Reiki intervention for supporting healthcare professional care behaviors in pediatric palliative care: A pilot study.

OBJECTIVES: Pediatric healthcare professionals (HCPs) working in a palliative setting may experience challenges during their clinical practice in addressing the complex end-of-life phase of children and their families. Nurses, especially, have a frontline role in providing assistance, thereby becoming at risk of physical and psychological burden. Pediatric psychologists have an ethical responsibility to help colleagues by proposing self-care interventions that will improve their well-being and, indirectly, the work climate. This study investigated the impact of a complementary therapy, delivered by a pediatric psychologist and a nurse, on physical and psychological variables among nurses at the Paediatric Hospice of the Regina Margherita Children's Hospital in Italy. METHODS: Thirty-five nurses participated in 5 weeks of Reiki sessions for an overall total of 175 sessions. The effect of the sessions was analyzed through a paired t-test analysis comparing the values of heart rate, oxygen saturation, and systolic and diastolic pressure collected before and after each session. The same test was conducted comparing the values of the 3 burnout subscales for each of the 35 nurses collected before the beginning of the first session with those collected at the end of the last session 2 months later. RESULTS: Results underlined a positive short-term effect with a significant decrease in heart rate before and after each session (t = 11.5, p < .001) and in systolic pressure (t = 2, p < .05). In addition, a decrease in emotional exhaustion symptoms was found (t = 2.3, p < .05) at the end of the intervention. SIGNIFICANCE OF RESULTS: Reiki could be a valid strategy to complement traditional pediatric psychology clinical practice designed to protect HCPs from emotional and physical demands and to create a more supportive workplace for staff and patients alike.

Midwives' occupational wellbeing and its determinants. A cross-sectional study among newly qualified and experienced Dutch midwives.

OBJECTIVE: Internationally, about 40 percent of midwives report symptoms of burnout, with young and inexperienced midwives being most vulnerable. There is a lack of recent research on burnout among Dutch midwives. The aim of this study was to examine the occupational wellbeing and its determinants of newly qualified and inexperienced midwives in the Netherlands. The majority of practicing Dutch midwives are aged under 40, which could lead to premature turnover. DESIGN: A cross-sectional study was conducted using an online questionnaire that consisted of validated scales measuring job demands, job and personal resources, burnout symptoms and work engagement. The Job Demands-Resources model was used as a theoretical model. SETTING AND PARTICIPANTS: We recruited Dutch midwives who were actually working in midwifery practice. A total of N=896 midwives participated in this study, representing 28 percent of practicing Dutch midwives. MEASUREMENTS AND FINDINGS: Data were analysed using regression analysis. Seven percent of Dutch midwives reported burnout symptoms and 19 percent scored high on exhaustion. Determinants of burnout were all measured job demands, except for experience level. Almost 40 percent of midwives showed high work engagement; newly qualified midwives had the highest odds of high work engagement. Master's or PhD-level qualifications and employment status were associated with high work engagement. All measured resources were associated with high work engagement. KEY CONCLUSIONS: A relatively small percentage of Dutch midwives reported burnout symptoms, the work engagement of Dutch midwives was very high. However, a relatively large number reported symptoms of exhaustion, which is concerning because of the risk of increasing cynicism levels leading to burnout. In contrast to previous international research findings, being young and having less working experience was not related to burnout symptoms of Dutch newly qualified midwives. IMPLICATIONS FOR PRACTICE: The recognition of job and personal resources for midwives' occupational wellbeing must be considered for a sustainable midwifery workforce. Midwifery Academies need to develop personal resources of their students that will help them in future practice.

Relationships Between Burnout, Secondary Traumatic Stress, Mindfulness, and Self-Compassion in Victim Advocates.

Victim advocates experience burnout and secondary traumatic stress (STS) in response to their exposure to trauma at work. Mindful awareness may serve as a protective factor against these negative outcomes. The current study examined a sample of 133 victim advocates from across the country to better understand and predict STS and burnout. Higher mindful awareness was found to be associated with lower STS and burnout, even when controlling for other best-known predictors. Self-compassion partially mediated these relationships. These findings support further research exploring the effects of mindful awareness training for victim advocates to reduce STS and burnout.

Compassion fatigue and moral sensitivity in midwives in COVID-19.

BACKGROUND: The Covid-19 pandemic has impacted compassion fatigue and the mental health of health care providers, particularly midwives and nurses. Although there are studies involving health workers such as nurses and physicians affected by the pandemic's compassion fatigue, few studies include midwives. RESEARCH OBJECTIVE: The present study seeks to investigate the effects of compassion fatigue experienced by midwives working under intense stress during the third wave of the COVID-19 pandemic on the level of moral sensitivity. RESEARCH DESIGN: This is a descriptive-correlation study. PARTICIPANTS: The statistical population consisted of all the midwives in Türkiye hospitals in 2021. This cross-sectional study was collected through a questionnaire using convenience sampling. Three hundred and ten midwives working in different units of the country participated in the study. ETHICAL CONSIDERATIONS: Approval from the researcher's university Institutional Review Board for ethical review was obtained with the code of IRB 20/510. FINDINGS: The average age of the midwives is 34.29 ± 8.39. It has been noticed that 43.5% of the midwives work in public hospitals and 38.1% in family health and community health centers. Midwives' mean MR-CS score is 67.11 ± 25.13, secondary trauma sub-dimension average 15.77 ± 6.23, and occupational burnout sub-dimension 40.69 ± 16.35. The mean moral sensitivity questionnaire score is determined as 93.86 ± 19.51. It has been observed that the working style and working time are effective on compassion fatigue. In the linear regression model, 98% of compassion fatigue was explained. Age, secondary trauma, and occupational burnout sub-dimensions affect the model. DISCUSSION: Working year, working style, second trauma, age, and occupational burnout parameters may help explain some of the links between midwives' symptoms of compassion fatigue. CONCLUSION: The pandemic affects the compassion fatigue of midwives. It is crucial to provide social support to midwives and health workers to prevent compassion fatigue and examine and control groups at risk in mental health.

For Clinicians to Do Less, Organizations Must Do More.

Medicine is defined by doing; however, bias, error, and burnout are potential consequences of speed and constant activity. On an individual level, slowing down might reduce bias; resting might reduce error; mindfulness might reduce burnout. Despite its benefits, stillness can be an unattainable privilege for some due to systems of power, including gender, race, and capitalism. In response, institutions must confront these systems and support individual clinicians through radical acts of solidarity because, just as we have fought to make doing-speaking, learning, and working-equal opportunity, so must we ensure that "non-doing" belongs to everyone.

Efficacy of physiotherapy management on burnout syndrome amongst IT professionals during the COVID-19 pandemic.

BACKGROUND: Burnout is a state of emotional, physical, and mental exhaustion caused by excessive stress. Burnout weakens the energy of an individual which reduces productivity and leaves this individual helpless, hopeless, cynical, and resentful. Thus, an early diagnosis of this syndrome has to be done and ways to prevent the level of progression and complication of burnout syndrome has to be planned. OBJECTIVE: To determine the efficacy of self-supervised Jacobson's relaxation technique along with Bhastrika Pranayama in reducing the level of burnout among the work-from-home IT professionals during the COVID-19 pandemic. METHOD: Thirty participants with burnout syndrome were randomly divided into two groups (15 participants in each group) using random allocation. The experimental group received Jacobson's relaxation technique along with Bhastrika Pranayama, whereas the control group received diaphragmatic breathing exercises and chest expansion exercises. Pre-test and post-test values using Maslach Burnout Inventory were used to interpret the results. RESULTS: Data collected were analyzed statistically by the Wilcoxon Signed Rank Test. It shows that there is a significant reduction in the level of burnout in the experimental group when compared to the control group at a p-value of 0.001. CONCLUSION: From the results, it is concluded that Jacobson's relaxation technique along with diaphragmatic breathing exercises showed significant improvement in the reduction of burnout levels.

Compassion fatigue and compassion satisfaction among Chinese midwives working in the delivery room: A cross-sectional survey.

BACKGROUND AND AIMS: Compassion fatigue can negatively affect not only healthcare professionals' physical and mental health but also the quality of care they provide and organizational outcomes. However, little is known about compassion fatigue among Chinese midwives working in the delivery room. This study aimed to examine compassion fatigue and compassion satisfaction levels among Chinese midwives working in the delivery room and correlate their compassion fatigue and compassion satisfaction. METHODS: A multisite cross-sectional study with a convenience sampling approach was conducted at 62 hospitals in Henan Province, central China, from May to July 2020. The participants were recruited through an online survey. A self-designed sociodemographic and work-related data sheet, the Social Support Rating Scale (SSRS), and the Professional Quality of Life Scale (ProQoL) were used to measure the participants'basic information, level of social support, compassion fatigue(consists of burnout and secondary traumatic stress) and compassion satisfaction. Descriptive analysis was used to describe the characteristics of the participants' social support, compassion fatigue and compassion satisfaction. Multiple linear regression analysis was employed to identify associations with the participants' sociodemographic and professional characteristics, compassion fatigue and compassion satisfaction. RESULTS: A total of 213 questionnaires were completed, 206 of which were valid (96.71%). The majority of the participants reported moderate risks for compassion satisfaction (75.24%) and burnout (59.71%) and low risks for secondary traumatic stress (61.65%). Higher job satisfaction as a midwife, lower average working hours per week in the past year, higher social support, extroverted personality, and work recognition in the past month were positively associated with compassion satisfaction, explaining 48.7% of the total variance. Always considering giving up a midwifery career, lower social support, working a day-night shift, poor health condition, more exposure to traumatic birth events per month on average in recent years, and lower job satisfaction as a midwife were negative factors for burnout, explaining 35.3% of the total variance. Four factors, including more exposure to traumatic birth events per month on average in recent years, always considering giving up a midwifery career, working a day-night shift and poor sleep quality, were negatively related to secondary traumatic stress, explaining 14.2% of the variance. CONCLUSIONS: In this study, midwives showed moderate levels of compassion satisfaction and burnout and low levels of secondary traumatic stress which should attract the attention of health institutions. A healthy and supportive work environment is crucial to midwives' health, well-being and job satisfaction. Tailored strategies such as trauma management, emotional literacy, peer and social support networks should be implemented to support midwives' compassion satisfaction, while prevent and lower midwives' burnout and secondary traumatic stress.

Who is at risk of burnout? A cross-sectional survey of midwives in a tertiary maternity hospital in Melbourne, Australia.

BACKGROUND: Burnout is an occupational phenomenon with the potential to affect a person's physical and mental health, job satisfaction and quality of work. There is evidence of burnout occurring in the midwifery profession, but inadequate data on the prevalence of, and the factors associated with, burnout. AIM: Identify the prevalence of burnout in a population of midwives and explore what individual and workforce characteristics, and what occupational stressors, were associated with burnout. METHODS: A cross-sectional survey of permanently employed midwives was conducted in a tertiary maternity service in Melbourne, Australia in 2017. Data collected included individual and workforce-related characteristics and occupational stressors. Burnout was explored using the Copenhagen Burnout Inventory. Univariate and multivariate analyses were conducted to ascertain associations between respondents' characteristics, stressors, and burnout levels. FINDINGS: A total of 257/266 midwives (97%) responded. There were significant levels of exhaustion and fatigue among respondents; 68% of midwives were experiencing personal burnout, 51% work-related burnout, and 10% were experiencing client-related burnout. Being aged ≤ 35 years, and/or having inadequate support was associated with personal and work-related burnout. Having inadequate acknowledgement was associated with client-related burnout. CONCLUSION: Health services need to understand the risk factors for burnout among midwives, identify and support groups that are most vulnerable, and address areas that are amenable to intervention. In our context this means ensuring midwives receive adequate acknowledgement and support, particularly younger midwives. These findings need to be tested in other settings to help inform a broader understanding and ensure the sustainability of the midwifery profession.

Factors influencing mindfulness among clinical nurses in China: An observational cross-sectional study.

AIM: The aim of this study was to evaluate factors influencing mindfulness among clinical nurses in China. BACKGROUND: Mindfulness has positive effects on nurses' negative emotions and job burnout. However, few studies have explored the antecedent variables of mindfulness. METHODS: A total of 358 clinical nurses in Beijing Aerospace Center Hospital completed a cross-sectional survey between July and September 2020. The study employed self-report questionnaires covering social demographics, mindfulness, anxiety, job burnout, emotion regulation, stress perception, resilience, well-being and loneliness. RESULTS: The mean Mindful Attention Awareness Scale score was 66.82 ± 11.53, which is near the cut-off score between the high and medium mindfulness categories. Anxiety, stress perception, emotional exhaustion and expressive suppression negatively affected the level of mindfulness, while mental resilience and cognitive reappraisal positively influenced the level of mindfulness (all P < .05). CONCLUSION: Hospital nurses have higher-than-normal levels of mindfulness. The mindfulness level of clinical nurses is related to anxiety, stress perception, resilience, cognitive reappraisal, emotional exhaustion and expressive suppression. IMPLICATIONS FOR NURSING MANAGEMENT: Nursing managers should consider the role and mechanism of positive psychology and develop targeted intervention measures to improve nurses' mindfulness, in order to further reduce their negative emotions, improve their sense of professional benefit and thus ensure the quality and safety of nursing.

[THE CONNECTION BETWEEN MORAL INJURY AND BURNOUT].

INTRODUCTION: Medical work requires complete dedication to work, long hours of absence from home and family, as well as personal sacrifice on various issues. This results in impaired quality of life, and the phenomenon of depression and suicide is more common among physicians than in the general population. The impairment in quality of life and function was defined for years as burnout, and this figure of speech reflected the physician's inability to cope with existing pressures. In recent years, the concept of 'moral injury' has been emerging to explain a significant part of the burnout phenomenon. The term describes the poor mental state of the physician who is forced to make immoral choices as part of the organizational demands. This perception fundamentally changes the concept that the poor function at work and in personal life is only the weakness of the doctor who lacks coping resources and resilience, therefore needing personal support such as yoga and mindfulness exercise. It emphasizes the organization responsibility for change, which will minimize moral dilemmas, thereby the moral injury. This will allow the doctor to live professional, as well as personal life, in an optimal way.

Burnout trauma both? Identifying and addressing needs during COVID-19 through informatics.

In this brief article, the author notes that discussion of work/life integration have become increasingly com mon at her institution, as school-age children regularly make appearances in Zoom meetings, and team mem bers have to shift between dynamic roles in their work and family lives throughout the day. Talk of burnout abounds-and she often find herself wondering if in fact they are only experiencing burnout as an occupational phenomenon, or whether it is a compounded experi ence of burnout and the emotional exhaustion of collective trauma and grief. Even when concerns dissipate about COVID's relentless spread and severe disease, there is no doubt that we will have lingering mental health hangovers from the psychologi cal impacts of the past year; we must be pre pared to leverage informatics and technology to stem the tide. We will navigate through these uncharted waters through thoughtful and effective leadership that culti vates community and a work environment that is with aligned with our organizational and personal values; and as the past year has demonstrated, it is evi dent that technology and informatics will play a piv otal role in the future of work. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Prevalence and Predictors of Moral Injury Symptoms in Health Care Professionals.

ABSTRACT: This study examined the prevalence and predictors of moral injury (MI) symptoms in 181 health care professionals (HPs; 71% physicians) recruited from Duke University Health Systems in Durham, NC. Participants completed an online questionnaire between November 13, 2019, and March 12, 2020. Sociodemographic, clinical, religious, depression/anxiety, and clinician burnout were examined as predictors of MI symptoms, assessed by the Moral Injury Symptoms Scale-Health Professional, in bivariate and stepwise multivariate analyses. The prevalence of MI symptoms causing at least moderate functional impairment was 23.9%. Younger age, shorter time in practice, committing medical errors, greater depressive or anxiety symptoms, greater clinician burnout, no religious affiliation, and lower religiosity correlated with MI symptoms in bivariate analyses. Independent predictors in multivariate analyses were the commission of medical errors in the past month, lower religiosity, and, especially, severity of clinician burnout. Functionally limiting MI symptoms are present in a significant proportion of HPs and are associated with medical errors and clinician burnout.

Mindfulness, emotional intelligence and occupational burnout in intensive care nurses: A mediating effect model.

AIM(S): To construct structural equation models to test the mediating role of emotional intelligence in the relationship between mindfulness and occupational burnout. BACKGROUND: Reports assessing the relationships among mindfulness, emotional intelligence and burnout, specifically in ICU nurses, are scarce. METHODS: This was a descriptive, correlational, cross-sectional research design with 883 ICU nurses enrolled by convenience sampling from 29 ICUs in seven tertiary hospitals in urban areas of Chengdu, China. Mediation analysis was performed by structural equation modelling. Indirect effects were evaluated through bootstrapping. RESULTS: The associations among mindfulness, emotional intelligence, emotional exhaustion, depersonalization and personal accomplishment were all significant (p < .001). In the mediation models, emotional intelligence partially mediates the relationships between mindfulness and emotional exhaustion (indirect effect 0.118, p = .006; direct effect -0.374, p = .010; total effect -0.492, p = .011) and between mindfulness and depersonalization (indirect effect -0.182, p = .006; direct effect -0.452, p = .015; total effect -0.633, p = .018). Emotional intelligence plays a total mediating role between mindfulness and personal accomplishment (indirect effect 0.293, p = .004; direct effect 0.119, p = .053). CONCLUSIONS: The results suggest that nursing manager could implement mindfulness training to improve occupational burnout in ICU nurses. IMPLICATIONS FOR NURSING MANAGEMENT: Nursing managers could help create a more favourable working environment by providing mindfulness training. Such mindfulness training could help improve nursing quality, reduce errors and ensure patient safety, possibly improving patient prognosis and probably satisfaction.

The Experiences of Well-being of Palliative Care Providers in Malaysia: A Thematic Analysis.

Palliative care providers find meaning in their work, even though stress, burnout, and compassion fatigue can be a concern. In this study, we aimed to explore the experiences of well-being of palliative care providers in Malaysia. Data collected using semistructured interviews were thematically analyzed. Eighteen palliative care providers participated: 9 doctors and 9 nurses. Five subthemes were generated: (1) values and strengths, (2) coping and work-life balance, (3) social support and spirituality, (4) passion and satisfaction, and (5) learning, growth, and transformation. These subthemes were further categorized into 2 themes: resilience and reward. The results may inform the development of interventions in the promotion and sustenance of well-being of palliative care providers.

[Follow-up study on the reduction of burnout levels through mindfulness meditation in health care professionals.] / Studio di follow-up sulla riduzione dei livelli di burnout con la meditazione mindfulness in professionisti socio-sanitari.

SUMMARY: The 8-week mindfulness meditation (MM) trainings have proven to be helpful for reducing burnout due to work-related stress. Most studies reported these positive effects with evaluations made immediately before and immediately after the therapeutic interventions. Little is known, however, about the symptoms of burnout in the months following these interventions. In our exploratory study, the effects of an 8-week MM training were assessed in a group of health care professionals (n = 19) with vulnerability to develop burnout; a 9-month follow-up was conducted on the subjects (n=8) who continued to meditate after the end of the training. Other health care professionals of the same company, who did not meditate during this research, served as control group. Burnout, mindfulness abilities and job satisfaction were evaluated through self-reports. Data showed that during the training the levels of burnout did not decrease, but significant reductions were observed during the follow-up. This indicates the possibility of obtaining results with MM even in subjects who do not have standard response time to the therapy and highlights the importance of monitoring the healing process.

Burnout among behavioral health providers in integrated care settings.

INTRODUCTION: Burnout in health care, especially among physicians, is a growing concern. It is now well accepted that physician burnout leads to increased depersonalization of patients, lower personal accomplishment, employee turnover, and worse patient outcomes. What is not known, however, is to what extent behavioral health providers (BHPs) in medical settings experience burnout and its associated sequela. METHOD: Participants (n = 230) from a variety of practice settings and levels of integrated care completed practice and burnout questions via an online survey. Practice-related questions and a modified version of the Maslach Burnout Inventory was administered to BHPs who work in different levels of collaboration with other medical providers. RESULTS: Overall, BHPs who work primarily in fully integrated care settings reported higher rates of personal accomplishment in their everyday job (B = 1.49; 95% confidence interval [CI] = 0.40, 2.58). Additionally, those who have worked more than 10 years in these types of settings reported both higher personal accomplishment (B = 1.58; 95% CI = 0.68, 2.49) and lower rates of depersonalization (B = -1.32; 95% CI = -2.28, -0.36). DISCUSSION: In contrast to high rates of burnout among many clinicians in the United States, this is the first study to document relatively low rates of reported burnout among integrated care BHPs. The relationships between lower burnout, working in a fully integrated care practice, and experience as a BHP is important to understand when creating and sustaining team-based primary care jobs. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Mindfulness-based intervention to reduce burnout and psychological distress, and improve wellbeing in psychiatry trainees: a pilot study.

BACKGROUND: Healthcare professionals including psychiatry trainees experience high amounts of occupational stress. This pilot study aims to assess the impacts and feasibility of a mindfulness-based intervention program as an occupational intervention in a metropolitan hospital. METHOD: Psychiatry trainees participated in an mindfulness-based intervention training program consisting of 1-h weekly sessions over 8 weeks. Levels of psychological distress and mindfulness were measured pre and post-intervention. Qualitative data through an open-ended feedback survey were also collected. RESULTS: There was an improved level of mindfulness and a decreased level of burnout among trainees post-intervention. Advantages of the program included having a compassionate facilitator and the program being tailored to healthcare staff. Limiting factors included time restraints and clinical responsibilities. CONCLUSION: Psychiatry trainees can benefit from an occupational MBI program. This can positively impact their health as well as improve their work performance. A number of factors important for implementation of a mindfulness-based intervention program were also identified.