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Prevalence and correlates of burnout in health professionals in Ecuador
Abstract
Background:
Although burnout is a widespread phenomenon among healthcare professionals, there are no studies about its prevalence in Ecuador. This study assesses the prevalence of burnout syndrome among Ecuadorian healthcare professionals and examine the relationship with their personal and organizational characteristics.
Methods:
A total of 2404 healthcare professionals (average age 40.0years; 68.4% women) from the capitals of all 24 provinces in Ecuador participated in this study. Trained psychologists assessed the presence of burnout by applying the Maslach Burnout Inventory. Sociodemographic variables, emotional distress, social support and coping styles as well as organizational variables were also collected.
Results:
Of all healthcare professionals surveyed, 2.6% presented burnout syndrome. By dimensions, 17.2% of the participants presented a high level of emotional exhaustion, 13.5% of depersonalization, and 18.2% had reduced personal accomplishment. Being non-mestizo, being classified as a probable case of mental disorder and using more passive coping were associated with a greater probability of presenting burnout; having >10years of experience was associated with a lower probability of burnout.
Conclusions:
A significant number of active health professionals suffer from burnout. It is necessary to develop effective psychotherapeutic interventions for those who have the syndrome and to evaluate potential prevention strategies in those who have not yet developed it.
... Personas que experimentan los tres síntomas tienen el mayor grado de agotamiento. (Ramírez et al., 2018) Pines y Aronson en 1988 plantean que cualquier tipo de profesional puede padecerlo, aunque no brinde ayude a otras personas (como los profesionales de la salud) y la definen como estado de agotamiento físico, emocional y mental causado por situaciones emocionalmente exigentes. (Carlin M & Garcés E, 2010) Estudios realizados por Schaufeli y Enzmann, definen el agotamiento como un estado mental persistente, negativo y relacionado con el trabajo en individuos 'normales' que se acompaña de angustia, sensación de competencia reducida, disminución de la motivación y actitudes disfuncionales en el trabajo. ...
... (Marrau, 2004) Además, se considera un factor de riesgo para los trastornos mentales y la enfermedad física lo que hace importante su identificación y manejo adecuado. (Ramírez et al., 2018) A pesar de su reconocimiento como un daño en el ámbito laboral por parte de la OMS y su corriente diagnóstico por parte de médicos y profesionales de la salud mental, el Síndrome del quemado no se describe en la Clasificación internacional de enfermedades (CIE-10), ni en el Manual diagnóstico y estadístico de los trastornos mentales (DSMIV) (5), ni se incluye en la nueva versión del Manual de la Asociación Estadounidense de Psicología (DSM-V). (Korczak et al., 2010) El Síndrome de Burnout se considera un problema de salud pública, que afecta principalmente a profesionales de la salud, y es el resultado de la interacción entre factores psicosociales y características individuales. ...
... (Moukarzel et al., 2019) El agotamiento emocional se asocia con altos costos para la sociedad, mayor ausentismo laboral, discapacidad laboral crónica, Además del impacto en la calidad de la atención prestada y satisfacción del paciente. (Ramírez et al., 2018) El estudio "Empaty and Burnout" menciona que en el Reino Unido los Servicios de Urgencia de los Hospitales son los lugares con mayor estrés ocupacional comparados con otros servicios médicos, ratificando la problemática de salud que representa el síndrome de agotamiento emocional en los profesionales. (Yuguero et al., 2017) El trabajo de los profesionales en los Servicios de Emergencia es complejo y depende de la articulación de equipos multidisciplinarios, se ven expuestos a situaciones de violencia, agonía, muerte al tratar con pacientes directamente en situaciones críticas. ...
El Síndrome de burnout o síndrome de agotamiento profesional, es una respuesta inapropiada al estrés crónico en contextos laborales, fue definido por primera vez por Freudenberger en 1974. Abarca la perspectiva clínica y psicosocial, la primera es considera como un detrimento por exposición al estrés laboral, y la segunda, es un proceso que se desarrolla por la interacción de características extralaborales e intralaborables. Objetivo: Determinar el grado de afectación del Síndrome de Burnout en la pandemia Covid-19 en los trabajadores del servicio de emergencia del Hospital IESS-Riobamba en el año 2020. Materiales y método: Estudio Cuantitativo no experimental transversal y descriptivo, a 52 trabajadores del Hospital General IESS-Riobamba, se aplicó la técnica de la encuesta test de Maslach de 16 preguntas, se emplearon criterios de inclusión exclusión. Para el análisis de la información se empleó la descripción de frecuencias y porcentajes y el cálculo estadístico del Chi-cuadrado (inferencias entre variables nominales y resultados del test). Resultados: Se encuestaron a un total de 52 trabajadores, el 26,9 % de sexo masculino y el 73,1% de sexo femenino. El rango de edad prevalente fue 31-40 años (59,6%), con 1 a 5 años (73,1%) de antigüedad. En relación con las características laborales, 3 trabajadores (5,8%) fueron Médicos Especialistas, 21 (40,4%) Médicos Residentes; 18 (34,6%) Enfermeras, 5 (9,6%) Camilleros, 5 (9,6%) Auxiliares de Enfermería 25 (47,2%). Se identificó que el 78,4% de la población presentaron alta exposición de desgaste emocional, el 71,1% obtuvo puntajes altos en cinismo y en eficacia profesional 50%. Conclusión: Se identificó una incidencia del 53,8% en los trabajadores del Servicio de Emergencia durante la pandemia Covid-19, 25 de ellos cumplen con las 3 dimensiones psicológicas del síndrome por ende mayor riesgo de detrimento
... Dentro dos fatores de risco relacionados com o trabalho identificam-se a sobrecarga de trabalho 6,[8][9][10][11] , a falta de reconhecimento profissional e estagnação remuneratória 6,8-9,12-13 , a escassez de suporte e confiança interpares 6,8,11,[14][15][16] e a SAÚDE & TECNOLOGIA . MAIO | 2020 | #23 | P. 38-50 . ...
... Nos fatores demográficos destacam-se a idade, o género, o estado civil, o número de filhos, as habilitações literárias, o tempo de exercício profissional e a posição hierárquica, entre outros 6,[9][10]18 . ...
... A maioria dos cuidados de saúde centra-se na assistência ao paciente, onde a interação com ele e seus familiares se torna imprescindível 4,9 . Vários estudos revelam uma forte relação entre o stress laboral e a responsabilidade por pessoas 5,[9][10]27 . A relação de cuidado entre o profissional de saúde e o paciente envolve experiências emocionais significativas, algumas extremamente gratificantes, outras emocionalmente desgastantes. ...
RESUMO: Introdução-O burnout é descrito como uma síndroma que envolve exaustão emocional, física e mental e que resulta da exposição continuada ao stress laboral. É caracterizada por elevada exaustão emocional, despersonalização e baixa realização pessoal. Objetivo-Este estudo procurou avaliar o risco de burnout nos técnicos de radiologia que exercem funções em instituições de saúde da região do Porto, Portugal. Materiais e Métodos-Os níveis de burnout foram estimados através do Maslach Burnout Inventory-Human Services Survey composto por 22 questões. A amostra foi constituída por 122 indivíduos, provenientes de sete instituições de saúde, públicas e privadas, em que 61,5% eram do sexo feminino, com média de idades e desvio-padrão de 38,3 (±9,3) anos. Na análise relacional entre as variáveis sociodemográficas e os resultados do MBI-HSS foram utilizados os testes Qui-quadrado de Pearson ou Exato de Fisher, conforme a percentagem de células com contagem menor que 5 era menor ou maior que 20% para as variáveis qualitativas. Para as variáveis quantitativas realizaram-se os testes ANOVA ou Kruskal-Wallis, conforme a homogeneidade da variância entre grupos. A interpretação dos testes estatísticos correlacionais foi efetuada com base no nível de significância de α=0,05 com intervalo de confiança de 95%. Resultados-A análise dos níveis das dimensões do burnout revelou valores médios de 21,73 (±11,37) para a exaustão emocional, de 7,42 (±5,40) para a despersonalização e de 32,79 (±8,46) para a realização pessoal, o que se coaduna com níveis moderados para as duas primeiras dimensões e baixos para a última. Deste grupo de técnicos, 39,3% e 29,5% exibem elevados níveis de exaustão emocional e despersonalização, respetivamente. A baixa realização pessoal é experienciada por 48,4% dos inquiridos. Discussão-As mulheres são mais afetadas pela exaustão emocional (51%), bem como os profissionais com tempo na função entre os 11 e os 30 anos. Em serviços compostos por 20 a 40 técnicos observa-se um nível mais elevado de exaustão emocional (63%). A maioria dos inquiridos afirma que o trabalho afeta a sua autoes-tima, vida familiar e social, nomeadamente de forma negativa, o que posteriormente se relaciona com alguns valores elevados de exaustão emocional e despersonalização e baixos de realização pessoal. Conclusão-A ocorrência de burnout nos técnicos de radiologia é relevante e estes resul-tados alertam para a necessidade de intervir no sentido de melhorar as condições de trabalho, formação contínua e implementação de medidas de suporte emocional dos profissionais de saúde, de forma a garantir a qualidade do serviço prestado aos utentes e o bem-estar pessoal destes profissionais.
Abstract: Introduction-Burnout is described as a syndrome that involves emotional, physical, and mental exhaustion that results from continued exposure to work stress. It is characterized by high emotional exhaustion, depersonalization, and low personal accomplishment. Objective This study sought to evaluate the risk of burnout in the radiology technicians who work in health care institutions of Porto district, Portugal. Materials and Methods-Burnout levels were
... En lo que respecta a los objetivos de la investigación en primera instancia se determinó los puntajes de las dimensiones del sindrome de burnout. El 25.8% demostró niveles altos de agotamiento emocional, cifra que difiere de diferentes estudios que presentan porcentajes medianamente bajos que van desde 13.5% a 17.2% (Chaput et al., 2015;Ramírez et al., 2018). En la dimensión de despersonalización el 17.6% obtuvo puntajes altos, estudios como el de Ramírez et al. (2018) En la prevalencia del síndrome de burnout, se evidenció 2.8%, estos datos se relacionan con los trabajos de Lorenz, Benatti, y Sabino (2010), Muñoz y Velázquez (2016) y Ramírez et al. (2018) que identificaron una prevalencia comprendida entre el 2.6 al 7.3. ...
... El 25.8% demostró niveles altos de agotamiento emocional, cifra que difiere de diferentes estudios que presentan porcentajes medianamente bajos que van desde 13.5% a 17.2% (Chaput et al., 2015;Ramírez et al., 2018). En la dimensión de despersonalización el 17.6% obtuvo puntajes altos, estudios como el de Ramírez et al. (2018) En la prevalencia del síndrome de burnout, se evidenció 2.8%, estos datos se relacionan con los trabajos de Lorenz, Benatti, y Sabino (2010), Muñoz y Velázquez (2016) y Ramírez et al. (2018) que identificaron una prevalencia comprendida entre el 2.6 al 7.3. ...
... El 25.8% demostró niveles altos de agotamiento emocional, cifra que difiere de diferentes estudios que presentan porcentajes medianamente bajos que van desde 13.5% a 17.2% (Chaput et al., 2015;Ramírez et al., 2018). En la dimensión de despersonalización el 17.6% obtuvo puntajes altos, estudios como el de Ramírez et al. (2018) En la prevalencia del síndrome de burnout, se evidenció 2.8%, estos datos se relacionan con los trabajos de Lorenz, Benatti, y Sabino (2010), Muñoz y Velázquez (2016) y Ramírez et al. (2018) que identificaron una prevalencia comprendida entre el 2.6 al 7.3. ...
Este trabajo de investigación estuvo en función determinar la prevalencia del síndrome de burnout y su relación con estrategias afrontamiento con una muestra de 142 médicos. Los instrumentos utilizados fueron: Cuestionario sociodemográfico [Ad hoc], Maslach Burnout Inventory [MBI] Maslach y Jackson (1986); y COPE-28 [Brief COPE] Carver (1997). En relación con la prevalencia del síndrome de burnout se identificó un 2.8%. Los altos niveles de agotamiento emocional fueron 25.8%, en despersonalización el puntaje alto fue de 17.6% y con una baja realización personal de 61.2%. Las estrategias de afrontamiento que presentaron una media mayor a 4.5 y una desviación estándar 1.9 fueron, replanteamiento positivo, aceptación, planificación y apoyo instrumental en cuanto a la correlación entre las estrategias de afrontamiento y el burnout existe un nivel de significancia alto con: autodistracción r(142)= -.147 p< 0.001, afrontamiento activo r( 142)= -.313 p< 0.001 desahogo r(142)= .208 p= 0.011, replanteamiento positivo r(142)= - .313 p< 0.001 y culpa r(142)=.179 p=0.029.
... DP is negative attitudes and feelings and a lack of sensitivity and empathy towards the people who are being served. Reduced PA is the tendency to assess oneself and one's work negatively, with the avoidance of interpersonal relationships, low productivity, and lack of resistance to stress [13]. ...
... Health professionals work in emotional situations and face the physical, economic, social, and psychological problems of patients and their families [14]. They experience a lot of stress due to the need for quick responses to the needs of patients and their families, the high workload, and long hours of work in a complex working environment [13]. Exposure to these conditions can lead to burnout [11]. ...
... Recent studies indicate a high level of stress and burnout in healthcare workers. Studies from around the world, including on physicians [6,15,16], nurses [10,17,18], physiotherapists [14][15][16][17][18][19], primary health care workers [20][21][22] and other health professionals [4,7,13,23], have reported prevalence rates of burnout from 2.6% to 75%. In addition, the results of two studies from Iran showed that the prevalence of burnout in PHC workers is 17.3% to 34.5% [21,24]. ...
: Burnout, which is an emerging challenge in health systems, is very common among primary health care (PHC) workers. The aim of this study was to investigate the level of burnout among PHC workers, and its predictive factors, in a region in the west of Iran.In this cross-sectional study, all the health network staff (n = 539) were enrolled. The data collection instrument was the Maslach Burnout Inventory (MBI), which consists of 22 items and the three subscales of emotional exhaustion (EE), depersonalization (DP), and personal achievement (PA). High scores in EE and DP and low scores in PA are indicative of high burnout. Logistic regression was used to determine the predictors of high burnout. The data were analyzed using SPSS version 16. The findings showed that 90.5% of the staff had high DP, 55.3% had high EE, and 98.9% had low PA scores. Also, 52.9% (277 people) of the staff suffered from high burnout. Single people (OR = 3.33), less experienced employees (OR = 9.09), people aged over 35 years (OR = 2.35), physicians (OR = 1.72), and staff with permanent employment (OR = 5.0) were more likely to suffer high levels of burnout. We conclude that burnout is a common problem in PHC workers. Less experienced, younger, single employees and physicians were more at risk of suffering from high burnout. Preventive measures, such as strengthening social skills, communication competencies, and coping strategies, and reduction of risk factors such as job stress, are suggested for reducing employees’ risk of burnout.
... (32) Compared to the present study, lower levels of burnout were generally recorded by Ecuadorian health professionals, and Spanish and Turkish oncologists. (33,34) A national American study in 2012, explored burnout among 27,276 US physicians from all specialties. The study found that 37.9% of US physicians had high EE grade, 29.4% had high DP, and 12.4% had a diminished PA sensation. ...
... (5) However, marital status was not significantly associated with burnout syndrome in French (37) and Ecuadorian healthcare professionals. (33) Physicians had significantly higher means of EE and PA compared to nurses. However, adjusted regression models for burnout subscales revealed that job type was not a significant predictor in any of them. ...
... However, adjusted regression models for burnout subscales revealed that job type was not a significant predictor in any of them. Other studies reported the absence of significant differences between physicians and nurses in burnout perception (5,33,38) Comparing proportion of burnout among Egyptian healthcare workers in Tanta university hospital, high EE and diminished PA were higher among nurses while physicians were significantly more depersonalized. (11) Working away from home country may significantly affect burnout perception. ...
Background & Objective(s): Job burnout and satisfaction of healthcare providers are important
elements of quality of provided health services. Aim of the study: This study aimed to assess the
levels of burnout and job satisfaction as well as their correlates among healthcare providers in Aswan
University Hospital.
Methods: : A cross sectional study design was applied. Interviewing questionnaire was filled from
134 physicians and 149 nurses (total 283) working in clinical departments in Aswan University
Hospital. The questionnaire included personal and job characteristics, assessment of burnout using
Maslach burnout inventory (MBI), evaluation of Job satisfaction by applying short form of
Minnesota satisfaction questionnaire and measurement of satisfaction with life (SWLS) and
flourishing status using Diner scales.
Results: Proportion of high level in burnout dimensions were as follows: emotional exhaustion was
50%, low personal accomplishment was 39% and depersonalization was 33%. The mean job
satisfaction score among the studied population was 63.81±15.37 out of 100. Increasing age was a
significant predictor for emotional exhaustion. Currently unmarried significantly perceived higher
emotional exhaustion and depersonalization. Higher job satisfaction scores significantly predicted
low perception of emotional exhaustion and depersonalization and high personal accomplishment.
The significant predictors for job satisfaction were current unmarried status, working as nurse,
residing outside Aswan, age increase, high personal accomplishment score and low emotional
exhaustion score.
Conclusion: Considerable levels of burnout were detected among healthcare providers in Aswan
University Hospital. Increasing age, being originally from outside Aswan Governorate and being
currently unmarried were significant correlates of burnout and job dissatisfaction.
Recommendations: Modification in the work nature could be conducted for old aged healthcare
providers. Social support activities such as recreational activities and moral incentives, should be
promoted especially for those who are unmarried and residents from outside Aswan Governorate.
... 400), ref. [7]. These are determinants for the development of burnout symptoms, such as those developed by health care workers (doctors, nurses, psychologists, etc.) [44,45]. ...
... In normal situations it has already been reported that journalism is a profession with a high prevalence of mental health problems [26], and that an increase would be expected in crisis situations. In this sample, high prevalence of symptoms associated with burnout, such as low personal accomplishment (17.3%) and emotional exhaustion (16.3%) are reported, which are very similar to those reported in health workers in Ecuador [45]. In non-crisis situations, this could be associated with deficiencies in their training to cover emergencies and that one out of eight perceives low social support-this factor has demonstrated its ability to influence emotional exhaustion in health workers in Ecuador [55]. ...
Journalist’s mental health could predict their job change. This study aims at determining the prevalence of mental health issues and their association with perception of aptitude for covering emergencies and difficulty in seeing a corpse, and also to determine the mental health factors associated with job change. These results guide the psychosocial risk prevention processes for journalists, as well as the training needs that universities could consider to protect the mental health of this vulnerable group.
... 400), [7]. These are determinants for the development of burnout symptoms, such as those developed by health care workers (doctors, nurses, psychologists, etc.) [44,45]. ...
... In normal situations it has already been reported that journalism is a profession with a high prevalence of mental health problems [26], and that an increase would be expected in crisis situations. In this sample, high prevalence of symptoms associated with burnout, such as low personal accomplishment (17.3%) and emotional exhaustion (16.3%) are reported, which are very similar to those reported in health workers in Ecuador [45]. In non-crisis situations, this could be associated with deficiencies in their training to cover emergencies and that one out of eight perceives low social support-this factor has demonstrated its ability to influence emotional exhaustion in health workers in Ecuador [55]. ...
Journalist's mental health could predict their job change. This study aims at determining the prevalence of mental health issues and their association with perception of aptitude for covering emergencies and difficulty in seeing a corpse, and also to determine the mental health factors associated with job change. An ad hoc survey, GHQ-28 (Somatization, Anxiety-Insomnia, Social Dys-function, Depression), MBI-P (Burnout, Emotional Exhaustion, Depersonalization, personal accomplishment) and Brief scale to diagnose Post-Traumatic Stress Disorder and Suicide Risk were applied to 196 journalists (female = 51.6%). Descriptive analysis, correlations (Pearson and Spearman), T-test and binary logistic regression were performed. It was found that one third part of journalists perceive themselves as having low aptitude to cover emergencies and difficulty in seeing a corpse, 17.3% would consider changing jobs and 42.1% could only access free mental health services. The most frequent mental health problems are: low personal accomplishment, emotional exhaustion and post-traumatic stress disorder (11.2 to 17.3%). People who want to change jobs present more: social dysfunction, depression, emotional exhaustion, depersonalization, low personal accomplishment , post-traumatic stress disorder and suicide risk. The two mental health factors associated with desire of changing jobs are high emotional exhaustion, and low personal accomplishment. These results guide the psychosocial risk prevention processes for journalists, as well as the training needs that universities could consider to protect the mental health of this vulnerable group.
... Given the importance of maturity, the construct could be vital for student selection and hiring decisions [37][38][39][40]. Maturity may be related to better healthcare professionals' well-being including satisfaction with life [41], coping with stressors [42], favorable transition to clinical environment [43], and reduced burnout [44,45]. However, maturity in much of this research is mentioned but not assessed by the researchers. ...
... Maturity is an important component for job performance such as collaboration on healthcare teams [31][32][33]. Furthermore, maturity appears related to medical professionals' well-being including reduced likelihood of burnout [41][42][43][44][45]. The present research indeed supports this prior research by showing consistent relationships between maturity and indicators of well-being. ...
... Given the importance of maturity, the construct could be vital for student selection and hiring decisions [37][38][39][40]. Maturity may be related to better healthcare professionals' well-being including satisfaction with life [41], coping with stressors [42], favorable transition to clinical environment [43], and reduced burnout [44,45]. However, maturity in much of this research is mentioned but not assessed by the researchers. ...
... Maturity is an important component for job performance such as collaboration on healthcare teams [31][32][33]. Furthermore, maturity appears related to medical professionals' well-being including reduced likelihood of burnout [41][42][43][44][45]. The present research indeed supports this prior research by showing consistent relationships between maturity and indicators of well-being. ...
Researchers have noted an association between maturity and well-being. However, this body of research uses different measures and conceptualizations of maturity (e.g., ego development, psychosocial maturity) and often only a few indicators of well-being. In the present research, we examined associations between a single self-rated measure of maturity and a variety of different indicators of well-being. Furthermore, we examined this association across a variety of samples. We hypothesized that maturity would show a positive relationship with measures related to well-being. Samples of college students (Studies 1, 3, 4), Star Wars fans (Study 2), and individuals in the U.S., Canada, Brazil, Vietnam, and India (Study 5) completed a short measure of maturity and measures related to well-being. Across the studies, self-rated maturity was consistently positively correlated with various indicators of well-being (e.g., psychological, physical) and related constructs (e.g., self-compassion, empathy). The results highlight the association between maturity and well-being. Furthermore, the results address the fragmented nature of this association in the literature by showing consistent relationships with a variety of well-being indicators with a single measure of maturity. Assessments of maturity may be beneficial in hiring decisions and student evaluation in the healthcare profession.
... En el contexto ecuatoriano se ha realizado diversos estudios para determinar este puede afectar al personal de salud. De acuerdo a Ramírez et al. [2], antes de la pandemia del COVID 19 tan solo el 2.6% del personal presentó el Síndrome del Burnout. Torres et al. [3] realizó un estudio durante la crisis sanitaria, y evidenció que un 8,59% del personal médico presento burnout en su totalidad. ...
... • Coping will be measured using the 28-item Brief COPE [38]. The Spanish Brief COPE has been used to measure coping in previous studies in Latin America and has been found to be associated with other constructs of interest to this study (e.g., psychological wellbeing, social support) [39,40]. Psychometric analyses of the Spanish version of the Brief COPE identified a unique factor structure that. ...
Background
Community- and strengths-based psychosocial interventions are central to mental health and psychosocial support guidelines, but rigorous evidence regarding the effectiveness of these interventions is limited. The complexity and variability that is inherent to many community-based psychosocial interventions requires innovative strategies in order to facilitate the comparability and synthesis across research studies without compromising the fit and appropriateness of interventions to specific study populations and context. Entre Nosotras is a community-based psychosocial intervention developed for migrant and host community women that is designed to be flexible enough to enable integration of external intervention components and adaptable to diverse study contexts and populations. This protocol describes a study that aims to evaluate the appropriateness, acceptability, and feasibility of integrating a standardized stress management intervention into Entre Nosotras.
Methods
This study will evaluate the appropriateness, acceptability, feasibility, and safety of intervention and research procedures for a cluster randomized comparative effectiveness trial conducted in Ecuador and Panamá with migrant and host community women. In this feasibility trial, we will allocate communities nested within the three study sites to the integrated Entre Nosotras + stress management intervention versus Entre Nosotras alone through stratified randomization. Migrant and host community women residing in these study communities who report low to moderate levels of distress will be allocated to the intervention condition that their community is assigned (n = 220 total). We will collect quantitative measures of psychosocial wellbeing, psychological distress, coping, social support, and functioning from study participants. We will collect quantitative measures of fidelity and facilitator competencies through observation and facilitator self-assessment. Data on appropriateness, acceptability, feasibility, and safety will be gathered from participants and facilitators through quantitative assessments at 0, 5, and 10 weeks post-enrollment and qualitative interviews conducted with all facilitators and a subset of 70 study participants during the post-intervention follow-up period.
Discussion
Results from this feasibility trial will determine whether a multi-site cluster randomized comparative effectiveness trial of an adaptable community-based psychosocial intervention for migrant and host community women is relevant, acceptable, and feasible.
Trial registration
ClinicalTrials.gov identifier: NCT05130944. Registered November 23, 2021—retrospectively registered.
... If you think about traditional societies, the position of a healer is very respected, but it is also accountable to the community." [40] Work burnout and anxiety have always been highlighted as causes of emotional exhaustion that can hinder healthcare providers' performance [41]. During the pandemic, front-line caregivers have faced hard decisions to make [42] and have lived situations of injustice due to the pandemic that have made them feel powerless, all of which has been associated with the burnout they have felt. ...
Turnover of healthcare professionals’ is a rapidly growing human resource issue that affects
healthcare systems. During the COVID-19 pandemic, healthcare professionals have faced stressful
situations that have negatively impacted their psychological health. In this study, we explored
impacts of the emotional wellbeing of healthcare professionals on their intention to quit their jobs. A
cross-sectional survey design was used for this study. The respondents were selected based on simple
random sampling. In total, 345 questionaries were returned and used for the analysis. Respondents
were healthcare professionals (nurses, doctors, midwives, technicians, etc.) working in a pandemic
hospital in Turkey. A multivariable logistic regression model was used to predict the emotions that
encouraged the respondents to intend to quit their jobs. Emotions including anxiety, burnout, and
depression were measured using validated scales. We found that the COVID-19 situation increased
the turnover intention, especially among doctors and nurses (ORnurse/midwife = 22.28 (2.78–41.25),
p = 0.01; ORdoctors = 18.13 (2.22–2.27), p = 0.01) mediating the emotional pressure it was putting them
under. Anxiety related to work-pressure and burnout especially were the main emotional predictors
of turnover intention. The more severe the anxiety was, the more the professional considered
quitting (ORmoderate = 18.96 (6.75–137.69), p = 0.005; ORsevere = 37.94 (2.46–107.40), p = 0.016). Only
severe burnout, however, engendered such an intention among them (ORsevere = 13.05 (1.10–33.48),
p = 0.000).
... If you think about traditional societies, the position of a healer is very respected, but it is also accountable to the community." [40] Work burnout and anxiety have always been highlighted as causes of emotional exhaustion that can hinder healthcare providers' performance [41]. During the pandemic, front-line caregivers have faced hard decisions to make [42] and have lived situations of injustice due to the pandemic that have made them feel powerless, all of which has been associated with the burnout they have felt. ...
Turnover of healthcare professionals’ is a rapidly growing human resource issue that affects healthcare systems. During the COVID-19 pandemic, healthcare professionals have faced stressful situations that have negatively impacted their psychological health. In this study, we explored impacts of the emotional wellbeing of healthcare professionals on their intention to quit their jobs. A cross-sectional survey design was used for this study. The respondents were selected based on simple random sampling. In total, 345 questionaries were returned and used for the analysis. Respondents were healthcare professionals (nurses, doctors, midwives, technicians, etc.) working in a pandemic hospital in Turkey. A multivariable logistic regression model was used to predict the emotions that encouraged the respondents to intend to quit their jobs. Emotions including anxiety, burnout, and depression were measured using validated scales. We found that the COVID-19 situation increased the turnover intention, especially among doctors and nurses (ORnurse/midwife = 22.28 (2.78–41.25), p = 0.01; ORdoctors = 18.13 (2.22–2.27), p = 0.01) mediating the emotional pressure it was putting them under. Anxiety related to work-pressure and burnout especially were the main emotional predictors of turnover intention. The more severe the anxiety was, the more the professional considered quitting (ORmoderate = 18.96 (6.75–137.69), p = 0.005; ORsevere = 37.94 (2.46–107.40), p = 0.016). Only severe burnout, however, engendered such an intention among them (ORsevere = 13.05 (1.10–33.48), p = 0.000).
... Mientras que en Ecuador, Ramírez et al. (9), en el año 2018 reportó una incidencia de burnout de 2,6% en médicos de 24 provincias, en los momentos actuales las cifras se han incrementado hasta el 95,36%, en el personal sanitario que labora en los hospitales centinelas de la pandemia, puntuando a moderado y severo (10), por otro lado Torres et al, obtuvieron en profesionales sanitarios ecuatorianos del sector público y privado, burnout severo con despersonalización del 95% y agotamiento emocional en 47,8% (11), por último en Riobamba en un hospital docente las cifras reportadas fueron de 35,64% (12). ...
Introducción: El Síndrome de Burnout se caracteriza por despersonalización, agotamiento emocional y baja realización personal, tiene lugar en médicos que por su rol se ven expuesto a estrés crónico y la pandemia no ha sido la excepción, países como Rumania, México, Colombia entre otros, han reportado prevalencias altas del síndrome, en comparación al periodo anterior a la pandemia. El presente estudio tuvo como objetivo caracterizar a médicos residentes con Burnout durante la pandemia COVID-19. Métodos: Se realizó estudio descriptivo, observacional y transversal a 40 médicos residentes del Hospital Provincial de Portoviejo, Manabí, Ecuador. Aplicando el MBI-HSS con sus tres dimensiones despersonalización, agotamiento emocional y realización personal. Resultados: Del total de la población se obtuvieron 17 casos con alto agotamiento emocional (42.5%) y despersonalización 19 casos (47.5%): con realización personal baja 18 (45%). De estos, 15 (37.8%) profesionales cumplían los 3 criterios del burnout, en su mayoría mujeres (80%), edad promedio 30,75±2.30, casadas (60%), jornadas semanales ≤ 72 horas (75%), con hijos (91.67%), antigüedad laboral ≤ a 3 años (83.33%) que laboraban en emergencias (75%). Conclusión: Durante el periodo de estudio, se logró caracterizar a la población medica con burnout, en su mayoría mujeres, casadas, con más de un hijo, que laboran 3 días a la semana haciendo guardias en el servicio de emergencias, haciendo necesaria la identificación oportuna de estos casos para abordarlo efectiva e inmediata.
... Por fim, vale ressaltar que alguns estudos foram excluídos, por não apresentarem os resultados em separado para os profissionais da psicologia, trazendo os resultados em conjunto com outros profissionais da saúde. Apesar da relevância destes achados, percebemos como uma limitação, ao investigar exclusivamente a síndrome de burnout em psicólogos (Finkelstein, Bachner, Greenberger, Brooks, & Tenenbaum, 2018;Ramírez, et al., 2018). ...
This paper intended raise and summarize the main researches results about Burnout Syndrome among psychologists in the world. Queries were conducted on PsycINFO, Scielo and PubMed databases in the period 2009-2019. The search procedure defined by descriptors "Burnout Syndrome" and "Psychologists" identified, after inclusion and exclusion criteria, 16 articles that have been evaluated using 8 categories of analysis. The analysis of the results indicated a predominance of quantitative and cross-sectional studies, conducted in the USA. The most investigated variables were sex and time of service in the profession. The findings of the study reinforce the need for further qualitative, experimental and longitudinal research that address the influence of characteristics of the individual's personality, ways of coping and the impacts that support from family, or conflicts arising from this relationship, might cause.
... Our study suggested that pandemic-related burnout negatively influenced preventive practice among healthcare workers. Burnout can seriously affect the physical and mental health of health professionals which can lead to low productivity, absenteeism, and accident at the workplace [27]. Experience from the SARS pandemic revealed that burnout during a pandemic can be devastating and long-lasting which leads to serious effects on the well-being of healthcare providers [28]. ...
Introduction:
COVID-19 pandemic has placed the entire world, including Malaysia in a state of fear. The rising burden on healthcare facilities has put healthcare workers consistently at risk of healthcare-associated infection. We sought to identify determinants of preventive practice against COVID-19 at work among primary healthcare professionals in Sabah, Malaysia.
Method:
This was a cross-sectional study involving healthcare workers of the Penampang and Putatan districts of Sabah, Malaysia. A total of 167 health professionals from primary healthcare settings took part in this study via a self-administered questionnaire from November 2020 until January 2021. Independent t-test and Analysis of Variance were used to determine differences in preventive practice for categorical independent variables. Pearson product-moment correlation was applied to assess the relationship between Job Satisfaction, burnout, and preventive practice. Subsequently, predictors of preventive practice at work among healthcare workers in Sabah were identified through Binomial Logistic Regression.
Results:
The prevalence of good preventive practice among health professionals at work was 71.3%. There was no difference in preventive practice between professions. Almost all participants reported having good personal protective equipment compliance and hand hygiene practice at work. Marital status (AOR= 4.170, 95% CI = 1.787, 9.733; p= 0.001), average sleep hours (AOR= 1.775, 95% CI = 1.144, 2.754; p= 0.01), and pandemic-related burnout (AOR= 0.905, 95% CI = 0.847, 0.967; p= 0.003) were identified as significant predictors of preventive practice at primary healthcare facilities.
Conclusions:
The outcome of this study is beneficial to the healthcare organization. It can serve as a useful guide to tackle issues related to poor preventive practice against COVID-19 at work for health professionals.
... Por fim, vale ressaltar que alguns estudos foram excluídos, por não apresentarem os resultados em separado para os profissionais da psicologia, trazendo os resultados em conjunto com outros profissionais da saúde. Apesar da relevância destes achados, percebemos como uma limitação, ao investigar exclusivamente a síndrome de burnout em psicólogos (Finkelstein, Bachner, Greenberger, Brooks, & Tenenbaum, 2018;Ramírez, et al., 2018). ...
Universidade do Vale do Rio dos Sinos ________________________________________________________________________________________ Abstract: This paper intended raise and summarize the main researches results about Burnout Syndrome among psychologists in the world. Queries were conducted on PsycINFO, Scielo and PubMed databases in the period 2009-2019. The search procedure defined by descriptors "Burnout Syndrome" and "Psychologists" identified, after inclusion and exclusion criteria, 16 articles that have been evaluated using 8 categories of analysis. The analysis of the results indicated a predominance of quantitative and cross-sectional studies, conducted in the USA. The most investigated variables were sex and time of service in the profession. The findings of the study reinforce the need for further qualitative, experimental and longitudinal research that address the influence of characteristics of the individual's personality, ways of coping and the impacts that support from family, or conflicts arising from this relationship, might cause.
... Por fim, vale ressaltar que alguns estudos foram excluídos, por não apresentarem os resultados em separado para os profissionais da psicologia, trazendo os resultados em conjunto com outros profissionais da saúde. Apesar da relevância destes achados, percebemos como uma limitação, ao investigar exclusivamente a síndrome de burnout em psicólogos (Finkelstein, Bachner, Greenberger, Brooks, & Tenenbaum, 2018;Ramírez, et al., 2018). ...
... Por fim, vale ressaltar que alguns estudos foram excluídos, por não apresentarem os resultados em separado para os profissionais da psicologia, trazendo os resultados em conjunto com outros profissionais da saúde. Apesar da relevância destes achados, percebemos como uma limitação, ao investigar exclusivamente a síndrome de burnout em psicólogos (Finkelstein, Bachner, Greenberger, Brooks, & Tenenbaum, 2018;Ramírez, et al., 2018). ...
... Por fim, vale ressaltar que alguns estudos foram excluídos, por não apresentarem os resultados em separado para os profissionais da psicologia, trazendo os resultados em conjunto com outros profissionais da saúde. Apesar da relevância destes achados, percebemos como uma limitação, ao investigar exclusivamente a síndrome de burnout em psicólogos (Finkelstein, Bachner, Greenberger, Brooks, & Tenenbaum, 2018;Ramírez, et al., 2018). ...
Resumo: Este artigo objetivou levantar e sumarizar os principais resultados de pesquisas realizadas sobre a Síndrome de Burnout em Psicólogos. Foram consultadas as bases de dados PsycINFO, Scielo e PubMed entre os anos de 2009 e 2019. O procedimento de busca definido pelos descritores “Síndrome de Burnout” e “Psicólogos” obteve, após critérios de inclusão e exclusão, 16 artigos que foram avaliados a partir de oito categorias de análise. A análise dos resultados indicou predominância de estudos quantitativos e transversais, realizados nos E.U.A. As variáveis mais investigadas foram sexo e tempo de serviço na profissão. Os achados dos estudos indicam a necessidade de novaspesquisas de método qualitativo, experimental, longitudinal e que enfoquem a influência das características da personalidade do indivíduo, as formas de enfrentamento e as repercussões que o apoio da família ou os conflitos derivados dessa relação possam ocasionar.Palavras-chave: síndrome de burnout; psicólogos; revisão sistemática.Abstract: This paper intended raise and summarize the main researchesresults about Burnout Syndrome among psychologists in the world. Queries were conducted on PsycINFO, Scielo and PubMed databases in the period 2009-2019. The search procedure defined by descriptors "Burnout Syndrome" and "Psychologists" identified, after inclusion and exclusion criteria, 16 articles that have been evaluated using 8 categories of analysis. The analysis of the results indicated a predominance of quantitative and cross-sectional studies, conducted in the USA. The most investigated variables were sex and time of service in the profession. The findings of the study reinforce the need for further qualitative, experimental and longitudinal research that address the influence of characteristics of the individual's personality, ways of coping and the impacts that support from family, or conflicts arising from this relationship, might cause.Keywords:burnout syndrome; psychologists; systematic review.
... On the other hand, unlike doctors' on-call and shift systems, hospital administrators have relatively regular working hours, so the degree of depersonalization burnout is relatively low. In this study, 50.6% of the participants showed severe low personal accomplishment, higher than previous studies in some Asian and African countries with PA rates ranging from 8.8% to 34.6% [13,53]. This may be because the main force of the hospital is doctors and nurses. ...
(1) Purpose: To analyze the role of job burnout in connection with working hours and subjective well-being (SWB) among hospital administrators in China's tertiary public hospitals. (2) Methods: A multi-stage, stratified, cluster random sampling method was used to select 443 hospital administrators in six tertiary public hospitals for study. The data were collected and analyzed using the working hours measuring scale, Maslach burnout, and the subjective well-being schedule. Pearson correlation, structural equation model, and bootstrap tests were conducted to examine the association between job burnout, working hours, and SWB. (3) Results: Among the 443 respondents, 330 worked more than 8 h per day on average (76.2%), 81 had the longest continuous working time more than 16 h (18.7%), and 362 worked overtime on weekends (82.2%). The prevalence of job burnout in hospital administrators was 62.8%, among which, 59.8% have mild burnout and 3.00% have severe burnout. In the dimension of emotional exhaustion, depersonalization, and reduced personal achievement, the proportion of people in high burnout was 21.0% (91/433), 15.0% (65/433), and 45.3% (196/433), respectively. Job burnout has a mediating effect between working hours and SWB, which accounted for 95.5% of the total effect. (4) Conclusion: Plagued by long working hours and severe job burnout, the hospital administrators in China's tertiary public hospitals may have low SWB. Working hours have a negative direct impact on job burnout and SWB, and an indirect impact on SWB through job burnout as a mediator. Targeted strategies should be taken to adjust working hours to promote the physical and mental health of hospital administrators.
... Similarly, according to the research performed among Nigerian nurses, a relationship between strong and moderate tendency to apply emotion-focused coping strategies and a high level of reduced personal accomplishment was found [12]. Consistent results which confirm that emotion-focused coping strategies contribute to professional burnout were obtained in the research conducted among 314 staff nurses in Taiwan, 2 404 medical professionals in Ecuador as well as Portuguese oncology personnel [13][14][15]. ...
Introduction. Professional burnout, as a defensive, psycho-physical reaction to chronic occupational stress resulting from the imbalance between the demands of the environment and resources of an individual, is the phenomenon which considerably affects the nursing profession. Coping strategies reflect typical ways of reacting to stressful events. The following dissertation is an attempt to provide information on which coping strategies predispose nurses to burnout.
Aim. The aim of the study is determination of coping strategies that are predictors of professional burnout in Polish nurses.
Material and methods. The research group comprised 29 nurses employed in hospitals located in Eastern Poland. The authors’ own socio-demographic questionnaire and standardised psychometric tools were utilised in the course of the research. Brief COPE by S.CH. Carver, adapted into Polish by Z. Juczyński and N. Ogińska-Bulik was applied to determine coping strategies. Link Burnout Questionnaire by M. Santinello, adapted into Polish by A. Jaworowska, was used to measure burnout.
Results. Psychophysical exhaustion is to a great extent connected with such coping strategies as self-blame and planning. Relationship deterioration affects individuals who tend to react to a stressful event by venting emotions. The greater the tendency to self-blame and venting when faced with a stress-related situation, the greater the risk of experiencing the sense of professional ineffectiveness. Disillusion with work is conditioned by denial whereas self-distraction protects from disillusion.
Conclusions. Polish nurses present a moderate and high level of burnout. Some coping strategies (self-blame, venting, self-distraction, planning and denial) are predictors of professional burnout in nurses. It can be assumed that interventions aimed at training certain coping strategies based on the research results may enhance resistance to burnout in nursing professionals.
... 38 This could be explained by the difference in the socioeconomic status of the study areas and participants. On the other hand, the burden of burnout in this study is higher than that of studies conducted among health professionals in Ghana (9.9%), 39 Ecuador (2.6%), 40 Andalusia, Spain (8.19%), 5 Canada (34.1%), 41 Tehran, Iran (17.6%), 42 and Aracaju, Brazil (6.7%-10.8%,). 43 The possible reason for these differences could be the variation in workplace culture, the number of patients, the nature of the health system, and working conditions. ...
Objective
to estimate the pooled national burden of occupational stress, burnout and contributing factors among health care workers in Ethiopia.
Data Sources
both published and unpublished observational studies conducted on the burden of occupational stress and burnout among health workers in Ethiopia were included.
Study Selection
This systematic review and meta-analysis pursued the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline, and was registered on PROSPERO (CRD42020166585). The eligibility of the studies was evaluated based on pre-determined inclusion and exclusion criteria.
Data Extraction
Data extraction was conducted using major databases; Pub Med, Google Scholar, CINAHL, Scopes, Cochrane library, the Web of Science, and African Journals Online were involved in the review. Two reviewers extracted data independently using a standardized data extraction checklist on Microsoft excel. Any discrepancy was resolved by including the third reviewer for a possible consensus.
Data Synthesis
Fourteen studies, with a total of 4066 health care workers, were included in the meta-analysis. The pooled burden of occupational stress and burnout were 52.9% (95%CI, 46.2, 59.7) and 39.1% (95%CI, 23.9, 52.3) respectively. Major determinants of occupational stress were being female (OR, 1.9, 95% CI, 1.1–3.3), being younger (OR, 1.4, 95% CI, 1.03–1.9), having lower educational level (OR, 2.7, 95% CI, 1.05–7.2) and satisfied with a job (OR, 0.3, 95%CI, 0.2-0.5). Whereas, being married (OR, 0.7, 95% CI, 0.5–0.9), having a lower educational level (OR 0.5, 95%CI, 0.4-0.8) and working in shift (OR 0.7, 95%CI, 0.5-0.9) were significant predictors of burnout.
Conclusions
More than half and more than one-third of health care workers were affected by occupational stress and burnout respectively in Ethiopia and; socio-demographic and occupation-related factors were significant factors. Measures that improve job satisfaction, career development, and educational opportunities should be strengthened.
... Por fim, vale ressaltar que alguns estudos foram excluídos, por não apresentarem os resultados em separado para os profissionais da psicologia, trazendo os resultados em conjunto com outros profissionais da saúde. Apesar da relevância destes achados, percebemos como uma limitação, ao investigar exclusivamente a síndrome de burnout em psicólogos (Finkelstein, Bachner, Greenberger, Brooks, & Tenenbaum, 2018;Ramírez, et al., 2018). ...
Este artigo objetivou levantar e sumarizar os principais resultados de pesquisas realizadas sobre a Síndrome de Burnout em Psicólogos. Foram consultadas as bases de dados PsycINFO, Scielo e PubMed entre os anos de 2009 e 2019. O procedimento de busca definido pelos descritores “Síndrome de Burnout” e “Psicólogos” obteve, após critérios de inclusão e exclusão, 16 artigos que foram avaliados a partir de oito categorias de análise. A análise dos resultados indicou predominância de estudos quantitativos e transversais, realizados nos E.U.A. As variáveis mais investigadas foram sexo e tempo de serviço na profissão. Os achados dos estudos indicam a necessidade de novas pesquisas de método qualitativo, experimental, longitudinal e que enfoquem a influência das características da personalidade do indivíduo, as formas de enfrentamento e as repercussões que o apoio da família ou os conflitos derivados dessa relação possam ocasionar.
... De este modo, revisiones sistemáticas realizadas en distintas naciones indican que varía entre 35,1% y 11,23% en médicos y enfermeros, respectivamente. (10,11) En Ecuador el estudio de Ramírez et al. en 2 404 profesionales sanitarios determinó que el 2,6% se ve afectado por esta condición. (12) Aún no se han realizado estudios para determinar la ocurrencia de SB en profesiones sanitarias durante la pandemia de la COVID-19 en este país. ...
Objetivo:
Determinar la ocurrencia e intensidad de Síndrome de Burnout (SB) en médicos y enfermeros/as ecuatorianos/as durante la pandemia del COVID-19.
Material y métodos:
Estudio observacional de corte transversal. Participaron 224 médicos/as y enfermeros/as de establecimientos de la red integral de salud ecuatoriana, a quienes se administró el Inventario de Burnout de Maslach. Se analizaron los datos a través de modelos de regresión lineal usando R.
Resultados:
Más del 90% del personal médico y de enfermería presento SB moderado-severo, el cual se asoció de manera estadísticamente significativa a función (médico vs. enfermera/o), edad y género. El personal médico es afectado con mayor frecuencia que el personal de enfermería, tanto a nivel global como en las subescalas de agotamiento emocional y despersonalización.
Conclusión:
Durante la pandemia de COVID-19 más del 90% del personal médico y de enfermería presentó SB moderado a severo, siendo el personal médico el afectado con más frecuencia.
... In our study, in line with the literature, the emotional exhaustion and depersonalization scores were determined to be higher in physicians, however, the personal accomplishment scores were lower compared to the family health workers [17][18][19]. This seems to be due to the huge burden of responsibilities in the medical profession and the fact that physicians have to make more critical decisions under uncertainty [26]. In addition, we think that since, compared to the family health workers, the physicians encounter more patients and face with much more cases such as malpractice, there is more burnout in physicians than family health workers. ...
Objective: Burnout syndrome is an important problem among health professionals. The aim of the study is to evaluate the relationship between the burnout status and communication skills in primary care staff. Methods: The study was conducted in the cross-sectional type between April and June 2019. The population of the study comprised of physicians and family health professionals working in primary care unit. The participants were administered the Maslach Burnout Inventory, certain questions concerning sociodemographic characteristics, and the communication skills evaluation scale. Results: In total, 383 individuals working in the primary care unit participated in the study. The mean age was 43 ± 8,1 and among them, 64.8% were women. The scores of the emotional exhaustion and depersonalization of physicians were significantly higher compared to nurses. While the depersonalization score of women was significantly lower than men, the sense of personal accomplishment score was higher than men. As the number of daily clinic visits of the physicians increased, the rate of their emotional exhaustion and depersonalization increased. While the communication skills decreased as the emotional exhaustion and depersonalization increased, the communication skills level increased as the sense of personal accomplishment increased. Women, nurses, the widowed/the divorced women, and age group were determined to have better communication skills. Conclusion: A significant relation was determined between burnout subscales and increased number of daily average clinic visits of physicians, gender and occupational groups. There was a significant relationship between communication skill levels and burnout subscales concerning occupational groups, gender, marital status and age groups.
... Uno de los objetivos de esta investigación fue determinar la prevalencia del síndrome de burnout en la muestra de docentes; se determina que existió el 8.3%. Estas cifra están en relación a varios trabajos que reportan una prevalencia entre 2.6% a 16% (Arias, & Jiménez, 2013;Colino, & Pérez de León, 2015;Correa-Correa, Muñoz-Zambrano, & Chaparro, 2010;Ramírez et al., 2018;Ramírez, 2017). ...
The term "burnout" was first used in 1974 by Freudenberger to describe lack of energy and fatigue of workers exposed to chronic stress. The burnout in teachers has been increasing, especially for the task they carry out and with great responsibility in ethics (Gantiva, Jaimes, and Villa 2010). A cross-correlatio-nal field research was carried out, with an accessibility sample of 60 Ecuadorian teachers. The instruments used were an Ad hoc Survey of sociodemographic and labor variables, Maslach Burnout Inventory-Educator Surver [MBI Ed], Eysenck Personality Questionnaire Revised-[EPQR-A] and finally the Goldberg Health Questionnaire-[GHQ-28]. A prevalence of 8.3% of burnout syndrome was reported, in emotional fatigue 28.3% a high level, in depersonalization 18.3% a high level and 40% have low personal achievement. As for correlations, somatic symptoms, anxiety, depression have a significant relationship with burnout, a significant negative relationship between burnout and neuroticism is also reported, finally a significant correlation was found between emotional tiredness with somatic symptoms, anxiety and depression
... De este modo, revisiones sistemáticas realizadas en distintas naciones indican que varía entre 35,1% y 11,23% en médicos y enfermeros, respectivamente. (10,11) En Ecuador el estudio de Ramírez et al. en 2 404 profesionales sanitarios determinó que el 2,6% se ve afectado por esta condición. (12) Aún no se han realizado estudios para determinar la ocurrencia de SB en profesiones sanitarias durante la pandemia de la COVID-19 en este país. ...
Abstract
Objective: To determine the occurrence and intensity of Burnout Syndrome (SB) in Ecuadorian
doctors and nurses during the COVID-19 pandemic.
Materials and methods: Observational cross-sectional study. 224 physicians and nurses from
establishments of the Ecuadorian comprehensive health network participated. Participants were
administered the Maslach Burnout Inventory. Data were analyzed through linear regression
models using R.
Results: More than 90% of the medical and nursing staff presented moderate-severe SB, which
was statistically significantly associated with function (doctor vs. nurse), age and gender.
Medical personnel were affected more frequently than nursing personnel, both globally and on
the emotional exhaustion and depersonalization subscales.
Conclusions: During the COVID-19 pandemine more than 90% of the medical and nursing
personnel presented moderate to severe SB, with the medical staff being the most frequently
affected.
Key-words: Burnout Syndrome, health personnel, COVID-19
... Therefore, our study revealed that an active coping style played a mediating role between sleep quality and learning burnout and its dimensions, while a passive coping style did not. As in previous studies, passive coping significantly predicted depression (Guerrero, 2003;Ramírez et al., 2018;García-Arroyo and Segovia, 2019). However, no significant relationship between passive coping and sleep quality, or even a mediating effect of passive coping, was found. ...
Learning burnout negatively influences students’ learning and well-being. Sleep quality is directly related to students’ health and learning outcomes. Research indicates that sleep quality and coping style may be associated with learning burnout. However, the interrelationship among learning burnout, sleep quality, and coping style has not yet been fully studied. This study aimed to explore the relationship between sleep quality and learning burnout and examine whether coping mediates this relationship in Chinese university students. A total of 228 undergraduate students were recruited to participate in this research. The Simplified Coping Style Questionnaire (SCSQ), Learning Burnout Questionnaire (LBQ), and Pittsburgh Sleep Quality Index-Chinese (PSQI-C) were employed to collect data. The results showed the following: (1) poor sleep quality had a positive association with learning burnout, and (2) active coping style mediated the effects of poor sleep quality on learning burnout and the dimensions of learning burnout (depression and low sense of achievement). The findings of the current study contribute to knowledge of learning burnout and provide theoretical evidence for further educational interventions.
... The prevalence of job-related burnout was higher than the figure of 56.6% found in one Chinese study among obstetricians and pediatricians working in provincial hospitals [28], while it was lower than the 76.9% in another Chinese study including physicians from 10 provinces in China [29]. Compared to other countries, our figure was also significantly higher than that among French physicians (49%, 95% CI: 45-53%) [30] and Iranian nurses (36%, 95% CI: 20-53%) [31], and greater than the health professionals in Ecuador (2.6%) [32] and physicians in USA (56.6%) [33]. Inconsistencies on the definition of burnout and assessment tools, etc., could partly explain the disparities between studies [4]. ...
Background:
This study aimed to examine the degrees of job burnout and occupational stressors and their associations among healthcare professionals from county-level health alliances in Qinghai-Tibet Plateau, China.
Methods:
A cross-sectional study was conducted in county-level health alliances in Qinghai Province, China, in November 2018. The Maslach Burnout Inventory-General Survey and the 38-item Chinese version of the "Scale for occupational stressors on clinicians" were used. Medical staff in four health alliances from two counties were invited to complete the questionnaire.
Results:
A total of 1052 (age: 34.06 ± 9.22 years, 79.1% females) healthcare professionals were included, 68.2% (95% CI: 65.2-71.0%) of the participants had job burnout symptoms. Occupational stressors had positive associations with moderate (OR = 1.06, 95% CI: 1.05-1.07) and serious (OR = 1.15, 95% CI: 1.13-1.19) level of job burnout. Stressors from vocational interest produced the greatest magnitude of odds ratio (OR = 1.76, 95% CI: 1.62-1.92) for serious degree of burnout, followed by doctor-patient relationship, interpersonal relationship as well as other domains of occupational stressors.
Conclusions:
Job burnout was very common among healthcare professionals working in Chinese county-level health alliances, different occupational stressors had associations with job burnout. Appropriate and effective policies and measures should be developed and implemented.
... Respecto a la prevalencia del burnout fue de 2.7%, al respecto existen otros estudios en los que la prevalencia oscila entre 2% a 5% (Arteaga-Romani, Junes-Gonzales y Navarrete-Saravia, 2018; Ramírez, 2017;Ramírez et al., 2018). ...
El burnout constituye un fenómeno global, especialmente en el ámbito de profesionales de lasalud por las características propias de estos profesionales supondría una mayor vulnerabilidad (Gluschkoff, Elovainio, Kinnunen, Mullola, Hintsanen, Keltikangas-Järvinen y Hintsa, 2016;). La presente investigación tuvo como objetivo identificar el burnout y la relación con los rasgos de personalidad (extroversión, psicoticismo, neuroticismo). Se utilizó una metodología descriptiva y correlacional, con una muestra de accesibilidad no probalística de 149 médicos de la zona sur del Ecuador.Los instrumentos utilizados fueron Inventario de Maslach [MBI-HSS] y el cuestionario de personalidad de Eysenck Revisado- [EPQR-A]. Entre los resultados relevantes se obtuvo una prevalencia de 2.7% del síndrome de burnout, en cuanto al agotamiento emocional 25.5% un nivel alto, en despersonalización el 10.7% un nivel alto y el 59.1% tiene baja realización personal. Como conclusiones generales se pudo identificar una correlación significativa entre neuroticismo y el burnout y con las dimensiones agotamiento emocional; despersonalización, así como también entre extroversión y despersonalización.
... This allows us to state that in the sample studied, the effect of coping strategies on health, and specifically on burnout, coincides with the results obtained to date in most European or American contexts and countries. Nevertheless, these results differ from presented by Ramírez et al. (2018) with samples of health professionals in Ecuador. These authors found that the use of more passive coping was associated with a higher probability of presenting exhaustion. ...
Changes in the education system in Ecuador have increased the workload of university teachers, producing stress and burnout. This study analyses the relation between work overload, coping styles and emotional exhaustion in a sample of 202 university teachers by using a hierarchical regression model analysis. The results show that work overload and evasive coping are positively related to emotional exhaustion, while active coping is negatively related to emotional exhaustion. Evasive coping moderated the relationship between work overload and emotional exhaustion so that teachers who use more evasive coping in situations of high work overload experience less burnout than teachers who use this coping style less. Finally, we discuss the limitations of this study and its theoretical and practical contributions for university professors in Latin American contexts. RESUMEN Los cambios en el sistema educativo de Ecuador han contribuido a un aumento de la sobrecarga de trabajo de los docentes universitarios produciendo estrés y burnout. Este estudio analiza la relación entre la sobrecarga de trabajo, los estilos de afrontamiento y el agotamiento emocional en una muestra de 202 profesores universitarios mediante modelos de regresión jerárquica. Los resultados muestran que la sobrecarga de trabajo y el afrontamiento evasivo están positivamente relacionados con el agotamiento mientras que el afrontamiento activo está relacionado negativamente. Además, el afrontamiento evasivo modula la relación entre la sobrecarga y el agotamiento de forma que los docentes que emplean mucho afrontamiento evasivo en situaciones de elevada sobrecarga experimentan menos agotamiento. Finalmente se discuten las limitaciones del estudio y sus implicaciones teóricas y prácticas para los docentes universitarios en contextos latinoamericanos.
... In the case of physicians, they usually share their time with busy private practices; other health care professionals moonlight in other positions. Furthermore, institutions rarely provide formal training in leadership skills, which probably contributes to the high emotional and physical burden of working within the medical education sector in LA. 10,11 Another important point is the unique cultural aspects of the Latin American people. Latin Americans tend to be more emotional, and usually highly value friendship and emotional attachment to their leaders. ...
Introduction: Social support has been found in many contexts, and in urban Ecuador, to be protective of health, particularly in the context of disaster. Fewer studies have explored the presence and impact of social support in rural Ecuador. This study engages a rural community in Ecuador to examine the general levels of social support, differences in social support based on different demographic groupings and relationships among social support and health outcomes and protective health behaviors.
Methods: A cross-sectional design was used to survey 416 people in a rural Ecuadorian community that had recently experienced an earthquake. Spanish-language versions of the Multidimensional Scale of Perceived Social Support and the Interpersonal Support Evaluation List-12 were applied, as well as questions about demographics and risk reduction behaviors. Body mass index, blood pressure, and cholesterol and blood sugar levels were assessed. Analysis of variance assessed differences in social support among demographic groupings, risk reduction behaviors, and health outcomes.
Results: Levels of social support were moderate. Few statistically significant (ie p<0.05) differences in amount of social support received or in sources of social support were found. Men, people 80 years or older, divorced or widowed people, and people living in peripheral areas received less social support than women, people of all other ages, married/cohabitating people, and people living within the village, respectively. Effect sizes of these differences were small. No relationship between social support and health outcomes were found, and few were found for risk reduction factors.
Conclusion: These findings indicate that social support may function differently in rural Ecuador than in urban contexts. Those promoting social support in rural communities may wish to focus on community-level, not individual-level, interventions. Limitations of applying an assessment of social support from urban Ecuadorian contexts to rural Ecuadorian contexts are discussed.
Se realizó una revisión sistemática de 23 artículos científicos, a través de las plataformas de: Pubmed, Scielo, Redalyc, Scopus, Springer, Taylor and Francis, Web of Science, Proquest, y EBSCO, con las palabras clave: “agotamiento psicológico”, “agotamiento profesional” y “personal de salud”, de los últimos 5 años, se encontró en idioma español, inglés y francés. Resultados: en series mundiales el agotamiento en general puede ser hasta del 75%, y de hasta de 50% en despersonalización, agotamiento emocional y baja realización personal, más frecuente en personal de áreas médicas críticas. Los factores de riesgo personales más importantes son la personalidad, comorbilidad clínica y mental, valores morales, cargas emocionales, mientras que los externos son rotación organizacional, perdida de autonomía y sistemas de compensación laboral inequitativas. Las consecuencias del agotamiento del profesional calan en las instancias personales repercutiendo en su salud física, psíquica y de su vida familiar, asi también con implicaciones de costos y de accesibilidad en el sistema de salud y en la satisfacción y seguridad de los pacientes. El diagnostico, orientado por síntomas, es dado por cuestionarios de los cuales el de Maslach es el mas fiable y el de Copenhague. Los enfoques terapéuticos se enfocan en aumentar la autoeficacia y autonomía personal y disminución de carga laboral en el área organizacional.
This cross-sectional study aimed to investigate the sleep quality of psychiatric nurses in China and explore the risk factors affecting it. This study used the stratified random sampling method. The general data questionnaire was conducted using the 10-item Kessler psychological distress scale (K10), the Maslach Burnout Inventory (MBI), and the Pittsburgh Sleep Quality Index (PSQI) were used to investigate the prevalence and risk factors of sleep quality among 812 psychiatric nurses in China. There were statistically significant differences in sleep quality among different shift frequency. Surveys demonstrated that sleep quality among psychiatric nurses was positively correlated with psychological distress and job burnout. Multiple logistics regression analysis showed that high psychological distress (OR = 0.907, p<0.001, 95% CI = 0.885~0.931), high emotional exhaustion (OR = 0.946, p<0.001, 95% CI = 0.921~0.972), low depersonalization (OR = 1.061, p=0.004, 95% CI = 1.019~1.104), and low personal accomplishment (OR = 0.972, p=0.018, 95% CI = 0.949~0.995) were the contributing factors of sleep quality. Future studies should investigate effective measures to relieve psychological distress and alleviate burnout, particularly for psychiatric nurses with poor sleep quality.
Introdução: Os trabalhadores em saúde mental são expostos a situações adversas e estressantes, agravadas por um constante estado de excitabilidade e atenção, sendo conhecido aumento na incidência da Sídrome de Burnout e de ansiedade nesse grupo. Objetivo: avaliar a prevalência da Síndrome na amostra e suas correlações com outras variáveis. Metodologia: Estudo transversal, observacional, onde 142 trabalhadores de um hospital psiquiátrico foram entrevistados por meio de três questionários: sociocultural, Maslach Burnout Inventory (MBI) e Beck Anxiety Inventory (BAI). Os dados foram tabulados e analisados por meio do teste de qui-quadrado, com valor de p significativo <0,05. Resultados: na amostra, a maioria era mulher, com média de idade 50 anos e média de 14 anos de trabalho nesse hospital. 55 trabalhadores apresentaram Burnout (pelo menos um critério comprometido), sendo 18 com diminuição da esfera de realização pessoal (RP), 41 com exaustão emocional (EE) e 23 sofrendo de despersonalização (DP). Foi encontrada uma relação da Síndrome de Burnout com elevados níveis de ansiedade (p=0.0008). Conclusões: O grupo com maiores níveis de ansiedade mostraram pior estados emocional e de saúde mental, associado à incidência da Síndrome de Burnout. Palavras-Chave: Saúde Mental; Burnout; Ansiedade; Profissionais da Saúde.
Introduction: Burnout is a psychological syndrome involving physical depletion, feelings of helplessness, negative self-concept, and negative attitudes towards work, life, and others. Burnout is a problem among health care professionals and nurses are found to be vulnerable. It is associated with a decrease in occupational well-being and increase in absenteeism, turnover and illness.
Objectives: To evaluate the prevalence and factors associated with burnout among nurses at International Hospital Kampala (IHK).
Methods: Analytical cross-sectional design was used. Data was collected from a sample of 120 nurses using questionnaire and Maslach Burnout Inventory (MBI) tools. Analysis was done using Statistical Package for Social Sciences and Microsoft excel.
Results: The prevalence of burnout within the MBI subscales was highest in the subscale of personal accomplishment (PA)-72.5%), followed by Depersonalization (DP)-66.8% and Emotional Exhaustion (EE)-61.7%. Overall prevalence of burnout among was 66.95%. Nurses with high burnout had the lowest level of personal accomplishment-18.33% while nurses with low burnout had the highest level of personal accomplishment-72.5%. Age (X 2 (2) =6.670, p=0.036) was associated with burnout. Respondent years in service was more highly associated with burnout (X 2 (2) = 10.961, p=0.004). Job satisfaction (X 2 (1) = 4.361, p=0.037) was associated with burnout. Emotional Exhaustion (EE) of the respondents (X 2 (2) =29.197, p=0.000) was associated with burnout. Many nurses, 61(50.8%) had EE and burnout. Depersonalization (DP) (X 2 (2) =72.803, p=0.000) was also associated with burnout. Hours worked in a day (X 2 (1) =72.803, p=0.016) was associated with burnout. Getting social support at work (X 2 (1) =72.803, p=0.016) was associated with burnout, thus 48(40.0%) of the nurses who got social support had burnout.
Conclusion: The prevalence of burnout is quite high among nurses.
In Europe, the Council Directive 89/391 for improvement of workers’ safety and health has emphasized the importance of addressing all occupational risk factors, and hence also psychosocial and organizational risk factors. Nevertheless, the construct of “work-related stress” elaborated from EU-OSHA is not totally corresponding with the “psychosocial” risk, that is a broader category of risk, comprising various and different psychosocial risk factors. The term “burnout”, without any binding definition, tries to integrate symptoms as well as cause of the burnout process. In Europe, the most important methods developed for the work related stress risk assessment are based on the Cox’s transactional model of job stress. Nevertheless, there are more specific models for predicting burnout syndrome. This literature review provides an overview of job burnout, highlighting the most important models of job burnout, such as the Job Strain, the Effort/Reward Imbalance and the Job Demands-Resources models. The difference between these models and the Cox’s model of job stress is explored.
The experience of burnout has been the focus of much research during the past few decades. Measures have been developed, as have various theoretical models, and research studies from many countries have contributed to a better understanding of the causes and consequences of this occupationally-specific dysphoria. The majority of this work has focused on human service occupations, and particularly health care. Research on the burnout experience for psychiatrists mirrors much of the broader literature, in terms of both sources and outcomes of burnout. But it has also identified some of the unique stressors that mental health professionals face when they are dealing with especially difficult or violent clients. Current issues of particular relevance for psychiatry include the links between burnout and mental illness, the attempts to redefine burnout as simply exhaustion, and the relative dearth of evaluative research on potential interventions to treat and/or prevent burnout. Given that the treatment goal for burnout is usually to enable people to return to their job, and to be successful in their work, psychiatry could make an important contribution by identifying the treatment strategies that would be most effective in achieving that goal.
Background
Burnout is a psychosomatic syndrome characterized by three dimensions (emotional exhaustion [EE], feelings of depersonalization [DP], and reduced personal accomplishment [PA]). We determined the prevalence of burnout and mental health status between HIV/AIDS healthcare workers and other healthcare workers, and determined the factors associated with burnout of HIV/AIDS healthcare workers.
Methods
All participants were asked to complete a self-administered questionnaire. The participants were recruited from the departments of infectious diseases in four hospitals which treated HIV/AIDS. The questionnaire included demographics, the Maslach Burnout Inventory-General Survey (MBI-GS), the Symptom Checklist 90 (SCL-90), the Eysenck Personality Questionnaire (EPQ), and the Trait Coping Style Questionnaire (TCSQ).
Results
A total of 512 questionnaires were distributed; 501 questionnaires were completed and collected (the response rate was 97.9 %). After eliminating nine invalid questionnaires (1.80 %), 264 physicians and nurses caring for HIV/AIDS and 228 physicians and nurses caring for other infectious diseases provided valid responses (98.2 %). The HIV/AIDS healthcare workers’ scores on the emotional exhaustion (F = 6.350, p = 0.012) and depersonalization dimensions (F = 8.533, p = 0.004) were significantly higher than other healthcare workers. The HIV/AIDS healthcare workers had higher total scores and positive items on the Symptom Checklist 90 (SCL-90) compared with other healthcare workers. Low job satisfaction, serious somatization, interpersonal sensitivity, poor quality of sleep, high psychoticism scores, and use of negative coping styles were frequently associated with burnout.
Conclusions
Burnout was shown to be highly prevalent in HIV/AIDS healthcare workers, 76.9 % of whom met the accepted criteria for burnout. In addition, compared with other healthcare workers, HIV/AIDS healthcare workers experienced lower levels of psychological health. Interventions should be targeted at reducing the occurrence of burnout and alleviating psychological pressure amongst HIV/AIDS healthcare workers.
Objectives:
12 h shifts are becoming increasingly common for hospital nurses but there is concern that long shifts adversely affect nurses' well-being, job satisfaction and intention to leave their job. The aim of this study is to examine the association between working long shifts and burnout, job dissatisfaction, dissatisfaction with work schedule flexibility and intention to leave current job among hospital nurses.
Methods:
Cross-sectional survey of 31 627 registered nurses in 2170 general medical/surgical units within 488 hospitals across 12 European countries.
Results:
Nurses working shifts of ≥12 h were more likely than nurses working shorter hours (≤8) to experience burnout, in terms of emotional exhaustion (adjusted OR (aOR)=1.26; 95% CI 1.09 to 1.46), depersonalisation (aOR=1.21; 95% CI 1.01 to 1.47) and low personal accomplishment (aOR=1.39; 95% CI 1.20 to 1.62). Nurses working shifts of ≥12 h were more likely to experience job dissatisfaction (aOR=1.40; 95% CI 1.20 to 1.62), dissatisfaction with work schedule flexibility (aOR=1.15; 95% CI 1.00 to 1.35) and report intention to leave their job due to dissatisfaction (aOR=1.29; 95% CI 1.12 to 1.48).
Conclusions:
Longer working hours for hospital nurses are associated with adverse outcomes for nurses. Some of these adverse outcomes, such as high burnout, may pose safety risks for patients as well as nurses.
Background:
Burnout is recognized as an occupational hazard, and nursing has a high risk of burnout. This study aims to explore the relationship between psychological capital (PsyCap) and burnout among Chinese nurses and the mediating role of coping style in this relationship.
Methods:
A total of 1,496 nurses (effective response rate: 80.11%) from two large general hospitals in Daqing City of China were selected as participants. Data were collected via the Chinese Maslach Burnout Inventory (CMBI), the psychological capital questionnaire (PCQ-24), the Chinese Trait Coping Style Questionnaire (TCSQ) and demographic and caregiver-patient relationship. Hierarchical linear regression analyses were performed to explore the mediating role of positive coping and negative coping, and we used the Bootstrap method to confirm the mediating effect.
Results:
Self-efficacy, hope, resilience and optimism of nurses were all negatively related with emotional exhaustion, depersonalization and reduced personal accomplishment among Chinese nurses. Positive coping partially mediated the relationship between hope/optimism and emotional exhaustion and between self-efficacy/optimism and reduced personal accomplishment. Negative coping fully mediated the relationship between self-efficacy and emotional exhaustion, and in the regression model self-efficacy was positively correlated with emotional exhaustion. And negative coping also partially mediated the relationship between hope/optimism and emotional exhaustion and between optimism and depersonalization.
Conclusion:
PsyCap had effects on burnout and coping style was a mediator in this relationship among Chinese nurses. Nurses who had a strong sense of self-efficacy adopted more negative coping style, which in turn would lead to higher levels of emotional exhaustion. These findings shed light on the influence of negative coping on burnout, and positive coping was a positive resource for fighting against nurses' burnout. Hence, in order to avoid negative coping style, improve skill of coping and enhance PsyCap of nurses, active interventions should be developed in the future.
Objectives
identify the frequency and intensity of the perception of adverse professional consequences and their association with burnout syndrome and occupational variables.
Methods
cross-sectional sample of 11,530 healthcare professionals resident in Spain and Latin America. The association of negative work-related consequences on burnout, as measured by the MBI and work-related variables was analyzed by multiple logistic regression.
Results
the emotional exhaustion was the first variable associated with absenteeism, with intention of giving up profession, personal deterioration, and family deterioration. Depersonalization was most associated with the perception of having made mistakes.
Conclusions
the findings indicate a considerable prevalence of adverse work-related consequences.
The current study identifies and assesses individual and work-related factors as correlates of burnout among mental health professionals. Results of a meta-analysis indicate that age and work setting variables are the most significant indicators of emotional exhaustion and depersonalization. In terms of level of personal accomplishment, the age and work hours variables were the most significant indicators with positive correlations. On the basis of these results, the authors seek to determine resources that can assist with developing programs for preventing and treating burnout syndromes of mental health professionals.
Background
Interest in the well-being of physicians has increased because of their contributions to the healthcare system quality. There is growing recognition that physicians are exposed to workplace factors that increase the risk of work stress. Long-term exposure to high work stress can result in burnout. Reports from around the world suggest that about one-third to one-half of physicians experience burnout. Understanding the outcomes associated with burnout is critical to understanding its affects on the healthcare system. Productivity outcomes are among those that could have the most immediate effects on the healthcare system. This systematic literature review is one of the first to explore the evidence for the types of physician productivity outcomes associated with physician burnout. It answers the question, “How does burnout affect physician productivity?”
Methods
A systematic search was performed of: Medline Current, Medline in process, PsycInfo, Embase and Web of Science. The search period covered 2002 to 2012. The searches identified articles about practicing physicians working in civilian settings. Articles that primarily looked only at residents or medical students were excluded. Productivity was captured by hours worked, patients seen, sick leave, leaving the profession, retirement, workload and presenteeism. Studies also were excluded if: (1) the study sample was not comprised of at least 50% physicians, (2) the study did not examine the relationship between burnout and productivity or (3) a validated measure of burnout was not used.
Results
The search identified 870 unique citations; 5 met the inclusion/exclusion criteria. This review indicates that globally there is recognition of the potential impact of physician burnout on productivity. Productivity was examined using: number of sick leave days, work ability, intent to either continue practicing or change jobs. The majority of the studies indicate there is a negative relationship between burnout and productivity. However, there is variation depending on the type of productivity outcome examined.
Conclusions
There is evidence that burnout is associated with decreased productivity. However, this line of inquiry is still developing. A number of gaps are yet to be filled including understanding how to quantify the changes in productivity related to burnout.
This meta-analysis examined the relationship between emotion regulation strategies (cognitive reappraisal, expressive suppression) and mental health (measured by life-satisfaction, positive affect, depression, anxiety, and negative affect). 48 studies, which included 51 independent samples, 157 effect sizes, and 21,150 participants, met the inclusion criteria. The results showed that cognitive reappraisal was correlated significantly and positively with positive indicators of mental health (r = .26) and negatively with negative indicators of mental health (r = -.20). Expressive suppression was correlated negatively with positive indicators of mental health (r = -.12), and positively with negative indicators of mental health (r =.15). Expressive suppression was correlated positively with positive indicators of mental health within the category of samples with Western cultural values (r = -.11) but not the category with Eastern cultural values. Moreover, the correlation of expressive suppression and negative indicators of mental health was stronger in the Western cultural values category (r = .19) than in the Eastern cultural values category (r = .06). Therefore, it is necessary for follow-up studies about emotion regulation and mental health to consider some moderator variable like the culture.
A high proportion of the US primary care workforce reports burnout, which is associated with negative consequences for clinicians and patients. Many protective factors from burnout are characteristics of patient-centered medical home (PCMH) models, though even positive organizational transformation is often stressful. The existing literature on the effects of PCMH on burnout is limited, with most findings based on small-scale demonstration projects with data collected only among physicians, and the results are mixed.
To determine if components of PCMH related to team-based care were associated with lower burnout among primary care team members participating in a national medical home transformation, the VA Patient Aligned Care Team (PACT).
Web-based, cross-sectional survey and administrative data from May 2012.
A total of 4,539 VA primary care personnel from 588 VA primary care clinics.
The dependent variable was burnout, and the independent variables were measures of team-based care: team functioning, time spent in huddles, team staffing, delegation of clinical responsibilities, working to top of competency, and collective self-efficacy. We also included administrative measures of workload and patient comorbidity.
Overall, 39 % of respondents reported burnout. Participatory decision making (OR 0.65, 95 % CI 0.57, 0.74) and having a fully staffed PACT (OR 0.79, 95 % CI 0.68, 0.93) were associated with lower burnout, while being assigned to a PACT (OR 1.46, 95 % CI 1.11, 1.93), spending time on work someone with less training could do (OR 1.29, 95 % CI 1.07, 1.57) and a stressful, fast-moving work environment (OR 4.33, 95 % CI 3.78, 4.96) were associated with higher burnout. Longer tenure and occupation were also correlated with burnout.
Lower burnout may be achieved by medical home models that are appropriately staffed, emphasize participatory decision making, and increase the proportion of time team members spend working to the top of their competency level.
To explore the prevalence and associated factors of burnout among five different medical professions in a regional teaching hospital.
Cross-sectional study.
Hospital-based survey.
A total of 1329 medical professionals were recruited in a regional hospital with a response rate of 89%. These voluntary participants included 101 physicians, 68 physician assistants, 570 nurses, 216 medical technicians and 374 administrative staff.
Demographic data included gender, age, level of education and marital status, and work situations, such as position, work hours and work shifts, were obtained from an electronic questionnaire. Job strain and burnout were measured by two validated questionnaires, the Chinese version of the Job Content Questionnaire and the Copenhagen Burnout Inventory.
Among the five medical professions, the prevalence of high work-related burnout from highest to lowest was nurses (66%), physician assistants (61.8%), physicians (38.6%), administrative staff (36.1%) and medical technicians (31.9%), respectively. Hierarchical regression analysis indicated that job strain, overcommitment and low social support explained the most variance (32.6%) of burnout.
Physician assistant is an emerging high burnout group; its severity is similar to that of nurses and far more than that of physicians, administrative staff and medical technicians. These findings may contribute to the development of feasible strategies to reduce the stress which results in the burnout currently plaguing most hospitals in Taiwan.
Burnout occurs when professionals use ineffective coping strategies to try to protect themselves from work-related stress. The dimensions of 'overload', 'lack of development' and 'neglect', belonging to the 'frenetic', 'under-challenged' and 'worn-out' subtypes, respectively, comprise a brief typological definition of burnout. The aim of the present study was to estimate the explanatory power of the different coping strategies on the development of burnout subtypes.
This was a cross-sectional survey with a random sample of university employees, stratified by occupation (n = 429). Multivariate linear regression models were constructed between the 'Burnout Clinical Subtypes Questionnaire', with its three dimensions -overload, lack of development and neglect- as dependent variables, and the 'Coping Orientation for Problem Experiences', with its fifteen dimensions, as independent variables. Adjusted multiple determination coefficients and beta coefficients were calculated to evaluate and compare the explanatory capacity of the different coping strategies.
The 'Coping Orientation for Problem Experiences' subscales together explained 15% of the 'overload' (p<0.001), 9% of the 'lack of development' (p<0.001), and 21% of the 'neglect' (p<0.001). 'Overload' was mainly explained by 'venting of emotions' (Beta = 0.34; p<0.001); 'lack of development' by 'cognitive avoidance' (Beta = 0.21; p<0.001); and 'neglect' by 'behavioural disengagement' (Beta = 0.40; p<0.001). Other interesting associations were observed.
These findings further our understanding of the way in which the effectiveness of interventions for burnout may be improved, by influencing new treatments and preventive programmes using features of the strategies for handling stress in the workplace.
The provision of Intensive Care (IC) can lead to a health care provider's physical, psychological and emotional exhaustion, which may develop into burnout. We notice the absence of specific studies regarding this syndrome in Portuguese Intensive Care Units (ICUs). Our main objective is to study the incidence and risk factors of burnout in Portuguese ICUs.
A self-fulfilment questionnaire containing 3 items: (i) socio-demographic data of the study population; (ii) experiences in the workplace; (iii) Maslach Burnout Inventory (MBI) - was applied to evaluate the influence of distinct factors on the prevalence of burnout among physicians and nurses working in ICUs.
Three hundred professionals (82 physicians and 218 nurses) from ten ICUs were included in the study, out of a total of 445 who were eligible. There was a high rate of burnout among professionals working in Portuguese ICUs, with 31% having a high level of burnout. However, when burnout levels among nurses and physicians were compared, no significant difference was found. Using multivariate analysis, we identified gender as being a risk factor, where female status increases the risk of burnout. In addition, higher levels of burnout were associated with conflicts and ethical decision making regarding withdrawing treatments. Having a temporary work contract was also identified as a risk factor. Conversely, working for another service of the same health care institution acts as a protective factor.
A high rate of burnout was identified among professionals working in Portuguese ICUs. This study highlights some new risk factors for burnout (ethical decision making, temporary work contracts), and also protective ones (maintaining activity in other settings outside the ICU) that were not previously reported. Preventive and interventive programmes to avoid and reduce burnout syndrome are of paramount importance in the future organization of ICUs and should take the above results into account.
Owner/managers of small-to-medium enterprises (SMEs) are an under-researched population in terms of psychological distress and the associated health and economic consequences. Using baseline data from the evaluation of the Business in Mind program, a mental health promotion intervention amongst SME owner/managers, this study investigated: (i) prevalence of high/very high psychological distress, past-month sickness absenteeism and presenteeism days in SME owner/managers; (ii) associated, self-reported lost productivity; and (iii) associations between work, non-work and business-specific factors and work attendance behaviours. In our sample of 217 SME owner/managers 36.8% reported high/very high psychological distress. Of this group 38.7% reported past-month absenteeism, 82.5% reported past-month presenteeism, and those reporting presenteeism were 50% less productive as than usual. Negative binomial regression was used to demonstrate the independent effects of socio-demographic, work-related wellbeing and health-related factors, as well as various individual and business characteristics on continuous measures of absenteeism and presenteeism days. Health-related factors (self-rated health and treatment) were the strongest correlates of higher presenteeism days (p < 0.05). Work-related wellbeing factors (job tension and job satisfaction) were the strongest correlates of higher absenteeism days (p < 0.05). Higher educational attainment, treatment and neuroticism were also correlated with more absenteeism days. SME-specific information about the occurrence of psychological distress, work attendance behaviour, and the variables that influence these decisions, are needed for the development of guidelines for managing psychological distress within this sector.
Burnout has been a major concern in the field of occupational health. However, there is a paucity of research exploring the factors related to burnout among Chinese doctors. Investigation of these factors is important to improve the health of doctors and the quality of healthcare services in China.
The study population consisted of 1,618 registered hospital doctors from Liaoning province of China. Burnout was measured using the Chinese version of the Maslach Burnout Inventory-General Survey. Occupational stress was measured using the Chinese versions of the Job Content Questionnaire and the Effort-Reward Imbalance Questionnaire. Data were collected on the respondents' demographic characteristics and work situations. Of the doctors solicited for enrollment, 1,202 returned the completed questionnaire (555 men, 647 women), giving a response rate of 74.3%. A general linear regression model was applied to analyze the factors associated with burnout.
The burnout mean scores were 11.46 (7.51) for emotional exhaustion, 6.93 (5.15) for cynicism, and 24.07 (9.50) for professional efficacy. In descending order of standardized estimates, variables that predicted a high level of emotional exhaustion included: high extrinsic effort, dissatisfaction with doctor-patient relationship, high overcommitment, working >40 h per week, low reward, and high psychological job demands. Variables that predicted a high level of cynicism included: high extrinsic effort, low reward, dissatisfaction with doctor-patient relationship, high overcommitment, low decision authority, low supervisor support, and low skill discretion. Variables that predicted a low perceived professional efficacy included: high psychological job demands, low coworker support, high extrinsic effort, low decision authority, low reward, and dissatisfaction with doctor-patient relationship.
These findings suggest that occupational stress is strongly related to burnout among hospital doctors in China. Strategies that aim to improve work situations and decrease occupational stress are necessary to reduce burnout, including health education, health promotion, and occupational training programs.
Background:
Nurses' practice involves working in complex organizational settings and facing multiple stressors over time that can lead to burnout. This study aimed to identify predictors of burnout among nurses working in hospitals.
Method:
A sample of 1,157 participants from four hospitals in the city of Porto (Portugal) was investigated (78% women, mean age = 34.7 years) using socio-demographic and work variable questionnaires, the Maslach Burnout Inventory (MBI-HSS), Personal Views Survey (PVS), Job Satisfaction Scale (S20/23), and Survey Work-Home Interaction - NijmeGen (SWING).
Results:
Multiple linear hierarchical regression analyses (stepwise method) showed that gender, age, years of experience at work, working in more than one institution, being involved in management positions, job satisfaction, hardiness, and experience of work-home and home-work interaction, seem to be predictors of burnout among nurses.
Conclusions:
This study adds support to the interactionist approach to burnout. In other words, it is crucial to investigate the relationship between several factors such as socio-demographic, work, and personality factors to understand burnout. Additionally, these findings should be taken into account when designing burnout prevention programs for nurses working in hospitals.
The literature on male–female differences in burnout has produced inconsistent results regarding the strength and direction of this relationship. Lack of clarity on gender differences in organizationally relevant phenomena, such as work burnout, frequently generates ungrounded speculations that may (mis)inform organizational decisions. To address this issue, we conducted a meta-analysis of the relationship between gender and burnout using 409 effect sizes from 183 studies. Results challenge the commonly help belief that female employees are more likely to experience burnout than male employees, revealing instead that women are slightly more emotionally exhausted than men (δ = .10), while men are somewhat more depersonalized than women (δ = −.19). Although these effects are small, they are practically noteworthy when translated into a percent overlap statistic. Moderator analyses further revealed some intriguing nuances to the general trends, such as larger gender differences in the USA compared to the EU. In contrast, gender differences did not vary significantly in male-typed vs. female-typed occupations. Our analyses also suggest discontinuation of the use of overall burnout measures because they are highly consistent with the emotional exhaustion dimension of burnout only.
To characterise the prevalence of burnout syndrome in a sample of family doctors (FDs) working in the Portuguese National Health System.
Cross-sectional survey.
Primary healthcare centres from the 18 continental districts and two archipelagos of Portugal.
The Portuguese version of the Maslach Burnout Inventory-Human Services Survey was sent to 40 randomly selected healthcare centres and distributed to the FDs employed. Socio-demographic and work-related data were also collected. Participants were classified as having high, average or low levels of emotional exhaustion (EE), depersonalisation (DP) and personal accomplishment (PA) dimensions of burnout.
371 questionnaires were sent, of which 153 (83 women, age range 29-64 years; response rate 41%) returned. One-quarter (25.3%, 95% CI 18.6% to 33.1%) of FDs scored high for EE, 16.2% (10.7% to 23.2%) for DP and 16.7% (11.1% to 23.6%) for lack of PA. On multivariate analysis, being married, of older age, having many years of practice or working in a personalised healthcare unit tended to be associated with increased burnout components. Men tended to present higher EE and DP but lower lack of PA than women. Finally, the prevalence (95% CI) of burnout ranged between 4.1% (1.5% to 8.6%) and 32.4% (25.0% to 40.6%), depending on the definition used.
High burnout is relatively common among Portuguese FDs. Burnout relief measures should be developed in order to prevent a further increase of burnout syndrome among Portuguese FDs.
Eating disorders are relatively rare among the general population. This review discusses the literature on the incidence, prevalence and mortality rates of eating disorders. We searched online Medline/Pubmed, Embase and PsycINFO databases for articles published in English using several keyterms relating to eating disorders and epidemiology. Anorexia nervosa is relatively common among young women. While the overall incidence rate remained stable over the past decades, there has been an increase in the high risk-group of 15-19 year old girls. It is unclear whether this reflects earlier detection of anorexia nervosa cases or an earlier age at onset. The occurrence of bulimia nervosa might have decreased since the early nineties of the last century. All eating disorders have an elevated mortality risk; anorexia nervosa the most striking. Compared with the other eating disorders, binge eating disorder is more common among males and older individuals.
Background and Objectives: Although depression is a commonly occurring mental illness, research concerning strategies for early detection and prophylaxis has not until now focused on the possible utility of measures of Emotional Intelligence (EI) as a potential predictive factor. The current study aimed to investigate the relationship between EI and a clinical diagnosis of depression in a cohort of adults. Methods: Sixty-two patients (59.70% female) with a DSM-IV-TR diagnosis of a major affective disorder and 39 aged matched controls (56.40% female) completed self-report instruments assessing EI and depression in a cross-sectional study. Results: Significant associations were observed between severity of depression and the EI dimensions of Emotional Management (r = -0.56) and Emotional Control (r = -0.62). The results show a reduced social involvement, an increased prior institutionalization and an increased incidence of "Schizophrenic Psychosis" and "Abnormal Personalities" in the sub-group of repeated admissions. Conclusions: Measures of EI may have predictive value in terms of early identification of those at risk for developing depression. The current study points to the potential value of conducting further studies of a prospective nature.
Nurses working 12-h shifts complain of fatigue and insufficient/poor-quality sleep. Objectively measured sleep times have not been often reported. This study describes sleep, sleepiness, fatigue, and neurobehavioral performance over three consecutive 12-h (day and night) shifts for hospital registered nurses. Sleep (actigraphy), sleepiness (Karolinska Sleepiness Scale [KSS]), and vigilance (Performance Vigilance Task [PVT]), were measured serially in 80 registered nurses (RNs). Occupational fatigue (Occupational Fatigue Exhaustion Recovery Scale [OFER]) was assessed at baseline. Sleep was short (mean 5.5 h) between shifts, with little difference between day shift (5.7 h) and night shift (5.4 h). Sleepiness scores were low overall (3 on a 1-9 scale, with higher score indicating greater sleepiness), with 45% of nurses having high level of sleepiness (score > 7) on at least one shift. Nurses were progressively sleepier each shift, and night nurses were sleepier toward the end of the shift compared to the beginning. There was extensive caffeine use, presumably to preserve or improve alertness. Fatigue was high in one-third of nurses, with intershift fatigue (not feeling recovered from previous shift at the start of the next shift) being most prominent. There were no statistically significant differences in mean reaction time between day/night shift, consecutive work shift, and time into shift. Lapsing was traitlike, with rare (39% of sample), moderate (53%), and frequent (8%) lapsers. Nurses accrue a considerable sleep debt while working successive 12-h shifts with accompanying fatigue and sleepiness. Certain nurses appear more vulnerable to sleep loss than others, as measured by attention lapses.
To examine the prevalence, correlates, persistence, and treatment-seeking related to symptoms of eating disorders (EDs) in a random sample of college students.
A random sample of students at a large university were recruited for an Internet survey in Fall 2005 and a follow-up survey in Fall 2007.
ED symptoms were measured using the SCOFF screen and adjusted for nonresponse using administrative data and a nonresponse survey.
2,822 (56%) students completed the baseline survey. Among undergraduates the prevalence of positive screens was 13.5% for women and 3.6% for men. Among students with positive screens, 20% had received past-year mental health treatment. In the follow-up sample (N = 753), ED symptoms at baseline significantly predicted symptoms 2 years later.
Symptoms of EDs were prevalent and persistent among college students in this study. These findings suggest that brief screens can identify a large number of students with untreated EDs.
Little information exists on work and stress related health of medical doctors in non-EU countries. Filling this knowledge gap is needed to uncover the needs of this target population and to provide information on comparability of health related phenomena such as burnout across countries. This study examined work related characteristics, work-home and home-work interference and burnout among Serbian primary healthcare physicians (PHPs) and compared burnout levels with other medical doctors in EU countries.
Data were collected via surveys which contained Maslach Burnout Inventory and other validated instruments measuring work and home related characteristics. The sample consisted of 373 PHPs working in 12 primary healthcare centres. Data were analysed using t-tests and Chi square tests.
No gender differences were detected on mean scores of variables among Serbian physicians, who experience high levels of personal accomplishment, workload, job control and social support, medium to high levels of emotional exhaustion, medium levels of depersonalisation and work-home interference, and low levels of home-work interference. There were more women than men who experienced low job control and high depersonalisation. Serbian physicians experienced significantly higher emotional exhaustion and lower depersonalisation than physicians in some other European countries.
To diminish excessive workload, the number of physicians working in primary healthcare centres in Serbia should be increased. Considering that differences between countries were detected on all burnout subcomponents, work-related interventions for employees should be country specific. The role of gender needs to be closely examined in future studies as well.
Afrontamiento, brief COPE, estrés, Psicometría, estrés psicológico, conducta y mecanismos de conducta.
Job dissatisfaction among nurses contributes to costly labor disputes, turnover, and risk to patients. Examining survey data from 95,499 nurses, we found much higher job dissatisfaction and burnout among nurses who were directly caring for patients in hospitals and nursing homes than among nurses working in other jobs or settings, such as the pharmaceutical industry. Strikingly, nurses are particularly dissatisfied with their health benefits, which highlights the need for a benefits review to make nurses' benefits more comparable to those of other white-collar employees. Patient satisfaction levels are lower in hospitals with more nurses who are dissatisfied or burned out-a finding that signals problems with quality of care. Improving nurses' working conditions may improve both nurses' and patients' satisfaction as well as the quality of care.
Burnout in the healthcare workers is formally defined as a state of physical, emotional and mental exhaustion caused by long-term involvement in situations that are emotionally demanding.
Using a random stratified sampling method and taking into account geographical location, specialty and type of employment, 172 physiotherapists working both in the private and public sectors completed an anonymous questionnaire that included several aspects related to burnout; the MBI scale, questions related to occupational stress, and questions pertaining to self image.
Almost half (46%) of the 172 participants believed that their job is stressful. Approximately 57% of the physiotherapists who worked in the public sector and 40% of those who worked in the private sector (p = 0.038) reported that their job is stressful. In total, 21.1% of participants met Maslach's criteria for burnout. The point prevalence of burnout was as follows: (1) 13.8% of those who worked in the public sector and 25.5% of those in the private sector (2) 22.2% of males and 20% of females (3) 21.6% who were married, 18% who were single and 33.3% who were separated. Gender was found to be associated with the level of personal accomplishment (chi-squared test; p = 0.049), as 17.8% of men compared with 24.3% of women reported high personal accomplishment. The number of years of working as a physiotherapist correlated negatively (r = -0.229, p = 0.004) with the total depersonalization score. Regression analysis showed that the perception that the job is stressful (p < 0.001) and the low salary (p = 0.016) were significant predictors of high emotional exhaustion scores, while age group (p = 0.027) predicted high scores of depersonalization and the employment sector (p = 0.050) as well as the low salary predicted high personal accomplishment scores.
Burnout levels in physiotherapists in Cyprus ranged from low to moderate.
Staff burnout is a critical issue for mental healthcare delivery, as it can lead to decreased work performance and, ultimately, to poorer treatment outcomes.
To explore the relative weight of job-related characteristics and perceived organisational factors in predicting burnout in staff working in community-based psychiatric services.
A representative sample of 2000 mental health staff working in the Veneto region, Italy, participated. Burnout and perceived organisational factors were assessed by using the Organizational Checkup Survey.
Overall, high levels of job distress affected nearly two-thirds of the psychiatric staff and one in five staff members suffered from burnout. Psychiatrists and social workers reported the highest levels of burnout, and support workers and psychologists, the lowest. Burnout was mostly predicted by a higher frequency of face-to-face interaction with users, longer tenure in mental healthcare, weak work group cohesion and perceived unfairness.
Improving the workplace atmosphere within psychiatric services should be one of the most important targets in staff burnout prevention strategies. The potential benefits of such programmes may, in turn, have a favourable impact on patient outcomes.
Importance
Establishing strategies to minimize the burden of burnout and poor quality of life (QOL) on surgeons relies on a thorough understanding of QOL and burnout among the various surgical specialties.
Objectives
To systematically review the literature across multiple surgical specialties and provide a comprehensive understanding of QOL and burnout among all surgeons, to delineate variation in rates of burnout and poor QOL, and to elucidate factors that are commonly implicated in these outcomes.
Evidence Review
An OVID electronic search encompassing MEDLINE, PsycInfo, and EMBASE was completed using the following MeSH search terms: quality of life, burnout, surgeon, surgical specialty, and United States. Full articles published in English from January 1, 1980, to June 10, 2015, that evaluated US surgical specialists and included more than 1 question related to QOL were included. Review articles and evaluations that included medical students or nonsurgical health care professionals were excluded. Of 1420 titles, 41 articles met these criteria. The standardized methodologic principles of PRISMA for reporting systematic reviews guided analysis. Primary end points were QOL scores and burnout rates that compared sex, age, level of training (resident vs attending), surgical specialty, and the type of assessment tool. Secondary outcomes included proposed work hours and income as factors contributing to burnout. Owing to the heterogeneity of data reporting among articles, qualitative analysis was also reported.
Findings
Of the 16 specialties included, pediatric (86% to 96%) and endocrine (96%) surgeons demonstrated the highest career satisfaction, whereas a portion of plastic surgeons (33%) and vascular surgeons (64%) were least satisfied. The effect of sex was variable. Residents demonstrated a significantly higher risk for burnout than attending surgeons across multiple specialties, including obstetrics and gynecology, otolaryngology, and orthopedic surgery. One-third of the studies found hours worked per week to be a statistically significant predictor of burnout, decreased career satisfaction, and poorer QOL.
Conclusions and Relevance
Burnout and QOL vary across all surgical specialties. Whether sex affects burnout rates remains unclear. Residents are at an increased risk for burnout and more likely to report a poor QOL than attending surgeons.
Compelling evidence for an association between major adverse life experience and subsequent major depression is reviewed. Determining individual vulnerability to life stress and the effect of stressors on treatment outcome of depression are highlighted as the next major targets for contemporary stress research. Methodological concerns in the evaluation of stressors are detailed, and available data on variables that may influence the stress-depression relationship are presented. The critical importance of multivariate models in understanding individual vulnerability and outcome is emphasized. As methods for ascertaining stressful life events and chronic stressors continue to be refined, and models addressing the complex relationship of stressors and depression continue to be developed, prediction of stressor effects in onset and outcome of major depression will become increasingly more precise.
Población y muestra: 301 individuos seleccionados sistemática-mente según patología, en consulta programada de cuatro médicos de familia. Intervenciones: Se pasó el cuestionario MOS de 20 ítems. La pri-mera pregunta sobre tamaño de la red social y 19 ítems referidos a cuatro dimensiones del apoyo social funcional: emocional/informa-cional, instrumental, interacción social positiva y apoyo afectivo. Resultados: Estudio de fiabilidad de la escala mediante un análi-sis factorial confirmatorio. Extracción de factores por componentes principales, más rotación de varimax. Análisis de la varianza para la comparación MOS con el sexo y las patologías. Para correlación entre edad y cada ítem de la escala se empleó el coeficiente de co-rrelación de Pearson. El 60,8% son mujeres, con una edad media de 48,8 años. El análi-sis factorial revela la existencia de 3 factores, que explican el 68,72% de la varianza global, en los tres se han obtenido valores cercanos a 1 (máxima consistencia). Las mujeres muestran una menor percepción de apoyo afectivo e instrumental y un menor ta-maño de su red. Al aumentar la edad disminuye la percepción de apoyo, en todos los grupos. Los pacientes con EPOC presentan menor percepción de apoyo so-cial que el resto, sobre todo apoyo emocional y afectivo.
Background: The purpose of this study is to investigate whether the type and number of stressful life events (SLEs) will be associated with suicidal behavior in a 3-year follow-up period in persons with major depressive disorder (MDD). Methods: Data came from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a nationally representative longitudinal survey of mental health in non-institutionalized adults in the United States. The survey consisted of two waves: Wave 1 (2001-2002) and Wave 2 (2004-2005), n = 34,653. Twelve past-year SLEs were assessed at baseline. These SLEs were categorized into the following groups based on previous research: Loss or victimization; Relationship, friendship, or interpersonal stress; Financial stress; and Legal problems. Only respondents with MDD at Wave 1 were included (n = 6004). Results: Several SLEs were strongly associated with suicide attempts, among which, "serious problems with neighbor, friend or relative" [adjusted odds ratio (AOR) = 2.21; 95% confidence interval (95% CI): 1.41, 3.45] and "major financial crisis, bankruptcy or unable to pay bills" [AOR = 2.31; 95% CI: 1.45, 3.66] were the most robust predictors of suicide attempts even after adjusting for sociodemographic variables and any anxiety, substance use, or personality disorder. Conclusions: People with MDD who had been exposed to certain SLEs are at elevated risk for future suicide attempts, even after accounting for the demographic factors and psychiatric comorbidity.
To understand the way children develop, Bronfenbrenner believes that it is necessary to observe their behavior in natural settings, while they are interacting with familiar adults over prolonged periods of time. His book offers an important blueprint for constructing a new and ecologically valid psychology of development.
Contemporary research involving Hispanic mental health is critically e-xamined. Selected problem areas that span a spectrum covering folk/traditional conceptualizations of mental illness, standardized concepts and methods employed in epidemiology, approaches to psychiatric diagnosis in biomedical settings, and more basic epistemological assumptions involving psychiatric nosology and theory receive systematic attention. The idea is developed that a dominating and exclusive "establishment psychiatry " stipulates concepts and methods of mental health research, thereby setting priorities and legitimating distinctive modes ofpractice and reimbursement for treatment. The need to challenge and broaden establishment psychiatry's paradigms and biases with insights and knowledge drawn from culturally sensitive Hispanic facts in contemporary mental health paradigms pertaining to psychiatric theory and practice is seen to contribute to a truly representative cultural psychiatry. These and related issues are analyzed using a framework that centers on mental health research but includes ideas from social medicine, political economy, and social evolution.
In response to A. Anastasi's (1958) long-standing challenge, the authors propose an empirically testable theoretical model that (1) goes beyond and qualifies the established behavioral genetics paradigm by allowing for nonadditive synergistic effects, direct measures of the environment, and mechanisms of organism–environment interaction, called proximal processes, through which genotypes are transformed into phenotypes; (2) hypothesizes that estimates of heritability (e.g., h–2) increase markedly with the magnitude of proximal processes; (3) demonstrates that heritability measures the proportion of variation in individual differences attributable only to actualized genetic potential, with the degree of nonactualized potential remaining unknown; and (4) proposes that, by enhancing proximal processes and environments, it is possible to increase the extent of actualized genetic potentials for developmental competence. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Treats studies, primarily in human populations, that show casual effects of certain agents, procedures, treatment or programs. Deals with the difficulties that comparative observational studies have because of bias in their design and analysis. Systematically considers the many sources of bias and discusses how care in matching or adjustment of results can reduce the effects of bias in these investigations.
Working in the context of the linear model y = Xβ + ε, we generalize the concept of variance inflation as a measure of collinearity to a subset of parameters in β (denoted by β1, with the associated columns of X given by X1). The essential idea underlying this generalization is to examine the impact on the precision of estimation—in particular, the size of an ellipsoidal joint confidence region for β1—of less-than-optimal selection of other columns of the design matrix (X2), treating still other columns (X0) as unalterable, even hypothetically. In typical applications, X1 contains a set of dummy regressors coding categories of a qualitative variable or a set of polynomial regressors in a quantitative variable; X2 contains all other regressors in the model, save the constant, which is in X0. If σV denotes the realized variance of , and σU is the variance associated with an optimal selection of X2, then the corresponding scaled dispersion ellipsoids to be compared are ℰv = {x : x′Vx ≤ 1} and ℰU = {x : x′Ux ≤ 1}, where ℰU is contained in ℰv. The two ellipsoids can be compared by considering the radii of ℰv relative to ℰU, obtained through the spectral decomposition of V relative to U. We proceed to explore the geometry of generalized variance inflation, to show the relationship of these measures to correlation-matrix determinants and canonical correlations, to consider X matrices structured by relations of marginality among regressor subspaces, to develop the relationship of generalized variance inflation to hypothesis tests in the multivariate normal linear model, and to present several examples.
We estimated the prevalence and correlates of mental health problems among college students in the United States. In 2007 and 2009, we administered online surveys with brief mental health screens to random samples of students at 26 campuses nationwide. We used sample probability weights to adjust for survey nonresponse. A total of 14,175 students completed the survey, corresponding to a 44% participation rate. The prevalence of positive screens was 17.3% for depression, 4.1% for panic disorder, 7.0% for generalized anxiety, 6.3% for suicidal ideation, and 15.3% for nonsuicidal self-injury. Mental health problems were significantly associated with sex, race/ethnicity, religiosity, relationship status, living on campus, and financial situation. The prevalence of conditions varied substantially across the campuses, although campus-level variation was still a small proportion of overall variation in student mental health. The findings offer a starting point for identifying individual and contextual factors that may be useful to target in intervention strategies.
deals with coping among persons with chronic nonmalignant pain / this term refers to pain that has persisted for 6 mo or longer and is not associated with cancer / patients with chronic low back pain (CLBP) form the largest subclass of chronic nonmalignant pain conditions, which also include rheumatoid arthritis, osteoarthritis, myofascial pain, and headache
begin by presenting a brief overview of the questionnaires that have been used to measure coping followed by a presentation of the classification systems that have arisen in an attempt to categorize the myriad coping strategies people have been reported to use in their daily efforts to cope with chronic pain / highlight strategies for coping with pain that consistently have been associated with more or less pain and functional impairment
this is followed by sections on the role of social support in coping with chronic pain and situational aspects of coping among chronic pain patients / the importance of prevention programs and interventions designed to enhance pain coping efforts are covered in a section that deals with primary prevention and early detection, secondary prevention, relapse prevention, and prevention of related difficulties that commonly co-occur with chronic pain / present a risk-adaptation model to guide interventions with patients suffering chronic pain and other distressing conditions / applying this model involves addressing the risks represented by the pain as well as the inevitable adaptation problems that accompany the experience of chronic pain
emphasize current conceptual and methodological issues that have led to important advances in our understanding of how people cope with chronic pain as well as those that we believe have hampered progress in the field / conclude with a critical review of research directions that have limited utility and comment on some of the complexities of coping with chronic pain that need to be addressed (PsycINFO Database Record (c) 2012 APA, all rights reserved)
