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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 -
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 -
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 -
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 -
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 -
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 -
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 -
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 -
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 -
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