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The Journal of Evidence-based Dental... Sep 2022Burnout syndrome has negative consequences on the dentist's health and performance during work. This systematic review aimed to assess the prevalence of Burnout syndrome... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
Burnout syndrome has negative consequences on the dentist's health and performance during work. This systematic review aimed to assess the prevalence of Burnout syndrome in dentists.
METHODS
Searches were carried out in Medline, Scopus, Web of Science, PsycINFO, EMBASE, LILACS databases, and searches in the gray literature on January 27, 2021. There were no restrictions on language and search period. For the diagnosis of Burnout, only studies that used the Maslach burnout inventory questionnaire and its subscales emotional exhaustion (EE), depersonalization (DP), and reduced personal accomplishment (PA) were included. Proportion meta-analyses were performed using the Stata 13.0 software.
RESULTS
A total of 37 articles were included in the narrative and 31 in quantitative syntheses. The overall prevalence of Burnout syndrome in dentists was 13% (95% confidence interval [CI]: 0.006-0.21; I²: 97.07%) and the total prevalence in the subscales EE, DP, and PA, were, respectively: 28% (95% CI: 0.24-0.32; I²: 20.70%), 18% (95% CI: 0.08-0.28; I²: 85.61%) and 10% (95% CI: 0.08-0.13; I²: 0%). About the levels of Burnout syndrome in the subscales, 25% (95% CI: 0.19-0.31; I² 92.58%) presented high EE, 18% (95% CI: 0.10-0.26; I² 96.62%) high DP and 32% (95% 0.20-0.45; I² 97.86%) low PA. About continuous data, the mean of EE, DP and PA was respectively 17.90 (95% CI: 9.36-26.43; I² 94.8), 6.93 (95% CI: 3.41-10.45; I² 80.2) and, 34.69 (95% CI: 23.82-45.55; I² 98.8). No study presented all the positive criteria of the Joanna Briggs Institute Critical Appraisal checklist.
CONCLUSION
In conclusion, there was a considerable prevalence of burnout syndrome in dentists, mainly in the subscale of emotional exhaustion.
Topics: Burnout, Professional; Burnout, Psychological; Dentists; Humans; Prevalence; Surveys and Questionnaires
PubMed: 36162888
DOI: 10.1016/j.jebdp.2022.101724 -
Medical Education Mar 2023The policies regarding resident physician work hours are constantly being evaluated and changed. However, the results of randomised control trials (RCTs) are mixed. This... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
The policies regarding resident physician work hours are constantly being evaluated and changed. However, the results of randomised control trials (RCTs) are mixed. This systematic review of RCTs aims to synthesise the evidence associated with resident duty hour restrictions and its impact on resident- and patient-based outcomes.
METHODS
A comprehensive search of the Cochrane Library, EMBASE and PubMed was conducted from inception until 31 July 2020. Any RCT evaluating the impact of longer resident physician work hours compared to shorter resident physician work hours on resident- and patient-based outcomes was eligible for inclusion. Two reviewers extracted data independently. The primary outcome was the impact of resident duty hour restrictions on emotional exhaustion, depersonalisation and personal accomplishment, as defined by the Maslach Burnout Inventory. The secondary patient-related outcomes were patient hospital length of stay, serious medical errors and preventable adverse events. Data were pooled using a random-effects model.
RESULTS
Of the 873 references, nine RCTs met the inclusion criteria. A shorter shift length compared with longer shift length was associated with significantly less emotional exhaustion (standardised mean difference [SMD] = -0.11, 95% CI = -0.21, -0.00) and less dissatisfaction with overall well-being (OR = 0.61, 95% CI 0.38, 0.99) but not with hospital length of stay (SMD = -0.01, 95% CI = -0.05, 0.02, p = 0.45) and serious medical errors per 1000 patient hours (OR = 1.07, 95% CI = 0.52, 2.21; p = 0.86).
CONCLUSIONS
Shorter resident duty hours is possibly associated with improvement in resident-based outcomes, specifically, emotional exhaustion, dissatisfaction with overall well-being, sleep duration and sleepiness. These findings may inform the policy change in support of reduced shift hours resulting in overall well-being for the residents with possible reduction in burnout without adverse impact on patient-based outcomes.
Topics: Humans; Internship and Residency; Burnout, Professional; Emotions
PubMed: 36181404
DOI: 10.1111/medu.14943 -
International Journal of Nursing... Dec 2017This study comprehensively analysed and systemized the elements associated with nursing sickness presenteeism (SP) and sickness absenteeism (SA). (Review)
Review
AIMS
This study comprehensively analysed and systemized the elements associated with nursing sickness presenteeism (SP) and sickness absenteeism (SA).
BACKGROUND
Both behaviours represent a real challenge to nursing departments because they can increase costs, cause health care adverse events, and impact the quality of health care.
DESIGN
The systematic review of cohort studies was designed to be consistent with the PRISMA guidelines.
DATA SOURCES
PubMed, ProQuest, and Emerald were systematically searched for peer-reviewed articles published from the 1950s to December 2016.
REVIEW METHODS
Cohort studies were included (12 SA and 1 SP) in the review if they examined the association between one or more exposures and SP and/or SA in nurses. The methodological quality of the included studies was assessed using the Newcastle-Ottawa Scale.
RESULTS
Twenty-three antecedents were associated with SA and grouped as work and organizational, mental and physical health, and demographic; 3 antecedents were associated with SP (job demands, burnout, and exhaustion). Exhaustion (fatigue) and job demands were associated with SA and SP. Depersonalization was an outcome of SP over time.
CONCLUSION
The ability to predict presenteeism and absenteeism in nursing is useful to constrain costs and ensure that quality care is delivered.
Topics: Absenteeism; Fatigue; Humans; Nurses; Presenteeism; Sick Leave; Workload
PubMed: 29094426
DOI: 10.1111/ijn.12598 -
Clinical Psychology & Psychotherapy Sep 2023Dissociative identity disorder and depersonalization-derealization have attracted research and clinical interest, facilitating greater understanding. However, little is... (Review)
Review
BACKGROUND
Dissociative identity disorder and depersonalization-derealization have attracted research and clinical interest, facilitating greater understanding. However, little is known about the experience of multiplicity of self outside of traumagenic or illness constructs. Consequently, this systematic review explored how people identifying as having multiple selves conceptualize their experiences and identity.
METHODS
A comprehensive search of qualitative studies reporting lived experiences of multiplicity was conducted through PsycINFO, PubMed and Scopus (PROSPERO ID: CRD42021258555). Thirteen relevant studies were retrieved (N = 98, 16-64 years, conducted in the United Kingdom, the United States, Hungary and Poland).
RESULTS
Using line-by-line thematic synthesis, four analytical themes were developed: multiplicity: disorder versus experience; impact of understanding multiplicity; importance of supporting multiplicity; and continuum of experiences.
DISCUSSION
This review highlights heterogeneity within multiplicity-spectrum experiences, emphasizing the need for person-centred, individualized understanding, separate from mental health conceptualizations. Therefore, training in person-centred individualized care to promote self-concept clarity is needed across health, education and social care. This systematic review is the first to synthesize voices of people with lived experience across the multiplicity spectrum, demonstrating how qualitative research can contribute to advancing our understanding of this complex phenomena with the community, acknowledging reciprocal psychosocial impacts of multiplicity and providing valuable recommendations for services.
PubMed: 37699854
DOI: 10.1002/cpp.2910 -
International Nursing Review Mar 2024This study aims to review available evidence about the relationship between structural and psychological empowerment and burnout among nurses. (Meta-Analysis)
Meta-Analysis Review
AIM
This study aims to review available evidence about the relationship between structural and psychological empowerment and burnout among nurses.
BACKGROUND
Nurses are key healthcare providers, who experience higher levels of burnout due to uncertainty and role conflicts about nursing roles and responsibilities and poor management. Nurse empowerment is an effective approach to reduce nurse burnout and enhance patient care quality.
INTRODUCTION
Positive working conditions along with positive attitudes and perceptions for nurses are crucial in the workplace. Nurse empowerment in the workplace results in quality improvements in work life and the provision of healthcare.
METHOD
We conducted a systematic review in accordance with the recommendations of the Joanna Briggs Institute and the PRISMA guideline. Relevant studies published between 2007 and 2022 were identified via PubMed, CINAHL, Web of Science, Scopus, Cochrane Library, Ovid MEDLINE (R), Science Direct and Turkish scientific literature databases. Studies that reported correlation coefficients were pooled to conduct a meta-analysis.
RESULTS
Random-effects meta-analyses showed a negative association between structural and psychological empowerment and emotional exhaustion. The overall findings showed a moderate and negative association between the six dimensions of structural empowerment and depersonalization. There was a positive association between structural empowerment and personal accomplishment.
DISCUSSION
There is a relationship between decreased burnout levels and nurse empowerment. The causal relationship between empowerment and burnout levels needs to be investigated in various healthcare settings in several countries.
CONCLUSION
The relationship between structural and psychological empowerment and burnout levels emphasizes that empowerment can reduce nurse burnout. Nurse empowerment is a critical management strategy for improving the quality of life for nurses, increasing the quality and effectiveness of patient care and achieving positive outcomes.
IMPLICATIONS FOR NURSING AND HEALTH POLICY
The encouragement and empowerment of nurses for prompt decision-making and effective resource utilization, reduces nurse burnout, enhancing nurses' job commitment, productivity, satisfaction and competence along with increased quality of care. The encouragement of nurses as empowered managers at the macro, meso and institutional levels not only improves the overall quality of health services but also helps to find solutions for the issues concerning healthcare service users and the health system environment.
Topics: Humans; Quality of Life; Job Satisfaction; Burnout, Professional; Burnout, Psychological; Workplace; Nurses
PubMed: 37597220
DOI: 10.1111/inr.12878 -
Health Psychology : Official Journal of... Jan 2022Significant proportions of burnout have been reported among both oncologists and oncology nurses. However, these groups have not been compared in a meta-analytic design.... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Significant proportions of burnout have been reported among both oncologists and oncology nurses. However, these groups have not been compared in a meta-analytic design. It is important to compare how burnout affects different types of health professionals to understand its individual implications and devise ways of minimizing and treating it.
OBJECTIVE
The current meta-analysis study aimed to systematically compare burnout prevalence between oncologists and oncology nurses.
METHOD
Authors assessed 34 studies (four included nurses and oncologists and 30 focused either on oncologists or oncology nurses) that used the Maslach Burnout Inventory (MBI) to measure burnout. Both fixed- and random-effects models were used to calculate meta-analytic estimates of the burnout subscales: emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA).
RESULTS
The pooled sample size was 4,705 oncologists and 6,940 oncology nurses. The average proportions of EE, DP, and PA were 32%, 26%, and 25%, respectively, among oncologists and 32%, 21%, and 26%, respectively, among oncology nurses. Higher DP was found among oncologists compared with oncology nurses, only in the analysis of studies that included samples of both oncologists and oncology nurses. The subgroup analysis showed higher levels of DP in Europe and Asia and lower PA in Asia and Canada. No evidence of publication bias was found.
CONCLUSIONS
Findings suggest differences in burnout between oncologists and oncology nurses and among geographic regions. This highlights the need for tailored interventions for different professions and regions. Hospitals should provide support and encourage teamwork to improve oncology professionals' well-being and provide optimal care for patients. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
Topics: Burnout, Professional; Burnout, Psychological; Emotions; Humans; Oncologists; Prevalence; Surveys and Questionnaires
PubMed: 35113585
DOI: 10.1037/hea0001155 -
Journal of Trauma & Dissociation : the... 2023Depersonalization-Derealization disorder (DDD) is a psychiatric condition characterized by persistent feelings of detachment from one's self and of unreality about the... (Review)
Review
Depersonalization-Derealization disorder (DDD) is a psychiatric condition characterized by persistent feelings of detachment from one's self and of unreality about the outside world. This review aims to examine the prevalence of DDD amongst different populations. A systematic review protocol was developed before literature searching. Original articles were drawn from three electronic databases and included only studies where prevalence rates of DDD were assessed by standardized diagnostic tools. A narrative synthesis was conducted. Twenty-three papers were identified and categorized into three groups of participants: general population, mixed in/outpatient samples, and patients with specific disorders. The prevalence rates ranged from 0% to 1.9% amongst the general population, 5-20% in outpatients and 17.5-41.9% in inpatients. In studies of patients with specific disorders, prevalence rates varied: 1.8-5.9% (substance abuse), 3.3-20.2% (anxiety), 3.7-20.4% (other dissociative disorders), 16.3% (schizophrenia), 17% (borderline personality disorder), ~50% (depression). The highest rates were found in people who experienced interpersonal abuse (25-53.8%). The prevalence rate of DDD is around 1% in the general population, consistent with previous findings. DDD is more prevalent amongst adolescents and young adults as well as in patients with mental disorders. There is also a possible relationship between interpersonal abuse and DDD, which merits further research.
Topics: Adolescent; Young Adult; Humans; Depersonalization; Prevalence; Dissociative Disorders; Substance-Related Disorders
PubMed: 35699456
DOI: 10.1080/15299732.2022.2079796 -
World Journal of Psychiatry Oct 2019Dissociation, which is defined as the failure to associate consciousness, memory, identity, emotion, perception, body representation, motor control, and behavior into an...
BACKGROUND
Dissociation, which is defined as the failure to associate consciousness, memory, identity, emotion, perception, body representation, motor control, and behavior into an integrated whole, has long been assumed to be generated by trauma. If dissociation is a product of trauma exposure, then dissociation would be a major mental health outcome observed in studies of disaster survivors. Although some studies have examined dissociation in disasters, no systematic literature reviews have been conducted to date on the topic.
AIM
To systematically evaluate the literature on the association between disaster and dissociation to determine the prevalence and incidence of dissociation after exposure to disaster and further examine their relationship.
METHODS
EMBASE, Medline, and PsychINFO were searched from inception to January 1, 2019 to identify studies examining dissociative disorders or symptoms related to a disaster in adult or child disaster survivors and disaster responders. Studies of military conflicts and war, articles not in English, and those with samples of 30 or more participants were excluded. Search terms used were "disaster*" and dissociation ("dissociat*," "multiple personality," "fugue," "psychogenic amnesia," "derealization," and "depersonalization"). Reference lists of identified articles were scrutinized to identify studies for additional articles.
RESULTS
The final number of articles in the review was 53, including 36 articles with samples of adults aged 18 and above, 5 of children/adolescents under age 18, and 12 of disaster workers. Included articles studied several types of disasters that occurred between 1989 and 2017, more than one-third (38%) from the United States. Only two studies had a primary aim to investigate dissociation in relation to disaster and none reported data on dissociative disorders. All of the studies used self-report symptom scales; none used structured interviews providing full diagnostic assessment of dissociative disorders or other psychopathology. Several studies mixed exposed and unexposed samples or did not differentiate outcomes between exposure groups. Studies examining associations between dissociation and disaster exposure have been inconclusive. The majority (75%) of the studies compared dissociation with posttraumatic stress, with inconsistent findings. Dissociation was found to be associated with a wide range of other psychiatric disorders, symptoms, and negative emotional, cognitive, and functional states.
CONCLUSION
The studies reviewed had serious methodological limitations including problems with measurement of psychopathology, sampling, and generation of unwarranted conclusions, precluding conclusions that dissociation is an established outcome of disaster.
PubMed: 31649861
DOI: 10.5498/wjp.v9.i6.83 -
International Journal of Environmental... Mar 2023Ambulance services are changing, and the SARS-CoV-2 pandemic has been a major challenge in the past three years. Job satisfaction and work engagement are important... (Review)
Review
Ambulance services are changing, and the SARS-CoV-2 pandemic has been a major challenge in the past three years. Job satisfaction and work engagement are important characteristics for a healthy organization and success in one's profession. The purpose of the current systematic review was to evaluate the predictors of job satisfaction and work engagement in prehospital emergency medical service personnel. Electronic databases, such as PubMed, Ovid Medline, Cochrane Library, Scopus, Web of Science, PsycINFO, PSYNDEX, and Embase, were utilized in this review. Predictors (ß coefficient, odds ratio, rho) of higher job satisfaction and work engagement were examined. Only prehospital emergency medical service personnel were considered. The review included 10 studies worldwide with 8358 prehospital emergency medical service personnel (24.9% female). The main predictor for job satisfaction was supervisors' support. Other predictors were younger or middle age and work experience. Emotional exhaustion and depersonalization, as burnout dimensions, were negative predictors for higher job satisfaction or work engagement. Quality demands for health care systems are a significant challenge for future emergency medical services. The psychological and physical strengthening of employees is necessary and includes constant supervision of managers or facilitators.
Topics: Middle Aged; Humans; Female; Male; Work Engagement; Job Satisfaction; COVID-19; SARS-CoV-2; Burnout, Professional; Ambulances; Surveys and Questionnaires; Workload
PubMed: 36901586
DOI: 10.3390/ijerph20054578 -
Journal of Clinical Orthopaedics and... Oct 2019Occupational burnout is a syndrome composing of emotional exhaustion, depersonalisation and low sense of personal accomplishment. Burnout has been shown to negatively... (Review)
Review
Occupational burnout is a syndrome composing of emotional exhaustion, depersonalisation and low sense of personal accomplishment. Burnout has been shown to negatively affect both the personal lives and professional performance of doctors. Orthopaedic surgery is a challenging specialty, and while burnout has been studied in orthopaedic surgeons, a comprehensive review article in this area is lacking. Hence we performed a systematic review to summarise the evidence regarding burnout in orthopaedic surgeons. We conducted a systematic literature review using the terms "orthopaedic surgeons" and "burnout" and related terms. Studies were reviewed by two independent reviewers. English articles that were (a) peer-reviewed original research articles; (b) measures burnout directly in study participants; (c) uses validated scales for burnout assessment; and (d) on orthopaedic surgeons, were included. Discrepancies between reviewers were resolved by panel discussion. 216 papers were identified and 14 papers were selected for qualitative synthesis. The prevalence of burnout varied considerably between orthopaedic surgeons from different centres and of different seniority. There is insufficient evidence to suggest that the burnout rate in orthopaedic surgeons is different from doctors in other specialties. A range of risk factors and protective factors associated with burnout were identified. Similar to prior studies in the general medical population, key determinants of burnout included personal, family, working environment and career factors. One paper identified an association between burnout and irritable behaviour during operation, yet no studies have assessed the effect of burnout on orthopaedic patient outcomes. We did not identify papers on the management of burnout in orthopaedic surgeons. To conclude, the evidence on burnout in orthopaedic surgeons is preliminary and key methodological limitations have been noted in the current studies. Large-scale prospective studies are warranted to better understand the determinants and effects of burnout in orthopaedic surgeons, in order to guide appropriate interventions against this occupational mental health hazard.
PubMed: 31695259
DOI: 10.1016/j.jcot.2019.01.028