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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 -
Intensive & Critical Care Nursing Jun 2024The severe conditions often experienced in an intensive care unit, combined with poor working conditions, increase stress and therefore decrease job satisfaction.... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
The severe conditions often experienced in an intensive care unit, combined with poor working conditions, increase stress and therefore decrease job satisfaction. Sustained stress in the workplace leads to the development of burnout, a syndrome characterised by three dimensions: emotional exhaustion, depersonalisation and perceived lack of personal fulfilment.
OBJECTIVE
To analyse the relationship between burnout syndrome and job satisfaction among ICU personnel.
DATA SOURCES
The PubMed, CINAHL and Scopus databases were used.
STUDY DESIGN
A systematic review and meta-analysis. The study sample consisted of 18 quantitative primary studies conducted in the last five years. Validated questionnaires were used to assess burnout in ICU healthcare workers, the most commonly used being the Maslach Burnout Inventory.
EXTRACTION METHODS
The search equation applied was: "job satisfaction AND nurs* AND burnout AND (ICU OR intensive care units)". The search was performed in October 2022.
PRINCIPAL FINDINGS
The search returned 514 results. Only 73 articles met the eligibility criteria. After reading the title and abstract, 20 articles were selected. After reading the full texts, 12 articles remained and after the reverse search, 18 articles were finally selected. The studies reported a 50% prevalence of burnout, all three dimensions of which were heightened by the COVID-19 pandemic. Analysis of the study findings revealed an inverse association between burnout and job satisfaction.
CONCLUSIONS
Job dissatisfaction of ICU nurses depends on lack of experience, working conditions or working environment among others. ICU nurses with lower job satisfaction have higher levels of burnout.
IMPLICATIONS FOR CLINICAL PRACTICE
This meta-analysis shows the potential value of job satisfaction on improving health outcomes related to burnout syndrome for nursing professional in Intensive Care Units. Different factors that could increase job satisfaction and consequently protect them from suffering high levels of burnout, such as salary, permanence in the service, mental health care are the responsibility of the hospital supervisor and, finally, of the own Health System. Knowledge of a risk profile based on the factors influencing job dissatisfaction would enable the implementation of effective workplace interventions to reduce or prevent the risk of burnout. Health policies should focus on protecting the worker, so in addition to improving working conditions, it would be interesting to promote coping skills in order to improve the quality of care and patient safety.
Topics: Humans; Job Satisfaction; Pandemics; Burnout, Professional; Intensive Care Units; Surveys and Questionnaires; Nurses; Psychological Tests; Self Report
PubMed: 38394983
DOI: 10.1016/j.iccn.2024.103660 -
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 -
European Journal of Radiology Open Dec 2023Burnout among physicians has a prevalence rate exceeding 50%. The radiology department is not immune to the burnout epidemic. Understanding and addressing burnout among... (Review)
Review
RATIONALE AND OBJECTIVES
Burnout among physicians has a prevalence rate exceeding 50%. The radiology department is not immune to the burnout epidemic. Understanding and addressing burnout among radiologists has been a subject of recent interest. Thus, our study aims to systematically review studies reporting the prevalence of burnout in physicians in the radiology department while providing an overview of the factors associated with burnout among radiologists.
MATERIALS AND METHODS
The search was conducted from inception until November 13th, 2022, in PubMed, Embase, Education Resources Information Center, PsycINFO, and psycArticles. Studies reporting the prevalence of burnout or any subdimensions among radiology physicians, including residents, fellows, consultants, and attendings, were included. Data on study characteristics and estimates of burnout syndrome or any of its subdimensions were collected and summarized.
RESULTS
After screening 6379 studies, 23 studies from seven countries were eligible. The number of participants ranged from 26 to 460 (median, 162; interquartile range, 91-264). In all, 18 studies (78.3%) employed a form of the Maslach Burnout Inventory. In comparison, four studies (17.4%) used the Stanford Professional Fulfillment Index, and one study (4.3%) used a single-item measure derived from the Zero Burnout Program survey. Overall burnout prevalence estimates were reported by 14 studies (60.9%) and varied from 33% to 88%. High burnout prevalence estimates were reported by only five studies (21.7%) and ranged from 5% to 62%. Emotional exhaustion and depersonalization prevalence estimates were reported by 16 studies (69.6%) and ranged from 11%-100% and 4%-97%, respectively. Furthermore, 15 studies (65.2%) reported low personal accomplishment prevalence, ranging from 14.7% to 84%. There were at least seven definitions for overall burnout and high burnout among the included studies, and there was high heterogeneity among the cutoff scores used for the burnout subdimensions.
CONCLUSION
Burnout in radiology is increasing globally, with prevalence estimates reaching 88% and 62% for overall and high burnout, respectively. A myriad of factors has been identified as contributing to the increased prevalence. Our data demonstrated significant variability in burnout prevalence estimates among radiologists and major disparities in burnout criteria, instrument tools, and study quality.
PubMed: 37920681
DOI: 10.1016/j.ejro.2023.100530 -
The American Journal of Medicine Mar 2024Physicians deal with intense professional pressures, which may contribute to increasing burnout. We sought to evaluate the efficacy of interventions designed to reduce... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Physicians deal with intense professional pressures, which may contribute to increasing burnout. We sought to evaluate the efficacy of interventions designed to reduce burnout in physicians, physicians-in-training, and other health care professionals.
METHODS
We searched PubMed and Embase (through January 6, 2023) and reference lists. We included all randomized studies assessing an intervention designed to reduce professional burnout in physicians and other health care personnel. We adhered to the PRISMA reporting guidelines. We abstracted data on study and participant characteristics, study outcomes, and study quality. We used a random-effects model to pool mean differences in burnout change (pre- and post-intervention) between intervention and control arms.
RESULTS
Thirty-one of the 38 eligible studies (81.6%) used the Maslach Burnout Inventory (MBI) questionnaire to assess burnout. When comparing the intervention and control groups, the mean difference in the emotional exhaustion component of the MBI was -1.11 (95% confidence interval [CI], -2.14 to -0.09; I2: 74.5%; 20 studies); the mean difference in the depersonalization component of the MBI was -0.32 (95% CI, -0.63 to -0.01; I2: 54.2%; 17 studies); and the mean difference in the personal accomplishment component of the MBI was 1.11 (95% CI, -0.21 to 2.43; I2: 94.3%; 16 studies).
CONCLUSIONS
Studies testing interventions to decrease physician burnout led to significant numerical improvements in some domains of burnout, but it is unlikely that these changes result in meaningful changes in clinical burnout. Further, the limited follow-up time, biased assessments, and heterogeneity in intervention efficacy suggest that a more nuanced understanding of the causes of burnout is needed to develop more effective interventions.
Topics: Humans; Burnout, Professional; Randomized Controlled Trials as Topic; Physicians; Surveys and Questionnaires; Psychological Tests; Self Report
PubMed: 37890569
DOI: 10.1016/j.amjmed.2023.10.003 -
Acta Clinica Belgica Feb 2024First, to provide a synthesis and analysis of available scientific literature regarding the level of work stress and burnout among emergency physicians. Second, to... (Review)
Review
AIM OF THE STUDY
First, to provide a synthesis and analysis of available scientific literature regarding the level of work stress and burnout among emergency physicians. Second, to identify the effect of the specific work situation-related factors.
METHODS
A systematic search was performed in NCBI PubMed and Embase. Comparative primary studies, both systematic review and cross-sectional, quantifying burnout in emergency physicians were included. Only studies published between 2011 and 2022 were retained. Synonym sets were compiled for the search key for 'burnout & stress', 'emergency', 'physician' and 'burnout & posttraumatic stress disorder'.
RESULTS
Thirty-five papers were retained for further research. Emergency physicians scored significantly higher for all dimensions of burnout compared to other healthcare professions. Significant correlations for burnout were found with work characteristic and organizational factors. Critical incidents and aggression were identified as the most important acute work characteristics and organizational factors impacting emergency physician's mental wellbeing including the development of posttraumatic stress disorder. Moreover, personal factors such as age, personality, and coping strategies also play an important role in the development of burnout as well as work-related trauma.
CONCLUSION
Available studies show that emergency physicians report higher scores of emotional exhaustion and depersonalization when compared to other healthcare professionals. Work characteristics contribute to this, but work-related traumatic incidents and aggression are important determinants. Personal characteristics such as age, personality type D, previous experiences and coping strategies seem to be determining factors likewise. Emergency physicians showed a high risk for developing burnout and work stress-related problems.
Topics: Humans; Cross-Sectional Studies; Prevalence; Burnout, Professional; Burnout, Psychological; Physicians
PubMed: 37889050
DOI: 10.1080/17843286.2023.2273611 -
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 -
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 -
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 -
Frontiers in Psychiatry 2023Stress in the healthcare environment causes negative effects in nurses such as burnout, anxiety, and depression. The COVID-19 pandemic has resulted in increased pressure...
BACKGROUND
Stress in the healthcare environment causes negative effects in nurses such as burnout, anxiety, and depression. The COVID-19 pandemic has resulted in increased pressure on medical staff globally, highlighting the potential benefits of mindfulness-based interventions in reducing nurses' stress levels. Despite numerous studies exploring the effect of mindfulness-based training on nurses, the results remain inconclusive.
OBJECTIVE
To systematically evaluate the impact of mindfulness training on nurse's performance and increase the certainty of existing evidence.
METHODS
This study searched various databases, including EBSCO, Embase, Web of Science, PubMed, ProQuest, Scopus, Cochrane Online Library, Wanfang, SinoMed, CNKI, and VIP, for randomized controlled trials on the impact of mindfulness-based interventions for nurses up until 02 December 2022. Two investigators independently screened and extracted data from the articles, while also assessing the risk of bias. The data was analyzed using RevMan 5.4 software.
RESULTS
This review identified 15 studies out of the 2,171 records retrieved, consisting of a total of 1,165 participants who were randomized. Post-intervention analysis provided very-low certainty evidence of moderate effectiveness of mindfulness-based training in reducing stress [standardized mean difference (SMD) = -0.81; 95% confidence interval (CI) = -1.11 to -0.52], with no significant effect on anxiety (SMD = -0.30; 95% CI = -0.72 to 0.13) or depression (SMD = -0.24; 95% CI = -0.55 to 0.07). However, the training was effective in reducing burnout, as demonstrated by the lower scores for emotional exhaustion (SMD = -4.27; 95% CI = -5.94 to -2.59) and depersonalization (SMD = -2.89; 95% CI = -4.24 to -1.54) and higher scores for personal accomplishment (SMD = 2.81; 95% CI = 0.12 to 5.50). There was a sustained improvement in stress levels in the short-term (≤3 months), with delayed benefits for burnout. However, only two studies were available for later follow-ups, and there was no significant evidence of long-term effects.
CONCLUSION
Mindfulness-based training may be a viable intervention for improving the psychological wellbeing of nurses, including reducing stress, burnout.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023387081.
PubMed: 37599884
DOI: 10.3389/fpsyt.2023.1218340