Reducing fatigue-related symptoms in Long COVID-19: a preliminary report of a lymphatic drainage intervention.

In the early days of the first global wave of the COVID-19 pandemic, the potential for a postviral syndrome to manifest following COVID-19 infection was first recognized. Here, we present an analysis of a case series of the first 20 patients' data collected in clinical practice to evaluate the potential of a possible alternative treatment for Long COVID. Methods: Face-to-face treatment sessions with Perrin technique practitioners occurred weekly involving effleurage/other manual articulatory techniques. The individuals being treated also undertook daily self-massage along with gentle mobility exercises. Patients recorded symptom severity using the self-report 54-item profile of fatigue-related states (PFRS) before and after treatment. Results: The mean age of male patients was 41.8 years (range, 29-53 years), and for female patients, 39.3 years (range, 28-50 years). None of the participants had a prior diagnosis of chronic fatigue syndrome, and all were new attendees to the clinics at the time of initial assessment. The average number of treatment sessions was 9.7 in men and 9.4 in women. The reduction in PFRS scores was 45% in men and 52% in women. The highest subscale scores on average were for fatigue, with the lowest for somatic symptoms. All subscale scores showed, on average, a similar reduction of approximately 50% postintervention, with the reduction in score relating to a decrease in the severity of symptoms. Conclusion: Our findings suggest that a specific manual lymphatic drainage intervention may help to reduce fatigue symptoms related to Long COVID. Perhaps preventing acute symptoms through early intervention.

Exploring Associations between Stressors and Burnout in Trainee Doctors During the COVID-19 Pandemic in the UK.

OBJECTIVE: The authors examined associations between stressors and burnout in trainee doctors during the COVID-19 pandemic. METHODS: An anonymous online questionnaire including 42 questions on general and pandemic-specific stressors, and the Maslach Burnout Inventory-Health Services Survey (MBI-HSS), was sent to 1000 randomly selected trainee doctors in North-West England. Main outcomes were burnout scores that were stratified into Emotional Exhaustion (EE), Depersonalisation (DP), and reduced Personal Accomplishment (PA) and associations between stressors and burnout using stepwise regression analysis. RESULTS: A total of 362 complete responses were received giving a response rate of 37%. Mean scores for EE, DP, and PA derived from the MBI-HSS were 27.7, 9.8, and 34.3 respectively. Twenty-three stressors were found to be associated with burnout dimensions. "Increase in workload and hours due to COVID-19," "Poor leadership and management in the National Health Service," and "Not feeling valued" were found to have strong associations with burnout dimensions. Only "Not confident in own abilities" was found to be associated with all burnout dimensions. CONCLUSIONS: Associations with burnout were found to be identified in a range of work, pandemic, and non-work-related stressors, supporting the need for multi-level interventions to mitigate burnout.

Cross-sectional study exploring the association between stressors and burnout in junior doctors during the COVID-19 pandemic in the United Kingdom.

OBJECTIVES: This study aims to develop a comprehensive list of stressors relevant to junior doctors and will also report findings exploring the associations between burnout and stressors, which include work and non-work-related stressors as well as pandemic-related stressors. METHODS: An anonymous online questionnaire was sent to 1000 randomly selected junior doctors in the North-West of England. The questionnaire included 37 questions on general and pandemic-specific stressors, and the Maslach Burnout Inventory Health Services Survey. The main outcomes of interest were junior doctor ratings of stressors and scores for burnout (emotional exhaustion [EE], depersonalisation [DP], and personal accomplishment [PA]). Stepwise regression analysis was undertaken to assess associations between stressors and burnout. RESULTS: In total, 326 responses were collected (response rate = 33%). Of the top 10 stressors rated by junior doctors, 60% were related to the pandemic. Multiple stressors were found to be associated with the burnout dimensions. Fatigue (ß = .43), pandemic-related workload increase (ß = .33), and feeling isolated (ß = .24) had the strongest associations with EE, whereas fatigue (ß = .21), uncertainty around COVID-19 information (ß = .22) and doing unproductive tasks (ß = .17) had the strongest associations with DP. Working beyond normal scope due to COVID-19 (ß = -.26), not confident in own ability (ß = -.24) and not feeling valued (ß = -.20) were found to have the strongest associations with PA. CONCLUSIONS: Junior doctors experience a combination of general stressors and additional stressors emerging from the pandemic which significantly impact burnout. Monitoring these stressors and targeting them as part of interventions could help mitigating burnout in junior doctors.

Contributors to stress and burnout in junior doctors during the COVID-19 pandemic

IntroductionJunior doctors have previously reported high levels of burnout;and additional stressors have likely emerged from the COVID-19 pandemic may further accelerate burnout. There is a need to identify which particular stressors are most likely to lead to burnout in junior doctors in order to develop appropriate interventions. Objectives1) To develop a comprehensive list of stressors that are relevant to junior doctors, which includes general work and non-work related stressors as well as stressors that have specifically emerged with the pandemic. 2) To assess which of these stressors are most strongly associated with burnout.MethodsAn anonymous online questionnaire was sent to 1000 randomly selected junior doctors in the North West of England between 10/07/20 to 04/08/20. It included 37 questions on general and pandemic-specific stressors, and the Maslach Burnout Inventory (MBI) Health Services Survey. Stepwise regression analyses were undertaken to assess associations between stressors and burnout.ResultsIn total, 326 responses were collected (response rate=33%). Of the top 10 stressors rated by junior doctors, 60% were related to the pandemic. Multiple stressors were found to be associated with the burnout dimensions. Fatigue (β=0.43), pandemic-related workload increase (β=0.33) and feeling isolated (β=0.24) had the strongest associations with Emotional Exhaustion, whereas fatigue (β=0.24), uncertainty around COVID-19 information (β=0.22) and doing unproductive tasks (β =0.22) had the strongest associations with Depersonalisation.ConclusionJunior doctors experience a combination of general stressors and additional stressors emerging from the pandemic which significantly to impact on burnout. Monitoring these stressors and targeting them as part of interventions could help mitigating burnout in junior doctors.