ArticleLiterature Review

Global prevalence of burnout symptoms among nurses: A systematic review and meta-analysis

April 2020
Journal of Psychiatric Research 123

DOI:10.1016/j.jpsychires.2019.12.015

Authors:

Arthur Tang

Sungkyunkwan University

Wilson W S Tam

National University of Singapore

WHO recently declared burnout as a "occupational phenomenon" in the International Classification of Diseases 11th revision (ICD-11), recognizing burnout as a serious health issue. Amongst healthcare workers, nurses are known to struggle with burnout symptoms the most, carrying serious consequences for patients, other healthcare professionals and healthcare organisations. Evidence has suggested that burnout symptoms in nurses is high across specialties and countries, but no meta-analysis have been performed to investigate burnout symptoms prevalence in nurses globally. We conducted a systematic review and meta-analysis to examine burnout symptoms prevalence in nurses worldwide using 8 academic research databases. Risk of bias, heterogeneity and subgroup analyses were further conducted in the meta-analysis. 113 studies were included for systematic review and 61 studies for the meta-analysis, consisting 45,539 nurses worldwide in 49 countries across multiple specialties. An overall pooled-prevalence of burnout symptoms among global nurses was 11.23%. Significant differences were noted between geographical regions, specialties and type of burnout measurement used. Sub-Saharan African region had the highest burnout symptoms prevalence rate while Europe and Central Asia region had the lowest. Paediatric nurses had the highest burnout symptoms prevalence rates among all specialties while Geriatric care nurses had the lowest. This study is the first study to synthesize published studies and to estimate pooled-prevalence of burnout symptoms among nurses globally. The findings suggest that nurses have high burnout symptoms prevalence warranting attention and implementation. This study serves as an impetus for intervention studies and policy change to improve nurses' work conditions and overall healthcare quality.

Unique and cumulative effects of different subtypes of sleep problems on burnout among Chinese nurses

Article

Full-text available

Oct 2024

Objective To investigate the unique and cumulative associations of different sleep problem subtypes with burnout among Chinese nurses. Methods A survey was conducted in Quanzhou, China, and a total of 744 nurses were included. Burnout was measured by Maslach Burnout Inventory-Human Services Survey across three dimensions: emotional exhaustion (EE), depersonalization (DP) and low personal accomplishment (PA). Pittsburgh Sleep Quality Index was used to measure 15 types of sleep problems. Binary logistic regression was employed to explore the association between sleep problems and burnout. Results Prevalence of sleep problems, high EE, high DP and low PA were 43.3, 6.9, 23.4, and 63.2%, respectively. Experience of sleep problems significantly increased risk for EE (OR = 1.31, 95%CI: 1.185–1.436), DP (OR = 1.08, 95%CI: 1.023–1.142) and PA (OR = 1.09, 95%CI: 1.036–1.146). Of the 15 sleep problem subtypes, “feel too cold” and “have pain” were significant predictors of high EE (OR = 3.89, 95%CI: 1.629–9.302; OR = 3.00, 95%CI: 1.314–6.827, respectively), and “daytime dysfunction” significantly predicted low PA (OR = 1.68, 95%CI: 1.135–2.491). Around 40.9% of nurses had reported more than three subtypes of sleep problems. Experiencing more than three subtypes of sleep problems were significantly associated with an increased risk of DP and PA (ORs range from 2.07 to 2.71). Conclusion These findings suggested that sleep problems was associated with an increased risk of burnout in nurses, with both unique and cumulative risks. Interventions should focus on the prevention and management of the effects of sleep problems among nurses.

Is the fire even bigger? Burnout in 800 medical and nursing students in a low middle income country

Article

Full-text available

Aug 2024
PLOS ONE

Background Burnout, characterized by emotional exhaustion (EX), depersonalization (DP), and a reduced sense of personal efficacy (PF) among medical and nursing students can lead to suicidal ideation, lack of empathy, and dropouts. Previous studies have used over-simplified definitions of burnout that fail to capture its complexity. We describe the prevalence of burnout profiles and its risk factors among medical and nursing students. Methods A cross sectional study was conducted at a tertiary care University Hospital in Pakistan. The Maslach Burnout Inventory (MBI) survey was disseminated via SurveyMonkey over a period of 4 months (November 2019 to February 2020) to 482 Medical and 441 nursing students. The MBI tool measures the dimensions of EX, DP, and PF to describe seven burnout profiles. Multivariable regression was used to identify predictors of burnout. Results The response rate was 92% in nursing and 87.3% in medical students. The prevalence of burnout in medical and nursing students was 16.9% and 6.7% respectively (p<0.001), with 55.7% (n = 427) suffering from at least one burnout profile. Only 32.5% (n = 250) students felt engaged, (42.3% medical, 22.7% nursing students, p<0.001). The most common profile was ineffective (32.5%, n = 250), characterized by a reduced sense of personal efficacy (35.6% medical, 29.4% nursing students; p = 0.065). Medical students were at higher risk of burnout compared to nursing students (OR = 2.49 [1.42, 4.38]; p<0.001) with highest risk observed in year 4 (OR = 2.47 [1.02, 5.99]; p = 0.046). Other risk factors for burnout included occasional drug use (OR = 1.83 [1.21, 8.49]; p = 0.017) and living in a hostel (OR = 1.64 [1.01,2.67]; p = 0.233). Conclusion and relevance Two-thirds of our participants experienced at least one dimension of burnout with the highest prevalence of a reduced sense of PF. Drivers of burnout unique to a lower-middle-income country need to be understood for effective interventions. Faculty training on principles of student evaluation and feedback may be beneficial.

Insight into perceived Positive Health of healthcare professionals. What can be done to improve and stabilize the perceived Positive Health?

Preprint

Full-text available

Nov 2024

Background The shortage of healthcare professionals, combined with the aging population, is leading to increasing pressure on healthcare professionals. To ensure that healthcare professionals are able to do their work and ensure good patient care, it is important to focus on their own health. Positive Health is a health-oriented approach and can be used for understanding and enhancing the health and well-being of healthcare professionals. The aim of the study is to gain insight in the perceived health, personal goals and how to improve or stabilise the Positive Health of employees of a large tertiary hospital in the Netherlands. Methods A qualitative study design was employed. Semi-structured interviews were conducted with employees (n = 15) of the Cardiology and Rheumatology department, using the Positive Health tool. The data was analysed using thematic content analysis. Results Employees are satisfied with their health or a specific part of their health, also when there are health complaints as well. There were personal goals in several themes being: lifestyle changes, balance, self-development, meaningfulness and social interaction. What is needed to achieve personal goals varies, also within the themes. To enhance well-being, employers can provide supervisor support, empower control over hours, create a pleasant environment, offer fruit, provide challenging opportunities, and integrate Positive Health principles. Conclusion In general, the interviewed employees experienced good Positive Health despite the presence of complaints. To enhance employee health, both work-related and personal measures were needed. The Positive Health approach was appreciated by employees and can be valuable for employers to gain insight into how to support employee health. This is particularly important given the growing pressure on the healthcare system.

Nurse Burnout and Patient Safety, Satisfaction, and Quality of Care: A Systematic Review and Meta-Analysis

Article

Full-text available

Nov 2024

Importance Occupational burnout syndrome is characterized by emotional exhaustion, depersonalization, and a diminished sense of personal accomplishment and is prevalent among nurses. Although previous meta-analyses have explored the correlates of nurse burnout, none have estimated their association with health care quality and safety and patient morbidity and mortality. Objective To evaluate the magnitude and moderators of the association between nurse burnout and patient safety, patient satisfaction, and quality of care. Data Source The Web of Science, Scopus, MEDLINE, Embase, PsycINFO, CINAHL, and ProQuest databases were searched from January 1, 1994, to February 29, 2024. Study Selection Two reviewers independently identified studies that reported a quantifiable association between nurse burnout and any of the outcomes of patient safety, patient satisfaction, or quality of health care. Data Extraction and Synthesis The PRISMA 2020 guideline was followed. Two reviewers independently extracted the standardized mean difference (SMD) (Cohen d ) estimates for a random-effects meta-analysis. Subgroup analyses and meta-regressions were conducted using prespecified variables. Main Outcomes and Measures Any measure of patient safety, patient satisfaction, or quality of health care previously associated with nurse burnout. Results A total of 85 studies (81 cross-sectional and 4 longitudinal) involving 288 581 nurses from 32 countries (mean [SD] age, 33.9 (2.1) years; 82.7% female; mean [SD] burnout prevalence rate with study-specific ascertainments, 30.7% [9.7%]) were included. Nurse burnout was associated with a lower safety climate or culture (SMD, −0.68; 95% CI, −0.83 to −0.54), lower safety grade (SMD, −0.53; 95% CI, −0.72 to −0.34), and more frequent nosocomial infections (SMD, −0.20; 95% CI, −0.36 to −0.04), patient falls (SMD, −0.12; 95% CI, −0.22 to −0.03), medication errors (SMD, −0.30; 95% CI, −0.48 to −0.11), adverse events or patient safety incidents (SMD, −0.42; 95% CI, −0.76 to −0.07), and missed care or care left undone (SMD, −0.58; 95% CI, −0.91 to −0.26) but not with the frequency of pressure ulcers. Nurse burnout was also associated with lower patient satisfaction ratings (SMD, −0.51; 95% CI, −0.86 to −0.17) but not with the frequencies of patient complaints or patient abuse. Finally, nurse burnout was associated with lower nurse-assessed quality of care (SMD, −0.44; 95% CI, −0.57 to −0.30) but not with standardized mortality rate. The associations were consistent across nurses’ age, sex, work experience, and geography and persistent over time. For patient safety outcomes, the association was smaller for the low personal accomplishment subcomponent of burnout than for emotional exhaustion or depersonalization, as well as for nurses with a college education. Conclusions and Relevance In this systematic review and meta-analysis, nurse burnout was found to be associated with lower health care quality and safety and lower patient satisfaction. This association was consistent across nurse and study characteristics.

Risk assessment of emotional burnout development among paediatric ward nurses during the COVID-19 pandemic

Article

Full-text available

Aug 2024

The issue of burnout among healthcare personnel is highly pertinent, particularly during the COVID-19 pandemic, which underlines the importance of this study. The research aimed to analyse the results of an anonymous survey conducted among paediatric ward nurses regarding burnout in the context of the COVID-19 pandemic, to optimise their work. The assessment of burnout levels was performed by analysing the results of an anonymous questionnaire (V. Boiko’s questionnaire) completed by 135 nurses working in paediatric wards of different specialisations in healthcare facilities in Chernivtsi. Respondents were divided into two observation groups. Group I consisted of 83 nurses working in non-infectious paediatric wards, while 52 nurses from infectious paediatric wards were included in Group II. The average age of the nurses in Group I was 38.02 ± 0.9 years, while for Group II it was 43.81 ± 1.6 years (p > 0.05), and the length of service was 18.01 ± 0.9 and 22.09 ± 1.4 years, respectively (p > 0.05). It was found that among the surveyed respondents in Groups I and II, the burnout scores were significantly higher for nurses in non-infectious wards, particularly in the phases of “tension” (42 and 28.2 points, respectively, (p < 0.05), “resistance” (54.9 and 37.8 points, respectively, (p < 0.05), and “exhaustion” (40.7 and 26.2 points, respectively, (p < 0.05). The risk scores for the development of burnout phases (≥37 points) among Group I nurses compared to Group II were as follows: “tension” phase: relative risk – 1.9, odds ratio – 4.2; “resistance” phase: relative risk – 1.9, odds ratio – 3.6; “exhaustion” phase: relative risk – 1.5, odds ratio – 2.7. It was established that during the COVID-19 pandemic, the chances of burnout registration among nurses in non-infectious wards increased by 2.7-4.2 times

Psychoemotional disorders and burnout in nurses working in rehabilitation departments for patients with impaired neuromuscular, skeletal or movement-related functions

Article

Oct 2024

Aim of the study was to assess the frequency of the symptoms of professional burnout, depression, anxiety and stress in nurses working in departments providing medical and rehabilitation services to patients with impaired functions of support and movement. Material and methods . We carried out an anonymous survey among the nurses working in two medical institutions in Novokuznetsk that provide medical rehabilitation services to patients with impaired neuromuscular, skeletal or movement-related functions. In order to detect the symptoms of burnout and to determine their severity we used the Maslach Burnout Inventory adapted by N.E. Vodopyanova. The extent of depression, anxiety and stress were assessed with the DASS-21. Results . The majority of the nurses showed symptoms of burnout varying from moderate to extremely high; psychoemotional exhaustion was present in 57.7 %, depersonalization in 76.9 % and reduced personal accomplishment in 57.7 %. The integral burnout index was moderate and high or extremely high in 69.3 % of the nurses. At the same time almost half (45.4 %) of the respondents had symptoms of depression and/or anxiety (stress) and their severity correlated with the extent of burnout. Conclusions. The nurses working in departments specializing in providing medical and rehabilitation services to patients with impaired neuromuscular, skeletal or movement-related functions belong to the groups of medical persons vulnerable to professional burnout, depression, anxiety and stress.

Comparison of Prevalence and Risk Factors for Burnout, Missed Nursing Care, and Intention-to-Leave the Job Among Intensive Care Unit and General Ward Nurses: A Cross-Sectional Study Across Six European Countries in the Covid-19 Era

Preprint

Full-text available

Sep 2024

An exploration of the emotional response among nurses in Bermuda, during the Covid-19 pandemic

Article

Full-text available

Sep 2024
PLOS ONE

Objectives This paper utilizes an ontological approach to conduct a qualitative literature review in order to investigate the emotional impact of the Covid-19 pandemic on nurses internationally. After identifying common themes in the literature review, primary research is conducted to investigate the emotional impact of the Covid-19 pandemic on nurses working in Bermuda´s only acute healthcare facility. Methods The literature review used the FRAMEWORK approach (Richie and Spencer, 1994, as cited in Hackett et al. (2018) to select a total of 16 papers for review, each of them qualitative primary research, aside from one paper reviewing international literature. Within the second part of this paper, investigating the experience of nurses in Bermuda, a grounded theory approach was utilised to collect primary data. Convenience sampling was used to recruit subjects to participate in one-on-one semi-structured interviews. Data saturation was achieved after 9 interviews. The FRAMEWORK method was utilised to analyse the interview transcripts, and identify, organise and collate themes. Results The literature review highlights that nurses have strong emotional responses to caring for patients during the Covid-19 pandemic. Specific responses include: higher stress levels at work due to higher, more challenging workload, and a reliance on clinical leaders to assuage this stress. Stigma experienced outside of work lead to feelings of anxiety and isolation. Despite this, there was a common theme that nurses felt a satisfaction within their role to ´play their part´ in the pandemic. The primary research conducted in Bermuda demonstrates that there was an initial fear of Covid-19, receding as the pandemic developed. Much anxiety was due to a perceived lack of knowledge about the disease, lack of a coherent strategy, and inadequate equipment to protect staff, and properly care for patients. An increased level of cooperation amongst staff, and mutual support amongst nurses was noted, as was social stigma leading to feelings of isolation and anxiety. Social interactions and holistic activities were identified as primary resources to alleviate stress and uncertainty. Conclusions Nurses in Bermuda elicited many of the same emotional responses as their international colleagues, as a result of caring for patients during the pandemic. These manifested as a result of higher, more challenging workload, and uncertainty about preparedness plan and quickly changing situations within the working environment. The results from this study can help formulate changes in policy to ensure smoother transitions to pandemic preparedness in the future.

Pengaruh Budaya Kerja Terhadap Kejadian Burnout Pada Petugas Kesehatan di Rumah Sakit Kota Jayapura Provinsi Papua

Article

Sep 2024

Burnout is a common psychological issue among nurses working in hospitals. Nurses, being healthcare professionals, often grapple with fatigue symptoms, which can significantly impact patients. Research indicates a notable prevalence of burnout symptoms among nurses globally, with a survey of 45,539 nurses across 49 countries revealing an 11.23% overall prevalence. This study's objective is to explore how dimensions of work culture affect nurse burnout incidence. The methodology employed is analytical survey research with a cross-sectional design, conducted at Jayapura City Regional Hospital over six months from April to September 2023. Findings suggest that 84% of nurses have a favorable work culture. The analysis of nurse burnout reveals 39% experiencing burnout, with the highest dimension being self-awareness at 77%. Logistic regression analysis indicates work culture's significant influence on nurse burnout, with a 24.4% impact. Furthermore, the partial influence test demonstrates that team collaboration dimension specifically impacts burnout. Hospital management must prioritize addressing burnout due to its potential risk to patient safety. Recommendations include fostering a supportive work culture and organizational climate to mitigate nurse burnout. Keywords: Work Culture, Burnout, Nurses, Jayapura City, Papua ABSTRAK Burnout adalah salah satu masalah psikologis yang sering dialami oleh perawat di rumah sakit. Perawat sering menghadapi gejala kelelahan, yang dapat berdampak serius pada pasien. Bukti menunjukkan bahwa gejala burnout pada perawat tinggi di beberapa Negara. Survei pada 45.539 perawat di 49 negara menunjukkan bahwa prevalensi gejala burnout secara keseluruhan di antara perawat global adalah 11,23%. Penelitian ini bertujuan untuk meneliti dampak dimensi budaya kerja terhadap kejadian burnout pada perawat. Jenis penelitian ini adalah survei analitik dengan desain cross-sectional. Penelitian ini dilaksanakan di Rumah Sakit wilayah kota Jayapura. Penelitian ini dilakukan selama enam bulan dari yaitu April- September 2023. Berdasarkan hasil penelitian menunjukkan budaya kerja perawat dalam kategori baik sebesar 84%. Gambaran kejadian burnout perawat menunjukkan bahwa terdapat 39% perawat mengalami kejadian burnout dimana dimensi penghargaan diri merupakan dimensi yang paling tinggi yaitu sebesar 77%. Analisi regresi logistik menunjukkan bahwa secara simultan terdapat pengaruh budaya kerja terhadap kejadian burnout pada perawat, kemampuan budaya kerja memberikan pengaruh terhadap kejadian burnout sebesar 24,4%. Hasil uji pengaruh secara parsial menunjukkan bahwa dimensi kerjasama tim yang hanya memiliki pengaruh terhadap kejadian burnout. Kejadian burnout merupakan aspek yang harus menjadi perhatian manajemen rumah sakit karena akan menciptakan resiko insiden keselamatan pasien. peneliti menyarankan untuk menciptakan budaya kerja dan iklim organisasi yang mendukung untuk mencegah terjadinya kelelahan pada perawat. Kata Kunci: Budaya Kerja, Burnout, Perawat, Kota Jayapura, Papua

Relationship between burnout and occupational fatigue exhaustion and recovery among orthopaedic nurses in Tabriz, Iran: a cross-sectional survey

Article

Full-text available

Aug 2024

Objective To examine the relationship between burnout and occupational fatigue exhaustion and recovery among orthopaedic nurses in Tabriz, Iran. Design Descriptive, cross-sectional survey and correlational analysis. Setting Two hospitals associated with Tabriz University of Medical Sciences, Iran, from August to September 2022. Participants 92 bedside nurses in orthopaedic wards, each with >1 year of clinical experience. Outcome measures Burnout was assessed using the Copenhagen Burnout Inventory, and occupational fatigue exhaustion/recovery was measured with the Occupational Fatigue Exhaustion/Recovery Scale. Pearson’s correlation, independent t-test, one-way analysis of variance and multivariable linear regression analyses determined statistical significance. Results The mean burnout score was 63.65 (±15.88) out of 100 and the recovery rate was 35.43 (±15.60) out of 100. There were significant correlations between total burnout and each of the exhaustion recovery dimensions: chronic fatigue (r=0.70), acute fatigue (r=0.65) and intershift recovery (r=0.56). Nurses exceeding 44 weekly work hours reported higher burnout (66.52±14.77, p=0.005) than those working fewer hours (56.25±16.12, p=0.005). Rotational shift status was associated with increased burnout (64.97±15.32) compared with fixed shifts (55.54±17.42, p=0.04). Chronic fatigue (B=0.39, 95% CI 0.21, 0.57; t=4.29, p<0.001) and intershift recovery (B=−0.241, 95% CI −0.46, −0.02; t=−2.16, p=0.035) were significant predictors of burnout. Conclusions Burnout is a critical concern among orthopaedic nurses and is significantly linked to occupational fatigue/recovery. Addressing chronic fatigue and enhancing intershift energy recovery could mitigate burnout risk. Therefore, optimising work conditions and schedules and developing tailored recovery protocols are vital to safeguarding orthopaedic nurses’ well-being.

Impact of Nursing Professional Values on Depression, Stress, and Anxiety among Nurses during the COVID-19 Pandemic

Article

Full-text available

Aug 2024
J Nurs Manag

Aim. The aim was to explore the association between nursing professional values (NPV) and mental health among registered nurses (RN) in Spain. Background. Nursing is a profession rooted in strong professional values, which guide and shape clinical practice and occupational behaviors. NPV should serve as a source of support in situations of great uncertainty. Methods. A cross-sectional study was conducted during the remission phase of the second wave of the COVID-19 pandemic (December 2020-January 2021) among a sample of Spanish RN (n = 420). NPV were assessed using the Nursing Professional Values Scale (NPVS-R), comprising 26 items grouped into five factors: caring, activism, trust, professionalism, and justice. Perceived stress, anxiety, and depression were measured by the Perceived Stress Scale (PSS-14) and the Hospital Anxiety and Depression Scale (HADS). Adjusted linear regressions were used to estimate b coefficients for the associations between NPV scores and the three mental health indicators. Results. The fully-adjusted analysis, including sociodemographic and occupational variables, revealed that higher activism scores were associated with higher scores of stress (b coefficient: 0.46; 95% confidence interval: 0.03–0.88; p value: 0.035), anxiety (0.24; 0.05–0.43; 0.014), and depression (0.19; 0.01–0.36; 0.035). No other NPV was associated with mental health. Conclusion. Organizational policies and programs should be established to protect the most activist RNs and to mitigate the potential detrimental effect of activism on mental health at times and/or circumstances of high workloads and personal stress.

Síndrome de Burnout em profissionais de saúde: uma revisão de literatura dos últimos 5 anos (2019 - 2024)

Article

Full-text available

Nov 2024

A Síndrome de Burnout (SB) é uma condição clínica que afeta principalmente profissionais de saúde, caracterizando-se por exaustão emocional, despersonalização e baixa realização pessoal. Entre os fatores associados ao desenvolvimento da SB, destacam-se os organizacionais, como sobrecarga de trabalho e dissonância emocional, e os individuais, como a falta de suporte social e estratégias ineficazes de enfrentamento. De mesmo modo, os sintomas variam entre os indivíduos e a SB pode se manifestar de diversas formas. Durante a pandemia de COVID-19, houve um aumento expressivo nos casos de SB entre profissionais de saúde, exacerbado pelas demandas psicológicas e físicas extremas enfrentadas. Por isso, este artigo tem como objetivo analisar os principais fatores de risco, os impactos da COVID-19 na saúde mental dos profissionais de saúde e as estratégias de prevenção da SB, ressaltando a necessidade de intervenções abrangentes para mitigar os efeitos dessa síndrome. Dessa forma, foi realizada uma revisão de literatura com estudos publicados entre o período de 2019 a 2024 nas bases de dados SciELO (Scientific Electronic Library Online) e PubMed (Public Medline). A partir da análise dos artigos selecionados, identificaram-se os principais fatores de risco, as consequências da SB no ambiente de trabalho, a forma como a pandemia da COVID-19 influenciou na saúde mental dos profissionais de saúde e as estratégias de enfrentamento mais eficazes, destacando a importância de intervenções organizacionais e individuais na prevenção e mitigação da síndrome.

Resilience and the Dynamics of Job Demands: A Diary Study on Interactions in Healthcare Professionals During the COVID‐19 Pandemic

Article

Full-text available

Nov 2024
J ADV NURS

Aim(s) To explore the day‐level interactions between challenge and hindrance job demands and their effects on work engagement and emotional exhaustion among healthcare professionals, focusing on the moderating role of resilience. Design A longitudinal, diary‐based design was employed. Methods This study utilised a multilevel modelling approach to analyse 351 diary entries from 85 healthcare professionals, collected during the COVID‐19 pandemic (in March–April 2021). Participants recorded their daily experiences, including job demands, work engagement, emotional exhaustion and resilience. Results Challenge demands, such as increased workload, are associated with both higher work engagement and greater emotional exhaustion, highlighting a dual impact. Resilience moderated these effects, reducing the negative impacts of both challenge and hindrance demands on emotional exhaustion. Surprisingly, higher resilience also diminished the positive relationship between effort and engagement. Conclusion The study highlights the critical role of resilience in moderating the effects of job demands on healthcare workers' well‐being, particularly under the stressful conditions of a global pandemic. Implications for the Profession and/or Patient Care Insights from this study can assist healthcare organisations in developing strategies to enhance employee resilience and effectively manage job demands. Improved management of these factors can lead to better employee well‐being and sustained engagement, ultimately benefiting patient care during high‐stress periods. Impact The study addressed the impact of daily job demands on the well‐being and performance of healthcare workers during the COVID‐19 pandemic. The main findings highlighted the dual effects of challenge demands and the protective role of resilience in mitigating the adverse effects of job demands. This research will impact healthcare organisations and policymakers, informing strategies to bolster workforce resilience and well‐being, thereby potentially enhancing patient care during crises. Reporting Method We adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Patient or Public Contribution Neither patients nor the public were involved in the design, conduct, reporting or dissemination plans of our research. Healthcare professionals participated only as research subjects and did not engage in any aspect of the research process.

Feasibility and effectiveness of the mindfulness-based stress reduction programs on relieving burnout of healthcare providers during the COVID-19 pandemic: a pilot randomized controlled trial in China

Article

Full-text available

Nov 2024
Hum Resour Health

Background The 2019 coronavirus disease (COVID-19) pandemic brings critical health problems to workers in many occupations, particularly healthcare providers. The aim of the study was to examine the feasibility and effectiveness of the mindfulness-based stress reduction (MBSR) program on relieving burnout of healthcare providers during the pandemic. The roles of positive and negative emotion as well as emotion regulation strategy in the intervention effects were also investigated. Methods A sample of 112 healthcare providers in China were recruited and randomly assigned to the MBSR (n = 56) or the control condition (n = 56). Measures were collected at pre-intervention, mid-intervention, and post-intervention, assessing mindfulness level, emotion regulation strategy, positive and negative emotion, and burnout. Results The MBSR program showed acceptable feasibility. Compared to the control group, healthcare providers in the MBSR group showed significant increase in personal accomplishment and decrease in emotional exhaustion after the intervention. No significant difference was detected on the dimension of depersonalization. Results of mediation analyses implied that cognitive reappraisal and positive affect partially mediated the intervention effects on personal accomplishment. Conclusions The study provided preliminary evidence that the MBSR programs might be effective in reducing healthcare providers’ burnout, even during the pandemic. Cognitive reappraisal and positive emotion might be important mechanisms of how the training took effect.

Exploring Factors Contributing to Occupational Burnout Among Nurses in Pediatric Infection Wards Post-COVID-19

Article

Full-text available

Nov 2024

Objective To explore the factors that lead to occupational burnout among nurses in pediatric infectious disease wards after two consecutive years of frontline anti-epidemic work since the admission of COVID-19 patients in January 2020, in order to lay a scientific basis for reducing nurse occupational burnout. Methods A total of 12 nurses who working in pediatric infection units were included in the study. Utilizing qualitative research methodologies, we used semi-structured interviews as the primary data collection method. The interview data underwent meticulous organization and were subjected to descriptive analysis. Results 12 nurses assigned to pediatric infection wards frequently encounter occupational burnout, primarily attributed to increased work intensity, nurse-patient relationships, occupational frustration, psychological pressure, hospital infections, and various other contributing factors. Conclusion We found that the severity of occupational burnout among nurses specializing in pediatric infectious diseases is noteworthy. Our recommendations include heightened consideration of this issue by government authorities and hospital administrators.

Prevalence and Risk Factors Associated with Depressive Symptoms Among Healthcare Professionals at a Tertiary Care Hospital in Mogadishu, Somalia: A Cross-Sectional Study

Article

Full-text available

Oct 2024

Background Depression, a prevalent mental health issue, can significantly impact healthcare workers (HCWs), leading to decreased productivity, increased turnover, and high medical errors. However, there is a dearth of information regarding depression among healthcare professionals in Somalia. Therefore, this study aimed to assess the magnitude and risk factors associated with depressive symptoms among healthcare professionals in Mogadishu, Somalia. Methods A hospital-based cross-sectional study was conducted among HCWs at Erdogan Hospital, in the capital city of Somalia. Data was collected using questionnaires on socio demographic, work-related characteristics and Patient Health Questionnaire-9 (PHQ-9). Bivariate and multivariate logistic regression analyses were conducted to identify variables associated with depressive symptoms. A p-values of 0.05 as a cutoff for a significant association. Results The prevalence of depressive symptoms among healthcare professionals was 48.9% (95% CI: 45.4–56.9%). In multivariable analysis, being female (AOR = 2.05; 95% CI: 1.17–3.60), being a nurse (AOR = 3.11; 95% CI: 1.14–8.48), unmarried (AOR = 1.83; 95% CI: 1.04–3.21), having insufficient sleep (AOR = 2.61; 95% CI: 1.45–4.70), a family history of mental illness (AOR = 3.31; 95% CI: 1.49–7.36), lack of physical activity (AOR = 2.59; 95% CI: 1.19–5.62), and having low social support (AOR = 3.06; 95% CI: 1.17–7.98) were all associated with increased odds of experiencing depressive symptoms. Conclusion The study showed that nearly half of healthcare professionals experienced depressive symptoms. The study underscores the importance of efficient screening methods for identifying psychological symptoms in healthcare professionals, which is essential for enhancing their mental health and patient care. Therefore, we recommend that healthcare institutions and policymakers develop and implement screening measures to identify and improve the mental health well-being of HCWs, as well as provide high-quality patient care.

Factors affecting occupational burnout in medical staff: a path analysis based on the job demands-resources perspective

Article

Full-text available

Oct 2024

Objective To assess occupational burnout conditions and work-related factors among frontline medical staff during the COVID-19 pandemic and analyse the relationships among these factors utilizing the job demands–resources (JD-R) model as a theoretical framework. Methods An online survey was distributed to medical staff in one city via convenience sampling during 12/29/2022–1/10/2023. Path analysis was utilized to explore the relationship between work-related factors and occupational burnout among frontline medical staff during the COVID-19 outbreak. Results Among 474 respondents, 455 frontline medical staff (female=79.56%) were included in the final analysis. Medical staff aged <35 exhibited higher levels of occupational burnout than did older staff. Depression/anxiety and workload were positively correlated with occupational burnout and negatively correlated with self-compassion, workplace health/safety, and workplace support. Path analysis indicated the direct effects of workplace support, depression/anxiety, workplace health/safety, self-compassion, and workload on occupational burnout. There were also partial mediating effects of workplace support, depression/anxiety, workplace health/safety, and self-compassion on occupational burnout. The model demonstrated good fit. Conclusion Workplace support, a crucial job resource, can improve occupational burnout among frontline medical staff in various ways. Reducing anxiety, depression, and workload and improving workplace support, health/safety, and self-compassion are practical and effective measures for mitigating occupational burnout.

Graduate pathways following nursing education during COVID-19

Article

Full-text available

Oct 2024
APPL NURS RES

The COVID-19 pandemic has exerted many effects on populations worldwide. Due to the nature of the pandemic, health and specifically nursing sectors have been particularly impacted. While the nursing sector had to grapple with the impact of the pandemic as well as associated government interventions, nursing students have experienced changes in their job prospects, satisfaction with their training and their propensity to engage in further studies, all impinging on the sustainability of nursing education. This study aims to analyze educational outcomes for nursing graduates undertaking VET (vocational education and training) programs in Australia. Impacts assessed include employment, satisfaction, and further study after completion. The paper is based on analysis of five large waves of a comprehensive survey of Australian vocational education completers, from 2019 to 2022 inclusive. We develop three separate logistic regression models for the outcomes of employment, satisfaction, and enrollment in further study in order to estimate the predictive margins for the interactions between year and field of education, including the Diploma of Nursing, all other health qualifications, and all other qualifications. Our results show that these graduates saw significantly improved employment outcomes and heightened satisfaction during and after the pandemic, pointing to the sector meeting sustainability challenges. Interestingly, enrolment in further studies, after a notable increase earlier in the pandemic, returned to pre-pandemic levels as the crises abated.

An estimate of burnout prevalence among oncology nurses

Article

Full-text available

Oct 2024
BMC Nurs

Background Registered nurses (RNs) in oncology must cope with the suffering of patients, the inevitability of death and their own transience. This poses a possible risk for the development of burnout, which can result in low job satisfaction and ultimately an increased intention to leave the job. Our aim was to assess psychological distress in registered nurses working in oncology. Objective and method A cross-sectional survey with the Oldenburger Burnout Inventory was presented to nurses within the German Cancer Society. It collected data on psychological distress via two subscales, exhaustion and disengagement. Socio-demographic data were assessed. Results Among 83 participating nurses, we found a prevalence of high disengagement in 17 oncology nurses (20.48%) and high exhaustion (MExh>2.5 = burnout) in 44 (53.00%). Looking at the highest values of both scales, 18.08% of respondents were at high risk for psychological distress. There was a low correlation between disengagement and age (r = 0.331, p < 0.01). The risk of high disengagement among nurses older than 50 (n = 9, 52.94%) was three times higher than for those who were 50 or younger (n = 8, 47.06%) (RR = 8.642, 95% CI: 1.475–5.749, p < 0,01). Conclusion This survey highlights a high rate of burnout among German oncology nurses. Interventions should be developed, implemented, and delivered in an age-appropriate manner. To ensure high-quality care and patient safety, oncology nurses should be offered preventive mental healthcare services later in their careers. Clinical trial registration number The study was registered with the German Clinical Trials Register (DRKS500018851).

Burnout Syndrome among Emergency Physicians and Residents: A Systematic Review

Article

Full-text available

Oct 2024

Objectives: To study the risk factors and prevalence of burnout and its dimensions among emergency physicians in Saudi Arabia. Methods: PubMed, SCOPUS, Web of Science, and Science Direct were systematically searched for relevant literature. Rayyan QRCI was employed throughout this comprehensive process. Results: We included fourteen studies with a total of 1810 patients, and 1068 (59%) were males. The MBI-HSS was the scale used to assess burnout. The prevalence of burnout ranged from 15.57% to 76%. The following factors were associated with higher burnout risk: smokers, people using medication for sleep disorders, number of vacation days annually, number of workdays per week, female sex, single status, early medical practice participants, resident physician/surgeon employment category participants, people whose current job negatively impacted their family life, and people with back pain. Conclusion: Saudi physicians in emergency medicine have the highest burnout rates of any profession, making them particularly vulnerable to burnout. Nonetheless, there remains a high level of job satisfaction among emergency physicians, and further research is necessary to fully understand the intricate relationship between burnout and job satisfaction. Because burnout is linked to particular personality traits and particularly coping mechanisms, doctors who are at high risk of experiencing burnout should be recognized early on and appropriately consulted. In order to make progress toward the goal of effectively treating burnout syndrome in the future, more case-control studies pertaining to behavioural intervention and the promotion of healthy lifestyles are required.

Prevalence, risk factors and clinical impact of burnout in internal medicine units: a call to action

Article

Full-text available

Oct 2024

Health workers, and in particular doctors and nurses working in internal medicine units (IMU), are at high risk of burnout. Overcrowding, complexity and severity of clinical cases, patients’ social and family issues, impact of death, and “workload" are all aspects that are specific risk factors that might lead to the development of burnout in this scenario. People suffering from burnout may face several psychological problems (including extreme physical and mental fatigue, emotional exhaustion, loss of enthusiasm concerning work, feelings of cynicism, and a low sense of personal accomplishment) and are also at risk of developing some somatic diseases. Furthermore, the quality of care delivered by a worker in burnout seems to worsen and slip down. In this review, we analyzed the main risk factors and consequences of burnout in IMUs, and we propose individual and organizational measures that may be applied to be able to prevent burnout in this setting.

Do emotional demands and exhaustion affect work engagement? The mediating role of mindfulness

Article

Full-text available

Oct 2024

Aim The current paper seeks to elucidate the interrelationships among emotional demands (ED), emotional exhaustion (EE), mindfulness, and work engagement (WE), with an explanation of the mediating role of mindfulness within indicated relationships. Background Nurses working in a stress-related environment face some emotional challenges. New methods such as mindfulness should be learned; therefore, positive outcomes occur along with new developments. Method Responses were received from nurses through a self-report questionnaire using the convenience sample technique. Four hundred and twenty-nine nurses from health institutions in Istanbul participated in the study. The PLS-SEM technique was used to test the research model. Results ED and mindfulness, EE and mindfulness, and mindfulness and WE relationships were found. While mindfulness was a mediator between EE and WE, it was not a mediator between ED and WE. Conclusion It has been revealed that nurses cope with job-related challenges by being present at the moment with high awareness. Furthermore, mindful nurses also foster positive outcomes. Implications for nursing management Precautions should be taken because of the nursing shortage. It is better to provide mindfulness training to nursing students in schools before their professional lives. Implementing and using technologies might be helpful for nurses.

Nurses’ Generational Differences of Burnout and Turnover Risk

Article

Jun 2024
Online J Issues Nurs

This study aimed to determine the impact of nurse generation on (a) turnover risk factors (low meaning/joy in work, low resilience, high occupational fatigue, high burnout) and (b) turnover intentions before and during the COVID-19 pandemic. Survey methods were used to compare two samples of hospital nurses who completed online surveys in 2017 or 2021. The results were compared on burnout and turnover risk by generation. Results indicate that in 2017, high acute fatigue and low inter-shift recovery differed by nurse generation, with Baby Boomers (Boomers) being the least affected. Additionally, Boomers were the least likely to report a likelihood of leaving the hospital within 6-12 months. However, in 2021, Millennial nurses experienced significantly higher levels of low meaning and joy in work, low resilience, high acute fatigue, low inter-shift recovery, and high burnout than Generation X (GenX) and Boomers. Millennials were the most likely generation to report turnover intention. This leads to the conclusion that the pandemic may have worsened the work experience of millennial nurses and increased their risk of leaving hospital jobs and the profession.

Psychoeducational Burnout Intervention for Nurses: Protocol for a Systematic Review

Article

Full-text available

Sep 2024

Background Nurses face high levels of stress and emotional exhaustion due to heavy workloads and demanding work environments. Prolonged exposure to these stressors predisposes nurses to burnout, which can adversely affect patient care. Addressing burnout among nurses requires a multifaceted approach, involving both personal and organizational strategies. While organizational strategies target systemic workplace issues, personal interventions are often favored for their ease of implementation, immediate benefits, and empowerment of health care workers through stress management and resilience-building. Prioritizing evidence-based interventions to mitigate burnout among nurses is crucial for managing occupational stress and promoting well-being. Person-directed psychoeducation is an effective personal intervention strategy used to equip nurses with the appropriate knowledge and skills to handle stressors, thereby safeguarding their mental health and ensuring high-quality patient care. Objective This protocol proposes a systematic review that aims to identify and assess the effectiveness of person-directed psychoeducational interventions for nurses. The review aims to pinpoint effective interventions that can be implemented to manage burnout and support the mental health of nurses. Methods This systematic review will follow the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines. In total of 5 electronic databases (PubMed-MEDLINE, EBSCOhost, Ovid MEDLINE, Scopus, and ScienceDirect) will be searched for studies published between January 1, 2014, and December 31, 2023. The search will encompass 3 main keywords: “nurses,” “burnout intervention,” and “burnout.” Predefined eligibility criteria will guide the screening process. Data will be extracted to address the objectives of the review. The risk of bias for each study will be assessed using Joanna Briggs Institute Critical Appraisal Tools. Results Preliminary searches have been initiated since February 2024, with the review expected to be completed by June 2024. The expected results will include a comprehensive list of psychoeducational interventions and their effectiveness in reducing burnout among nurses. The review will highlight interventions that demonstrate significant impact in published studies from various countries. Conclusions Given the rising prevalence of burnout among nurses and its detrimental effects on individuals and health care organizations, the findings from this systematic review are expected to inform health care policy and practice. By evaluating different interventions, it will provide insights into the most effective strategies, contributing to evidence-based practices that support nurses’ mental health and well-being. The findings can support stakeholders in developing and implementing targeted strategies to combat nurse burnout, ultimately enhancing the quality of patient care and health care delivery. In addition, the findings will also offer valuable information for researchers, guiding future practice and research in this area. Trial Registration PROSPERO CRD42024505762; https://tinyurl.com/4p84dk3d International Registered Report Identifier (IRRID) DERR1-10.2196/58692

Health Professionals' Views on the Use of Conversational Agents for Health Care: Qualitative Descriptive Study

Article

Sep 2024
J MED INTERNET RES

Background In recent years, there has been an increase in the use of conversational agents for health promotion and service delivery. To date, health professionals’ views on the use of this technology have received limited attention in the literature. Objective The purpose of this study was to gain a better understanding of how health professionals view the use of conversational agents for health care. Methods Physicians, nurses, and regulated mental health professionals were recruited using various web-based methods. Participants were interviewed individually using the Zoom (Zoom Video Communications, Inc) videoconferencing platform. Interview questions focused on the potential benefits and risks of using conversational agents for health care, as well as the best way to integrate conversational agents into the health care system. Interviews were transcribed verbatim and uploaded to NVivo (version 12; QSR International, Inc) for thematic analysis. Results A total of 24 health professionals participated in the study (19 women, 5 men; mean age 42.75, SD 10.71 years). Participants said that the use of conversational agents for health care could have certain benefits, such as greater access to care for patients or clients and workload support for health professionals. They also discussed potential drawbacks, such as an added burden on health professionals (eg, program familiarization) and the limited capabilities of these programs. Participants said that conversational agents could be used for routine or basic tasks, such as screening and assessment, providing information and education, and supporting individuals between appointments. They also said that health professionals should have some oversight in terms of the development and implementation of these programs. Conclusions The results of this study provide insight into health professionals’ views on the use of conversational agents for health care, particularly in terms of the benefits and drawbacks of these programs and how they should be integrated into the health care system. These collective findings offer useful information and guidance to stakeholders who have an interest in the development and implementation of this technology.

What is known about nurse retention in peri-COVID-19 and post-COVID-19 work environments: protocol for a scoping review of factors, strategies and interventions

Article

Full-text available

Sep 2024

Introduction The pandemic has highlighted a worsening of nurses’ working conditions and a global nursing shortage. Little is known about the factors, strategies and interventions that improve nurse retention in the peri-COVID and post-COVID time period. An improved understanding of approaches implemented to support and retain nurses will provide a blueprint for sustaining the nursing workforce. The objectives of this scoping review are to investigate and describe the following: (a) factors associated with nurse retention; (b) strategies suggested to support nurse retention and (c) interventions trialled to support nurse retention, during and after the COVID-19 pandemic. Methods and analysis Medline, Embase, CINAHL and Scopus will be searched. The included studies will be qualitative, quantitative, mixed methods and grey literature studies of nurses including factors, strategies and/or interventions to support nurse retention in the peri-COVID and post-COVID time period (2019 to present) that are in English or can be translated into English. The excluded studies will be those that focus on nurse managers, educators, students or those in advanced practice roles and studies where the population cannot be segmented to identify which data came from nurses. Systematic, scoping reviews and meta-syntheses will be excluded, but their reference lists will be hand-screened for suitable studies. Data will be evaluated for quality and synthesised qualitatively to map the current evidence available. The relevant studies will be reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. Ethics and dissemination Approval for the broader research study, including this scoping review, has been obtained from the university health sciences research board (protocol #00042510). All data for this scoping review will be collected from published literature, and findings will be published in a peer-reviewed journal and presented at relevant conferences. Trial registration number The protocol was registered on Open Science Framework (4 April 2024) https://doi.org/10.17605/OSF.IO/XWH45 .

A Burnt-Out Health: Stigma towards Mental Health Problems as a Predictor of Burnout in a Sample of Community Social Healthcare Professionals

Article

Full-text available

Sep 2024

Burnout is a primary psychosocial risk factor in the workplace. Mental health stigma, which includes negative cognitions, emotions, and behaviors, also undermines the performance of social healthcare professionals. This study aimed to explore the levels of burnout in a sample of community social healthcare workers as well as its relationships with variables such as stigma towards mental health problems, professional skills, and job characteristics. An online assessment was conducted with 184 social healthcare professionals (75.5% female, mean age = 40.82 years, SD = 9.9). Medium levels of burnout and stigma and high levels of professional skills were observed. Multiple linear regression analyses revealed that stigma towards mental health problems and professional skills predicted emotional exhaustion (R 2 = 0.153, F(4, 179) = 9.245, p < 0.001), depersonalization (R 2 = 0.213, F(3, 180) = 17.540, p < 0.001), and personal accomplishment (R 2 = 0.289, F(5, 178) = 15.87, p < 0.001). These findings suggest that social healthcare systems could benefit from taking care of the mental health of their workers by addressing burnout, tackling negative attitudes towards mental health problems, and providing professional skills training. This would help to make social healthcare systems more inclusive and of higher quality, thereby reducing health costs.

Can the stress be managed? Stress mindset as a mitigating factor in the influence of job demands on burnout

Article

Full-text available

Sep 2024

Aim Despite the serious consequences of exposure to high job demands for nursing staff, few studies have identified pathways that could reduce the influence of high job demands on burnout. The current study aimed to exaime whether a stress mindset mitigates the positive relationship between job demands and burnout. Design A cross‐sectional survey was adopted and data were collected employing self‐report questionnaires. Methods A convenience sample of 676 nurses recruited from six regional hospitals in China were invited to complete a demographic questionnaire, the Psychological Job Demand Scale, the Stress Mindset Scale and the Burnout Scale. Hierarchical multiple regression analysis and simple slope analysis were used to examine the moderating role of stress mindset. Results Higher job demands were positively linked to burnout, and stress mindset was negatively linked to burnout. Stress mindset moderated the positive relationship between job demands and burnout. Specifically, compared to nurses with a stress‐is‐debilitating mindset, the relationship will be smaller for nurses holding a stress‐is‐enhancing mindset. Patient or Public Contributions Based on these findings, nursing leaders should foster nurses' stress‐is‐enhancing mindset, which can ameliorate the adverse effect of job demands.

How can we measure psychological safety in mental healthcare staff? Developing questionnaire items using a nominal groups technique

Article

Full-text available

Aug 2024
INT J QUAL HEALTH C

There have been growing concerns about the well-being of staff in inpatient mental health settings, with studies suggesting that they have higher burnout and greater work-related stress levels than staff in other healthcare sectors. When addressing staff well-being, psychological safety can be a useful concept. However, there is no measure of psychological safety that is suitable for use in inpatient mental health settings. Edmondson (1999) is the most commonly used measure of psychological safety, but it was designed for use in general physical healthcare settings. As inpatient mental health settings are unique environments, transferability of knowledge from physical to mental healthcare settings cannot be assumed. We sought to develop questionnaire items that capture psychological safety among healthcare staff working in acute inpatient mental healthcare settings. We used the nominal group technique, a consensus method involving rounds of discussion, idea generation, and item rating/ranking to identify priorities. Twenty-eight stakeholders participated, including 4 who had lived experience of mental health problems, 11 academics and 18 healthcare professionals (8 participants identified with more than 1 category). The study involved a workshop with three parts: (i) an overview of current research and limitations of the Edmondson (1999) measure as outlined above, (ii) discussion on what items should be retained from the Edmondson (1999) measure, and (iii) discussion on what items should be added to the Edmondson (1999) measure. Twenty-one items were generated and retained to capture psychological safety in inpatient mental health settings. These measure professionals’ sense of being valued by their team and organization, feeling supported at work, feeling physically safe and protected from physical harm, and knowing they can raise concerns about risk and safety. This is the first study to generate questionnaire items suitable for measuring staff psychological safety in mental health settings. These have been generated via a consensus method to ensure stakeholders’ views are reflected. Further research is needed to evaluate factor structure, internal reliability, and convergent validity. Full text available here https://academic.oup.com/intqhc/article/36/3/mzae086/7746667?utm_source=etoc&utm_campaign=intqhc&utm_medium=email

Burnout, age, and cognitive functioning: A prospective study with nurses in geriatric care

Article

Full-text available

Aug 2024

Geriatric nurses are both ageing and at high risk for developing burnout symptoms. Burnout symptomatology relates to lower job performance and lower care quality. Developing impairments in cognitive functioning might explain such relationships. We examined prospective relationships of burnout symptoms and cognitive functioning (memory and executive functions objectively assessed). We included age as well as several control variables as predictors and searched for interaction effects to explain prior inconsistencies. German nurses (N = 191) from geriatric care filled out self-administered questionnaires at the workplace (t1) and performed a comprehensive cognitive test battery in the lab six months later at t2. Results showed expected age effects on executive functions but no relationships between burnout symptoms and cog-nitive functioning nor any interaction effects with age. Exhausted subjects had a slightly better performance in updating. The nearly robust null findings in this study indicate that the relationship of burnout symptoms and decreased cognitive functioning may be a predominantly clinical issue.

Awareness, support, and opinions of healthy food and drink policies: a survey of staff and visitors in New Zealand healthcare organisations

Article

Full-text available

Aug 2024
BMC PUBLIC HEALTH

Background In 2016, a voluntary National Healthy Food and Drink Policy (hereafter, “the Policy”) was released to encourage public hospitals in New Zealand to provide food and drink options in line with national dietary guidelines. Five years later, eight (of 20) organisations had adopted it, with several preferring to retain or update their own institutional-level version. This study assessed staff and visitors’ awareness and support for and against the Policy, and collected feedback on perceived food environment changes since implementation of the Policy. Methods Cross-sectional electronic and paper-based survey conducted from June 2021 to August 2022. Descriptive statistics were used to present quantitative findings. Free-text responses were analysed following a general inductive approach. Qualitative and quantitative findings were compared by level of implementation of the Policy, and by ethnicity and financial security of participants. Results Data were collected from 2,526 staff and 261 visitors in 19 healthcare organisations. 80% of staff and 56% of visitors were aware of the Policy. Both staff and visitors generally supported the Policy, irrespective of whether they were aware of it or not, with most agreeing that “Hospitals should be good role models.” Among staff who opposed the Policy, the most common reason for doing so was freedom of choice. The Policy had a greater impact, positive and negative, on Māori and Pacific staff, due to more frequent purchasing onsite. Most staff noticed differences in the food and drinks available since Policy implementation. There was positive feedback about the variety of options available in some hospitals, but overall 40% of free text comments mentioned limited choice. 74% of staff reported that food and drinks were more expensive. Low-income staff/visitors and shift workers were particularly impacted by reduced choice and higher prices for healthy options. Conclusions The Policy led to notable changes in the healthiness of foods and drinks available in NZ hospitals but this was accompanied by a perception of reduced value and choice. While generally well supported, the findings indicate opportunities to improve implementation of food and drink policies (e.g. providing more healthy food choices, better engagement with staff, and keeping prices of healthy options low) and confirm that the Policy could be expanded to other public workplaces.

Unravelling the Nexus: Exploring How Workplace Incivility Shapes Nurses Well-Being via Emotional Exhaustion Pathways

Article

Full-text available

Apr 2024

Based on the Conservation of Resource theory, the current research investigates how workplace incivility affects employees' psychological well-being. It also discovers how the psychological resources are depleted through emotional exhaustion among Pakistani nurses in health care centers; as a result, the psychological well-being of the nurses deteriorates. When extrinsic and extrinsic motivation does not replenish psychological resources, nurses' psychological well-being may be compromised. The present study primarily focuses on the registered nurses working in different secondary and tertiary hospitals in southern Punjab, Pakistan. Data was collected from 350 nurses in different government hospitals using the nonprobability, purposive sampling technique. The primary data is collected by disseminating and collecting structured questionnaires to maintain the anonymity of the respondents. The findings represent that Pakistani nurses do encounter incivility in the workplace. This study suggests that, among the factors considered, workplace incivility has the most substantial adverse effect on nurses' psychological well-being. The research suggests developing better human resource practices by bringing attention to this issue. Such initiatives could focus on encouraging support for nurses, diminishing workplace incivility, and ultimately enhancing their psychological well-being.

Impact of burnout on depression among nurses at a private hospital in Johannesburg, South Africa

Article

Full-text available

Jul 2024

Background: Burnout is a syndrome that is understood as emanating from chronic workplace stressors that have not been managed successfully. Little is known about the causes of burnout among nurses in South Africa. The study aimed to determine the prevalence of burnout and its impact on depression and assess the relationship between burnout and depression among nurses at a Johannesburg private hospital. Methods: Nurses at a private hospital in Johannesburg were asked about their exposure to depression and burnout using a closed-ended questionnaire as part of a quantitative, cross-sectional study design. A p -value < 0.05 was considered statistically significant. The respondents were selected using the simple-random sampling method. The collected data were analysed using IBM-SPSS version 28. Results: The study involved 112 nurses, of whom 95 (84.8%) were females. Most of the nurses, that is, 56 (50.0%) were registered nurses. Emotional exhaustion ( p = 0.001) and depersonalisation ( p = 0.001) were significantly associated with depression. Work experience ( p = 0.001) and depersonalisation ( p = 0.002) had an impact on depression. Conclusion: The study revealed a high prevalence of burnout among nurses at a Johannesburg private hospital. The study found that depression was significantly associated with emotional exhaustion and depersonalisation. The study also found that work experience and depersonalisation have an impact on depression. Contribution: The study’s recommendations can help mitigate burnout and improve the well-being of nurses, ultimately enhancing the quality of healthcare services provided at the hospital.

The problem with resilience in nursing

Article

Nov 2024

Burnout among Nurses in Critical Care Units: Addressing a Persistent Challenge

Article

Full-text available

Oct 2024

Background: Burnout is a highly prevalent occupational disease among nurses, especially those working in complex critical care settings. Objective: To determine the level of burnout among nurses practicing in critical care units. Methods: This study employed a descriptive cross-sectional design, involving 377 nurses working in critical care units across 13 hospitals in Iraq. Data were collected using sociodemographic, professional characteristics of the nursing competency and performance, and the Burnout Assessment Tool. The data was analysed using descriptive statistics. Results: The study showed a high prevalence of overall burnout among nurses, with a mean score of 2.53. The study also revealed medium levels of mental detachment, cognitive impairment, emotional impairment, and psychological distress, with mean scores of 2.18, 1.85, 2.17, and 2.71, respectively. The exhaustion and psychosomatic complaints scored highly, with mean scores of 3.07 and 2.87, respectively. Conclusion: Nurses in critical care units experienced a high level of burnout. Within the dimensions of burnout, high levels of exhaustion and psychosomatic complaints were found, as were medium levels for each of the dimensions of mental distance, cognitive impairment, emotional impairment, and psychological distress.

Teamwork, psychological detachment from work during nonwork time, and burnout experienced by hospital‐based nurses

Article

Nov 2024
INT NURS REV

Aims To assess the relationships in nursing teamwork, psychological detachment from work during nonwork time, and burnout, and the mediating effect of psychological detachment on the relationship between nursing teamwork and burnout. Background Nurse burnout has serious implications for nurses’ health and performance and the overall functioning of their organizations. Evidence on the relationships between nursing teamwork, psychological detachment, and nurse burnout is limited. This study adds to the international body of knowledge by examining the interplay between nursing teamwork, psychological detachment, and burnout in nurses, a topic of global relevance. Methods This cross‐sectional study used survey data collected in May 2021 from 1115 Korean hospital nurses. The measurements included the Nursing Teamwork Survey, a subscale of the Recovery Experience Questionnaire, and the Copenhagen Burnout Inventory. We performed mediation analysis using PROCESS Macro based on 5000 bootstrapped samples to estimate the indirect effect of nursing teamwork. Results Nurses in units with stronger teamwork were more likely to report being psychologically detached from work during nonwork time. Nurses who distanced themselves from work‐related thoughts during nonwork time reported lower personal, work‐related, and patient‐related burnout. Nursing teamwork had significant indirect effects on each burnout outcome through psychological detachment. Conclusion By providing empirical evidence on the associations between nursing teamwork, psychological detachment, and burnout, this study enriches the international discourse on nurse burnout and the benefits of psychological detachment. Enhanced nursing teamwork can facilitate nurses’ mental distance from work during nonwork time, thereby reducing burnout. Implications for nursing and nursing policy Organizational efforts to manage nurse burnout can include increasing nursing teamwork among nurses and improving nurses’ psychological detachment during nonwork hours. Interventions should include improving nursing teamwork and developing a supportive and collaborative unit culture.

Occupational Risk Factors for Burnout Syndrome Among Healthcare Professionals: A Global Systematic Review and Meta-Analysis

Article

Full-text available

Nov 2024
Int J Environ Res Publ Health

Health professionals are disproportionately affected by burnout compared to other occupational groups. This study aims to systematically review and meta-analyze thirteen occupational risk factors related to burnout syndrome among health professionals globally. A comprehensive literature search was conducted in August 2023. The protocol was registered in The International Prospective Register of Systematic Reviews (PROSPERO), registration number CRD42023396081. Using a random-effects model, this meta-analysis assessed the association between occupational risk factors and burnout, reporting odds ratios (ORs) and 95% confidence intervals (CIs). The meta-analysis included 109 studies from diverse global locations. Key factors influencing burnout included workplace bullying, job stress, and poor communication, with protective factors such as supportive work environments, adequate staffing, and individual resilience. All risk factors examined showed a significant positive relationship with burnout incidence. Workplace bullying was strongly associated with increased burnout (OR 4.05–15.01, p < 0.001). Similarly, low job satisfaction and high job stress were strongly associated with burnout, with ORs of 5.05 (95% CI 3.88–6.56, p < 0.001) and 4.21 (95% CI 1.62–10.94, p = 0.003), respectively. The review findings highlight the importance of addressing these risk factors through enhanced supportive work environments and promoting personal resilience strategies.

The effects of psychological flexibility and night shifts on mental health and well-being in nurses

Article

Full-text available

Nov 2024
PLOS ONE

Background Examining mental health among nurses in the later stages of the COVID-19 pandemic could offer valuable information for addressing these symptoms in the long term. Therefore, the current study aimed to assess the mental health and well-being of Chinese nurses, as well as investigate the impact of psychological flexibility and night shifts on this relationship. Method In cross-sectional, hospital-based, multicenter study, 422 Chinese nurses were selected by multistage stratified cluster random sampling. The mental health status, psychological flexibility, and wellbeing were assessed via 12-item General Health Questionnaire (GHQ-12), Chinese version of Personalized Psychological Flexibility Index, and Chinese version of the 5-item WHO Well-Being Index, respectively. To examine the proposed theoretical model, we conducted structural equation modeling using SPSS Amos 26 version. The age, gender, night shift, psychological flexibility, mental health, and well-being data were entered into the model. Pearson correlation and chi-square were used to explore the correlation between variables. Results The high night shifts, being young and low psychological flexibility significantly had a direct effect on worse mental health (night shifts: ES, 95% CI: 0.619, 0.328–0.725; age: ES, 95% CI: 0.542, 0.226–0.993; psychological flexibility: ES, 95% CI: 0.675, 0.369–1.466). The low psychological flexibility and worse mental health were able to directly effect on worse wellbeing (psychological flexibility: ES, 95% CI: 0.419, 0.757–1.519; mental health: ES, 95% CI: 0.719, 1.109–2.607). In addition, psychological flexibility through the mediation of mental health also had an indirect effect on wellbeing (ES, 95% CI: 0.269, 0.957–2.165). Conclusions Being young, having more night shifts and having less psychological flexibility can be related to the deterioration of mental health and well-being in nurses. Therefore, it is recommended that nurses use the shift routine program with the least focus on the night shifts. Also, interventions to teach younger nurses how to face work stress and interventions to improve the psychological flexibility of all nurses are needed.

Experience Among Postnatal Nurses With Two or Three Children Returning to Work Within 3 Months in China: A Qualitative Study

Article

Full-text available

Nov 2024

Aim To analyse experience in postnatal nurses returning to work within 3 months following the delivery of a second or third child and recommend appropriate measures to relieve pressure and enhance work engagement among this group. Methods This study adopted a descriptive phenomenological approach. Semi‐structured interview was carried out with 12 postnatal nurses who had returned to work in the postpartum period following the delivery of a second or third child. The collected data were analysed using the Colaizzi method. Results Experience among postnatal nurses with two or three children was found to stem from three factors: declining physical quality after childbirth (pelvic floor disorder, fatigue, postpartum memory decline and sleep disturbance), poor psychological adjustment after childbirth (work–family conflict, conflict between clinical work and breastfeeding and role maladjustment) and lack of clear career planning. Conclusion This study emphasised the importance of psychological experience when postnatal nurses returning to clinical work in the early phase. Postnatal nurses and nurse leaders can use these results to make comprehensive solution in order to improve work engagement in the postpartum return. Public Contribution No patient or public contribution.

Creating Perinatal Nursing Care Plans Using ChatGPT: A Pathway to Improve Nursing Care Plans and Reduce Documentation Burden

Article

Nov 2024
J PERINAT NEONAT NUR

Background : Extensive time spent on documentation in electronic health records (EHRs) impedes patient care and contributes to nurse burnout. Artificial intelligence–based clinical decision support tools within the EHR, such as ChatGPT, can provide care plan recommendations to the perinatal nurse. The lack of explicit methodologies for effectively integrating ChatGPT led to our initiative to build and demonstrate our ChatGPT-4 prompt to support nurse care planning. Methods : We employed our process model, previously tested with 22 diverse medical-surgical patient scenarios, to generate a tailored prompt for ChatGPT-4 to produce care plan suggestions for an exemplar patient presenting with preterm labor and gestational diabetes. A comparative analysis was conducted by evaluating the output against a “nurse-generated care plan” developed by our team of nurses on content alignment, accuracy of standardized nursing terminology, and prioritization of care. Results : ChatGPT-4 delivered suggestions for nursing diagnoses, interventions, and outcomes comparable to the “nurse-generated care plan.” It accurately identified major care areas, avoided irrelevant or unnecessary recommendations, and identified top priority care. Of the 24 labels generated by ChatGPT-4, 16 correctly utilized standardized nursing terminology. Conclusion : This demonstration of the use of our ChatGPT-4 prompt illustrates the potential of leveraging a large language model to assist perinatal nurses in creating care plans. The next steps are improving the accuracy of ChatGPT-4–generated standardized nursing terminology and integrating our prompt into EHRs. This work supports our broader goal of enhancing patient outcomes while mitigating the burden of documentation that contributes to nurse burnout.

The relationships among safety climate, occupational burnout, and psychosocial factors for hospital nurses: Using structural equation modeling

Article

Oct 2024

Síndrome de Burnout: Características gerais e impactos na prática laboral dos trabalhadores da saúde

Chapter

Full-text available

Oct 2024

Esta obra constituiu-se a partir de um processo colaborativo entre professores, estudantes e pesquisadores que se destacaram e qualificaram as discussões neste espaço formativo. Resulta, também, de movimentos interinstitucionais e de ações de incentivo à pesquisa que congregam pesquisadores das mais diversas áreas do conhecimento e de diferentes Instituições de Educação Superior públicas e privadas de abrangência nacional e internacional. Tem como objetivo integrar ações interinstitucionais nacionais e internacionais com redes de pesquisa que tenham a finalidade de fomentar a formação continuada dos profissionais da educação, por meio da produção e socialização de conhecimentos das diversas áreas do Saberes. Agradecemos aos autores pelo empenho, disponibilidade e dedicação para o desenvolvimento e conclusão dessa obra. Esperamos também que esta obra sirva de instrumento didático-pedagógico para estudantes, professores dos diversos níveis de ensino em seus trabalhos e demais interessados pela temática.

Evaluating a peer-support mind-body medicine intervention for healthcare leaders

Article

Oct 2024
WORLDV EVID-BASED NU

Background Mind–body medicine (MBM) is an evidence‐based intervention associated with trauma and stressful events. The MBM intervention alleviates symptoms of work‐related stress and builds resilience by utilizing self‐care techniques facilitated in small group settings. Healthcare leaders who experienced traumatic stress through the COVID‐19 pandemic may benefit from interventions aimed at their needs. Aim We evaluated the effects of a peer support MBM intervention on perceived stress, resilience, well‐being, and empathy for nurse leaders and compassionate care leaders. Methods A pre–post intervention was conducted via 7 virtual and 2 on‐site groups, recruiting from a large multihospital health system in the United States. Participants engaged in an 8‐week program facilitated by a certified faculty group leader from The Center for Mind–Body Medicine and engaged in resilience skills building activities along with facilitated sharing. Validated instruments were used to measure outcomes at pre, post, 1 month, and 6 month follow‐up intervals. Surveys included open‐ended questions for qualitative feedback related to facilitators, barriers, and group experiences. Results Seventy‐three leaders completed the MBM program, and 22 completed the four research surveys; all qualitative responses were included for feedback. Perceived stress decreased after the intervention ( p < .008) and was maintained for 6 months post intervention ( p < .005). Resilience increased after the intervention ( p < .034) and for 1 month ( p < .049) but decreased after 6 months. Qualitative responses showed that time and workload factors were the most significant barrier to participation, while the benefits included protected time with peers, learning well‐being skills, and having a safe place to process emotions. Linking Evidence to Action Healthcare leaders face unique challenges, including workplace trauma and crises. Interventions that support their stress response, resilience, and overall well‐being should take into consideration the nature of their work, the balance of time demands, and the need for peer support to overcome barriers to sustainable interventions.

Burnout and anxiety among Chinese nurses: The mediating roles of positive coping strategies and interpersonal problems: A cross-sectional study

Preprint

Full-text available

Aug 2024

Background Burnout among nurses is a global problem that results in increased turnover as well as decreased career satisfaction and poor nursing service. Previous researchers have suggested that anxiety is associated with burnout. However, the internal mechanism by which anxiety affects burnout remains unclear. Furthermore, the question of how the demographic characteristics of nurses predict burnout remains unanswered. Aims This study aimed to explore the mechanisms by which anxiety affects burnout, to verify the mediating roles of interpersonal relationship problems and positive coping in the relationship between anxiety and burnout, and to explore the factors that can predict burnout among nurses. Methods A total of 4,856 nurses were enrolled in this study. The ability of anxiety, positive coping, interpersonal relationship problems, and demographic factors to predict burnout were explored via linear regression models. The relationships among anxiety, positive coping, interpersonal relationship problems, and burnout were also explored by developing a parallel mediation model with the assistance of SPSS PROCESS 3.3 software. Results The following factors can predict burnout among nurses: internal medicine ward (β = 0.075 P < 0.01), surgery ward (β = 0.054 P < 0.01), operating room (β = 0.022 P = 0.037), a number of night shifts worked per month higher than 10 (β = 0.046 P < 0.01), and possession of a master's degree or higher level of education (β = 0.03 P < 0.01). Positive coping (β = 0.029, 95% CI: 0.022 to 0.036) and interpersonal problems (β = 0.134, 95% CI: 0.118 to 0.151) mediate the relationship between anxiety and burnout. Conclusion The results of this study reveal that nurses’ department, level of education, and number of night shifts worked per month are effective predictors of burnout. Positive coping and interpersonal relationships mediate the relationship between anxiety and burnout.

Exploring the Bidirectional Relationship Between Job Burnout and Empathy in Nurses: A Longitudinal Study

Article

Sep 2024
PATIENT EDUC COUNS

Evaluación del síndrome de burnout en trabajadores de la fundación familia salesiana: caso práctico

Article

Sep 2024

La presente investigación referente al Síndrome de Burnout o del quemado, considerado como un tipo de estrés laboral crónico que se caracteriza por el agotamiento físico, mental y emocional causado por la exposición prolongada a situaciones estresantes en el trabajo, condiciones no adecuadas. El objetivo del estudio es determinar los niveles del Síndrome de Burnout y sus dimensiones en los trabajadores de la Fundación Familia Salesiana. Se aplica el test MBI (Maslach Burnout Inventory), para realizar una evaluación en tres dimensiones: la despersonalización, cansancio emocional y realización personal, se realiza una modificación en el cuestionario añadiendo variables sociodemográficas para determinar su correlación por medio del V de Cramer. La población a la cual se aplica la encuesta es todo el personal que labora en la fundación entre operativo y administrativo, un total de 35 trabajadores, que arrojaron los siguientes resultados. El resultado encontrado de Burnout: 42.9 % bajo, 51.4 % medio y 5.7 % alto, se establece la correlación de las dimensiones por medio del V de Cramer de las variables sociodemográficas las mismas van entre moderado a muy fuerte en su p valor con el test aplicado de MBI. Se concluye la presencia de Síndrome de Burnout entre medio y alta, lo que revela la necesidad de implementar un plan de mitigación con medidas preventivas que ayuden a solucionar los efectos nocivos para la salud física y mental del personal de la empresa mediante psicología positiva que genere bienestar y confort.

The Mediation Impact of Compassion Competence on the Link Between Mindfulness and Job Burnout in Nurses: A Cross-Sectional Study

Article

Sep 2024
J CLIN NURS

Aims This study explores the link between mindfulness, compassion competence and job burnout among nurses, and analyses the mediating role that compassion competence plays in this relationship. Background Understanding nurses' mindfulness, compassion competence and job burnout is important, which could help devise interventions to relieve burnout in clinical nurses. Methods This study adopts convenience sampling method and descriptive design quantitative research. A cross‐sectional study of 513 nurses was conducted from June to October 2023 in mainland China. The Socio‐demographic Questionnaire, Mindful Attention Awareness Scale, Maslach Burnout Inventory‐Human Service Survey and Compassion Competence Scale for the Nurses were utilised to gather basic demographic information on nurses and to evaluate their level of mindfulness, compassion competence and job burnout. Descriptive statistics, Spearman's correlation analyses and structural equation model were used to analyse the data. Results Five hundred and thirteen valid questionnaires were gathered. Spearman's correlation analysis revealed a strong negative link between mindfulness and job burnout, and between compassion competence and burnout, and a significant positive correlation between mindfulness and compassion competence. The results of the mediation analysis revealed that the relationship between mindfulness and job burnout was partially mediated by compassion competence, and the mediating effect accounted for 18.6% of the total effect. Conclusion Compassion competence performed as a partial mediator between mindfulness and job burnout among nurses. Nursing managers could enhance nurses' mindfulness level and compassion competence through Mindfulness interventions and Compassion training to reduce their burnout. Relevance to Clinical Practice This study offers a fresh viewpoint on enhancing clinical nurses' compassion competence and reducing job burnout. Healthcare organisations and medical institutions can mitigate nurses' job burnout by improving their mindfulness levels and compassion competence. Reporting Method The study used the STROBE checklist for reporting. Patient or Public Contribution All participants were nurses who completed an electronic questionnaire related to this study.

Stress and Resilience in the Nursing Profession: Staff and Supervisor Perceptions, Assumptions and Responsibility for Health: A Generic Qualitative Study

Preprint

Full-text available

Jul 2024

Background Supervisor–subordinate relationship is high relevant in dealing with work-related stress and providing a compassionate, high-quality, and safe nursing care while meeting the needs of the hospital. Our aim was to identify and compare nurses’ work-related stress and the factors of resilience from the perspective of registered nurses and supervisors in clinical inpatient settings. Design Generic qualitative study using half-standardized interviews. Methods Fifty nurses and supervisors from different departments from a German hospital of maximum medical care participated in this study between August and November 2018. Nineteen face-to-face interviews and five focus groups were conducted. Transcripts were subjected to structured qualitative content analysis. Results Systematised in Lazarus’s transactional model, nurses, and supervisors mentioned similar risk and resilience factors of stress. Disagreement in suggested responsibility for nurses’ stress or health and an evaluation of implemented measures meeting the nurses’ needs are discussed. Conclusion Nursing staff and supervisors should enforce exchange to reduce disagreements in perceptions and to improve mutual understanding. Furthermore, measures to meet nurses’ needs to minimize stress and to improve collaboration and job satisfaction should be developed in close coordination with the target group. The focus should be placed on restructuring training and education programs with supplementation of self-responsibility promotion. Trail registration The study was registered with the German Register for Clinical Studies (DRKS00013482).

Nurses' burnout and patient safety culture: The moderating effect of structural empowerment

Article

Full-text available

Aug 2024
J ADV NURS

Aims To identify correlations among job burnout, structural empowerment, and patient safety culture (PSC), and to explore the potential moderating effect of structural empowerment on the associations between burnout and PSC. Design The study used a cross‐sectional survey design. Methods Convenient sampling was employed. We conducted an anonymous online survey in January 2024 among nurses employed at hospitals in three regions of China. Job burnout, structural empowerment, and perceptions of PSC were assessed. A total of 1026 useable surveys were included in the analyses. Descriptive statistics were performed using SPSS software. A latent structural equation modeling approach using Mplus software was used to analyze the moderating effect. Results The proposed hypothetical model was supported. Job burnout had a strong direct negative effect on structural empowerment and PSC. Structural empowerment had a significant moderating effect on the relationship between job burnout and PSC. Conclusion The empirically validated moderation model and study results suggest that managers of healthcare organisations can improve patient safety and care quality by fostering empowerment and providing sufficient support to clinical nurses. Implication The findings of this study suggest that providing more support, resources, and information is likely to be effective in weakening the detrimental impact of job burnout on PSC. This study provides insights into the possible approaches that may improve patient safety. To control the impact of nurses' burnout on care quality, nurse managers should increase empowerment as well as staff nurse engagement. Reporting Method We have adhered to relevant EQUATOR guidelines and conducted an observational study, following the STROBE checklist. Public Contribution During the data collection phase of this study, clinical caregivers participated in completing the online survey.

An estimate of burnout prevalence among oncology nurses

Preprint

Full-text available

Jul 2024

Background: Nurses in oncology must cope with the suffering of patients, the inevitability of death and their own transience. This poses a possible risk for the development of burnout, which can result in low job satisfaction and ultimately an increased intention to leave the job. Our aim was to assess psychological distress in registered nurses working in oncology. Objective and method: A cross-sectional survey with the Oldenburger Burnout Inventory was presented to nurses within the German Cancer Society. It collected data on psychological distress via two subscales, exhaustion and disengagement. Socio-demographic data were assessed. Results: Among 83 participating nurses, we found a prevalence of high disengagement in 17 RNs (20.48%) and high exhaustion (MExh>2.5 = burnout) in 44 (53.00%). Looking at the highest values of both scales, 18.08% of respondents were at high risk for psychological distress. There was a low correlation between disengagement and age (r=.331, p<0.01). The risk of high disengagement among nurses older than 50 (n = 9, 52.94%) was three times higher than for those who were 50 or younger (n = 8, 47.06%) (RR = 8.642, 95% CI: 1.475–5.749, p<0,01). Conclusion: This survey highlights a high rate of burnout among German oncology nurses. Interventions should be developed, implemented, and delivered in an age-appropriate manner. To ensure high-quality care and patient safety, oncology nurses should be offered preventive mental healthcare services later in their careers. Clinical trial registration number: The study was registered with the German Clinical Trials Register (DRKS500018851).

Inquiry Into the Correlation Between Burnout and Depression

Article

Full-text available

Apr 2019

The extent to which burnout refers to anything other than a depressive condition remains an object of controversy among occupational health specialists. In three studies conducted in two different countries and two different languages, we investigated the discriminant validity of burnout scales by evaluating the magnitude of the correlation between (latent) burnout and (latent) depression. In Study 1 (N = 911), burnout was assessed with the Maslach Burnout Inventory-General Survey’s Exhaustion subscale and depression with the PHQ-8. In Study 2 (N = 1,386), the Shirom-Melamed Burnout Measure was employed to assess burnout, and the PHQ-9 was used to assess depression. In Study 3 (N = 734), burnout was assessed with the Maslach Burnout Inventory-Educators Survey and depression, with the PHQ-9 and the CES-D-10; additionally, anxiety was measured with the GAD-7. In each study, we examined the burnout-depression association based on confirmatory factor analysis (CFA), controlling for item-level content overlap. In the three studies, latent exhaustion, the core of burnout, and latent depression were highly correlated (correlations ranging from .83 to .88). In Studies 2 and 3, the models we constructed were sufficiently identified to allow us to conduct second-order CFAs, which indicated that depressive (and anxiety) symptoms and the exhaustion and depersonalization components of burnout are reflective of the same higher-order distress/dysphoria factor. Our findings, with their replication across samples, languages, and measures, together with their consistency with meta-analytic findings cast serious doubt on the discriminant validity of the burnout construct. The implications of burnout’s problematic discriminant validity are discussed.

Determinants of compassion satisfaction, compassion fatigue and burn out in nursing: A correlative meta-analysis

Article

Full-text available

Jun 2018

Background: Compassionate care is essential for better clinical and patient outcomes, but during healthcare provision it can be compromised by several factors. This study evaluates factors affecting compassion satisfaction, compassion fatigue and burnout in nursing. Methods: Literature search in electronic databases was followed by data extraction, conversion, and meta-analyses under random effect model. Correlation coefficients (r) reported by individual studies were first converted to z-scores for meta-analyses and the overall effect sizes were then back-transformed into r. Results: Eleven studies (4054 respondents; 64.34 [95% confidence interval: 38.82, 89.86] % response rate; age 39.81 [31.36, 48.27] years; 87.11 [79.48, 94.73] % females) were used for meta-analysis. There was a strong positive correlation between compassion fatigue and burnout (r = 0.59), whereas compassion satisfaction had weak negative correlation with compassion fatigue (r = -0.226) but moderate with burnout (r = -0.446). Stress and negative affect were moderately positively associated with compassion fatigue (r = 0.405) but weakly correlated with burnout (r = 0.119). Positive affect and personal/social factors had weak inverse relationship with burnout (r = -0.197). Positive affect also had a moderately positive relationship with compassion satisfaction (r = 0.396). Demographic or professional factors were not significantly related to compassion satisfaction, compassion fatigue, or burnout. Conclusion: In nursing, a variety of stressful factors and negative affect promote compassion fatigue and burnout whereas positive affect is helpful in achieving compassion satisfaction.

Burnout syndrome and its prevalence in primary care nursing: A systematic review and meta-analysis

Article

Full-text available

May 2018
BMC FAM PRACT

Background: burnout syndrome is a significant problem in nursing professionals. Although, the unit where nurses work may influence burnout development. Nurses that work in primary care units may be at higher risk of burnout. The aim of the study was to estimate the prevalence of emotional exhaustion, depersonalization and low personal accomplishment in primary care nurses. Methods: We performed a meta-analysis. We searched Pubmed, CINAHL, Scopus, Scielo, Proquest, CUIDEN and LILACS databases up to September 2017 to identify cross-sectional studies assessing primary care nurses' burnout with the Maslach Burnout Inventory were included. The search was done in September 2017. Results: After the search process, n = 8 studies were included in the meta-analysis, representing a total sample of n = 1110 primary care nurses. High emotional exhaustion prevalence was 28% (95% Confidence Interval = 22-34%), high depersonalization was 15% (95% Confidence Interval = 9-23%) and 31% (95% Confidence Interval = 6-66%) for low personal accomplishment. Conclusions: Problems such as emotional exhaustion and low personal accomplishment are very common among primary care nurses, while depersonalization is less prevalent. Primary care nurses are a burnout risk group.

Prevalence of burnout in paediatric nurses: A systematic review and meta-analysis

Article

Full-text available

Apr 2018
PLOS ONE

Introduction Although burnout in paediatric nurses has been addressed in previous research, the heterogeneous nature of the results obtained and of the variables studied highlights the need for a detailed analysis of the literature. Objective The aim of this study was to analyse the literature on burnout characteristics, reported prevalence, severity and risk factors, to achieve a better understanding of the risk of emotional exhaustion, depersonalisation and feelings of low personal accomplishment. Method For this purpose, we carried out a systematic review and meta-analysis of the literature. The databases consulted were CINAHL, LILACS, PubMed, the Proquest Platform (Proquest Health & Medical Complete), Scielo and Scopus. This study used the search equation “burnout AND “pediatric nurs*””, and was conducted in July 2017. Results The search produced 34 studies targeting burnout in paediatric nurses, with no restrictions on the date of publication. Many of these studies detected moderate-high values for the three dimensions of burnout, and highlighted sociodemographic, psychological and job-related variables associated with this syndrome. The sample population for the meta-analysis was composed of 1600 paediatric nurses. The following prevalence values were obtained: (i) emotional exhaustion, 31% (95% CI: 25–37%); (ii) depersonalisation, 21% (95% CI: 11–33%); (iii) low personal accomplishment, 39% (95% CI: 28–50%). Conclusions A significant number of paediatric nurses were found to have moderate-high levels of emotional exhaustion and depersonalisation, and low levels of personal accomplishment. These nurses, therefore, were either experiencing burnout or at high risk of suffering it in the future. These results support the need for further study of the risk factors for burnout in paediatric nurses. They also highlight the importance of developing interventions or therapies to help prevent or attenuate the above symptoms, thus helping nurses cope with the workplace environment and with situations that may lead to burnout.

Article

Full-text available

Mar 2018
Int J Adolesc Med Health

Background One of the most prevalent problems in work places that is considered as an important risk factor for the health of the employee is job burnout (JB). JB could be harmful to employees, their families and society. Therefore, decreasing JB among individuals and determining factors associated with it is important to improve the working environment and prevent its negative outcomes. This study aims to elicit the conditions and factors that cause job burnout among nurses of the Razi Psychiatric Hospital, Iran. Methods This study was a descriptive correlational and cross-sectional survey which the demographic and occupational burnout variables of nurses were measured. The study was conducted from January to April 2016. Accordingly, with a type I error probability of 0.05 and a power of 0.80, the sample size was determined to be 100 nurses for each group (men and women). Then, 200 were selected in the Razi Psychiatric Hospital (of whom approx. 60% worked in a rotating shift schedule). The data were collected in two phases: the first step was created by the authors, including gathering demographic data with questionnaire such as gender, age, marital status, education level, years of professional experience, hours of overtime working per month, shift schedules, and their working hospitals and wards. The second step was the Maslach burnout inventory (MBI), human services survey (HSS) version, developed by Maslach and Jackson to assess the three dimensions of burnout. Descriptive statistics (frequency distribution) were used for integrating the demographic variables. Additionally, logistical regression was applied to realize the association between demographic characteristics with the job burnout in SPSS software V.19. Results Our findings indicated that age, hours of work per week, nursing skills, management experience and work experiences accounted for 30% of the variance of depersonalization. Formal employment was significantly associated with emotional exhaustion (p < 0.04). Also, sex was significantly associated with low personal accomplishment (p < 0.006). Conclusion The employment status and gender of nurses participating in the study has an effect on emotional exhaustion and personal achievement. Paying more attention to gender in the nursing profession and the change in their work status to a stable and formalized format can lead to a reduction in job burnout among nurses.

Prevalence of and factors associated with burnout among health care professionals in Arab countries: A systematic review

Article

Full-text available

Jul 2017
BMC HEALTH SERV RES

Background Burnout among healthcare professionals is one of the key challenges affecting health care practice and quality of care. This systematic review aims to (1) estimate the prevalence of burnout among health care professionals (HCP) in Arab countries; and (2) explore individual and work-related factors associated with burnout in this population. Methods Multiple electronic databases were searched for studies published in English or Arabic from January 1980 to November 2014 assessing burnout (using the Maslach Burnout Inventory; MBI) amongst health care professionals (HCP) in Arab countries. Results Nineteen studies (N = 4108; 49.3% females) conducted on HCP in Bahrain, Egypt, Jordan, Lebanon, Palestine, Saudi Arabia and Yemen were included in this review. There was a wide range of prevalence estimates for the three MBI subscales, high Emotional Exhaustion (20.0–81.0%), high Depersonalization (9.2–80.0%), and low Personal Accomplishment (13.3–85.8%). Gender, nationality, service duration, working hours, and shift patterns were all significantly associated with burnout. Conclusions Within the constraints of the study and the range of quality papers available, our review revealed moderate-to-high estimates of self-reported burnout among HCP in Arab countries that are similar to prevalence estimates in non-Arabic speaking westernized developed countries. In order to develop culturally appropriate interventions, further research using longitudinal designs is needed to confirm the risk factors for burnout in specific HCP settings and specialties in Arab countries. Electronic supplementary material The online version of this article (doi:10.1186/s12913-017-2319-8) contains supplementary material, which is available to authorized users.

Governing the mixed health workforce: Learning from Asian experiences

Article

Full-text available

Apr 2017

Examination of the composition of the health workforce in many low and middle-income countries (LMICs) reveals deep-seated heterogeneity that manifests in multiple ways: varying levels of official legitimacy and informality of practice; wide gradation in type of employment and behaviour (public to private) and diverse, sometimes overlapping, systems of knowledge and variably specialised cadres of providers. Coordinating this mixed workforce necessitates an approach to governance that is responsive to the opportunities and challenges presented by this diversity. This article discusses some of these opportunities and challenges for LMICs in general, and illustrates them through three case studies from different Asian country settings.

Prevalência da Síndrome de Burnout em profissionais de enfermagem da atenção básica à saúde Prevalence of Burnout Syndrome in nursing professionals of basic health care

Article

Full-text available

Jan 2017

Objetivo: Estimar a prevalência da Síndrome de Burnout entre profissionais de enfermagem da Atenção Básica à Saúde de um município do sudoeste baiano. Método: Estudo de corte transversal, realizado com 60 profissionais de enfermagem da Atenção Básica. Utilizou-se um questionário sociodemográfico e laboral e o Maslach Burnout Inventory. Os dados foram tabulados no SPSS, versão 22.0 e analisados segundo estatística descritiva. Resultados: A prevalência de Síndrome de Burnout foi de 58,3% de acordo os critérios de Grunfeld et al., e de 16,7% segundo Ramirez et al.. Encontraram-se altos níveis na dimensão despersonalização (48,3%) e baixa realização profissional (56,6%). A prevalência da Síndrome de Burnout na população estudada foi alta, assim como foi alto o índice de predisposição para desenvolver esta síndrome. Conclusões: O estudo apontou a necessidade de implementação de medidas preventivas e interventivas para garantir um ambiente de trabalho benéfico e promissor de saúde.

Prevalence, Risk Factors, and Levels of Burnout Among Oncology Nurses: A Systematic Review

Article

Full-text available

May 2016

Problem Identification: To determine (a) the average levels of emotional exhaustion (EE), depersonalization (D), and personal accomplishment (PA) among oncology nurses; (b) the prevalence of low, medium, and high levels of burnout for each dimension; and (c) the risk factors for burnout. Literature Search: A systematic review was carried out using the CUIDEN, CINAHL®, LILACS, ProQuest, PubMed, SciELO, and Scopus databases. Data Evaluation: The 436 search results obtained were reduced to a final sample of 27 articles after applying the inclusion and exclusion criteria. Synthesis: With respect to levels of burnout, published results differ in their conclusions. In general, they indicate that oncology nurses feel little sense of PA and suffer from EE, although few signs of D exist. Conclusions: Oncology nurses present high levels of EE and of reduced PA. A large proportion of these nurses are at risk of developing burnout. Age, work experience, workload, and communication skills are among the factors that may influence development of the syndrome. Implications for Practice: Programs should be developed to identify interventions that would reduce EE and enhance feelings of PA. In addition, risk factors and protective measures should be studied more comprehensively.

Prevalence of Burnout syndrome in health professionals of an onco-hematological pediatric hospital

Article

Full-text available

Mar 2015

OBJECTIVE To identify the prevalence of Burnout Syndrome in medical professionals, nurses and nursing technicians working in an Onco-Hematological Pediatric Hospital in São Paulo. METHOD An exploratory, descriptive study with cross-sectional design and quantitative approach, with a sample of 188 health professionals. Data were collected using two self-report instruments: the Maslach Burnout Inventory (MBI-HSS) which is a biosocial data form, and a non-participant observation guide. RESULTS High depersonalization for nurses (29.8%), low job performance for physicians (27.8%), and of nursing technicians (25.5%). High scores were identified in at least two domains of Burnout in 19.2% of nurses, 16.8% of nursing technicians, and 16.6% of doctors. CONCLUSION Health professionals are highly vulnerable to each of the dimensions of Burnout syndrome - namely emotional exhaustion, alienation, and low job performance/satisfaction- in the hospital work.

The association between Internet addiction and psychiatric co-morbidity: A meta-analysis

Article

Full-text available

Jun 2014
BMC PSYCHIATRY

Background This study evaluates the association between Internal Addiction (IA) and psychiatric co-morbidity in the literature. Methods Meta-analyses were conducted on cross-sectional, case–control and cohort studies which examined the relationship between IA and psychiatric co-morbidity. Selected studies were extracted from major online databases. The inclusion criteria are as follows: 1) studies conducted on human subjects; 2) IA and psychiatric co-morbidity were assessed by standardised questionnaires; and 3) availability of adequate information to calculate the effect size. Random-effects models were used to calculate the aggregate prevalence and the pooled odds ratios (OR). Results Eight studies comprising 1641 patients suffering from IA and 11210 controls were included. Our analyses demonstrated a significant and positive association between IA and alcohol abuse (OR = 3.05, 95% CI = 2.14-4.37, z = 6.12, P < 0.001), attention deficit and hyperactivity (OR = 2.85, 95% CI = 2.15-3.77, z = 7.27, P < 0.001), depression (OR = 2.77, 95% CI = 2.04-3.75, z = 6.55, P < 0.001) and anxiety (OR = 2.70, 95% CI = 1.46-4.97, z = 3.18, P = 0.001). Conclusions IA is significantly associated with alcohol abuse, attention deficit and hyperactivity, depression and anxiety.

How to get started with a systematic review in epidemiology: an introductory guide for early career researchers

Article

Full-text available

Aug 2013

Systematic review is a powerful research tool which aims to identify and synthesize all evidence relevant to a research question. The approach taken is much like that used in a scientific experiment, with high priority given to the transparency and reproducibility of the methods used and to handling all evidence in a consistent manner.Early career researchers may find themselves in a position where they decide to undertake a systematic review, for example it may form part or all of a PhD thesis. Those with no prior experience of systematic review may need considerable support and direction getting started with such a project. Here we set out in simple terms how to get started with a systematic review. Advice is given on matters such as developing a review protocol, searching using databases and other methods, data extraction, risk of bias assessment and data synthesis including meta-analysis. Signposts to further information and useful resources are also given. A well-conducted systematic review benefits the scientific field by providing a summary of existing evidence and highlighting unanswered questions. For the individual, undertaking a systematic review is also a great opportunity to improve skills in critical appraisal and in synthesising evidence.

The Copenhagen Burnout Inventory: A new tool for the assessment of burnout

Article

Full-text available

Jul 2005

So far, the large majority of studies on burnout in the international literature have employed the Maslach Burnout Inventory (MBI). In this paper we criticize the MBI on a number of points and present a new tool for the measurement of burnout: the Copenhagen Burnout Inventory (CBI). The CBI consists of three scales measuring personal burnout, work-related burnout, and client-related burnout, for use in different domains. On the basis of an ongoing prospective study of burnout in employees in the human service sector, the PUMA study (Project on Burnout, Motivation and Job Satisfaction; N=1914 at baseline), we analysed the validity and reliability of the CBI. All three scales were found to have very high internal reliability, and non-response rates were small. The scales differentiated well between occupational groups in the human service sector, and the expected pattern with regard to correlations with other measures of fatigue and psychological well-being was found. Furthermore, the three scales predicted future sickness absence, sleep problems, use of pain-killers, and intention to quit. Analyses of changes over time showed that substantial proportions of the employees changed with regard to burnout levels. It is concluded that the analyses indicate very satisfactory reliability and validity for the CBI instrument. The CBI is being used in a number of countries and translations into eight languages are available.

El Desgaste profesional de enfermería. Desarrollo y validación factorial del CDPE

Article

Full-text available

The Global Shortage of Registered Nurses: AnOverview of Issues and Actions

Article

Full-text available

Jan 2004

The Staff Burn-out Syndrome in Alternative Institutions

Article

Full-text available

Apr 1975
PSYCHOTHERAPY

Herbert J. Freudenberger

Burn-out is defined as failure or exhaustion because of excessive demands on energy, strength, or resources. Its occurrence among the staff of alternative self-help (free clinic) institutions is discussed: causes, characteristics, and variations. Early signs and symptoms are described, measures to prevent burn-out are suggested, and how to help the burnt-out person is discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved)

Realigning Public and Private Healthcare in Southeast Asia

Article

Full-text available

Apr 2008

This paper compares health policy trends in Indonesia, Malaysia, the Philippines and Thailand with the purpose of drawing usable lessons in reform. The study finds that governments in the region are rapidly privatizing the provision of healthcare at the same time as they are expanding the government's role in financ-ing. The paper argues that expansion of public financing at the same time as private provision is misconceived as the combination would aggravate instances and sever-ity of market failures peculiar to the sector. The dysfunctional trend is particularly evident in Indonesia and the Philippines. In Thailand, in contrast, the expansion of public financing has occurred in the context of a health system dominated by public providers, which has had the effect of restraining healthcare costs. Malaysia occupies a mid position between Indonesia and the Philippines on the one hand and Thailand on the other. All four cases underline the value of state capacity in designing optimal policies and implementing them effectively. Southeast Asians have experienced substantial improvements in their health in recent decades, often under the aegis of massive state involvement in the provision and financing of healthcare (Ramesh and Asher 2000). However, the region now faces new challenges that make further improvements more difficult. The demand for quality and quantity of healthcare is increasing dramatically due to rapid economic growth, urbanization and ageing, which are placing a heavy burden on a public sector that is already stretched thin.

The Measurement of Experienced Burnout

Article

Full-text available

Apr 1981
J ORGAN BEHAV

A scale designed to assess various aspects of the burnout syndrome was administered to a wide range of human services professionals. Three subscales emerged from the data analysis: emotional exhaustion, depersonalization, and personal accomplishment. Various psychometric analyses showed that the scale has both high reliability and validity as a measure of burnout. Since the publication of this article in 1981, more extensive research was done on the MBI, which resulted in some modifications of the original measure. The present article has been re-edited to reflect those modifications. However, it does not include other new additions (which are contained in the MBI Manual distributed by the publisher, Mind Garden).

Burnout among Nurses in a Nigerian General Hospital: Prevalence and Associated Factors

Article

Full-text available

Apr 2012

Objective. To evaluate the prevalence and associated factors of burnout among nurses in a Nigerian general hospital. Methods. A total sampling method was utilized. Measurements. Burnout was evaluated using the Maslach Burnout Inventory; GHQ-12 was used to determine the presence of psychiatric morbidity. Results. A high level of burnout was identified in 39.1% of the respondents in the area of emotional exhaustion (EE), 29.2% in the area of depersonalization and 40.0% in the area of reduced personal accomplishment. Multivariate analysis showed that doctor/nurse conflict (OR = 3.1, 95% CI: 1.9-6.3), inadequate nursing personnel (OR = 2.6, 95% CI: 1.5-5.1), and too frequent night duties (OR = 3.1, 95% CI: 1.7-5.6) were predictors of burnout in the area of EE, doctor/nurse conflict (OR = 3.4, 95% CI: 2.2-7.6) and too frequent night duties (OR = 2.4, 95% CI 1.5-4.8) in the area of D, high nursing hierarchy (OR = 2.7, 95% CI: 1.5-4.8), poor wages (OR = 2.9, 95% CI: 1.6-5,6), and too frequent night duties (OR = 2.3, 95% CI: 2.3-4.5) in the area of RPA. Conclusions. Prevalence of burnout among these nurses was high. The government therefore needs to look into factors that will enhance nurses' recruitment and retention for effective health care delivery system.

Suffering among carers working in critical care can be reduced by an intensive communication strategy on end-of-life practices

Article

Full-text available

Nov 2011
INTENS CARE MED

Burnout syndrome (BOS) has frequently been reported in healthcare workers, and precipitating factors include communication problems in the workplace and stress related to end-of-life situations. We evaluated the effect of an intensive communication strategy on BOS among caregivers working in intensive care (ICU). Longitudinal, monocentric, before-and-after, interventional study. BOS was evaluated using the Maslach Burnout Inventory (MBI) and depression using the Centre for Epidemiologic Studies Depression Scale (CES-D) in 2007 (period 1) and 2009 (period 2). Between periods, an intensive communication strategy on end-of-life practices was implemented, based on improved organisation, better communication, and regular staff meetings. Among 62 caregivers in the ICU, 53 (85%) responded to both questionnaires in period 1 and 49 (79%) in period 2. We observed a significant difference between periods in all three components of the MBI (emotional exhaustion, p = 0.04; depersonalization p = 0.04; personal accomplishment, p = 0.01). MBI classified burnout as severe in 15 (28%) caregivers in period 1 versus 7 (14%) in period 2, p < 0.01, corresponding to a 50% risk reduction. Symptoms of depression as evaluated by the CES-D were present in 9 (17%) caregivers in period 1 versus 3 (6%) in period 2, p < 0.05, corresponding to a risk reduction of almost 60%. The implementation of an active, intensive communication strategy regarding end-of-life care in the ICU was associated with a significant reduction in the rate of burnout syndrome and depression in a stable population of caregiving staff.

Countering Compassion Fatigue: A Requisite Nursing Agenda

Article

Full-text available

Jan 2010
Online J Issues Nurs

Deborah Boyle

Nurses have a longstanding history of witnessing the tragedy experienced by patients and families; however, their own reactions to profound loss and premature death have not been systematically addressed. There is a paucity of research describing interventions to prevent or minimize the ramifications of repeated exposure to traumatic events in the clinical workplace. Compassion fatigue is a contemporary label affixed to the concept of personal vicarious exposure to trauma on a regular basis. Yet this phenomenon of compassion fatigue lacks clarity. In this article, the author begins by describing compassion fatigue and distinguishing compassion fatigue from burnout. Next she discusses risk factors for, and the assessment of compassion fatigue. The need to support nurses who witness tragedy and workplace interventions to confront compassion fatigue are described.

Nurses' Widespread Job Dissatisfaction, Burnout, And Frustration With Health Benefits Signal Problems For Patient Care

Article

Full-text available

Feb 2011
HEALTH AFFAIR

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.

Southeast Asia: An emerging focus for global health

Article

Full-text available

Feb 2011
LANCET

Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ioannidis JP, Clarke M, Devereaux PJ, Kleijnen J, Moher DThe PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ 339:b2700

Article

Full-text available

Feb 2009
Br Med J

Systematic reviews and meta-analyses are essential to summarise evidence relating to efficacy and safety of healthcare interventions accurately and reliably. The clarity and transparency of these reports, however, are not optimal. Poor reporting of systematic reviews diminishes their value to clinicians, policy makers, and other users. Since the development of the QUOROM (quality of reporting of meta-analysis) statement—a reporting guideline published in 1999—there have been several conceptual, methodological, and practical advances regarding the conduct and reporting of systematic reviews and meta-analyses. Also, reviews of published systematic reviews have found that key information about these studies is often poorly reported. Realising these issues, an international group that included experienced authors and methodologists developed PRISMA (preferred reporting items for systematic reviews and meta-analyses) as an evolution of the original QUOROM guideline for systematic reviews and meta-analyses of evaluations of health care interventions. The PRISMA statement consists of a 27-item checklist and a four-phase flow diagram. The checklist includes items deemed essential for transparent reporting of a systematic review. In this explanation and elaboration document, we explain the meaning and rationale for each checklist item. For each item, we include an example of good reporting and, where possible, references to relevant empirical studies and methodological literature. The PRISMA statement, this document, and the associated website (www.prisma-statement.org/) should be helpful resources to improve reporting of systematic reviews and meta-analyses.

Global nurse shortages - The facts, the impact and action for change

Article

May 2019
BRIT MED BULL

Introduction: Nurses comprise half the global health workforce. A nine million shortage estimated in 2014 is predicted to decrease by two million by 2030 but disproportionality effect regions such as Africa. This scoping review investigated: what is known about current nurse workforces and shortages and what can be done to forestall such shortages? Sources of data: Published documents from international organisations with remits for nursing workforces, published reviews with forward citation and key author searches. Areas of agreement: Addressing nurse shortages requires a data informed, country specific model of the routes of supply and demand. It requires evidence informed policy and resource allocation at national, subnational and organisation levels. Areas of controversy: The definition in law, type of education, levels and scope of practice of nurses varies between countries raising questions of factors and evidence underpinning such variation. Most policy solutions proposed by international bodies draws on data and research about the medical workforce and applies that to nurses, despite the different demographic profile, the work, the career options, the remuneration and the status. Growing points: Demand for nurses is increasing in all countries. Better workforce planning in nursing is crucial to reduce health inequalities and ensure sustainable health systems. Areas timely for developing research: Research is needed on: the nursing workforce in low income countries and in rural and remote areas; on the impact of scope of practice and task-shifting changes; on the impact over time of implementing system wide policies as well as raising the profile of nursing.

Professional burnout among physicians and nurses in Asian intensive care units: a multinational survey

Article

Nov 2018

Purpose Professional burnout is a multidimensional syndrome comprising emotional exhaustion, depersonalization, and diminished sense of personal accomplishment, and is associated with poor staff health and decreased quality of medical care. We investigated burnout prevalence and its associated risk factors among Asian intensive care unit (ICU) physicians and nurses. Methods We conducted a cross-sectional survey of 159 ICUs in 16 Asian countries and regions. The main outcome measure was burnout as assessed by the Maslach Burnout Inventory-Human Services Survey. Multivariate random effects logistic regression analyses of predictors for physician and nurse burnout were performed. Results A total of 992 ICU physicians (response rate 76.5%) and 3100 ICU nurses (response rate 63.3%) were studied. Both physicians and nurses had high levels of burnout (50.3% versus 52.0%, P = 0.362). Among countries or regions, burnout rates ranged from 34.6 to 61.5%. Among physicians, religiosity (i.e. having a religious background or belief), years of working in the current department, shift work (versus no shift work) and number of stay-home night calls had a protective effect (negative association) against burnout, while work days per month had a harmful effect (positive association). Among nurses, religiosity and better work-life balance had a protective effect against burnout, while having a bachelor’s degree (compared to having a non-degree qualification) had a harmful effect. Conclusions A large proportion of Asian ICU physicians and nurses experience professional burnout. Our study results suggest that individual-level interventions could include religious/spiritual practice, and organizational-level interventions could include employing shift-based coverage, stay-home night calls, and regulating the number of work days per month.

A systematic review and meta-analysis of the prevalence and associations of stress and burnout among staff in long-term care facilities for people with dementia

Article

Nov 2018

Background Care home staff stress and burnout may be related to high turnover and associated with poorer quality care. We systematically reviewed and meta-analyzed studies reporting stress and burnout and associated factors in staff for people living with dementia in long-term care. Methods We searched MEDLINE, PsycINFO, Web of Science databases, and CINAHL database from January 2009 to August 2017. Two raters independently rated study validity using standardized criteria. We meta-analyzed burnout scores across comparable studies using a random effects model. Results 17/2854 identified studies met inclusion criteria. Eight of the nine studies reporting mean Maslach Burnout Inventory (MBI) scores found low or moderate burnout levels. Meta-analysis of four studies using the 22-item MBI ( n = 598) found moderate emotional exhaustion levels (mean 18.34, 95% Confidence Intervals 14.59–22.10), low depersonalization (6.29, 2.39–10.19), and moderate personal accomplishment (33.29, 20.13–46.46). All three studies examining mental health-related quality of life reported lower levels in carer age and sex matched populations. Staff factors associated with higher burnout and stress included: lower job satisfaction, lower perceived adequacy of staffing levels, poor care home environment, feeling unsupported, rating home leadership as poor and caring for residents exhibiting agitated behavior. There was preliminary evidence that speaking English as a first language and working shifts were associated with lower burnout levels. Conclusions Most care staff for long-term care residents with dementia experience low or moderate burnout levels. Prospective studies of care staff burnout and stress are required to clarify its relationship to staff turnover and potentially modifiable risk factors.

Global prevalence of burnout symptoms among nurses: A systematic review and meta-analysis

Abstract

No full-text available