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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 -
Healthcare (Basel, Switzerland) Aug 2023Emergency medicine (EM) settings are very stressful, given the high workload, intense working environment, and prolonged working time. In turn, the rate of burnout and... (Review)
Review
The Global Prevalence and Associated Factors of Burnout among Emergency Department Healthcare Workers and the Impact of the COVID-19 Pandemic: A Systematic Review and Meta-Analysis.
BACKGROUND/AIM
Emergency medicine (EM) settings are very stressful, given the high workload, intense working environment, and prolonged working time. In turn, the rate of burnout and its three domains have been increasingly reported among healthcare workers (HCWs). Therefore, we conducted this meta-analysis to determine the prevalence and risk factors of burnout among EM HCWs.
METHODS
Six databases were searched in February 2023, yielding 29 articles (16,619 EM HCWs) reporting burnout or its three domains (emotional exhaustion "EE", depersonalization "DP", and personal accomplishment "PA"). The primary outcome was the prevalence of burnout and its domains, while secondary outcomes included the risk factors of high burnout, EE, DP, or low PA. Burnout rates were pooled across studies using STATA software. The prevalence was measured using the pooled effect size (ES), and the random-effects model was used when heterogeneity was encountered; otherwise, the fixed-effects model was used.
RESULTS
The prevalence of overall burnout was high (43%), with 35% of EM HCWs having a high risk of burnout. Meanwhile, 39%, 43%, and 36% of EM workers reported having high levels of EE and DP and low levels of PA, respectively. Country-specific changes in the rate of burnout were observed. The rate of high burnout, high EE, high DP, and low PA was higher during the COVID-19 pandemic as compared to the pre-pandemic period. The type of profession (nurses, physicians, residents, etc.) played a significant role in modifying the rate of burnout and its domains. However, gender was not a significant determinant of high burnout or its domains among EM workers.
CONCLUSIONS
Burnout is a prevalent problem in emergency medicine practice, affecting all workers. As residents progress through their training years, their likelihood of experiencing burnout intensifies. Nurses are most affected by this problem, followed by physicians. Country-associated differences in burnout and its domains are evident.
PubMed: 37570460
DOI: 10.3390/healthcare11152220 -
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 -
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 -
Nurse Education in Practice Oct 2023The aim of this study was to analyze burnout levels and prevalence in nursing students and to estimate prevalence levels with meta-analyses. (Review)
Review
AIM
The aim of this study was to analyze burnout levels and prevalence in nursing students and to estimate prevalence levels with meta-analyses.
BACKGROUND
Nurses are one of the healthcare professionals most affect by burnout, but nursing students, during their studies, can also suffer burnout.
DESIGN
a systematic review with meta-analysis was performed.
METHODS
The search equation used in Pubmed, CINAHL and Scopus databases was "burnout AND nursing students". Quantitative primary studies including information about burnout, emotional exhaustion, depersonalization, or personal accomplishment in nursing students were included. Four meta-analysis were performed.
RESULTS
the sample was of n = 34 studies, with n = 15 studies being included in the meta-analysis with n = 2744 nursing students. Burnout prevalence was 19% (95% CI 11-28%). Regarding burnout dimensions, the most affected was high emotional exhaustion with a prevalence of 41%(95% CI 23-61%; n = 2222) followed by 27% low personal accomplishment(95% CI 9-49%; n = 2096), 25% high depersonalization (95% CI 15-36%; n = 2096).
CONCLUSIONS
Prevalence of burnout and its dimensions vary from 19% to 41%, being emotional exhaustion the main problem in nursing students. This problem may affect their future as nursing professionals, and it would be of important to prevent and to treat burnout at university levels.
PubMed: 37651959
DOI: 10.1016/j.nepr.2023.103753 -
Academic Radiology Mar 2024Burnout, stemming from chronic work stress, is a significant issue in the medical field, especially among radiologists. It leads to compromised patient care and reduced... (Meta-Analysis)
Meta-Analysis Review
RATIONALE AND OBJECTIVES
Burnout, stemming from chronic work stress, is a significant issue in the medical field, especially among radiologists. It leads to compromised patient care and reduced job satisfaction. Addressing burnout in radiology is essential for the well-being of radiologists and, in turn, for improving patient care. This study aimed to assess the prevalence and dimensions of burnout among radiology trainees (RTs) and practicing radiologists (PRs).
MATERIALS AND METHODS
A systematic review and meta-analysis were conducted in accordance with established guidelines. The search encompassed PubMed, Scopus, Web of Science, and Embase databases up to June 20, 2023. Eligible studies that assessed the rate of burnout syndrome and/or its subscales, including depersonalization (DP), emotional exhaustion (EE), and personal accomplishment (PA), among RTs and/or PRs using the Maslach Burnout Inventory (MBI), were included. Relevant data were extracted and analyzed using R and STATA.
RESULTS
Among the 22 included studies, the pooled rates of positive MBI subscales for RTs and PRs were as follows: 54.7% (95% confidence interval [CI]: 43.8%-65.1%, I = 95.2%) for DP, 57.2% (95% CI: 48.7%-65.4%, I = 92.9%) for EE, and 38.6% (95% CI: 27%-51.7%, I = 95.5%) for low PA. The pooled rate indicating the presence of at least one positive MBI subscale was 82.9% (95% CI: 79.2%-86.1%, I = 57.4%). For two or more positive MBI subscales, the pooled rate was 55.5% (95% CI: 49.7%-61.3%, I = 60.2%), and for three positive MBI subscales, it was 16.7% (95% CI: 11.7%-23.3%, I = 82.7%).
CONCLUSION
This study emphasizes a notable prevalence of burnout in the radiology specialty, with 8 of 10 individuals exhibiting positive results in at least one MBI subscale. This highlights the urgent need for interventions and support systems to protect the well-being of both trainees and practitioners and uphold the quality of patient care.
Topics: Humans; Surveys and Questionnaires; Burnout, Professional; Radiologists; Radiology; Emotional Exhaustion; Psychological Tests; Self Report
PubMed: 37980223
DOI: 10.1016/j.acra.2023.10.046 -
Physiotherapy Feb 2024Work-related burnout is a significant concern amongst healthcare professionals, including physiotherapists. It can negatively impact on both staff well-being and the... (Review)
Review
BACKGROUND
Work-related burnout is a significant concern amongst healthcare professionals, including physiotherapists. It can negatively impact on both staff well-being and the quality of care delivered to patients.
OBJECTIVES
To estimate the prevalence of burnout among physiotherapists.
DATA SOURCES
PubMed, CINAHL, Web of Science, Embase, Scopus and PsycINFO, from inception to February 1st, 2022.
STUDY SELECTION OR ELIGIBILITY CRITERIA
Studies reporting burnout prevalence among physiotherapists.
DATA EXTRACTION AND DATA SYNTHESIS
Prevalence of burnout. Sub-analyses were performed grouping studies based on countries where surveys were conducted, classified as developed or developing countries. The risk of bias was assessed using a modified version of the Newcastle-Ottawa Scale.
RESULTS
32 studies were included in the systematic review and 31 in the meta-analysis, enrolling a total of 5984 physiotherapists from 17 countries. Pooled prevalence (95% confidence interval) of burnout was 8% (4-15). Prevalence figures for Maslach Burnout Inventory dimensions were: (i) emotional exhaustion, 27% (21-34) (ii) depersonalization, 23% (15-32) (iii) low personal accomplishment, 25% (15-40). Both overall and single components prevalence was higher, although not significantly, in studies from developing than in developed countries.
LIMITATIONS
Tools used to assess burnout and cut-off scores chosen to identify the burnout prevalence differed across studies.
CONCLUSION AND IMPLICATIONS OF KEY FINDINGS
Prevalence of burnout reported by physiotherapists appears high worldwide, in particular in developing countries, and compares with that reported by nurses and physicians. Substantial heterogeneity in the prevalence of burnout, in its definition and assessment methods across studies, and limited quality of most studies precludes drawing definitive conclusions.
SYSTEMATIC REVIEW REGISTRATION NUMBER
PROSPERO CRD42022307876 CONTRIBUTION OF THE PAPER.
PubMed: 38943718
DOI: 10.1016/j.physio.2024.01.007 -
Annals of the Royal College of Surgeons... Apr 2024Professional burnout is a syndrome of emotional exhaustion, depersonalisation and low sense of personal achievement related to the workplace. Orthopaedic surgeons train... (Review)
Review
INTRODUCTION
Professional burnout is a syndrome of emotional exhaustion, depersonalisation and low sense of personal achievement related to the workplace. Orthopaedic surgeons train and practise in highly demanding environments. Understanding up-to-date trends in burnout, particularly following the COVID-19 pandemic, is vital. For this reason, we carried out a systematic review on this topic.
METHODS
A scoping literature review of two databases was conducted. Two authors independently screened articles and conflicts were resolved by panel discussion. Articles pertaining to orthopaedic surgeons that used validated scales and were peer reviewed research were included. Non-English or abstract-only results were excluded.
RESULTS
A total of 664 papers were identified in the literature search and 34 were included in the qualitative review. Among 8,471 orthopaedic surgeons, the mean burnout prevalence was 48.9%. The wide range in rate of burnout between the studies (15-90.4%) reflected the variety in setting, subspecialty and surgeon grade. Common protective factors comprised dedicated mentorship, surgeon seniority, sufficient exercise and family support. Substance abuse, malpractice claims, financial stress and onerous on-call responsibilities were risk factors. Burnout prevalence during the COVID-19 pandemic was not noticeably different; there were a number of pandemic-associated risk and protective factors.
CONCLUSIONS
Nearly one in two orthopaedic surgeons are burnt out. There is a paucity of data on the short and long-term impact of COVID-19 on burnout. Burnout has deep organisational, personal and clinical implications. Targeted organisational interventions are required to prevent burnout from irrevocably damaging the future of orthopaedic surgery.
PubMed: 38563052
DOI: 10.1308/rcsann.2024.0009 -
Nursing Ethics Mar 2024Moral distress has been identified as an occupational hazard for clinicians caring for vulnerable populations. The aim of this systematic review was (i) to summarize the... (Review)
Review
Moral distress has been identified as an occupational hazard for clinicians caring for vulnerable populations. The aim of this systematic review was (i) to summarize the literature reporting on prevalence of, and factors related to, moral distress among nurses within acute mental health settings, and (ii) to examine the efficacy of interventions designed to address moral distress among nurses within this clinical setting. A comprehensive literature search was conducted in October 2022 utilizing Nursing & Allied Health, Embase, CINAHL, PsychInfo, and PubMed databases to identify eligible studies published in English from January 2000 to October 2022. Ten studies met inclusion criteria. Four quantitative studies assessed moral distress among nurses in acute mental health settings and examined relationships between moral distress and other psychological and work-related variables. Six qualitative studies explored the phenomenon of moral distress as experienced by nurses working in acute mental health settings. The quantitative studies assessed moral distress using the Moral Distress Scale for Psychiatric Nurses (MDS-P) or the Work-Related Moral Stress Questionnaire. These studies identified relationships between moral distress and emotional exhaustion, depersonalization, cynicism, poorer job satisfaction, less sense of coherence, poorer moral climate, and less experience of moral support. Qualitative studies revealed factors associated with moral distress, including lack of action, poor conduct by colleagues, time pressures, professional, policy and legal implications, aggression, and patient safety. No interventions targeting moral distress among nurses in acute mental health settings were identified. Overall, this review identified that moral distress is prevalent among nurses working in acute mental health settings and is associated with poorer outcomes for nurses, patients, and organizations. Research is urgently needed to develop and test evidence-based interventions to address moral distress among mental health nurses and to evaluate individual and system-level intervention effects on nurses, clinical care, and patient outcomes.
PubMed: 38490947
DOI: 10.1177/09697330241238337 -
JMIR Public Health and Surveillance Mar 2024Burnout is a multidimensional psychological syndrome that arises from chronic workplace stress. Health care workers (HCWs), who operate in physically and emotionally...
BACKGROUND
Burnout is a multidimensional psychological syndrome that arises from chronic workplace stress. Health care workers (HCWs), who operate in physically and emotionally exhausting work contexts, constitute a vulnerable group. This, coupled with its subsequent impact on patients and public economic resources, makes burnout a significant public health concern. Various self-care practices have been suggested to have a positive effect on burnout among HCWs. Of these, physical activity stands out for its ability to combine psychological, physiological, and biochemical mechanisms. In fact, it promotes psychological detachment from work and increases self-efficacy by inhibiting neurotransmitters and neuromodulators, increasing endorphin levels, enhancing mitochondrial function, and attenuating the hypothalamic pituitary-adrenal axis response to stress.
OBJECTIVE
Our objective was to conduct a systematic review of the evidence on the association between physical activity and burnout among HCWs.
METHODS
We considered HCWs, physical activity, and burnout, framing them as population, exposure, and outcome, respectively. We searched APA PsycArticles, MEDLINE, and Scopus until July 2022. We extracted relevant data on study design, methods to measure exposure and outcome, and statistical approaches.
RESULTS
Our analysis encompassed 21 independent studies. Although 10% (2/21) of the studies explicitly focused on physical activity, the remaining investigations were exploratory in nature and examined various predictors, including physical activity. The most commonly used questionnaire was the Maslach Burnout Inventory. Owing to the heterogeneity in definitions and cutoffs used, the reported prevalence of burnout varied widely, ranging from 7% to 83%. Heterogeneity was also observed in the measurement tools used to assess physical activity, with objective measures rarely used. In total, 14% (3/21) of the studies used structured questionnaires to assess different types of exercise, whereas most studies (18/21, 86%) only recorded the attainment of a benchmark or reported the frequency, intensity, or duration of exercise. The reported prevalence of physically active HCWs ranged from 44% to 87%. The analyses, through a variety of inferential approaches, indicated that physical activity is often associated with a reduced risk of burnout, particularly in the domains of emotional exhaustion and depersonalization. Furthermore, we compiled and classified a list of factors associated with burnout.
CONCLUSIONS
Our comprehensive overview of studies investigating the association between physical activity and burnout in HCWs revealed significant heterogeneity in definitions, measurements, and analyses adopted in the literature. To address this issue, it is crucial to adopt a clear definition of physical activity and make thoughtful choices regarding measurement tools and methodologies for data analysis. Our considerations regarding the measurement of burnout and the comprehensive list of associated factors have the potential to improve future studies aimed at informing decision-makers, thus laying the foundation for more effective management measures to address burnout.
Topics: Humans; Exercise; Health Personnel; Psychological Tests; Self Report; Burnout, Professional
PubMed: 38498040
DOI: 10.2196/49772