Burnout and Wellbeing during the Second Covid-19 Wave: Are There Differences between Medical Specialties?

Introduction: Burnout is common amongst clinical staff. Critical Care is widely accepted to have amongst the highest rates, with an incidence of >38%.1 The Covid-19 pandemic placed unprecedented pressures on staff, making them vulnerable to burnout.2 Although stressors were similar across medical teams, we suspected there were differences in burnout between medical specialties. Objective(s): This study aimed to examine burnout amongst the hospital MDT, focussing on three higher care clinical areas: Coronary Care (CCU), Respiratory (RSU) and Critical Care (ICU) and identify recurring positive and negative experiences. Method(s): Between March and April 2021 staff were invited to complete a two-part survey. Part one investigated demographic data and free text answers on feelings towards Covid-19. Part two questioned recipients on the 22 questions of the MBI -HSS (Maslach Burnout Index- Human Services Survey).3 This survey assesses burn-out in three domains: Emotional Exhaustion (EE), Depersonalisation (DP), and lack of Personal Accomplishment (PA). MBI-HSS results were analysed and a previously used 'high-risk' cut-off was used to calculate percentages per domain and overall. Free text analysis was conducted by two researchers to identify common themes, protective factors and negative factors which may increase burnout. Result(s): 148 staff members responded to the survey: 53% of respondents met the criteria for burnout in at least one domain. 58% of ICU staff, 42% of RSU staff and 44% of CCU staff were burnt out in one domain or more. ICU had the highest percentage of staff at high risk of EE and lack of PA. RSU had the highest percentage of staff scoring highly for DP. Free text analysis demonstrated some positive experiences from the Covid-19 pandemic: teamwork, communication, resilience, and opportunities to learn new skills were highlighted by staff across all areas. All areas found staffing and workload a negative factor. In ICU, workspace organisation and long shifts in PPE were key stressors which made communication and taking breaks safely difficult. Managing stress and uncertainty were highlighted by the ICU teams. In RSU, a significant proportion of staff found the lack of established treatments and poor outcomes difficult to manage, potentially highlighting the differences in Covid-19 management compared with ICU. As nursing staff work with higher ratios in RSU, some found managing patients' needs difficult: "Not having enough time to care for patients' basic needs . . . patients in side-rooms were left feeling isolated and scared". In CCU, there was a shift towards fear of catching the virus, PPE provision and poor infection control guidance, possibly arising from lower exposure to Covid-19: "It felt like the trust didn't give a s**t about their staff with regard to PPE and vaccinations." Conclusion(s): All clinical areas highlighted increased teamwork as a positive outcome of the Covid-19 pandemic, and good relationships have been built, a known protective factor against burnout. Many negative factors have impacted the rate of burnout, including high workload, staffing issues, redeployment and managing death and uncertainty. We hope to resurvey the same areas to assess wellbeing one year on, and address key factors to improve wellbeing.

Euro-Burn I: Assessment of burnout syndrome in health workers in a mediterranean country during the SARS-CoV-2 pandemic.

BACKGROUND: Burnout syndrome (BS) has a negative impact among health professionals. AIMS: Our research objective is to quantify the level of burnout in health workers of the Spanish National Health System during the COVID-19 pandemic using and comparing two independent measurement instruments. METHODS: Cross-sectional, descriptive and multicenter study conducted through an anonymous online survey among health workers of the National Health System, measuring the level of burnout using the Maslach Burnout Inventory (MBI) and the Copenhagen Burnout Inventory (CBI). RESULTS: A total of 448 questionnaires were analyzed, the mean age of the participants was 43.53 years (range: 20-64), 365 (81.5%) women. 161 (35.9%) participants presented BS measured with the MBI and 304 (67.9%) measured with the CBI. Regarding work contract, those who had greater job stability presented a higher degree of cynicism with respect to the eventual ones (p = .010), the eventual ones presenting higher mean scores in professional efficacy (p = .034). Urban workers had higher scores of exhaustion (p < .001) and cynicism (p < .001) than those living in rural areas. When comparing both tests, a high predictive value for exhaustion and cynicism was found to measure BS through the CBI (AUC = 0.92 and 0.84, respectively) and a low AUC with respect to the predictive value for efficacy (AUC = 0, 59). CONCLUSIONS: The results obtained show a high level of BS among the health workers who participated in our study. Both tests have an excellent correlation in the degree of exhaustion and cynicism, but not in efficacy. The BS measurement must be performed with at least two validated instruments to increase its reliability.

Features of the mental state of doctors of various specialties during the COVID-19 pandemic.

In the context of the COVID-19 pandemic, the burden on healthcare professionals at all levels has increased significantly, especially those who are at the forefront of the fight for patients' lives. Physicians directly caring for COVID-19 patients are exposed to excessive stress and significant biological and psychosocial risk. Objective. To identify the features of the mental state of doctors of various specialties during the COVID-19 pandemic. Material and methods. The study included 85 doctors of the Arkhangelsk region: 41 anesthesiologists/intensive care physicians (mean age 32.4+/-5.0 years) and 44 general practitioners (mean age 38.9+/-4.2 years). The study was conducted during the third wave of the COVID-19 pandemic (from May to June 2021). We used the following study methods: questionnaire, psychological testing (K. Maslach and S. Jackson Burnout Inventory (MBI), Beck's Depression Inventory, Perceived Stress Scale, World Health Organisation-Five Well-Being Index), mathematical and statistical processing of empirical data. Results and discussion. Analysis of the results showed that about half of the surveyed general practitioners and only 3 (7.3%) of the anesthesiologists/intensive care physicians had a history of COVID-19, having contracted it while performing professional duties. Manifestations of maladaptation, such as low professional competence, lack of soft skills, aggressiveness, introversion, risktaking, recklessness, and family problems, are more pronounced in anesthesiologists/intensive care physicians. They were more likely to have negative emotions and feelings, were less satisfied with themselves and life in general, and had a lower well-being index than general practitioners. General practitioners overestimated their professional burnout severity and more often complained about their state of health. Correlation analysis of the examination results for anesthesiologists/intensive care physicians allowed us to identify direct relationships between the level of perceived stress, overstrain and depression, low mood, difficulties in relationships with relatives and colleagues, dissatisfaction with various aspects of life, inverse relationships between the level of perceived stress and the well-being index. In general practitioners, direct relationships were established between perceived stress and overexertion, and inverse relationships were established between the level of perceived stress, the well-being index, and the reduction of personal achievements. Conclusion. The COVID-19 pandemic negatively impacts anesthesiologists/intensive care physicians more than general practitioners, causing negative emotions and maladaptation. In primary care physicians, the pandemic increases mobilization processes to address emerging professional challenges. Therefore, special attention should be paid to psychological support for anesthesiologists/intensive care physicians.Copyright © 2023, Media Sphera Publishing Group. All rights reserved.

Senior Vs. Junior Urology Trainees: Factors Associated with Burnout

INTRODUCTION AND OBJECTIVE: Burnout is one of the many challenges physicians may face in their careers. While there are studies focusing on burnout among surgical specialties, there are limited studies focusing on burn out at different levels of training. The aim of this study is to measure and compare rates of burnout between junior and senior trainees in urological surgery as well as to identify changes in training that could be made to improve work-life balance. METHOD(S): To assess professional burnout, respondents completed the 22-item Maslach Burnout Inventory Human Services Survey as part of the 2019 AUA census. Respondents were categorized into junior trainees (PGY1, PGY2, PGY3) and senior trainees (PGY4, PGY5, and fellow). RESULT(S): A total of 512 respondents were included. Senior trainees represented 57% while junior trainees represented 43% of the total cohort. The prevalence of burnout (p=0.005) and high levels of depersonalization (p=0.018) were 50% in junior trainees and 38% in senior trainees. High levels of emotional exhaustion were 9% for junior and 5% for senior trainees (p=0.053) (Table 1). The top changes to improve work life balance for urology trainees were access to meal plans, on-call rooms, and time to attend health appointments (Figure 1). CONCLUSION(S): Juniors experience higher levels of burnout, depersonalization, and emotional exhaustion when compared to seniors. Providing meal plans, on-call quarters, and time to attend health appointments are the top changes to improve work-life balance among urology trainees. These changes may have a dramatic impact on the well-being of our trainees, especially in this post-COVID era. (Figure Presented).

Validity and reliability of the Thai version of the Zoom Exhaustion and Fatigue Scale (ZEF-T)

Objective: Overuse of video conferencing during the COVID-19 pandemic may contribute to the new mental health problem called 'Zoom fatigue'. This study examined convergent validity, factor validity, internal consistency and test-retest reliability of the Thai version of the Zoom Exhaustion & Fatigue Scale (ZEF-T). Method(s): The participants were 386 medical students from Thammasat University. Convergent validity was based on comparing ZEF-T scores with the Maslach Burnout Inventory-Student Survey (MBI-SS). Confirmatory factor analysis (CFA) was done to examine factor validity. Test-retest reliability was evaluated in 25 participants using intraclass correlation coefficient (ICC) and Bland-Altman plot. Result(s): The ZEF-T demonstrated a positive correlation with emotional exhaustion of MBI-SS. (r = 0.42, p < 0.001). The CFA showed a satisfactory fit and supported the five-factor model with acceptable fit statistics. All items had factor loading of more than 0.7. Internal consistency and test-retest reliability of the total ZEF-T scores was excellent with the alpha of 0.93 and ICC 0.94 (p < 0.001), respectively. Conclusion(s): The ZEF-T was shown to be a valid and reliable assessment for measuring zoom fatigue in Thai university students.Copyright © 2023 IACFS/ME.

Burnout and Covid-19 Vaccination Intention among Dentists in Bulgaria: A Survey

Introduction: Dentists are potential candidates for burnout due to the specifities in clinical practice and additional external factors initiated by the current pandemic. The aim of this study was to investigate dentists'intentions and attitudes toward COVID-19 vaccination and to examine how the latter were associated with the levels of their occupational burnout. Material(s) and Method(s): An anonymous validated 43-question survey, including demographic and pandemic questions and the Maslach Burnout Inventory (MBI), was administered to a random sample of 1405 dentists from 73 settlements in Bulgaria. The data was analyzed with IBM SPSS Statistics 25.0 using standard descriptive statistics, one way ANOVA, Kolmogrov-Smirnov, and Shapiro-Wilk tests, Kruskal-Wallis H test and Mann-Whitney U test. Result(s): Overall, 387 dentists responded to the survey (response rate 27.5%). All three dimensions of burnout corresponded to moderate level of burnout (EE - 21.29+/-12.49, DP - 10.17+/-6.20 and PA - 34.76+/-7.87). A large proportion of respondents (n=151;39.0%) reported they did not intend to get vaccinated and almost 1/4 of dentists (n = 95;24.5%) believed that COVID-19 vaccines would have many side effects. COVID-19 vaccine unwillingness was significantly linked to the elevated levels of emotional exhaustion and depersonalization (p<0.05). There was also a significant relationship between vaccine side effects beliefs and burnout dimensions(p<0.05). Conclusion(s): Dentists'occupational burnout and intentions for vaccination were significantly associated. Developing programs to reduce vaccination hesitancy, increase trust and build favorable attitudes is vital for controlling the COVID-19 pandemic and can play a role in protection of psychological well-being of dentists.Copyright © 2023 by the authors. License to CARBONE EDITORE S.R.L., Palermo, Italy.

To Compare The Coping Strategies, Emotional Reactions, Burnout And Resilience In Doctors Caring And Not Caring For Covid19 Patients

Background: Rapid transmission of novel coronavirus (COVID-19) causing severe acute respiratory syndrome coronavirus 2 (SARSCoV- 2) occurred all across the world in few months causing a pandemic. Frontline medical staff as a result of heavy workload, insufficient protective equipment, a lack of information of the pathogen, and direct contact with patients faced the fear of getting infected themselves and their family. Anxiety, stress, and other negative emotions have led to a series of psychological crises in them. Aim(s): To compare the coping strategies, emotional reactions, burnout and resilience in doctors caring and not caring for COVID19 patients. Materials And Methods: Total 304 Doctors in tertiary care hospitals out of which 163 were caring and 141 were not caring for COVID19 patients participated in our study. Both groups were assessing and compared using The Fear of COVID-19 Scale, the coronavirus anxiety scale (CAS), Patient Health Questionnaire-2 (PHQ-2), Primary Care PTSD Screen for DSM-5 (PC-PTSD-5), Brief COPE, Connor-Davidson Resilience Scale abbreviated, Abbreviated Maslach Burnout Inventory, Two-Item Conjoint Screen (TICS) Results: All participants those who did COVID duty and those who did not do it showed high level of resilience though on comparison no significant different was found between two groups. Those who did not do COVID duty were scored higher in emotion focused coping strategies whereas who did not do COVID duty scored higher in avoidant coping strategies. Abbreviated version of Maslach Burnout Inventory indicated a great personal accomplishment, less depersonalization and low emotional exhaustion in all the participants irrespective of their duty status. Conclusion(s): On comparing those who did COVID duties against those who haven't, it was found that those who did not do COVID duty used more emotion-focused ways to cope and those who were doing COVID duties were using harmful avoidant coping to manage their daily chores. All the doctors participating in study showed high resilience irrespective of whether they did COVID duty or not.Copyright © 2022 Wolters Kluwer Medknow Publications. All rights reserved.

Junior Doctor Burnout Following the First Wave of the Covid-19 Pandemic

Objective The aim of the present study was to assess the burden of burnout in junior medical staff working across all surgical specialities at Great Ormond Street Hospital following the first wave of the COVID-19 pandemic. Methods We conducted a cross-sectional study in surgical junior doctors at Great Ormond Street Hospital following relaxation of the COVID-19-related restrictions at the end of June 2020. Burnout was evaluated using the Maslach Burnout Inventory (MBI). This is a widely-used validated questionnaire, which evaluates burnout across three domains: emotional exhaustion depersonalisation and personal accomplishment. All responses were anonymised points (0-6) were awarded for each response and composite scores were generated using an online tool. The degree of burnout was classified as low medium or high for each of the three domains using standardised score ranges. Results A total of 25 surgical junior doctors were included in our study. The response rate was 48% and scores from 12 fully completed MBI-HSS were included in subsequent analysis. 10 of the responders (83%) reported high burnout levels in at least one domain and 6 (50%) across at least two domains. The main contributor to burnout was the lack of feeling of personal accomplishment that was found to be high in 67% medium in 25% and low in 8% of the responders. We also found significant levels of emotional exhaustion (high: 42%;medium 42%;low 17%) as well as depersonalisation (high: 42%;medium 42%;low 17%). Conclusions Our study confirms the significant burden of burnout among junior doctors working in surgical specialities at Great Ormond Street Hospital for Children during the first wave of the COVID-19 pandemic. This could have detrimental effects on both doctor health and patient outcomes. Future work needs to focus on strategies to improve junior doctor wellbeing and prevent burnout.

The Relationship between Burnout Syndrome and Working Alliance in Psichiatric Residential Facilities: A Focus on Schizofrenia Spectrum Disorder

Introduction: Literature, especially following the COVID-19 pandemic, has given considerable attention to burnout experienced by mental health professionals. Burnout is a multidimensional syndrome that has three indicators (1): emotional exhaustion (EE, fatigue that can be related to devoting excessive time and effort to a task that is not perceived to be beneficial), depersonalization (DP, distant or indifferent attitude towards work, and negative interactions with colleagues and patients), and reduced personal accomplishment (PA, negative evaluation of the worth of one's work and generalized poor professional self-esteem) for the worker. Burnout does not solely impact the wellbeing and quality of life of health professionals but also induces a decline in the quality of care provided to clients. Studies of mental health professionals have shown that this condition could be triggered by associated working stressors including overload, time pressure, understaffing, negative social climate in the workplace, conflicts with patients, job insecurity, and organizational changes. As burnout has important implications for the quality of care, it is essential that the factors which influence burnout and its implications are explored in different contexts, such as in the context of residential facilities (RFs). Workers in the field of mental health are more vulnerable to burnout, as compared with other health professionals (2) because of stigma of the profession, threats of violence from patients and patient suicide and highly demanding therapeutic relationships (3). In a systematic review and meta-analysis, O'Connor and colleagues (4) investigated the prevalence and determinants of burnout in mental health professionals highlighting that staff working in community mental health teams may be more vulnerable to burnout than those working in some other specialist community teams. The key issue that is often left out in literature is the measure of the quality of the health professionals' relationship with patients. Since both the health professional's burnout and the working alliance between them and patients are predictors of therapy outcomes, understanding how burnout affects health professionals' relationship with patients is crucial. Working Alliance (WA) is a well-established index of this relationship as it represents the degree to which a treatment dyad is engaged in collaborative work (5). This construct has an enormous literature in the field of psychotherapy, but it has not been studied in the common treatment of individuals diagnosed with severe mental illness in terms of its relationship with burnout. To our knowledge, this is the first study to investigate the link between burnout among health professionals working in psychiatric RF and WA between individuals with SSD and staff in RF. Method(s): This study is part of a large multicentric observational study conducted in Italy: the DiAPAson study. The final sample of this study includes 303 patients living in RFs (69.3% males;41.0+/-9.8 years) and 164 health workers (27.4% males;41.2+/-9.9 years) of the 99 participating RFs. After collecting sociodemographic data, standardized assessment tools including clinician-administered tools (e.g., psychiatric history, illness duration, lifetime hospitalization stay, total number of psychiatric hospitalizations in the last year, time in the RF, antipsychotic therapy, Brief Psychiatric Rating Scale - BPRS, and Specific Levels of Functioning Scale - SLOF) for patients and self-administered scales (the Italian version of the Working Alliance Inventory short form for Patients, WAI-P;the Italian version of the Working Alliance Inventory short form for Staff, WAI-S;and the Maslach Burnout Inventory, MBI for Staff) were collected. We investigated the relationship between sociodemographic and clinical variables, staff's burnout and working alliance. After rejecting the hypothesis of normality of the variables (by Kolmogorov Smirnov test), we computed correlation matrices calculating Spearman's correlation coefficients. We perfor ed all the analysis with SAS Studio, R and SPSS, considering a p<0.05 value as statistically significant. Result(s): The staff sample presented high mean DP (13.8+/-9.6) while no high mean EE (3+/-3.5) neither low mean PA (38.4+/-5.7) were found according to O'Connor and colleagues' indications (4). Data show significative correlations between: MBI EE and BPRS (beta=0.17;p=0.005), SLOF (beta=-0.12;p=0.048) and WAI-S (beta=-0.17;p=0.003);MBI DP and BPRS (beta=0.22;p<0.001), SLOF (beta=-0.18;p=0.003), WAI-S (beta=-0.19;p=0.001), and WAI-P (beta=-0.13;p=0.028);MBI PA and patients' education years (beta=-0.146;p=0.014) and WAI-S (beta=0.26;p<0.001). Conclusion(s): The result of our large multicentric observational study suggested that health professionals working with SSD patients reported high scores on MBI for the DP domain. This datum is particularly worrying considering the theoretical framework that in 1978 brought to the reform of the Italian Health System that abolished the Psychiatric Hospitals in favor of a community-based treatment approach where the RF where conceived as a temporal intensive approach for the treatment of the most severe conditions, specifically thought to avoid long term seclusion, institutionalization, and patients' depersonalization. In our sample the burnout, specifically higher EE and DP was associated with more severe symptomatology (as measure with BPRS) and poor socio-occupational functioning. These associations are consistent with previous reports. Lower sense of PA was instead reported in working with patients with higher education grade. This effect could be partially associated with the WA. In fact, our data reported greater sense of PA with higher scores of WA as perceived by the staff, again associated with working with patients with lower education grade. WA as perceived by the staff significantly associate with other burnout domains, being inversely correlated with EE and DP. On the other hand, WA rated by the patients was also inversely associated with DP burnout domain. Even though no causal relationship could be assumed from our data, the clear association between burnout and WA, specifically regarding the DP domain, strongly reinforce the need to further investigate the WA between health professionals and RF patients suffering from SSD. Intervention directed toward the improvement of WA could be a complementary way to improve the quality of care provided to severe SSD patients and a way to reduce burnout.

Burnout syndrome increase during COVID-19 pandemic in attending Internal Medicine physicians.

INTRODUCTION: Burnout is a psychosocial syndrome caused by stressful situations in the workplace. It affects 30%-60% of medical professionals. The aim of this study is to carry out a comparative analysis of its frequency before and after the COVID-19 outbreak in Spanish internal medicine attending physicians. METHODS: Surveys that included the Maslach Burnout Inventory were sent via email and associated social networks to physicians who were members of the Spanish Society of Internal Medicine in 2019 and 2020. RESULTS: A non-significant increase in burnout was observed (38.0% vs. 34.4%). However, an increase in low personal fulfilment was observed (66.4% vs. 33.6%; p = 0.002), a dimension associated with the prevention of psychiatric morbidity, in addition to two others: emotional fatigue and depersonalization, which can negatively affect patient care. CONCLUSIONS: It is essential to address this syndrome individually and institutionally.

Assessment of Medical Students Burnout during COVID-19 Pandemic.

This study estimated the prevalence of burnout and its determinants among medical students at Jazan University during the COVID-19 pandemic. A total of 444 medical students completed an online survey containing the Maslach burnout inventory. The prevalence of burnout was 54.5%. Burnout reached its peak during the fourth year whereas it was the lowest in the internship year. Being a resident in mountain areas, being delayed in college-level, being divorced, and having divorced parents were all associated with an increased risk of burnout. During their time at medical school, students generally showed a trend of consistently high scores in the personal accomplishment subscale, a decreasing trend in the emotional exhaustion subscale, and an increasing trend in the depersonalization subscale. The most important predictive factor was having separated parents. Perceived study satisfaction appeared to be a significant protective factor in a dose-response manner. These findings suggest that burnout among medical students during the COVID-19 pandemic is a concern that should be monitored and prevented.

The relationship between physical activity and burnout among respiratory therapists in Jeddah City, Saudi Arabia.

Background/objective: Burnout is a condition in which a person feels physically fatigued and mentally drained. It occurs after a long period of work-related stress and may lead to mental disorders, such as depression and anxiety. Therefore, healthcare providers especially require early intervention. Regular physical activity has been reported to benefit individuals with mental illness, suggesting that a relationship between physical activity and burnout might exist. Hence, this study's objective was to analyze the relationship between physical activity and burnout among respiratory therapists and student interns in Jeddah City, Saudi Arabia. Methods: A cross-sectional descriptive study with respiratory therapists and interns working in public and private hospitals was conducted from November 2, 2020, to November 27, 2020. Participants responded to an electronic survey consisting of the Maslach Burnout Inventory - Human Services Survey for Medical Personnel, which measures the burnout dimensions of emotional exhaustion, depersonalization, and personal accomplishment. They also completed the International Physical Activity Questionnaire - Long Form and a demographic questionnaire. Results: Among the 250 eligible respiratory therapists and interns, data from the 152 respondents who completed the electronic survey were analyzed. Although no association between physical activity and burnout was found, a significant effect of the novel coronavirus disease 2019 (COVID-19) on physical activity and significant associations of high burnout (emotional exhaustion) with nationality and smoking were found. Conclusion: No association was found between burnout level and physical activity. Confounding factors, such as the COVID-19 pandemic during the study's data collection and analyses, likely contributed to the study's findings.

Burnout among oncologists, nurses, and radiographers working in oncology patient care during the COVID-19 pandemic.

INTRODUCTION: Oncology care professionals are exposed to high levels of stress that can lead to burnout. The aim of this study was to investigate the prevalence of burnout among nurses, oncologists and radiographers working in oncology patient care during the COVID -19 pandemic. METHODS: Our electronic questionnaire was sent to e-mail contacts registered in the system of the Hungarian Society of Oncologists and to all oncology staff via an internal information system in each cancer center. Burnout was measured using the Maslach Burnout Inventory, which measures depersonalization (DP), emotional exhaustion (EE), and personal accomplishment (PA). Demographic and work-related characteristics were collected in our self-designed questionnaire. Descriptive statistics, chi-square tests, two-sample t-tests, analyzes of variance, Mann-Whitney and Kruskal-Wallis tests were performed. RESULTS: A total of 205 oncology care workers' responses were analyzed. Oncologists (n = 75) were found to be significantly more committed to DP and EE (p = 0.001; p = 0.001). Working more than 50 h per week and being on-call had a negative effect on the EE dimension (p = 0.001; p = 0.003). Coming up with the idea of working abroad had a negative effect on all three dimensions of burnout (p ≤ 0.05). Respondents who did not leave their job due to their current life situation had significantly higher DE, EE, and lower PA (p ≤ 0.05). Intention to leave current profession was specific in (n = 24/78; 30.8%) of nurses (p = 0.012). CONCLUSION: Our results suggest that male gender, being an oncologist, working more than 50 h per week and taking on call duties have a negative impact on individual burnout. Future measures to prevent burnout should be integrated into the professionals' work environment, regardless of the impact of the current pandemic. IMPLICATIONS FOR PRACTICE: Prevention and oncopsychological training should be developed gradually at the organisational or personal level to avoid early burnout of professionals.

Burnout in OMFS Trainees and Consultants - A multi-centre study

Introduction/Aims: Burnout is a state of physical, emotional and mental exhaustion as a result of prolonged and excessive stress exposure at work. It is believed to affect at least 40% of surgeons. This study aims to understand how this affects OMFS trainees and consultants and identify the factors that contribute to burnout. Material(s) and Method(s): A questionnaire based on the psychometric properties of the Maslach Burnout Questionnaire - Human Survey Services (MBI-HSS) were studied amongst 65 Oral & Maxillofacial Surgery trainees and consultants across the UK over one week. The data was analysed. Results/Statistics: 58.5% respondents are male, 56.9% respondents are aged between 31-40 years and 69.2% respondents are married. 65.5% did dentistry first. 97% respondents worked during the COVID-19 pandemic. Based on the 22 items from MBI-HSS scale, majority of trainees/consultants demonstrated scores indicating high burnout: 67.7% respondents had scores of >26 in the emotional exhaustion scale, 90.7% had scores of >9 in the depersonalisation scale and 93.8% scored <34 in their personal accomplishment evaluation. >50% of respondents report working during COVID-19 and its effects as contributing factors to their burnout. Over 90% report administrative overload as key contributing factors. Childcare, financial, personal concerns and lack of sleep also contribute to it. Conclusions/Clinical Relevance: Burnout has been shown to be prominent in OMFS. COVID-19 has contributed to this. 60% of respondents think about leaving OMFS at least a few times a year, if not more. With this in mind, strategic interventions need to be implemented imminently to reduce burnout and promote mental health within the OMFS specialty Copyright © 2022

[Burnout syndrome increase during COVID-19 pandemic in attending Internal Medicine physicians]. / Aumento del síndrome de burnout en los adjuntos de Medicina Interna durante la pandemia de COVID-19.

Introduction: Burnout is a psychosocial syndrome caused by stressful situations in the workplace. It affects 30% to 60% of medical professionals. The aim of this study is to carry out a comparative analysis of its frequency before and after the COVID-19 outbreak in Spanish internal medicine attending physicians. Methods: Surveys that included the Maslach Burnout Inventory were sent via email and associated social networks to physicians who were members of the Spanish Society of Internal Medicine in 2019 and 2020. Results: A non-significant increase in burnout was observed (38.0% vs. 34.4%). However, an increase in low personal fulfilment was observed (66.4% vs. 33.6%; p = 0.002), a dimension associated with the prevention of psychiatric morbidity, in addition to two others: emotional fatigue and depersonalization, which can negatively affect patient care. Conclusions: It is essential to address this syndrome individually and institutionally.

Burnout in primary healthcare physicians and nurses in Turkey during COVID-19 pandemic.

BACKGROUND: Due to additional responsibilities and uncertainties during the COVID-19 pandemic, primary healthcare (PHC) workers are at increased risk of burnout. AIM: To determine and compare the burnout levels and related factors in PHC nurses and family physicians (FPs) during the COVID-19 pandemic. METHODS: An online survey was delivered to PHC workers. Non-random sampling method was used. To evaluate burnout, the Maslach Burnout Inventory was used, which investigates burnout in three categories: emotional exhaustion (EE), depersonalization (DP) and reduced personal accomplishment (PA). Multivariate linear regression was used to analyze factors associated with burnout for FPs and nurses separately. FINDINGS: Among the participants, 55.7% were nurses, the mean age was 42.34. FPs and nurses experienced similar levels of burnout in terms of EE. Family physicians had higher levels of low PA and DP. Based on the results of the multivariate analysis, while higher EE levels were significantly associated with unequal distribution of workload and communication problems within the Family Health Center for physicians, the unequal distribution of PPE, lack of appreciation by patients or colleagues and restrictions on work-related rights were relevant factors for nurses. Lack of appreciation and restrictions of the rights were associated with increased DP scores in both groups. Unequal distribution of workload was also associated with reduced PA among FPs. CONCLUSION: PHC physicians and nurses are affected by burnout in different ways under the conditions of the COVID-19 pandemic based on gender, socioeconomic status and working conditions. To protect the mental health of PHC workers in the next public health emergency, clarification in the organization of services, empowering PHC workers in emergency risk communication and provision of timely, adequate and free PPE is essential. It is also crucial to ensure the rights of health workers through macro policy changes especially during emergencies.

Evaluating the impact of coronavirus disease on burnout among healthcare workers using maslach burnout inventory tool: A systematic review

Background Burnout has been prevalent among healthcare workers (HCWs). However, the effect of the Coronavirus Disease (COVID-19) pandemic on this phenomenon in HCWs is unclear. Objective This systematic review aims to evaluate the impact of COVID-19 on burnout of HCWs using Maslach Burnout Inventory (MBI). Methods A systematic search was performed on PubMed database for articles published between 1 December 2019 and 30 June 2021. Search strategy combined terms for HCWs, COVID-19, burnout, and MBI. The main outcome of interest was burnout, including both mean prevalence and MBI scores for high emotional exhaustion (EE), high depersonalisation (DP) and low personal accomplishment (PA). Results Four cohort studies, 90 cross-sectional studies and one randomised-controlled trial were included for review. Only one cohort study compared burnout data among HCWs before and during COVID-19. It reported a statistically significant increase in mean EE and PA scores from 21.9 to 24.8 (p = .001), and 42.7 to 48.7 (p = .001), respectively. The remaining studies only evaluated burnout data during COVID-19 but were missing burnout data prior to the pandemic for comparison. Across these studies, the overall mean prevalence of burnout among HCWs was 39.95%, with mean MBI EE scores of 22.07, DP scores of 7.83, and PA scores of 32.53. Burnout outcomes were generally comparable across specific healthcare professions such as doctors and nurses. Conclusion Whilst quality research elucidating the effect of pandemic on burnout is lacking, current burnout prevalence among HCWs during COVID-19 is notable.

Assessing the Impact of the COVID-19 Pandemic on Pharmacy Faculty Burnout

Introduction: Burnout in academia is an issue of growing concern. The COVID-19 pandemic has increased the risk of burnout;however, the data are limited for pharmacy faculty and the associating factors have not been identified. Research Question or Hypothesis: To evaluate the factors contributing to burnout among pharmacy faculty during the COVID-19 pandemic. Study Design: Quantitative survey study Methods: Pharmacy faculty in the U.S. and Canada were invited to take part in a web-based survey. The survey collected demographic information, responses from the standardized Maslach Burnout Inventory Educators Survey (MBI-ES) and questions assessing how the pandemic has affected the respondent's personal and professional life. MBI-ES specifically measured emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA). Responses to each of the three MBI-ES subcategories were converted to a sum score. Factors contributing to burnout were identified by comparing the mean sum scores of the MBI-ES versus demographics, primary responsibilities, academic ranks, and other variables. Single-factor analysis of variance and the post-hoc Tukey HSD-Kramer test were used to determine statistical significance between groups. Result(s): We received 128 responses during a 10-week period. The mean sum scores for EE, DP, and PA for the entire cohort were 25.9, 6.1, and 33.6 respectively. These scores are higher than those from studies conducted before the pandemic, suggesting higher burnout in general. Junior faculty experienced higher burnout. Faculty with primarily research responsibilities experienced the greatest EE;those with primarily patient-care responsibilities experienced the most DP;and those with primarily didactic teaching responsibilities experienced the lowest PA. Factors having the most impact on burnout included increased workhours, having school-age children, and not having a consistent work location. Conclusion(s): Pharmacy faculty experienced a heightened level of burnout during the pandemic. Interventions should be targeted towards junior faculty, those with significant research responsibilities, and those with school-age children.

Assessing Wellness and Wellness Initiatives Across Medical Schools and Residency Programs: A Pre-vs. Post-Pandemic Comparison

Introduction &Objective: Burnout continues to increase in the healthcare field, particularly amongst our trainees, yet there is no 'gold standard' for preventing burnout or promoting wellness. Given reports on the impact of the COVID-19 pandemic on mental health combined with increased calls by institutional leadership to prevent burnout amongst healthcare workers, our objective was to assess wellness initiatives and burnout levels amongst trainees at the start and two years into the pandemic. Method(s): This was a prospective survey distributed to medical students and residents at two timepoints: (1) Peak onset of the COVID-10 pandemic (April-May 2020, N = 121) and two years later following vaccine availability and reductions in social distancing precautions (March 2022, N = 77). Trainees provided demographic information and described wellness or burnout prevention initiatives currently available to them. They also took two standardized assessments (Maslach Burnout Inventory, Perceived Stress Scale). Result(s): Satisfaction with burnout mitigation education appears in Figure 1. Trainees were only slightly satisfied with their current ability to reduce wellness and mitigate burnout, as well as with the education or training currently provided to them (ps <0.05). Over the two-year pandemic, trainees reported that the amount of wellness education provided by their program formally had increased (p < 0.01) but remained very low (p < 0.001). Trainees also reported less ability to fulfil work requirements without compromising their own health and wellness (p < 0.001). Although levels of burnout (MBI) and stress (PSS) did not differ across training level (p > 0.1), scores on the MBI were significantly related to perceived need for additional wellness education and training (ps <0.05). Conclusion(s): Even following calls from leadership to increase burnout mitigation for healthcare workers, trainees are still not satisfied with the amount of education and training related to burnout mitigation and think more is needed to succeed in their current and post-graduation careers, with those experiencing higher burnout reporting this more strongly. These results suggest the need for formalized wellness and burnout mitigation education.

Analysis of Burnout and Its Relationship with Scientific Activity in a Sample of Professionals Caring for Oncological Patients at the Asst Valle Olona

Background: The bornout syndrome is an uncomfortable situation, resulting from psychophysically exhausting work. Iit often affect healthcare professionals who manage cancer patients and could be increased by the stress related to the SARS-CoV-2 pandemic. We conducted a survey targeting public health professionals caring for cancer patients after two years pandemic, assuming that there might be an association between scientific activity and lower risk of emotional exhaustion and depersonalization. Materials (patients) and Methods: In March 2022, a survey was proposed to physicians and psychologists of our company involved in the cancer patient's care pathway, and collected the results anonymously. Participants were tested with the Maslach Burnout Inventory (MBI) providing three subscales: (A) emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA). A profile analysis was performed. From the literature, cut-off scores for these three scales had been identified that categorize subjects into three ranges: low, medium, and high emotional exhaustion, depersonalization, and personal accomplishment. A chi-square analysis was performed to observe whether there was a statistically significant association between burnout dimensions and the number of publications made in the past 10 years (0, <5, >=5). Result(s): Data from 58 anonymous questionnaires were collected and analyzed. The responders had different specialties: surgery (33.9%), medical (39%), or other (27.1%). A statistical significant multivariate effect was found: Wilk's A = 0.83, p = 0.035. Professionals with higher scientific production (a number of >=5) reported statistically significant lower levels of EE (p = 0.027), lower levels of DP (p = .016), and more scientific publications appear to be associated with higher PA (p = 0.035) than colleagues with limited or no scientific production, regardless of the type of medical specialty. Conclusion(s): Increased scientific activity appears to protect health care workers from burnout risk. These results highlight the importance of involving professionals in different activities that allow them not to focus only on strictly patient-related activities - providing protective factors against the burn-out syndrome.