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Zana-Taïeb E, Kermorvant E, Beuchée A, Patkaï J, Rozé JC, Torchin H. Excessive workload and insufficient night-shift remuneration are key elements of dissatisfaction at work for French neonatologists. Acta Paediatr 2023; 112:2075-2083. [PMID: 37300876 DOI: 10.1111/apa.16871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 06/06/2023] [Accepted: 06/08/2023] [Indexed: 06/12/2023]
Abstract
AIM Neonatologists are exposed to ethical issues and unplanned emergencies that require 24-h in-house coverage. These elements may affect quality of life at work, which we surveyed. METHODS This was a self-administered, voluntary and anonymous cross-sectional survey of French neonatologists. An online questionnaire was sent to members of the French Society of Neonatology from June to October 2022. RESULTS Of approximately 1500 possible responses, 721 were analysed, with a response rate of 48%. Respondents were mostly women (77%), aged 35-50 years (50%), and hospital practitioners (63%). Reported weekly working time was over 50 h for 80%. Among the 650 neonatologists with on-call duty, 47% worked ≥5 shifts per month. For 80% of practitioners, on-call duty was perceived to have a negative impact on personal life; 49% indicated having sleep disorders. The mean satisfaction score at work was 5.7 ± 1.7 on a scale of 0-10. The main reasons for dissatisfaction were excessive working hours and insufficient remuneration for on-call duty. CONCLUSION This first evaluation of the quality of life at work of French neonatologists showed high workload. The working conditions and specificities of NICU activity may have significant consequences for their mental health.
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Affiliation(s)
- Elodie Zana-Taïeb
- Médecine et Réanimation néonatales de Port-Royal, Centre Hospitalier Cochin Port-Royal, AP-HP, Paris, France
- FHU Prema, Paris, France
- Université Paris Cité, Paris, France
| | - Elsa Kermorvant
- Université Paris Cité, Paris, France
- AP-HP, Pédiatrie et Réanimation Néonatales, Hôpital Necker-Enfants Malades, Paris, France
| | - Alain Beuchée
- University of Rennes, CHU Rennes, Inserm, LTSI-UMR 1099, Rennes, France
| | - Juliana Patkaï
- Médecine et Réanimation néonatales de Port-Royal, Centre Hospitalier Cochin Port-Royal, AP-HP, Paris, France
- FHU Prema, Paris, France
| | - Jean-Christophe Rozé
- Department of Neonatology, CHU Nantes, UMR PhAN 1280 INRAE, CIC004 INSERM, Nantes, France
| | - Héloïse Torchin
- Médecine et Réanimation néonatales de Port-Royal, Centre Hospitalier Cochin Port-Royal, AP-HP, Paris, France
- FHU Prema, Paris, France
- Université Paris Cité, Paris, France
- CRESS Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, INSERM, INRAE, Université Paris Cité, Paris, France
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2
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Caillaud I, Torchin H, Basset A, Mouillé M, Jarreau PH, Zana-Taïeb É. [Caregivers' experiences with extreme prematurity]. Soins Psychiatr 2022; 43:10-13. [PMID: 36731975 DOI: 10.1016/j.spsy.2022.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Neonatal intensive care units receive very immature premature newborns. Mortality and morbidity rates remain high in this particularly fragile population. Caregivers involved with the child and his or her parents may experience moral distress. There are few studies on the experience of caregivers in these situations. Training, service architecture and sharing of experiences with specifically trained psychologists can improve this experience in these highly technical services.
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Affiliation(s)
- Isabelle Caillaud
- Service de médecine et réanimation néonatales de Port-Royal, AP-HP, Université Paris Cité, Site Cochin, 123 boulevard de Port-Royal, 75014 Paris, France
| | - Héloïse Torchin
- Service de médecine et réanimation néonatales de Port-Royal, AP-HP, Université Paris Cité, Site Cochin, 123 boulevard de Port-Royal, 75014 Paris, France; Fédération hospitalo-universitaire Combattre la prématurité (FHU Préma), Maternité de Port-Royal, AP-HP, 123 boulevard de Port-Royal, 75014 Paris, France; Centre de recherche en épidémiologie et statistiques/Cress, Inserm, Inrae, Université Paris Cité, 1 place du Parvis Notre-Dame, 75004 Paris, France
| | - Aurélie Basset
- Service de médecine et réanimation néonatales de Port-Royal, AP-HP, Université Paris Cité, Site Cochin, 123 boulevard de Port-Royal, 75014 Paris, France; Fédération hospitalo-universitaire Combattre la prématurité (FHU Préma), Maternité de Port-Royal, AP-HP, 123 boulevard de Port-Royal, 75014 Paris, France
| | - Marion Mouillé
- Service de médecine et réanimation néonatales de Port-Royal, AP-HP, Université Paris Cité, Site Cochin, 123 boulevard de Port-Royal, 75014 Paris, France; Fédération hospitalo-universitaire Combattre la prématurité (FHU Préma), Maternité de Port-Royal, AP-HP, 123 boulevard de Port-Royal, 75014 Paris, France
| | - Pierre-Henri Jarreau
- Service de médecine et réanimation néonatales de Port-Royal, AP-HP, Université Paris Cité, Site Cochin, 123 boulevard de Port-Royal, 75014 Paris, France; Fédération hospitalo-universitaire Combattre la prématurité (FHU Préma), Maternité de Port-Royal, AP-HP, 123 boulevard de Port-Royal, 75014 Paris, France; Centre de recherche en épidémiologie et statistiques/Cress, Inserm, Inrae, Université Paris Cité, 1 place du Parvis Notre-Dame, 75004 Paris, France
| | - Élodie Zana-Taïeb
- Service de médecine et réanimation néonatales de Port-Royal, AP-HP, Université Paris Cité, Site Cochin, 123 boulevard de Port-Royal, 75014 Paris, France; Fédération hospitalo-universitaire Combattre la prématurité (FHU Préma), Maternité de Port-Royal, AP-HP, 123 boulevard de Port-Royal, 75014 Paris, France.
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3
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Basset A, Zana-Taïeb E, Bénard M, Gascoin G, Tourneux P, Pierrat V, Butin M, Brémaud-Csizmadia C, Torchin H. Nurses and physicians at high risk of burnout in French level III neonatal intensive care units: an observational cross-sectional study. J Perinatol 2022; 42:669-670. [PMID: 35094021 DOI: 10.1038/s41372-021-01266-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 10/20/2021] [Accepted: 10/29/2021] [Indexed: 11/09/2022]
Affiliation(s)
- A Basset
- Department of Neonatal Medicine, Cochin-Port Royal Hospital, FHU PREMA, AP-HP, Paris, F-75014, France.
| | - E Zana-Taïeb
- Department of Neonatal Medicine, Cochin-Port Royal Hospital, FHU PREMA, AP-HP, Paris, F-75014, France
| | - M Bénard
- Department of Neonatal Medicine, Children Hospital, 31000, Toulouse, France
| | - G Gascoin
- Department of Neonatal Medicine, University Hospital, 49000, Angers, France
| | - P Tourneux
- Department of Neonatal Medicine, Pôle Femme-Couple-Enfant, University Hospital, PériTox, UMR_I 01, UFR de Médecine, UPJV, 80000, Amiens, France
| | - V Pierrat
- Department of Neonatal Medicine, Jeanne de Flandre Hospital, F-59000, Lille, France.,University of Paris, Epidemiology and Statistics Research Center/CRESS, INSERM, INRA, F-75004, Paris, France
| | - M Butin
- Department of Neonatal Medicine, Femme Mère Enfant Hospital, Hospices Civils de Lyon, Infectiology Research International Center, Unité INSERM U1111 CNRS UMR5308 ENS de Lyon, Lyon University, 69000, Lyon, France
| | - C Brémaud-Csizmadia
- University Hospital, Neonatal and Paediatric Intensive Care Unit, 86000, Poitiers, France
| | - H Torchin
- Department of Neonatal Medicine, Cochin-Port Royal Hospital, FHU PREMA, AP-HP, Paris, F-75014, France.,University of Paris, Epidemiology and Statistics Research Center/CRESS, INSERM, INRA, F-75004, Paris, France
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4
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Profit J, Adair KC, Cui X, Mitchell B, Brandon D, Tawfik DS, Rigdon J, Gould JB, Lee HC, Timpson WL, McCaffrey MJ, Davis AS, Pammi M, Matthews M, Stark AR, Papile LA, Thomas E, Cotten M, Khan A, Sexton JB. Randomized controlled trial of the "WISER" intervention to reduce healthcare worker burnout. J Perinatol 2021; 41:2225-2234. [PMID: 34366432 PMCID: PMC8440181 DOI: 10.1038/s41372-021-01100-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 04/26/2021] [Accepted: 05/06/2021] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Test web-based implementation for the science of enhancing resilience (WISER) intervention efficacy in reducing healthcare worker (HCW) burnout. DESIGN RCT using two cohorts of HCWs of four NICUs each, to improve HCW well-being (primary outcome: burnout). Cohort 1 received WISER while Cohort 2 acted as a waitlist control. RESULTS Cohorts were similar, mostly female (83%) and nurses (62%). In Cohorts 1 and 2 respectively, 182 and 299 initiated WISER, 100 and 176 completed 1-month follow-up, and 78 and 146 completed 6-month follow-up. Relative to control, WISER decreased burnout (-5.27 (95% CI: -10.44, -0.10), p = 0.046). Combined adjusted cohort results at 1-month showed that the percentage of HCWs reporting concerning outcomes was significantly decreased for burnout (-6.3% (95%CI: -11.6%, -1.0%); p = 0.008), and secondary outcomes depression (-5.2% (95%CI: -10.8, -0.4); p = 0.022) and work-life integration (-11.8% (95%CI: -17.9, -6.1); p < 0.001). Improvements endured at 6 months. CONCLUSION WISER appears to durably improve HCW well-being. CLINICAL TRIALS NUMBER NCT02603133; https://clinicaltrials.gov/ct2/show/NCT02603133.
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Affiliation(s)
- Jochen Profit
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, CA, USA
- California Perinatal Quality Care Collaborative, Palo Alto, CA, USA
| | - Kathryn C Adair
- Department of Psychiatry, Duke University School of Medicine, Duke University Health System, Durham, NC, USA
- Duke Center for Healthcare Safety and Quality, Duke University Health System, Durham, NC, USA
| | - Xin Cui
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, CA, USA
- California Perinatal Quality Care Collaborative, Palo Alto, CA, USA
| | - Briana Mitchell
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, CA, USA
| | - Debra Brandon
- Duke University School of Nursing, Durham, USA
- Department of Pediatrics, Duke University School of Medicine, Durham, USA
| | - Daniel S Tawfik
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, CA, USA
| | - Joseph Rigdon
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Jeffrey B Gould
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, CA, USA
- California Perinatal Quality Care Collaborative, Palo Alto, CA, USA
| | - Henry C Lee
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, CA, USA
- California Perinatal Quality Care Collaborative, Palo Alto, CA, USA
| | - Wendy L Timpson
- Department of Neonatology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Martin J McCaffrey
- Division of Neonatal-Perinatal Medicine, University of North Carolina Chapel Hill School of Medicine and University of North Carolina Children's Hospital, Chapel Hill, NC, USA
| | - Alexis S Davis
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, CA, USA
| | - Mohan Pammi
- Section of Neonatology, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| | - Melissa Matthews
- Department of Pediatrics-Neonatology, The University of Texas Health Science Center and Children's Memorial Hermann Hospital, Houston, TX, USA
| | - Ann R Stark
- Department of Pediatrics, Division of Newborn Medicine, Harvard Medical School, Boston, MA, USA
| | - Lu-Ann Papile
- Division of Neonatology, Department of Pediatrics, The University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - Eric Thomas
- Department of Internal Medicine, The University of Texas Health Science Center and Memorial Hermann Medical Center, Houston, TX, USA
| | - Michael Cotten
- Division of Pediatrics-Neonatology, Duke University School of Medicine and Duke University Hospital, Durham, NC, USA
| | - Amir Khan
- Division of Neonatology, Department of Pediatrics, The University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - J Bryan Sexton
- Department of Psychiatry, Duke University School of Medicine, Duke University Health System, Durham, NC, USA.
- Duke Center for Healthcare Safety and Quality, Duke University Health System, Durham, NC, USA.
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Vanstone M, Sadik M, Smith O, Neville TH, LeBlanc A, Boyle A, Clarke FJ, Swinton ME, Takaoka A, Toledo F, Baker AJ, Phung P, Cook DJ. Building organizational compassion among teams delivering end-of-life care in the intensive care unit: The 3 Wishes Project. Palliat Med 2020; 34:1263-1273. [PMID: 32519615 DOI: 10.1177/0269216320929538] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The 3 Wishes Project is a semistructured program that improves the quality of care for patients dying in the intensive care unit by eliciting and implementing wishes. This simple intervention honors the legacy of patients and eases family grief, forging human connections between family members and clinicians. AIM To examine how the 3 Wishes Project enables collective patterns of compassion between patients, families, clinicians, and managerial leaders in the intensive care unit. DESIGN Using a qualitative descriptive approach, interviews and focus groups were used to collect data from family members of dying patients, clinicians, and institutional leaders. Unconstrained directed qualitative content analysis was performed using Organizational Compassion as the analytic framework. SETTING/PARTICIPANTS Four North American intensive care units, participants were 74 family members of dying patients, 72 frontline clinicians, and 20 managerial leaders. RESULTS The policies and processes of the 3 Wishes Project exemplify organizational compassion by supporting individuals in the intensive care unit to collectively notice, feel, and respond to suffering. As an intervention that enables and empowers clinicians to engage in acts of kindness to enhance end-of-life care, the 3 Wishes Project is particularly well situated to encourage collective responses to suffering and promote compassion between patients, family members, and clinicians. CONCLUSIONS Examining the 3 Wishes Project through the lens of organizational compassion reveals the potential of this program to cultivate the capacity for people to collectively notice, feel, and respond to suffering. Our data document multidirectional demonstrations of compassion between clinicians and family members, forging the type of human connections that may foster resilience.
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Affiliation(s)
- Meredith Vanstone
- Department of Family Medicine, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Marina Sadik
- Department of Family Medicine, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Orla Smith
- Critical Care Department, St. Michael's Hospital, Toronto, ON, Canada
| | - Thanh H Neville
- Division of Pulmonary & Critical Care, Department of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Allana LeBlanc
- Department of Nursing, Vancouver Coastal Health, Vancouver, BC, Canada
| | - Anne Boyle
- Department of Family Medicine, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.,Department of Palliative Care, St. Joseph's Healthcare, Hamilton, ON, Canada
| | - France J Clarke
- Department of Critical Care, St. Joseph's Healthcare, Hamilton, ON, Canada.,Departments Medicine and Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Marilyn E Swinton
- Departments Medicine and Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Alyson Takaoka
- Department of Critical Care, St. Joseph's Healthcare, Hamilton, ON, Canada.,Departments Medicine and Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Feli Toledo
- Department of Spiritual Care, St. Joseph's Healthcare, Hamilton, ON, Canada
| | - Andrew J Baker
- Critical Care Department, St. Michael's Hospital, Toronto, ON, Canada
| | - Peter Phung
- Division of General Internal Medicine, Department of Medicine, Palliative Care Program, University of California, Los Angeles, Los Angeles, CA, USA
| | - Deborah J Cook
- Department of Critical Care, St. Joseph's Healthcare, Hamilton, ON, Canada.,Departments Medicine and Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
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Abstract
OBJECTIVE To describe the syndrome of physician burnout within neonatology, its relation to neonatal quality of care, and outline potential solutions. FINDINGS Burnout affects up to half of physicians, including up to one-third of neonatologists, at any given time. It is linked to suicidality, substance abuse, and intent to leave practice, and it is strongly associated with reduced quality of care in the published literature. Resilience and mindfulness interventions rooted in positive psychology may reduce burnout among individual providers. Because burnout is largely driven by organizational factors, system-level attention to leadership, teamwork, and practice efficiency can reduce burnout at the level of the organization. CONCLUSIONS Burnout is common among neonatologists and consistently relates to decreased quality of patient care in a variety of dimensions. Personal resilience training and system-wide organizational interventions are needed to reverse burnout and promote high-quality neonatal care.
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Affiliation(s)
- Daniel S. Tawfik
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA 770 Welch Road, Suite 435, Palo Alto, CA, USA 94304
| | - Jochen Profit
- Perinatal Epidemiology and Health Outcomes Research Unit, Division of Neonatology, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA; California Perinatal Quality Care Collaborative, Palo Alto, CA, USA
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7
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Bresesti I, Folgori L, De Bartolo P. Interventions to reduce occupational stress and burn out within neonatal intensive care units: a systematic review. Occup Environ Med 2020; 77:515-519. [PMID: 32132183 DOI: 10.1136/oemed-2019-106256] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 01/22/2020] [Accepted: 02/18/2020] [Indexed: 01/23/2023]
Abstract
Occupational stress is an emerging problem among physician and nurses, and those working in intensive care settings are particularly exposed to the risk of developing burnout. To verify what types of interventions to manage occupational stress and burn out within neonatal intensive care units (NICUs) have been introduced so far and to verify their efficacy among caregivers. PsycINFO (PsycINFO 1967-July week 3 2019), Embase (Embase 1996-2019 week 29) e Medline (Ovid MEDLINE(R) without revisions 1996-July week 2 2019) were systematically searched combining MeSH and free text terms for "burn out" AND "healthcare provider" AND "NICU". Inclusion criteria were interventions directed to healthcare providers settled in NICUs. Only English language papers were included. Six articles were included in the final analysis. All the studies reported an overall efficacy of the interventions in reducing work-related stress, both when individual focused and organisation directed. The analysis revealed low quality of the studies and high heterogeneity in terms of study design, included populations, interventions and their evaluation assessment. There is currently very limited evidence regarding the management of occupational stress and burn out within NICUs. The quality of available studies was suboptimal. The peculiarities of the NICUs should be considered when developing strategies for occupational stress management. Training self-awareness of workers regarding their reactions to the NICU environment, also from the pre-employment stage, could be an additional approach to prevent and manage stress.
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Affiliation(s)
- Ilia Bresesti
- Department of Pediatrics, Luigi Sacco University Hospital, Milano, Italy .,Department of Human Science, Guglielmo Marconi University, Roma, Italy
| | - Laura Folgori
- Department of Pediatrics, Luigi Sacco University Hospital, Milano, Italy.,Pediatric Infectious Diseases Research Group, Institute for Infection and Immunity, St George's University of London, London, UK
| | - Paola De Bartolo
- Department of Human Science, Guglielmo Marconi University, Roma, Italy.,Laboratory of Experimental Neurofisiology, IRCCS Fondazione Santa Lucia, Roma, Italy
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8
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Dombrecht L, Cohen J, Cools F, Deliens L, Goossens L, Naulaers G, Beernaert K, Chambaere K. Psychological support in end-of-life decision-making in neonatal intensive care units: Full population survey among neonatologists and neonatal nurses. Palliat Med 2020; 34:430-434. [PMID: 31739740 DOI: 10.1177/0269216319888986] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Moral distress and burnout related to end-of-life decisions in neonates is common in neonatologists and nurses working in neonatal intensive care units. Attention to their emotional burden and psychological support in research is lacking. AIM To evaluate perceived psychological support in relation to end-of-life decisions of neonatologists and nurses working in Flemish neonatal intensive care units and to analyse whether or not this support is sufficient. DESIGN/PARTICIPANTS A self-administered questionnaire was sent to all neonatologists and neonatal nurses of all eight Flemish neonatal intensive care units (Belgium) in May 2017. The response rate was 63% (52/83) for neonatologists and 46% (250/527) for nurses. Respondents indicated their level of agreement (5-point Likert-type scale) with seven statements regarding psychological support. RESULTS About 70% of neonatologists and nurses reported experiencing more stress than normal when confronted with an end-of-life decision; 86% of neonatologists feel supported by their colleagues when they make end-of-life decisions, 45% of nurses feel that the treating physician listens to their opinion when end-of-life decisions are made. About 60% of both neonatologists and nurses would like more psychological support offered by their department when confronted with end-of-life decisions, and 41% of neonatologists and 50% of nurses stated they did not have enough psychological support from their department when a patient died. Demographic groups did not differ in terms of perceived lack of sufficient support. CONCLUSION Even though neonatal intensive care unit colleagues generally support each other in difficult end-of-life decisions, the psychological support provided by their department is currently not sufficient. Professional ad hoc counselling or standard debriefings could substantially improve this perceived lack of support.
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Affiliation(s)
- Laure Dombrecht
- End-of-Life Care Research Group, Ghent University and Vrije Universiteit Brussel (VUB), Ghent, Belgium.,Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Joachim Cohen
- End-of-Life Care Research Group, Ghent University and Vrije Universiteit Brussel (VUB), Ghent, Belgium
| | - Filip Cools
- Department of Neonatology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Luc Deliens
- End-of-Life Care Research Group, Ghent University and Vrije Universiteit Brussel (VUB), Ghent, Belgium.,Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Linde Goossens
- Department of Neonatology, Ghent University Hospital, Ghent, Belgium
| | - Gunnar Naulaers
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - Kim Beernaert
- End-of-Life Care Research Group, Ghent University and Vrije Universiteit Brussel (VUB), Ghent, Belgium.,Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Kenneth Chambaere
- End-of-Life Care Research Group, Ghent University and Vrije Universiteit Brussel (VUB), Ghent, Belgium.,Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
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9
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Abstract
BACKGROUND Few understand the experience of having an infant in the neonatal intensive care unit (NICU). This article provides a discussion about the importance of an annual reunion for former NICU infants, their families, and neonatal staff. PURPOSE The purpose of this article is to explain the impact of the NICU reunion on families and neonatal healthcare providers and describe the experience of organizing this reunion over the past 20 years. METHODS This is a description of how a NICU reunion was organized at a regional neonatal center. Graphic-designed invitations were e-mailed to NICU graduates, who previously agreed to being contacted, 2 months prior to the reunion date. Social media were utilized to publicize the event on the hospital's Web site. RESULTS At the reunion, parents and families introduced their NICU graduate to the neonatal staff who cared for them while hospitalized. Sometimes staff found it difficult to recognize the NICU graduates, who were toddlers or older. Parents were relaxed, expressing their appreciation for care received. IMPLICATIONS FOR PRACTICE The impact of seeing an infant, born at 24 weeks, now walking, talking, and running cultivates pride in the NICU healthcare team. The reunion adds a positive dimension to the work of NICU caregivers. Parents look forward to attending the reunion to reconnect with NICU staff and other NICU parents. IMPLICATIONS FOR RESEARCH Directions for future study include a comparison of staff and families who attend the NICU reunion and those who do not, by using a survey or online evaluation tool, to improve future reunions.
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10
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Yeo CJJ, Román GC, Kusnerik D, Burt T, Mersinger D, Thomas S, Boone T, Powell SZ. Trainee Responses to Hurricane Harvey: Correlating Volunteerism With Burnout. Front Public Health 2018; 6:224. [PMID: 30211142 PMCID: PMC6121183 DOI: 10.3389/fpubh.2018.00224] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 07/24/2018] [Indexed: 11/30/2022] Open
Abstract
Background: Natural disasters take a heavy toll not only on their victims, but also on physicians who suffer vicarious trauma and burnout. New trainees in Houston, from entering PGY1 residents to entering fellows, underwent even more upheaval and stress during Hurricane Harvey. Many responded to calls for volunteer help. Objective: To investigate the impact of Hurricane Harvey on new trainees at our institution, and correlate volunteerism with measures of burnout and resilience. Methodology: Thirty three new trainees out of 90 (43% of population) from all specialties in our institution voluntarily responded to an online survey on the impact of Hurricane Harvey on their lives, whether or not they volunteered and in what form, and answered questions drawing from the abbreviated Maslach burnout survey and Resiliency Quiz. Statistical analyses were conducted using GraphPad Prism and Excel data analysis. Results: The top areas impacted were emotional health (32%), eating habits (29%), family (25%) and finances (25%). The main voluntary activities were covering for colleagues who could not make it to hospital (50%), donating money and supplies (36%), and cleaning and rebuilding (36%). Volunteering was associated with feelings of appreciation (76%), happiness (62%), thankfulness (57%), purposefulness (43%) and pride (33%). Fewer volunteers scored lowly in personal achievement as compared to non-volunteers (10 vs. 38%, p = 0.05). Significance: Hurricane Harvey affected health, finances and family of new trainees, more than half of whom volunteered to help. Volunteers had a greater sense of personal achievement as compared to non-volunteers. This may be due to having more volunteers among less burnt-out trainees or because volunteering reduced burnout and stress responses/trauma. These results suggest that volunteer opportunities should be made available in programs targeting resident burnout.
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Affiliation(s)
| | - Gustavo C. Román
- Houston Methodist Neurological Institute, Houston, TX, United States
| | - David Kusnerik
- Graduate Medical Education, Houston Methodist Hospital, Houston, TX, United States
| | - Trevor Burt
- Graduate Medical Education, Houston Methodist Hospital, Houston, TX, United States
| | - Dottie Mersinger
- Graduate Medical Education, Houston Methodist Hospital, Houston, TX, United States
| | - Shaylor Thomas
- Graduate Medical Education, Houston Methodist Hospital, Houston, TX, United States
| | - Timothy Boone
- Graduate Medical Education, Houston Methodist Hospital, Houston, TX, United States
| | - Suzanne Z. Powell
- Houston Methodist Neurological Institute, Houston, TX, United States
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11
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Sulaiman CFC, Henn P, Smith S, O'Tuathaigh CMP. Burnout syndrome among non-consultant hospital doctors in Ireland: relationship with self-reported patient care. Int J Qual Health Care 2018; 29:679-684. [PMID: 28992145 DOI: 10.1093/intqhc/mzx087] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 07/03/2017] [Indexed: 11/15/2022] Open
Abstract
Objective Intensive workload and limited training opportunities for Irish non-consultant hospital doctors (NCHDs) has a negative effect on their health and well-being, and can result in burnout. Burnout affects physician performance and can lead to medical errors. This study examined the prevalence of burnout syndrome among Irish NCHDs and its association with self-reported medical error and poor quality of patient care. Methods A cross-sectional quantitative survey-based design. Setting All teaching hospitals affiliated with University College Cork. Participants NCHDs of all grades and specialties. Intervention(s) The following instruments were completed by all participants: Maslach Burnout Inventory-Human Service Survey (MBI-HSS), assessing three categories of burnout syndrome: Emotional exhaustion (EE), Personal Achievement (PA) and Depersonalization (DP); questions related to self-reported medical errors/poor patient care quality and socio-demographic information. Main outcome measure(s) Self-reported measures of burnout and poor quality of patient care. Results Prevalence of burnout among physicians (n = 265) was 26.4%. There was a significant gender difference for EE and DP, but none for PA. A positive weak correlation was observed between EE and DP with medical error or poor patient care. A negative association was reported between PA and medical error and reduced quality of patient care. Conclusions Burnout is prevalent among NCHDs in Ireland. Burnout syndrome is associated with self-reported medical error and quality of care in this sample population. Measures need to be taken to address this issue, with a view to protecting health of NCHDs and maintaining quality of patient care.
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Affiliation(s)
- Che Fatehah Che Sulaiman
- School of Medicine, Brookfield Health Sciences Complex, University College Cork, College Road, Cork T12 AK54, Ireland
| | - Patrick Henn
- School of Medicine, Brookfield Health Sciences Complex, University College Cork, College Road, Cork T12 AK54, Ireland
| | - Simon Smith
- School of Medicine, Brookfield Health Sciences Complex, University College Cork, College Road, Cork T12 AK54, Ireland
| | - Colm M P O'Tuathaigh
- School of Medicine, Brookfield Health Sciences Complex, University College Cork, College Road, Cork T12 AK54, Ireland
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12
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Nonnis M, Massidda D, Cuccu S, Cortese CG. The Impact of Workaholism on Nurses’ Burnout and Disillusion. ACTA ACUST UNITED AC 2018. [DOI: 10.2174/1874350101811010077] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:The literature has shown that workaholism acts at the root of burnout, but research regarding these constructs in the nursing profession is scant. Similarly, little attention has been paid to the impact of workaholism on disillusion, which is a dimension of burnout linked to professional vocation.Objectives:Contribute to the ongoing research on the relationship between workaholism and burnout among nurses. Moreover, this study considers disillusion as a dimension to be considered when investigating the relationship between workaholism and burnout, since nursing entails professional vocation.Method:The study followed a cross-sectional design. 614 nurses of six hospitals in South Italy have compiled two Self-report questionnaires: the Dutch Utrecht WorkAholism Scale (workaholism - Italian version) and the Link Burnout Questionnaire (burnout). Part of the group of subjects was diagnosed with both syndromes or considered at risk of developing them. The impact of workaholism on burnout was examined using Structural Equation Models for each variable.Results:More than 26% of the nurses are affected by burnout whereas 21% are workaholics. Working excessively proved to be a good predictor of both psychophysical exhaustion and disillusion.Conclusions:Nurses are at risk of workaholism and burnout. The study shows that workaholism is a predictor of nurses’ burnout, in particular working excessively (a dimension of workaholism) affects their psychophysical well-being and professional vocation.
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13
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Tawfik DS, Sexton JB, Adair KC, Kaplan HC, Profit J. Context in Quality of Care: Improving Teamwork and Resilience. Clin Perinatol 2017; 44:541-552. [PMID: 28802338 PMCID: PMC5644508 DOI: 10.1016/j.clp.2017.04.004] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Quality improvement in health care is an ongoing challenge. Consideration of the context of the health care system is of paramount importance. Staff resilience and teamwork climate are key aspects of context that drive quality. Teamwork climate is dynamic, with well-established tools available to improve teamwork for specific tasks or global applications. Similarly, burnout and resilience can be modified with interventions such as cultivating gratitude, positivity, and awe. A growing body of literature has shown that teamwork and burnout relate to quality of care, with improved teamwork and decreased burnout expected to produce improved patient quality and safety.
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Affiliation(s)
- Daniel S Tawfik
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Stanford University School of Medicine, 770 Welch Road, Suite 435, Stanford, CA 94304, USA; Lucile Packard Children's Hospital, 725 Welch Road, Palo Alto, CA 94304, USA.
| | - J Bryan Sexton
- Department of Psychiatry, Duke University School of Medicine; Duke University Health System, Durham, NC, USA,Duke Patient Safety Center, Duke University Health System, Durham, NC, USA
| | - Kathryn C Adair
- Department of Psychiatry, Duke University School of Medicine; Duke University Health System, Durham, NC, USA,Duke Patient Safety Center, Duke University Health System, Durham, NC, USA
| | - Heather C Kaplan
- Department of Pediatrics, Perinatal Institute, James M. Anderson Centre for Health Systems Excellence, Cincinnati Children’s Hospital Medical Center
| | - Jochen Profit
- Perinatal Epidemiology and Health Outcomes Research Unit, Division of Neonatology, Department of Pediatrics, Stanford University School of Medicine and Lucile Packard Children’s Hospital; Palo Alto, CA, USA,California Perinatal Quality Care Collaborative; Palo Alto, CA, USA
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14
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Tawfik DS, Phibbs CS, Sexton JB, Kan P, Sharek PJ, Nisbet CC, Rigdon J, Trockel M, Profit J. Factors Associated With Provider Burnout in the NICU. Pediatrics 2017; 139:peds.2016-4134. [PMID: 28557756 PMCID: PMC5404731 DOI: 10.1542/peds.2016-4134] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/23/2017] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND NICUs vary greatly in patient acuity and volume and represent a wide array of organizational structures, but the effect of these differences on NICU providers is unknown. This study sought to test the relation between provider burnout prevalence and organizational factors in California NICUs. METHODS Provider perceptions of burnout were obtained from 1934 nurse practitioners, physicians, registered nurses, and respiratory therapists in 41 California NICUs via a validated 4-item questionnaire based on the Maslach Burnout Inventory. The relations between burnout and organizational factors of each NICU were evaluated via t-test comparison of quartiles, univariable regression, and multivariable regression. RESULTS Overall burnout prevalence was 26.7% ± 9.8%. Highest burnout prevalence was found among NICUs with higher average daily admissions (32.1% ± 6.4% vs 17.2% ± 6.7%, P < .001), higher average occupancy (28.1% ± 8.1% vs 19.9% ± 8.4%, P = .02), and those with electronic health records (28% ± 11% vs 18% ± 7%, P = .03). In sensitivity analysis, nursing burnout was more sensitive to organizational differences than physician burnout in multivariable modeling, significantly associated with average daily admissions, late transfer proportion, nursing hours per patient day, and mortality per 1000 infants. Burnout prevalence showed no association with proportion of high-risk patients, teaching hospital distinction, or in-house attending presence. CONCLUSIONS Burnout is most prevalent in NICUs with high patient volume and electronic health records and may affect nurses disproportionately. Interventions to reduce burnout prevalence may be of greater importance in NICUs with ≥10 weekly admissions.
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Affiliation(s)
- Daniel S. Tawfik
- Division of Pediatric Critical Care Medicine,,Department of Health Research and Policy
| | - Ciaran S. Phibbs
- Perinatal Epidemiology and Health Outcomes Research Unit, Division of Neonatology, and,Health Economics Research Center and Center for Innovation to Implementation, Veteran’s Affairs Palo Alto Health Care System, Palo Alto, California
| | - J. Bryan Sexton
- Department of Psychiatry, Duke University School of Medicine, and,Duke Patient Safety Center, Duke University Health System, Durham, North Carolina
| | - Peiyi Kan
- Perinatal Epidemiology and Health Outcomes Research Unit, Division of Neonatology, and,California Perinatal Quality Care Collaborative, Palo Alto, California; and
| | - Paul J. Sharek
- Division of Pediatric Hospitalist Medicine, Department of Pediatrics, Stanford University School of Medicine and Lucile Packard Children’s Hospital, Palo Alto, California;,Center for Quality and Clinical Effectiveness, Lucile Packard Children’s Hospital, Palo Alto, California
| | - Courtney C. Nisbet
- Division of Pediatric Hospitalist Medicine, Department of Pediatrics, Stanford University School of Medicine and Lucile Packard Children’s Hospital, Palo Alto, California;,California Perinatal Quality Care Collaborative, Palo Alto, California; and
| | | | - Mickey Trockel
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, California
| | - Jochen Profit
- Perinatal Epidemiology and Health Outcomes Research Unit, Division of Neonatology, and,California Perinatal Quality Care Collaborative, Palo Alto, California; and
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15
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Burnout in the neonatal intensive care unit and its relation to healthcare-associated infections. J Perinatol 2017; 37:315-320. [PMID: 27853320 PMCID: PMC5334140 DOI: 10.1038/jp.2016.211] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2016] [Revised: 10/04/2016] [Accepted: 10/06/2016] [Indexed: 12/03/2022]
Abstract
OBJECTIVE To examine burnout prevalence among California neonatal intensive care units (NICUs) and to test the relation between burnout and healthcare-associated infection (HAI) rates in very low birth weight (VLBW) neonates. STUDY DESIGN Retrospective observational study of provider perceptions of burnout from 2073 nurse practitioners, physicians, registered nurses and respiratory therapists, using a validated four-item questionnaire based on the Maslach Burnout Inventory. The relation between burnout and HAI rates among VLBW (<1500 g) neonates from each NICU was evaluated using multi-level logistic regression analysis with patient-level factors as fixed effects. RESULTS We found variable prevalence of burnout across the NICUs surveyed (mean 25.2±10.1%). Healthcare-associated infection rates were 8.3±5.1% during the study period. Highest burnout prevalence was found among nurses, nurse practitioners and respiratory therapists (non-physicians, 28±11% vs 17±19% physicians), day shift workers (30±3% vs 25±4% night shift) and workers with 5 or more years of service (29±2% vs 16±6% in fewer than 3 years group). Overall burnout rates showed no correlation with risk-adjusted rates of HAIs (r=-0.133). Item-level analysis showed positive association between HAIs and perceptions of working too hard (odds ratio 1.15, 95% confidence interval 1.04-1.28). Sensitivity analysis of high-volume NICUs suggested a moderate correlation between burnout prevalence and HAIs (r=0.34). CONCLUSION Burnout is most prevalent among non-physicians, daytime workers and experienced workers. Perceptions of working too hard associate with increased HAIs in this cohort of VLBW infants, but overall burnout prevalence is not predictive.
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16
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Zhang H, Isaac A, Wright ED, Alrajhi Y, Seikaly H. Formal mentorship in a surgical residency training program: a prospective interventional study. J Otolaryngol Head Neck Surg 2017; 46:13. [PMID: 28193248 PMCID: PMC5307740 DOI: 10.1186/s40463-017-0186-2] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Accepted: 02/02/2017] [Indexed: 11/21/2022] Open
Abstract
Background Otolaryngology-Head and Neck surgery resident physicians (OHNSR) have a high prevalence of burnout, job dissatisfaction and stress as shown within the literature. Formal mentorship programs (FMP) have a proven track record of enhancing professional development and academic success. More importantly FMP have an overall positive impact on residents and assist in improving job satisfaction. The purpose of the study is to determine the effects of a FMP on the well-being of OHNSR. Methods A FMP was established and all OHNSR participation was voluntary. Eight OHNSR participated in the program. Perceived Stress Survey (PSS) and the Maslach Burnout Inventory (MBI) were administered at baseline and then at 3, 6, 9, and 12 month intervals. World Health Quality of Life-Bref Questionnaire (WH-QOL) was administered at baseline and at 12 months. Results Baseline statistics found a significant burden of stress and burnout with an average PSS of 18.5 with a high MBI of 47.6, 50.6, and 16.5 for the emotional, depersonalization, and personal achievement domains respectively. Quality of life was also found to be low with a WH-QOL score of 71.9. After implementation of the FMP, PSS was reduced to 14.5 at 3 months (p = 0.174) and a statistically significant lower value of 7.9 at 12 months (p = 0.001). Participants were also found to have lower emotional scores (14.9, p < 0.0001), levels of depersonalization (20.1, p < 0.0001), and higher personal achievement (42.5, p < 0.0001) on MBI testing at 12 months. Overall quality values using the WH-QOL was also found to be significantly improved (37.5, P = 0.003) with statistically significant lower scores for the physical health (33.9, p = 0.003), psychological (41.1, p = 0.001), social relationship (46.9, p = 0.019), and environment (53.5, p = 0.012) domains. Conclusion This is the first study to show that FMP can potentially alleviate high levels of stress and burnout within a surgical residency program and achieve higher levels of personal satisfaction as well as overall quality of life.
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Affiliation(s)
- Han Zhang
- Division of Otolaryngology-Head and Neck Surgery, University of Alberta, Edmonton, Alberta, Canada.
| | - Andre Isaac
- Division of Otolaryngology-Head and Neck Surgery, University of Alberta, Edmonton, Alberta, Canada
| | - Erin D Wright
- Division of Otolaryngology-Head and Neck Surgery, University of Alberta, Edmonton, Alberta, Canada
| | - Yaser Alrajhi
- Division of Otolaryngology-Head and Neck Surgery, University of Alberta, Edmonton, Alberta, Canada
| | - Hadi Seikaly
- Division of Otolaryngology-Head and Neck Surgery, University of Alberta, Edmonton, Alberta, Canada
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Abstract
The quality of care that families and infants receive during their time on the neonatal unit will be influenced by the well-being of the people who care for them. The emotional work of caring for infants and families in this demanding setting often goes unrecognized and can result in stress, burnout, and compassion fatigue, which in turn are a threat to the quality of care. Resilience and well-being can be fostered by encouraging self-maintenance, supportive systems organization, providing a healthy working environment, education, and opportunities for reflection.
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18
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Weintraub AS, Geithner EM, Stroustrup A, Waldman ED. Compassion fatigue, burnout and compassion satisfaction in neonatologists in the US. J Perinatol 2016; 36:1021-1026. [PMID: 27490191 DOI: 10.1038/jp.2016.121] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 06/07/2016] [Accepted: 06/27/2016] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Compassion fatigue (CF) is distress experienced by caregivers from ongoing contact with patients who are suffering. Burnout (BO) is occupational stress directly related to dissonance between job demands and available resources. Compassion satisfaction (CS) is professional fulfillment experienced through helping others. CF in physicians is not well studied. Neonatologists may be at particular risk for CF by virtue of recurrent exposure to distress in patients and their families. The objectives of this study were to determine the prevalence of CF, BO and CS, and to identify potential predictors for these phenomena in neonatologists. STUDY DESIGN A modified Compassion Fatigue and Satisfaction Self-Test and a questionnaire of professional details and personal characteristics were distributed electronically to neonatologists nationally. Multivariable logistic and linear regression models for CF, BO and CS as a function of potential predictors were constructed. RESULTS The survey response rate was 47%. The prevalence of CF, BO and CS was 15.7, 20.8 and 21.9%, respectively. Female gender, emotional depletion, distress from 'a clinical situation', 'co-workers', 'personal health issues' and 'not talking about distressing issues' were each significant determinants of CF. Emotional depletion, distress from the 'physical work environment' and 'co-workers', and 'not talking about distressing issues' were significant determinants of BO. Self-identification as Hispanic; 'not currently feeling distressed'; talking about distressing issues; and utilization of pediatric palliative care services were significant determinants of higher CS. CONCLUSIONS CF and BO may impact emotional well-being and professional performance of neonatologists. Enhancement of CS is a potential target for intervention.
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Affiliation(s)
- A S Weintraub
- Division of Newborn Medicine and Department of Pediatrics, Kravis Children's Hospital, Mount Sinai Medical Center and The Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - A Stroustrup
- Division of Newborn Medicine and Department of Pediatrics, Kravis Children's Hospital, Mount Sinai Medical Center and The Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Preventive Medicine, The Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - E D Waldman
- Division of Hematology/Oncology and Pediatric Palliative Care, New York Presbyterian, Morgan Stanley Children's Hospital, Columbia University Medical Center, New York, NY, USA
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Gracino ME, Zitta ALL, Mangili OC, Massuda EM. A saúde física e mental do profissional médico: uma revisão sistemática. SAÚDE EM DEBATE 2016. [DOI: 10.1590/0103-1104201611019] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
RESUMO O objetivo desta revisão sistemática da literatura foi de identificar as principais doenças que acometem os médicos em todo o mundo, mediante uma pesquisa eletrônica na base de dados Biblioteca Virtual em Saúde (BVS) baseada na metodologia Preferred Reporting Items for Systematic Reviews and Meta-Analyses (Prisma). Foram analisados 57 dos 374 artigos científicos encontrados sobre o tema em inglês, português e espanhol, publicados entre 2005 e 2015. Os resultados encontrados apontaram que os acometimentos mentais prevaleceram, destacando-se o esgotamento profissional (síndrome de burnout). Entre as doenças físicas, predominaram os acometimentos musculoesqueléticos.
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20
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Hall SL, Cross J, Selix NW, Patterson C, Segre L, Chuffo-Siewert R, Geller PA, Martin ML. Recommendations for enhancing psychosocial support of NICU parents through staff education and support. J Perinatol 2015; 35 Suppl 1:S29-36. [PMID: 26597803 PMCID: PMC4660046 DOI: 10.1038/jp.2015.147] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Accepted: 09/23/2015] [Indexed: 12/25/2022]
Abstract
Providing psychosocial support to parents whose infants are hospitalized in the neonatal intensive care unit (NICU) can improve parents' functioning as well as their relationships with their babies. Yet, few NICUs offer staff education that teaches optimal methods of communication with parents in distress. Limited staff education in how to best provide psychosocial support to families is one factor that may render those who work in the NICU at risk for burnout, compassion fatigue and secondary traumatic stress syndrome. Staff who develop burnout may have further reduced ability to provide effective support to parents and babies. Recommendations for providing NICU staff with education and support are discussed. The goal is to deliver care that exemplifies the belief that providing psychosocial care and support to the family is equal in importance to providing medical care and developmental support to the baby.
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Affiliation(s)
- S L Hall
- Division of Neonatology, St John's Regional Medical Center, Oxnard, CA, USA
| | - J Cross
- Department of Social Work, Widener University, Chester, PA, USA
| | - N W Selix
- School of Nursing and Health Professions, University of San Francisco, San Francisco, CA, USA
| | - C Patterson
- Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - L Segre
- College of Nursing and Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, USA
| | - R Chuffo-Siewert
- Department of Nursing, University of Iowa Children's Hospital, Iowa City, IA, USA
| | - P A Geller
- Departments of Psychology, Obstetrics/Gynecology and Public Health, Drexel University, Philadelphia, PA, USA
| | - M L Martin
- Department of Nursing, McLeod Regional Medical Center, Florence, SC, USA
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van Mol MMC, Kompanje EJO, Benoit DD, Bakker J, Nijkamp MD. The Prevalence of Compassion Fatigue and Burnout among Healthcare Professionals in Intensive Care Units: A Systematic Review. PLoS One 2015; 10:e0136955. [PMID: 26322644 PMCID: PMC4554995 DOI: 10.1371/journal.pone.0136955] [Citation(s) in RCA: 315] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2014] [Accepted: 08/11/2015] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Working in the stressful environment of the Intensive Care Unit (ICU) is an emotionally charged challenge that might affect the emotional stability of medical staff. The quality of care for ICU patients and their relatives might be threatened through long-term absenteeism or a brain and skill drain if the healthcare professionals leave their jobs prematurely in order to preserve their own health. PURPOSE The purpose of this review is to evaluate the literature related to emotional distress among healthcare professionals in the ICU, with an emphasis on the prevalence of burnout and compassion fatigue and the available preventive strategies. METHODS A systematic literature review was conducted, using Embase, Medline OvidSP, Cinahl, Web-of-science, PsychINFO, PubMed publisher, Cochrane and Google Scholar for articles published between 1992 and June, 2014. Studies reporting the prevalence of burnout, compassion fatigue, secondary traumatic stress and vicarious trauma in ICU healthcare professionals were included, as well as related intervention studies. RESULTS Forty of the 1623 identified publications, which included 14,770 respondents, met the selection criteria. Two studies reported the prevalence of compassion fatigue as 7.3% and 40%; five studies described the prevalence of secondary traumatic stress ranging from 0% to 38.5%. The reported prevalence of burnout in the ICU varied from 0% to 70.1%. A wide range of intervention strategies emerged from the recent literature search, such as different intensivist work schedules, educational programs on coping with emotional distress, improving communication skills, and relaxation methods. CONCLUSIONS The true prevalence of burnout, compassion fatigue, secondary traumatic stress and vicarious trauma in ICU healthcare professionals remains open for discussion. A thorough exploration of emotional distress in relation to communication skills, ethical rounds, and mindfulness might provide an appropriate starting point for the development of further preventive strategies.
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Affiliation(s)
- Margo M. C. van Mol
- Department of Intensive Care Adults, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Erwin J. O. Kompanje
- Department of Intensive Care Adults, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Dominique D. Benoit
- Department of Intensive Care, Medical Unit Ghent University Hospital, Ghent, Belgium
| | - Jan Bakker
- Department of Intensive Care Adults, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Marjan D. Nijkamp
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, The Netherlands
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Sexton JB, Sharek PJ, Thomas EJ, Gould JB, Nisbet CC, Amspoker AB, Kowalkowski MA, Schwendimann R, Profit J. Exposure to Leadership WalkRounds in neonatal intensive care units is associated with a better patient safety culture and less caregiver burnout. BMJ Qual Saf 2014; 23:814-22. [PMID: 24825895 DOI: 10.1136/bmjqs-2013-002042] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Leadership WalkRounds (WR) are widely used in healthcare organisations to improve patient safety. The relationship between WR and caregiver assessments of patient safety culture, and healthcare worker burnout is unknown. METHODS This cross-sectional survey study evaluated the association between receiving feedback about actions taken as a result of WR and healthcare worker assessments of patient safety culture and burnout across 44 neonatal intensive care units (NICUs) actively participating in a structured delivery room management quality improvement initiative. RESULTS Of 3294 administered surveys, 2073 were returned for an overall response rate of 62.9%. More WR feedback was associated with better safety culture results and lower burnout rates in the NICUs. Participation in WR and receiving feedback about WR were less common in NICUs than in a benchmarking comparison of adult clinical areas. CONCLUSIONS WR are linked to patient safety and burnout. In NICUs, where they occurred more often, the workplace appears to be a better place to deliver and to receive care.
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Affiliation(s)
- J Bryan Sexton
- Department of Psychiatry, Duke University School of Medicine, Duke University Health System, Durham, North Carolina, USA Patient Safety Training and Research Center, Duke University Health System, Durham, North Carolina, USA
| | - Paul J Sharek
- Division of General Pediatrics, Department of Pediatrics, Stanford University, Palo Alto, California, USA California Perinatal Quality Care Collaborative, Palo Alto, California, USA Center for Quality and Clinical Effectiveness, Lucile Packard Cahildren's Hospital, Palo Alto, California, USA
| | - Eric J Thomas
- University of Texas at Houston- Memorial Hermann Center for Healthcare Quality and Safety, University of Texas Medical School, Houston, Texas, USA
| | - Jeffrey B Gould
- Division of General Pediatrics, Department of Pediatrics, Stanford University, Palo Alto, California, USA California Perinatal Quality Care Collaborative, Palo Alto, California, USA Perinatal Epidemiology and Health Outcomes Research Unit, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, California, USA
| | - Courtney C Nisbet
- Division of General Pediatrics, Department of Pediatrics, Stanford University, Palo Alto, California, USA California Perinatal Quality Care Collaborative, Palo Alto, California, USA
| | - Amber B Amspoker
- Levine Cancer Institute, Carolinas Health Care System, Charlotte, North Carolina, USA Duke University School of Nursing, Durham, North Carolina, USA
| | - Mark A Kowalkowski
- Levine Cancer Institute, Carolinas Health Care System, Charlotte, North Carolina, USA Duke University School of Nursing, Durham, North Carolina, USA
| | - René Schwendimann
- Patient Safety Training and Research Center, Duke University Health System, Durham, North Carolina, USA Institute of Nursing Science, University of Basel, Basel, Switzerland
| | - Jochen Profit
- Division of General Pediatrics, Department of Pediatrics, Stanford University, Palo Alto, California, USA California Perinatal Quality Care Collaborative, Palo Alto, California, USA Perinatal Epidemiology and Health Outcomes Research Unit, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, California, USA
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23
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Profit J, Sharek PJ, Amspoker AB, Kowalkowski MA, Nisbet CC, Thomas EJ, Chadwick WA, Sexton JB. Burnout in the NICU setting and its relation to safety culture. BMJ Qual Saf 2014; 23:806-13. [PMID: 24742780 DOI: 10.1136/bmjqs-2014-002831] [Citation(s) in RCA: 144] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Burnout is widespread among healthcare providers and is associated with adverse safety behaviours, operational and clinical outcomes. Little is known with regard to the explanatory links between burnout and these adverse outcomes. OBJECTIVES (1) Test the psychometric properties of a brief four-item burnout scale, (2) Provide neonatal intensive care unit (NICU) burnout and resilience benchmarking data across different units and caregiver types, (3) Examine the relationships between caregiver burnout and patient safety culture. RESEARCH DESIGN Cross-sectional survey study. SUBJECTS Nurses, nurse practitioners, respiratory care providers and physicians in 44 NICUs. MEASURES Caregiver assessments of burnout and safety culture. RESULTS Of 3294 administered surveys, 2073 were returned for an overall response rate of 62.9%. The percentage of respondents in each NICU reporting burnout ranged from 7.5% to 54.4% (mean=25.9%, SD=10.8). The four-item burnout scale was reliable (α=0.85) and appropriate for aggregation (intra-class correlation coefficient-2=0.95). Burnout varied significantly between NICUs, p<0.0001, but was less prevalent in physicians (mean=15.1%, SD=19.6) compared with non-physicians (mean=26.9%, SD=11.4, p=0.0004). NICUs with more burnout had lower teamwork climate (r=-0.48, p=0.001), safety climate (r=-0.40, p=0.01), job satisfaction (r=-0.64, p<0.0001), perceptions of management (r=-0.50, p=0.0006) and working conditions (r=-0.45, p=0.002). CONCLUSIONS NICU caregiver burnout appears to have 'climate-like' features, is prevalent, and associated with lower perceptions of patient safety culture.
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Affiliation(s)
- Jochen Profit
- Perinatal Epidemiology and Health Outcomes Research Unit, Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, USA California Perinatal Quality Care Collaborative, Palo Alto, USA
| | - Paul J Sharek
- California Perinatal Quality Care Collaborative, Palo Alto, USA Center for Quality and Clinical Effectiveness, Lucile Packard Children's Hospital, Palo Alto, USA Division of General Pediatrics, Department of Pediatrics, Stanford University, Palo Alto, USA
| | - Amber B Amspoker
- Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, USA Health Policy and Quality Program, Houston Veterans Affairs (VA) Health Services Research and Development Center of Excellence, Michael E. DeBakey VA Medical Center, Houston, USA
| | - Mark A Kowalkowski
- Levine Cancer Institute, Carolinas HealthCare System, Charlotte, North Carolina, USA
| | - Courtney C Nisbet
- California Perinatal Quality Care Collaborative, Palo Alto, USA Division of General Pediatrics, Department of Pediatrics, Stanford University, Palo Alto, USA
| | - Eric J Thomas
- University of Texas at Houston-Memorial Hermann Center for Healthcare Quality and Safety, University of Texas Medical School, Houston, USA
| | - Whitney A Chadwick
- Department of Pediatrics, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, USA
| | - J Bryan Sexton
- Department of Psychiatry, Duke University School of Medicine, Duke University Health System, Durham, USA Duke Patient Safety Center, Duke University Health System, Durham, USA
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