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1.
PLoS One ; 17(1): e0261502, 2022.
Article in English | MEDLINE | ID: covidwho-1632387

ABSTRACT

BACKGROUND: The COVID-19 pandemic has exerted great pressure on national health systems, which have aimed to ensure comprehensive healthcare at all times. Healthcare professionals working with COVID-19 patients are on the frontline and thereby confronted with enormous demands. Although early reports exist on the psychological impact of the pandemic on frontline medical staff working in Asia, little is known about its impact on healthcare professionals in other countries and across various work sectors. The present cross-sectional, online survey sought to investigate common work stressors among healthcare professionals, their psychological stress as well as coping resources during the pandemic. METHODS: A sample of 575 healthcare professionals (57% male) in three different sectors (hospital, prehospital emergency care, and outpatient service) reported their experiences concerning work and private stressors, psychological stress, and coping strategies between April 17, 2020 and June 5, 2020. To capture pandemic-specific answers, most of the items were adapted or newly developed. Exploratory factor analyses (EFA) were conducted to detect underlying latent factors relating to COVID-specific work stressors. In a next step, the effects of these latent stressors across various work sectors on psychological stress (perceived stress, fatigue, and mood) were examined by means of structural equation models (SEM). To add lived experience to the findings, responses to open-ended questions about healthcare professionals' stressors, effective crisis measures and prevention, and individual coping strategies were coded inductively, and emergent themes were identified. RESULTS: The EFA revealed that the examined work stressors can be grouped into four latent factors: "fear of transmission", "interference of workload with private life", "uncertainty/lack of knowledge", and "concerns about the team". The SEM results showed that "interference of workload with private life" represented the pivotal predictor of psychological stress. "Concerns about the team" had stress-reducing effects. The latent stressors had an equal effect on psychological stress across work sectors. On average, psychological stress levels were moderate, yet differed significantly between sectors (all p < .001); the outpatient group experienced reduced calmness and more stress than the other two sectors, while the prehospital group reported lower fatigue than the other two sectors. The prehospital group reported significantly higher concerns about the team than the hospital group (p < .001). In their reports, healthcare professionals highlighted regulations such as social distancing and the use of compulsory masks, training, experience and knowledge exchange, and social support as effective coping strategies during the pandemic. The hospital group mainly mentioned organizational measures such as visiting bans as effective crisis measures, whereas the prehospital sector most frequently named governmental measures such as contact restrictions. CONCLUSION: The study demonstrated the need for sector-specific crisis measures to effectively address the specific work stressors faced by the outpatient sector in particular. The results on pandemic-specific work stressors reveal that healthcare professionals might benefit from coping strategies that facilitate the utilization of social support. At the workplace, team commitment and knowledge exchange might buffer against adverse psychological stress responses. Schedules during pandemics should give healthcare workers the opportunity to interact with families and friends in ways that facilitate social support outside work. Future studies should investigate cross-sector stressors using a longitudinal design to identify both sector- and time-specific measures. Ultimately, an international comparison of stressors and measures in different sectors of healthcare systems is desirable.


Subject(s)
Burnout, Professional/epidemiology , COVID-19 , Health Personnel/psychology , SARS-CoV-2 , Adult , COVID-19/epidemiology , COVID-19/psychology , Female , Germany/epidemiology , Humans , Male , Middle Aged , Prospective Studies
3.
J Trauma Nurs ; 29(1): 51-54, 2022.
Article in English | MEDLINE | ID: covidwho-1638407

ABSTRACT

BACKGROUND: Posttraumatic stress syndrome has been on the rise across all nursing specialties. When dealing with high-stress situations in the workplace, it has become clear that health care providers require tools to maintain a healthy environment. OBJECTIVE: The purpose of this article is to describe an initiative to provide baccalaureate nursing students with mindfulness techniques to manage their internal reactions to day-to-day events during a pandemic. METHODS: This is an innovative classroom initiative reviewing nursing student engagement on a discussion board related to mindfulness reflection questions before and after implementing an 8-week mindfulness program conducted from August to October 2020 in a first-year undergraduate nursing program in Texas. RESULTS: A total of 124 student nurses participated in a mindfulness program. The majority of these were women (83.9%), aged 19-50 years, single (78.2%), and Hispanic or Latino (84.7%). Discussion board engagement increased from n = 1,001 posts over 16-week premindfulness program implementation to n = 4,191 over the first 10 weeks of the program implementation. CONCLUSION: Nursing implications include providing an atmosphere in which nurses can practice mindfulness skills, such as being in touch with their thoughts and bodies, which will help them transition into the position of trauma nurse. As nurse educators, it is our responsibility to assist in developing tools that students and patients may use to deal with their anxiety and foster an environment that promotes learning, understanding, and compassion.


Subject(s)
Burnout, Professional , Education, Nursing, Baccalaureate , Mindfulness , Students, Nursing , Female , Humans , Male , Pandemics
4.
Acta Biomed ; 92(S2): e2021428, 2021 12 21.
Article in English | MEDLINE | ID: covidwho-1625057

ABSTRACT

This study aimed to systematically synthesize evidence regarding burnout and post-traumatic stress disorder (PTSD) among nurses engaged in the frontline during the COVID-19 pandemic, highlighting their risk and protective factors. The specific literature on nurses' mental health outcomes still remains not synthesized. A systematic review was performed (PROSPERO: CRD42021227939), searching literature published in 2020 on Pubmed, Scopus, CINAHL, and PsycInfo. We quantitatively pooled means of included studies measuring burnout and PTSD with the same tools. Twenty-five studies were included in this review. Seven (3766 nurses) were included in the meta-analysis for estimating means of depersonalization and emotional exhaustion assessed using the Maslach Burnout Inventory, respectively: 7,40 (95%CI=6,00-8,80) and 22,82 (95%CI=19,24-26,41). Likely, 12 studies were used to estimate two pooled means for PTSD, one for six studies adopting the Impact of Event Scale-Revised (1551 nurses), and six adopting the PTSD Scale for DSM-5 (8547 nurses). The main risk and protective factors of both outcomes were female sex and younger age, work-related variables, and physical and mental factors, such as concerns, skin lesions from wearing personal protective equipment. This systematic review portrayed the situation described in literature during 2020 on nurses' burnout and PTSD during the COVID-19 pandemic. Although the outcomes' levels described in the included studies are diverse, the broad situation appears alarming, and supportive multi-level strategies, considering individual and system-level, should be planned to decrease the described worsening scenario within the clinical settings avoid middle and long-term negative consequences.


Subject(s)
Burnout, Professional , COVID-19 , Stress Disorders, Post-Traumatic , Burnout, Professional/epidemiology , Burnout, Psychological , Female , Humans , Pandemics , SARS-CoV-2 , Stress Disorders, Post-Traumatic/epidemiology , Stress Disorders, Post-Traumatic/etiology
5.
Br J Nurs ; 31(1): S10-S15, 2022 Jan 13.
Article in English | MEDLINE | ID: covidwho-1622855

ABSTRACT

The COVID-19 pandemic has created a set of unprecedented challenges for healthcare services and staff. The authors conducted a national online survey of nurses employed to work in HIV services in England, Wales, Scotland, Northern Ireland and the Republic of Ireland to establish how the COVID-19 pandemic has impacted on the professional quality of life of HIV nurses. Professional quality of life was assessed using the ProQOL scale; 132 nurses completed the survey, 99 of whom completed the ProQOL scale. Just over 1 in 3 were redeployed in the first pandemic wave, dropping to 1 in 6 in subsequent waves. In multivariate analysis, redeployment in both waves increased burnout scores by nearly 10 points and decreased compassion satisfaction scores by nearly 5 points, with no effect on secondary traumatic stress scores. A supportive workplace environment will have a key role in supporting the path to recovery.


Subject(s)
Burnout, Professional , COVID-19 , HIV Infections , Burnout, Professional/epidemiology , HIV Infections/epidemiology , Humans , Job Satisfaction , Pandemics , Quality of Life , SARS-CoV-2 , Surveys and Questionnaires
6.
J Nurs Educ ; 61(1): 46-49, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1622662

ABSTRACT

BACKGROUND: A private university nursing program established the Initiative for Vital Practice in response to increasing levels of compassion fatigue (CF) and burnout among faculty and staff during an undergraduate program revision and accompanying leadership transitions. METHOD: A pilot mixed-method project evaluated self-management practices meant to mitigate CF among faculty and staff. RESULTS: Faculty and staff (N = 34) identified four primary risk factors for CF, including physical symptoms (14 of 34 = 41%); feeling trapped in work (14 of 34 = 41%); lacking time away from work (11 of 34 = 32%); and inability to work hard enough (10 of 34 = 29%). Individual and organizational stressors and alleviators were analyzed; aggregate scores for three Professional Quality of Life scales presented at a "moderate level." CONCLUSION: Preliminary results establish a baseline to measure the effect of burnout and secondary stress and guide further development of our organizational framework and initiative. [J Nurs Educ. 2022;61(1):46-49.].


Subject(s)
Burnout, Professional , Compassion Fatigue , Empathy , Humans , Job Satisfaction , Leadership , Quality of Life , Surveys and Questionnaires
7.
J Occup Health ; 64(1): e12311, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1620088

ABSTRACT

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.


Subject(s)
Burnout, Professional , COVID-19 , Burnout, Professional/epidemiology , Cross-Sectional Studies , Humans , Pandemics , SARS-CoV-2 , Surveys and Questionnaires , United Kingdom/epidemiology
8.
Int J Environ Res Public Health ; 19(1)2022 Jan 04.
Article in English | MEDLINE | ID: covidwho-1613767

ABSTRACT

The purpose of this study was to identify the mediating effects of perceived health status (PHS) and perceived organizational support (POS) in the association between emotional labor and burnout in public health nurses (PHNs). The participants were 207 PHNs convenience sampled from 30 public health centers and offices in Jeju, Korea. Data regarding emotional labor, PHS, POS, and burnout were collected between February and March 2021 using a structured questionnaire. Collected data were analyzed by Pearson's correlation coefficient and multiple regression analysis. Burnout of PHNs was positively correlated with emotional labor (r = 0.64, p < 0.001) and negatively correlated with PHS (r = -0.51, p < 0.001) and POS (r = -0.51, p < 0.001). In the association between emotional labor and burnout, PHS (B = -1.36, p < 0.001) and POS (B = -0.42, p = 0.001) had a partial mediating effect. Reduction of burnout among PHNs requires not only effective management of emotional labor but also personal and organizational efforts to improve PHS and POS.


Subject(s)
Burnout, Professional , COVID-19 , Nurses, Public Health , Burnout, Professional/epidemiology , Burnout, Psychological , Health Status , Humans , Pandemics , SARS-CoV-2 , Surveys and Questionnaires
9.
IEEE Pulse ; 12(6): 19-22, 2021.
Article in English | MEDLINE | ID: covidwho-1607461

ABSTRACT

Health care workers were already stressed before the pandemic. Now, deep into the second year of COVID-19, many find their mental health sliding even further. In the USA, some have had to care for desperately ill but recalcitrant patients who had access to a vaccine but refused to take it. Others, in both the USA and around the world, are working in hospitals, especially rural ones, which are perilously short-staffed [1].


Subject(s)
Burnout, Professional , COVID-19 , Burnout, Psychological , Delivery of Health Care , Health Personnel , Humans , SARS-CoV-2
10.
Nursing ; 52(1): 29-32, 2022 Jan 01.
Article in English | MEDLINE | ID: covidwho-1606527

ABSTRACT

ABSTRACT: Pandemic-related stress factors have been profoundly impacting the wellness of nurses, resulting in job burnout, moral distress, and some nurses deciding to leave the profession. This article examines strategies to identify stressors and develop self-care and coping skills.


Subject(s)
Burnout, Professional , COVID-19 , Nurses , Burnout, Professional/epidemiology , Burnout, Professional/prevention & control , Humans , Job Satisfaction , Pandemics/prevention & control , SARS-CoV-2 , Surveys and Questionnaires
11.
Appl Clin Inform ; 13(1): 10-18, 2022 01.
Article in English | MEDLINE | ID: covidwho-1604728

ABSTRACT

OBJECTIVES: This study aimed to develop a virtual electronic health record (EHR) training and optimization program and evaluate the impact of the virtual model on provider and staff burnout and electronic health record (EHR) experience. METHODS: UCHealth created and supported a multidisciplinary EHR optimization and training program, known as the Epic Sprint Program. The Sprint Team conducted dozens of onsite Sprint events over the course of several years prior to the pandemic but transitioned to a fully virtual program and successfully "sprinted" 21 outpatient clinics from May to December 2020. Core program components of group and 1:1 training, workflow analysis, and new or adjusted EHR build were unchanged from the onsite model. Pre- and post-Sprint surveys provided detailed, objective data about EHR usability, EHR proficiency, job satisfaction, and burnout. RESULTS: The EHR Net Promoter Score (NPS), a likelihood to recommend metric, increased by 39 points (-3 pre and 36 post; p < 0.001) for providers and 29 points (8 pre and 37 post; p = 0.001) for staff post-Sprint. Positive provider (NPS = +53) and staff (NPS = +47) NPS scores indicated a high likelihood to recommend the Sprint Program. Post-Sprint surveys also reflect an increase in providers (10%; p = 0.04) and staff (9%; 0.13) who indicated "no burnout" or "did not feel burned out." DISCUSSION: The UCHealth Sprint Team transitioned this comprehensive, enterprise level initiative from an onsite model to a fully virtual EHR training and optimization program during the first few months of the novel coronavirus disease (COVID-19) pandemic. Despite this change in program delivery, survey data clearly demonstrated improved EHR satisfaction, a high likelihood to recommend a sprint to a friend or colleague, and a trend toward burnout reduction in providers and staff. CONCLUSION: Changing an existing on-site EHR optimization program to a purely virtual format can be successful, and this study showed improved provider and staff EHR satisfaction with reduced burnout.


Subject(s)
Burnout, Professional , COVID-19 , Electronic Health Records , Humans , Outpatients , SARS-CoV-2
14.
Lancet ; 398(10303): 920-930, 2021 09 04.
Article in English | MEDLINE | ID: covidwho-1593950

ABSTRACT

The COVID-19 pandemic has heightened interest in how physician mental health can be protected and optimised, but uncertainty and misinformation remain about some key issues. In this Review, we discuss the current literature, which shows that despite what might be inferred during training, physicians are not immune to mental illness, with between a quarter and a third reporting increased symptoms of mental ill health. Physicians, particularly female physicians, are at an increased risk of suicide. An emerging consensus exists that some aspects of physician training, working conditions, and organisational support are unacceptable. Changes in medical training and health systems, and the additional strain of working through a pandemic, might have amplified these problems. A new evidence-informed framework for how individual and organisational interventions can be used in an integrated manner in medical schools, in health-care settings, and by professional colleagues is proposed. New initiatives are required at each of these levels, with an urgent need for organisational-level interventions, to better protect the mental health and wellbeing of physicians.


Subject(s)
Mental Disorders/epidemiology , Physicians/psychology , Suicide/statistics & numerical data , Burnout, Professional , COVID-19/epidemiology , Female , Humans , Male , Mental Disorders/prevention & control , Pandemics , Physicians, Women/psychology , Risk Factors , SARS-CoV-2 , Substance-Related Disorders/epidemiology , Suicide/prevention & control , Work Schedule Tolerance
16.
Int J Environ Res Public Health ; 18(24)2021 12 19.
Article in English | MEDLINE | ID: covidwho-1580718

ABSTRACT

This study aimed to evaluate the mental health outcomes of health care workers (HCWs) of the Verona academic hospital trust (Italy) one year after the outbreak of COVID-19 and to identify predicted risk factors. A web-based survey was conducted from mid-April to mid-May 2021 on hospital workers one year after the first evaluation performed during the lock-down phase of the COVID-19 pandemic. Post-traumatic stress, general anxiety, depression, and burnout were assessed by using, respectively, the impact of event scale (IES-R), the self-rating anxiety scale (SAS), the patient health questionnaire (PHQ-9) and the Maslach burnout inventory-general survey (MBI-GS). Multivariate logistic regression analysis was performed to identify factors associated with each of the four mental health outcomes one year after the COVID-19 outbreak. A total of 1033 HCWs participated. The percentage of HCWs scoring above the cut-off increased from 2020 to 2021 in all of the outcome domains (anxiety, 50.1% vs. 55.7, p < 0.05; depression, 26.6% vs. 40.6%, p < 0.001; burnout, 28.6% vs. 40.6%, p < 0.001; chi-square test), with the exception of post-traumatic distress. There was also an increase when stratifying by occupation and workplace, with a greater increase for depression and burnout. Multivariate analysis revealed that, one year after the COVID-19 outbreak, nurses were at the greatest risk of anxiety and depression, whereas residents were at the greatest risk of burnout (in terms of low professional efficacy). Working in intensive care units was associated with an increased risk of developing severe emotional exhaustion and a cynical attitude towards work.


Subject(s)
Burnout, Professional , COVID-19 , Anxiety/epidemiology , Burnout, Professional/epidemiology , Communicable Disease Control , Cross-Sectional Studies , Depression/epidemiology , Disease Outbreaks , Health Personnel , Humans , Pandemics , SARS-CoV-2 , Tertiary Care Centers
18.
J Nurs Adm ; 52(1): 57-66, 2022 Jan 01.
Article in English | MEDLINE | ID: covidwho-1575154

ABSTRACT

OBJECTIVE: The aim of this study was to explore relationships between organizational factors and moral injury among healthcare workers and the impact of perceptions of their leaders and organizations during COVID-19. BACKGROUND: COVID-19 placed healthcare workers at risk for moral injury, which often involves feeling betrayed by people with authority and can impact workplace culture. METHODS: Secondary data from a Web-based survey of mid-Atlantic healthcare workers were analyzed using mixed methods. Data were synthesized using the Reina Trust & Betrayal Model. RESULTS: Fifty-five percent (n = 328/595) of respondents wrote comments. Forty-one percent (n = 134/328) of commenters had moral injury scores of 36 or higher. Three themes emerged: organizational infrastructure, support from leaders, and palliative care involvement. Respondents outlined organizational remedies, which were organized into 5 domains. CONCLUSIONS: Findings suggest healthcare workers feel trust was breached by their organizations' leaders during COVID-19. Further study is needed to understand intersections between organizational factors and moral injury to enhance trust within healthcare organizations.


Subject(s)
Burnout, Professional , COVID-19 , Health Personnel/organization & administration , Health Personnel/psychology , Mental Health , Morals , Workplace , Adult , Humans , Workplace/organization & administration , Workplace/psychology
19.
J Grad Med Educ ; 13(6): 858-862, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1573877

ABSTRACT

Background: Preliminary studies reveal challenges posed by the COVID-19 pandemic to the well-being of health care workers. Little is known about the effects of the pandemic on the well-being of graduate medical education (GME) residents or about protective factors and post-traumatic growth. Through deeper examination of resident well-being during this unique crisis, we can identify trends and associated lessons to apply broadly to resident well-being. Objective: To characterize resident burnout, resilience, and loneliness before and during the COVID-19 pandemic. Methods: All residents in any specialty at a single institution were anonymously surveyed semiannually for 2 years (2019-2020), including the time period of the COVID-19 pandemic. Surveys included demographics, the 10-item Connor-Davidson Resilience Scale, the Maslach Burnout Inventory, and the UCLA Loneliness Scale. Results: Overall response rates were 53% (508 of 964) in spring 2019, 55% (538 of 982) in fall 2019, 51% (498 of 984) in spring 2020, and 57% (563 of 985) in fall 2020. The overall rates of burnout were stable across all time periods and did not change during the COVID-19 pandemic. Among frontline residents, burnout rates were higher than other resident populations in both the pre- and post-COVID-19 pandemic time periods. Resilience and loneliness measures were similar for frontline and non-frontline residents and remained stable during the pandemic. Conclusions: Initial data from this single institution survey of all GME residents in the first 8 months of the COVID-19 pandemic demonstrated burnout and loneliness did not increase and resilience was preserved.


Subject(s)
Burnout, Professional , COVID-19 , Internship and Residency , Burnout, Professional/epidemiology , Humans , Pandemics , SARS-CoV-2 , Surveys and Questionnaires
20.
BMC Public Health ; 21(1): 1951, 2021 10 27.
Article in English | MEDLINE | ID: covidwho-1560679

ABSTRACT

BACKGROUND: This paper is an empirical investigation that examines a path model linking COVID-19 perceptions to organisational citizenship behaviour (OCBs) via three mediators: job insecurity, burnout, and job satisfaction. The research examines the path model invariance spanning Generations X, Y, and Z. Three countries in the Middle East and North Africa (MENA) were the focus of the study. METHODS: The data was collected from a sample of employees in service companies (n = 578). We used a Partial Least Square Structural Equation Modelling (PLS-SEM) to analyse the data. RESULTS: Our findings reveal that COVID-19 perceptions positively predict job insecurity, which positively impacts burnout levels. Burnout negatively predicts job satisfaction. The findings established that job satisfaction positively predicts OCBs. The mediation analysis determined that job insecurity, burnout and job satisfaction convey the indirect effects of COVID-19 perceptions onto OCBs. Finally, our hypothesised model is non-equivalent across Generations X, Y and Z. In that regard, our multi-group analysis revealed that the indirect effects of COVID-19 perceptions on OCBs were only valid amongst younger generations, i.e., Generation Y and Generation Z. Specifically, younger generations are substantially more vulnerable to the indirect effects of COVID-19 perceptions on their engagement in OCBs than Generation X whose job satisfaction blocks the effects of COVID-19 perceptions on OCBs. CONCLUSIONS: The present study extends our knowledge of workplace generational differences in responding to the perceptions of crises or pandemics. It offers evidence that suggests that burnout, job attitudes and organisational outcomes change differently across generations in pandemic times.


Subject(s)
Burnout, Professional , COVID-19 , Burnout, Professional/epidemiology , Humans , Job Satisfaction , Perception , SARS-CoV-2 , Surveys and Questionnaires , Workplace
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