Burned Out, Engaged, Both, or Neither? Exploring Engagement and Burnout Profiles among Social Workers in Spain.

Few studies have analyzed the existence of homogeneous groups (profiles) in burnout and engagement among professionals, and none in social workers. This study with 448 social workers from Spain mainly examined their profiles in burnout and engagement and the characteristics of each profile in relevant job-related variables. Cluster analyses yielded four distinct profiles: the first, Burned Out, showed high burnout and low engagement; the second, Engaged, exhibited the inverse pattern with low burnout and high engagement; the third, Both, displayed simultaneously high burnout and high engagement; the fourth, Neither, showed low burnout and low engagement. The profiles also differed greatly in work-related variables: job demands (i.e., workload and work--family conflict), job resources (i.e., support from supervisor and coworkers), personal resources (i.e., psychological detachment and relaxation), and outcomes (i.e., intrinsic job satisfaction and intent to leave). The findings support interventions, individual and organizational, tailored to the characteristics of different groups to boost engagement and decrease burnout and turnover.

Intermittent inotropic support with levosimendan in advanced heart failure as destination therapy: The LEVO-D registry.

AIM: Patients with advanced heart failure (AHF) who are not candidates to advanced therapies have poor prognosis. Some trials have shown that intermittent levosimendan can reduce HF hospitalizations in AHF in the short term. In this real-life registry, we describe the patterns of use, safety and factors related to the response to intermittent levosimendan infusions in AHF patients not candidates to advanced therapies. METHODS AND RESULTS: Multicentre retrospective study of patients diagnosed with advanced heart failure, not HT or LVAD candidates. Patients needed to be on the optimal medical therapy according to their treating physician. Patients with de novo heart failure or who underwent any procedure that could improve prognosis were not included in the registry. Four hundred three patients were included; 77.9% needed at least one admission the year before levosimendan was first administered because of heart failure. Death rate at 1 year was 26.8% and median survival was 24.7 [95% CI: 20.4-26.9] months, and 43.7% of patients fulfilled the criteria for being considered a responder lo levosimendan (no death, heart failure admission or unplanned HF visit at 1 year after first levosimendan administration). Compared with the year before there was a significant reduction in HF admissions (38.7% vs. 77.9%; P < 0.0001), unplanned HF visits (22.7% vs. 43.7%; P < 0.0001) or the combined event including deaths (56.3% vs. 81.4%; P < 0.0001) during the year after. We created a score that helps predicting the responder status at 1 year after levosimendan, resulting in a score summatory of five variables: TEER (+2), treatment with beta-blockers (+1.5), Haemoglobin >12 g/dL (+1.5), amiodarone use (-1.5) HF visit 1 year before levosimendan (-1.5) and heart rate >70 b.p.m. (-2). Patients with a score less than -1 had a very low probability of response (21.5% free of death or HF event at 1 year) meanwhile those with a score over 1.5 had the better chance of response (68.4% free of death or HF event at 1 year). LEVO-D score performed well in the ROC analysis. CONCLUSION: In this large real-life series of AHF patients treated with levosimendan as destination therapy, we show a significant decrease of heart failure events during the year after the first administration. The simple LEVO-D Score could be of help when deciding about futile therapy in this population.

Vicarious Trauma Scale: Psychometric Properties in a Sample of Social Workers from Spain.

As a result of secondary exposure to traumatic material, social workers may experience vicarious trauma. However, the analysis of this variable among social workers is scarce. The Vicarious Trauma Scale (VTS) is a brief instrument designed to measure the stress consequence of shared trauma. This study aims to examine the psychometrics of the VTS in a sample of 448 social workers from Spain. The results from the exploratory and confirmatory factor analyses (EFA and CFA) indicated that the VTS has satisfactory psychometric properties. Different indices of internal consistency supported the reliability of the VTS. Both EFA and CFA revealed the existence of two factors, corresponding to the cognitive and affective consequences of secondary exposure to trauma. Finally, the correlations of the VTS with other relevant and well-known job variables (workload, work-family conflict, detachment, supervisor support, burnout, and engagement) followed the expected pattern, and the VTS differentiated the social workers by their trauma caseload. Therefore, the VTS can be considered an adequate screening method of social workers' vicarious trauma, and its application recommended to examine the possible risk and protective factors and consequences.

Social Workers' Self-Care Practices: Buffering the Influence of Work-Family Interferences on Burnout and Engagement.

As a reaction to specific job stressors, social workers can experience job burnout. The job demands-resources theory posits that personal characteristics would mediate the influence of job stressors on either burnout or engagement. Within this framework, this cross-sectional research aimed to analyze the relationships between work-family interferences (as predictors), self-care practices (as mediators), and burnout and engagement (as outcomes). The sample included 437 graduate social workers from Spain. Structural equation modeling showed that family-work and work-family conflicts negatively predicted self-care practices and positively predicted burnout. Professional and personal self-care practices positively predicted engagement, negatively predicted burnout, and attenuated the impact of work-family interferences on burnout and engagement. To the authors' knowledge, the present article is the first to test the job demands-resources theory with these variables on social workers. The findings support interventions for social work students and professionals enhancing self-care practices to promote engagement and to reduce burnout, and highlight the need to decrease job stressors and enhance job resources for social workers.

Professional preference for mental illness: The role of contact, empathy, and stigma in Spanish Social Work undergraduates.

The treatment of the mentally ill people is a challenge across the world, and different professionals, such as doctors, social workers, psychologists, or nurses, take care of this group. Nonetheless, mental health is not a vocational sector preferred by students and professionals of many of these careers. Research has proposed that professional preference for a patient group would be positively influenced by intergroup contact (quantity and quality) and empathy (perspective-taking), and negatively associated with intergroup anxiety and social distance. However, the evidence testing this proposal was partial and mainly referring to other patient groups such as minorities or immigrants. The major aim of this cross-sectional study was to clarify two research questions referring to mentally ill persons: Do contact and empathy protect undergraduates from intergroup anxiety and social distance and promote professional preference? Do intergroup anxiety and social distance predict professional preference and mediate the influence of contact and empathy in professional preference? A convenience sample of 409 Social Work undergraduates (81% females) from three Spanish universities completed a questionnaire between February and June 2020. Concerning direct relationships, the structural equation model showed that the quantity of contact only predicted intergroup anxiety negatively; quality of contact and empathy negatively predicted intergroup anxiety and social distance; intergroup anxiety positively predicted social distance; intergroup anxiety and social distance negatively predicted professional preference. Concerning mediated relationships, the influence of quality of contact and empathy on social distance was mediated by intergroup anxiety; social distance mediated the relationship of intergroup anxiety with professional preference; both anxiety and distance mediated the influence of quality of contact and empathy in professional preference. These results encourage interventions aimed at enhancing professional preference for mental illness by improving contact, knowledge, and empathy and reducing stigma in students and workers from diverse mental health careers.

Remote heart failure management using the HeartLogic algorithm. RE-HEART registry.

INTRODUCTION AND OBJECTIVES: HeartLogic is a multiparametric algorithm incorporated into implantable cardioverter-defibrillators (ICD). The associated alerts predict impending heart failure (HF) decompensations. Our objective was to analyze the association between alerts and clinical events and to describe the implementation of a protocol for remote management in a multicenter registry. METHODS: We evaluated study phase 1 (the investigators were blinded to the alert state) and phases 2 and 3 (after HeartLogic activation, managed as per local practice and with a standardized protocol, respectively). RESULTS: We included 288 patients from 15 centers. In phase 1, the median observation period was 10 months and there were 73 alerts (0.72 alerts/patient-y), with 8 hospitalizations and 2 emergency room admissions for HF (0.10 events/patient-y). There were no HF hospitalizations outside the alert period. In the active phases, the median follow-up was 16 (95%CI, 15-22) months and there were 277 alerts (0.89 alerts/patient-y); 33 were associated with HF hospitalizations or HF death (n=6), 46 with minor decompensations, and 78 with other events. The unexplained alert rate was 0.39 alerts/patient-y. Outside the alert state, there was only 1 HF hospitalization and 1 minor HF decompensation. Most alerts (82% in phase 2 and 81% in phase 3; P=.861) were remotely managed. The median NT-proBNP value was higher within than outside the alert state (7378 vs 1210 pg/mL; P <.001). CONCLUSIONS: The HeartLogic index was frequently associated with HF-related events and other clinically relevant situations, with a low rate of unexplained events. A standardized protocol allowed alerts to be safely and remotely detected and appropriate action to be taken on them.