-
Emergency Medicine Australasia : EMA Apr 2020Paramedic wellness is an increasing priority within the profession. Burnout has been described as having areas of 'emotional exhaustion, depersonalisation and reduced... (Review)
Review
Paramedic wellness is an increasing priority within the profession. Burnout has been described as having areas of 'emotional exhaustion, depersonalisation and reduced personal accomplishment'. Prevalence of burnout is unclear, hampering evaluation of protective initiatives. The aim of this systematic review was to identify prevalence and predictors of burnout in paramedic populations. A systematic review was registered via PROSPERO and conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. MEDLINE, EMBASE, CINAHL, ERIC, PsycINFO and PsycARTICLES were searched from 2000 to present. Abstract screening and selection of articles was undertaken with good agreement. Quality assessment of included articles used Hoy's validated quality assessment tool, with excellent inter-rater agreement (K = 0.9). Qualitative synthesis of included studies was performed. Each step of the process was performed independently by two authors, with a third arbitrating disputes as required. Five studies met inclusion criteria; two were from the USA, and one each from Australia, South Africa and Israel. Burnout measurement varied; three used Copenhagen Burnout Inventory (CBI), one Maslach's Burnout Inventory (MBI), and one General Burnout Measure (GBM). Prevalence of burnout ranged between 16% and 56%. Higher prevalence was reported in CBI studies (30%, 38% and 56%), while lower prevalence was seen with other tools (MBI 18%, GBM 16%). Included studies were of low to moderate quality. The prevalence of burnout in paramedics varies from 16% to 56%. Existing evidence describing burnout in paramedics is weak; research of good methodological rigour is needed to quantify prevalence of burnout, providing a reliable baseline against which protective interventions could be measured.
Topics: Allied Health Personnel; Burnout, Professional; Burnout, Psychological; Cross-Sectional Studies; Humans; Prevalence
PubMed: 32067408
DOI: 10.1111/1742-6723.13478 -
Frontiers in Psychiatry 2022This systematic review and meta-analysis aims to explore overall prevalence of burnout among physicians during early and late COVID-19 pandemic and geographical...
OBJECTIVE
This systematic review and meta-analysis aims to explore overall prevalence of burnout among physicians during early and late COVID-19 pandemic and geographical differences in burnout.
METHODS
This review was registered prospectively with PROSPERO (CRD42022327959). A comprehensive search of several databases, including Ovid MEDLINE(R) and Epub Ahead of Print, In-Process & Other Non-Indexed Citations and Daily, Ovid Embase, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, PsycINFO, and Scopus, spanning from December 2019 to May 2022 was conducted. Eligible studies included physicians or medical professionals including physicians that worked directly or indirectly with COVID-19 patients, whilst reporting burnout outcomes using a validated scale. Literature that did not include physicians or did not occur in a hospital setting were excluded. Literature including medical students were also excluded.
RESULTS
Forty-five observational studies were included, all of which were cross-sectional studies. The pooled estimate of overall prevalence of burnout was 54.60% (95% CI: 46.7, 62.2). Mean emotional exhaustion, depersonalization, and personal accomplishment was found to be 22.06% (95% CI: 18.19, 25.94), 8.72 (95% CI: 6.48, 10.95) and 31.18 (95% CI: 27.33, 35.03) respectively. Frontline workers displayed higher rates of burnout than second-line healthcare workers (HCW) (OR: 1.64, 95% CI: 1.13, 2.37). Studies from the early pandemic period reported burnout prevalence of 60.7% (95% CI: 48.2, 72) compared to a prevalence of 49.3% (95% CI: 37.7, 60.9) from the late pandemic period. Geographically, burnout was highest amongst Middle East and North Africa (MENA) studies (66.6%, 95% CI: 54.7, 78.5), followed by Europe (48.8%, 95% CI: 40.3, 57.3) and then South America (42%, 95% CI: -0.4, 84.4). Lastly, burnout prevalence overall (OR = 0.77, 95% CI: 0.36, 1.67) emotional exhaustion (MD = -0.36, 95% CI: -4.64, 3.91), depersonalization (MD = -0.31, 95% CI: -1.80, 1.18), and personal accomplishment (MD = 0.55, 95% CI: -0.73, 1.83) were found comparable between physicians and nurses.
CONCLUSION
COVID-19 has had significant consequences on HCW burnout. Further research is needed to examine early signs of burnout and to develop effective coping strategies.
PubMed: 36713915
DOI: 10.3389/fpsyt.2022.1071397 -
BMC Medical Education Jun 2024Burnout levels in medical students are higher than in other student groups. Empathy is an increasingly desired outcome of medical schools. Empathy is negatively... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Burnout levels in medical students are higher than in other student groups. Empathy is an increasingly desired outcome of medical schools. Empathy is negatively associated with burnout in physicians. Our objective was to quantitatively review the available literature on associations between empathy and burnout in medical students, and to explore associations between specific empathy aspects (cognitive and affective) and burnout sub-dimensions (emotional exhaustion, depersonalization and personal accomplishment).
METHODS
A comprehensive search of the literature published up until January 2024 was undertaken in the PubMed, EMBASE, CINAHL, The Cochrane Library, and PsycINFO databases. Two independent reviewers screened 498 records and quality-rated and extracted data from eligible studies. The effect size correlations (ESr) were pooled using a random-effects model and between-study variation explored with meta-regression. The review was preregistered with PROSPERO (#CRD42023467670) and reported following the PRISMA guidelines.
RESULTS
Twenty-one studies including a total of 27,129 medical students published between 2010 and 2023 were included. Overall, empathy and burnout were negatively and statistically significantly associated (ESr: -0.15, 95%CI [-0.21; -0.10], p < .001). When analyzing sub-dimensions, cognitive empathy was negatively associated with emotional exhaustion (ESr: -0.10, 95%CI [-0.17; -0.03], p = .006) and depersonalization (ESr: -0.15, 95%CI [-0.24; 0.05], p = .003), and positively associated with personal accomplishment (ESr: 0.21, 95%CI [0.12; 0.30], p < .001). Affective empathy was not statistically significantly associated with emotional exhaustion, depersonalization or personal accomplishment. Supplementary Bayesian analysis indicated the strongest evidence for the positive association between cognitive empathy and personal accomplishment. Response rate and gender moderated the relationship so that higher response rates and more male respondents strengthen the negative association between empathy and burnout.
CONCLUSION
Greater empathy, in particular cognitive empathy, is associated with lower burnout levels in medical students. This appears to be primarily driven by cognitive empathy's positive association with personal accomplishment.
PROTOCOL REGISTRATION
#CRD42023467670.
Topics: Humans; Students, Medical; Empathy; Burnout, Professional; Depersonalization
PubMed: 38849794
DOI: 10.1186/s12909-024-05625-6 -
Frontiers in Public Health 2023This review aimed to compare available evidence examining burnout using the Maslach Burnout Inventory (MBI) in nurses before and during the COVID-19 pandemic. The...
INTRODUCTION
This review aimed to compare available evidence examining burnout using the Maslach Burnout Inventory (MBI) in nurses before and during the COVID-19 pandemic. The specific objective was to compare nurse burnout scores in terms of emotional exhaustion, depersonalization, and personal accomplishment.
METHODS
A comprehensive search was conducted for studies on nurses' burnout using the MBI published between 1994 and 2022. In total, 19 studies conducted prior to the pandemic and 16 studies conducted during the pandemic were included and compared using the criteria from the Joanna Briggs Institute Critical Appraisal Tool.
RESULTS
Surprisingly, the results indicated that nurses' burnout scores did not differ significantly before ( = 59,111) and during ( = 18,629) the pandemic. The difference observed was qualitative rather than quantitative.
DISCUSSION
The outbreak of the COVID-19 pandemic exacerbated an already critical situation, and while COVID-19 may serve as an additional triggering factor for staff mental illness, it cannot solely explain the observed burnout levels. These findings underscore the need for long-term clinical and preventive psychological interventions, suggesting that psychological resources should not be limited to emergencies but extended to address the ongoing challenges faced by nurses.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=399628, identifier: CRD42023399628.
Topics: Humans; Pandemics; COVID-19; Burnout, Psychological; Disease Outbreaks; Emotions
PubMed: 37732086
DOI: 10.3389/fpubh.2023.1225431 -
The British Journal of General Practice... May 2022Burnout is a work-related syndrome documented to have negative consequences for GPs and their patients. (Meta-Analysis)
Meta-Analysis
BACKGROUND
Burnout is a work-related syndrome documented to have negative consequences for GPs and their patients.
AIM
To review the existing literature concerning studies published up to December 2020 on the prevalence of burnout among GPs in general practice, and to determine GP burnout estimates worldwide.
DESIGN AND SETTING
Systematic literature search and meta-analysis.
METHOD
Searches of CINAHL Plus, Embase, MEDLINE, PsycINFO, and Scopus were conducted to identify published peer-reviewed quantitative empirical studies in English up to December 2020 that have used the Maslach Burnout Inventory - Human Services Survey to establish the prevalence of burnout in practising GPs (that is, excluding GPs in training). A random-effects model was employed.
RESULTS
Wide-ranging prevalence estimates (6% to 33%) across different dimensions of burnout were reported for 22 177 GPs across 29 countries were reported for 60 studies included in this review. Mean burnout estimates were: 16.43 for emotional exhaustion; 6.74 for depersonalisation; and 29.28 for personal accomplishment. Subgroup and meta-analyses documented that country-specific factors may be important determinants of the variation in GP burnout estimates. Moderate overall burnout cut-offs were found to be determinants of the variation in moderate overall burnout estimates.
CONCLUSION
Moderate to high GP burnout exists worldwide. However, substantial variations in how burnout is characterised and operationalised has resulted in considerable heterogeneity in GP burnout prevalence estimates. This highlights the challenge of developing a uniform approach, and the importance of considering GPs' work context to better characterise burnout.
Topics: Burnout, Professional; Burnout, Psychological; Family Practice; Humans; Prevalence; Workplace
PubMed: 34990391
DOI: 10.3399/BJGP.2021.0441 -
Japan Journal of Nursing Science : JJNS Oct 2023To evaluate the effectiveness of interventions to reduce nurses' burnout. (Meta-Analysis)
Meta-Analysis
AIM
To evaluate the effectiveness of interventions to reduce nurses' burnout.
DESIGN
A systematic review and meta-analysis.
METHODS
The research was carried out using the following databases: MEDLINE, CINAHL, Cochrane Library, ULAKBİM Turkish National Database, Science Direct, and Web of Science. The study selection, quality assessments, and data extractions of the included studies were carried out by the researchers independently. The PRISMA checklist was used to assure the quality and transparency of the report. The risk of bias of the included studies was evaluated using the Cochrane Collaboration tool. The meta-analysis was performed using Comprehensive Meta-Analysis (CMA) 3.0 software.
RESULTS
A total of 19 studies including 1139 nurses were included in the study. Of these, only 13 were included in the meta-analysis, as six contained incomplete data. Interventions aimed at reducing burnout in nurses were mostly person-directed interventions. The meta-analysis revealed that attempts to reduce burnout had a small effect on nurses' emotional exhaustion and depersonalization, and a moderate effect on their personal accomplishment.
CONCLUSIONS
Interventions are more effective at preventing the sense of personal accomplishment of nurses from decreasing. Evidence in the literature on organization-directed interventions and combined interventions to reduce burnout in nurses is limited. Person-directed interventions are effective at low and medium levels. In future studies, it will be more effective to implement combined interventions including both person-directed and organization-directed interventions to reduce the burnout of nurses.
Topics: Humans; Burnout, Professional; Emotions; Nurses
PubMed: 37285864
DOI: 10.1111/jjns.12542 -
Psychological Medicine Jul 2022The dissociative subtype of post-traumatic stress disorder (PTSD-DS) was introduced in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders... (Meta-Analysis)
Meta-Analysis Review
The dissociative subtype of post-traumatic stress disorder (PTSD-DS) was introduced in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), and is characterised by symptoms of either depersonalisation or derealisation, in addition to a diagnosis of post-traumatic stress disorder (PTSD). This systematic review and meta-analysis sought to estimate the point prevalence of current PTSD-DS, and the extent to which method of assessment, demographic and trauma variables moderate this estimate, across different methods of prevalence estimation. Studies included were identified by searching MEDLINE (EBSCO), PsycInfo, CINAHL, Academic Search Complete and PTSDpubs, yielding 49 studies that met the inclusion criteria ( = 8214 participants). A random-effects meta-analysis estimated the prevalence of PTSD-DS as 38.1% (95% CI 31.5-45.0%) across all samples, 45.5% (95% CI 37.7-53.4%) across all diagnosis-based and clinical cut-off samples, 22.8% (95% CI 14.8-32.0%) across all latent class analysis (LCA) and latent profile analysis (LPA) samples and 48.1% (95% CI 35.0-61.3%) across samples which strictly used the DSM-5 PTSD criteria; all as a proportion of those already with a diagnosis of PTSD. All results were characterised by high levels of heterogeneity, limiting generalisability. Moderator analyses mostly failed to identify sources of heterogeneity. PTSD-DS was more prevalent in children compared to adults, and in diagnosis-based and clinical cut-off samples compared to LCA and LPA samples. Risk of bias was not significantly related to prevalence estimates. The implications of these results are discussed further.
Topics: Adult; Child; Diagnostic and Statistical Manual of Mental Disorders; Dissociative Disorders; Humans; Prevalence; Stress Disorders, Post-Traumatic
PubMed: 35734787
DOI: 10.1017/S0033291722001647 -
Healthcare (Basel, Switzerland) Oct 2021Mindfulness-based interventions (MBIs) are reported by experimental studies as practical approaches to reduce burnout in primary healthcare professionals (PHCP).... (Review)
Review
Mindfulness-based interventions (MBIs) are reported by experimental studies as practical approaches to reduce burnout in primary healthcare professionals (PHCP). However, to date, no research has synthesized the evidence to determine the overall effects of MBIs for reducing burnout in PHCP. We conducted a systematic review and meta-analysis to analyze the effects of MBIs to reduce burnout in PHCP. We searched articles in the PubMed/MEDLINE, Web of Science, Cochrane, and Scopus databases from inception to September 2021 using MeSH terms: "mindfulness", "burnout", and "primary healthcare". Two reviewers extracted the data and assessed the risk of bias. We used a random-effects meta-analysis to calculate the standardized mean differences (SMD) and mean differences (MD) with 95% confidence intervals (CI) of emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA) domains of burnout. Of 61 records, ten were included ( = 417). Overall, the studies were rated as having a high risk of bias and limited quality evidence. MBIs significantly reduced EE (SMD = -0.54, 95%CI: -0.72 to -0.36; MD = -5.89, 95%CI: -7.72 to -4.05), DP (SMD = -0.34, 95%CI: -0.52 to -0.17; MD = -1.96, 95%CI: -2.96 to -0.95), and significantly increased PA (SMD = 0.34, 95%CI: 0.17 to 0.52; MD = 2.05, 95%CI: 1.04 to 3.06). Although further high-quality research is needed, our findings support the implementation of MBIs for reducing burnout in PHCP.
PubMed: 34683022
DOI: 10.3390/healthcare9101342 -
Journal of Educational Evaluation For... 2022The current study aimed to identify the prevalence of burnout and related factors in nursing faculty members through a systematic review of the literature. (Review)
Review
PURPOSE
The current study aimed to identify the prevalence of burnout and related factors in nursing faculty members through a systematic review of the literature.
METHODS
A comprehensive search of electronic databases, including Scopus, PubMed, Web of Science, Iranmedex, and Scientific Information Database was conducted via keywords extracted from Medical Subject Headings, including burnout and nursing faculty, for studies published from database inception to April 1, 2022. The quality of the included studies in this review was assessed using the appraisal tool for cross-sectional studies.
RESULTS
A total of 2,551 nursing faculty members were enrolled in 11 studies. The mean score of burnout in nursing faculty members based on the Maslach Burnout Inventory (MBI) was 59.28 out of 132. The burnout score in this study was presented in 3 MBI subscales: emotional exhaustion, 21.24 (standard deviation [SD]=9.70) out of 54; depersonalization, 5.88 (SD=4.20) out of 30; and personal accomplishment, 32.16 (SD=6.45) out of 48. Several factors had significant relationships with burnout in nursing faculty members, including gender, level of education, hours of work, number of classroom, students taught, full-time work, job pressure, perceived stress, subjective well-being, marital status, job satisfaction, work setting satisfaction, workplace empowerment, collegial support, management style, fulfillment of self-expectation, communication style, humor, and academic position.
CONCLUSION
Overall, the mean burnout scores in nursing faculty members were moderate. Therefore, health policymakers and managers can reduce the likelihood of burnout in nursing faculty members by using psychosocial interventions and support.
Topics: Burnout, Professional; Burnout, Psychological; Cross-Sectional Studies; Faculty, Nursing; Humans; Prevalence; Surveys and Questionnaires
PubMed: 35843600
DOI: 10.3352/jeehp.2022.19.16 -
Journal of Affective Disorders Mar 2019Burnout syndrome is the consequence of chronic work-related stress exposure and is 2-3 times higher than in physicians than in other professions. Many studies exploring... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Burnout syndrome is the consequence of chronic work-related stress exposure and is 2-3 times higher than in physicians than in other professions. Many studies exploring burnout in French physicians have been published with inconsistent data regarding its prevalence and associated factors.
OBJECTIVE
To assess the prevalence of burnout and associated factors in French physicians in a systematic review and meta-analysis.
MATERIAL AND METHODS
Studies assessing the prevalence of French physician's burnout and its three dimensions emotional exhaustion (EE), depersonalization (DP) and personal accomplishment (PA) were selected in the following databases from 2000 to April 2017: MEDLINE, BIOSIS WEB OF SCIENCE, PASCAL ET FRANCIS, SCIENCES DIRECT, PSYCHinfo, and BDSP. Burnout was defined by one abnormal score in one or more of the 3 dimensions of the MBI scale (EE, DP or PA). Severe burnout was defined by the association of high scores of EE and DP, and low score of PA. High EE was defined by an EE score ≥27. High DP was defined by a score ≥10. Low PA was defined by a score ≤33.
RESULTS
A total of 37 studies and 15,183 French physicians were included in the present meta-analysis. The random effects pooled prevalence estimate was 49% (95% CI 45%-53%, P < 0.001, I = 93.1%) for burnout, 5% (95% CI 4-7, P < 0.001, I= 92.7%) for severe burnout, 21% (95% CI 19-24, P < 0.001, I = 94.7%) for high EE, 29% (95% CI 25-33, P < 0.001, I = 96.7%) for high DP, and 29% (95% CI 24-34, P < 0.001, I = 97.7%) for low PA. Emergency physicians were found to have a trend to higher rates of burnout (P = 0.051), and significantly more severe burnout compared to other physicians (b = 0.05, se[b] = 0.02, P = 0.019). Junior residents were found to have higher rates of DP; junior residents, sample size, and monthly number of night shifts were associated with lower PA; and anesthesiologists were found to have lower rates of high EE and high DP.
CONCLUSION
Burnout is highly prevalent in French physicians. Some recommendations may be suggested to reduce this rate, including reducing the number or duration of night shifts to increase personal accomplishment and targeting emergency physicians and junior residents in priority. Other specialties should be explored in future studies.
Topics: Burnout, Professional; France; Humans; Physicians; Prevalence; Risk Factors
PubMed: 30580199
DOI: 10.1016/j.jad.2018.12.056