Burnout among public servants after the Great East Japan Earthquake: decomposing the construct aftermath of disaster

Long-term mental health crisis among municipal public employees caused by the Fukushima nuclear accident and subsequent disasters: Questionnaire survey 10 years postdisaster

Aim

After the Fukushima nuclear accident in 2011, several municipal offices were forced to evacuate, and municipal public employees (MPEs) had to perform many administrative tasks related to the disaster. Typhoons and the COVID-19 pandemic also affected the area afterwards. We conducted a survey for MPEs to investigate the mental health impacts and related factors.

Methods

This survey was conducted in the 10th year after the accident. Participants were MPEs working in the severely affected areas. We used a self-administered questionnaire that included participants' psychological distress (K6), experience during/after the disaster, job-related stress, current problems, and the impacts of subsequent disasters. Based on K6 total scores, we analyzed factors related to mental health and the current problems among high-risk MPEs.

Results

Of all the 775 participants, the number of high-risk MPEs was 101 (13.0%) and many of those had comorbid suicide risk. Factors related to high-score K6 were some individual-related stress factors, including male and younger people, and some job-related stress factors, including unaccustomed work and uncertainty about the future. The mental health status of MPEs in areas severely affected by the disaster has remained very serious more than 10 years later.

Conclusion

The problems and processes caused by the nuclear disaster, such as long-term evacuation, were very specific compared to those of natural disasters. Compared to affected residents, MPEs could be more severely affected by the disasters over the long term. We consider it important to develop a mental health care system to prepare for future disasters.

Burnout levels and correlates among healthcare providers in Syria following the 2023 Turkish-Syrian earthquakes: A cross-sectional study

Background and Aims

This article examines the prevalence of burnout among healthcare providers in the aftermath of the recent earthquakes in Syria and Turkey and explores the associated risk factors.

Methods

This cross-sectional study included 270 healthcare providers in three Syrian cities damaged by earthquakes. Participants were asked to fill out a validated questionnaire on the fifth day of emergency response using the Geldard Occupational Burnout questionnaire.

Results

The mean score for the Geldard Occupational Burnout Questionnaire was 129.79, with 81.4% indicating moderate burnout risk and only 3% indicating high risk. Gender was not significantly associated with burnout, but there was a significant difference in burnout scores between city groups, with Latakia scoring significantly lower than Aleppo.

Conclusion

This study highlights the prevalence of burnout among healthcare providers in the aftermath of an earthquake in Syria, with the majority having a moderate risk of burnout. Gender was not significantly associated with burnout risk. Further research is needed to develop effective interventions and address study limitations. The study emphasizes the importance of prioritizing healthcare providers' mental health to ensure high-quality care after natural disasters.

Difficulties and distress experienced by Japanese public health nurses specializing in quarantine services when dealing with COVID-19: A qualitative study in peri-urban municipality

Public health nurses (PHNs) are among the few municipal civil servants who lead community infection control and prevention initiatives in Japanese public health centers (PHCs). This study aims to investigate the distress faced by PHNs and clarify their difficulties and working environment relative to infection prevention control activities during the COVID-19 pandemic. We adopted a qualitative description methodology in this study of 12 PHNs who were involved in COVID-19 prevention and control in PHCs in Prefecture A. The distress during the early phase of the pandemic was due to the uncertainty of the SARS-CoV-2 related disease, which caused panic in medical institutions and among residents. PHNs were overwhelmed, distressed and exhausted by their inability to control the 'pandemic', lack of patient cooperation for prevention control and the unsustainable organizational environment. They were also distressed because they were one of the specialized personnel responsible for saving residents' lives with limited medical resources and while having identity crises due to an inability to carry out the PHN's role of controlling infection in the community. For future crises, rapid, drastic innovation defying conventional organizational systems is critical to reform sustainable organizations so that they play an effective role in the community. Innovation in crisis communication and strengthening the medical system will help achieve a resilient community in a health crisis.

Experience and Resilience of Japanese Public Health Nurses during the COVID-19 Pandemic and Their Impact on Burnout

Japanese public health nurses (PHNs) at public health centers (PHCs) have played critical roles in infection prevention and control during the COVID-19 pandemic. This study aimed to examine the actual pandemic-related experiences of PHNs and the relation between their experiences, individual resilience, two components of organizational resilience (system and human resilience), and burnout. An analysis of the responses of 351 PHNs revealed that mid-level PHNs scored higher in experience and lower in organizational resilience compared with those in other positions. More than 80% of respondents experienced inappropriate staff allocation. Multiple regression revealed that burnout was positively associated with the components of the experience of PHNs and negatively with individual and human resilience. In hierarchical multiple regression with depersonalization as the dependent variable, the sign of system resilience reversed from negative to positive when human resilience was added. The results highlight the need to prepare for future health crises including establishing a system with enough personnel, promoting human resilience such as collaboration among staff members, and burnout prevention measures, especially among mid-level PHNs. The study also described alternative approaches to comprehend system resilience-namely, a suppression variable of human resilience, promotion of depersonalization, and multicollinearity-and the need for further research on organizational resilience.

Mass Disasters and Burnout in Nephrology Personnel: From Earthquakes and Hurricanes to COVID-19 Pandemic

Mass disasters result in extensive health problems and make health care delivery problematic, as has been the case during the COVID-19 pandemic. Although COVID-19 was initially considered a pulmonary problem, it soon became clear that various other organs were involved. Thus, many care providers, including kidney health personnel, were overwhelmed or developed burnout. This review aims to describe the spectrum of burnout in mass disasters and suggests solutions specifically for nephrology personnel by extending previous experience to the COVID-19 pandemic. Burnout (a psychologic response to work-related stress) is already a frequent part of routine nephrology practice and, not surprisingly, is even more common during mass disasters due to increased workload and specific conditions, in addition to individual factors. Avoiding burnout is essential to prevent psychologic and somatic health problems in personnel as well as malpractice, understaffing, and inadequate health care delivery, all of which increase the health care burden of disasters. Burnout may be prevented by predisaster organizational measures, which include developing an overarching plan and optimizing health care infrastructure, and ad hoc disaster-specific measures that encompass both organizational and individual measures. Organizational measures include increasing safety, decreasing workload and fear of malpractice, optimizing medical staffing and material supplies, motivating personnel, providing mental health support, and enabling flexibility in working circumstances. Individual measures include training on coping with stress and problematic conditions, minimizing the stigma of emotional distress, and maintaining physical health. If these measures fall short, asking for external help is mandatory to avoid an inefficient disaster health care response. Minimizing burnout by applying these measures will improve health care provision, thus saving as many lives as possible.

Health Risks in Disaster Responders: A Conceptual Framework

INTRODUCTION

Disasters cause severe disruption to socio-economic, infrastructural, and environmental aspects of community and nation. While the impact of disasters is strongly felt by those directly affected, they also have significant impacts on the mental and physical health of relief/recovery workers and volunteers. Variations in the nature and scale of disasters necessitate different approaches to risk management and hazard reduction during the response and recovery phases.

METHOD

Published articles (2010-2017) on the quantitative and quantitative relationship between disasters and the physical and mental health of relief/recovery workers and volunteers were systematically collected and reviewed. A total of 162 relevant studies were identified. Physical injuries and mental health impacts were categorized into immediate, short-term, and chronic conditions. A systematic review of the literature was undertaken to explore the health risks and injuries encountered by disaster relief workers and volunteers, and to identify the factors contributing to these and relating mitigation strategies.

RESULTS

There were relatively few studies into this issue. However, the majority of the scrutinized articles highlighted the dependence of nature and scope of injuries with the disaster type and the types of responders, while the living and working environment and socio-economic standing also had significant influence on health outcomes.

CONCLUSION

A conceptual framework derived from the literature review clearly illustrated several critical elements that directly or indirectly cause damage to physical and mental health of disaster responders. Pre-disaster and post-disaster risk mitigation approaches may be employed to reduce the vulnerability of both volunteers and workers while understanding the identified stressors and their relationships.Khatri KC J, Fitzgerald G, Poudyal Chhetri MB. Health risks in disaster responders: a conceptual framework. Prehosp Disaster Med. 2019;34(2):209-216.

Factors Associated with Maintaining the Mental Health of Employees after the Fukushima Nuclear Disaster: Findings from Companies Located in the Evacuation Area

After the nuclear disaster in Fukushima on 11 March 2011, some businesses were permitted to continue operating even though they were located in the evacuation area designated by the Japanese government. The aim of this study was to examine differences in the mental health status, workplace, living environment, and lifestyle of employees in the evacuation and non-evacuation areas. We also investigated factors related to their mental health status. Data for this cross-sectional study were collected from the questionnaire responses of 647 employees at three medium-sized manufacturing companies in the evacuation and non-evacuation areas. Through a cross-tabulation analysis, employees who worked at companies in the evacuation areas showed an increase in the duration of overtime work, work burden, and commute time, and had experienced separation from family members due to the radiation disaster and perceived radiation risks. The results of a multivariate logistic regression analysis showed that, even in a harsh workplace and living environment, being younger, participating regularly in physical activity, having a social network (Lubben Social Network Scale-6 ≤ 12), laughing frequently, and feeling satisfied with one's workplace and domestic life were significantly associated with maintaining a healthy mental health status after the disaster. These findings are applicable for workers' health management measures after disasters.

Organizing the Confusion Surrounding Workaholism: New Structure, Measure, and Validation

Since "workaholism" was coined, a considerable body of research was conducted to shed light on its essence. After at least 40 years of studying this important phenomenon, a large variety of definitions, conceptualizations, and measures emerged. In order to try and bring more integration and consensus to this construct, the current research was conducted in two phases. We aimed to formulate a theoretical definitional framework for workaholism, capitalizing upon the Facet Theory Approach. Two basic facets were hypothesized: A. Modalities of workaholism, with three elements: cognitive, emotional, and instrumental; and B. Resources of workaholism with two elements: time and effort. Based on this definitional framework, a structured questionnaire was conceived. In the first phase, the new measure was validated with an Israeli sample comparing two statistical procedures; Factor Analysis (FA) and Smallest Space Analysis (SSA). In the second phase, we aimed to replicate the findings, and to contrast the newly-devised questionnaire with other extant workaholism measures, with a Romanian sample. Theoretical implications and future research suggestions are discussed.

Effect of Job Strain on Job Burnout, Mental Fatigue and Chronic Diseases among Civil Servants in the Xinjiang Uygur Autonomous Region of China

Job strain is a major concern in view of its effects among civil servants associated with job burnout, mental fatigue and chronic diseases. The objective of this study was to assess the job strain level among civil servants and examine the effect of job strain on job burnout, mental fatigue and the resulting chronic diseases. A cross-sectional study with a representative sample consisting of 5000 civil servants was conducted from March to August 2014. Using a structured questionnaire, the job strain level, job burnout and mental fatigue were measured by using the Personal Strain Questionnaire (PSQ), Maslach Burnout Inventory (MBI) and Multidimensional Fatigue Inventory (MFI-20), respectively. Overall, 33.8% of the civil servants were found to be afflicted with high and moderate job strain. The characteristics of most of the civil servants with a higher-job strain level were as follows: female, Uygur, lower educational level and job title rank, shorter working experience, married marital status, and lower income level. Civil servants suffering from chronic disease mainly had hypertension and coronary heart disease, which accounted for 18.5% of the diseases. Civil servants with a high-job strain level exhibited higher rates of burnout, mental fatigue scores and incidence of chronic diseases. There was a multiple linear regression model composed of three predictor variables in job burnout, which accounted for 45.0% of its occurrence: female gender, lower-income level, higher-job strain in civil servants, the greater the rate of job burnout was. Four factors—male gender, lower-job title rank, higher-job strain, shorter-job tenure of civil servants—explained 25.0% of the mental fatigue model. Binary logistic regression showed that intermediate-rank employees (OR = 0.442, 95% CI: 0.028–0.634; p < 0.05), job tenure of 10–20 years (OR = 0.632, 95% CI: 0.359–0.989; p < 0.05), and low-job strain (OR = 0.657, 95% CI: 0.052–0.698; p < 0.05) were all associated with significantly lower odds of chronic disease. The risk of chronic disease was higher in civil servants with high-job burnout scores and mental fatigue scores compared with civil servants with lower scores (OR = 1.139, 95% CI: 1.012–3.198; OR = 1.697, 95% CI: 1.097–2.962). These data provide evidence for the effects of job strain on job burnout, mental fatigue and chronic diseases among civil servants.

Stress and Burnout in Health-Care Workers after the 2009 L'Aquila Earthquake: A Cross-Sectional Observational Study

Burnout is a work-related mental health impairment, which is now recognized as a real problem in the context of the helping professions due to its adverse health outcomes on efficiency. To our knowledge, the literature on the postdisaster scenario in Italy is limited by a focus on mental health professionals rather than other health-care workers. Our cross-sectional study aims to evaluate the prevalence of burnout and psychopathological distress in different categories of health-care workers, i.e., physicians, nurses, and health-care assistants, working in different departments of L'Aquila St. Salvatore General Hospital 6 years after the 2009 earthquake in order to prevent and reduce work-related burnout. With a two-stage cluster sampling, a total of 8 departments out of a total of 28 departments were selected and the total sample included 300 health-care workers. All the participants completed the following self-reporting questionnaires: a sociodemographic data form, a Maslach Burnout Inventory and a General Health Questionnaire 12 Items (GHQ-12). Statistically significant differences emerged between the total scores of the GHQ-12: post hoc analysis showed that the total average scores of the GHQ-12 were significantly higher in doctors than in health-care assistants. A high prevalence of burnout among doctors (25.97%) emerged. Using multivariate analysis, we identified a hostile relationship with colleagues, direct exposure to the L'Aquila earthquake and moderate to high levels of distress as being burnout predictors. Investigating the prevalence of burnout and distress in health-care staff in a postdisaster setting and identifying predictors of burnout development such as stress levels, time-management skills and work-life balance will contribute to the development of preventative strategies and better organization at work with a view to improving public health efficacy and reducing public health costs, given that these workers live in the disaster-affected community as survivors and serve as disaster relief workers at the same time.