Project

Coping with stress, burnout and secondary trauma among health care professionals who are involved in the process of donation and transplantation of organs

Goal: The working and organizational conditions, traumatic tasks, as well as the various challenges that health institutions and professionals have to face have changed over time, sometimes stemming from the continuous changes that are taking place in society. An area that has experienced a particularly large increase over the last years is the organ transplant area. The reason for this increase is twofold: (1) the continuing medical advances in the process of donation and transplantation which are essential for improving the survival of humans; (2) an increasing demand for organs due to diseases related to an aging population and certain pathological conditions. In order to keep the process of donation and transplants efficient, the task that health professionals perform every day is essential.
From this perspective, this project analyses the organizational factors and deficiencies in the work environment which are causes of occupational risks that these professionals may suffer (i.e., stress, burnout, secondary traumatic stress) as well as personal factors which moderate or mediate the problem. Some studies show that professionals neglect the emotional demands in their work and, aggravating the problem, do not receive adequate organizational support. To this end, the aim of the project focuses on variables that can generate or inversely prevent psychosocial risks faced by health workers in these units daily and on a general level, contributing to the adoption of preventive measures within health institutions as well as to the optimal functioning of the process of donation and transplantation of organs. The project involves studying whether these results are different in other health institutions such as the Brazilian

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Project log

Luis Manuel Blanco-Donoso
added a research item
This study aimed to explore whether an acceptance and commitment (ACT) approach to stress management training improved the levels of depression, anxiety, and stress among a group of twenty-two health professionals from an intensive care unit. Questionnaires were administered before and after training, and follow-up was carried out one month after training, including semi-structured interviews with nine participants. The results reflected that the quasi-experimental group reduced their depression and stress levels significantly and showed improvements in stress in the follow-up. A qualitative thematic analysis of interviews showed that nurses were seeking a tool that would help them to cope more effectively with stressful situations and increase their knowledge of stress management. The themes in the professionals’ comments claimed specific improvements in their health, well-being, relationships, and psychological processes. In conclusion, ACT-based trainings offer a possible framework for mental health promotion in health care organizations.
Luis Manuel Blanco-Donoso
added a research item
Abstract: There is an intensification of work in global health systems, a phenomenon that could increase work-family conflict, exhaustion, and intentions to leave among healthcare workers. The main objective of this study is to analyze if daily work-family conflict and burnout could explain the daily leaving intentions and vitality of healthcare workers. This is a diary study, which employs an experience-sampling methodology (ESM). A total of 56 physicians, nurses, and nursing aides from intensive care and nephrology units filled out various quantitative scales during 5 working days (56 × 5 = 280 observations). Multilevel hierarchical analysis showed that daily work-family conflict and burnout were significantly associated with higher daily intentions of leaving the profession, and with lower levels of daily vitality. In addition, those workers who experienced more work-family conflict and depersonalization on a daily basis were those who showed more intentions to leave and less daily vitality, showing an interactive effect. The results highlight the importance of examining the psychosocial risks experienced by healthcare workers by employing experience-sampling methodologies, which could help us to deepen our understanding of the proximal antecedents of their intentions to leave and their psychological well-being. Citation: Blanco-Donoso, L.M.; Moreno-Jiménez, J.; Hernández-Hurtado, M.; Cifri-Gavela, J.L.; Jacobs, S.; Garrosa,
Luis Manuel Blanco-Donoso
added a research item
The objective of this study is twofold: first, to analyze whether the daily level of energy in terms of vigor at work could explain the way in which workers psychologically detach from their work, relax, practice challenging activities, and have the feeling of having control over their leisure time when arriving home. Second, to check if the daily emotional job demands could hinder that relationship, reversing the positive effect of vigor in recovery. For this purpose, a multilevel study with a diary methodology was designed. In total, 94 nurses from various hospital and primary care centers in Madrid and Basque Country (Spain) participated in this study. They completed daily questionnaires twice a day (in the afternoon after work and at night before going to bed) for five consecutive workdays from Monday to Friday (N = 94*5 = 470). The results revealed that on days that vigor at work was high, nurses experienced more psychological detachment, relaxation, feelings of mastery, and time control at home. Moreover, on days that emotional job demands were high, vigor was more negatively related to psychological detachment and time control at home. Additionally, vigor was more positively related to all recovery experiences at home in days that emotional demands were low. Therefore, daily vigor can act as an energy resource that helps the worker to recover. However, this effect can occur in situations in which stressors are not present in high intensity. These results have clear practical implications for both health organizations and workers. https://www.tandfonline.com/eprint/BRZ4EXIB2HXCVK5JBC25/full?target=10.1080/00223980.2020.1870910
Elton Carlos Almeida
added 2 research items
Background: The goal of this study was to identify the tendency toward donations of tissue and organs from donors with brain death between 2001 and 2016 as registered by an organ procurement organization in São Paulo City. Methods: This quantitative, retrospective, exploratory study encompassed all Tissue and Organ Donation Terms signed between 2001 and 2016. A logistic regression model was applied to verify whether there was an upward or downward trend in donation. Results: After statistical analysis, a significant change trend was identified in skin, bones, valve, vessel, heart, lung, and pancreas donations, indicating an increase in the donation rate through the years. The donation rate did not show changes over the years for donations of liver, kidneys, and corneas. Conclusions: The decision-making process regarding organ and tissue donation is restricted not only to the dilemma of whether to donate but another question then arises as well: which organs and tissues are to be donated? The discrepancy between the authorization for organ donation and the authorization for tissue donation, as well as the option for one or another organ and/or tissue, must be thoroughly examined because these factors directly affect the number of transplants and acquirements effectively accomplished. These factors may be related to explaining to one's relatives aspects of the surgery, body reassembling, and usage of such organs and/or tissues. They may also be related to the lack of knowledge concerning organ donation and the symbolism represented by the organ and/or tissue, among other factors.
S. M. V.; DONOSO, L. M. B.; REIS, L. N. dos; VIEIRA, T. R. Aspectos ético-legais envolvidos no proces-so de doação/transplante. Arq. Ciênc. Saúde UNIPAR, Umuarama, v. 16, n. 3, p. 105-109, set./dez. 2012. RESUMO: A pesquisa evidencia os aspectos ético-legais de equipes intra-hospitalares no processo de doação/transplante de órgãos e tecidos, delineando os fatores que interferem no processo de doação/transplante na perspectiva desses profissionais. Participaram 11 pro-fissionais que atuam nesse processo em oito hospitais autorizados para captação de órgãos no Noroeste do Paraná-Brasil. Tratou-se de uma pesquisa qualitativa, exploratória, utilizando-se de entrevista semiestruturada. Identificaram-se através da técnica do Discurso do Sujeito Coletivo, as seguintes Ideias Centrais: contato entre as famílias do doador e do receptor; autorização familiar; necessidade de preparo profissional; autorização legal para a retirada dos órgãos. Disto depreender-se que o contato entre os familiares pode trazer conflitos pós transplantes e, a clareza de como proceder diante um indigente, bem como a importância do preparo profissional para uma abordagem eficaz demonstram preocupação com a transparência nos procedimentos a serem realizados, após a autorização familiar. PALAVRAS-CHAVE: Doação de órgãos; Obtenção de tecidos e órgãos; Doação dirigida de tecido; Família; Atitude do pessoal de saúde. ETHICAL AND LEGAL ASPECTS INVOLVING THE DONATION/TRANSPLANTATION PROCESS ABSTRACT: The research emphasizes the ethical and legal aspects of intra-hospital teams in the donation and transplantation of organs and tissues, outlining the factors that interfere in the donation and transplantation process from the perspective of these professionals. A total of 11 professionals involved in this process in eight hospitals authorized for organ donation in the state of Paraná, Brazil, participated in the study. This was a qualitative exploratory study using semi-structured interviews. By using the Collective Subject Discourse technique, the following central ideas were identified: contact between the donor and receptor families; family authorization; need for professional training; legal authorization for the removal of organs. It could be conclude that this contact between family members can bring post-transplant conflicts and, the clarity about how to proceed in case of an indigent, as well as the importance of professional training for an effective approach, expressing concern about transparency in the procedures to be performed after the family consent is received.
Luis Manuel Blanco-Donoso
added a research item
Nursing professionals who work in intensive care units and participate in activities related to organ donation and transplantation are exposed to a significant number of stressors their work, which favors the appearance of certain psychosocial risks such as work stress, burnout, secondary traumatic stress, moral stress, and the conflict between work and family. In addition, the new scenarios in our country in relation to organ donation, such as uncontrolled and controlled donation after cardiac death, or the intensive cares oriented to organ donation, generate new situations and stressors among these professionals that increase their exposure to psychosocial risks. Therefore, this paper reviews and proposes the specific demands and causes that could influence the development of these risks these professionals, as well as their possible consequences. It also proposes a series of job and personal resources that could be useful to these workers to face these job demands. These proposals meet many of the needs pointed by reference institutions in this field to prevention and promotion of health and well-being in this group of professionals, as well as to improve the process of organ donation and transplantation.
Elton Carlos Almeida
added 2 research items
Atualmente, o transplante de órgãos sólidos e tecidos humanos é uma das opções de tratamento para melhorar a qualidade de vida de pessoas de todas as idades, que apresentam doença crônica irreversível e em seu estágio final. A equipe de enfermagem possui um grande diferencial na atuação direta da melhoria da qualidade de vida de pacientes transplantados, porém estudos comprovam que estudantes de enfermagem não se sentem preparados para atuarem como enfermeiro no tema de doação de órgãos e transplante e que, ao final do curso, se declaram incapazes e imaturos para exercerem a profissão. Dessa forma, este trabalho teve como objetivo realizar uma revisão integrativa sobre as dificuldades enfrentadas pela equipe de enfermagem no cuidado aos pacientes transplantados. Para isso, foi realizada uma revisão nas bases de dados da BDENF, LILACS e PubMed, nas línguas portuguesa, inglesa e espanhola, com os descritores: Transplantes, Cuidados de Enfermagem e Equipe de Enfermagem. Foram encontrados 227 artigos, entretanto, somente cinco responderam a questão norteadora: - dificuldades apontadas pela equipe de enfermagem no cuidado com o paciente transplantado. Foram identificadas dificuldades como a cobrança médica e da equipe de enfermagem sobre o enfermeiro, o ambiente estressante e repetitivo, as orientações dadas ao paciente que somente é ofertada na alta, fazendo com que o paciente não assimile todos os devidos cuidados que deverá ter em domicílio, a falta de conhecimento e de adesão do paciente em relação ao seu tratamento submetido e de sua evolução, entre outras.
This study investigates the mediating role of psychological meaningfulness among social job resources (i.e., coworkers and supervisor support), vigor, and emotional exhaustion in a nursing context. In spite of progress in understanding which organizational influence affects nurses’ vigor and emotional exhaustion, the psychological mechanisms assumed to underlie the associations have not been fully explored. The sample for this study consisted of 171 nurses from Spanish hospitals (54.4 %) and Primary Care Centers (45.6 %). The mediation model was tested using the bootstrapping procedure. Our findings confirmed that psychological meaningfulness fully mediates the impact of social job resources on vigor at work. Moreover, psychological meaningfulness partially mediated the impact of social job resources on emotional exhaustion. Results suggest that meaningfulness plays an important role in the connection between job resources, vigor, and emotional exhaustion. The findings contribute to our understanding of the psychological processes that can explain how job resources contribute to the energetic aspect of burnout and engagement among nurses. Providing nurses with more social job resources, such as coworker and supervisor support, could activate their levels of personal meaningfulness and thus enhance their levels of well-being at work.
Luis Manuel Blanco-Donoso
added a research item
Nurses develop their work in a highly stressful context, where their emotional, attentional and well-being resources are frequently impaired. Because the health care work context is a dynamic and changing context, it is necessary to continue implementing and evaluating the efficacy of brief interventions that consider the organizational needs. The aim of the current paper is showing the result of a pilot study, which implemented and assessed the efficacy of a brief intervention based on Acceptance and Commitment Therapy and Mindfulness to improve nurses levels of psychological flexibility, mindfulness and well-being. Intervention was conducted in a public and tertiary-level hospital in Madrid, specifically in their Intensive Care Units and Emergency Room. For this pilot study, 50 nurses were randomly selected of a total professional population of 164. They were assigned to two groups: the experimental and the waiting-list group. Between-group comparison showed that the intervention had significant benefits in terms of vitality and purpose of life among participants when compared with controls. Intra-group comparisons also showed significant benefits on nurses' psychological flexibility and negative affect when both groups received the intervention. The intervention also significantly changed nurses' vitality at follow-up. These results were discussed in terms of strengths and limitations that a brief intervention of these characteristics could have in the work context.
Luis Manuel Blanco-Donoso
added a project goal
The working and organizational conditions, traumatic tasks, as well as the various challenges that health institutions and professionals have to face have changed over time, sometimes stemming from the continuous changes that are taking place in society. An area that has experienced a particularly large increase over the last years is the organ transplant area. The reason for this increase is twofold: (1) the continuing medical advances in the process of donation and transplantation which are essential for improving the survival of humans; (2) an increasing demand for organs due to diseases related to an aging population and certain pathological conditions. In order to keep the process of donation and transplants efficient, the task that health professionals perform every day is essential.
From this perspective, this project analyses the organizational factors and deficiencies in the work environment which are causes of occupational risks that these professionals may suffer (i.e., stress, burnout, secondary traumatic stress) as well as personal factors which moderate or mediate the problem. Some studies show that professionals neglect the emotional demands in their work and, aggravating the problem, do not receive adequate organizational support. To this end, the aim of the project focuses on variables that can generate or inversely prevent psychosocial risks faced by health workers in these units daily and on a general level, contributing to the adoption of preventive measures within health institutions as well as to the optimal functioning of the process of donation and transplantation of organs. The project involves studying whether these results are different in other health institutions such as the Brazilian