Job burnout among Israeli healthcare workers during the first months of COVID-19 pandemic: The role of emotion regulation strategies and psychological distress

Does the level of burnout differ between occupational groups in Lithuania?

Background

The strain on workers of the healthcare system and education sector increased psychological distress and burnout. This study aimed to distinguish the occupational group that is the most affected by occupational burnout and to reveal the scope of psychosocial risk factors among each occupational group.

Methods

This is a cross-sectional study that analyzed burnout syndrome among 1,046 participants of different occupational groups in association with psychosocial work environment factors in Lithuania. The anonymous questionnaire was composed of the standardized Job Content Questionnaire (JCQ), and the Copenhagen Burnout Inventory (CBI). To find out associations between psychosocial work environment factors and burnout dimensions, a multiple logistic regression model using the stepwise method was applied.

Results

The burnout levels in all three dimensions (personal, work-related, and client-related burnout) were significantly higher in physicians' and nurses' groups compared with public health professionals, teachers, and managers (p < 0.05). The job demands were associated with the personal burnout subscale for all occupations, except public health specialists - each one-unit increase of this variable significantly increased the probability of personal burnout from 10 to 16%, respectively by the occupation. Co-worker support was found to have a buffering effect for all occupational groups, except managers - and significantly reduced personal burnout for physicians (OR = 0.80), nurses (OR = 0.75), public health specialists (OR = 0.75), and teachers (OR = 0.79).

Conclusion

The burnout levels in all three dimensions differed between occupational groups: there were significantly higher in physicians' and nurses' groups compared with public health professionals, teachers, and managers. Considering the occupational preventive measures in the healthcare sector attention should be paid to the reduction of workload and ensuring good relations between co-workers.

Posttraumatic stress symptoms in healthcare workers during the COVID-19 pandemic: A four-wave longitudinal study

BACKGROUND

Posttraumatic stress symptoms of healthcare workers have become a significant public concern in the healthcare system that have long COVID-19. It is less known how the pandemic impacts the HCWs' PTSS longitudinally and long-term risk factors for it.

METHODS

Four consecutive surveys were conducted among healthcare workers in China from 2019 to 2023 COVID-19 outbreaks. Multilevel mixed-effect models were used to examine longitudinal changes and risk factors. Network analysis was utilized to explore network centrality changes in PTSS symptoms.

RESULTS

HCWs' PTSS symptoms were increased over time during the COVID-19 pandemic. Being female, being nurse, working in the emergency department, working longer hours, less frequently going back home and having COVID-19 infection are risk factors of PTSS for HCWs; unmarried is the protective factor. Significant interaction between symptom changes and profession exists. PTSS networks showed that Avoidance of thoughts, Emotional-cue activity, Exaggerated startle response and Hypervigilance were the central symptoms during four waves. The global strength of the PTSS network grows over time, and nodal strength of Avoidance of thoughts, Loss of interest and Negative beliefs increased by COVID-19.

CONCLUSION

The pandemic's impacts on healthcare workers vary by professions. PTSS symptoms exacerbate, reinforce each other, and persists with recurring waves.

Psychological distress among teaching staff during the COVID-19 pandemic: A transdiagnostic perspective on profiles of risk and resilience

Teaching staff are especially vulnerable to COVID-19-related stress, due to the significant demands they have experienced. Yet, many have shown resilience-good mental health despite stress exposure. The current study used a person-centered approach to identify distinct profiles according to individual differences in psychosocial risk and protective factors. Latent Profile Analysis and ANOVAs were employed among 350 Israeli teaching staff during the fourth wave of COVID-19. Two distinct profiles, "risk" (55%) and "resilience" (45%) were identified. While groups showed no differences in COVID-19-related stress outcomes, they consistently differed in their psychological reaction to COVID-19 (psychopathology, compassion fatigue, and compassion satisfaction).

Does acceptance lead to change? Training in radical acceptance improves implementation of cognitive reappraisal

Third-wave cognitive behavioral treatments such as dialectical behavioral therapy (DBT) theorize that emotional acceptance facilitates cognitive change. However, empirical evidence to support this notion is scarce. This study assessed how a two-week online training in using acceptance or cognitive change DBT skills influences the implementation of these strategies in an emotion regulation task. During six training sessions, 120 healthy individuals recorded personal negative events. In a Radical Acceptance group, participants implemented a DBT skill aimed to promote acceptance of the negative events they described. In a Check the Facts group, participants reappraised their interpretations of the described events. A Control group described negative events but did not use any DBT skill. Results supported our preregistered hypotheses showing that following the training, participants who practiced Radical Acceptance improved in their ability to implement both emotional acceptance and cognitive reappraisal (cognitive change) in an emotion regulation task. In contrast, the Check the Facts group improved only in the ability to use cognitive reappraisal, but not emotional acceptance. The control group did not improve in either strategy. The findings provide empirical evidence to support the notion that cultivating acceptance can subsequently improve the ability to reinterpret reality for coping adaptively with negative events.

Burnout, Organizational Justice, Workload, and Emotional Regulation among Medical and Non-Medical Personnel Working in Romanian Healthcare Units

Background and objectives: The goal of this study was to evaluate the levels of organizational justice, emotional regulation, and workload associated with the level of burnout experienced in medical and non-medical staff from public and private medical units. Materials and Methods: A cross-sectional study was conducted on a sample of 230 healthcare professionals, including 139 medical personnel and 91 non-medical staff respondents. The collected socio-demographic and organizational data and psychological tools were the Maslach Burnout Inventory (MBI HSS), the ECO System, and the emotional regulation questionnaire (ERQ). Results: For medical staff, burnout was measured in terms of emotional exhaustion (M = 27.05 ± 12.34), depersonalization (M = 8.26 ± 3.95), and personal accomplishment (M = 47.35 ± 6.78). The scores for non-medical staff were emotional exhaustion (M = 35.84 ± 14.71), depersonalization (M = 11.79 ± 6.30), and personal accomplishment (M = 44 ± 7.37). In terms of workload, higher scores were observed for non-medical staff (M = 25.43 ± 7.87), while medical staff recorded lower values (M = 20.35 ± 7.65). The scores for the cognitive reappraisal dimension were as follows: medical personnel (M = 32.02 ± 5.37) and non-medical staff (M = 31.67 ± 6.19). In terms of the expressive suppression dimension, medical staff registered at M = 17.99 ± 5.61, and non-medical staff registered at M = 17.19 ± 5.53. For organizational justice, higher scores were registered for medical staff (M = 25.87 ± 6.02) and lower scores for non-medical staff (M = 21.34 ± 5.72). Conclusions: Medical staff felt a higher sense of organizational justice than non-medical staff, as is also evidenced by the level of the workload dimension, which registers higher values for non-medical personnel. In the case of burnout, higher levels of emotional exhaustion and depersonalization dimensions were also revealed for non-medical staff and, in the case of the professional fulfillment dimension, higher scores were registered for medical staff.

The Role of Emotion Regulation as a Potential Mediator between Secondary Traumatic Stress, Burnout, and Compassion Satisfaction in Professionals Working in the Forced Migration Field

BACKGROUND

Professionals working with refugees are vicariously exposed to complex traumatic experiences lived by forced migrants, which can lead to the risk of developing secondary traumatic stress, burnout, and a poor compassion satisfaction. The current study aimed to explore the effects of secondary traumatic stress on burnout and compassion satisfaction in 264 Italian professionals working with refugees and forced migrants. Moreover, it examined the mediating role of emotion regulation between secondary traumatic stress and both burnout and compassion satisfaction.

METHODS

A structural equation modeling (SEM) was performed to test the hypothesis.

RESULTS

The results showed that increased levels of secondary traumatic stress were associated with an increase of burnout both directly and indirectly through the mediation of emotion regulation. Emotion regulation also totally mediated the relationship between secondary traumatic stress and compassion satisfaction.

CONCLUSIONS

The results suggested that prevention or interventions programs targeting emotion regulation might be important to improve the professional quality of life of operators working with refugees and forced migrants.

Working in corona-designated departments in a fortified underground hospital: Concerns about corona and predictors of job burnout

Background

In August 2020 during Israel's second COVID-19 wave Rambam Medical Center opened the Sammy Ofer Fortified Underground Emergency Hospital. This was declared a regional Corona center in the north of Israel, receiving the most severe Corona patients from the region. Alongside the advanced inpatient capacity and technology within the underground facility, there was a severe shortage of trained medical and paramedical staff, as well as harsh working conditions. The current study examined the implications and effects of working in an underground facility on healthcare workers, focusing on emotion regulation tendencies and profession as predictors of job burnout.

Methods

Seventy-six healthcare workers, who had worked in the underground hospital for a minimum continuous period of 2 weeks during the peak of the COVID-19 pandemic, and a control group of 40 healthcare workers from northern Israel were asked to fill out an online survey administered via Qualtrics (total sample 116). The survey comprised six questionnaires: a demographic survey questionnaire; a COVID-19 concerns questionnaire; a psychological distress questionnaire (DASS, Depression Anxiety Stress Scale); trait worry (PSWQ; Penn State Worry Questionnaire); emotion regulation (ERQ, Emotion Regulation Questionnaire), and burnout (SMBM, Shirom - Melamed Burnout Measure).

Results

Independent-samples t-tests revealed no significant differences in psychological distress or burnout between Rambam Underground hospital workers and the control group. Conversely, COVID-19 concern scores were significantly different in the two groups, the Rambam hospital workers showing less concern (M = 2.9, SD = 0.73) than the control group (M = 3.47, SD = 0.76) [t ₍₁₁₄₎ = -3.974, p < 0.001]. Hierarchical linear regression analysis identified the significant predictors of burnout among healthcare workers. Participants' profession (physician), psychological distress (total DASS score), and a personality trait of worry were statistically significant predictors for job burnout (p = 0.028, p < 0.001, p = 0.023, respectively). Concerns about COVID-19 marginally predicted job burnout (p = 0.09). Group (underground vs. control) and emotion regulation tendencies did not predict burnout.

Conclusion

The two groups showed no significant differences in psychological distress nor in burnout. Being a physician, having an intrinsic trait of being overly worried and experiencing psychological distress were significant predictors for job burnout among healthcare workers, regardless of work environment (underground vs. control).

Emerging lessons from the COVID-19 pandemic about the decisive competencies needed for the public health workforce: A qualitative study

The global COVID-19 crisis exposed the critical need for a highly qualified public health workforce. This qualitative research aimed to examine public health workforce competencies needed to face COVID-19 challenges and identify the gaps between training programs and the competency demands of real-world disasters and pandemics. Through a sample of thirty-one participant qualitative interviews, we examined the perspectives of diverse stakeholders from lead public health organizations in Israel. Grounded Theory was used to analyze the data. Six themes emerged from the content analysis: public health workforce's low professional status and the uncertain future of the public health workforce; links between the community and Higher Education institutions; the centrality of communication competencies; need to improve health promotion; the role of leadership, management, and partnership, and innovation in public health coherence. Increasing the attractiveness of the profession, professional and financial support, and improving the working conditions to ensure a sustainable and resilient PH system were deemed necessary. This paper describes and cultivates new knowledge and leadership skills among public health professionals, and lays the groundwork for future public health leadership preparedness programs.

Relationship between Psychological Distress, Basic Psychological Needs, Anxiety, Mental Pressure, and Athletic Burnout of Chinese College Football Athletes during the COVID-19 Pandemic

The rapid spread of the COVID-19 pandemic in early 2020 poses a significant threat to mental health, which may lead to psychological stress in a number of individuals. Athlete burnout is a common psychological phenomenon that has a negative influence on their sports career. The main purpose of this study was to evaluate the relationship between psychological distress and athletic burnout among Chinese college football athletes during the COVID-19 pandemic, and the mediating role of basic psychological needs, anxiety and mental pressure. In an online cross-sectional survey conducted in February 2022, the team coaches sent an electronic questionnaire to college football athletes. Participants completed questionnaires on relevant variables. Pearson correlation analysis and mediation effect analysis were carried out by using SPSS software and its plug-in process V3.3. The study included 672 participants and the results showed that: (1) psychological distress, basic psychological needs, anxiety, mental pressure and athletic burnout were significantly pairwise correlated, (2) mental pressure, anxiety and basic psychological needs play a mediating role between psychological distress and athletic burnout respectively, and (3) basic psychological needs and anxiety, basic psychological needs and mental pressure, anxiety and mental pressure, as well as mental pressure, anxiety and basic psychological needs respectively play a chain mediating role between psychological distress and athletic burnout. In conclusion, psychological distress during the COVID-19 pandemic is an important factor leading to athletic burnout among Chinese college football athletes and may further affect the level of athletic burnout through basic psychological needs, anxiety and mental pressure. The government and schools should strengthen the recognition of these factors in order to improve the situation of athletic burnout among Chinese college football athletes.