The Frequency of Burnout among Iranian Orthopedic Surgeons and Residents.

Background: Burnout is an emotional, psychological, and physical exhaustion syndrome with feelings of negativism toward one's job and reduced attention to clients. This complication is caused by the lack of control over work-related stress. Physicians, especially surgeons, are at higher risk for burnout due to critical responsibility and heavy workload. Given the importance and consequences of this dilemma, the present study aimed to investigate the frequency of burnout among orthopedic surgeons and residents. Methods: The present cross-sectional, analytical study was conducted in 2019 in the cities of Tehran and Yazd, in Iran. A total of 180 orthopedic surgeons and residents participated in the study. A demographic characteristics form and the Maslach Burnout Inventory (MBI) were employed to assess burnout in the participants. Results: The mean age of the participants was 42.8 years, and 94.4%, 23.9%, 52.2%, and 23.9% of the participants were male, residents, general orthopedic specialists, and fellowship-trained orthopedics, respectively. Out of 180 participants, 90 (50%) cases were suffering from burnout, of whom 26.7%, 16.1%, and 7.2% got a pathological score in one, two, and three criteria. No significant relationship was observed between burnout and gender, marital status, years of experience, and the average number of surgeries per week. However, there was a significant association between burnout and younger age, lower academic rank or being a resident, working in the public sector, and spending less time in leisure and sports activities. Conclusion: The prevalence of burnout (50%) among orthopedists was remarkable and worrying. The frequency of burnout was higher among residents and the ones working in the public sector. This study demonstrates that the issue of burnout and its related risk factors have to be addressed in Iranian orthopedic surgeons and residents.

Effectiveness of interventions based on lazarus and folkman transactional model on improving stress appraisal for hemodialysis patients in Tehran.

Today, we witness an increase in the prevalence of chronic kidney disease, which is a very stressful process. In order to cope with the stress caused by this disease, the first step is to appraise the stressful situation correctly. Therefore, the present study was conducted with the aim of investigating the effect of training on the basis of Lazarus and Folkman transactional model on stress appraisal for hemodialysis (HD) patients. The present quasi-experimental study was conducted on 116 filed HD patients in two dialysis centers in Tehran. The patients were randomly divided into two groups: experimental and control groups. The data were collected using a researcher-made questionnaire whose validity and reliability were confirmed. After performing the intervention, the primary and secondary appraisals' scores were investigated before and three months after the intervention. The data were analyzed using independent /?-test, paired /-test, and covariance at a significant level of 0.05 using software Statistical Package for the Social Sciences version 16.0. The mean age of participants in the study was 52.86 years. In this study, the difference between the mean score of the primary appraisal and substructure of perceived susceptibility, motivational relevance, self-blame (casual focus), and secondary appraisal and self-efficacy substructure after the intervention was significant in the experimental group. However, these differences were not significant in the control group. According to the study results, it can be concluded that the use of training based on Lazarus and Folkman tran- sactional model can be useful for improving the correct appraisal of individuals for stressful situations.

Experiences of stress appraisal in hemodialysis patients: A theory-guided qualitative content analysis.

Chronic renal failure and prolonged hospitalization for the treatment of renal disease incur immense stress and anxiety in patients. Considering the increased prevalence of renal failure, the present study aimed to explain the experiences of stress assessment in hemodialysis (HD) patients based on the transactional model of Lazarus and Folkman. The data collection method was semi-structured interview with 22 patients from dialysis centers in Tehran. Sampling was purposive and continued until data saturation. Data were analyzed using the directed content analysis method. Data analyzed to the extraction of 80 codes that were classified into two predetermined categories of appraisal structures in the transactional stress model, including primary and secondary appraisal, and also seven subcategories (perceived susceptibility, perceived severity, motivational relevance, casual focus, perceived control over outcoms, perceived control over emotions, and self-efficacy). During this study, 15 sub-subcategories were obtained for the stress appraisal in HD patients. The results showed that the subcategories of perceived susceptibility, perceived severity, and casual focus were the most effective factors in the stress appraisal in HD patients. According to the results, an arrangement should be made so that HD patients can evaluate the stressful conditions properly. patients need help to improve their evaluation in subcategories of motivational relevance, perceived control over outcomes, perceived control over emotion, and self-efficacy. In this regard, one of the best models that can be used to identify the appraisals in HD patients and design appropriate interventions for them is the transactional model.

What Are the Hemodialysis Patients' Style in Coping with Stress? A Directed Content Analysis.

BACKGROUND: Nowadays, the prevalence of chronic diseases, such as chronic renal failure, is rising. These patients need hemodialysis to continue their treatment, which is a stressful process. This research was conducted with the purpose of explaining coping styles in hemodialysis patients regarding stress factors based on the Lazarus and Folkman's transactional model. METHODS: This qualitative study was conducted as a content analysis. The data collection method was semi-structured interview with 22 patients from dialysis centers in Tehran. The data were collected from October to January 2017. Sampling was purposive and continued until data saturation. Data were analyzed using the directed content analysis method. The process of data analysis proposed by Hsieh and Shannon's was followed. RESULTS: 106 codes and 24 sub subcategories were obtained through this research and classified into 8 sub-categories of transactional stress model including: problem management, emotional regulation, social support, dispositional coping styles, positive reappraisal, revised goals, spiritual beliefs and positive events; and 3 categories of coping structures that included coping efforts, meaning-based coping and moderators. CONCLUSION: Dialysis patients are making efforts to cope with their stress in order to reduce their stress; in some cases, these efforts lead to reduction in stress, and in some cases, due to using unsound coping style, they are ineffective or even harmful. Therefore, the necessity of planning and proper interventions is felt by health care providers to control stress in dialysis patients.

The effect of industrial noise exposure on attention, reaction time, and memory.

PURPOSE: Noise, a common physical hazard in many workplaces, may affect different aspects of human cognitive function. In this study, the effect of exposure to noise on some aspects of cognitive function was assessed in industrial workers. MATERIALS AND METHODS: This was a cross-sectional study on 84 individuals exposed to noise level higher than 85 dBA in a metal industry (noise group), comparing a group of workers from the same industry (n = 80) with exposure to noise level lower than 80 dBA (control group). The individuals in the noise group were classified as well according to noise intensity into: high exposure (90 dBA and higher) and low exposure (between 85 and 90 dBA). Selective attention score, divided attention score, selective response time, divided response time, and memory scale were measured before and after work shift. Data were analyzed by SPSS (Ver. 16) using Kolmogorov-Smirnov test, paired t test, Student's t test and Mann-Whitney U test were used to compare mean difference of the variables between two groups. p < 0.05 was considered as significant. RESULTS: All measured cognitive functions were significantly changed after work shift in the noise group and the difference was statistically significant between noise and control group. Exposure to higher noise intensity caused more change in cognitive function. CONCLUSION: Exposure to noise higher than 85 dBA affects some aspects of cognitive function (reaction time, attention and memory).