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International Journal of Medical... Aug 2024Improved survival of patients after acute coronary syndromes, population growth, and overall life expectancy rise have led to a significant increase in the proportion of...
BACKGROUND
Improved survival of patients after acute coronary syndromes, population growth, and overall life expectancy rise have led to a significant increase in the proportion of patients with stable coronary artery disease (CAD), creating a significant load on the entire healthcare system. The disease often progresses with the development of many complications while significantly increasing the likelihood of hospitalization. Developing and applying a machine learning model for predicting hospitalizations of patients with CAD to an inpatient medical facility will allow for close monitoring of high-risk patients, early preventive interventions, and optimized medical care.
AIMS
Development and external validation of personalized models for predicting the preventable hospitalizations of patients with stable CAD and its complications using ML algorithms and data of real-world clinical practice.
METHODS
135,873 depersonalized electronic health records of 49,103 patients with stable CAD were included in the study. Anthropometric measurements, physical examination results, laboratory, instrumental, anamnestic, and socio-demographic data, widely used in routine medical practice, were considered as potential predictors, a total of 73 features. Logistic regression, decision tree-based methods including gradient boosting (AdaBoost, LightGBM, XGBoost, CatBoost) and bagging (RandomForest and ExtraTrees), discriminant analysis (LinearDiscriminant, QuadraticDiscriminant), and naive Bayes classifier were compared. External validation was performed on the data of a separate region.
RESULTS
The best results and stability to external validation data were shown by the CatBoost model with an AUC of 0.875 (95% CI 0.865-0.885) for the internal testing and 0.872 (95% CI 0.856-0.886) for the external validation. The best model showed good performance evaluated through AUROC, Brier score and standardized net benefit (for the target NPV threshold) for the validation dataset that was only slightly similar to the train data.
CONCLUSION
The metrics of the best model were superior to previously published studies. The results of external validation demonstrated the relative stability of the model to new data from another region that confirms the possibility of the model's application in real clinical practice.
Topics: Humans; Coronary Artery Disease; Machine Learning; Female; Male; Hospitalization; Aged; Middle Aged; Electronic Health Records; Algorithms
PubMed: 38743996
DOI: 10.1016/j.ijmedinf.2024.105476 -
European Journal of Psychotraumatology 2024While several studies documented a positive correlation between childhood maltreatment severity and dissociation severity, it is currently unknown whether specific...
While several studies documented a positive correlation between childhood maltreatment severity and dissociation severity, it is currently unknown whether specific dissociative symptoms cluster together among individuals with childhood trauma histories ranging from none to severe. We aimed to explore symptom constellations across the whole spectrum of dissociative processing from patients with severe dissociative disorders to healthy controls and relate these to maltreatment severity and sociodemographic characteristics. We employed latent profile analysis to explore symptom profiles based on five subscales, measuring absorption, depersonalization, derealization, somatoform and identity alteration, based on the 20 items of the German short version of the Dissociative Experiences Scale-II (20) in a large aggregate sample ( = 3,128) overrepresenting patients with trauma-related disorders. We then related these profiles to maltreatment severity as measured by the five subscales of the Childhood Trauma Questionnaire as well as sociodemographic characteristics. Based on the five FDS subscales, six clusters differentiated by symptom severity, but not symptom constellations, were identified. Somatoform dissociation varied in accordance with the remaining symptom clusters. The cluster with the highest overall symptom severity entailed nearly all subjects diagnosed with Dissociative Identity Disorder and was characterized by extreme levels of childhood maltreatment. Both abuse and neglect were predictive of cluster membership throughout. The higher the severity of dissociative processing in a cluster, the more subjects reported high severity and multiplicity of childhood maltreatment. However, some subjects remain resilient to the development of dissociative processing although they experience extreme childhood maltreatment.
Topics: Humans; Dissociative Disorders; Female; Male; Adult; Surveys and Questionnaires; Adult Survivors of Child Abuse; Middle Aged; Adverse Childhood Experiences; Child Abuse; Germany; Psychiatric Status Rating Scales; Child
PubMed: 38739008
DOI: 10.1080/20008066.2024.2348345 -
Frontiers in Public Health 2024Burnout is a longstanding issue among educators and has been associated with psychological and physical health problems such as depression, and insomnia.
BACKGROUND
Burnout is a longstanding issue among educators and has been associated with psychological and physical health problems such as depression, and insomnia.
OBJECTIVE
To assess the prevalence and predictors of the three dimensions of burnout (emotional exhaustion, depersonalization and lack of professional accomplishment) among elementary and high school teachers.
METHODS
This is a quantitative cross-sectional study with data collected via an online survey. The Maslach Burnout Inventory-Educator Survey (MBI-ES), the Brief Resilience Scale (BRS) and the Perceived Stress Scale were used, respectively, to assess burnout, resilience and stress among teachers. Data was collected between September 1st, 2022 and August 30th, 2023. SPSS (version 28, IBM Corp) was used for the data analysis.
RESULTS
Overall, 1912 educators received a link to the online survey via a text message, and 780 completed the burnout survey questions, resulting in a response rate of 41%. The prevalence of emotional exhaustion, depersonalization, and lack of professional accomplishment were 76.9, 23.2, and 30.8%, respectively. Participants with high-stress symptoms were 6.88 times more likely to experience emotional exhaustion (OR = 6.88; 95% CI: 3.31-14.29), 2.55 times (OR = 2.55; 95% CI: 1.65-3.93) more likely to experience depersonalization and 2.34 times (OR = 2.34; 95% CI: 1.64-3.35) more likely to experience lack of professional fulfilment. Additionally, respondents with low resilience were 3.26 times more likely to experience emotional exhaustion symptoms (OR = 3.26; 95% CI: 2.00-5.31), than those with high resilience. Males were about 2.4 times more likely to present with depersonalization compared to female teachers, whilst those who indicated their marital status as partnered or cohabiting and those who selected "other" were 3.5 and 7.3 times, respectively, more likely to present with depersonalization compared with those who were single. Finally, Physical Education were 3.8 times more likely to present with depersonalization compared with English teachers.
CONCLUSION
The current study highlights the predictive effects of low resilience and high stress on the three dimensions of burnout among teachers in Canada. Interventions aimed at addressing systemic stress and fostering resilience are needed to reduce burnout among teachers.
Topics: Humans; School Teachers; Burnout, Professional; Cross-Sectional Studies; Male; Female; Prevalence; Adult; Surveys and Questionnaires; Middle Aged; Canada; Resilience, Psychological; Stress, Psychological
PubMed: 38737860
DOI: 10.3389/fpubh.2024.1396461 -
Exploratory Research in Clinical and... Jun 2024Community pharmacists (CPs) are the most accessible healthcare professionals in primary care due to pharmacies' open-door policy and convenience, resulting in high...
INTRODUCTION
Community pharmacists (CPs) are the most accessible healthcare professionals in primary care due to pharmacies' open-door policy and convenience, resulting in high patient and prescription volumes, and numerous free-of-charge consultations. Therefore, they are at high risk for burnout.
OBJECTIVES
The primary objective of this study was to assess the levels of burnout among community pharmacists in Greece, marking the first investigation of its kind within the country. Additionally, this study aimed to explore potential correlations between demographic variables and other health-related factors with burnout scores
METHODS
This study used a quantitative cross-sectional design involving two validated questionnaires(the Greek version of Maslach (MBI) questionnaire and the SF-36 questionnaire). Prior to data collection, all the relevant documentation was approved by the Metropolitan College Research Ethics Committee and was adopted under the auspices of the Panhellenic Pharmaceutical Association. Random sampling was used. Data collection period was July to August 2022.
RESULTS
A total of 368 responses were included in the analysis, with the majority being pharmacy-owners ( = 292, 79.3%). Notably, a significant proportion of respondents were female practitioners working within community pharmacy settings ( = 230, 62.5%). Analysis revealed that the sample exhibited low levels of personal achievement (M = 30.99, SD = 6.41), high levels of emotional exhaustion (M = 41.73, SD = 6.94), and moderate levels of depersonalization (M = 23.38, SD = 3.78), indicative of substantial occupational burnout. Furthermore, gender had a discernible impact on depersonalization, with women scoring higher than men ( = -3.29, < 0.01). Pharmacists who identified medicine shortages as their primary challenge in daily practice reported lower emotional burnout and depersonalization, albeit with a diminished sense of accomplishment ( = -2.62, < 0.01.
CONCLUSIONS
This study sheds light on burnout levels and health-related quality of life among community pharmacists in Greece.
PubMed: 38726241
DOI: 10.1016/j.rcsop.2024.100445 -
Behavioural Neurology 2024The phenomenon of burnout among healthcare workers during the COVID-19 pandemic is a widespread problem with several negative consequences for the healthcare system. The...
BACKGROUND
The phenomenon of burnout among healthcare workers during the COVID-19 pandemic is a widespread problem with several negative consequences for the healthcare system. The many stressors of the pandemic have led to an increased development of anxiety and depressive disorders in many healthcare workers. In addition, some manifested symptoms of the so-called postpandemic stress syndrome and the emergence of occupational burnout syndrome, commonly referred to as "COVID-19 burnout." The aim of this study was to assess the burnout and life satisfaction of healthcare workers during the COVID-19 pandemic.
MATERIALS AND METHODS
The study was conducted in 2020-2022 among medical staff working in hospitals in Silesia, Poland. The instruments used to assess life satisfaction and burnout were the Satisfaction with Life Scale (SWLS) and the Maslach Burnout Inventory (MBI), which assesses three dimensions: emotional exhaustion (EE), depersonalisation (DEP), and sense of reduced professional accomplishment (SRPA).
RESULTS
The study group included 900 participants. There were 300 physicians (mean age 38 ± 7 years), 300 nurses (mean age 35 ± 6 years), and 300 paramedics (mean age 31 ± 5 years). Life satisfaction as measured by the SWLS was lowest among nurses and paramedics in 2021 and among doctors in 2022. Male respondents and those with fewer years of work had higher levels of life satisfaction. People with more years of work had higher scores in EE and DEP and lower scores in SRPA ( = 0.001). We found a negative correlation between life satisfaction and EE ( = 0.001), DEP ( = 0.001), and SRPA ( = 0.002).
CONCLUSIONS
The results highlight the need for further research into the causes of burnout among medical professionals and the need for effective interventions to promote well-being and prevent burnout in this group.
Topics: Humans; COVID-19; Burnout, Professional; Poland; Adult; Male; Female; Health Personnel; Personal Satisfaction; SARS-CoV-2; Job Satisfaction; Pandemics; Surveys and Questionnaires; Middle Aged; Nurses; Physicians
PubMed: 38725562
DOI: 10.1155/2024/9945392 -
JAMA Network Open May 2024
Topics: Humans; Burnout, Professional; Male; Female; Disabled Persons; Physicians; Middle Aged; Adult; Cross-Sectional Studies; Surveys and Questionnaires
PubMed: 38722631
DOI: 10.1001/jamanetworkopen.2024.10701 -
Global Mental Health (Cambridge,... 2024Chinese nurses working with immense stress may have issues with burnout during COVID-19 regular prevention and control. There were a few studies investigating status of...
BACKGROUND
Chinese nurses working with immense stress may have issues with burnout during COVID-19 regular prevention and control. There were a few studies investigating status of burnout and associated factors among Chinese nurses. However, the relationships remained unclear.
OBJECTIVES
To investigate status and associated factors of nurses' burnout during COVID-19 regular prevention and control.
METHODS
784 nurses completed questionnaires including demographics, Generalized Anxiety Disorder-7, Patient Health Questionnaire-9, Insomnia Severity Index, Impact of Event Scale-revised, Perceived Social Support Scale, Connor-Davidson Resilience Scale, General Self-efficacy Scale and Maslach Burnout Inventory.
RESULTS
310 (39.5%), 393 (50.1%) and 576 (73.5%) of respondents were at high risk of emotional exhaustion (EE), depersonalization (DP) and reduced personal accomplishment (PA). The risk of EE, DP and reduced PA were moderate, high and high. Nurses with intermediate and senior professional rank and title and worked >40 h every week had lower scores in EE. Those worked in low-risk department reported lower scores in PA. Anxiety, post-traumatic stress disorder (PTSD), self-efficacy and social support were influencing factors of EE and DP, while social support and resilience were associated factors of PA.
CONCLUSION
Chinese nurses' burnout during COVID-19 regular prevention and control was serious. Professional rank and title, working unit, weekly working hours, anxiety, PTSD, self-efficacy, social support and resilience were associated factors of burnout.
PubMed: 38721485
DOI: 10.1017/gmh.2024.42 -
Leadership in Health Services... May 2024The COVID-19 pandemic has burdened the health-care system and exposed nurses to immense stress. This study therefore aims to investigate nurses' mental well-being who...
PURPOSE
The COVID-19 pandemic has burdened the health-care system and exposed nurses to immense stress. This study therefore aims to investigate nurses' mental well-being who are working with COVID-19-positive patients. Burnout leads to decreased productivity and manifests as emotional exhaustion, depersonalisation (cynicism) and low personal accomplishment (professional efficacy). Authentic leadership is built on a humanistic value system, which is the core value of nurses and other health-care professionals. This study therefore used authentic leadership as the independent variable.
DESIGN/METHODOLOGY/APPROACH
A cross-sectional quantitative research method was adopted by distributing validated online questionnaires to 1,334 nurses in a private pathology laboratory and 241 questionnaires were analysed with 93.4% female respondents. Multiple linear regression model testing was conducted.
FINDINGS
Multiple regression analyses showed statistically significant negative correlations between authentic leadership and emotional exhaustion, cynicism, job stress and job-stress-related presenteeism, and a positive correlation between authentic leadership and professional efficacy.
PRACTICAL IMPLICATIONS
This study provides empirical data to encourage organisations to focus on developing authentic leaders to decrease nurses' burnout, job stress and presenteeism. The health-care sector should strive to create an environment where nurses are valued and their talent is recognised to increase employee engagement and commitment.
ORIGINALITY/VALUE
There were two contributions in this study: first, to determine whether there is a relationship between authentic leadership job stress and job-stress-related presenteeism. Second, to determine whether there is a relationship between authentic leadership and the three sub-constructs of burnout.
Topics: Humans; COVID-19; Burnout, Professional; Leadership; Female; Cross-Sectional Studies; Male; Presenteeism; Adult; Surveys and Questionnaires; SARS-CoV-2; Pandemics; Occupational Stress; Middle Aged; Nursing Staff, Hospital
PubMed: 38708939
DOI: 10.1108/LHS-10-2023-0082 -
International Nursing Review May 2024This study aimed to analyze the trend in job burnout among nurses in Shanghai, China.
AIM
This study aimed to analyze the trend in job burnout among nurses in Shanghai, China.
BACKGROUND
The nursing profession globally faces a significant challenge due to aging populations, causing a human resources crisis. Job burnout notably impacts nurses' enthusiasm for work and their overall well-being. Understanding the trends in job burnout among nurses is crucial for addressing this issue.
METHODS
A cross-sectional study involving 799 nurses from a tertiary-care hospital and 11 community health service centers in Pudong New Area South, Shanghai, was conducted using convenience sampling. Data were collected through a general information questionnaire and the Maslach Burnout Inventory scale, to assess job burnout levels. These data were compared with the established Maslach and Hangzhou norms in China.
RESULTS
74.6% of the participants experienced job burnout. The emotional exhaustion dimension had an average score of 27.27 ± 13.93, indicating high levels of burnout; the depersonalization dimension had an average score of 7.83 ± 6.68, showing moderate levels of fatigue; and the personal achievement dimension had an average score of 26.75 ± 10.26, also indicating moderate fatigue. Notably, nurses aged 32-33 years with 11-12 years of professional experience were the most affected. The findings suggest that job burnout is a significant issue in Pudong New Area South, Shanghai, with a notable increase in severe burnout cases over the past decade.
CONCLUSION
Nurses, particularly during the COVID-19 pandemic, face high rates of burnout, with emotional exhaustion being particularly prevalent. To support and retain the nursing workforce, hospital administrators must implement external reward mechanisms and develop policies that encourage personal growth, career development, and a humanistic approach to care.
IMPLICATIONS FOR NURSING AND HEALTH POLICY
From our review of the literature, we identified instances where burnout standards are either not assessed or lack uniformity in their application. Therefore, it is imperative to adopt a standardized occupational burnout scale for a nationwide survey, encompassing nurse populations across various levels, including province, region, city, and institution. This approach will facilitate the establishment of a practical norm for occupational burnout within China. This norm would enable conducting regular assessments and comparisons to understand the evolving trends of job burnout among nurses, which could pave the way for the creation of targeted support interventions for the nursing profession.
PubMed: 38708847
DOI: 10.1111/inr.12952 -
Journal of Continuing Education in... May 2024Nurse burnout is a widespread issue in the health care industry, jeopardizing the well-being of both health care professionals and the patients they serve, manifesting...
BACKGROUND
Nurse burnout is a widespread issue in the health care industry, jeopardizing the well-being of both health care professionals and the patients they serve, manifesting as an intense sense of exhaustion, depersonalization, and a diminished sense of personal achievement.
METHOD
In nursing, professionals are exposed to an extraordinary array of challenges and demands that increase their likelihood of experiencing burnout and resulting mental health issues. Although burnout has been aggressively discussed and studied in recent years, strategies for preventing and mitigating burnout have been underreported.
RESULTS
This article highlights leading causes of burnout, delves into its alarming prevalence, and underscores the critical need for comprehensive strategies to address and prevent it.
CONCLUSION
This article highlights several initiatives established by a resilience program at a college of nursing that can be implemented within health care systems to directly address both individual and organizational burnout. .
PubMed: 38696780
DOI: 10.3928/00220124-20240426-04