Job satisfaction and burnout syndrome among intensive-care unit nurses: A systematic review and meta-analysis

INTRODUCTION

The severe conditions often experienced in an intensive care unit, combined with poor working conditions, increase stress and therefore decrease job satisfaction. Sustained stress in the workplace leads to the development of burnout, a syndrome characterised by three dimensions: emotional exhaustion, depersonalisation and perceived lack of personal fulfilment.

OBJECTIVE

To analyse the relationship between burnout syndrome and job satisfaction among ICU personnel.

DATA SOURCES

The PubMed, CINAHL and Scopus databases were used.

STUDY DESIGN

A systematic review and meta-analysis. The study sample consisted of 18 quantitative primary studies conducted in the last five years. Validated questionnaires were used to assess burnout in ICU healthcare workers, the most commonly used being the Maslach Burnout Inventory.

EXTRACTION METHODS

The search equation applied was: "job satisfaction AND nurs* AND burnout AND (ICU OR intensive care units)". The search was performed in October 2022.

PRINCIPAL FINDINGS

The search returned 514 results. Only 73 articles met the eligibility criteria. After reading the title and abstract, 20 articles were selected. After reading the full texts, 12 articles remained and after the reverse search, 18 articles were finally selected. The studies reported a 50% prevalence of burnout, all three dimensions of which were heightened by the COVID-19 pandemic. Analysis of the study findings revealed an inverse association between burnout and job satisfaction.

CONCLUSIONS

Job dissatisfaction of ICU nurses depends on lack of experience, working conditions or working environment among others. ICU nurses with lower job satisfaction have higher levels of burnout.

IMPLICATIONS FOR CLINICAL PRACTICE

This meta-analysis shows the potential value of job satisfaction on improving health outcomes related to burnout syndrome for nursing professional in Intensive Care Units. Different factors that could increase job satisfaction and consequently protect them from suffering high levels of burnout, such as salary, permanence in the service, mental health care are the responsibility of the hospital supervisor and, finally, of the own Health System. Knowledge of a risk profile based on the factors influencing job dissatisfaction would enable the implementation of effective workplace interventions to reduce or prevent the risk of burnout. Health policies should focus on protecting the worker, so in addition to improving working conditions, it would be interesting to promote coping skills in order to improve the quality of care and patient safety.

The prevalence of imposter syndrome among neurosurgeons in Europe: An EANS YNC survey

Introduction

Imposter syndrome (IS), characterized by persistent doubts about one's abilities and fear of exposure as a fraud, is a prevalent psychological condition, particularly impacting physicians. In neurosurgery, known for its competitiveness and demands, the prevalence of IS remains high.

Research question

Recognizing the limited literature on IS within the neurosurgical community, this European survey aimed to determine its prevalence among young neurosurgeons and identify associated factors.

Material and methods

The survey, conducted by the Young Neurosurgeon Committee of the European Association of Neurosurgical Societies, gathered responses from 232 participants. The survey included demographics, the Clance Imposter Phenomenon Survey (CIPS), and an analysis of potential compensatory mechanisms.

Results

Nearly 94% of respondents exhibited signs of IS, with the majority experiencing moderate (36.21%) or frequent (40.52%) symptoms. Analyses revealed associations between IS and factors such as level of experience, sex, and board-certification.

Discussion and conclusion

The findings suggest a significant prevalence of IS among young neurosurgeons, with notable associations with sex and level of experience. Compensatory mechanisms, such as working hours, article reading, and participation in events, did not show significant correlations with IS. Notably, male sex emerged as an independent protective factor against frequent/intense IS, while reading more than five articles per week was identified as a risk factor. The identification of protective and risk factors, particularly the influence of gender and reading habits, contributes valuable insights for developing targeted interventions to mitigate IS and improve the well-being of neurosurgeons.

Burnout in Neurosurgery

BACKGROUND

Burnout is a pervasive psychosocial syndrome that manifests as a chronic response to interpersonal stressors encountered in the occupational setting. Neurosurgeons exhibit a high prevalence rate of burnout, ranging from 33% to 67%. The primary objective of this study is to examine the prevalence of Burnout syndrome within the neurosurgical community and identify the contributing factors.

METHODS

A prospective observational study was conducted utilizing an anonymous survey format, incorporating the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) questionnaire. Additional inquiries were made regarding demographic characteristics, occupational factors, lifestyle choices, and the Hospital Anxiety and Depression Scale (HADS) questionnaire. The survey was disseminated between March 23rd, 2023, and April 4th, 2023, utilizing the email registries of the Spanish Society of Neurosurgery (SENEC) and the Latin American Federation of Neurosurgical Societies (FLANC). Descriptive analysis was performed, comparing responses between participants with and without burnout syndrome using cross-tabulation and the Chi-square test to assess the presence of dependency.

RESULTS

A total of 282 neurosurgeons completed the survey. The sample comprised 30.1% females and 69.9% males, with a median age within the 30-40 range. Among the surveyed neurosurgeons, 66.7% exhibited a prevalence of burnout, while 23.4% met the criteria for defined burnout. Significantly higher rates of burnout syndrome were observed among residents, specifically those in their fifth year of residency, as well as those whose departments perform a moderate range of surgeries (500-1000), participating in on-call duties, lacking regular physical exercise (at least twice a week), engaging infrequently in social activities with friends, lacking extracurricular hobbies, and obtaining scores exceeding 10 points in any of the HADS subscales.

CONCLUSIONS

Burnout syndrome affects nearly a quarter of the neurosurgical specialists included in this study. Moreover, a distinct profile associated with defined burnout among neurosurgeons emerges, encompassing characteristics such as being a fifth-year resident, belongs to departments with a moderate number of surgeries, with few extra-occupational distractions and exhibiting symptoms of depression or anxiety.

Occurrences of post-traumatic stress disorder, anxiety, depression, and burnout syndrome in ICU staff workers after two-year of the COVID-19 pandemic: the international PSY-CO in ICU study

PURPOSE

The present study aimed at assessing the prevalences of post-traumatic stress disorder (PTSD) (main objective), anxiety, depression, and burnout syndrome (BOS) and their associated factors in intensive care unit (ICU) staff workers in the second year of the COVID-19 pandemic.

MATERIALS AND METHODS

An international cross-sectional multicenter ICU-based online survey was carried out among the ICU staff workers in 20 ICUs across 3 continents. ICUs staff workers (both caregivers and non-caregivers) were invited to complete PCL-5, HADS, and MBI questionnaires for assessing PTSD, anxiety, depression, and the different components of BOS, respectively. A personal questionnaire was used to isolate independent associated factors with these disorders.

RESULTS

PCL-5, HADS, and MBI questionnaires were completed by 585, 570, and 539 responders, respectively (525 completed all questionnaires). PTSD was diagnosed in 98/585 responders (16.8%). Changing familial environment, being a non-caregiver staff worker, having not being involved in a COVID-19 patient admission, having not been provided with COVID-19-related information were associated with PTSD. Anxiety was reported in 130/570 responders (22.8%). Working in a public hospital, being a woman, being financially impacted, being a non-clinical healthcare staff member, having no theoretical or practical training on individual preventive measures, and fear of managing COVID-19 patients were associated with anxiety. Depression was reported in 50/570 responders (8.8%). Comorbidity at risk of severe COVID-19, working in a public hospital, looking after a child, being a non-caregiver staff member, having no information, and a request for moving from the unit were associated with depression. Having received no information and no adequate training for COVID-19 patient management were associated with all 3 dimensions of BOS.

CONCLUSION

The present study confirmed that ICU staff workers, whether they treated COVID-19 patients or not, have a substantial prevalence of psychological disorders.

Assessment of burnout syndrome and associated factors among medical students during the COVID-19 pandemic

Background: Overwhelming requirements, a high degree of work, and prolonged exposure to emotionally demanding circumstances in work and life settings can lead to burnout syndrome. The purpose of the study is to assess burnout syndrome and its associated factors among medical students during the COVID-19 pandemic. Methods: A cross-sectional, prospective, descriptive study was conducted in a Mexican medical school during the last week of the spring semester of 2021 using the Maslach Burnout Inventory-Student Survey (MBI-SS) and an associated factors survey. Results: Based on the MBI-SS definition, most students (54.2%, n = 332) had burnout symptoms and high emotional exhaustion (79.6%, n = 448), high cynicism (57.3%, n = 351), and low academic effectiveness (36.4%, n = 223). After adjusting the associated factors, a significant correlation between the school year and the presence of burnout was identified (OR 1.127, 95% CI [1.023-1.241], p<0.05). Regarding the current pandemic, the death of a family member by COVID-19 also put students at risk of developing burnout (OR 1.598*, 95% CI [1.080-2.363, p<0.05]). Limitations: The main limitation of this study was the lack of a control group (before the pandemic); therefore, the high prevalence of burnout can only be hypothesized due to the pandemic but cannot be objectively evidenced. A prospective study after the pandemic is needed to resolve this question. Conclusion: The coronavirus pandemic represents a challenge to the academic and psychological stability of students. It essential to continue assessing burnout levels in medical students and the general population to treat them in time and improve mental health.

Attitudes toward death and burnout syndrome in geriatrics and gerontology healthcare personnel

INTRODUCTION

Geriatric and gerontology healthcare workers are associated with a series of psychosocial risks such as death, bereavement and illness, and this implies a significant emotional and work overload, which can lead to negative attitudes toward death.

OBJECTIVE

The aims of this study were to assess attitudes toward death, the level of burnout and the relationship between geriatrics and gerontology professionals.

METHOD

A correlational, cross-sectional study was conducted, in which the 42 participants in the sample completed an online questionnaire including the Revised Profile of Attitudes to Death (PAM-R) and the Maslach Burnout Inventory-Human Services Survey (MBI-HSS).

RESULTS

The results obtained show that the predominant attitude toward death in the sample is that of neutral acceptance, and with regard to burnout syndrome, moderate average levels are found in the dimensions of emotional exhaustion and personal accomplishment, but a low level of depersonalisation.

CONCLUSION

Healthcare workers with attitudes of greater fear of death or acceptance of escape tend to experience higher levels of emotional exhaustion and depersonalisation, as do those with an attitude of death avoidance, who also have lower personal fulfillment.

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

BACKGROUND

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

AIMS

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Burnout syndrome and depression in students of a Colombian medical school, 2018

INTRODUCTION AND OBJECTIVES

Burnout syndrome (BS) has been evaluated in few populations of medical students, and its relationship with depression is even less studied. The objective was to determine the frequency of BS in medical students of the Universidad Pedagógica y Tecnológica de Colombia (UPTC), in Tunja, Colombia, as well as its association with depression and other social, economic, demographic, and academic factors.

METHODS

An observational, analytical, cross-sectional study was carried out on 182 UPTC medical students during 2018. The Maslach Burnout Inventory-Student Survey (MBI-SS) was applied, with which 3 components were obtained to determine positive SB. This was crossed in the Stata 15 program for depression and other social, economic, demographic, and academic covariates with the Generalised Linear Model (GLM).

RESULTS

Of 182 respondents, 51.4% were women. The median age was 21 years (20-23 years). 14% had BS, of which 48% had depression. In the multiple regression, BS was significantly associated with a higher frequency of depression (RPa = 5.54; IC95%, 2.36-13.02; P < 0.001) and the feeling of insufficient money (RPa = 4.37; IC95%, 1.95-9.83; P < 0.001), in contrast to a negative association with smoking (RPa = 0.13; IC95%, 0.06-0.30; P < 0.001) and being a woman (RPa = 0.32; IC95%, 0.12-0.82; P = 0.018). The age of onset of marijuana use was not significant.

CONCLUSIONS

BS shows a high association with increased depression and a feeling that the money is not enough at the end of the month, but it showed a negative association with tobacco consumption and being a woman. Such students should be detected to provide them with adequate academic support.

The shared and dissociable aspects of burnout, depression, anxiety, and irritability in health professionals during COVID-19 pandemic: A latent and network analysis

Burnout syndrome (BS) has been classified as an independent 'work-related phenomenon', however, there is still an important discussion on whether BS is a unique clinical construct due to the overlapping symptoms with other domains of negative affect such as symptoms of depression, anxiety, and irritability. Thus, we investigated the common and dissociable aspects between BS and domains of negative affect such as depression, anxiety, and irritability through a cross-sectional study with 3428 essential service professionals from a national project during the COVID-19 pandemic. Participants were assessed with Burnout Assessment Tool (BAT) and the Patient-Reported Outcomes Measurement Information System (PROMIS) scales to assess the severity of depression, anxiety, and irritability. The discriminability between the constructs was investigated using correlation tests, Bifactor Exploratory Structural Equation Modeling Bifactor (ESEM), and network analyzes. The mean correlation among the four subscales of BAT-12 was stronger with each other than with depression, anxiety, and irritability. Both ESEM and network analysis, despite showing shared characteristics, clearly delineated that Burnout domains were dissociable from other domains of negative affect. Our findings corroborate the ICD-11 strategy to include BS as a separate entity that cannot be fully explained by variance accounted for by other domains.

Vocal Problems and Burnout Syndrome in Nonuniversity Teachers in Galicia, Spain

INTRODUCTION

Voice disorders and burnout syndrome are common among teachers. This study aimed to explore the relationship among vocal problems, burnout syndrome, and some personal work factors.

METHODS

This cross-sectional descriptive study enrolled 90 nonuniversity teachers who completed the Multidimensional Vocal Scale for Teachers (EVM-D) to evaluate vocal problems and an adapted Spanish version of the Maslach Burnout Inventory-Educators Survey (MBI-ES) to detect burnout syndrome.

RESULTS

Overall, 16% of teachers expressed symptoms compatible with burnout, and 60% of them were in the interval above the 75th percentile of the EVM-D, i.e., they had a high risk of vocal problems. An association between burnout and more vocal problems was established among teachers, particularly between the vocal symptoms and vocal abuse dimensions with the emotional exhaustion subscale of the MBI-ES. A history of anxiety/depression and fewer years of professional experience were associated with more vocal problems. The burnout group perceived more "loss of vocal power," "vocal fatigue," "vocal effort," and "hoarseness." Vocal abuse items received the highest scores of EVM-D. However, only "shouting" in the classroom was significantly different between the groups with and without burnout.

CONCLUSION

Emotional exhaustion of burnout syndrome, history of anxiety/depression, and a shorter professional experience were associated with vocal problems, which could limit the performance of teachers. Reducing classroom noise, establishing strategies to avoid shouting, or strengthening personal accomplishments in teachers could be useful in breaking the cycle of vocal problems and emotional exhaustion, particularly at the beginning of their professional experience.

Impact of psychosocial risk on intention to leave work during COVID-19 in Indonesia: The mediatory roles of burnout syndrome and job satisfaction

The COVID-19 pandemic intensified the complexity of work in the health sector, leading to an increase in the intention to leave work (ITL) in Indonesia. Previous research has revealed a theoretical gap in investigating the roles of burnout syndrome (BS) and job satisfaction (JS) as mediators of the effect of psychosocial risk (PR) on ITL. This research study aimed to fill this gap by examining the effect of PR on ITL during the COVID-19 pandemic, with BS and JS as mediators. Data was collected from 306 health workers in public and private hospitals of Central Jakarta, Indonesia. This data was analyzed as part of a cross-sectional research study involving the partial least square-structural equation modeling (PLS-SEM) method and using SmartPLS software. The questionnaire was based on the Copenhagen Psychosocial Questionnaire (COPSOQ) III short version, the Burnout Assessment Tools (BAT), and a modified Turnover Intention. The findings revealed that, within the direct effect pathways, JS was the highest predictor of health workers' ITL, and workplace PR significantly impacted employees' JS and BS. Another notable finding was related to the research gap vis-a-vis the indirect effect pathways: it showed that JS and BS had partial mediatory power over the relationship between PR and ITL. BS and JS were found to have a high and significant impact on employees' ITL. Therefore, this research study has contributed to the model's novelty in measuring ITL mediated by JS and BS.

Prevalence of burnout syndrome in Spanish radiologists

BACKGROUND AND AIMS

The primary objective was to analyze the prevalence and degree of professional burnout in radiologists in Spain. Secondary objectives were to identify possible factors that increase or decrease the risk of burnout to enable preventive and corrective measures, decrease the stress associated with this condition, and thereby increase radiologists' performance and satisfaction at work.

MATERIAL AND METHODS

This cross-sectional observational study used a voluntary, anonymous online survey of attending radiologists and residents through Google Forms®. The survey was structured into three sections: a qualitative assessment of the degree of professional burnout with the Maslach Burnout Inventory Human Services Survey (MBI-HSS), a series of sociodemographic and work-related questions, and a final section centered on possible causes of stress and improvements to the working environment. The results of the survey were analyzed statistically to determine which variables were associated with burnout syndrome as well as to identify possible risk factors and protective factors.

RESULTS

After disseminating the survey through social networks and email contacts, we received a total of 226 responses (175 from attending radiologists and 51 from residents; 52% men; mean age, 41 ± 11 years; age range, 25-68). The prevalence of the syndrome was 33%, without significant differences between attending radiologists and residents. No risk factors associated with burnout were identified. Teaching in the workplace was the only protective factor.

CONCLUSIONS

One-third of the respondents had burnout syndrome. Because the consequences of this syndrome can affect professionals' personal life and their ability to do their jobs, early detection and intervention should be prioritized.

Genome-wide associations, polygenic risk, and Mendelian randomization reveal limited interactions between John Henryism and cynicism

BACKGROUND

John Henryism (JH) is a strategy for dealing with chronic psychological stress characterized by high levels of physical effort and work. Cynicism is a belief that people are motivated primarily by self-interest. High scores on the JH scale and cynicism measures correlate with an increased risk of cardiovascular disease. High cynicism is also a hallmark of burnout syndrome, another known risk factor for heart disease.

AIM

To evaluate possible interactions between JH and cynicism hoping to clarify risk factors of burnout.

METHODS

We analyzed genetic and psychological data available from the Database of Genotypes and Phenotypes for genome-wide associations with these traits. We split the total available samples and used plink to perform the association studies on the discovery set (n = 1852, 80%) and tested for replication using the validation set (n = 465). We used scikit-learn to perform supervised machine learning for developing genetic risk algorithms.

RESULTS

We identified 2, 727, and 204 genetic associations for scores on the JH, cynicism and cynical distrust (CD) scales, respectively. We also found 173 associations with high cynicism, 109 with high CD, but no associations with high JH. We also produced polygenic classifiers for high cynicism using machine learning with areas under the receiver operator characteristics curve greater than 0.7.

CONCLUSION

We found significant genetic components to these traits but no evidence of an interaction. Therefore, while there may be a genetic risk, JH is not likely a burnout risk factor.

Burnout in General Surgeons. A Systematic Review

Occupational burnout is particularly widespread amongst surgical professionals. During the past 10 years, both the awareness and the ability to reliably measure and classify "burnout" in medical professionals have increased. The purpose of this systematic review was to summarize the current evidence on the burnout levels of general surgeons. Online searches were carried out using the scientific search engines PubMed, Embase, Cinahl, and Google scholar, from 2010 to 2020, before the COVID-19 pandemic. Articles that met the inclusion criteria were critically evaluated using the critical appraisal skills programme (CASP) tool. Five studies pertaining to 669 subjects were included in this review. As expected, "burnout syndrome" was mainly due to the exhaustive and demanding conditions of working life and was strongly observed in general surgeons. The incidence of the burnout syndrome increased with their years of service, compromised their quality of life, and had detrimental effects on their mental and physical health. Personal achievements and emotional satisfaction were protective for the occurrence of the syndrome. We conclude that valid recognition and prevention of the burnout syndrome are necessary. Further research is needed to manage this phenomenon within the healthcare settings and the surgical departments.

Job demands-resources model and burnout in physical education teaching: A mixed-method sequential explanatory study

BACKGROUND

While literature includes a number of studies about burnout in teaching, investigations on teaching field-specific perspective remain limited. Research is needed to improve practical implications based on structured theoretical models and methodological basis that focusses on the unique environment of PE teaching field and causal factors behind burnout.

OBJECTIVE

The present study aimed to examine burnout among physical education (PE) teachers based on the job demands-resources (J-DR) model.

METHODS

A sequential explanatory mixed design was conducted in the study. 173 teachers replied to questionnaires, of which 14 teachers thereafter participated in semi-structured interviews. Demographic information form, Maslach Burnout Inventory, and J-DR scale for PE teachers were used, as well as an interview form. 173 teachers were first asked to report demographic information, and score Maslach Burnout Inventory and J-DR scale. Then a subsample group (n = 14) was identified/sampled for a semi-structured interview. Canonical correlation and constant comparative analysis were used to unpack the data.

RESULTS

Teachers' states of burnout varied, and physical, organisational, and socio-cultural resources were closely related with burnout levels. Demands that cause pressure on burnout were determined as paperwork and bureaucracy, student-related factors, and pandemic-related experiences. In addition to supporting the general model, specific J-DR factors for PE teaching were observed that is linked with burnout.

CONCLUSION

J-DR factors that might lead to negative conditions in the teaching environment should be considered, and field-specific factors should be focused on through arrangements to increase teaching efficiency and improve the quality of PE teachers' professional life.

Impact of COVID-19 pandemic on nurses' burnout and related factors: A rapid systematic review

AIM

This study aimed to investigate the effect of COVID-19 pandemic on nurses' burnout and related factors.

BACKGROUND

Nurses at the frontlines in every field of the health system and composed most of the health service industry closely experience all negative events during the pandemic.

METHODS

This study is a rapid systematic review.

RESULTS

A total of 751 studies were selected, of which 13 studies were compatible with the inclusion criteria. The sample size ranged from 107 to 12.596. The studies determined that nurses' burnout levels were generally moderate level and above during the COVID-19 pandemic. Sociodemographic, occupational, psychological, and COVID-19-related factors affected this burnout.

CONCLUSION

The results of this review may use to make implications that would ease the effect of the pandemic on nurses and develop strategies to protect nurses from burnout in similar possible situations. The protocol information is included here for blind peer review.

PROSPERO REGISTRATION NUMBER (ID)

CRD42021244849.

REGISTRATION AND PROTOCOL

Prior to undertaking the review, we registered the protocol in the International Prospective Register of Systematic Reviews (PROSPERO). The registration number is CRD42021244849. Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021244849. The changes made during the review process were registered in PROSPERO with an update.

A shared fate: adapting and personalising medical care from the perspective of a refugee reception country

The article outlines socio-medical challenges faced by a country hosting refugees. Since the full-scale Russian invasion, more than 3.6 million Ukrainians have fled to Poland. Among these, a 9-year-old post-transplant patient, Tetiana. The story of the girl and her family reveals the refugees’, the authors’, and other doctors’ varied attitudes towards the war. Considering differences between the Polish and Ukrainian health care systems, and the need for well-coordinated and effective assistance, a professional, and realistically financed system needs to be established. The presence of Ukrainian doctors is potentially advantageous because of the shared language with Ukrainian refugees. Notwithstanding the medical community’s demonstrable solidarity, the months of effort and the awareness that many people may not be helped may result in burnout. Supporting others starts with us, so that neither poor management, nor cultural differences or simple fatigue, undermine the community cohesion that Poles and Ukrainians can build together.

Burnout in diabetes and endocrinology specialist registrars across England, Scotland and Wales in the pre-COVID era

BACKGROUND

Presence of either emotional exhaustion, depersonalization or lack of personal accomplishment define Burnout Syndrome which may lead to decreased workforce productivity, increased absenteeism, depression and medical errors as well as decreased patient satisfaction.

OBJECTIVE

The aim of this study was to assess the frequency of burnout syndrome among Diabetes Specialist Registrars across England, Scotland and Wales and to identify any self-reported factors which may be contributory to burnout.

METHODS

Over 430 Diabetes Specialist Registrars were invited to anonymously participate in an electronic survey which used Maslach Burnout Inventory and selfreporting questionnaire to identify burnout and contributory factors.

RESULTS

In this pre-pandemic times study, Burnout was identified in 61 (57.5%; n = 106) respondents using Maslach burnout cut-off scores. 45.2% (48/106) participants had scored high in Emotional Exhaustion, while lack of personal accomplishment and depersonalization was seen in 24.5% (26/106) and 21.6% (23/106) of the respondents respectively. The commonest self-reported stressors by participants were "General Internal Medicine workload" 60.4% (64/106) followed by "Lack of specialty training" 36.8% (39/106) and "Lack of audit/research/Continuing Professional Development time" 10.8% (11/106) CONCLUSION: Burnout syndrome is frequent among the participating Diabetes Specialist Registrars and urgent steps may be required address this problem nationally to ensure that these physicians remain physically and mentally healthy, especially after the pandemic.

Burnout and Self-Perceived Stress in Workers in Essential Services after the Impact of Hurricanes Irma and Maria

OBJECTIVE

To examine the levels of burnout and self-perceived stress in workers at the Puerto Rico Electric Power Authority, who experienced major disasters: Hurricanes Irma and Maria.

METHODS

A quantitative descriptive cross-sectional study with a non-probabilistic convenience sample was conducted in workers at the Puerto Rico Electric Power Authority. A structured questionnaire was administered to a sample of 163 eligible participants, aged 21 years and older, who participated voluntarily. Using employees of the electric company, the study examined the relationships between burnout and several characteristics (years of employment, existing health conditions, and coping strategies) both before and after Hurricanes Irma and Maria. Burnout was assessed with Gil-Monte's Spanish Burnout Inventory, and self-perceived stress was assessed with the 14-item Perceived Stress Scale.

RESULTS

Before the hurricanes, 16.6% of the workers reported high levels of burnout syndrome, while, after the hurricanes, the proportion increased to one-fifth (20.9%). Prior to the 2 hurricanes, more than one-fourth (23.4%) of the sample reported being extremely stressed; after the hurricanes, that proportion increased to 55%. Factors such as years of employment, counseling, and self-perceived stress showed significant statistical associations (P < .05) with burnout.

CONCLUSION

From a public health standpoint, priority should be given to this population, thereby preventing burnout and any other negative effects of the aftermath (i.e., the lengthy response, recovery, and reconstruction) of these kinds of major disaster.

Mental health of healthcare workers of Latin American countries: a review of studies published during the first year of COVID-19 pandemic

OBJECTIVE

Identify and review articles that evaluated mental health of HCW of Latin American countries (except Brazil), published during the first year of COVID-19 pandemic.

METHOD

We systematically searched EMBASE, PsycINFO, Scopus, PUBMED/ Medline, Web of Science, PePSIC, and Scielo for articles published during the first year of the COVID-19 pandemic. Two independent researchers reviewed titles and abstracts and then, for eligible studies, extracted data from full texts. Outcomes included mental health variables, country where the study was conducted, period of data collection, healthcare professional categories, study design, mental health measurements and main outcomes. The quality and risk assessment was also performed.

RESULTS

Out of 248 records identified, 24 initially were assessed for eligibility. From those, 17 studies matched eligibility criteria and were included in the review. Higher scores of anxiety were reported in different studies, as well as an increased level of depression among HCW. Being a female, younger age, and closer distance of the epicenter of the outbreak increased the likelihood to develop mental health disorder. Concerns and fear related to COVID-19 have a greater impact on stress, anxiety, and depression symptoms.

CONCLUSION

Our findings highlight that COVID-19 pandemic had been worse for HCW from Latin America, showing the harmful effects of burnout on their health. Greater psychological distress, as well as anxiety and depression had been experienced by HCW from Latin America in their fight against COVID-19, demonstrating the importance of psychological well-being policies for them during and post- the pandemic.

COVID-19 and mental disorders in healthcare Personnel: A novel framework to develop Personas from an online survey

BACKGROUND

In this paper we propose a novel framework for the definition of Personas for healthcare workers based on an online survey, with the aim of highlighting different levels of risk of developing mental disorders induced by COVID-19 and tailor psychological support interventions.

METHODS

Data were gathered from Italian healthcare workers between April and May 2020. Information about socio-demographic characteristics, current lifestyle, occupational, COVID-19 infection, and psychological indexes (Maslach Burnout Inventory, Impact of Event Scale and Patient Health Questionnaire) was collected. Respondents were divided in four subgroups based on their health profession: physicians (P), nurses (N), other medical professionals (OMP) and technical-administrative (TA). For each sub-group, collected variables (46) were reduced using Principal Component Analysis and clustered by means of k-medoids clustering. Statistical analysis was then applied to define which variables were able to differentiate among the k clusters, leading to the generation of a Persona card (i.e., a template with textual and graphical information) for each of the obtained clusters.

RESULTS

From the 538 respondents (153 P, 175 N, 176 OMP, 344 TA), the highest stress level, workload impact and risk of mental disorders were found in the N subgroup. Two clusters were identified for P, three clusters for N, two for OMP and one for TA.

CONCLUSIONS

The proposed framework was able to stratify different risk levels of possible development of mental health issues in healthcare workers due to COVID-19. This approach could represent the first step towards the development of mobile health tools to tailor psychological interventions in pandemic situations.

Psychological immune competency predicts burnout syndrome among the high-risk healthcare staff: A cross-sectional study

BACKGROUND

Burnout and psychological immune competency have not been investigated together among employees of high-risk specializations such as emergency medicine, intensive care or surgery.

AIM

In this study we aim to examine the prevalence of burnout among high-risk clinical staff and explore whether the strength of psychological immune competency predict burnout.

DESIGN

A cross-sectional design utilizing a self-administrated questionnaire was used to collect data from the participants (n = 216). Nurses (n = 145) and physicians (n = 71) from emergency medicine, intensive care and surgery departments participated in the study.

METHOD

Burnout syndrome was measured using the Maslach Burnout Inventory, while psychological immune competency was measured using the Psychological Immune Competency Questionnaire. The data collection started in June of 2018 and was finished in March of 2019.

RESULTS

Participants with higher psychological immune competency reported lower levels of burnout: emotional exhaustion (r = -0.478; p < 0.001), depersonalization (r = -0.459; p < 0.001) and personal accomplishment (r = 0.543; p < 0.001). Multiple linear stepwise regression analysis revealed the psychological immune competency to be a stable predictor of burnout on all three scales.

CONCLUSION

Psychological immune competency shows a strong relationship with scales of burnout syndrome and as such should be further examined due to development of successful intervention and prevention programs.

Development of Korean Version Burnout Syndrome Scale (KBOSS) Using WHO's Definition of Burnout Syndrome

BACKGROUND

Burnout syndrome (BOS) is defined by the World Health Organization (WHO) as a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed. This study aims to create the Korean version burnout syndrome scale (KBOSS) that conforms to WHO's definition of BOS and present the cut-off points for screening.

METHODS

We developed the KBOSS based on WHO's definition of BOS. An online survey was conducted through a specialized online research company. We recruited 444 workers for this research. The validity of the KBOSS was assessed using factor analysis and Pearson's correlation. The KBOSS reliability was assessed using Cronbach's alpha coefficient. The cut-off points for each of the three dimensions were derived using the upper quartile score.

RESULTS

The validity and reliability of the KBOSS were good. Regarding reliability, the scale's overall Cronbach's alpha was 0.813. Cronbach's alpha of each three-dimension was as follows: exhaustion, 0.916; cynicism, 0.865; and professional inefficacy, 0.819. The cut-off points of BOS three dimensions are exhaustion ≧ 21; cynicism ≧ 18; and inefficacy ≧ 15.

CONCLUSION

The developed questionnaire (KBOSS) can be a useful tool for screening of BOS.

Burnout and spirituality among nurses: A scoping review

OBJECTIVE

To investigate the relationship between spirituality / religiousness and Burnout Syndrome in nurses, as well as to examine the current evidence for spiritual/religious interventions to alleviate their symptoms.

DATA SOURCES

A scoping review was conducted using CINAHL, SCOPUS, Web of Science, Pubmed databases, and grey literature, between January and July 2020.

STUDY SELECTION

Two researchers performed the searches with a 95% agreement rate for the inclusion and exclusion of the studies. Both quantitative and qualitative studies published in peer-reviewed journals, using Spanish, Portuguese or English language were included. Restriction on publication date was not applied.

DATA EXTRACTION

A total of 1143 articles were identified and 18 were included in the final analysis. Quality assessment was performed, following CONSORT, STROBE, PRISMA and COREQ guidelines. Finally, the following data were extracted: authors, year, country, study design and sample characteristics, purpose of the study, and major findings.

DATA SYNTHESIS

The results of the present review show that spirituality / religiousness is a common strategy used by nurses when coping with stress and burnout. Most studies reveal that spiritual and religious beliefs are correlated with lower levels of burnout, exhaustion and depersonalization in different settings. Nevertheless, two studies have not found any relationship and one study has found worse outcomes.

CONCLUSIONS

There is a lack of experimental studies trying to examine if spiritual interventions could modify burnout levels in clinical practice. Health managers should be aware of the spirituality / religiousness of their nurses and provide the appropriate spiritual support.

Severity and prevalence of burnout syndrome in paediatric intensive care nurses: A systematic review

OBJECTIVES

The aim of this study is to identify burnout syndrome severity and prevalence in paediatric intensive care unit nurses.

DESIGN

Systematic review.

SETTING

Paediatric intensive care unit.

MAIN OUTCOME MEASURES

A librarian was consulted on methodology before the search process. MEDLINE (via PubMed), EMBASE, the Cochrane Library, CINAHL, and PsycINFO were searched for full-text studies published before September 2019 in any language. Only those observational studies exploring burnout syndrome, including paediatric intensive care unit nurses, were included. Two authors independently screened studies. We assessed the risk of bias within each study based on the Office of Health Assessment and Translation tool.

RESULT

After screening 1238 articles, we identified six studies which met the systematic review criteria. All studies included were published after 2012 and participant sample sizes were between 35 and 195 nurses. Three studies were conducted in the United States of America while the others were from the United Kingdom, Turkey and Taiwan. Prevalence of burnout syndrome in pediatric intensive care unit nurses was reported in these studies as between 42% and 77%. The assessment tools used in these studies were the (abbreviated) Maslach Burnout Inventory, Abbreviated Maslach Burnout Inventory, Occupational Burnout Inventory, and Professional Quality of Life Scale Version 5. We could not conduct a meta-analysis due to the lack of studies.

CONCLUSION

Our systematic review identifies that a low number (6 total) of relevant studies focused on burnout syndrome for pediatric intensive care unit nurses with a prevalence of burnout syndrome in paediatric intensive care unit nurses of between 42% and 77%.

Anxiety and burnout in anesthetists and intensive care unit nurses during the COVID-19 pandemic: a cross-sectional study

Background

This study aimed to measure the levels of anxiety and burnout among healthcare workers, including attending physicians, residents, and nurses in intensive care units during the coronavirus disease 2019 (COVID-19) pandemic.

Methods

This is a cross-sectional survey analysis of healthcare workers in our institution. Data were collected on demographic variables, COVID-19 symptoms and test, disease status, anxiety level (assessed by the Beck Anxiety Inventory), and burnout level (measured by the Maslach Burnout Inventory). Subscales of the burnout inventory were evaluated separately.

Results

A total of 104 participants completed the survey. Attending physicians, residents, and nurses constituted 25%, 33.7%, and 41.3% of the cohort, respectively. In comparison to untested participants, those tested for COVID-19 had a lower mean age (p = 0.02), higher emotional exhaustion and depersonalization scores (p = 0.001, 0.004, respectively), and lower personal accomplishment scores (p = 0.004). Furthermore, moderate to severe anxiety was observed more frequently in tested participants than untested ones (p = 0.022). Moderate or severe anxiety was seen in 23.1% of the attending physicians, 54.3% of the residents, and 48.8% of the nurses (p = 0.038). Emotional exhaustion, personal accomplishment, and depersonalization scores differed depending on the position of the healthcare workers (p = 0.034, 0.001, 0.004, respectively).

Conclusion

This study revealed higher levels of anxiety and burnout in younger healthcare workers and those tested for COVID-19, which mainly included residents and nurses. The reasons for these observations should be further investigated to protect their mental health.

The lived body (Der Leib) as a diagnostic and therapeutic instrument in general practice

Based on vignettes from clinical cases, supervision and Balint groups this article presents a neo-phenomenological perspective on the lived experience of healthcare professionals in interactions with patients and relatives. Specifically, the familiar phenomenon of "something in the air" between two persons will be analyzed.Constellations and situations are presented as fundamental and generic (ontological) categories that can be differentiated to understand the details and the whole (die Gestalt) of an interaction.The term atmosphere is introduced to investigate the material carrier of something that "colors the air" between healthcare provider and patient.The neo-phenomenological taxonomy of the lived body (der Leib) is used to describe the recipient structure of atmospheric mood.Finally, the potential of these concepts for a more comprehensive diagnosis and for therapeutic use in general practice will be elucidated.

Quality of life, physical activity and burnout syndrome during online learning period in Brazilian university students during the COVID-19 pandemic: a cluster analysis

The COVID-19 pandemic caused several changes in the teaching-learning process, as it abruptly replaced the conventional classes into online classes despite social distancing requirements. Such changes may be associated with several mental health problems and negatively affect the quality of life and academic performance of university students. We performed a cluster analysis in a large sample of Brazilian undergraduate students, considering sociodemographic data, physical activity frequency, study areas, Burnout Syndrome (BS), Quality of Life (QoL) and perception of online learning (OL) during COVID-19 pandemic. Seven hundred and three students (between 17 and 62 years, from 67 higher education institutions) participated in the study. We identified three different profiles of students regarding psychological aspects and OL perception. The first profile, called as the 'Low QoL' group was composed of younger students, mainly females, with higher frequency of psychological disorders (as evidenced by the self-report of depression and/or anxiety), in addition to higher Burnout scores, lower QoL and worse OL perception. The second profile called 'Intermediate QoL' comprised participants with an average age of 45 years, with a greater number of men, married, with kids and working in addition to studying. They presented better OL scores than the 'Low QoL' group. The third profile called 'Better QoL' comprised students with higher scores in all domains of QoL and better OL perception, with greater frequency of physical activity and lower BS scores. Students from Health courses showed higher scores for general QoL, and also for the psychological and environmental domains in relation to the other areas. Besides, students of the Exact Sciences courses showed higher scores on all OL perception items in comparison to the other courses. Our results provide insights regarding the mental health profile of undergraduate students, allowing educational managers to outline specific coping strategies to assist students during the pandemic.

Burnout syndrome and resilience in medical students from a Brazilian public college in Salvador, Brazil

INTRODUCTION

Burnout syndrome is highly prevalent among medical students. Whereas burnout syndrome has been associated with negative outcomes, like suicidal ideation, protective factors are still unknown.

OBJECTIVE

To evaluate if there is an association between burnout syndrome and resilience in medical students, assessing covariates such as depressive symptoms, suicidal ideation, and religiosity.

METHOD

This cross-sectional study was carried out with a sample of 209 students from a medical school in Brazil. Burnout syndrome was assessed using the Maslach Burnout Inventory - Student Survey. Potential protective factors and aggravators to burnout syndrome were investigated using appropriate scales.

RESULTS

Fifty-nine students (28.2%) presented burnout. Multivariate analysis showed that resilience was a protective factor (p < 0.001), along with being older, married or having better academic performance. Depressive symptoms were positively associated with burnout. Religiosity was not a protective factor and suicidal ideation was not associated with burnout when adjusted for depressive symptoms.

CONCLUSION

Burnout is frequent among medical students, impacting mental health and academic performance. Resilience seems to be a protective factor, and the relationship between burnout and suicidal ideation is possibly mediated by depressive symptoms. Prospective studies are needed to further investigate the associations found in this study.

Factors Predisposing to Burnout Syndrome among Medical Staff Participating in Complex Surgical Processes

Background

Burnout syndrome is a serious manifestation of distress among health-care professionals.

Objective

Due to the specific nature of work in operating theaters, factors that affect the staff performance and therefore predispose to burnout syndrome were assessed.

Methods

Based on the original questionnaire, 254 respondents working in the operating theaters of the university hospital, appraised levels of work satisfaction, sources of stress, and psychosocial burden. Work-related mental stress was assessed using the Meister's questionnaire. Burnout levels were evaluated in the group extended to 316 employees with Maslach Burnout Inventory.

Results

Work satisfaction analysis indicated unsatisfactory management and remuneration as the negative agents. The majority of the respondents emphasized the maintenance of medical records as a prominent stress factor. A large number of participants (n = 221; 87%) described work as emotionally burdensome. The results showed that the highest burden was related to the following variables: time pressure, responsibility, problems, and conflicts. The examined group was qualified to the second degree of mental load related to the work. Similarly, the entire group reached a high level of emotional exhaustion.

Conclusions

Presented data indicate the need of evaluation to minimize occupational burnout problem.

Burnout among Portuguese radiographers during the COVID-19 pandemic

INTRODUCTION

The COVID-19 pandemic has had a global impact, including in health services, placing health professionals under enormous tension, pressure, and stress. Professionals involved in the care, diagnosis, and treatment of COVID-19-infected patients have been subject to emotional and physical distress that can potentially enhance the development of occupational diseases. The aim of this study was to assess the impact of the COVID-19 pandemic on the incidence of burnout among Portuguese radiographers.

METHODS

This was a cross-sectional, quantitative study. Burnout levels were estimated using the Maslach Burnout Inventory-Human Services Survey, composed of 22 questions. Specific questions were developed to characterize the socio-demographic situation and the impact of the pandemic on the radiographers. Data were descriptively analyzed and Mann-Whitney and Kruskal-Wallis tests were used for correlation analysis.

RESULTS

The study sample comprised 386 radiographers, 68.7% of whom where female and 31.3% male. The mean sample age was 36.3 (±9.1) years. A total of 43.5% and 45.5% of subjects had a high level of emotional exhaustion and depersonalization, respectively, and 59.8% experienced low personal accomplishment. Altogether, 23.3% of study participants were at high risk of burnout in the three dimensions assessed and 77.2% in at least one.

CONCLUSION

Study results showed that radiographers were at high risk of developing burnout in the COVID-19 pandemic setting. Health institutions should actively monitor these professional's mental health and develop restorative strategies that enable their emotional wellbeing, preventing absenteeism and increasing patients' quality of care.

IMPLICATIONS FOR PRACTICE

Burnout of health professionals has a strong impact on health services organization, resulting in increased absenteeism and error probability, frequent work delays, low productivity and job satisfaction, inter- and intra-professional conflicts, high job turnover, high job quit, and decreased quality of care perceived by users.

Overload of Medical Documentation: A Disincentive for Healthcare Professionals

This review addresses the theories concerning the development and functioning of medical bureaucracy creating an excess of the patient records. An ever-growing number of medical files comply with the typical development of the bureaucratic management of an entrepreneurial organization, an essential feature of which is the life cycle of documentation. When the life cycle ends, an update is created with a multiplication of forms and items to be filled out, resembling that of what happens with the outdated computer program. Yet medical records should have a logical and well-functioning structure using the language of computer science in the form of a cascade or evolutionary model. Further, we believe that mass computerization, in contradistinction to the primary predestination purpose, increases the number of time-consuming medical records, with the evidence that it enhances the occupational burnout among physicians. Clear and concise medical documentation is necessary to handle economic and legal issues in medicine. However, the creation of medical records sits at the crux between a health-conscious provision of the best evidence-driven treatment and the continuum of care and a potential health detriment caused by taking away the time and care devoted to the patient by healthcare professionals. We submit that the hitherto pattern of creating medical records requires a turnabout to attain the intended reasons and user-friendliness for practical ends.

Prevalence of burnout syndrome among Italian volunteers of the Red Cross: a cross-sectional study

Burnout syndrome (BOS) is a work-related constellation of symptoms characterized by emotional exhaustion, depersonalization, and personal accomplishment. A cross-sectional survey was performed to study the prevalence of BOS among a randomly selected sample of 280 Italian Red Cross volunteers. A socio-demographic questionnaire and the Maslach Burnout Inventory (MBI)-HSS were used to collect data. 241 volunteers participated (response rate: 86.1%). A significant proportion of the workers had BOS subscale scores in the highest tertile: emotional exhaustion 8.0%, depersonalization 35.9% and perceived lack of accomplishment 23.5%, respectively. Volunteers in emergency care reported higher levels of emotional exhaustion (p=0.004) and depersonalization (p=0.001), and lower level of personal accomplishment (p=0.042) than volunteers engaged in non-healthcare social and administrative duties. These findings support the opportunity of a set of administrative, organizational and individual preventive interventions for emergency volunteers' mental health.

Alexithymia, traumatic stress symptoms and burnout in female healthcare professionals

Objective

The burnout syndrome represents a defence mechanism against stress and includes stages with decreased ability to experience feelings and emotional states. This finding suggests that burnout might be closely linked to emotional ‘blindness’ as a defence mechanism against negative and overwhelming emotions known as alexithymia. The aim of this study is to examine the relationships between burnout syndrome, alexithymia, depression and traumatic stress symptoms in healthcare professionals.

Methods

This empirical study assessed female healthcare professionals who work with a population of patients with diabetes, utilizing the Maslach Burnout Inventory (MBI-HSSMP), Burnout Measure (BM), Toronto Alexithymia Scale (TAS-20), Beck Depression Inventory (BDI-II) and Traumatic Stress Checklist (TSC-40). Data were analysed using Spearman’s correlation coefficient.

Results

A total of 114 female participants were included (age range, 31–60 years; mean age, 46.62 ± 8.71 years). Statistically significant associations were found between burnout syndrome (BM scores) and alexithymia (TAS-20) (r = 0.41), and between BM scores and traumatic stress (TSC-40; r = 0.63). The MBI-HSSMP emotional exhaustion subscale also correlated with alexithymia (TAS-20) (r = 0.37).

Conclusion

Findings of this study suggest that alexithymia and traumatic stress are related to burnout symptoms. This dynamic may be potentially useful for detecting and preventing burnout syndrome.

[Burnout syndrome in hemodialysis health workers in Cameroon: Prevalence and associated factors]

BACKGROUND

Hemodialysis medical staffs usually work in a stressful environment. In low resource countries, professional conditions are worse and can lead to burnout syndrome. The aim of this study was to determine the prevalence of burnout syndrome and its associated factors in hemodialysis health care workers in Cameroon.

PATIENTS AND METHODS

We conducted a cross sectional study in all hemodialysis centers from Cameroon between January to August 2017. The Maslach Burnout Inventory was used for assessment of burnout level. Burnout syndrome was defined as the presence of emotional exhaustion, depersonalization or decreased professional achievement.

RESULTS

A total of 92 health workers (women 60%; n=55) among 105 identified were recorded. The median age was 42 years. Most of the workers were nurses (78.5%) and 8.5% were nephrologists. Burnout syndrome was found in 76 (82.6%) workers, 35 (38%) had emotional exhaustion, 44 (48%) depersonalization and 57 (62%) decreased professional achievements. Burnout was significantly more prevalent in overcrowded centers (100% vs. 47%; P<0.001). Hemodialysis position<5 years was less prevalent in participants with emotional exhaustion and depersonalization. Desire to change position (OR 19.61 [2.074-185.4]; P=0,009) was associated with burnout syndrome.

CONCLUSION

Burnout syndrome is very common among Cameroonian hemodialysis medical staff. Improvement of work conditions, limiting posting in hemodialysis to less than 5 years and change of position when requested may be potential preventive measures.

Prevalence of burnout syndrome and its associated factors among doctors in Sabah, Malaysia

Burnout syndrome is a condition marked by emotional exhaustion, deterioration in motivation and lack of commitment, resulting from long-lasting workplace stress, characterized by exhaustion, negative feelings towards one's work and reduced professional efficacy. Healthcare workers are at particularly high risk for burnout due to high levels of stress. Our objectives were to determine the prevalence of burnout syndrome among doctors in Sabah and factors associated with it. This multi-centre cross-sectional study was carried out among doctors working in five Sabah main hospitals. Data were collected by using self-administered questionnaires consisting of basic socio-demographic information and Copenhagen Burnout Inventory (CBI). Overall, a total of 523 doctors consented to participate in this study. The prevalence of personal burnout, work-related burnout, and patient-related burnout among doctors were 57.1%, 48.8%, and 30.4% respectively. Chi-square analysis showed factors that were associated to personal burnout and work-related burnout, were marital status, duration of service and position in the service. Duration of service was the only factor associated with patient-related burnout. The prevalence of burnout syndrome in Sabah should not to be overlooked and more researches are indicated to look into prevention of burnout syndrome in Malaysian setting.

[Psychological effects of emergency calls management on medical dispatcher assistants in a SAMU-Center 15]

INTRODUCTION

In France, the emergency call center is called SAMU (service d'aide médicale d'urgence). The Medical Dispatcher Assistant (MDA) is the first responder and is exposed to first calls of distress and has a high risk of stress disorder.

AIM

Psychological impact of emergency calls on MDA.

METHOD

National multicenter prospective study from January to August 2018 by electronic surveys, including all MDA of 13 SAMU, subdivided in 5 sections: population characteristics, PCL-5 scale (DSM-5) assessing post-traumatic stress disorder (PTSD), ProQOL assessing professional quality of life, call categories and an MDA's emotional perception, and work impacts on an MDA's quality of life. Univariate descriptive statistical analysis of the group with PCL-5≥34 (=complete PTSD group) and with PCL-5<34 (=group without complete PTSD).

RESULTS

Of 400 MDA asked to be interviewed, 283 (71 %) replied of whom 72 % (205) were women and 28 % (79) men. Age groups: 9 % (25) for 18-25 yrs, 39 % (110) for 26-35 yrs, 31 % (89) 36-45 yrs, 15 % (43) 46-55 yrs and 6 % (16) for more than 56 yrs. All MDA reported having been exposed to death experience. For 46 % (129) the most recent traumatic event occurred within the last 7 months. 78 % (219) have reported intense fear, feeling helpless, or even sensed horror when answering the calls. 97 % (273) could talk about it with colleagues but only 64 % (180) with family. 72 % (203) felt lack of recognition at work. 78 % (220) had no knowledge about psycho-traumatic disorder. While 11 % (30) suffered symptoms suggestive of a complete PTSD, 15 % (42) an incomplete PTSD, 3 % (8) suffer burnout and 4 % (11) compassion fatigue, none reported secondary traumatic stress. The only significant difference (P<0.05) between the two groups characteristics was on the education level. 74 % (22) of the MDA with a complete PTSD had a High School diploma or less. MDA with symptoms suggestive of complete PTSD developed significantly (P<0.001) more stress reduction strategies (alcohol, drugs, medication) (13 % vs 2 %), had more food disorders (80.5 % vs 38 %), more sleeping problems (75.5 % vs 21 %), more anxiety (67 % vs 17 %), and more sick leaves (13 % vs 4 %) than the group without complete PTSD.

CONCLUSION

Part of the surveyed MDAs showed symptoms suggestive of PTSD. The study highlights that MDAs is a vulnerable population, and PTSD prevention techniques should be systematically implemented for them. The study also highlights that a higher education level prevents the psycho traumatic process with its accompanying disorders.

Burnout, resilience and work engagement among Dutch intensivists in the aftermath of the COVID-19 crisis: A nationwide survey

PURPOSE

The COVID-19 crisis put a strain on intensive care resources everywhere in the world increasing the risk of burnout. Previously, the prevalence of burnout among Dutch intensivists was found to be low. Engagement and resilience among intensivists have not previously been studied quantitatively, however, both are related to burnout and provide a possible way to mitigate burnout. Our objective was to study burnout and its association with work engagement and resilience among Dutch intensivists in the aftermath of the COVID-19 crisis.

METHODS

An online questionnaire was sent to all Dutch intensivists. The questionnaire consisted of questions on personal and work-related characteristics and validated questionnaires: the Maslach Burnout Inventory, the Utrecht Work Engagement Scale, and the Resilience Evaluation Scale.

RESULTS

The response rate was 27.2% with 162 evaluable responses. Thirteen respondents (8.0%) were classified as having burnout, 63 (38.9%) respondents were reporting high work engagement. Burnout was found to be negatively associated with both work engagement and resilience.

CONCLUSION

In the aftermath of the 2020 COVID-19 crisis, we found a raised prevalence of burnout among intensivists, however this is still low in international comparisons. Intensivists with burnout scored low on resilience and low on work engagement.

Syndrome of professional wear and tear or «burnout» in Andalusian ophthalmology

INTRODUCTION

Burnout syndrome refers to the physical and psychological fatigue suffered by workers as a result of their professional activity. It has three main characteristics: emotional exhaustion, depersonalization and lack of personal fulfillment.

PURPOSE

To determine the prevalence of burnout syndrome among Andalusian ophthalmologists, both consultants and residents, analyzing its relationship with several sociodemographic variables.

MATERIAL AND METHODS

Descriptive cross-sectional study. All the sociodemographic variables were included in a Google® form together with the standardized questionnaire Maslach Burnout Inventory-Human Services Survey (MBI-HSS). This form was sent to the Andalusian ophthalmological community by different electronic means (Andalusian Society of Ophthalmology, instant messaging mobile apps, etc.).

RESULTS

One hundred fourty two ophthalmologists answered the form, with a similar distribution by sex and a mean age of 43.77 years, with 67.1% of them meeting criteria of burnout syndrome. Its prevalence was higher among young ophthalmologists, with fewer years of clinical practice, divorced/separated, those with fewer children, belonging to centers in the province of Huelva, workers in rural/regional areas, those with exclusive public activity, consultants with temporary contracts and four-year residents. Regarding subspecialties, its prevalence was higher among those who focused on cornea-ocular surface-refractive surgery.

CONCLUSIONS

This study quantify for the first time in Andalusia the prevalence of burnout syndrome among ophthalmologists. The fact that two thirds of the analyzed sample meet criteria proves the need to implement improvements in the clinical and professional conditions of our group.

Burnout syndrome in healthcare professionals who care for patients with prolonged disorders of consciousness: a cross-sectional survey

BACKGROUND

Burnout is more common among healthcare professionals, that is an important problem of professional distress that can seriously affect healthcare professionals' emotional state, health, medical quality and doctor-patient relationship. However, only few studies researched the burnout status of healthcare professionals who care for patients with prolonged disorders of consciousness. The aim of this study was to evaluate the level of burnout and related contributing personal and environment factors in healthcare professionals managing these patients.

METHODS

Institution-based cross-sectional study. Maslach Burnout Inventory-Human Services Survey was used to evaluate burnout in professionals who specially care for patients with prolonged disorders of consciousness in the neurorehabilitation department.

RESULTS

A total of 200 questionnaires were distributed, 121 were collected, among them 93 questionnaires could be used for further analysis. In this study, 61 participants (65.6%) showed burnout (55.2% physicians and 82.9% nurses). For the risks and Maslach Burnout Inventory scores, emotional exhaustion and depersonalization were correlated with age, gender, occupation, marital status, years of practice, and education level. Reduced personal accomplishment was correlated with marital status. The variables of age (< 29 years old), occupation (nurses), marital status (unmarried), years of practice (< 5 years), and educational level (≤ Undergraduate) were associated with high levels of burnout.

CONCLUSIONS

Healthcare professionals who care for patients with disorders of consciousness experienced high levels of burnout. Especially those who were younger, nurse, unmarried, less practice experience or lower educational levels were more likely to experience high burnout.

Burnout syndrome in Romanian medical residents in time of the COVID-19 pandemic

Burnout is a state of physical or mental collapse caused by overwork or stress. Burnout during residency training has gained significant attention secondary to concerns regarding job performance and patient care. The new COVID-19 pandemic has raised public health problems around the world and required a reorganization of health services. In this context, burnout syndrome and physical exhaustion have become even more pronounced. Resident doctors, and especially those in certain specialties, seem even more exposed due to the higher workload, prolonged exposure and first contact with patients. This article is a short review of the literature and a presentation of some considerations regarding the activity of the medical residents in a non-Covid emergency hospital in Romania, based on the responses obtained via a questionnaire. Burnout prevalence is not equal in different specialties. We studied its impact and imagine the potential steps that can be taken in order to reduce the increasing rate of burnout syndrome in the pandemics.

Burnout syndrome among nephrologists - a burning issue - results of the countrywide survey by the Polish Society of Nephrology

Background

Burnout syndrome in physicians is associated with adverse patient safety events, poorer quality of care and reduced patients’ satisfaction. There has been scarce information on the risk factors of burnout affecting professionals working in the renal care settings. As yet the phenomenon has not been studied in the population of Polish nephrologists therefore a nationwide cross-sectional study was established by the Polish Society of Nephrology to assess the prevalence of the syndrome.

Methods

The survey, that consisted of the abbreviated Maslach Burnout Inventory, questions about strategies for dealing with burnout symptoms and demographic data, was distributed during two main national meetings that gather nephrologists in Poland. 177 participants filled out the survey – 64% of participants were women, 88% were specialists and 12% - doctors in training.

Results

52% of participants demonstrated a high level of depersonalization and almost half of the study group showed high level of emotional exhaustion. Reduced personal accomplishment was more pronounced in doctors working mostly in dialysis units compared to other nephrologists (p = 0.017). 37% of participants reported that they treat some patients as they were impersonal objects and 48% felt emotionally drained from their work. 59% of participants would like to take part in the remedy program.

Conclusions

Burnout syndrome seems to be an important problem in the population of Polish nephrologists. Doctors working mostly in dialysis settings might be at increased risk of reduced personal accomplishment. The results of the survey may be useful to prepare burnout remedy program.

Determinants of depression among nursing students in Cameroon: a cross-sectional analysis

Background

Nursing students are highly susceptible to depression given the heavy workload and clinical demands of the curriculum. Depression has negative impacts on their health and academic performance. This study aimed to determine the determinants of depression amongst nursing students in the English-speaking regions of Cameroon.

Methods

A cross-sectional analysis of 447 nursing students recruited from a combination of state-owned and private nursing institutions in the English-speaking regions of Cameroon from January – April 2018 was carried out. Independent correlates of depression were determined using multivariable regression analysis, with the level of significance set at 95%.

Results

The overall prevalence of depression (Patient Health Questionnaire - 9 > 4) and major depressive disorder (Patient Health Questionnaire - 9 > 9) in these students was 69.57 and 26.40% respectively. Independent correlates of depression were found to be: total Oldenburg Burnout Inventory score (aOR: 1.18; 95% CI: 1.11, 1.25; p value < 0.01); level of studies (aOR: 0.72; 95% CI: 0.55, 0.94; p value = 0.02) and occurrence of a life-changing crises (aOR: 2.13; 95% CI: 1.28, 3.55, p value < 0.01).

Conclusion

The prevalence of depression amongst nursing students in Cameroon is high. Determinants proposed in this study require further assessment to facilitate early identification and management of depression in this high-risk group, in order to limit the negative effects linked with the condition.

Original targeted therapy for the management of the burnout syndrome in nurses: an innovative approach and a new opportunity in the context of predictive, preventive and personalized medicine

Background

Currently considered an occupational disease, the burnout syndrome affects 13-27% of the active population in multiple occupational sectors of the modern world.

Objectives

Considering the burnout syndrome from the new perspective of the predictive, preventive, personalized medicine concept as a pathological entity with a predictable appearance and evolution which allows a preventive approach and a personalized therapy, the main objective of the study is to highlight the possibility of psychotherapeutic interventions for producing measurable psychological changes in order to decrease the burnout level of hospital nurses.

Method

The research design is experimental, the independent variable being the participation or non-participation of nurses in psychotherapeutic sessions where specific classical psychodrama techniques are originally used. Nurses previously identified with medium or high levels of burnout participated in the clinical study, split into two groups: the experimental one, with 150-min weekly sessions, and the control one, without any intervention. Pre- and post-intervention questionnaires were administered to the members of both groups.

Results

The statistical analysis of the differences between pre- and post-intervention revealed (a) the decrease of the levels of personal burnout and of burnout generated by the working conditions and (b) the decrease of the depression and of anxiety on four dimensions (self-awareness, ergic tension, veiled and general anxiety).

Conclusions

The classical psychodrama method can be an effective solution in the prophylaxis and treatment of the burnout syndrome. The multidisciplinary approach according to the PPPM concept including changes of the environmental factors within the professional framework associated with stress control programmes can be promising solutions for the management of this syndrome.

Burnout Syndrome Risk in Child and Adolescent Tennis Players and The Role of Adherence to the Mediterranean Diet

This cross-sectional study examined the impact of adherence to Mediterranean diet on burnout syndrome risk in 94 athletes 8-15 years old. Diet pattern and burnout syndrome risk were assessed through the Athlete Burnout Questionnaire and the KIDMED Questionnaire. 55.3% of girls and 16.1% of boys had a high risk of burnout syndrome and the risk increased with age. Of the 78.7% with low adherence to Mediterranean diet, 31.1% showed no risk of burnout syndrome, 33.8% had a moderate risk, and 35.1% high risk. Of the 21.3% with a high adherence to Mediterranean diet, 35% had no risk of burnout syndrome, 45% had a moderate risk, and 20% had a high risk. Participants with moderate/high burnout syndrome risk were more likely to be girls and spend a higher number of hours watching television or playing video games. There is not enough statistical evidence in this study to reject the independence between the level of adherence to the Mediterranean diet and the risk of burnout syndrome in children, except in the case of daily consumption of fresh or cooked vegetables.

Prevalence of burnout syndrome in gastroenterologists and endoscopists: results of a national survey in Mexico

BACKGROUND

Burnout syndrome (BOS) is characterized by emotional exhaustion, depersonalization and reduced personal accomplishment. It affects doctors, patients and their inter-relationship. There is a lack of data on BOS in Mexico. The main objective of the present study is to evaluate the prevalence of BOS in physician members of the Mexican gastroenterological association (MGA) and Mexican association for gastrointestinal endoscopy (MAGE).

MATERIALS AND METHODS

Cross sectional, prospective study through anonymous electronic survey via e-mail, sent to members of the MGA (n = 1192) and MAGE (n = 600). The survey included questions about basic sociodemographic information, Maslach Burnout Inventory, and factors potentially associated with BOS. Continuous variables were summarized as means and ANOVA or Kruskal-Wallis test were used to compare groups. Nominal variables were summarized as proportions and Fisher's exact test or Χ2 test were used, as appropriate.

RESULTS

A total of 1792 e-mail invitations were delivered and 411 answers were received with a response rate of 22.9%. The prevalence of BOS according to the Maslach Burnout Inventory was 26.3% (108/411). The prevalence of BOS according to the single-item self-defined burnout question (SISDBOQ) was 32.6% (134/411). The Kappa coefficient for emotional exhaustion between the SISDBOQ and Maslach inventory was 0.48 (p = 0.0001). Factors associated with BOS included performing endoscopic procedures (OR 2.9 (1.2-6.6); p = 0.008), lack of support from colleagues upon complications (OR 0.2 (0.1-0.4); p = 0.0001), receiving frequent reprimands from superiors (OR 2.4 (1.5-3.8); p = 0.0001), work unrelated to medicine (OR 2.4 (1.4-3.9); p = 0.0001), work violence/harassment (OR 3.0 (1.9-4.9); p = 0.0001) and living in a big city (OR 1.9 (1.2-3); p = 0.005).

CONCLUSION

BOS is a frequent entity in Mexican gastroenterologists and endoscopists. There are potentially modifiable factors associated with BOS.

Lifestyle among urology trainees and young urologist in the context of burn-out syndrome

INTRODUCTION

Burnout syndrome has increased dramatically in urology within recent years. A healthy lifestyle has been described as a protective factor. However, data on lifestyle is lacking among residents and urologists and remains to be elucidated. We aim to assess lifestyle among urology residents and young urologists across Europe.

MATERIALS AND METHODS

Members of the European Society of Residents in Urology (ESRU) designed a 34-item online survey via surveymonkey.com. The survey was designed in accordance with Checklist for Reporting Results of Internet E-Surveys (CHERRIES) guidelines and was distributed via e-mail and social media in 23 European countries to urology residents and young urologists. The primary endpoint was reported as self-perceived health status. Secondary endpoints included questions on sleeping disorders, exercise and dietary habits. Data was analyzed SPSS software.

RESULTS

A total of 412 residents and young urologists responded to the survey. The mean age of the respondents was 31.4±3.9 yr. The data on dietary intake demonstrate a mean of 2 or more cups/day of coffee and alcohol consumption 2-3 times/week. The intake of fruits and vegetables is very low, almost 60% of responders consume<1 portions of fruit/day and more than half (52%) eat<1 portion of vegetable/day. Overall, the majority of respondents reported to have a moderate to low satisfaction with lifestyle (59.65%) and low to moderate self-perceived health status (45.94%). Moreover, 46% of respondents reported to have some kind of sleep disturbance and 60% only slept 6hours/night or less with 53% reporting a moderate to very low quality of Sleep. Regular exercise of at least 30min twice weekly was only performed by 33% of the respondents.

CONCLUSIONS

Residents and young urologists have unbalanced diet, tend to exercise too little and often suffer from sleep disturbances all of which increases the risk of burnout. Physicians, organizations and institutions should strive to promote healthy lifestyle, resiliency and support programs.

Burnout syndrome prevalence during internship in public and private hospitals: a survey study in Mexico

Burnout syndrome is a psychological condition that commonly affects health professionals, medical students, and others in professions with long shifts. It is defined by a high amount of emotional exhaustion, depersonalization, and low personal job satisfaction. We aimed to determine the prevalence of burnout syndrome in medical interns and establish the relationships between this condition and the time and type of hospital at which students worked during their medical internship. This was a survey study in which we used the Maslach Burnout Inventory, applied to fifth-year medical students on an internship at private and public hospitals in Mexico. The participants were 96 women (54.5%) and 80 men (45.5%), with ages ranging from 21 to 34 years old. We found burnout syndrome in 20% of these medical students 22% of the women and 18.6% of the men in the sample. Second-semester interns suffered burnout at a rate of 29%, in contrast to 15% of first-semester students. Emotional exhaustion and depersonalization scores were higher in second-semester interns who worked in public hospitals. However, the prevalence did not differ between public and private hospitals. Our study reports a higher prevalence of burnout syndrome during the second semester of internship. Students who practiced their internship in a public hospital showed higher scores in emotional exhaustion and depersonalization than those who practiced in a private hospital.

Burnout as a predictor of depression: a cross-sectional study of the sociodemographic and clinical predictors of depression amongst nurses in Cameroon

Background

Depression is a debilitating mental health condition which affects an estimated 350 million people worldwide annually. Nurses are twice as likely to suffer from depression than professionals in other professions. This leads to a considerable loss of efficiency and productivity. We sought to determine the prevalence and predictors of depression among nurses in Cameroon.

Methods

Cross-sectional analysis carried out over 6 months (January – June 2018) using nurses from public and private healthcare institutions sampled consecutively in the two English-speaking regions (North west and South west regions) of Cameroon. The nurses were handed a structured, printed, self-administered questionnaire to fill and hand in at their earliest convenience. Depression and burnout were assessed using the Patient Health Questionnaire – 9 and the Oldenburg Burnout Inventory respectively.

Results

A total of 143 nurses were recruited (mean age: 29.75 ± 6.55 years; age range: 20–55 years, 32.87% male). The overall prevalence of depression was 62.24%. Independent predictors of depression after multivariable analysis were: Number of night shifts a week (adjusted odds ratio: 1.58; p value: 0.045, 95% CI; 1.01, 2.48) and Total Oldenburg Burnout Inventory score (adjusted odds ratio: 1.21, p value: 0.001; 95% CI; 1.08, 1.35). Recreational drug use was also found to perfectly predict the outcome – depression.

Conclusion

Depression is highly prevalent among nurses in the English-speaking regions of Cameroon. Accurate predictors could prove vital for early detection and management of affected individuals. Predictors presented herein require further investigation via multicentric nationwide studies, to obtain more generalizable results.

Prevalence and correlates of depression, anxiety, and stress in medical residents of a Brazilian academic health system

BACKGROUND

Several studies correlate medical residency with the occurrence of mental health disorders, Burnout Syndrome and quality of life impairment. It has been demonstrated that mental health disorders increase medical errors and lead to less effective patient care. Considering such context, this study aimed to evaluate the prevalence of anxiety, depression, stress and to identify its correlates with Burnout Syndrome and quality of life in a sample of medical residents and fellow physicians of the largest Brazilian academic health system.

METHODS

In 2017, 1648 participants were voluntarily and anonymously surveyed online about demographic characteristics, Burnout Syndrome, mental symptoms, and quality of life measured by validated questionnaires. Responses were captured through REDCap platform and multivariate statistical analyses were performed with STATA 15.

RESULTS

A total of 606 (36.8%) residents/fellows physicians completed the survey. Depression symptoms were present in 19%, anxiety symptoms in 16% and stress symptoms in 17.7% of the sample. Burnout Syndrome was present in 63% of the sample. Multivariate analysis showed a statistical significant positive correlation between Burnout Syndrome and depression, anxiety and stress symptoms and a negative correlation between mental symptoms and quality of life scores.

CONCLUSIONS

Mental health symptoms prevalence in this study is similar to other studies and their occurrence is positively correlated with Burnout Syndrome among medical residents/fellow physicians of the largest Brazilian academic health system. These results are relevant and must be confirmed by multicentric longitudinal studies. This study reinforces the importance of debating interventions to improve mental health among doctors in training.