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Journal of Personalized Medicine Aug 2022Dissociative disorders encompass loss of integration in essential functions such as memory, consciousness, perception, motor control, and identity. Nevertheless,... (Review)
Review
BACKGROUND
Dissociative disorders encompass loss of integration in essential functions such as memory, consciousness, perception, motor control, and identity. Nevertheless, neuroimaging studies, albeit scarce, have suggested the existence of particular brain activation patterns in patients belonging to this diagnostic category. The aim of this review is to identify the main functional neuroimaging correlates of dissociative disorders.
METHODS
we searched the PubMed database to identify functional neuroimaging studies conducted on subjects with a diagnosis of a dissociative disorder, following the PRISMA guidelines. In the end, we included 13 studies in this systematic review, conducted on 51 patients with dissociative identity disorder (DID), 28 subjects affected by depersonalization disorder, 24 with dissociative amnesia, and 6 with other or not specified dissociative disorders.
RESULTS
Prefrontal cortex dysfunction seems prominent. In addition, changes in the functional neural network of the caudate are related to alterations of identity state and maintenance of an altered mental status in DID. Another role in DID seems to be played by a dysfunction of the anterior cingulate gyrus. Other regions, including parietal, temporal, and insular cortices, and subcortical areas were reported to be dysfunctional in dissociative disorders.
CONCLUSIONS
Prefrontal dysfunction is frequently reported in dissociative disorders. Functional changes in other cortical and subcortical areas can be correlated with these diagnoses. Further studies are needed to clarify the neurofunctional correlations of each dissociative disorder in affected patients, in order to identify better tailored treatments.
PubMed: 36143190
DOI: 10.3390/jpm12091405 -
Iranian Journal of Nursing and... 2021Occupational burnout, as a reaction to persistent work pressures, reduces efficiency, wastes manpower, and causes physical and psychological complications. The aim of... (Review)
Review
BACKGROUND
Occupational burnout, as a reaction to persistent work pressures, reduces efficiency, wastes manpower, and causes physical and psychological complications. The aim of this study was to determine the frequency and intensity of occupational burnout among pre-hospital emergency staff in Iran.
MATERIALS AND METHODS
This study was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data resources included Scientific Information Database (SID), Magiran, Islamic World Science Citation Center (ISC), Irandoc, PubMed, Scopus, Web of Science, and Google Scholar.
RESULTS
Initially, 178 articles were extracted, and then 13 articles were finally analyzed. Overall,2034 pre-hospital emergency personnel were examined. Mean of occupational burnout in term of frequency, respectively for emotional exhaustion (16.78, 95% CI = 8.89-24.67, I = 62.30%, = 0.004), depersonalization (11.57, 95% CI = 6.97-16.18, I = 68.50%, = 0.001) and the lack of personal accomplishment (16.11, 95% CI = 8.60 -23.62, I = 74.70%, = 0 <001) were determined. Also, in term of intensity, respectively for emotional exhaustion (17.90, 95% CI = 8.24-27.57, I = 64.80, = 0.004), depersonalization (11.20, 95% CI = 6.80-16.22, I = 49.60%, = 0.044) and the lack of personal accomplishment (23.45, 95% CI = 13.41 -33.49, I = 84.80%, = 0 <001) were determined.
CONCLUSIONS
According to findings, depersonalization and lack of personal accomplishment had moderate and high-level, respectively. Therefore, it is necessary health policymakers pay special attention to identifying and resolving the causes of occupational burnout in this population.
PubMed: 33954093
DOI: 10.4103/ijnmr.IJNMR_175_20 -
Frontiers in Human Neuroscience 2021Burnout can be defined as an occupational syndrome resulting from poorly managed chronic workplace stress. It is characterized by three dimensions: feelings of energy...
Burnout can be defined as an occupational syndrome resulting from poorly managed chronic workplace stress. It is characterized by three dimensions: feelings of energy depletion or exhaustion; increased mental distance from one's job, or feelings of negativism or cynicism related to one's job; and reduced professional efficacy. Teachers are among the human service professionals particularly vulnerable to occupational burnout. Teaching is a highly demanding and challenging task, in that requires constant confrontation with different stakeholders (students and their parents, administrators). Among teachers, physical education teachers have been particularly understudied even though a recently published systematic review has found that they are exposed to high levels of stress. To better explore burnout syndrome among physical education teachers, the present systematic review was undertaken, searching up to six languages. Fifty-six studies were included in the present review. The reported rate of high emotional exhaustion ranged from 11.52 to 60.6%, according to the single study. Pooling together 12 studies and totaling 2,153 physical education teachers, the prevalence rate of high emotional exhaustion was computed to be 28.6 [95% CI 21.9-35.8]. The reported rate of high depersonalization ranged from 3.6 to 45.2%, according to the single study. Pooling together 11 studies and totaling 2,113 physical education teachers, the prevalence rate of high depersonalization was computed to be 14.5% [95% CI 8.0-22.4]. The reported rate of low personal accomplishment ranged from 13.63 to 55.6%, according to the single study. Pooling together 12 studies and totaling 2,153 physical education teachers, the prevalence rate of low personal accomplishment was computed to be 29.5% [95% CI 23.8-35.4]. The reported rate of overall burnout ranged from 10.0 to 51.6%, according to the single study. Pooling together 7 studies and totaling 1,101 physical education teachers, the prevalence rate of overall burnout was computed to be 23.9% [95% CI 13.6-36.0]. No evidence of publication bias could be found, both visually inspecting the funnel plot and conducting the Egger's linear regression test. Burnout imposes a significant burden among physical education teachers. Based on the information contained in the present systematic review and meta-analysis, tailored interventions could be designed to mitigate such a burden. However, due to the limitations of the studies included in the present systematic review and meta-analysis, further research in the field is urgently warranted. https://osf.io/69ryu/, identifier: 10.17605/OSF.IO/69RYU.
PubMed: 34955783
DOI: 10.3389/fnhum.2021.553230 -
Indian Journal of Psychological Medicine 2020With increasing workload and dismal working conditions, healthcare professionals (HCPs) in India often suffer from burnout. Understanding the extent of these problems... (Review)
Review
BACKGROUND
With increasing workload and dismal working conditions, healthcare professionals (HCPs) in India often suffer from burnout. Understanding the extent of these problems and the contributing factors is necessary to build a healthy workforce capable of serving the society. The purpose of this study was to systematically review and analyze: 1) the prevalence of burnout among HCPs in India and 2) the factors associated with burnout in this population.
METHODS
A systematic search of MEDLINE and EMBASE, from the inception of these databases to October 2019, was conducted using keywords. The search results were screened to identify studies evaluating burnout among HCPs in India using a standard burnout tool. Using a random effect model, the pooled prevalence of burnout was estimated using Maslach Burnout Inventory (MBI) in three domains: emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA). Risk factors for burnout were assessed qualitatively.
RESULTS
A total of 15 studies assessing burnout in 3845 Indian HCPs were identified. The pooled prevalence of burnout was 24% in the EE domain, 27% in the DP domain, and 23% in the PA domain. Younger age, female gender, unmarried status, and difficult working conditions were associated with increased risk of burnout.
CONCLUSION
Burnout is highly prevalent among Indian HCPs, with close to one-fourth of them suffering from burnout. A number of personal and professional factors are associated with burnout, and these should be considered while developing solutions to tackle burnout.
PubMed: 32346250
DOI: 10.4103/IJPSYM.IJPSYM_387_19 -
Heliyon Jul 2022To analyze surveys measuring the prevalence of burnout among Chinese doctors and reveal the overall prevalence, characteristics, timeline, and factors related to burnout. (Review)
Review
OBJECTIVE
To analyze surveys measuring the prevalence of burnout among Chinese doctors and reveal the overall prevalence, characteristics, timeline, and factors related to burnout.
METHODS
A comprehensive search was conducted on China National Knowledge Infrastructure, WANFANG, PubMed, EMBASE, PsycINFO and Cochrane Library databases from their inception to 28 February 2021. Random-effects meta-analyses, meta-regression and planned subgroup analyses were performed, and the standardized mean difference was adopted for comparisons between subgroups. Egger's and Begg's tests were performed to evaluate publication bias. Heterogeneity across the studies was tested using the I statistic. The study protocol was registered on PROSPERO (CRD42018104249).
RESULTS
In total, 3,210 records were reviewed; 64 studies including 48,638 Chinese doctors were eligible for meta-analysis. The prevalence of burnout increased continuously from 2008 to 2017 and decreased significantly from 2018 to 2020, a little increase from 2020 to 2021. The overall prevalence of burnout was 75.48% (95% CI, 69.20 to 81.26; I = 99.23%, P < 0.001), and high burnout was 9.37% (95% CI, 4.91 to 15.05, I = 98.88%, P < 0.001). The prevalence of emotional exhaustion was 48.64% (95% CI, 38.73 to 58.59; I = 99.53%, P < 0.001), depersonalization was 54.67% (95% CI, 46.95 to 62.27; I = 99.20%, P < 0.001), and reduced personal accomplishment was 66.53% (95% CI, 58.13 to 74.44; I = 99.37%, P < 0.001). Gender, marriage, professional title and specialty all influenced burnout.
CONCLUSIONS
The results showed that the total prevalence of doctor burnout in China is very high. The prevalence of burnout varies by location. Gender, marital status and professional title all affect burnout scores.
PubMed: 35855985
DOI: 10.1016/j.heliyon.2022.e09821 -
International Journal of Environmental... Aug 2022Burnout is a state of emotional, physical, and mental exhaustion often caused by excessive and prolonged stress. Given the emotionally and often physically demanding... (Review)
Review
Burnout is a state of emotional, physical, and mental exhaustion often caused by excessive and prolonged stress. Given the emotionally and often physically demanding nature of the work of correctional professionals, they are at substantial risk of suffering the adverse consequences of burnout. We systematically reviewed (Stage 1) the influence of burnout amongst forensic psychologists, psychiatrists, case workers, nurses, and correction officers. Interventions were then reviewed (Stage 2) at the individual and collective level to examine the effectiveness or efficacy of treatments for burnout among professionals working in corrections.
Topics: Burnout, Professional; Emotions; Humans; Mental Fatigue; Surveys and Questionnaires
PubMed: 36011590
DOI: 10.3390/ijerph19169954 -
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 -
Journal of the American College of... Jan 2023Burnout among surgeons is increasingly recognized as a crisis. However, little is known about changes in burnout prevalence over time. We evaluated temporal trends in...
BACKGROUND
Burnout among surgeons is increasingly recognized as a crisis. However, little is known about changes in burnout prevalence over time. We evaluated temporal trends in burnout among surgeons and surgical trainees of all specialties in the US and Canada.
STUDY DESIGN
We systematically reviewed MEDLINE, Embase, and PsycINFO for studies assessing surgeon burnout from January 1981 through September 2021. Changes in dichotomized Maslach Burnout Inventory scores and mean subscale scores over time were assessed using multivariable random-effects meta-regression.
RESULTS
Of 3,575 studies screened, 103 studies representing 63,587 individuals met inclusion criteria. Publication dates ranged from 1996 through 2021. Overall, 41% of surgeons met criteria for burnout. Trainees were more affected than attending surgeons (46% vs 36%, p = 0.012). Prevalence remained stable over the study period (-4.8% per decade, 95% CI -13.2% to 3.5%). Mean scores for emotional exhaustion declined and depersonalization declined over time (-4.1 per decade, 95% CI -7.4 to -0.8 and -1.4 per decade, 95% CI -3.0 to -0.2). Personal accomplishment scores remained unchanged. A high degree of heterogeneity was noted in all analyses despite adjustment for training status, specialty, practice setting, and study quality.
CONCLUSIONS
Contrary to popular perceptions, we found no evidence of rising surgeon burnout in published literature. Rather, emotional exhaustion and depersonalization may be decreasing. Nonetheless, burnout levels remain unacceptably high, indicating a need for meaningful interventions across training levels and specialties. Future research should be deliberately designed to support longitudinal integration through prospective meta-regression to facilitate monitoring of trends in surgeon burnout.
Topics: Humans; Prospective Studies; Burnout, Professional; Surgeons; Prevalence; Regression Analysis
PubMed: 36519921
DOI: 10.1097/XCS.0000000000000402 -
Psychological Reports Oct 2021To investigate the prevalence of occupational burnout among ophthalmologists in order to better understand the mental and physical well-being of eye physicians and... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To investigate the prevalence of occupational burnout among ophthalmologists in order to better understand the mental and physical well-being of eye physicians and surgeons in the professional workplace.
STUDY DESIGN
A systematic review and meta-analysis.
METHODS
Online computer databases MEDLINE, EMBASE, CINAHL, and ProQuest Dissertations and Theses were searched systematically and thoroughly. Conferences held through Association for Research in Vision and Ophthalmology, American Academy of Ophthalmology, and Canadian Society of Ophthalmology were searched. Studies were screened using Covidence software. Data on reported burnout prevalence was extracted. STATA 15.0 was used to conduct meta-analysis. Our search strategy identified 318 records from online databases and 11 records from grey literature search, which were screened at 2-levels. Title and abstracts of each record were screened resulting in 24 records moving to full-text screening. Total of 9 records were utilized for quantitative analysis in the data extraction stage. Our results indicated significant professional burnout among ophthalmologists (ES = 0.41; CI: [0.26, 0.56]) with significant emotional exhaustion (ES = 0.43; CI: [0.33, 0.53]), depersonalization (ES = 0.29; CI: [0.13, 0.46]), and a low sense of personal accomplishment (ES = 0.36; CI: [0.08, 0.63]).
CONCLUSIONS
Significant occupational burnout among ophthalmologists is concerning because burnout can have a negative effect on the physical and mental health of eye physicians and surgeons. It could impact productivity, cutbacks in work hours, or lead to early retirement from the profession. Contributing factors in ophthalmologist burnout including work overload need to be addressed in a timely manner.
Topics: Burnout, Professional; Burnout, Psychological; Canada; Humans; Ophthalmologists; Prevalence
PubMed: 32865483
DOI: 10.1177/0033294120954135 -
Healthcare (Basel, Switzerland) Aug 2020: To determine levels of burnout among paediatric oncology nurses, and the risk factors that may influence its development. : A literature review with meta-analysis was... (Review)
Review
: To determine levels of burnout among paediatric oncology nurses, and the risk factors that may influence its development. : A literature review with meta-analysis was conducted, via a search in the PubMed, CINHAL, Scopus, ProQuest (Health and Medical Complete), Scielo and PsycINFO databases, using the search equation: "Nurs* AND burnout AND oncology AND pediatric". : The final sample of selected studies was of eight articles. All were quantitative studies of paediatric oncology nurses, using the Maslach Burnout Inventory, written in English or Spanish. No search restrictions were established on the year of publication. The eight studies reported moderate-high levels of burnout in each of its three dimensions. These dimensions were all related to the characteristics of the profession, in terms of complexity, shifts and workload, and to sociodemographic variables such as marital status, work experience, age and gender. The prevalence meta-analytical estimation for a sample of = 361 nurses were 37% for high emotional exhaustion, 16% for high depersonalisation and 27% for low personal fulfilment. : Most paediatric oncology nurses present moderate-high levels of burnout. Therefore, strategies and interventions should be identified and implemented to protect these workers from the syndrome.
PubMed: 32872437
DOI: 10.3390/healthcare8030309