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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 Multidisciplinary Healthcare 2024Burnout Syndrome constitutes a critical concern in healthcare, particularly among practitioners operating in high-stress, critical care settings. Understanding the...
BACKGROUND
Burnout Syndrome constitutes a critical concern in healthcare, particularly among practitioners operating in high-stress, critical care settings. Understanding the multifaceted factors contributing to burnout in this context is pivotal for devising effective interventions and promoting the well-being of critical care professionals.
OBJECTIVE
To investigate the prevalence, contributing factors, and potential interventions related to Burnout Syndrome among critical care health providers in Saudi Arabia.
METHODS
A cross-sectional research design was employed, gathering data from a sample of critical care health providers, including medical practitioners. A self-administered structured electronic questionnaire was used, incorporating the Maslach Burnout Inventory (MBI) with its three subscales: emotional exhaustion, depersonalization, and personal accomplishment. The target population was male and female critical care health providers over 18 years age, most participants lies between 25 years to 34 years.
RESULTS
Statistical analysis shows significant disparities in response distribution (p<0.05), highlighting the importance of understanding encounters with emotional exhaustion, personal accomplishment, and depersonalization. The Durbin-Watson statistic indicated limited autocorrelation, and collinearity tolerance values suggested nominal intercorrelations among predictors. A significant positive correlation was found between the "Depersonalization Loss of Empathy MBI" factor and the outcome variables, indicating complex relationships between emotional exhaustion, personal accomplishment, and depersonalization.
CONCLUSION
The study highlights the multifaceted nature of burnout, revealing intricate relationships between emotional exhaustion, personal accomplishment, and depersonalization. These findings collectively form an important foundation for future guidelines and interventions to enhance the well-being of healthcare professionals.
PubMed: 38434482
DOI: 10.2147/JMDH.S452294 -
Journal of the American Medical... May 2024To identify factors associated with high and low "voice"-or level of input in patient care decisions-among home care workers (HCWs), an often marginalized workforce that...
OBJECTIVES
To identify factors associated with high and low "voice"-or level of input in patient care decisions-among home care workers (HCWs), an often marginalized workforce that provides care in the home to older adults and those with chronic conditions.
DESIGN
We conducted a secondary analysis of data from a cross-sectional survey assessing experiences of HCWs in caring for adults with heart failure. The survey measured HCWs' voice using a validated, 5-item instrument.
SETTING AND PARTICIPANTS
The survey was conducted virtually from June 2020 to July 2021 in partnership with the 1199 Service Employees International Union (1199SEIU) Training and Employment Funds, a union labor management fund. English- or Spanish-speaking HCWs employed by a certified or licensed home care agency in New York, NY, were eligible.
METHODS
HCW voice was the main outcome of interest, which we assessed by tertiles (low, medium, and high, with medium as the referent group). Using multinominal logistic regression, we calculated odds ratios (ORs) and 95% CIs for the relationship between participant characteristics and low and high levels of voice.
RESULTS
The 261 HCWs had a mean age of 48.4 years (SD 11.9), 96.6% were female, and 44.2% identified as Hispanic. A total of 38.7% had low voice, 37.9% had medium voice, and 23.4% had high voice. In the adjusted model, factors associated with low voice included Spanish as a primary language (OR 3.71, P = .001), depersonalization-related burnout (OR 1.14, P = .04), and knowing which doctor to call (OR 0.19, P < .001). Factors associated with high voice included Spanish as a primary language (OR 2.61, P = .04) and job satisfaction (OR 1.22, P = .001).
CONCLUSIONS AND IMPLICATIONS
Organizational factors such as team communication practices-including among non-English speakers-may play an important role in HCW voice. Improving HCW voice may help retain HCWs in the workforce, but future research is needed to evaluate this.
Topics: Humans; Female; Male; Cross-Sectional Studies; Home Health Aides; Middle Aged; Adult; Surveys and Questionnaires; Heart Failure
PubMed: 38432645
DOI: 10.1016/j.jamda.2024.01.021 -
JAMA Network Open Feb 2024Burnout is a work-related syndrome of depersonalization (DP), emotional exhaustion (EE), and low personal achievement (PA) that is prevalent among internal medicine...
IMPORTANCE
Burnout is a work-related syndrome of depersonalization (DP), emotional exhaustion (EE), and low personal achievement (PA) that is prevalent among internal medicine resident trainees. Prior interventions have had modest effects on resident burnout. The association of a new 4 + 4 block schedule (4 inpatient weeks plus 4 outpatient weeks) with resident burnout has not previously been evaluated.
OBJECTIVE
To evaluate the association of a 4 + 4 block schedule, compared with a 4 + 1 schedule, with burnout, wellness, and self-reported professional engagement and clinical preparedness among resident physicians.
DESIGN, SETTING, AND PARTICIPANTS
This nonrandomized preintervention and postintervention survey study was conducted in a single academic-based internal medicine residency program from June 2019 to June 2021. The study included residents in the categorical, hospitalist, and primary care tracks in postgraduate years 1 and 2 (PGY1 and PGY2). Data analysis was conducted from October to December 2022.
INTERVENTION
In the 4 + 4 structure, resident schedules alternated between 4-week inpatient call-based rotations and 4-week ambulatory non-call-based rotations.
MAIN OUTCOMES AND MEASURES
The primary outcome was burnout, assessed using the Maslach Burnout Inventory subcategories of EE (range, 0-54), DP (range, 0-30), and PA (range, 0-48), adjusted for sex and PGY. Secondary outcomes included In-Training Examination (ITE) scores and a questionnaire on professional, educational, and health outcomes. Multivariable logistic regression was used to assess the primary outcome, 1-way analysis of variance was used to compare ITE percentiles, and a Bonferroni-adjusted Kruskal Wallis test was used for the remaining secondary outcomes. The findings were reexamined with several sensitivity analyses, and Cohen's D was used to estimate standardized mean differences (SMDs).
RESULTS
Of the 313 eligible residents, 216 completed the surveys. A total of 107 respondents (49.5%) were women and 109 (50.5%) were men; 119 (55.1%) were PGY1 residents. The survey response rates were 78.0% (85 of 109) in the preintervention cohort and 60.6% (63 of 104) and 68.0% (68 of 100) in the 2 postintervention cohorts. The PGY1 residents had higher response rates than the PGY2 residents (119 of 152 [78.2%] vs 97 of 161 [60.2%]; P < .001). Adjusted EE scores (mean difference [MD], -6.78 [95% CI, -9.24 to -4.32]) and adjusted DP scores (MD, -3.81 [95% CI, -5.29 to -2.34]) were lower in the combined postintervention cohort. The change in PA scores was not statistically significant (MD, 1.4 [95% CI, -0.49 to 3.29]). Of the 15 items exploring professional, educational, and health outcomes, a large positive association was observed for 11 items (SMDs >1.0). No statistically significant change in ITE percentile ranks was noted.
CONCLUSIONS AND RELEVANCE
In this survey study of internal medicine resident physicians, a positive association was observed between a 4 + 4 block training schedule and internal medicine resident burnout scores and improved self-reported professional, educational, and health outcomes. These results suggest that specific 4 + 4 block combinations may better improve resident burnout than a 4 + 1 combination used previously.
Topics: Male; Humans; Female; Burnout, Psychological; Self Report; Inservice Training; Emotional Exhaustion; Hospitalists; Psychological Tests
PubMed: 38416498
DOI: 10.1001/jamanetworkopen.2024.0037 -
Clinics (Sao Paulo, Brazil) 2024To adapt the Scale of Perception of Respect for and Maintenance of the Dignity of the Inpatient (CuPDPH) to the Brazilian language and culture and to assess its...
Cross-cultural adaptation of the Scale of Perception of Respect for and Maintenance of the Dignity of the Inpatient (CuPDPH) to Brazilian Portuguese and its psychometric properties-A multicenter cross-sectional study.
OBJECTIVE
To adapt the Scale of Perception of Respect for and Maintenance of the Dignity of the Inpatient (CuPDPH) to the Brazilian language and culture and to assess its psychometric properties.
RESULTS
The scale was evaluated by 15 experts, and 239 patients from three tertiary hospitals in Rio de Janeiro. All participants signed a consent form. Data have shown adequacy of the model (KMO=0.839, Bartlett's test of sphericity: χ(171) = 2241.3, p = 0.000010), good adjusted content validity (CVC ≥ 0.90), internal consistency and reliability, such as α = 0.927.
DISCUSSION
CuPDPH is a rating scale on observable professional attitudes. Illnesses change lives and impose adaptation to a new situation, perceived as depersonalization, leading patients to try to regain control of their lives. Patients expressed "ill will" to fill out the scale. Psychiatric patients' scale filling time was higher than others. A sample from three Rio de Janeiro third-level hospitals may not reflect the country's population; also, this adaptation may not comprise all linguistic variations of Brazilian Portuguese and Portuguese-speaking countries.
CONCLUSION
The Portuguese version of the Scale of Perception of Respect for and Maintenance of the Dignity of the Inpatient (CuPDPH), a 19-item, six-component version is a reliable instrument to measure the perception of internal medicine, surgical, and psychiatric patients on the maintenance of their dignity in Rio de Janeiro, Brazil. This knowledge could be used in advancing research on patients' perception of dignity, as well as professional ethical competencies, staff-patient relationship skills, and leadership development in medical and other healthcare professional education.
Topics: Humans; Brazil; Cross-Cultural Comparison; Cross-Sectional Studies; Surveys and Questionnaires; Inpatients; Psychometrics; Respect; Reproducibility of Results; Language; Perception; Translations
PubMed: 38412639
DOI: 10.1016/j.clinsp.2024.100328 -
Scientific Reports Feb 2024The firefighting profession carries a heightened risk of musculoskeletal disorders. A firefighter's job is physically demanding and includes activities such as running,...
The firefighting profession carries a heightened risk of musculoskeletal disorders. A firefighter's job is physically demanding and includes activities such as running, climbing, dragging, and lifting. Often, these tasks are unpredictable, performed in harsh environments, and have been found to cause psychological stress. The purpose of this study was to investigate the effects of occupational stress on work-related musculoskeletal disorders (WRMSD) in firefighters. In addition, the mediating effects of depression and job burnout on proposed relationships were examined. Data informing this study were collected using a survey questionnaire. The survey questionnaire included the Beck Depression Inventory, the Center for Epidemiological Studies Depression Scale (CES-D), the Maslach Burnout Inventory, the Post Traumatic Stress Disorder Inventory (PCL), and the Nordic Musculoskeletal Questionnaire. Collected data were analyzed using structural equation modeling approach in AMOS. The results of the 2339 responding firefighters suggest that work related stress is positively related to WRMSDs in firefighters and can lead to musculoskeletal symptoms through four paths, being emotional exhaustion, personal accomplishment, CES-D total score, and depersonalization. Through depersonalization, job stress had the most significant impact on musculoskeletal symptoms (coefficient = 0.053). Furthermore, the results showed that post-traumatic stress disorders (PTSD) can affect musculoskeletal symptoms through ten paths, again through depersonalization, PTSD had the most significant impact on musculoskeletal symptoms (coefficient = 0.141). The results of this study suggest that organizations should design interventions and policies to prevent and manage occupational stress, depression, and job burnout to negate its undesired consequences on firefighters' health (i.e. WRMSD).
Topics: Humans; Firefighters; Depression; Occupational Stress; Burnout, Professional; Burnout, Psychological; Surveys and Questionnaires; Psychological Tests; Self Report
PubMed: 38409336
DOI: 10.1038/s41598-024-55468-w -
Biomedicines Feb 2024Physician burnout, characterized by chronic job-related stress leading to emotional exhaustion, depersonalization, and reduced personal accomplishment. This...
BACKGROUND
Physician burnout, characterized by chronic job-related stress leading to emotional exhaustion, depersonalization, and reduced personal accomplishment. This cross-sectional study investigates cortisol reactivity in male physicians with burnout compared to healthy controls during an acute psychosocial stress test.
METHODS
Sixty male physicians (30 burnout, 30 healthy controls) participated between September 2019 and December 2021 to investigate the impact of burnout on cardiovascular health. Salivary cortisol levels were measured before and after a Trier Social Stress Test (TSST). Burnout was assessed with the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). Covariates included age, BMI, and physical activity. Data were analyzed using repeated measures analysis and area under the curve analysis.
RESULTS
Male physicians with burnout exhibited significantly greater cortisol reactivity during the TSST, notably post-stress to 15 min post-stress. Emotional exhaustion correlated with reduced cortisol increase from pre-stress and smaller post-stress to 15- and 45-min declines.
DISCUSSION
Findings suggest heightened cortisol reactivity in male physicians with burnout, possibly reflecting initial chronic stress stages. This study highlights the necessity for long-term research on cortisol's influence on cardiovascular health and stress responses across diverse groups.
CONCLUSIONS
The findings contribute to comprehending physiological responses in burnout-afflicted physicians, emphasizing cortisol reactivity's pivotal role in stress-related research and its potential health implications, particularly within the burnout context.
PubMed: 38397938
DOI: 10.3390/biomedicines12020335 -
International Journal of Environmental... Jan 2024Work engagement represents a positive work-related state of mind characterized by three dimensions: Vigor (high levels of energy and mental resilience during work),...
Work engagement represents a positive work-related state of mind characterized by three dimensions: Vigor (high levels of energy and mental resilience during work), Dedication (strong involvement in one's work), and Absorption (complete-joyous immersion in one's tasks). This study aimed to investigate work engagement and burnout in health professionals in a private healthcare unit in Greece. A cross-sectional study was conducted with a sample of 151 professionals, including doctors, nurses, administrative staff, and other health professionals involved in this setting. The study duration was four months (January-April 2022). The questionnaire covered sociodemographic and work-related information, along with the Utrecht Work Engagement Scale and the Maslach Burnout Inventory. Regarding the subdimensions of the Utrecht Work Engagement Scale, participants demonstrated a moderate score in Absorption and medium to high scores in Vigor and Dedication. In terms of burnout, they showed a low score in Depersonalization, a medium score in Emotional Exhaustion, and a high score in Personal Accomplishment. Those with nonpermanent employment contracts scored higher in all dimensions of burnout compared to those with permanent employment contracts. Vigor, Dedication, and Absorption correlated negatively with Emotional Exhaustion and Depersonalization and positively with Personal Accomplishment. Vigor negatively predicted Emotional Exhaustion, Depersonalization, and Personal Accomplishment. In conclusion, healthcare professionals in the private healthcare sector in Greece demonstrate moderate work engagement and experience moderate burnout. There are differences in work engagement and burnout based on sociodemographic and work-related characteristics. Promoting work engagement (especially the dimension of Vigor) is essential to preventing and addressing burnout among healthcare professionals.
Topics: Humans; Cross-Sectional Studies; Greece; Burnout, Professional; Delivery of Health Care; Work Engagement; Psychological Tests; Self Report
PubMed: 38397621
DOI: 10.3390/ijerph21020130 -
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 -
European Journal of Investigation in... Feb 2024This study, which focuses on 227 participants (196 females and 31 males) comprising 187 clinical specialists and 40 surgical physicians, examines the prevalence of...
This study, which focuses on 227 participants (196 females and 31 males) comprising 187 clinical specialists and 40 surgical physicians, examines the prevalence of burnout in medical specialists. We investigate the effects of the emotional exhaustion (EE), Depersonalization (D), and personal accomplishment (PA) dimensions on professional satisfaction and plans to change careers using the modified licensed Maslach Burnout Inventory-Human Services Survey (MBI-HSS (MP)). High emotional exhaustion is reported by 52.63% of men and 71.28% of women in the clinical medicine group ( = 188). In the surgical specialties ( = 39), scores are significantly higher, with 75% of men and 77.77% of women reporting EE. In our sample group, 71.36% express high levels of emotional exhaustion, with similar patterns across specialization and gender. Clinical medicine respondents report high degrees of depersonalization in 33.13% of females and 21.05% of males, while surgical specialty respondents report high levels in 33.33% of females and 50% of males. Across genders and specializations, 33.03% of all respondents show high levels of depersonalization. Clinical medicine participants report high levels of personal accomplishment (42.60% of females and 42.10% of males), whereas surgical specialties report 44.44% of females and 66.66% of male on the PA dimension. Of the total number of respondents, 44.05% report having a high level of personal accomplishment; differences exist depending on specialty and gender. In addition, questions regarding professional fulfilment and intention to change careers were presented to the participants. A total of 53.40% (16 male and 105 female) of the clinical medicine respondents said they intended to change careers, while 33 participants (9 male, 34 female) doubted if they would remain in the same specialization. Furthermore, 86 individuals (9 male and 77 female) in the surgical specialties said they would never choose to work in healthcare again. Regression analysis suggests that being male, higher in age, and working in surgical specialties with lower job satisfaction and a higher intention to change profession are associated with higher levels of EE. Age and work satisfaction are significant predictors of depersonalization, and higher career satisfaction is associated with increased levels of PA.
PubMed: 38391488
DOI: 10.3390/ejihpe14020021