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Lancet Regional Health. Americas Nov 2022Burnout is common among doctors working in emergency departments. It has significant consequences and is multifactorial. Self-care and resilience tendencies may...
BACKGROUND
Burnout is common among doctors working in emergency departments. It has significant consequences and is multifactorial. Self-care and resilience tendencies may contribute to being burnt out, or not. This study explores burnout and resilience amongst physicians working in Caribbean emergency departments.
METHODS
Data were collected from 111 participants using the Maslach Burnout Inventory (MBI) and the Resilience Scale-14 (RS14) as measures of burnout and resilience, respectively. Questions collected data on participant demographics and characteristics related to self-care. The associations between demographic characteristics and total burnout and resilience scales were explored.
FINDINGS
Among participants, 88.6% had medium to high range emotional exhaustion, 82.8% exhibited medium to high range depersonalization, and 19.6% had low to medium range personal accomplishment. Participants in Barbados had higher emotional exhaustion and depersonalization scores (p=0.009), and those in a postgraduate programme had higher depersonalization scores (p=0.047). The mean RS-14 score was 81.1 out of a maximum of 98.0 with a standard deviation of 13.1 and a range of 26 to 98. Depression correlated with high emotional exhaustion scores (p=0.004) and low resilience scores (p<0.0001). Emotional exhaustion scores increased among participants using alcohol daily (p=0.01), using recreational drugs (p=0.021) and sleeping aids (p=0.028).
INTERPRETATION
High burnout, despite high resilience, is present in this sample of physicians working in emergency departments of teaching hospitals in the Caribbean. Although resilience scores were high, those with lower resilience tendencies had poorer self-care habits.
FUNDING
No external funding.
PubMed: 36778072
DOI: 10.1016/j.lana.2022.100357 -
Annals of Family Medicine Jul 2017Over the span of their career, physicians experience changes to their professional role and professional identity. The process of continual adaptation in their work...
Over the span of their career, physicians experience changes to their professional role and professional identity. The process of continual adaptation in their work setting incurs losses. These losses can be ambiguous, cumulative, and may require grieving. Grief in the workplace is unsanctioned, and may contribute to physicians' experience of burnout (emotional exhaustion, depersonalization, low sense of achievement). Acknowledging loss, validating grief, and being prescient in dealing with physician burnout is essential.
Topics: Burnout, Professional; Depersonalization; Grief; Humans; Physicians; Workplace
PubMed: 28694277
DOI: 10.1370/afm.2074 -
Journal of Psychiatric Research Jun 2023Dissociative and posttraumatic stress disorder (PTSD) symptoms are commonly co-occurring responses to psychological trauma. Yet, these two groups of symptoms appear to...
BACKGROUND
Dissociative and posttraumatic stress disorder (PTSD) symptoms are commonly co-occurring responses to psychological trauma. Yet, these two groups of symptoms appear to be related to diverging patterns of physiological response. To date, few studies have examined how specific dissociative symptoms, namely, depersonalization and derealization, relate to skin conductance response (SCR), a marker of autonomic function, within the context of PTSD symptoms. We examined associations among depersonalization, derealization, and SCR during two conditions - resting control and breath-focused mindfulness - in the context of current PTSD symptoms.
METHODS
Sixty-eight trauma-exposed women (82.4% Black; M = 42.5, SD = 12.1) were recruited from the community for a breath-focused mindfulness study. SCR data were collected during alternating resting control and breath-focused mindfulness conditions. Moderation analyses were conducted to examine relations among dissociative symptoms, SCR, and PTSD for these different conditions.
RESULTS
Moderation analyses revealed that depersonalization was linked to lower SCR during resting control, B = 0.0005, SE = 0.0002, p = .006, in participants low-to-moderate PTSD symptoms; however, depersonalization was associated with higher SCR during breath-focused mindfulness, B = -0.0006, SE = 0.0003, p = .029, in individuals with similar levels of PTSD symptoms. No significant interaction between derealization and PTSD symptoms on SCR was observed.
CONCLUSIONS
Depersonalization symptoms may associate with physiological withdrawal during rest, but greater physiological arousal during effortful emotion regulation in individuals with low-to moderate levels of PTSD, which has significant implications for barriers to treatment engagement as well as treatment selection in this population.
Topics: Humans; Female; Adult; Child; Depersonalization; Mindfulness; Stress Disorders, Post-Traumatic; Psychological Trauma; Dissociative Disorders
PubMed: 37172509
DOI: 10.1016/j.jpsychires.2023.05.028 -
Saudi Journal of Anaesthesia Jan 2012Anesthesiology may be stressful and most anesthesiologists develop mechanisms for coping. However, inexperienced trainee anesthesiologists seem to be vulnerable. We...
BACKGROUND
Anesthesiology may be stressful and most anesthesiologists develop mechanisms for coping. However, inexperienced trainee anesthesiologists seem to be vulnerable. We studied stress perception and job burnout in trainee anesthesiologists.
METHODS
Responses to perceived stress scale (PSS) and Maslach Burnout Inventory (MBI) were evaluated in 159 trainee anesthesiologists.
RESULTS
In our results, when perceived stress was increased, emotional exhaustion and depersonalization increased but personal accomplishment decreased, as expected. Perceived stress was very high in the early years of training. There was a negative correlation between age and emotional exhaustion and depersonalization, but positive correlation with personal accomplishment. Female anesthesiologists had higher personal accomplishment, but lower depersonalization points than male anesthesiologists in our study. There was no statistical association between marital status, PSS, and MBI; ≥2 children group had a significant high personal accomplishment but low depersonalization and emotional exhaustion scores. Line regression analysis showed a statistically significant relationship between PSS and emotional exhaustion and between age and depersonalization.
CONCLUSIONS
Social factors such as gender and number of children affect the work life of our trainees.
PubMed: 22412777
DOI: 10.4103/1658-354X.93059 -
CJEM Apr 2022A previous survey of Canadian emergency medicine (EM) physicians during the first wave of the COVID-19 pandemic documented less than 20% experienced high levels of...
OBJECTIVES
A previous survey of Canadian emergency medicine (EM) physicians during the first wave of the COVID-19 pandemic documented less than 20% experienced high levels of burnout. This study examined the experience of a similar group of physicians during the second pandemic wave. We reported the associations between burnout and physician age, gender, having children at home and training route.
METHODS
This study utilized a national survey of Canadian emergency physicians. We collected data on demographics and measured burnout using the Maslach Burnout Inventory (MBI). Multiple logistic regression models identified associations between the emotional exhaustion and depersonalization domains of the MBI and EM physician demographics (age, gender, children living at home, and training route).
RESULTS
Between November 25, 2020, and February 4, 2021, 416 emergency physicians completed the survey, representing all Provinces or Territories in Canada (except Nunavut). The mean participant age was 44, 53% were male, 64% had children living at home and 41% were FRCPC and 41% CCFP-EM trained. Sixty percent reported high burnout (either high emotional exhaustion and/or high depersonalization). Increasing age was associated with lower emotional exhaustion and depersonalization; female or nonbinary gender was associated with an increase in emotional exhaustion; and having children living at home was associated with lower depersonalization.
CONCLUSIONS
Most Canadian emergency physicians participating in our study during the COVID-19 pandemic reported high burnout levels. Younger physicians and female physicians were more likely than their coworkers to report high burnout levels. Hospitals should address emergency physician burnout during the pandemic because it is a threat to quality of patient care and retention of the workforce for the future.
Topics: Burnout, Professional; Burnout, Psychological; COVID-19; Canada; Child; Emergency Medicine; Female; Humans; Male; Pandemics; Physicians; Surveys and Questionnaires
PubMed: 35084710
DOI: 10.1007/s43678-021-00259-9 -
Annals of Family Medicine 2021We investigated whether physician race and ethnicity were associated with burnout among a nationally representative sample of family physicians. (Observational Study)
Observational Study
PURPOSE
We investigated whether physician race and ethnicity were associated with burnout among a nationally representative sample of family physicians.
METHODS
We undertook a cross-sectional observational study using survey data from 1,510 American Board of Family Medicine recertification applicants in 2017 and 1,586 respondents to the 2017 National Graduate Survey. Of the 3,096 total family physicians, 450 (15%) were from racial and ethnic groups underrepresented in medicine. We used structural equation models to test the effects of underrepresented status on single-item measures of emotional exhaustion and depersonalization.
RESULTS
Family physicians underrepresented in medicine were significantly less likely than their non-underrepresented counterparts to report emotional exhaustion (adjusted odds ratio = 0.82; 95% CI, 0.69-0.99; total effect) and depersonalization (adjusted odds ratio = 0.54; 95% CI, 0.41-0.71; total effect). The underrepresented physicians were more likely than non-underrepresented peers to practice in more racially and ethnically diverse counties and less likely to practice obstetrics, both of which partly mediated the protective effect of underrepresented status on depersonalization.
CONCLUSIONS
Although factors such as racism might be expected to adversely affect the well-being of underrepresented clinicians, underrepresented family physicians reported a lower frequency of emotional exhaustion and depersonalization. The mediating protective effect of working in more racially and ethnically diverse counties is consistent with evidence of the beneficial effect of cultural diversity on health outcomes for minorities. Because physician burnout is a known predictor of job turnover and may also be associated with poorer quality of care, the lower burnout observed among underrepresented family physicians may be an asset for the health care system as a whole.
Topics: Adult; Burnout, Professional; Burnout, Psychological; Child; Cross-Sectional Studies; Ethnicity; Female; Humans; Job Satisfaction; Occupational Stress; Physicians, Family; Social Environment; Surveys and Questionnaires
PubMed: 34264839
DOI: 10.1370/afm.2696 -
Psychiatria Polska 2016The symptoms of dissociation, depersonalization and derealization are often associated with exposure of patients to mental and physical injuries, usually occurring in...
INTRODUCTION
The symptoms of dissociation, depersonalization and derealization are often associated with exposure of patients to mental and physical injuries, usually occurring in childhood. Most of these observations were carried out in populations of patients with various disorders (posttraumatic, conversion-dissociation, personality disorders - especially borderline), who reported their exposure to adverse life circumstances through questionnaire interviews.
AIM
Assessment of the risk associated with various traumatic events in childhood and adolescence concerning the symptoms of pain and tactile dissociation, depersonalization and derealization.
MATERIAL AND METHOD
The coexistence of the earlier life circumstances and the currently existing symptoms was examined on the basis of KO "0" Symptom Checklist and Life Inventory, completed prior to treatment in a day hospital for neurotic disorders.
RESULTS
In the group of 2582 women, patients of a day hospital for neurotic and personality disorders, the symptoms of pain and tactile dissociation, depersonalization and derealization were present in 24-36 % of patients, while the maximum severity of these symptoms reported approximately 4-8 % of patients. The studied patients reported the exposure during childhood and adolescence (before 18yo) to numerous traumatic events of varying severity and frequency, including hostility of one parent (approximately 5% of respondents), the sexual initiation before 13yo (1%), worse than peers material conditions (23%), harassment of the family of origin (2%), reluctance of their peers (9%). Conducted regression analysis showed illustrated by the coefficients OR (odds ratios) a statistically significant relationship between the majority of the analyzed symptoms and many of the listed events, such as being regarded as worse than siblings, mother's anger in the situation of the patient's disease in childhood, lack of support, indifference of parent, poverty and worseness of the family of origin, inferior position in the classroom and the school grades, total sexual unawareness, incest or its attempt.
CONCLUSIONS
The symptoms of dissociation, depersonalization and derealization occurred in significantly more patients reporting burdening life events - difficult situations in childhood and adolescence. Therefore, in clinical practice in patients presenting such symptoms, regardless of diagnosis (e. g. a specific neurotic disorder), we can expect revealing information about such events.
Topics: Adult; Adult Survivors of Child Adverse Events; Depersonalization; Dissociative Disorders; Female; Humans; Middle Aged; Neurotic Disorders; Pain; Women's Health
PubMed: 27086330
DOI: 10.12740/PP/OnlineFirst/36296 -
Investigacion Y Educacion En Enfermeria Feb 2020Investigate the burnout syndrome among undergraduate students in nursing.
OBJECTIVES
Investigate the burnout syndrome among undergraduate students in nursing.
METHODS
Explanatory sequential mixed method study conducted at a public university in Brazil. Of the 119 nursing students, 114 consented to participate and answered a questionnaire composed of sociodemographic, academic variables, and the Maslach Burnout Inventory - Student Survey, which were analyzed by multiple linear regression. The participants of the quantitative phase with the indicative / risk of burnout were interviewed individually (n=21) to provide an in-depth understanding of the students' experiences regarding the dimensions of the syndrome, whose statements were analyzed by the Collective Subject Discourse.
RESULTS
The prevalence of burnout syndrome was 10.5% among the surveyed. The more advanced the school year, the higher were the exhaustion (p=0.003), depersonalization (p < 0.001) and low academic effectiveness (p=0.012) scores. Students with a higher workload of assignments also had higher scores of exhaustion (p=0.001), depersonalization (p < 0.001) and academic (in)effectiveness (p=0.042). Dissatisfaction with the course was related to higher exhaustion (p=0.049) and depersonalization (p=0.001). The collective speeches showed the daily demands of the course, considered as intense, producing overload and exhaustion, which produced symptoms of physical and mental illness. Thus, there was the student's distancing from the course activities, as a defensive attitude, which culminated in feelings of incompetence and frustration.
CONCLUSIONS
The occurrence of burnout syndrome dimensions among nursing students was related to the activities of academic daily life. It is urgent to invest in health promotion and prevention actions of these individuals in the university context.
Topics: Academic Performance; Adolescent; Adult; Brazil; Burnout, Professional; Curriculum; Depersonalization; Education, Nursing, Baccalaureate; Female; Health Surveys; Humans; Linear Models; Male; Prevalence; Qualitative Research; Students, Nursing; Workload; Young Adult
PubMed: 32124575
DOI: 10.17533/udea.iee.v38n1e07 -
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 -
Psychiatry Research Oct 2020The dissociative subtype of posttraumatic stress disorder (D-PTSD) is estimated to occur in approximately 14% of those with posttraumatic stress disorder (PTSD), and is...
The dissociative subtype of posttraumatic stress disorder (D-PTSD) is estimated to occur in approximately 14% of those with posttraumatic stress disorder (PTSD), and is characterized by clinically significant dissociative symptoms in addition to typical PTSD symptoms. Prior research has found childhood maltreatment contributes to dissociation and D-PTSD susceptibility, but more nuanced questions about the nature of childhood maltreatment remain unexplored. We investigated how childhood maltreatment type and severity are associated with the dissociative symptoms of D-PTSD among women with PTSD (N = 106) receiving psychiatric care at a program specializing in trauma-related disorders. Participants completed self-report surveys of psychiatric symptoms and prior trauma exposure including the PTSD Checklist for DSM-5, the Dissociative Subtype of PTSD Scale, and the Childhood Trauma Questionnaire. We used multivariate linear regression to model the association of childhood maltreatment types and dissociation. In our final model childhood emotional abuse and physical abuse significantly predicted the dissociative symptoms of D-PTSD. This suggests childhood maltreatment type and severity, in particular of emotional and physical abuse, are associated with the dissociative symptoms of D-PTSD. This work points toward potential etiological contributions to D-PTSD.
Topics: Adolescent; Adult; Adult Survivors of Child Abuse; Child Abuse; Cross-Sectional Studies; Depersonalization; Diagnostic and Statistical Manual of Mental Disorders; Dissociative Disorders; Female; Humans; Male; Middle Aged; Physical Abuse; Predictive Value of Tests; Stress Disorders, Post-Traumatic; Surveys and Questionnaires; Young Adult
PubMed: 32736266
DOI: 10.1016/j.psychres.2020.113301