Australian cancer nurses' experiences of burnout: Exploring the job demands and job resources of metropolitan cancer nurses during 2019-2020.

BACKGROUND: Existing studies that seek to understand nurses' experiences of burnout are dominated by cross-sectional, quantitative survey designs employing predetermined measures, often overlooking important job-related stressors that can be highly dependent on industry and professional contexts. Cancer nurses are a group of professionals who warrant special attention, as burnout in this profession is often attributed to high job demands and the challenge of caring for a vulnerable cohort of patients. A deeper understanding of the job demands associated with cancer nursing is required to provide insights about the work experiences of cancer nurses and identify aspects that mitigate burnout and stress. PURPOSE: This study describes the antecedents of burnout among Australian cancer nurses by focusing on the demands and resources inherent in their work. We aim to build on the existing literature by identifying job resources that may serve to mitigate the antecedents of burnout. METHODOLOGY/APPROACH: An in-depth interview study of cancer nurses across a spectrum of age and experience in Australian metropolitan public health care services was conducted over a 2-year period that coincided with the COVID-19 pandemic. The job demands and resources model framed this study of job-related factors associated with burnout and conversely job resources that may foster work engagement. RESULTS: Patient aggression, workload, emotional demands, and abusive peers and managers were reported as distinct job demands, whereas job significance and supportive peers who demonstrated leadership, along with task variety, were identified as job resources. CONCLUSION: Australian cancer nurses work in an environment where job demands are increasingly disproportionate to job resources, leading to significant risk of burnout. PRACTICE IMPLICATIONS: Our study identifies modifiable strategies for improving work conditions for this group who play a critical role in the health care system.

Stress load of Chinese nurses in Fangcang Shelter Hospitals during the COVID-19 pandemic: A latent profile analysis.

The Omicron wave of the COVID-19 pandemic significantly affected Shanghai, China, from March to June 2022. Numbers of Fangcang Shelter Hospitals (FSHs) were conversed from stadiums and exhibition centers to tackle the pandemic. This study aimed to identify the stress load profiles of nurses working in FSHs and explore the characteristics and factors influencing stress load profiles. Totally, 609 out of 700 FSH nurses (with an effective response rate of 87%) participated in an online survey investigating their socio-demographic information, work-related stressors, and stress load. Results of the latent profile analysis identified four classes of stress load, which were labeled as the low (Class 1), mild (Class 2), moderate (Class 3), and high (Class 4) stress load class. Maternity status and self-perceived health condition were significantly different between the four stress load classes by comparisons using the Chi-square test and the Kruskal-Wallis test. The contributors to the stress load profiles were determined by the multinomial logistic regression analysis, including age, education, maternity status, self-perceived health condition, working time in FSHs, and the four dimensions of work-related stressors. Participants who were less healthy (OR = 0.045, 95% CI:0.012,0.171), worked longer time in FSHs (OR = 40.483, 95% CI: 12.103,135.410), faced with more workload (OR = 3.664, 95% CI: 1.047,12.815), and worse working environment (OR = 12.274, 95% CI: 3.029,49.729) were more likely to be classified to the high stress load class. The task arrangement and working environment for FSH nurses should be optimized, and psychological training should be conducted routinely.

Physician exhaustion and work engagement during the COVID-19 pandemic: A longitudinal survey into the role of resources and support interventions.

BACKGROUND: Physicians increasingly show symptoms of burnout due to the high job demands they face, posing a risk for the quality and safety of care. Job and personal resources as well as support interventions may function as protective factors when demands are high, specifically in times of crisis such as the COVID-19 pandemic. Based on the Job Demands-Resources theory, this longitudinal study investigated how monthly fluctuations in job demands and job and personal resources relate to exhaustion and work engagement and how support interventions are associated with these outcomes over time. METHODS: A longitudinal survey consisting of eight monthly measures in the period 2020-2021, completed by medical specialists and residents in the Netherlands. We used validated questionnaires to assess job demands (i.e., workload), job resources (e.g., job control), personal resources (e.g., psychological capital), emotional exhaustion, and work engagement. Additionally, we measured the use of specific support interventions (e.g., professional support). Multilevel modeling and longitudinal growth curve modeling were used to analyze the data. RESULTS: 378 medical specialists and residents were included in the analysis (response rate: 79.08%). Workload was associated with exhaustion (γ = .383, p < .001). All job resources, as well as the personal resources psychological capital and self-judgement were associated with work engagement (γs ranging from -.093 to .345, all ps < .05). Job control and psychological capital attenuated the workload-exhaustion relationship while positive feedback and peer support strengthened it (all ps < .05). The use of professional support interventions (from a mental health expert or coach) was related to higher work engagement (estimate = .168, p = .032) over time. Participation in organized supportive group meetings was associated with higher exhaustion over time (estimate = .274, p = .006). CONCLUSIONS: Job and personal resources can safeguard work engagement and mitigate the risk of emotional exhaustion. Professional support programs are associated with higher work engagement over time, whereas organized group support meetings are associated with higher exhaustion. Our results stress the importance of professional individual-level interventions to counteract a loss of work engagement in times of crisis.

Measuring Occupational Fatigue among Higher and Middle Management at a Specialized Cancer Center during the COVID-19 Pandemic.

PURPOSE: This study aims to measure the occupational fatigue level and describe the sources and consequences of occupational fatigue among middle and higher management at an international specialized cancer center during the COVID-19 pandemic. METHODS: A mixed-method design was used in this study. A convenience sampling technique was utilized to select the participants from King Hussein Cancer Center, Amman, Jordan. The data was collected through a self-administered questionnaire. This questionnaire included both quantitative and qualitative sections. We utilized Fatigue Risk Assessment and Management in High-Risk Environments (FRAME)-26 items scale for the quantitative section. Two main questions were included in the survey to identify the sources and consequences of occupational fatigue. RESULTS: The results show that the average mean of occupational fatigue was 2.95/5 (SD=0.70). The level of changes in fatigue levels after the COVID-19 pandemic increased by 0.87/3 (SD=1.45). The sources of occupational fatigue could be categorized into five themes: workload, work environment, staffing, psychological, and physical sources. There are four themes categorizing occupational fatigue: social, economic, health, and daily activity and lifestyle. CONCLUSION: This study affords valuable insight into the level, source, and consequences of occupational fatigue among middle and higher management at an international specialized cancer hospital in developing countries. The results indicate that the occupational fatigue level was moderate, and the fatigue level was negatively impacted by the COVID-19 pandemic.

Australian cancer nurses' experiences of burnout: Exploring the job demands and job resources of metropolitan cancer nurses during 2019-2020.

BACKGROUND: Existing studies that seek to understand nurses' experiences of burnout are dominated by cross-sectional, quantitative survey designs employing predetermined measures, often overlooking important job-related stressors that can be highly dependent on industry and professional contexts. Cancer nurses are a group of professionals who warrant special attention, as burnout in this profession is often attributed to high job demands and the challenge of caring for a vulnerable cohort of patients. A deeper understanding of the job demands associated with cancer nursing is required to provide insights about the work experiences of cancer nurses and identify aspects that mitigate burnout and stress. PURPOSE: This study describes the antecedents of burnout among Australian cancer nurses by focusing on the demands and resources inherent in their work. We aim to build on the existing literature by identifying job resources that may serve to mitigate the antecedents of burnout. METHODOLOGY/APPROACH: An in-depth interview study of cancer nurses across a spectrum of age and experience in Australian metropolitan public health care services was conducted over a 2-year period that coincided with the COVID-19 pandemic. The job demands and resources model framed this study of job-related factors associated with burnout and conversely job resources that may foster work engagement. RESULTS: Patient aggression, workload, emotional demands, and abusive peers and managers were reported as distinct job demands, whereas job significance and supportive peers who demonstrated leadership, along with task variety, were identified as job resources. CONCLUSION: Australian cancer nurses work in an environment where job demands are increasingly disproportionate to job resources, leading to significant risk of burnout. PRACTICE IMPLICATIONS: Our study identifies modifiable strategies for improving work conditions for this group who play a critical role in the health care system.

Burnout Among Respiratory Therapists Amid the COVID-19 Pandemic.

BACKGROUND: Burnout is a major challenge in health care and is associated with poor overall well-being, increased medical errors, worse patient outcomes, and low job satisfaction. There is scant literature focused on the respiratory therapist's (RT) experience of burnout, and a thorough exploration of RTs' perception of factors associated with burnout has not been reported. The aim of this qualitative study was to understand the factors associated with burnout as experienced by RTs amid the COVID-19 pandemic. METHODS: We performed a post hoc, qualitative analysis of free-text responses from a survey of burnout prevalence in RTs. RESULTS: There were 1,114 total and 220 free-text responses. Five overarching themes emerged from the analysis: staffing, workload, physical/emotional consequences, lack of effective leadership, and lack of respect. Respondents discussed feelings of anxiety, depression, and compassion fatigue as well as concerns that lack of adequate staffing, high workload assignments, and inadequate support from leadership contributed to feelings of burnout. Specific instances of higher patient acuity, surge in critically ill patients, rapidly evolving changes in treatment recommendations, and minimal training and preparation for an extended scope of practice were reported as stressors that led to burnout. Some respondents stated that they felt a lack of respect for both the RT profession and the contribution of RTs to patient care. CONCLUSIONS: Themes associated with burnout in RTs included staffing, workload, physical and emotional exhaustion, lack of effective leadership, and lack of respect. These results provide potential targets for interventions to combat burnout among RTs.

Psychosocial burden in nurses working in nursing homes during the Covid-19 pandemic: a cross-sectional study with quantitative and qualitative data.

BACKGROUND: The Covid-19 pandemic led to increased work-related strain and psychosocial burden in nurses worldwide, resulting in high prevalences of mental health problems. Nurses in long-term care facilities seem to be especially affected by the pandemic. Nevertheless, there are few findings indicating possible positive changes for health care workers. Therefore, we investigated which psychosocial burdens and potential positive aspects nurses working in long-term care facilities experience during the Covid-19 pandemic. METHODS: We conducted a mixed-methods study among nurses and nursing assistants working in nursing homes in Germany. The survey contained the third German version of the Copenhagen Psychosocial Questionnaire (COPSOQ III). Using Welch's t-tests, we compared the COPSOQ results of our sample against a pre-pandemic reference group of geriatric nurses from Germany. Additionally, we conducted semi-structured interviews with geriatric nurses with a special focus on psychosocial stress, to reach a deeper understanding of their experiences on work-related changes and burdens during the pandemic. Data were analysed using thematic coding (Braun and Clarke). RESULTS: Our survey sample (n = 177) differed significantly from the pre-pandemic reference group in 14 out of 31 COPSOQ scales. Almost all of these differences indicated negative changes. Our sample scored significantly worse regarding the scales 'quantitative demands', 'hiding emotions', 'work-privacy conflicts', 'role conflicts', 'quality of leadership', 'support at work', 'recognition', 'physical demands', 'intention to leave profession', 'burnout', 'presenteeism' and 'inability to relax'. The interviews (n = 15) revealed six main themes related to nurses' psychosocial stress: 'overall working conditions', 'concern for residents', 'management of relatives', 'inability to provide terminal care', 'tensions between being infected and infecting others' and 'technicisation of care'. 'Enhanced community cohesion' (interviews), 'meaning of work' and 'quantity of social relations' (COPSOQ III) were identified as positive effects of the pandemic. CONCLUSIONS: Results clearly illustrate an aggravation of geriatric nurses' situation and psychosocial burden and only few positive changes due to the Covid-19 pandemic. Pre-existing hardships seem to have further deteriorated and new stressors added to nurses' strain. The perceived erosion of care, due to an overemphasis of the technical in relation to the social and emotional dimensions of care, seems to be especially burdensome to geriatric nurses.

Occupational Burnout Symptoms and Its Relationship With Workload and Fear of the SARS-CoV-2 Pandemic Among Hospital Nurses.

Introduction: The pandemic has intensified physical and psychological work demands experienced by nurses in a hospital environment. The purpose of this study was to examine personal and work environmental risk factors associated with occupational burnout among hospital nurses. Methods: We conducted a cross-sectional from April to November 2020. Data from 831 nurses who worked professionally in four educational hospitals were compiled through survey questionnaires to report the prevalence of burnout, occupational and individual factors. Independent t-test and Mann-Whitney test measured the link between the scopes of occupational burnout and risk factors. Results: About half of the participants indicated moderate symptoms of burnout. The fear of the nurses correlated significantly with emotional exhaustion (r = 0.71, p = 0.001), depersonalization (r = 0.67, p = 0.02), and personal accomplishment (r = 0.63, p = 0.05). Mental demand (r = 0.74, p = 0.01) and effort at work (r = 0.68, 0.001) correlated significantly with emotional exhaustion (r = 0.51, p = 0.03). Conclusion: The findings indicated a high prevalence of burnout symptoms, particularly emotional exhaustion, among hospital nursing professionals. Occupational health services should consider burnout as an occupational-related condition and provide interventions to reduce workplace chronic stressors and burnout in hospitals.

Employee psychological well-being during the COVID-19 pandemic in Germany: A longitudinal study of demands, resources, and exhaustion.

Many governments react to the current coronavirus/COVID-19 pandemic by restricting daily (work) life. On the basis of theories from occupational health, we propose that the duration of the pandemic, its demands (e.g., having to work from home, closing of childcare facilities, job insecurity, work-privacy conflicts, privacy-work conflicts) and personal- and job-related resources (co-worker social support, job autonomy, partner support and corona self-efficacy) interact in their effect on employee exhaustion. We test the hypotheses with a three-wave sample of German employees during the pandemic from April to June 2020 (Nw1  = 2900, Nw12  = 1237, Nw123  = 789). Our findings show a curvilinear effect of pandemic duration on working women's exhaustion. The data also show that the introduction and the easing of lockdown measures affect exhaustion, and that women with children who work from home while childcare is unavailable are especially exhausted. Job autonomy and partner support mitigated some of these effects. In sum, women's psychological health was more strongly affected by the pandemic than men's. We discuss implications for occupational health theories and that interventions targeted at mitigating the psychological consequences of the COVID-19 pandemic should target women specifically.

When there is a will there is a way: The role of proactive personality in combating COVID-19.

The global COVID-19 pandemic has disrupted personal and work lives and created great uncertainty and stress, especially for frontline health care professionals like doctors and nurses who risk personal health while facing increased workloads and new COVID-related tasks. People can passively respond to this disruption, or they can be more active and choose to shape the conditions surrounding their work during the crisis. We designed a multiwave, multisource study examining whether a proactive orientation is a key resource for frontline health care professionals in the COVID-19 pandemic. Drawing from proactive and conservation of resources theories, we studied a sample of 408 doctors and nurses at a COVID-19 hospital in the locked-down area surrounding Wuhan City, China during the first wave of the virus. Our aim is to examine how personal agency contributes to health care professionals' performance and well-being when combating COVID-19. Proactive personality as a dispositional resource was associated with higher levels of perceived strengths use, a job-related motivational resource. This effect was jointly moderated by routine disruption and perceived organizational support. Proactive personality was indirectly associated with performance and two indicators of well-being (resilience and thriving) through perceived strengths use. More frequent physical exposure to the virus magnified the effects of perceived strengths use on an archival indicator of performance during the first wave of the pandemic. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

A Large Scale of Nurses Participated in Beating down COVID-19 in China: The Physical and Psychological Distress.

The outbreak of coronavirus disease 2019 (COVID-19) posed an unprecedented threat to health care providers (HCPs) in Wuhan, China, especially for nurses who were frequently exposed to infected or suspected patients. Limited information was available about the working experience of nurses in fighting against the pandemic. To learn the physical and psychological responses of nurses during the pandemic and explore the potential determinants, we conducted a large-scale survey in Wuhan. This multicenter cross-sectional study enrolled 5521 nurses who worked in designated hospitals, mobile cabins, or shelters during the pandemic. A structured online questionnaire was distributed to assess the physical discomforts, emotional distress and cognitive reactions of nurses at work, and the log-binomial regression analysis was performed to explore potential determinants. A considerable proportion of nurses had symptoms of physical discomforts [3677 (66.6%)] and emotional distress [4721 (85.5%)]. Nurses who were directly involved in the care of patients (i.e., care for severe patients: RR, 2.35; 95% CI, 1.95-2.84), with irregular work schedules (RR, 2.36; 95% CI, 1.95-2.87), and working overtime (RR, 1.34; 95% CI, 1.08-1.65) were at a higher risk for physical discomforts. Nurses who were directly involved in the care of patients (i.e., care for severe patients: RR, 1.78; 95% CI, 1.40-2.29), with irregular work schedules (RR, 3.39; 95% CI, 2.43-4.73), and working overtime (RR, 1.51; 95% CI, 1.12-2.04) were at a higher risk for emotional distress. Therefore, formulating reasonable work schedules and improving workforce systems are necessary to alleviate the physical and emotional distress of nurses during the pandemic.

Supporting nurses' recovery during and following the COVID-19 pandemic.

Research suggests that working during traumatic events can lead to deteriorating physical and mental health for nurses, a phenomenon that has been demonstrated during the coronavirus 2019 (COVID-19) pandemic. However, research has also shown that there are evidence-based strategies that can be used to assist nurses in their recovery from such events. Promoting awareness among individual nurses about the effects of COVID-19 enables them to adopt positive coping strategies, both on an individual and organisational level. This article details strategies including formal and informal debriefing, taking regular breaks, and using stress mitigation strategies during shifts. The article also discusses the potential for post-traumatic psychological growth. This acknowledges that while working in a healthcare environment during COVID-19 can be extremely challenging, it also enables nurses to experience personal growth such as the development of emotional intelligence. As nurses adapt to the 'new normal' of working during COVID-19, healthcare organisations should ensure that they provide nurses with the support that enables them to recover effectively.

Sick leave accessibility in junior doctors at an Australian health service.

BACKGROUND: Doctors commonly continue to work when they are unwell. This norm is increasingly problematic during the COVID-19 (SARS-CoV-2) pandemic when effective infection control measures are of paramount importance. This study investigates the barriers existing before COVID-19 that prevent junior doctors with an acute respiratory illness working in Canberra, Australia, from taking sick leave, and offers suggestions about how to make sick leave more accessible for junior doctors. METHODS: Anonymous online survey study. RESULTS: 192 junior doctors were invited to participate in the study. Fifty-four responded, and only those who had worked whilst unwell with an acute respiratory illness were included, providing a total number of fifty responses. Of these, 72% believed they were infectious at the time they worked whilst unwell. 86% of respondents did not feel supported by the workplace to take sick leave when they were unwell, and 96% identified concerns about burdening colleagues with extra workload and lack of available cover as the main deterrents to accessing sick leave. CONCLUSION: Junior doctors at our health service, pre-COVID-19, do not widely feel empowered to take sick leave when they have an acute respiratory illness. Junior doctors are primarily concerned about burdening their colleagues with extra workloads in an environment where they perceive there to be a lack of available cover. Having more available cover, leadership from seniors, and clearer guidelines around the impact of sick leave on registration may contribute to a culture where junior doctors feel supported to access sick leave.

COVID-19 pandemic: The testing times for healthcare workers.

Dear Editor, There is an increasing pressure on healthcare systems around the globe since the onset of the current coronavirus disease 2019 (COVID-19) pandemic to cope up with the increasing workload...

Prevalence, Associated Factors, and Consequences of Burnout Among Egyptian Physicians During COVID-19 Pandemic.

Objectives: COVID-19 has been recognized as a pandemic by the World Health Organization, and physicians are at the frontline to confront the disease. Burnout syndrome (BOS) is a syndrome resulting from chronic workplace stress that has not been successfully managed. The objective of this study is to evaluate the frequency and associated risk factors of BOS among a sample of Egyptian physicians during the COVID-19 pandemic. Methods: Using Maslach Burnout Inventory Human Services Survey, a cross-sectional electronic survey was conducted to assess BOS among the target group. Results: Two hundred and twenty physicians participated in the study. The frequency of BOS among the research group was 36.36%. The possibility of development of BOS increased two times with the need to buy personal protective equipment (PPE) from participants' own money, with harassment by patients' families, and was less likely to develop in doctors with older age. While male gender was a predictor of depersonalization (DP), female gender showed a significant association with higher emotional exhaustion (EE). Infection or death from COVID-19 among colleagues or relatives showed significant association with elevated EE and lowered personal achievement (PA), respectively. Conclusion: COVID-19 pandemic added new factors to the development of BOS in our research group. Several measures should be taken to support physicians at this stage. These measures include psychological support, organizing work hours, adjusting salaries, and providing personal protective equipment and training on safety measures.

Effects of simulation training on COVID-19 control ability and psychological states of nurses in a children's hospital.

OBJECTIVE: This study aims to discuss the effects of simulation training on improving the pre-examination, triage, prevention, and control of coronavirus disease 2019 (COVID-19), explain the psychological states of pre-examination and triage staff in general hospitals during the COVID-19 epidemic, and analyze relevant influencing factors. This study may serve as a reference of psychological consultation services to medical staff. SUBJECTS AND METHODS: This study included 60 nurses assigned in the pre-examination department, fever clinics, and isolation wards of a general hospital from January 26th to February 1st, 2020. Before assuming the posts, the nurses received simulation training on the clinical reception of suspected patients with COVID-19. Operation skills of the nurses before and after the training were assessed. RESULTS: The percent of passing significantly increased from 65% before the training to 98.33% after training (p<0.05). Training also significantly relieved the anxiety and depression of the nurses (p<0.05). CONCLUSIONS: Scenario-simulation training can increase the emergency abilities of pediatric nurses in the prevention and control of the COVID-19 epidemic and relieve the anxiety of nurses.

Exploring nurses' perception of taking care of patients with coronavirus disease (COVID-19): A qualitative study.

Aim: Healthcare staff, especially nurses, who are in the frontline of caring of patients with COVID-19 have valuable experiences about taking care of these patients. Therefore, the aim of this study was exploring nurses' perception of taking care of patients with COVID-19. Design: This qualitative study was performed using the conventional content analysis method. Methods: 13 nurses who were taking care of patients with COVID-19 were selected using purposeful sampling in the Lorestan University of Medical Sciences. The data were collected through telephone interviews and analysed based on the Lundman and Graneheim's approach. Results: Qualitative analysis of the data revealed 3 sub-categories, 8 categories and 3 main categories including care erosion, nursing professional growth and necessities. Relevance to clinical practice: Improve the work situation of the nurses during care of COVID-19 patients, which can directly or indirectly improve the quality of care of these patients.