Civismo como estrategia de prevención del acoso laboral en estudiantes de enfermería: Una revisión de la literatura / Civility as a prevention strategy for workplace bullying in nursing students: A review of the literatura

INTRODUCCIÓN El acoso laboral en estudiantes de enfermería afecta el bienestar de su salud física y mental dificultando el proceso de aprendizaje y la atención del paciente en el entorno clínico, disminuyendo su capacidad para prosperar y alcanzar su máximo potencial. OBJETIVO Conocer el civismo como estrategia de prevención, definiendo el concepto, y la promoción de una cultura de civilidad para que los estudiantes se desarrollen en ambientes educacionales positivos y puedan prosperar y alcanzar su máximo potencial. METODOLOGÍA Se realizó una revisión bibliográfica narrativa sistematizada, para lo cual se utilizaron las bases de datos PubMed, Science Direct y Epistmónikos, seleccionando 13 los artículos de acuerdo a criterio de inclusión y exclusión establecidos. RESULTADOS Se observa que en el 100% (13) de los artículos revisados se identificó la incivilidad o acoso laboral sufrida por estudiantes de enfermería durante su entorno clínico y en un 92% (12) de los estudios incentiva a formar una cultura de civismo en la educación en enfermería como estrategia para prevenir el acoso o incivilidad. El civismo puede ser implementado a nivel organizacional, de académicos y decanos y a nivel individual. CONCLUSIÓN Las organizaciones de educación en enfermería deben asumir la implementación de un cultura de civismo para promover la civilidad en los entornos de aprendizaje, donde lo primero que se debe realizar es implementar canales de comunicación efectiva, códigos de conducta profesional, y autorreflexión

INTRODUCTION Workplace bullying in nursing students affects the well-being of their physical and mental health, hindering the process of learning and patient care in the clinical environment, reducing their ability to thrive and reach their full potential. OBJETIVE Learn about civility as a prevention strategy, defining the concept, and promoting a culture of citizenship so that students develop in positive educational environments and can thrive and reach their full potential. METHODOLOGY A systematized narrative bibliographical review was carried out, for which the Pubmed, Science Direct and Epistmonikos databases were used, selecting 13 articles according to the established inclusion and exclusion criteria. RESULTS It is observed that in 100% (13) of the reviewed articles the lack of civility or workplace harassment suffered by nursing students during their clinical environment is identified and in 92% (12) of the studies it is encouraged. the formation of a culture of civility in nursing education as a strategy to prevent bullying or lack of civility. Citizenship can be implemented at the organizational, faculty and dean level, and at the individual level. CONCLUSION Nursing education organizations must assume the implementation of a culture of citizenship to promote citizenship in learning environments, where the first thing to do is implement effective communication channels, codes of professional conduct and self-reflection

Evaluation of the Impact of Intraoperative Distractions on Teamwork, Stress, and Workload.

BACKGROUND: Within the operating rooms (ORs), distractions occur on a regular basis, which affect the surgical workflow and results in the interruption of urgent tasks. This study aimed to observe the occurrence of intraoperative distractions in Tunisian ORs and evaluate associations among distractions, teamwork, workload, and stress. METHODS: This observational cross-sectional study was conducted in four different ORs (orthopedic, urology, emergency, and digestive surgery) of Sahloul University Hospital for a period of 3 mo in 2018. Distractions and teamwork were recorded and rated in real time during the intraoperative phase of each case using validated observation sheets. Besides, at the end of each operation, stress and workload of team members were measured. RESULTS: Altogether, 50 cases were observed and 160 participants were included. Distractions happened in 100% of the included operations. Overall, we recorded 933 distractions that occurred once every 3 min, with a mean frequency of M = 18.66 (standard deviation [SD] = 8.24) per case. It is particularly noticeable that procedural distractions occurred significantly higher during teaching cases compared with nonteaching cases (M = 3.85, M = 0.60, respectively, P < 0.001). The mean global teamwork score was M = 3.85 (SD = 0.67), the mean workload score was M = 58.60 (SD = 24.27), and the mean stress score was M = 15.29 (SD = 4.00). Furthermore, a higher stress level among surgeons was associated with distractions related to equipment failures and people entering or exiting the OR (r = 0.206, P < 0.01 and r = 0.137, P < 0.01, respectively). Similarly, nurses reported a higher workload in the presence of distractions related to the work environment in the OR (r = 0.313, P < 0.05). CONCLUSIONS: This study highlighted a serious problem, which often team members seem to ignore or underestimate. Taking our findings into consideration, we recommend the implementation of the Surgical Checklist and preoperative briefings to reduce the number of surgical distractions. Also, a continuous teamwork training should be adopted to ensure that OR staff can avoid or handle distractions when they happen.

Enhanced Stress Resilience Training in Surgeons: Iterative Adaptation and Biopsychosocial Effects in 2 Small Randomized Trials.

OBJECTIVE: To determine the effects of ESRT (an iteratively adapted and tailored MBI) on perceived stress, executive cognitive function, psychosocial well-being (ie, burnout, mindfulness), and pro-inflammatory gene expression in surgical (ESRT-1) and mixed specialty (ESRT-2) PGY-1 volunteers. SUMMARY OF BACKGROUND AND DATA: Tailored MBIs have proven beneficial in multiple high-stress and high-performance populations. In surgeons, tailored MBIs have been shown to be feasible and potentially beneficial, but whether mindfulness-based cognitive training can improve perceived stress, executive function, well-being or physiological distress in surgical and nonsurgical trainees is unknown. METHODS: In 2 small single-institution randomized clinical trials, ESRT, a tailored mindfulness-based cognitive training program, was administered and iteratively adapted for first-year surgical (ESRT-1, 8 weekly, 2-hour classes, n = 44) and mixed specialty (ESRT-2, 6 weekly, 90-minute classes, n = 45) resident trainees. Primary and secondary outcomes were, respectively, perceived stress and executive function. Other prespecified outcomes were burnout (assessed via Maslach Burnout Inventory), mindfulness (assessed via Cognitive Affective Mindfulness Scale - Revised), and pro-inflammatory gene expression (assessed through the leukocyte transcriptome profile "conserved transcriptional response to adversity"). RESULTS: Neither version of ESRT appeared to affect perceived stress. Higher executive function and mindfulness scores were seen in ESRT-1, and lower emotional exhaustion and depersonalization scores in ESRT-2, at pre-/postintervention and/or 50-week follow-up (ESRT-1) or at 32-week follow-up (ESRT-2), compared to controls. Pooled analysis of both trials found ESRT-treated participants had reduced pro-inflammatory RNA expression compared to controls. CONCLUSIONS: This pilot work suggests ESRT can variably benefit executive function, burnout, and physiologic distress in PGY-1 trainees, with potential for tailoring to optimize effects.

Pilot Study Using Neurofeedback as a Tool to Reduce Surgical Resident Burnout.

BACKGROUND: Burnout is prevalent among surgical residents. Neurofeedback is a technique to train the brain in self-regulation skills. We aimed to assess the impact of neurofeedback on the cognitive workload and personal growth areas of surgery residents with burnout and depression. STUDY DESIGN: Fifteen surgical residents with burnout (Maslach Burnout Inventory [MBI] score > 27) and depression (Patient Health Questionnaire-9 Depression Screen [PHQ-9] score >10), from 1 academic institution, were enrolled and participated in this institutional review board-approved prospective study. Ten residents with more severe burnout and depression scores were assigned to receive 8 weeks of neurofeedback treatments, and 5 others with less severe symptoms were treated as controls. Each participant's cognitive workload (or mental effort) was assessed initially, and again after treatment via electroencephalogram (EEG) while the subjects performed n-back working memory tasks. Analysis of variance (ANOVA) tested for significance between the degree of change in the treatment and control groups. Each subject was also asked to rate changes in growth areas, such as sleep and stress. RESULTS: Both groups showed high cognitive workload in the pre-assessment. After the neurofeedback intervention, the treatment group showed a significant (p < 0.01) improvement in cognitive workload via EEG during the working memory task. These differences were not noted in the control group. There was significant correlation between time (NFB sessions) and average improvement in all growth areas (r = 0.98) CONCLUSIONS: Residents demonstrated high levels of burnout, correlating with EEG patterns indicative of post-traumatic stress disorder. There was a notable change in cognitive workload after the neurofeedback treatment, suggesting a return to a more efficient neural network.

Trainee Wellness and Safety in the Context of COVID-19: The Experience of One Institution.

The COVID-19 pandemic has had significant ramifications for provider well-being. During these unprecedented and challenging times, one institution's Department of Surgery put in place several important initiatives for promoting the well-being of trainees as they were redeployed to provide care to COVID-19 patients. In this article, the authors describe these initiatives, which fall into 3 broad categories: redeploying faculty and trainees, ensuring provider safety, and promoting trainee wellness. The redeployment initiatives are the following: reframing the team mindset, creating a culture of grace and forgiveness, establishing a multidisciplinary wellness committee, promoting centralized leadership, providing clear communication, coordinating between departments and programs, implementing phased restructuring of the department's services, establishing scheduling flexibility and redundancy, adhering to training regulations, designating a trainee ombudsperson, assessing physical health risks for high-risk individuals, and planning for structured deimplementation. Initiatives specific to promoting provider safety are appointing a trainee safety advocate, guaranteeing personal protective equipment and relevant information about these materials, providing guidance regarding safe practices at home, and offering alternative housing options when necessary. Finally, the initiatives put in place to directly promote trainee wellness are establishing an environment of psychological safety, providing mental health resources, maintaining the educational missions, solidifying a sense of community by showing appreciation, being attentive to childcare, and using social media to promote community morale. The initiatives to carry out the department's strategy presented in this article, which were well received by both faculty and trainee members of the authors' community, may be employed in other departments and even outside the context of COVID-19. The authors hope that colleagues at other institutions and departments, independent of specialty, will find the initiatives described here helpful during, and perhaps after, the pandemic as they develop their own institution-specific strategies to promote trainee wellness.

Estresse ocupacional no contexto da COVID-19: análise fundamentada na teoria de Neuman / Estrés laboral en el contexto de la COVID-19: análisis fundamentado en la teoría de Neuman / Occupational stress in the context of COVID-19: analysis based on Neuman's theory

Resumo Objetivo Identificar os estressores ocupacionais em profissionais de saúde e as intervenções voltadas para a prevenção no contexto da COVID-19, fundamentado no Modelo de Sistemas de Betty Neuman. Método Realizou-se uma revisão da literatura com o método scoping review, conforme Joanna Briggs Institute nas bases de dados The Cochrane Library, Scopus, Web of Science, National Library of Medicine (MEDLINE/PubMed), The Cumulative Index to Nursing and Allied Health Literature (CINAHL) e Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS). Incluíram-se os estudos relacionados aos fatores estressores e as intervenções voltadas para a prevenção diante do estresse ocupacional em profissionais de saúde no contexto da COVID-19, publicados em qualquer idioma e disponíveis, na íntegra, gratuitamente. Os dados foram analisados à luz da Teoria de Betty Neuman. Resultados A amostra final foi composta por 27 artigos. Os estressores identificados foram categorizados em intrapessoais: medo de contágio e conhecimento restrito da doença; interpessoais: mudança nos relacionamentos sociais e receio de transmissão aos familiares, vivenciar o adoecimento de colegas e familiares e perda de entes queridos; e extrapessoais: sistema de saúde inadequado e sobrecarga de trabalho. As intervenções focadas na prevenção foram elencadas segundo o nível de atenção à saúde primário, secundário e terciário. Conclusão A maioria dos estudos enfatizaram medidas de prevenção primária. A utilização do referencial teórico permitirá ao enfermeiro e gestores de saúde a tomada de decisão e elaboração de futuras intervenções para o manejo do estresse ocupacional dos profissionais que lidam diariamente com a COVID-19.

Resumen Objetivo Identificar los estresores laborales en profesionales de la salud y las intervenciones dirigidas a la prevención en el contexto de la COVID-19, con fundamentación en el modelo de sistemas de Betty Neuman. Método Se realizó una revisión de la literatura con el método scoping review, de acuerdo con el Joanna Briggs Institute en las bases de datos The Cochrane Library, Scopus, Web of Science, National Library of Medicine (MEDLINE/PubMed), The Cumulative Index to Nursing and Allied Health Literature (CINAHL) y Literatura Latinoamericana y del Caribe en Ciencias de la Salud (LILACS). Se incluyeron estudios relacionados con los factores estresores y las intervenciones dirigidas a la prevención ante el estrés laboral en profesionales de la salud en el contexto de la COVID-19, publicados en cualquier idioma y con texto completo disponible gratuitamente. Los datos fueron analizados de acuerdo con la teoría de Betty Neuman. Resultados La muestra final estuvo compuesta por 27 artículos. Los estresores identificados fueron categorizados en intrapersonales: miedo al contagio y conocimiento limitado de la enfermedad; interpersonales: cambios en las relaciones sociales y temor de transmisión a familiares, ver a compañeros y familiares enfermarse y pérdida de seres queridos; y extrapersonales: sistema de salud inadecuado y sobrecarga de trabajo. Las intervenciones centradas en la prevención fueron enumeradas según el nivel de atención en salud primaria, secundaria y terciaria. Conclusión La mayoría de los estudios enfatizan medidas de prevención primaria. La utilización del marco referencial teórico permitirá que los enfermeros y administradores de la salud puedan tomar decisiones y elaborar futuras intervenciones para el manejo del estrés laboral de los profesionales que lidian a diario con la COVID-19.

Abstract Objective To identify occupational stressors in healthcare professionals and interventions focused on prevention in the context of COVID-19, based on betty Neuman's systems model. Method A literature review was conducted with the scoping review method, according to Joanna Briggs Institute in the databases The Cochrane Library, Scopus, Web of Science, National Library of Medicine (MEDLINE/PubMed), The Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Latin American and Caribbean Literature on Health Sciences (LILACS). Studies related to stressors and interventions aimed at prevention in the face of occupational stress in healthcare professionals in the context of COVID-19, published in any language and available, in full, free of charge were included. Data were analyzed in the light of Betty Neuman's Theory. Results The final sample consisted of 27 articles. The stressors identified were categorized into intrapersonal: fear of contagion and restricted knowledge of the disease; interpersonal: change in social relationships and fear of transmission to family members, experiencing the illness of colleagues and family members and loss of loved ones; inadequate health system and work overload. Interventions focused on prevention were indexed according to the level of primary, secondary and tertiary healthcare. Conclusion Most studies have emphasized primary prevention measures. The use of the theoretical framework will allow nurses and health managers to make decisions and develop future interventions for the management of occupational stress of professionals who deal daily with COVID-19.

Fadiga de alarmes em bombas de infusão no contexto pediátrico: revisão integrativa / Alarm fatigue in infusion pumps in the pediatric context: integrative review / Fatiga de alarma en bombas de infusión en el contexto pediátrico: revisión integrativa

Objetivo: identificar as causas da fadiga de alarmes em estudos de usabilidade de bomba de infusão em terapia intensiva pediátrica. Métodos: Realizou-se uma revisão integrativa nas bases de dados LILACS, SciELO, IBECS, SCOPUS e MEDLINE. Resultados: Foram identificadas 1.164 publicações e selecionados seis estudos primários que emergiram em duas temáticas: compreender as causas dos alarmes da bomba de infusão que constou: biblioteca de fármacos incompleta, limites absolutos e relativos rígidos, falta de protocolo de preparo e administração de medicação, período de férias dos funcionários; e as medidas que podem evitar a fadiga de seus alarmes.Conclusão:falhas na usabilidade de bombas de infusão aumentam os alarmes desnecessários que podem promovem sua fadiga. A utilização segura de bombas de infusão demanda uma equipe que monitore suas práticas e atue promovendo mudanças no contexto de trabalho

Objective: to identify the causes of alarm fatigue in studies of infusion pump usability in pediatric intensive care. Methods: an integrative review was carried out in the LILACS, SciELO, IBECS, SCOPUS and MEDLINE databases. Results: 1,164 publications were identified and six primary studies were selected that emerged in two themes: understanding the causes of the infusion pump alarms that consisted of: incomplete drug library, absolute and strict relative limits, lack of preparation protocol and medication administration, employee vacation period; and measures that can prevent fatigue from your alarms. Conclusion: the causes of alarm fatigue involve low user interaction with the equipment, inadequate work processes and low investment in preventive measures for its occurrence The safe use of infusion pumps requires a team to monitor their practices and act by promoting changes in the work context

Objetivo: identificar las causas de la fatiga de alarma en estudios de usabilidad de bombas de infusión en cuidados intensivos pediátricos. Métodos: se realizó una revisión integradora en las bases de datos LILACS, SciELO, IBECS, SCOPUS y MEDLINE. Resultados: se identificaron 1.164 publicaciones y se seleccionaron seis estudios primarios que surgieron en dos temas: comprender las causas de las alarmas de la bomba de infusión que consistían en: biblioteca de medicamentos incompleta, límites relativos absolutos y estrictos, falta de protocolo de preparación y administración de medicamentos, período de vacaciones de los empleados; y medidas que pueden prevenir la fatiga de sus alarmas. Conclusión: las causas de la fatiga de las alarmas involucran baja interacción del usuario con el equipo, procesos de trabajo inadecuados y baja inversión en medidas preventivas para su ocurrencia. El uso seguro de las bombas de infusión requiere que un equipo monitoree sus prácticas y actúe promoviendo cambios en el contexto de trabajo

The effect of COVID-19 quarantine on physical and social parameters of physical education providers and youth sport coaches.

The potential ramifications of the COVID-19 pandemic global shut down on physical education providers and youth sport coaches may be particularly severe due to substantial cutbacks on many of their normal activities. This population faces unique challenges in engaging in "virtual learning" given the physical nature of their job, potentially leading to sedentary lifestyle, weight gain, and the development of depressive mood disorders. This commentary aims to explore options to mitigate worsening of stress, depression, physical inactivity, and social disconnection in youth sport coaches following the guidelines of the American College of Sports Medicine (ACSM) and to call attention to this vulnerable demographic which has been substantially impacted by the COVID-19 pandemic.

Estratégias de enfrentamento e coping do estresse ocupacional utilizadas por profissionais de enfermagem no ambiente hospitalar: scoping review / Estrategias de afrontamiento y coping del estrés ocupacional utilizadas por los profesionales de enfermería en el ámbito hospitalario: scoping review / Coping strategies for occupational stress used by nursing professionals in the hospital environment: scoping review

OBEJTIVO: Identificar e mapear as estratégias de enfrentamento e coping do estresse ocupacional utilizadas por profissionais de enfermagem no ambiente hospitalar. MÉTODO: Trata-se de uma scoping review baseada nas recomendações do Joanna Briggs Institute. A coleta de dados ocorreu em junho de 2020, em bancos de dados que indexam artigos científicos, dissertações e teses. Os dados foram analisados pela estatística descritiva simples. RESULTADOS: A amostra final foi constituída de 63 estudos, dos quais 49 (77,8%) correspondiam a artigos. As estratégias de enfrentamento do estresse ocupacional apresentadas nos estudos foram: coping ativo; autocuidado; Práticas Integrativas e Complementares; suporte social; capacitações; suporte organizacional; e estratégia negativa. Essas devem abarcar os níveis de prevenção primária, prevenção secundária e terciária. CONCLUSÃO: As estratégias de enfrentamento elencadas nos estudos contemplaram medidas que asseguram a redução de sobrecarga de trabalho; auxiliam o desenvolvimento de habilidades para lidar com o estresse; e elaborem programas de assistência especial.

OBJETIVO: Identificar y mapear las estrategias de afrontamiento y coping del estrés laboral utilizadas por los profesionales de enfermería en el ámbito hospitalario. MÉTODO: Es una scoping review basada en las recomendaciones del Joanna Briggs Institute. La recolección de datos tuvo lugar en junio de 2020, en bases de datos que indexan artículos científicos, disertaciones y tesis. Los datos se analizaron mediante estadística descriptiva simple. RESULTADOS: La muestra final estuvo constituida por 63 estudios, de los cuales 49 (77,8%) correspondieron a artículos. Las estrategias para afrontar el estrés ocupacional presentadas en los estudios fueron: coping activo; cuidados personales; Prácticas integradoras y complementarias; apoyo social; formación; apoyo organizacional; y estrategia negativa. Estos deben abarcar los niveles de prevención primaria, prevención secundaria y terciaria. CONCLUSIÓN: Las estrategias de afrontamiento enumeradas en los estudios incluían medidas que aseguran la reducción de la sobrecarga de trabajo; ayudar en el desarrollo de habilidades para lidiar con el estrés; y diseñar programas de asistencia especial.

OBJECTIVE: To identify and map the coping strategies related to occupational stress used by nursing professionals in the hospital environment. METHOD: This is a scoping review based on the recommendations of the Joanna Briggs Institute. Data collection occurred in June 2020, in databases indexing scientific articles, dissertations and theses. The data were analyzed by simple descriptive statistics. RESULTS: The final sample consisted of 63 studies, of which 49 (77.8%) corresponded to articles. The coping strategies with occupational stress presented in the studies were: Active coping; Self-care; Integrative and Complementary Practices; Social support; Training; Organizational support; and Negative strategy. These should include levels of primary prevention, secondary and tertiary prevention. CONCLUSION: The coping strategies that were included in the studies included measures that ensure the reduction of work overload; help the development of skills to deal with stress; and develop special care programs.

Estrés, Agotamiento Profesional y Psicopatología en médicos de planta y con cargos jerárquicos de un Hospital Universitario de la Ciudad de Buenos Aires / STRESS, PROFESSIONAL EXHAUSTION, AND PSYCHOPATHOLOGY IN GENERAL PRACTITIONERS AND WITH HIERARCHICAL POSITIONS OF A UNIVERSITY HOSPITAL OF THE CITY OF BUENOS AIRES

Si bien el estrés en el trabajo puede afectar a muchas ocupaciones, los profesionales de la salud tienen una mayor predisposición a desarrollarlo. Asimismo, el estrés a largo plazo puede llevar a padecer el Síndrome de Agotameinto Profesional (Burnout). Alguien que padezca alguna de estas entidades puede presentar signos de psicopatología. El objetivo de este trabajo fue determinar la prevalencia de estrés laboral, síndrome de agotamiento profesional generalizado y psicopatología en médicos de planta y con cargos jerárquicos en un Hospital Universitario. La prevalencia de estrés en la muestra analizada fue del 85,95%; la prevalencia del Síndrome de Agotamiento Profesional fue del 72,9% y la psicopatología del 10%. Todos los encuestados con resultados positivos del cuestionario GHQ-12 obtuvieron puntuaciones positivas para el estrés y el síndrome de agotamiento. Por lo tanto, esta situación necesita acciones y soluciones inmediata

Although stress at work can affect many occupations, health professionals have a greater predisposition to develop it. Likewise, long-term stress may lead to suffering from Professional Burnout Syndrome. Someone who suffers from any of these entities may have signs of psychopathology. The objective of this work was to determine the prevalence of work-related stress, burnout syndrome and psychopathology in staff medical doctors and with hierarchical positions in a University Hospital. The prevalence of stress in the analyzed sample was 85.95%; the prevalence of the Professional Burnout Syndrome was 72.9%, and psychopathology was 10%. All respondents with positive results from the GHQ-12 questionnaire had positive scores for stress and burnout syndrome. Therefore, this situation needs immediate action and solutions

Perspectives on Professional Burnout and Occupational Stress among Medical Oncologists: A Cross-sectional Survey by Korean Society for Medical Oncology (KSMO).

PURPOSE: This study aimed to investigate the prevalence and risk factors of burnout and occupational stress among medical oncologists in Korea. MATERIALS AND METHODS: A survey was conducted of medical oncologists who were members of Korean Society for Medical Oncology (KSMO) using the Korean Occupational Stress Scale, the validated Maslach Burnout Inventory (MBI) and supplemental questions about work and lifestyle factors. RESULTS: Among 220 active KSMO members, 111 responses were collected. The median age was 42 years (range, 32 to 63 years). Two-thirds of responders worked 6 days per week and half of them worked a total of 60-80 hours per week. Each medical oncologist treated a median of 90-120 patients per week in outpatient clinics and 20-30 patients per week in patient practices. MBI subscales indicated a high level of emotional exhaustion in 74%, a high level of depersonalization in 86%, and a low level of personal accomplishment in 65%: 68% had professional burnout according to high emotional exhaustion and high depersonalization scores. The risk of burnout was higher for medical oncologists aged from 30-39 than 40-49 years, and unmarried than married. Considering personal accomplishment, females had a higher risk of burnout. The median score of occupational stress was 63 (range, 43 to 88). Having night-duty call was the strongest risk factor on more stress. A higher stress score was associated with a higher prevalence of burnout. CONCLUSION: Burnout and occupational stress are quite common amongst Korean medical oncologists. Achieving a healthy work-life balance, ensuring balanced workload distribution, and engaging in proper stress relief solutions are necessary.

Effects of music therapy on occupational stress and burn-out risk of operating room staff.

The operating theatre staff is exposed to various constraints such as excessive working hours, severe medical conditions and dreadful consequences in case of malpractice. These working conditions may lead to high and chronic levels of stress, which can interfere with medical staff well-being and patients quality of care. The aim of this study is toassess the impact of music therapy on stress levels and burnout risk on the operating room staff. This is a pre-experimental study including the operating rooms staff of urology and maxillofacial surgery in the academic hospital of Sahloul Sousse (Tunisia) over a period of six weeks. The study consisted of three phases. The first was an initial assessment of stress level with a predefined survey. The second included three music therapy sessions per day over one month. The third was an immediate stress level reassessment following the intervention. Stress levels were evaluated using the Perceived Stress Scale version PSS-10 and the Maslach Burnout Inventory. The overall response rate was 73.9%.The average age of the study population was 37.8 ± 7.7 years with a female predominance (64.7%). After the music therapy program, Perceived Stress Scale average score decreased from 22 ± 8.9 to 16 ± 7.9 (p = 0.006). Concerning the burnout, only the average score of emotional exhaustion decreased significantly from 27 ± 10.8 to 19.2 ± 9.5 (p = 0.004). Music therapy is an innovative approach that seems to reduce operating theatre staff stress. It must be considered as a non pharmacological, simple, economic and non invasive preventive tool.

Attitudes of Anesthesiology Specialists and Residents toward Patients Infected with the Novel Coronavirus (COVID-19): A National Survey Study.

Background: The novel coronavirus (COVID-19) emerged in Wuhan, China, in December 2019. This study aims to evaluate the knowledge of anesthesiology specialists and residents in Turkey about COVID-19 and their attitudes toward the strategies and application methods to be used for a suspected/confirmed COVID-19 case that needs to be operated on or followed up in an intensive care unit, as well as to raise awareness about this issue. Methods: This descriptive study comprised anesthesiology specialists and residents working in various health institutions in Turkey. The data used in this study were obtained online between March 13, 2020 and March 25, 2020 through the website SurveyMonkey (SurveyMonkey, San Mateo, CA) by using a survey form. We contacted members of the Turkish Anaesthesiology and Reanimation Society through the social media platforms Twitter, LinkedIn, and WhatsApp, as well as through their e-mail addresses and invited them to participate in the study. Those who agreed to participate responded to the aforementioned survey. We used SPSS 22.0 (IBM, Armonk, NY) to analyze the survey data statistically. Results: A total of 346 anesthesiology specialists and residents participated in the study. Although the majority of the participants exhibited the correct attitudes toward airway management, research assistants with little professional experience were observed to be undecided or had the tendency to make incorrect decisions. Conclusions: The COVID-19 pandemic is spreading rapidly worldwide. The incidence of COVID-19 cases is increasing daily, and this disease can cause patient death. Anesthesiology specialists and residents who perform emergency operations on these patients in settings other than intensive care units should follow simple and easy-to-understand algorithms to ensure safety. The provision of theoretical and practical training to healthcare providers before they meet patients will help ensure patient-healthcare provider safety and prevent panic, which can cause distress among healthcare providers.

[Consideration of surgeons participating in 2019 coronavirus disease emergency medical rescue].

As a newly epidemic, 2019 coronavirus disease (COVID-19) with a concentrated outbreak poses a great challenge to medical treatment. The severe and critical patients are complex complicatied with the psychological problems, and the medical staff are overworked and under tremendous psychological pressure. The surgeon participated in emergency medical rescue could provide professional treatment for the patients combined with surgical diseases, as well as specialized training for the non-surgeon crew, to reduce surgical-related mortality. With the advantages of good team consciousness, strong aseptic concept and good psychological quality, the surgeons can quickly adapt to and carry out rescue work under the premise of good self-protection. Surgeons need to develop critical care management concepts and focus on the critical care support equipment. Some suggestions are put forward for the standardized training of resident surgeons to cultivate compound talents. It is hoped that this article can lead to the thinking of how to participate in the emergency medical rescue of infectious diseases among surgeons and provide some enlightenment for future surgical education.

The Resilience Bank Account: Skills for Optimal Performance.

The day-to-day life of a cardiothoracic surgeon and other high-stakes occupations is riddled with chronic stress punctuated by acute, sometimes life-threatening, crises. Additional stress from the realms of a surgeon's personal life can add to the silent burden surgeons often carry. The tolls paid for poor management of the cumulative stress load can impact surgeons and their patients, leading to errors of clinical judgment, burnout, early departures from practice, health issues, and substance abuse. This article reviews 6 individual skills or habits that can, when proactively integrated into a daily routine, make the difference. The idea of investing in a resilience bank account is suggested as a metaphor for the reserve building and cumulative positive impact of these habits over time.

Improved Understanding of Female Pelvic Medicine and Reconstructive Surgery Concepts Through Targeted Case-Based Educational Intervention: A Pilot Study.

OBJECTIVES: Given the complex anatomy and pathophysiology of urogynecologic disorders, obstetrics and gynecology residents can have difficulty learning the subject's principles. There are no standardized resources for educators in this subspecialty. We hypothesized that our case-based educational intervention was associated with enhanced knowledge and greater resident satisfaction versus traditional urogynecology lectures. METHODS: This is a prospective study involving 19 obstetrics and gynecology residents at a single institution. Residents participated in three 1-hour case-based lectures, which included prelecture and postlecture topic knowledge assessments. Nonparametric Wilcoxon signed-rank tests were used to compare the before and after responses. Resident satisfaction was assessed using a 5-point Likert scale questionnaire. RESULTS: The median scores for the pretraining and posttraining assessments of resident urogynecology subject knowledge were 8 (5-10) and 10 (8-10), respectively. A stratified analysis was performed based on postgraduate year (PGY) and median prelectures and postlectures scores showed statistically significance (P < 0.001). Analysis of the PGY subgroups demonstrated statistical significance in PGY1 (P = 0.004), PGY2 (P = 0.008), and PGY3 (P = 0.03). However, the PGY4 subgroup (P = 0.06) did not reach statistical significance.All residents regardless of PGY level either agreed or strongly agreed that the case-based educational intervention enhanced resident knowledge, engagement, and clarity of the relevant teaching points and decreased resident stress about urogynecology topics. CONCLUSIONS: The case-based educational intervention significantly improved resident knowledge in urogynecology and enhanced resident satisfaction with this teaching method versus traditional lectures.