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European Radiology Feb 2024To analyze the prevalence of burnout among radiology residents. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To analyze the prevalence of burnout among radiology residents.
METHOD
Five databases (PubMed, Web of Science, Embase, PsycINFO, and Scopus) were searched for studies reporting burnout in radiology residents for the period up to November 7, 2022.
RESULTS
A total of 423 studies were identified, and eventually, 16 studies were selected for the qualitative analysis, of which 11 studies were used in the meta-analysis. There was a total of 2164 radiology residents. Six studies reported the prevalence of burnout but the data could not be pooled due to their inconsistent definitions of burnout. The mean scores of three burnout subscales indicated a moderate to high degree of severity: emotional exhaustion = 25.2 (95% CI, 22.1-28.3; I = 94.4%), depersonalization = 10.2 (95% CI, 8.5-11.9; I = 93.0%), and low perception of personal accomplishment = 32.9 (95% CI, 30.5-35.4; I = 94.4%). The pooled prevalence of high-degree emotional exhaustion was 49.9% (95% CI, 43.6-56.1%; I = 55.7%), high-degree depersonalization was 45.1% (95% CI, 38.3-52.0%; I = 63.2%), and high-degree diminished personal accomplishment was 58.2% (95% CI, 36.0-77.6%; I = 84.9%). The impact of the COVID-19 pandemic on radiology residents was not investigated. In addition, there are inconsistent findings on the effects of female sex, seniority, and social support on burnout.
CONCLUSIONS
About half of the radiology residents showed at least one of the three burnout manifestations (emotional exhaustion, depersonalization, and personal accomplishment), with a moderate to high degree of severity.
CLINICAL RELEVANCE STATEMENT
Such a high prevalence and severity of burnout among radiology residents warrant the attention of residency program directors.
KEY POINTS
• Burnout, not uncommon among radiology residents, has not been effectively analyzed. • Nearly half of the radiology residents experience at least one of the three manifestations of burnout to a moderate to high degree. • The high prevalence and severe degree of burnout among radiology residents warrant the attention of residency program directors.
Topics: Humans; Female; Pandemics; Surveys and Questionnaires; Radiology; Burnout, Psychological; Burnout, Professional; Emotional Exhaustion; Internship and Residency; Prevalence
PubMed: 37589905
DOI: 10.1007/s00330-023-09986-2 -
Frontiers in Public Health 2024Many of the essential practices in palliative care (PC) had to be adapted to the COVID-19 pandemic. This global spread of the infectious respiratory disease, caused by...
INTRODUCTION
Many of the essential practices in palliative care (PC) had to be adapted to the COVID-19 pandemic. This global spread of the infectious respiratory disease, caused by SARS-CoV-2, created unprecedented obstacles. The aim of this research was to comprehensively assess the experiences and perceptions of healthcare professionals, individuals, and families in palliative and end-of-life situations during the COVID-19 pandemic.
METHODS
A scoping review was conducted using the databases CINAHL Complete, MEDLINE, Scopus, SciELO, Cochrane Central Register of Controlled Trials, Psychology and Behavioral Sciences, MEDIClatina, and Portugal's Open Access Scientific Repository. The review followed the JBI methodological approach for scoping reviews.
RESULTS
Out of the initially identified 999 articles, 22 studies were included for analysis. The deprivation of relationships due to the safety protocols required to control the spread of COVID-19 was a universally perceived experience by healthcare professionals, individuals in PC, and their families. Social isolation, with significant psychological impact, including depersonalization and despair, was among the most frequently reported experiences by individuals in palliative situation. Despite healthcare professionals' efforts to mitigate the lack of relationships, the families of these individuals emphasized the irreplaceability of in-person bedside contact.
SYSTEMATIC REVIEW REGISTRATION
https://osf.io/xmpf2/.
Topics: Humans; Palliative Care; COVID-19; Pandemics; SARS-CoV-2; Health Personnel
PubMed: 38596518
DOI: 10.3389/fpubh.2024.1330370 -
European Review For Medical and... Feb 2024This study aimed to explore the treatment effects of various intervention methods on the stress, anxiety, and fatigue of medical workers during the 2019 Coronavirus... (Meta-Analysis)
Meta-Analysis
Effects of different intervention methods on psychological anxiety, stress, and fatigue among healthcare workers during COVID-19 pandemic: a systematic review and meta-analysis.
OBJECTIVE
This study aimed to explore the treatment effects of various intervention methods on the stress, anxiety, and fatigue of medical workers during the 2019 Coronavirus Disease (COVID-19) pandemic.
MATERIALS AND METHODS
We conducted computer searches in both Chinese and English databases including China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform (Wang Fang), VIP Chinese Journal Service Platform (VIP), Web of Science, Embase, PubMed, Cochrane Library, Scopus, and ScienceDirect to include prospective randomized controlled studies (Prospective RCT) published before September 30, 2023, regarding different treatment methods for stress, anxiety, and fatigue among healthcare workers during COVID-19. Data on anxiety, stress, and fatigue of research participants were extracted from the included studies, followed by statistical analysis of treatment effects using R software with the meta package.
RESULTS
A total of 9 articles were eventually included, involving a total of 1,466 participants, including 686 in the control group and 780 in the study group. Intervention measures included mindfulness-based therapy in 4 studies and other intervention methods in 5. The anxiety status of the health workers was assessed using the Generalized Anxiety Disorder-7 (GAD-7), and the meta-analysis revealed a pooled mean difference (MD) of -0.53 (95% CI: -1.42, 0.37). Stress status was evaluated by Perceived Stress Scale 4 (PSS-4), and the meta-analysis results showed a post-treatment MD of 0.13 (95% CI: -0.39, 0.65), with a pre- and post-treatment difference MD of -0.44 (95% CI: -2.65, 1.76). Maslach Burnout Inventory (MBI) was employed for the evaluation of fatigue. The meta-analysis results showed an MD of -6.13 (95% CI: -16.68, 4.43) for the MBI Emotional index, an MD of 5.04 (95% CI: -3.25, 13.33) for the Personal Accomplishment index, and an MD of -1.68 (95% CI: -6.50, 3.13) for the Depersonalization index.
CONCLUSIONS
Maintaining the mental health of frontline health workers is crucial during the COVID-19 pandemic, and mindfulness-based therapy is the most extensively employed psychological intervention method. However, its effectiveness requires further research confirmation.
Topics: Humans; Pandemics; Prospective Studies; COVID-19; Anxiety; Anxiety Disorders; Fatigue; Psychological Tests; Self Report
PubMed: 38436194
DOI: 10.26355/eurrev_202402_35491 -
Journal of General Internal Medicine Apr 2024Surveillance of burnout by the gold-standard Maslach Burnout Inventory (MBI) is hindered by cost and length. The validity and benchmarking of the commonly recommended...
BACKGROUND
Surveillance of burnout by the gold-standard Maslach Burnout Inventory (MBI) is hindered by cost and length. The validity and benchmarking of the commonly recommended and used single-item burnout question (SIBOQ) are unknown. We sought to (1) derive an equation for predicting the gold standard MBI from the SIBOQ and (2) measure the correlation of the SIBOQ with the full MBI and its subscales.
METHODS
We sought studies in PubMed along with citations by and to included studies. We included studies that either correlated the SIBOQ and the MBI or reported the rates of burnout measured by both instruments. Two reviewers extracted data and CLARITY risk of bias. We used generalized linear mixed regression to separately quantify the predictive (benchmarking) and explanatory (hot-spotting) capabilities of the SIBOQ. We created a regression equation for converting SIBOQ scores to MBI scores. We meta-analyzed correlation coefficients (r) for the SIBOQ and MBI subscales. For all analyses, we considered an r of 0.7 as acceptable reliability for group-level comparisons.
RESULTS
We included 17 studies reporting 6788 respondents. All studies had a high risk of bias, as no study had a response rate over 75% and no study was able to examine non-responders. The correlations (r) of the SIBOQ with the overall MBI were explanatory r = 0.82 and predictive r = 0.56. Regarding MBI subscales, the correlations of the SIBOQ with emotional exhaustion were adequate with r = 0.71 (95% CI 0.67-0.74; I = 89%), and depersonalization was r = 0.44 (95% CI 0.34-0.52; I = 90%). However, in 8 of 15 comparisons, the r was less than 0.70.
DISCUSSION
The SIBOQ's usually adequate explanatory abilities allow "hot-spotting" to identify subgroups with high or low burnout within a single, homogenous survey fielding. However, the predictive ability of the SIBOQ indicates insufficient reliability in comparing local results to external benchmarks.
Topics: Humans; Burnout, Professional; Reproducibility of Results; Surveys and Questionnaires; Psychometrics
PubMed: 38424346
DOI: 10.1007/s11606-024-08685-y -
Journal of Trauma & Dissociation : the... 2024A PTSD subtype with dissociative symptoms (D-PTSD) was included in the DSM-5 recognizing the existence of a more severe form of PTSD, associated to past trauma, high... (Review)
Review
A PTSD subtype with dissociative symptoms (D-PTSD) was included in the DSM-5 recognizing the existence of a more severe form of PTSD, associated to past trauma, high comorbidity, and complex clinical management. As research is rapidly growing and results are inconsistent, a better investigation of this subtype is of primary importance. We conducted a systematic review of studies using Latent Profile Analysis to investigate the existence of a D-PTSD subtype. Covariates of D-PTSD were included, to understand additional symptoms, risk factors and comorbidities. The search was performed on PubMed, EBSCOHost, and PTSDPubs according to 2020 PRISMA guidelines. Eligible articles assessed trauma exposure, PTSD symptoms and diagnosis, and dissociation, in adult samples. 13 of 165 articles met the inclusion criteria. All identified a dissociative subtype of PTSD, mainly characterized by higher levels of depersonalization and derealization. D-PTSD profile sometimes presented other dissociative symptoms, such as gaps in awareness and memory, other comorbid disorders, and a history of abuse. Despite some limitations, this review supports the existence of a dissociative subgroup of individuals among those with PTSD. More rigorous studies are needed to clarify these findings and their clinical implications.
Topics: Adult; Humans; Stress Disorders, Post-Traumatic; Comorbidity; Dissociative Disorders; Depersonalization; Diagnostic and Statistical Manual of Mental Disorders
PubMed: 36062756
DOI: 10.1080/15299732.2022.2120155 -
Neuroscience and Biobehavioral Reviews Jun 2024Depersonalisation-derealisation disorder (DDD) is characterised by distressing experiences of separation from oneself and/or one's surroundings, potentially resulting... (Review)
Review
Depersonalisation-derealisation disorder (DDD) is characterised by distressing experiences of separation from oneself and/or one's surroundings, potentially resulting from alterations in affective, cognitive, and physiological functions. This systematic review aimed to synthesise current experimental evidence of relevance to proposed mechanisms underlying DDD, to appraise existing theoretical models, and to inform future research and theoretical developments. Studies were included if they tested explicit hypotheses in DDD samples, with experimental manipulations of at least one independent variable, alongside behavioural, subjective, neurological, affective and/or physiological dependent variables. Some evidence for diminished subjective responsivity to aversive images and sounds, and hyperactivation in neurocircuits associated with emotional regulation when viewing aversive images emerged, corroborating neurobiological models of DDD. Inconsistencies were present regarding behavioural and autonomic responsivity to facial expressions, emotional memory, and self-referential processing. Common confounds included small sample sizes, medication, and comorbidities. Alterations in affective reactivity and regulation appear to be present in DDD; however, further research employing more rigorous research designs is required to provide stronger evidence for these possible mechanisms.
PubMed: 38944228
DOI: 10.1016/j.neubiorev.2024.105783 -
Women and Birth : Journal of the... May 2024A variety of technologies are used to monitor fetal wellbeing in labour. Different types of fetal monitoring devices impact women's experiences of labour and birth. (Review)
Review
How does the use of continuous electronic fetal monitoring influence women's experiences of labour? A systematic integrative review of the literature from high income countries.
BACKGROUND
A variety of technologies are used to monitor fetal wellbeing in labour. Different types of fetal monitoring devices impact women's experiences of labour and birth.
AIM
This review aims to understand how continuous electronic fetal monitoring (CEFM) influences women's experiences, with a focus on sense of control, active decision-making and mobility.
METHODS
A systematic search of the literature was conducted. Findings from qualitative, quantitative and mixed methods studies were analysed to provide a review of current evidence.
FINDINGS
Eighteen publications were included. The findings were synthesised into three themes: 'Feeling reassured versus anxious about the welfare of their baby', 'Feeling comfortable and free to be mobile versus feeling uncomfortable and restricted', and 'Feeling respected and empowered to make decisions versus feeling depersonalised with minimal control '. Women experienced discomfort and a lack of mobility as a result of some CEFM technologies. They often felt anxious and had mixed feelings about their baby's welfare whilst these were in use. Some women valued the data produced by CEFM technologies about the welfare of their baby. Many women experienced a sense of depersonalisation and lack of control whilst CEFM technologies were used.
DISCUSSION
Fetal monitoring technologies influence women's experiences of labour both positively and negatively. Wireless devices were associated with the most positive response as they enabled greater freedom of movement.
CONCLUSION
The design of emerging fetal monitoring technologies should incorporate elements which foster freedom of movement, are comfortable and provide women with a sense of choice and control. The implementation of fetal monitoring that enables these elements should be prioritised by health professionals.
PubMed: 38754249
DOI: 10.1016/j.wombi.2024.101619 -
Global estimate of burnout among the public health workforce: a systematic review and meta-analysis.Human Resources For Health May 2024Burnout is an occupational phenomenon resulting from chronic workplace stress. We conducted this review to estimate the pooled global prevalence of burnout among the... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Burnout is an occupational phenomenon resulting from chronic workplace stress. We conducted this review to estimate the pooled global prevalence of burnout among the public health workforce.
METHODS
We conducted this review as per the PRISMA 2020 guidelines. We included only cross-sectional studies reporting outcome estimates among the study population. We included articles published before December 2023. We used a search strategy to systematically select the articles from PubMed, Embase, and Google Scholar. We assessed the quality of the studies using an adapted version of NIH's study tool assessment for cross-sectional and observational cohort studies. We estimated the pooled proportion using the random-effects model.
RESULTS
We included eight studies in our review, covering a sample size of 215,787. The pooled proportion of burnout was 39% (95% CI: 25-53%; p-value: < 0.001). We also identified high heterogeneity among the included studies in our review (I: 99.67%; p-value: < 0.001). Seven out of the eight studies were of good quality. The pooled proportion of the studies conducted during the COVID-19 pandemic was 42% (95% CI: 17-66%), whereas for the studies conducted during the non-pandemic period, it was 35% (95% CI: 10-60%).
CONCLUSION
In our review, more than one-third of public health workers suffer from burnout, which adversely affects individuals' mental and physical health. Burnout among the public health workforce requires attention to improve the well-being of this group. Multisite studies using standardized definitions are needed for appropriate comparisons and a better understanding of variations in burnout in various subgroups based on sociodemographic characteristics and type of work responsibilities. We must design and implement workplace interventions to cope with burnout and increase well-being.
LIMITATIONS
Due to the limited research on burnout among public health workers, we could not perform a subgroup analysis on various factors that could have contributed to burnout.
Topics: Humans; Burnout, Professional; COVID-19; Cross-Sectional Studies; Health Personnel; Health Workforce; Prevalence; Public Health; SARS-CoV-2; Workplace
PubMed: 38773482
DOI: 10.1186/s12960-024-00917-w