ABSTRACT
BACKGROUND: Professional quality of life greatly impacts wellbeing and performance of professionals working in the field of caring. The study aims at assessing the components of professional quality of life and their predictors. DESIGN AND METHODS: The cross-sectional study was performed on 167 physicians enrolled by using stratified random sampling from tertiary care hospitals, Ismailia, Egypt. It was conducted by a structured interview questionnaire which included Maslach Burnout Inventory to assess burnout syndrome, and Professional Quality of Life version 5 (Pro QOL- 5) subscale to assess compassion fatigue and satisfaction. RESULTS: Among participants, 78.9% had high burnout, 76% had moderate potential compassion satisfaction and 82% had moderate potential compassion fatigue. The correlation between scales of professional quality of life scores showed significant results (p<0.05). The multiple linear regression analysis showed that marital status, frequency of dealing with critical patients, and compassion fatigue score (B= -6.959, B= 3.573, B= 1.115) were significant predictors of burnout score (p 0.05). Marital status (B= 2.280, p=0.024), and burnout score (B = 0.179, p=0.000) were significant positive predictors of compassion fatigue. While compassion satisfaction score was negative predictor (B= -2.804, p=0.006). The predictors of compassion satisfaction were the marital status (B = 5.039, p=0.000), and compassion fatigue score (B = -0.254, p=0.006). CONCLUSION: High prevalence rates of burnout, compassion fatigue and satisfaction indicate poor professional quality of life were detected among physicians in tertiary care hospitals.
ABSTRACT
OBJECTIVES: Thoracic endovascular aortic repair (TEVAR) has surpassed open surgical repair in the management of blunt traumatic aortic injuries (BTAIs) over the past two decades. It is a less morbid procedure associated with lower mortality. We sought to determine the outcomes of early versus delayed TEVAR of BTAI in our population. METHODS: We conducted a retrospective analysis of a prospectively collected registry that looked at patients presenting with an image-proven diagnosis of BTAI at three tertiary health care facilities in Muscat, Oman. Forty consecutive patients were identified between January 2012 and July 2017, of which four were excluded for incomplete data. The remaining 36 patients were divided based on the timing of repair into early (< 7 days) or delayed (3 7 days) repair. In both cohorts, variables analyzed included patient demographics, mechanism of injury, injury severity score, need for blood products transfusion, use of anti-impulse medications, anticoagulation, intensive care unit (ICU) stay, and total hospital stay. Primary endpoints included: in-hospital mortality, TEVAR-related morbidity, and the need for reintervention. RESULTS: Our study subjects were young with a mean age of 33.5±14.8 and 29.9±11.0 years in the early and delayed repair cohorts, respectively. Motor vehicle collisions accounted for the majority of cases (82.6% and 76.9% in early and delayed repair, respectively). Thoracic injuries were the most commonly associated injuries in both early and delayed repair cohorts. Compared to early repair, the delayed repair cohort had a higher incidence of exploratory laparotomies, but the difference was not statistically significant (p = 0.161). There were four incidences of cerebrovascular accidents (CVAs) post-TEVAR; three in the early repair cohort and one in the delayed repair cohort (p = 1.000). There was no statistically significant correlation between left subclavian total or partial coverage and the incidence of CVA (p = 0.220) and type 1 (p = 0.466) or type 2 endoleak (p = 0.102). The early repair cohort had a longer but not statistically significant ICU stay (7.8±6.8 vs. 5.3±10.7, p = 0.386). Prolonged ICU stay was associated with more blood transfusion requirement (p < 0.001), and higher respiratory (p = 0.010) and gastrointestinal complications (p = 0.026). CONCLUSIONS: The short-term outcomes for TEVAR of BTAI continue to show its feasibility in managing BTAI in severely injured patients. There was no clear statistical significance in mortality and morbidity comparing early versus delayed repair. However, our experience is based on a small sample size and short median follow-up but provides a good platform for further analysis.
