this study in a low- and middle income country has enhanced the scientific understanding of burnout in these regions. Given the identified predictive factors for burnout, such as workload, work-home conflict, support from peers, neuroticism, and meaningfulness, it is necessary to focus on these elements when developing burnout interventions.

Pediatric Occupational Therapists and Occupational Stress: A Scoping Review

The purpose of this scoping review was to provide further insight into the stress and the stressors experienced by pediatric occupational therapists in the work environment. Using the Arksey and O'Malley framework, the search was conducted in eight databases, nine electronic journals, and eight gray literature sources to identify articles related to stress and stressors of pediatric occupational therapists. Review selection and characterization were performed by two independent reviewers. Twelve articles published from 2011 to 2020 were identified and varied in terms of purpose, population, and results although the articles all shared similar methodologies and outcome measures. Only 25% of the articles (3/12) addressed pediatric occupational therapy stress and stressors directly while the remaining addressed occupational stress, but with varying levels of attention to pediatric occupational therapists. Stress and stressors experienced by pediatric occupational therapists have been studied to a limited extent. Occupational stress is associated with increased burnout, decreased health, and decreased job satisfaction and performance. Several knowledge gaps have been identified, as well as priorities for future research into pediatric occupational therapists and occupational stress.

Burnout Among Saudi Radiographers

INTRODUCTION

Burnout research is limited in Saudi Arabia, particularly among radiographers. Burnout among Saudi radiographers may have a negative impact on the services offered.

OBJECTIVE

This study aims to assess the burnout among radiographers in Medina hospitals.

MATERIALS AND METHODS

This quantitative cross-sectional study included 104 radiographers from government and private Medina hospitals. The Maslach Burnout Inventory-Human Services Survey for Medical Personnel, which consists of 22 questions, was used to measure the burnout level. The data were evaluated descriptively using the Statistical Package for the Social Sciences (version 25), and independent t-tests and analysis of variance were applied to assess group differences and linear regression analysis to evaluate associations between the burnout level and sociodemographic variables (ie sex, age, experience, and department).

RESULTS

The emotional exhaustion (EE) and depersonalization (DP) scores were moderate, while the personal accomplishment (PA) score was high, with total scores of 23.53 (9.32), 7.29 (5.95), and 29.70 (1.35), respectively. The DP score was influenced by the participants' experience. Specifically, an experience of 1-5 years yielded a substantially higher burnout score than did an experience of >10 years (p>0.05). Conversely, sex, age, and department did not affect the DP score (p<0.05). Similarly, the EE and PA scores were not influenced by sex, age, experience, or department (p<0.05).

CONCLUSION

Burnout is prevalent among radiographers in Medina hospitals in Saudi Arabia. The EE and DP scores are moderate, while the PA score is high, indicating a suitable work environment. Policymakers should take the required steps to identify the variables contributing to employee burnout and enhance the work environment.

Burnout among Nurses and Doctors Working at a Tertiary Care Government Hospital: A Descriptive Cross-sectional Study

INTRODUCTION

Work environment related feelings of dissatisfaction, exhaustion, decreased interest and isolation is common. Burnout among health professionals has been on rise at every stage of professional growth affecting wellness of service providers, patient care and health care organizational efficiency. Assessment of burnout among health care workers from government setup in the current context in this post COVID era in our socio-geographical context has become essential. The aim of this study was to find the prevalence of burnout among nurses and doctors working at a tertiary care government hospital in Nepal.

METHODS

This descriptive cross sectional study was conducted among nurses and doctors working at a tertiary level government hospital from May 2022 to Nov 2022 after approval from Institutional Review Committee of the same institute. Nurses and doctors available on duty, from all ages were included. Trainees and students, those unable to participate due to their illness, on leave, known cases of mental illness were excluded. The point estimate was calculated at 95% Confidence Interval.

RESULTS

Among 180 participants, the prevalence of moderate burnout was 94 (52.22%) (44.92-59.51, 95% Confidence Interval). Among nurses 72 (50%), while in doctors 22 (61.11%) had moderate burnout. Out of those with moderate levels of burnout, the majority of 66 (52.80%) were in the age group 26-50 years.

CONCLUSIONS

The prevalence of burnout among nurses and doctors is high, similar to other studies done in similar settings.

Challenges faced by women oncologists in Africa: a mixed methods study

Objective

Recent studies have identified challenges facing women oncologists in Western contexts. However, similar studies in Africa have yet to be conducted. This study sought to determine the most common and substantial challenges faced by women oncologists in Africa and identify potential solutions.

Methods and analysis

A panel of 29 women oncologists from 20 African countries was recruited through professional and personal networks. A Delphi consensus process identified challenges faced by women oncologists in Africa, and potential solutions. Following this, focus group discussions were held to discuss the results. Descriptive statistics were used to identify the most common challenges indicated by participants and thematic analysis was conducted on focus group transcripts.

Results

African women oncologists experienced challenges at individual, interpersonal, institutional and societal levels. The top-ranked challenge identified in the Delphi study was 'pressure to maintain a work-family balance and meet social obligations'. Some of the challenges identified were similar to those in studies on women oncologists outside of Africa while others were unique to this African demographic. Solutions to improve the experience of women oncologists were identified and discussed, including greater work flexibility and mentorship opportunities.

Conclusion

Women oncologists in Africa experience many of the challenges that have been previously identified by studies in other regions. These challenges and potential solutions exist at all levels of the social-ecological framework. Women oncologists must be empowered in number and leadership, and gender-sensitive curricula and competencies must be implemented. A systems-level dialogue could bring light to these challenges and foster tangible action and policy-level changes.

A Model of Burnout Among Healthcare Professionals

BACKGROUND

Burnout is common and can lead to worse outcomes for both healthcare workers and patients. Our study purpose was to assess the structural relationship among factors that protect against or worsen burnout.

DATA SOURCES AND STUDY SETTING

We surveyed healthcare professionals in 15 different Japanese intensive care units during the 3rd wave of the COVID-19 pandemic (March 2021). Surveys assessed burnout (Mini Z 2.0), resilience (Brief Resilience Scale), depressive (PHQ-9) and anxiety (GAD-7) symptoms, job and work environment characteristics, and personal experience with COVID. We explored survey domains with principal component factor analysis and modeled our results using structural equation modeling.

PRINCIPAL FINDINGS

Among 936 ICU professionals, 24.3% met criteria for burnout. Our model suggested that resilience (β =  - 0.26, 95% CI - 0.32 to - 0.20), teamwork (β =  - 0.23, 95% CI - 0.30 to - 0.16), and feeling safe (β =  - 0.11, 95% CI - 0.18 to - 0.04) reduced burnout. Depression (β =  - 0.32, 95% CI - 0.41 to - 0.23) and anxiety (β =  - 0.20, 95% CI - 0.29 to - 0.10) both decreased resilience as did COVID fear (β = 0.08, 95% CI - 0.14 to - 0.02). In addition to directly reducing resilience, anxiety also indirectly reduced resilience by increasing COVID fear (0.23, 95% CI 0.17 to 0.23), which decreased resilience (β - 0.08, 95% CI - 0.14 to - 0.02).

CONCLUSIONS

Burnout is common among Japanese ICU professionals. Resilience, teamwork, and safety are all correlated with reduced burnout. Those who had depression or anxiety or COVID fear had higher degrees of burnout, an effect that appears to be mediated by reduced resilience. These are potential targets for interventions to reduce burnout.

The Relationship Between Nurses' Psychological Well-Being and Their Work Productivity Loss: A Descriptive Correlational Study

Introduction

Nurses play a vital role in ensuring effective patient care delivery and organizational productivity. Hence, it becomes imperative to prioritize their psychological well-being and explore how its impairment may be associated with their productivity loss.

Aims

The study aims to investigate the relationship between nurses' psychological well-being and their work productivity loss by examining how nurses self-reported their own psychological well-being and work productivity loss.

Methods

A descriptive correlational design was conducted at an Egyptian university hospital. A convenience sample of 400 nurses completed two tools: (a) Outcome Questionnaire-45 was used to assess the psychological well-being of nurses and (b) the Work Productivity and Activity Impairment - General Health Questionnaire was used to measure nurses' work productivity.

Results

Among the 400 surveyed nurses, 66.7% reported overall poor psychological well-being. Regarding work productivity loss, 22.8% of nurses missed an average of 974.81 work hours due to absenteeism, and 62.0% lost an average of 10,630 work hours due to presenteeism. Additionally, 75.5% experienced impaired daily living activities. Approximately 13.4% of total working hours were missed due to health problems or psychological distress. Regression analysis revealed that poor psychological well-being significantly predicts work productivity loss, accounting for 2.0% of absenteeism, 11.0% of presenteeism, 17.0% of daily activity impairment, and 9.0% of overall productivity loss, with the model being significant (p < 0.01).

Conclusion

Nurses often experience poor psychological well-being and distress that hinder their daily activities and cause work productivity loss. Therefore, hospital management should prioritize improving nurses' physical and mental health and bolstering their self-efficacy and resilience to minimize the effects of symptom distress on productivity. Investing in nurses' well-being through managerial caring, organizational support, and fostering a supportive work environment are vital strategies for promoting quality patient care and enhancing their work productivity.

The high cost of healing and teaching: a cross-sectional survey of burnout among academic physicians in Nigeria

BACKGROUND

Globally, the medical and teaching professions are two major professions with the highest prevalence of burnout, and academic physicians bestride the two professions. This study investigated the prevalence and associated factors of burnout among academic physicians working in tertiary hospitals in Nigeria.

METHODOLOGY

This was a self-administered online survey. Burnout was measured using the Maslach Burnout Inventory for Educators (MBI-ES) on Google Form and sent to 256 academic physicians in tertiary hospitals across Nigeria using the WhatsApp broadcast feature. MBI-ES was categorized into two categories (Burnout and No Burnout), and binary logistic regression was used to test the influence of 13 predictors on the three dimensions of MBI-ES as well as MBI in its entirety.

FINDINGS

A total of 155 academic physicians responded, resulting in a response rate of 60.5%. There were 121 (80.7%) males and 29 (19.3%) females (five cases respondents omitted this detail). Eighty-seven respondents exhibited moderate to high burnout in at least one of the dimensions of the MBI, translating to a prevalence rate of 57.7% in our study. Five variables, number of peer reviewed articles published, hours of weekly teaching, enjoyment of academic writing, apathy to teaching and religion were all significantly associated with burnout. Moderate to high emotional exhaustion was reported by 30.8% (45 respondents), moderate to high depersonalization by 5.5% (8 respondents),, and low to moderate personal accomplishment by 43.5% (67 respondents).Eight variables: religion, geopolitical zone of practice, enjoyment of academic writing, apathy toward teaching, university ownership, number of published peer-reviewed articles, salary, and supplementary income were significantly associated with emotional exhaustion, while the number of weeks spent teaching in a year and teaching hours/week were significantly associated with depersonalization and personal accomplishment, respectively. Age (OR 1.302, CI 1.080-1.570), Teaching hours/week (OR 0.924, CI 0.854-0.999), Salary (OR 0.996, CI 0.993-1.0), and supplementary salary (OR 0.996, CI 0.993-0.999) were found to significantly predict emotional exhaustion.

CONCLUSION

The study reveals a high prevalence of burnout (57.7%) among academic physicians in Nigeria, highlighting an urgent need for targeted interventions and policy changes. Given the significant role these professionals play in healthcare and medical education, immediate action is essential to address this issue. Future research should focus on evaluating the effectiveness of preventive measures and exploring the long-term impacts of burnout.

Analyzing Role Overload, Mental Health, and Quality of Life Among Jordanian Female Healthcare Professionals: A Cross-Sectional Study

PURPOSE

To identify the role overload, mental health distress, and quality of life among Jordanian female healthcare professionals and explore their interrelationships.

PATIENTS AND METHODS

This cross-sectional correlational research involved 412 female participants (physicians, nurses, and pharmacists) from the government and private sectors in Jordan. The Role Overload, Depression, Anxiety, and Stress Scale-21 (DASS-21) and the World Health Organization Quality of Life-Brief Version were used for data collection. Statistical analyses included descriptive statistics, Pearson correlation, multiple linear regression, multivariate analysis of variance, Tukey's post hoc test, Spearman rho, and linear regression tests (p=0.05).

RESULTS

Results indicate that 83.2% of participants experienced moderate to high role overload, with 72.9% displaying signs of moderate to extreme depression. Professionals working >40 hours/week experienced elevated stress levels, while those with chronic illnesses exhibited higher mean scores for depressive symptoms (M= 16.91 vs M= 14.49, p=0.002) and stress (M= 20.55 vs M= 18.57, p=0.033). Professionals attending older individuals reported increased role overload (M= 3.66 vs M= 3.14, p<0.001), higher stress (M=19.99 vs M=18.14, p=0.027), and lower physical (M=51.79 vs 55.41, p =0.025) and psychological (M=50.04 vs M=53.57, p=0.045) quality of life. Simple regression analysis revealed that role overload significantly predicted stress, depression, and anxiety. Role overload's impact on depression scores (β = 2.108, t=5.234, p<0.001), as well as anxiety (β =1.933, t=5.014, p<0.001), was associated with an inverse correlation with both physical (β =1.671, R2= 3.4, p<0.001) and psychological (β =1.914, R2= 1.4%, p=0.018) quality of life of healthcare professionals. Mental distress and role overload significantly predicted participants' physical and psychological quality of life.

CONCLUSION

This study established a significant association between role overload, quality of life, and psychological health of female healthcare professionals in Jordan, with implications for enhancing their well-being.

Efficacy of mHealth aided 12-week meditation and breath intervention on change in burnout and professional quality of life among health care providers of a tertiary care hospital in north India: a randomized waitlist-controlled trial

Introduction

Burnout is "Chronic workplace stress that has not been successfully managed." Professional quality of life (PQL) includes work related experiences of compassion satisfaction and compassion fatigue. Healthcare providers (HCPs) are highly susceptible to burnout and compassion fatigue due to their demanding work, which lowers PQL. Burnout leads to poor care, medical errors, and patient safety across healthcare disciplines. Yoga has been shown to improve resilience, reduce stress, and increase self-compassion and psycho-physiological coherence. This study compared HCPs in a mHealth-aided 12-week yoga-based meditation and breath intervention to waitlist controls for HCP burnout and PQL at a north Indian tertiary care hospital.

Methods

This was randomized waitlist-controlled trial. Total 98 HCPs (62 males and 36 females) with an average age of 28.26 ± 3.547 years were enrolled consecutively from March 2021 to November 2022. Randomization was done with opaque sealed envelopes numbered in a computer-generated sequence. The experimental group (n = 49) received 12 online weekly yoga sessions and performed daily home practice (6 days a week). The waitlisted control group (n = 49) continued their daily routine. Maslach's burnout inventory (MBI), professional quality of life (PQL) and anthropometric measurements were assessed at baseline and after 12 weeks.

Results

After 12 weeks, the MBI outcomes of emotional exhaustion, depersonalization, and personal accomplishment showed a highly significant difference between the two groups (p < 0.001). PQL outcomes of compassion satisfaction, burnout, and secondary trauma also differed significantly (p < 0.001). Within group analysis showed that MBI and PQL outcomes improved significantly (p < 0.001) for the experimental group after 12 weeks.

Conclusion

The current study contributes to the existing evidence on the effectiveness of Yoga in managing stress and developing resilience among doctors, nurses, and other medical professionals. Integrating yoga into healthcare settings is crucial for addressing the detrimental impact of burnout on decision-making and promoting positive patient outcomes. mHealth technologies have the potential to enhance the user-friendliness of yoga-based interventions by personalizing the practice space and time. Yoga-based interventions and mHealth technologies can effectively address physician burnout, in a simple and implementable manner.

Euro-Burn I: Assessment of burnout syndrome in health workers in a mediterranean country during the SARS-CoV-2 pandemic

BACKGROUND

Burnout syndrome (BS) has a negative impact among health professionals.

AIMS

Our research objective is to quantify the level of burnout in health workers of the Spanish National Health System during the COVID-19 pandemic using and comparing two independent measurement instruments.

METHODS

Cross-sectional, descriptive and multicenter study conducted through an anonymous online survey among health workers of the National Health System, measuring the level of burnout using the Maslach Burnout Inventory (MBI) and the Copenhagen Burnout Inventory (CBI).

RESULTS

A total of 448 questionnaires were analyzed, the mean age of the participants was 43.53 years (range: 20-64), 365 (81.5%) women. 161 (35.9%) participants presented BS measured with the MBI and 304 (67.9%) measured with the CBI. Regarding work contract, those who had greater job stability presented a higher degree of cynicism with respect to the eventual ones (p = .010), the eventual ones presenting higher mean scores in professional efficacy (p = .034). Urban workers had higher scores of exhaustion (p < .001) and cynicism (p < .001) than those living in rural areas. When comparing both tests, a high predictive value for exhaustion and cynicism was found to measure BS through the CBI (AUC = 0.92 and 0.84, respectively) and a low AUC with respect to the predictive value for efficacy (AUC = 0, 59).

CONCLUSIONS

The results obtained show a high level of BS among the health workers who participated in our study. Both tests have an excellent correlation in the degree of exhaustion and cynicism, but not in efficacy. The BS measurement must be performed with at least two validated instruments to increase its reliability.

Exploring the relationship between burnout and emotional intelligence among academics and clinicians at King Saud University

BACKGROUND

Academics and clinicians are exposed to significant workload pressures and are at a high risk of stress and burnout.

OBJECTIVES

This study aimed to examine the relationship between burnout and emotional intelligence (EI) by comparing and corelating burnout and EI scores among academics and clinicians against several factors.

METHODS

In this cross-sectional study, academics and clinicians at King Saud University and King Saud University Medical City and Affiliated Hospitals were invited to complete anonymous questionnaires: Maslach Burnout Inventory-Human Services Survey and the Trait Emotional Intelligence Questionnaire Short Form. The collected data were analyzed using the SPSS software for descriptive studies, group comparisons, regression analyses, and Pearson's (r) correlation tests.

RESULTS

Study participants included 126 individuals (men = 65, 51.6%; women = 61, 48.4%). Of these, 65% were Saudi nationals and 35% were expatriates, and 76 were academics while 50 were clinicians. The mean (minimum to maximum) burnout total score was 55 ± 18.9 (8 to 97) and the global TEIQue-SF score ranged between 2.8 and 6.7 (5.04 ± 0.7). Burnout scores varied between departments and were higher among younger participants and non-Saudis. Age had a small direct correlation with self-control (r = .17, p = .05), and there was no statistically significant correlation with other EI factors. However, there was a moderate inverse correlation between age and emotional exhaustion (EE) (r = -0.33, p < 0.0001), and a small inverse correlation with depersonalization (DP) (r = -0.21, p = 0.02). T-tests demonstrated a statistically significant difference in EI factor "emotionality" among Saudis (5.2 ± .8) and non-Saudis (4.9 ± .8) (t124 = 2.2, p = 0.03), and for burnout subscales, there was a statistically significant difference in DP among Saudis (6.4 ± 4.8) and non-Saudis (8.5 ± 5.6), (p = 0.03). Moderate (r = -0.3, p = 0.01) and weak (r = -0.2, p = 0.05) negative correlations were found between EI factors and burnout subscales (EE, DP).

CONCLUSION

This study confirmed an inverse relationship between burnout and EI scores among academics and clinicians. The findings suggest the need for introducing measures and implementing a system for early detection of burnout among staff and providing support to enhance EI and requisite care for those undergoing burnout episodes.

Psychometric properties of the arabic version of the maslach burnout inventory-human services survey (MBI-HSS) among lebanese dentists

BACKGROUND

Dentists are at risk of burnout syndrome, which can have negative impacts on their work environment and productivity. Assessing burnout is crucial for maintaining the well-being and effectiveness of dentists in their profession. The present study aims to evaluate the psychometric properties of the Arabic version of the Maslach Burnout Inventory Human Services Survey (MBI-HSS) among dentists.

METHODS

The original English version of the MBI-HSS was translated into Arabic, and then back-translated into English by experienced bilingual professionals. Lebanese dentists were asked to participate in the study between February and June 2019. Data collected included demographic information and items from the Arabic version of the MBI-HSS.

RESULTS

A total of 441 people participated in the study, of whom 58.3% were men. The mean age of the sample was 39.6 years (SD = 12.8), with a range of 23 to 68 years old. Approximately 60% of dentists were specialists. Cronbach's alphas were as follows: emotional exhaustion (alpha = 0.855), depersonalization (alpha = 0.823), and personal achievement (alpha = 0.667). The results of the test-retest reliability assessment demonstrated the strong reproducibility of the MBI-HSS [EE, ICC = 0.927 (0.845, 0.966), p-value < 0.0001; PA, ICC = 0.963 (0.921-0.983), p-value < 0.001; DP, ICC = 0.764 (0.497-0.889), p-value < 0.0001]. The exploratory factor analysis of the MBI-HSS yielded three psychometrically robust sub-domains representing dimensions of "emotional exhaustion," "depersonalization," and "personal achievement," which explained 57.8% of the scale's total variance. The confirmatory factor analysis revealed that the 15-item model (excluding items 4, 5, 12, 13, 16, 20, and 22) was the most fitting for the data.

CONCLUSIONS

The Arabic version of the MBI-HSS scale demonstrated good psychometric properties in Lebanese dentists. However, it would be important to conduct further research to confirm its reliability and validity in other Arab countries.

Understanding and Fostering Mental Health and Well-Being among University Faculty: A Narrative Review

In recent years, there has been increasing recognition of mental health concerns in academia, with stress, burnout, anxiety, and depression being reported among faculty members. The demanding work environment, the need to balance personal and professional duties, and the constant pressure of productivity while navigating multiple tasks of teaching, research, mentorship, professional development, and service all impact the mental health and overall well-being of faculty. Higher education institutions have structurally changed as has the research landscape. These changes as well as faculty-specific and student-specific factors coupled to the effect of the COVID-19 pandemic have led to profound effects on the mental health of academics. This paper is a narrative review of the pertinent literature describing faculty mental health and well-being. It summarizes the available evidence on factors influencing faculty mental health and shows the prevalence of anxiety, depression, stress, and burnout among faculty from various academic fields and along the whole academic ladder. Using a suggested framework that collates the efforts of leaders and faculty, the paper concludes by exploring strategies that promote work-life balance among academics and suggesting effective interventions to improve their mental health outcomes.

Psychological contract breach and emotional exhaustion among self-initiated expatriates: The role of social support and cultural orientation

Self-initiated expatriates (SIEs) face a unique set of challenges associated with working abroad without organizational sponsorship or support. A lack of clarity about mutual obligations and responsibilities can often lead to misunderstandings about the terms of the employment relationship and to perceptions of psychological contract breach. Drawing on a sample of self-initiated expatriates working in the United Arab Emirates, this study examines the relationship between psychological contract breach and emotional exhaustion exploring how culturally based value orientations and social support affect the relationship. Results indicate that individual-level cultural orientation can shape the responses of SIEs to perceived breaches and to its detrimental emotional effects. Individuals with a collectivist as opposed to an individualist orientation utilize more effectively social support from co-workers and supervisors and are less likely to be negatively affected by psychological contract breaches.

Comparison of the burnout among medical residents before and during the pandemic

OBJECTIVE

This study aims to compare the level of burnout syndrome in medical residents before and during the COVID-19 pandemic and identify potential risk factors.

METHODS

This cross-sectional study was conducted on medical residents from three different university hospitals in Turkey in March 2021, one year after the pandemic hit Turkey. Burnout is measured by the Maslach Burnout Inventory which assesses three dimensions of it: emotional exhaustion, depersonalization, and personal accomplishment. Collected data were combined and compared with data from a previous study which was held in the same hospitals in December 2019, three months before the pandemic.

RESULTS

412 medical residents from three universities participated. The mean age was 27.8 ± 2.4 and half of them were female. Compared to pre-pandemic levels, no significant differences in emotional exhaustion (pre:19.0 ± 7.6 post:18.8 ± 7.8), depersonalization (pre:7.3 ± 4.3 post:7.2 ± 4.4), and personal accomplishment (pre:20.8 ± 5.1 post:21.1 ± 5) scores were observed one year after pandemic. Adjusting for confounders, multiple linear regression models indicated that who are female, are in surgical specialty, have vulnerable cohabitant, and have more night shifts faces higher emotional exhaustion. Depersonalisation is higher among who spent more years in residency, have more night shifts, or COVID-19 outpatient duty. Females and those who have vulnerable cohabitant has lower levels of Personal Achievement.

CONCLUSION

This study does not support the hypothesis that pandemic increases the burnout levels. Yet it identifies a couple of pandemic related factors that are associated with burnout and confirming the association of several previously known factors.

Burnout in primary healthcare physicians and nurses in Turkey during COVID-19 pandemic

BACKGROUND

Due to additional responsibilities and uncertainties during the COVID-19 pandemic, primary healthcare (PHC) workers are at increased risk of burnout.

AIM

To determine and compare the burnout levels and related factors in PHC nurses and family physicians (FPs) during the COVID-19 pandemic.

METHODS

An online survey was delivered to PHC workers. Non-random sampling method was used. To evaluate burnout, the Maslach Burnout Inventory was used, which investigates burnout in three categories: emotional exhaustion (EE), depersonalization (DP) and reduced personal accomplishment (PA). Multivariate linear regression was used to analyze factors associated with burnout for FPs and nurses separately.

FINDINGS

Among the participants, 55.7% were nurses, the mean age was 42.34. FPs and nurses experienced similar levels of burnout in terms of EE. Family physicians had higher levels of low PA and DP. Based on the results of the multivariate analysis, while higher EE levels were significantly associated with unequal distribution of workload and communication problems within the Family Health Center for physicians, the unequal distribution of PPE, lack of appreciation by patients or colleagues and restrictions on work-related rights were relevant factors for nurses. Lack of appreciation and restrictions of the rights were associated with increased DP scores in both groups. Unequal distribution of workload was also associated with reduced PA among FPs.

CONCLUSION

PHC physicians and nurses are affected by burnout in different ways under the conditions of the COVID-19 pandemic based on gender, socioeconomic status and working conditions. To protect the mental health of PHC workers in the next public health emergency, clarification in the organization of services, empowering PHC workers in emergency risk communication and provision of timely, adequate and free PPE is essential. It is also crucial to ensure the rights of health workers through macro policy changes especially during emergencies.

Evaluation of compassion fatigue and compassion satisfaction among emergency nurses in Jordan: A cross-sectional study

BACKGROUND

Nurses working in emergency departments are overworked and exposed to frequent stressors over time, leading to compassion fatigue, burnout, and secondary traumatic stress.

AIMS

This study aimed to assess the levels of compassion fatigue and compassion satisfaction, and examine the relationship of these two variables with specific demographic, health-related, and work-related factors among emergency nurses in Jordan.

METHODS

This is a cross-sectional study. The Professional Quality of Life Scale Version 5 was used to collect data.

RESULTS

A convenience sampling method was used to recruit 203 registered nurses from emergency departments in Jordan. The mean compassion fatigue and satisfaction scores were moderate. There was a significant but negligible correlation between compassion satisfaction and educational levels (r = 0.15, p < 0.05) and between secondary traumatic stress and comorbid diseases (r = -0.16, p < 0.05).

CONCLUSIONS

Although the levels of compassion fatigue and satisfaction were moderate, both may negatively affect nurses' care and patient outcomes. Conversely, compassion satisfaction should be improved in order to overcome the negative effects of compassion fatigue.

Burnout and Depressive Symptoms in Healthcare Professionals: A Cross-Sectional Study in Saudi Arabia

OBJECTIVES

The study objectives were to examine the prevalence of burnout among healthcare professionals, analyze the association of depression and burnout among healthcare professionals, and explore the factors related to burnout.

METHODS

A prospective cross-sectional study using a validated questionnaire was conducted among healthcare professionals in a tertiary teaching hospital in Saudi Arabia's central region. The Maslach Burnout Inventory (MBI) questionnaire was used to measure burnout through emotional exhaustion, depersonalization, and personal accomplishment. Descriptive and inferential statistics were carried out using SAS version 9.4.

RESULTS

The study sample was composed of 139 healthcare professionals. Around 48% of the study sample were nurses, 26% were physicians, 19% were pharmacists, and 6% were other healthcare professionals. About 61% screened positive for depression. Overall, one third of the participants had a high risk of burnout. Around 61.8% of the participants were in the high-risk group of the EE, 58.3% of the DP, and 41.0% of the PA subscales. Scores for the overall MBI were significantly different between various age groups, gender, those with social and financial responsibility, income, job titles, or years of experience. A higher risk of burnout in all subscales was observed among those with depression.

CONCLUSIONS

A high risk of burnout was observed among healthcare professionals. The level of burnout was connected to workplace factors and the presence of depression. The burnout suffering among these healthcare professionals underlines the need to study further how to reduce the factors that contribute to burnout and the impact of interventions to reduce healthcare professionals' burnout levels. The burnout scientific literature would benefit from further high-quality research with larger samples using longitudinal study designs to identify the causal risk factors.

The role of chronic physical illness and job dissatisfaction on burnout’s risk among medical interns in Oman: a study of prevalence and determinants

Background

Medical interns are at risk of burnout due to several organizational and individual factors. There is scarcity of studies exploring the role of chronic physical illness and job dissatisfaction on burnout experience among medical interns. This study examined the prevalence of burnout syndrome and explored whether chronic physical illness and job dissatisfaction could independently predict burnout syndrome among medical interns in Oman. This cross-sectional study was conducted among a random sample of medical interns enrolled in the Omani internship program. One-hundred and eighty interns participated in this study and filled in a self-reported questionnaire that included Maslach Burnout Inventory (MBI), Job Satisfaction Survey (JSS), and data related to physical illness.

Results

The prevalence of burnout syndrome was 15%. Having a physical illness (OR = 7.285, 95% CI = 1.976–26.857, P = 0.003) and job dissatisfaction (OR = 16.488, 95% CI = 5.371–50.614, P = 0.0001) was significant independent predictors of high levels of the EE subscale. In addition, having a physical illness (OR = 4.678, 95% CI = 1.498–14.608, P = 0.008) and being dissatisfied (OR = 2.900, 95% CI = 11.159–7.257, P = 0.023) were significant independent predictors of the high DP subscale. Having physical illness was independent predictors of the low personal accomplishment subscale (OR = 0.258, 95% CI = 0.088–0.759, P = 0.014).

Conclusions

Burnout syndrome is prevalent among medical interns in Oman. Job dissatisfaction and chronic physical illness are risk factors for burnout syndrome. Internship programs should consider these factors when designing burnout mitigative strategies.

A Shorter Form of the Work Extrinsic and Intrinsic Motivation Scale: Construction and Factorial Validation

While workplace mental health has attracted attention in many countries, work motivation remains under-researched. Research identified that work motivation is associated with many organisational positive outcomes including workplace mental health. One well-recognised measure is the Work Extrinsic and Intrinsic Motivation Scale (WEIMS). Conceptualised on the Self-Determination Theory, this 18-item scale examines six types of work motivation: Intrinsic Motivation, Integrated Regulation, Identified Regulation, Introjected Regulation, External Regulation, and Amotivation. WEIMS can be too long for busy people at work. Accordingly, we constructed and validated a shorter form of WEIMS (SWEIMS), comprising 12 items that evaluate the same six work motivation types. Data collected from two professional samples were analysed to construct and validate the factorial structure: 155 construction workers (138 males and 17 females, Age 40.28 ± 11.05) and 103 hospitality workers (47 males and 56 females, Age 28.2 ± 8.6 years). Correlation analyses and confirmatory factor analyses were performed. Two items from each type were selected based on the strength of correlations with the target WEIMS subscale. SWEIMS demonstrated adequate internal consistency (α ≧ 0.65), and strong correlations with the original version of WEIMS (r = 0.73) in both samples. SWEIMS confirmatory factor analysis replicated the six-factor model of the original SWEIMS. SWEIMS can be a reliable, valid, and user-friendly alternative to WEIMS.

Burnout syndrome among pediatric dentists in Egypt

Background

Pediatric dentists in Egypt are exposed to chronic stress associated with pediatric dental care. After long years of specialization, training, and practice, they seem to be unsatisfied. An increased prevalence of burnout could be the reason. This study aimed to determine the prevalence of occupational burnout among Egyptian pediatric dentists.

This study is a cross-sectional, observational study, which was carried by a self-administered online survey questionnaire that was sent to active members in the Egyptian Pediatric Dentistry Associations. A total number of 100 pediatric dentists participated in this study. All of them were offered to fulfill the questionnaires including that of Maslach Burnout Inventory and the semi-structured questionnaire to complete their sociodemographic and work-related data.

Results

It was found that the number of kids raised up by the practitioner is significantly associated with the level of depersonalization. It was also found that the number of working hours per week and number of patients treated per day have a significant association with the level of exhaustion, depersonalization, and personal accomplishment. There were no gender differences in the prevalence of burnout or depression.

Conclusions

Burnout prevalence among pediatric dentist in Egypt is high and higher than its prevalence among other dentists. Marriage and sleeping in home with the family have protective effects against burnout statistically. There is significant association between high number of working hours of the pediatric dentist per week and burnout.

Impact of Extracorporeal Membrane Oxygenation Service on Burnout Development in Eight Intensive Care Units. A National Cross-Sectional Study

OBJECTIVES

This study aimed at investigating the effects of an extracorporeal membrane oxygenation (ECMO) service on Burnout syndrome (BOS) development in the intensive care unit (ICU).

DESIGN

The authors conducted a cross-sectional descriptive study.

SETTINGS

Eight ICUs within 5 tertiary hospitals in 1 country.

PARTICIPANTS

Intensive care practitioners (nurses, physicians, and respiratory therapists).

INTERVENTION

Using an online questionnaire, the Maslach Burnout Inventory Human Services Survey for Medical Personnel. In addition, demographic variables, workload, salary satisfaction, and caring for COVID-19 patients were assessed. Participants were divided based on working in an ICU with ECMO (ECMO-ICU) and without (non-ECMO-ICU) ECMO service, and burnout status (burnout and no burnout).

MEASUREMENTS AND MAIN RESULTS

The response rate for completing the questionnaire was 36.4% (445/1,222). Male patients represented 53.7% of the participants. The overall prevalence of burnout was 64.5%. The overall burnout prevalence did not differ between ECMO- and non-ECMO-ICU groups (64.5% and 63.7, respectively). However, personal accomplishment (PA) score was significantly lower among ECMO-ICU personnel compared with those in a non-ECMO-ICU (42.7% v 52.6, p = 0.043). Significant predictors of burnout included profession (nurse or physician), acquiring COVID-19 infection, knowing other practitioners who were infected with COVID-19, salary dissatisfaction, and extremes of workload.

CONCLUSION

Burnout was equally prevalent among participants from ECMO- and non-ECMO-ICU, but PA was lower among participants in the ICU with an ECMO service. The reported high prevalence of burnout, and its predictors, requires special attention to try to reduce its occurrence.

Alleviating Work Exhaustion, Improving Professional Fulfillment, and Influencing Positivity Among Healthcare Professionals During COVID-19: A Study on Sudarshan Kriya Yoga

Demanding work-life and excessive workload, the conflict between professional and personal lives, problems with patients and those related to the occurrence of death and high risk for their own life are a few factors causing burnout, disengagement, and dissatisfaction in the professional lives of healthcare professionals (HCPs). The situation worsened during the COVID-19 pandemic. It is of utmost importance to find effective solutions to mitigate the stress and anxiety adversely affecting the mental well-being and professional lives of HCPs. This study was designed to examine the efficacy of Sudarshan Kriya Yoga (SKY) for alleviating work exhaustion, improving Professional Fulfillment, and influencing positivity among HCPs during COVID-19. In a comparative observation before the intervention (Pre), after the intervention (Post), and 30 days after the intervention (Day 30) in the Experimental Group (29 physicians) and Control Group (27 physicians), it was found that immediately after SKY, HCPs experienced a significant improvement in Professional Fulfillment (p = 0.009), work exhaustion (0.008), positive affect (p = 0.02), and negative affect (p < 0.001) compared to the Control Group. The effect of SKY continued until Day 30 for Professional Fulfillment and had positive and negative effects. Findings suggest that SKY elevated Professional Fulfillment among HCPs during the COVID-19 pandemic and reduced their work exhaustion and the negative effect on their mental health. SKY can aid HCPs in maintaining their well-being when faced with unprecedented challenges.

Burnout assessment among academic dental staff during COVID-19: Data from Arab countries

Purpose/objective

This study aimed to identify factors that were associated with high burnout and investigate the prevalence of burnout among academic dental staff during the COVID‐19 pandemic.

Method

A cross‐sectional online survey was carried out among academic dentists who are working in multiple dental schools in Arab countries. The Copenhagen Burnout Inventory was used to assess participants’ work‐related burnout. Logistic regression was used to assess the factors that increase the risk of burnout among academic dentists.

Results

Of the 254 participants who took part in the study, 141 were males (55.5%). The average age of the participants in the study was 42.1 years (standard deviation = 10.0). The prevalence of burnout among participants was 44.9% (n = 114). Using a fully adjusted logistic regression model, age (odds ratio [OR] = 1.05, 95% confidence interval [CI]: 1.01–1.09, p = 0.008) and gender (OR = 0.54, 95% CI: 0.31–0.94, p = 0.03) were significant variables associated with high overall burnout. Female individuals had a substantially reduced risk of experiencing high personal burnout than male participants (OR = 0.56, 95% CI: 0.32–0.98, p = 0.043) in the personal burnout subdomain. While in the patient's burnout subdomain, age (OR = 1.04, 95% CI: 1.00–1.08, p = 0.048), type of speciality (OR = 2.44, 95% CI: 1.02–5.83, p = 0.044), and teaching place (OR = 2.49, 95% CI: 1.21–5.11, p = 0.013) were associated with higher burnout.

Conclusion

This study concluded that gender and age are characteristics that increase the risk of higher burnout among academic dentists during the COVID‐19 pandemic.

Occupational burnout in Iranian health care workers during the COVID-19 pandemic

BACKGROUND AND AIM

Health care workers (HCWs), mostly frontliners, are encountering numerous physical and psychosocial stressors, and even managing some conflicts over the course of the novel coronavirus disease 2019 (COVID-19). In this respect, the present study was to investigate the prevalence rate of occupational burnout (OB) in such workers during this pandemic.

MATERIALS AND METHODS

This cross-sectional study was conducted between April 6 and May 30, 2020, via an online survey in 31 provinces of Iran, on HCWs selected based on convenience sampling method. For data collection, a socio-demographic information form and the Maslach Burnout Inventory (MBI) was utilized. Descriptive statistics, Chi-square test, and multivariate regression analysis were also applied to test the research hypotheses.

RESULTS

In total, 7626 HCWs participated in the present study. Accordingly, 73.2 and 26.8% of the workers were female and male, respectively. As well, 57.8% of the respondents were nurses and 14.4% of the cases were clinicians. Moreover, 44.8% of the participants had thus far worked in isolation wards and 40.3% of these individuals reported working for 4-8 hours with COVID-19 patients. The prevalence rate of OB was 18.3%. Besides, 34.2, 48.7, and 56.1% of the respondents had severe levels of emotional exhaustion (EE), higher depersonalization (DP), and decreased sense of personal accomplishment (PA), respectively. Besides, the HCWs at the age range of 20 to 30, having female gender, no children, and a bachelor's degree, and working in isolation wards showed the higher levels of OB with reference to the Chi-square test results (p < 0.001). Accordingly, the statistical test outcomes demonstrated that a history of physical illnesses (p = 0.001) and psychiatric disorders (p = 0.044) could be the best predictor of OB throughout the first peak of the COVID-19 pandemic.

CONCLUSION

Regarding the high prevalence rate of OB among the HCWs and the remaining COVID-19 journey in Iran, health care managers are recommended to orient the required management and coping strategies toward improving mental health in these individuals.

Occupational Burnout and Productivity Loss: A Cross-Sectional Study Among Academic University Staff

Background

Burnout has been endorsed with serious negative health- and work-related outcomes. This study is aimed to assess the prevalence of burnout and its association with work productivity among academic staff.

Methods

This cross-sectional study involved 240 academic staff working at a public university in Egypt. Participants were invited to complete a web-based questionnaire involving basic personal, health, and work-related characteristics. Besides, Maslach Burnout Inventory-Human Services Survey (MBI-HSS) was used to assess occupational burnout dimensions (i.e., emotional exhaustion "EE," depersonalization "DP," and personal accomplishment "PA"), while work productivity was assessed with the Health and Work Performance Questionnaire (HPQ).

Results

In total, 28% of respondents scored high in EE [95% confidence interval (CI): 22.5-33.8%], 18.3% high in DP (95% CI: 13.8-3.6%), and 88.3% scored low in PA (95% CI: 83.8-91.9%). Seventy percent of respondents scored high in only one burnout dimension, 21.7% scored high in two dimensions, while 7.1% scored high in all three dimensions. Multivariable analysis showed that EE was the only burnout dimension that showed a statistically significant association between absenteeism and presenteeism rates. The absenteeism rates among respondents with moderate and high EE were 2.1 and 3.3 times the rates among those with low EE, respectively. Likewise, the presenteeism rates among respondents with moderate and high EE were 2.4 and 4.7 times the rates among those with low EE, respectively.

Conclusions

Academic staff showed a high prevalence of at least one burnout dimension. Moderate and high EE scores were significantly associated with increased productivity loss when compared to low EE.

Prevalence of burnout syndrome among unmatched trainees and residents in surgical and nonsurgical specialties: a cross-sectional study from different training centers in Palestine

BACKGROUND

Burnout is a psychological syndrome that involves physical, mental, and emotional exhaustion. This study was conducted to determine the prevalence of burnout among unmatched trainees and residents in surgical and nonsurgical specialties in Palestine. Additionally, this study also sought to identify the associated variables and predictors of higher burnout scores.

METHODS

This study was conducted in a cross-sectional design using a questionnaire in the period between October 2020 and March 2021. The questionnaire collected sociodemographic characteristics of the residents and trainees in 18 different training centers/hospitals. The Copenhagen Burnout Inventory was used to determine burnout among the residents and trainees. Pearson's correlations, analysis of variance, Student's t-test, and multiple linear regressions were used to analyze the data.

RESULTS

The study tool was completed by 250 residents and trainees in surgical and nonsurgical specialties (response rate = 83.3%). Of all participants, 203 (81.2%) reported a moderate-severe degree of burnout in the personal domain, 188 (75.2%) reported a moderate-severe degree of burnout in the work-related domain, and 97 (38.8%) reported moderate-severe degree of burnout in the client-related domain. There was a moderate and positive correlation between personal and work-related burnout scores (Pearson's r = 0.69, p-value < 0.001), and client-related burnout scores (Pearson's r = 0.52, p-value < 0.001). Similarly, there was a moderate and positive correlation between work-related and client-related burnout scores (Pearson's r = 0.57, p-value < 0.001). The multiple linear regression model showed that higher burnout scores were predicted by being married, not having another paid employment, inability to financially support oneself, frequent consumption of tea/coffee, dissatisfied with the training/job, thinking to change the profession, and long working hours.

CONCLUSION

The findings of this study indicated that burnout was highly prevalent among residents and trainees in surgical and nonsurgical specialties in Palestine. Decision-makers in healthcare authorities, hospital managers, professional groups, directors of residency programs, and educators/trainers should consider addressing burnout and improving the well-being of residents and trainees in surgical and nonsurgical specialties in Palestine. Future studies are still needed to determine which interventions could be effective in reducing burnout among residents and trainees in surgical and nonsurgical specialties in Palestine.

Prevalence and Risk Factors of Burnout Among Female Oncologists From the Middle East and North Africa

Background

Burnout (BO) is a recognized challenge among the oncology workforce. It affects both genders with a higher frequency among women. This study examined the factors contributing to the development of burnout among female oncologists from the Middle East and North Africa (MENA).

Methods

An online cross-sectional survey was distributed to oncology professionals from different countries in the MENA region. The validated Maslach Burnout Inventory (MBI) of emotional exhaustion (EE), Depersonalization (DE), and Personal Achievement (PA) plus questions about demography/work-related factors and attitudes toward oncology were included. Data were analyzed to measure BO prevalence and related factors.

Results

Between 10 February and 15 March 2020, 545 responses were submitted by female oncologists. The responses pre-dated the COVID-19 pandemic emergence in the region. BO prevalence was 71% among female professionals. Women aged <44 years represented 85% of the cohort. Sixty-two percent were married, 52% with children and one-third practiced a hobby. Two-thirds worked in medical oncology, worked for <10 years and 35% worked in academia. The majority (73%) spent >25% on administrative work daily. Nearly half of the respondents (49%) expressed a recurring thought of quitting oncology and 70% had no burnout support or education. Inability to deliver optimal care was reported as distressing for career development in 82%. Factors significantly influencing the BO risk were identified. Marital status, having children, academia and years in practice did not impact the risk of BO among female oncologists from MENA.

Conclusion

Female oncologists from the Middle East and North Africa (MENA) were found to have a high prevalence of BO. In this cohort, the majority of women oncology workers were young and in their early to mid-career stages. Burnout was linked to being younger, practicing in North African nations, having a heavy administrative load, and having persistent thoughts of quitting. Practicing a hobby and engaging in oncology communication, on the other hand, reduced the chance of BO. Burnout support and education, specifically for oncology women, is required.

A cross-sectional survey of burnout in a sample of resident physicians in Sudan

BACKGROUND

Resident physicians in Sudan face a variety of physical and psychological stressors. Nevertheless, the prevalence of burnout syndrome among this critical population remains unknown. The purpose of this study was to estimate the prevalence rate of burnout and its associated factors in a sample of resident physicians in Sudan.

METHODS

A cross-sectional design was used to assess the burnout syndrome among resident physicians at the teaching hospitals of Wad-Medani in Gezira state, east-central Sudan. Three hundred resident physicians at the dermatology, general surgery, pediatrics, obstetrics and gynecology, psychiatry, ear, nose and throat (ENT), oncology, urology, and internal medicine departments, were approached and invited to participate in the study. The Arabic version of the Maslach Burnout Inventory was distributed to respondents from July to October 2021.

RESULTS

From the 300 resident physicians, 208 (69.3%) responded. The average age of the study population was 29.99 ± 3.01 years, with more than half were females (56.7%), single (59.6%), and with more than three years of residency experience (50.5%). In total, 86.1% met the criteria for burnout in at least one dimension and 13.9% in all three dimensions. On the dimension of emotional exhaustion (EE), 70.7% reported high levels of burnout. While, 44.2% reported high levels of depersonalization (DP), and 73.1% experienced a sense of decreased professional accomplishment (PA). There were significant differences in burnout, EE, and DP levels among different specialties, with the pediatrics-specialty trainees reported higher levels. Burnout syndrome was associated with the working hours per single duty; participants who reported working for more than 24 hours had experienced higher levels of burnout, EE, and DP.

CONCLUSION

Large-scale studies are required to assess the determinants of burnout syndrome among resident physicians in Sudan. In addition, Stakeholders should urgently implement effective remedies to protect the mental health of resident physicians.

Applied Mindfulness for Physician Wellbeing: A Prospective Qualitative Study Protocol

BACKGROUND

Physician burnout has significant adverse impacts on the wellbeing of individual physicians, and by extension the healthcare delivery systems of which they are part. Mindfulness is consistently cited as a pragmatic approach to effectively address burnout and enhance physician wellbeing. However, very few empirical studies have been published on Mindfulness Based Interventions (MBIs) for physicians. Moreover, the majority of these studies have been quantitative, leaving a gap in understanding the practical application of mindfulness in the context of physicians' daily lives.

OBJECTIVES

This paper outlines the rationale, development and design of a novel prospective qualitative study examining the acceptability, feasibility, and pragmatic application of a mindfulness intervention for physician wellness.

METHODS

The study will be conducted in three groups of at least 8 practicing physicians from a broad range of medical specialties at a tertiary care hospital in a large urban center in Eastern Canada. The intervention will consist of an innovative program based on the teachings of internationally renowned scholar and Zen Master Thích Nhãt Hạnh. It will include 5 weekly 2-h mindfulness sessions delivered by two health providers trained in mindfulness and in the teachings of Thich Nhat Hanh. The primary outcome measure will be an in-depth Thematic Analysis of post-program semi-structured interviews. Field data will also be collected through participant observation. The study will be theoretically grounded within the interpretive paradigm utilizing "the Mechanisms of Mindfulness Theory". An external advisory committee formed by four senior members of Thích Nhãt Hạnh's community will provide guidance across all phases of the study.

DISCUSSION

Our innovative approach provides a new framework to further understand the mechanisms by which mindfulness interventions can impact physician wellbeing, and by extension their patients, colleagues, and broader healthcare systems. Through a clear articulation of the rigorous application of accepted procedures and standards used in our protocol, this paper seeks to provide a roadmap for other researchers who wish to develop further studies in this area. Lessons learned in the preparation and conduction of this study can be applied to other healthcare contexts including non-physician health provider wellbeing, clinical care, and population-level mental health.

The Prevalence of Burnout and Its Associated Factors Among Surgical Specialists in Kuwait Ministry of Health Hospitals

Background

Workplace burnout is a state of emotional exhaustion (EE), depersonalization of others (DP), and low personal accomplishment (PA) owing to workplace stressors. This study aimed to assess the prevalence of burnout and its associated factors among surgical specialists in Kuwait.

Methods

This cross-sectional study assessed the prevalence of burnout among 489 surgeons in practice at Kuwait Ministry of Health (MOH). Data were collected using a self-administered questionnaire. Burnout was assessed using the Maslach Burnout Inventory, which defines burnout as having a high score of EE or DP, or a low score of PA; with severe burnout involving all. The associations between burnout or severe burnout with sociodemographic and occupational characteristics were assessed using multivariate binary logistic regression to adjust for potential confounders.

Results

Prevalence estimates for burnout and severe burnout were 76.9% (95% Confidence Interval = 72.9–80.7%) and 14.0% (11.0–17.5%), respectively. The prevalence estimates for high EE, high DP, and low PA scores were 44.7, 43.1, and 47.2%, respectively. The prevalence of burnout and severe burnout was highest among neurosurgeons. Burnout was lowest among otolaryngology surgeons and severe burnout was lowest among cardiothoracic surgeons. After adjustment, burnout was associated with younger age, lower income, and more on-calls per month. The four most common sources of stress included less family time, verbal assault, case overload, and highly complicated cases.

Conclusion

The prevalence of burnout among surgeons in Kuwait MOH hospitals is high. Occupational health programs should use these findings to design and implement interventions that can treat and prevent burnout in this population.

Implications of resource constraints and high workload on speaking up about threats to patient safety: a qualitative study of surgical teams in Ghana

Background

Although under-resourcing of healthcare facilities and high workload is known to undermine patient safety, there is a dearth of evidence about how these factors affect employee voice and silence about unsafe care. We address this gap in the literature by exploring how resource constraints and high workload influence the willingness of staff to speak up about threats to patient safety in surgical departments in Ghana.

Method

Semistructured interviews with a purposeful sample of 91 multidisciplinary professionals drawn from a range of specialities, ranks and surgical teams in two teaching hospitals in Ghana. Conservation of Resources theory was used as a theoretical frame for the study. Data were processed and analysed thematically with the aid of NVivo 12.

Results

Endemic resource constraints and excessive workload generate stress that undermines employee willingness to speak up about unsafe care. The preoccupation with managing scarce resources predisposes managers in surgical units to ignore or downplay concerns raised and not to instigate appropriate remedial actions. Resource constraints lead to rationing and improvising in order to work around problems with inadequate infrastructure and malfunctioning equipment, which in turn creates unsupportive environments for staff to air legitimate concerns. Faced with high workloads, silence was used as a coping strategy by staff to preserve energy and avoid having to take on the burden of additional work.

Conclusion

Under-resourcing and high workload contribute significantly towards undermining employee voice about unsafe care. We highlight the central role that adequate funding and resourcing play in creating safe environments and that supporting ‘hearer’ courage may be as important as supporting speaking up in the first place.