Clinician Burnout and Effectiveness of Guideline-Recommended Psychotherapies.

Importance: Clinician burnout has been associated with clinician outcomes, but the association with patient outcomes remains unclear. Objective: To evaluate the association between clinician burnout and the outcomes of patients receiving of guideline-recommended trauma-focused psychotherapies for posttraumatic stress disorder (PTSD). Design, Setting, and Participants: This cohort study was set at the US Veterans Affairs Health Care System and included licensed therapists who provided trauma-focused psychotherapies and responded to an online survey between May 2 and October 8, 2019, and their patients who initiated a trauma-focused therapy during the following year. Patient data were collected through December 31, 2020. Data were analyzed from May to September 2023. Exposures: Therapists completing the survey reported burnout with a 5-point validated measure taken from the Physician Worklife Study. Burnout was defined as scores of 3 or more. Main Outcomes and Measures: The primary outcome was patients' clinically meaningful improvement in PTSD symptoms according to the PTSD Checklist for the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition). Patient dropout, therapist adherence, and session spacing was assessed through electronic health records. Multivariable random-effects logistic regression examined the association of therapist burnout and clinically meaningful improvement, adjusted for case-mix. Results: In this study, 165 of 180 (91.7%) therapists (89 [53.9%] female) completed the burnout measure and provided trauma-focused psychotherapies to 1268 patients (961 [75.8%] male) with outcome data. Fifty-eight (35.2%) therapists endorsed burnout. One third of patients (431 [34.0%]) met criterion for clinically meaningful improvement. Clinically meaningful improvement in PTSD symptoms was experienced by 120 (28.3%) of the 424 patients seen by therapists who reported burnout and 311 (36.8%) of the 844 patients seen by therapists without burnout. Burnout was associated with lower odds of clinically meaningful improvement (adjusted odds ratio [OR],0.63; 95% CI, 0.48-0.85). The odds of clinically meaningful improvement were reduced for patients who dropped out (OR, 0.15; 95% CI, 0.11-0.20) and had greater session spacing (OR, 0.80; 95% CI, 0.70-0.92). Therapist adherence was not associated with therapy effectiveness. Adjusting for dropout or session spacing did not meaningfully alter the magnitude of the association between burnout and clinically meaningful improvement. Conclusions and Relevance: In this prospective cohort study, therapist burnout was associated with reduced effectiveness of trauma-focused psychotherapies. Studying when and how burnout affects patient outcomes may inform workplace interventions.

Burnout in podiatrists associated with individual characteristics, workplace and job satisfaction: A national survey.

BACKGROUND: Burnout is highly prevalent among health practitioners. It negatively impacts job performance, patient care, career retention and psychological well-being. This study aimed to identify factors associated with burnout among Australian podiatrists. METHODS: Data were collected from registered podiatrists via four online surveys administered annually from 2017 to 2020 as part of the Podiatrists in Australia: Investigating Graduate Employment (PAIGE) study. Information was collected about work history, job preferences, personal characteristics, health, personality, life experiences and risk-taking behaviours. Multiple logistic regression analyses were used to determine if (i) individual characteristics, (ii) workplace factors and (iii) job satisfaction measures were associated with burnout (based on the abbreviated Maslach Burnout Inventory). RESULTS: A total of 848 responses were included, with 268 podiatrists (31.6%) experiencing burnout. Participants experiencing burnout were slightly younger, more recent to practice, had poorer health, greater mental distress, lower scores for resilience, extraversion, agreeableness, conscientiousness, emotional stability and openness to experiences. They were less likely to have financial and clinical risk-taking behaviour and more likely to have career risk-taking behaviour. Prediction accuracy of these individual characteristic variables for burnout was 72.4%. Participants experiencing burnout were also more likely to work in private practice, have more work locations, work more hours, more direct patient hours, see more patients, have shorter consultation times, more likely to bulk bill chronic disease management plans, have less access to sick leave and professional development and be more likely to intend to leave patient care and the profession within 5 years than participants not experiencing burnout. Prediction accuracy of these workplace-related variables for burnout was 67.1%. Participants experiencing burnout were less satisfied with their job. Prediction accuracy of these variables for burnout was 78.8%. CONCLUSIONS: Many of the factors associated with burnout in Australian podiatrists are modifiable, providing opportunities to implement targeted prevention strategies. The strength of association of these factors indicates high potential for strategies to be successful.

Sequential mediation analysis of physical activity, healthy diet, BMI, and academic burnout in the Pakistani educational landscape.

Research has indicated a negative impact of physical activity on academic burnout among students, however, there is a paucity of evidence about the underlying mechanism of this association in Pakistani students. The present research seeks to investigate the relationship between physical activity and academic burnout by investigating the potential mediating effects of adherence to the Mediterranean diet (MD) and body mass index (BMI). A sample of 596 students using a cross-sectional survey design was gathered from two public universities (Riphah International University and Mohammed Ali Jinnah University) in Rawalpindi, Pakistan from June to July 2022. The study participants were asked to fill out the Physical Activity Rating Scale-3, the Learning Burnout Scale, and the Test of Adherence to MD questionnaires. The study employed descriptive, bivariate, and path analysis through regression utilizing the SPSS software version 27. The findings demonstrated a negative correlation between academic burnout and BMI, physical activity, and adherence to the MD. The relationship between physical activity and academic burnout was mediated by BMI. Physical activity and academic burnout were inversely correlated, with adherence to the MD and BMI interacting as sequential mediators. The outcomes of this research have expanded our knowledge of the association between physical activity and academic burnout and have suggested crucial and appropriate strategies for addressing student academic burnout.

Gender and Clinical Status in Burnout in Medicine.

This survey study assesses feelings of satisfaction, stress, and burnout by gender and clinical status among health care workers at a single academic center.

The effect of commuting time on burnout: the mediation effect of musculoskeletal pain.

OBJECTIVES: This study explores the relationship among commuting, musculoskeletal (MS) pain, and burnout. METHODS: An observational and cross-sectional study was conducted at a medical university-affiliated hospital in Taichung, Taiwan in 2021. The two questionnaire was used and they included the Copenhagen Burnout Inventory (CBI) and the Nordic Musculoskeletal Questionnaire (NMQ). All participants were invited to complete the cross-sectional survey. A multiple linear regression was assessed correlations between commuting, MS pain, and burnout. RESULTS: After excluding those with missing data, 1,615 healthcare workers were deemed valid as research participants. In multiple linear regression, commuting time longer than 50 min was associated with personal burnout (PB) in the presence of adjusted confounders; however, long commuting time was not associated with work-related burnout (WB). Furthermore, the choice of commuting method did not affect PB or WB. Notably, both neck and shoulder pain (NBSP) and ankle pain (BAP) increase the risk of PB and WB. The mediation analysis demonstrated that NBSP is a mediating factor, increasing the level of PB and WB for commuting times longer than 50 min. CONCLUSIONS: Healthcare workers who commute for more than 50 min should be considered part of a high-risk group for burnout and musculoskeletal pain. They should also be provided with resources and programs focused on burnout prevention and MS pain relief.

Physician Coaching by Professionally Trained Peers for Burnout and Well-Being: A Randomized Clinical Trial.

Importance: Physician burnout is problematic despite existing interventions. More evidence-based approaches are needed. Objective: To explore the effect of individualized coaching by professionally trained peers on burnout and well-being in physicians. Design, Setting, and Participants: This randomized clinical trial involved Mass General Physician Organization physicians who volunteered for coaching from August 5 through December 1, 2021. The data analysis was performed from February through October 2022. Interventions: Participants were randomized to 6 coaching sessions facilitated by a peer coach over 3 months or a control condition using standard institutional resources for burnout and wellness. Main Outcomes and Measures: The primary outcome was burnout as measured by the Stanford Professional Fulfillment Index. Secondary outcomes included professional fulfillment, effect of work on personal relationships, quality of life, work engagement, and self-valuation. Analysis was performed on a modified intention-to-treat basis. Results: Of 138 physicians enrolled, 67 were randomly allocated to the coaching intervention and 71 to the control group. Most participants were aged 31 to 60 years (128 [93.0%]), women (109 [79.0%]), married (108 [78.3%]), and in their early to mid career (mean [SD], 12.0 [9.7] years in practice); 39 (28.3%) were Asian, 3 (<0.1%) were Black, 9 (<0.1%) were Hispanic, 93 were (67.4%) White, and 6 (<0.1%) were of other race or ethnicity. In the intervention group, 52 participants underwent coaching and were included in the analysis. Statistically significant improvements in burnout, interpersonal disengagement, professional fulfillment, and work engagement were observed after 3 months of coaching compared with no intervention. Mean scores for interpersonal disengagement decreased by 30.1% in the intervention group and increased by 4.1% in the control group (absolute difference, -0.94 poimys [95% CI, -1.48 to -0.41 points; P = .001), while mean scores for overall burnout decreased by 21.6% in the intervention group and increased by 2.5% in the control group (absolute difference, -0.79 points; 95% CI, -1.27 to -0.32 points; P = .001). Professional fulfillment increased by 10.7% in the intervention group compared with no change in the control group (absolute difference, 0.59 points; 95% CI, 0.01-1.16 points; P = .046). Work engagement increased by 6.3% in the intervention group and decreased by 2.2% in the control group (absolute difference, 0.33 points; 95% CI, 0.02-0.65 points; P = .04). Self-valuation increased in both groups, but not significantly. Conclusions and Relevance: The findings of this hospital-sponsored program show that individualized coaching by professionally trained peers is an effective strategy for reducing physician burnout and interpersonal disengagement while improving their professional fulfillment and work engagement. Trial Registration: ClinicalTrials.gov Identifier: NCT05036993.

Emergency Nurses' Reasons for Not Recommending Their Hospital to Clinicians as a Good Place to Work.

Importance: Half of emergency nurses report high burnout and intend to leave their job in the next year. Whether emergency nurses would recommend their workplace to other clinicians may be an important indicator of a hospital's ability to recruit clinicians. Objective: To examine why emergency nurses do not recommend their hospital to other clinicians as a good place to work. Design, Setting, and Participants: This qualitative study used directed content analysis of open-text responses (n = 142) from the RN4CAST-NY/IL survey of registered nurses licensed in New York and Illinois between April 13 and June 22, 2021. Inductive and deductive analytic approaches guided study theme development informed by the Social Ecological Model. The collected data were analyzed from April to June 2023. Main Outcomes and Measures: Nurses who answered "probably not" or "definitely not" to the survey question, "Would you recommend your place of employment as a good place to work?" were prompted to provide a rationale in an open-text response. Results: In this qualitative study of 142 emergency nurses (mean [SD] age, 43.5 [12.5] years; 113 [79.6%] female; mean [SD] experience, 14.0 [12.2] years), 94 (66.2%) were licensed to work in New York and the other 48 (33.8%) in Illinois. Five themes and associated subthemes emerged from the data. Themes conveyed understaffing of nurses and ancillary support (theme 1: unlimited patients with limited support); inadequate responsiveness from unit management to work environment safety concerns (theme 2: unanswered calls for help); perceptions that nurses' licenses were in jeopardy given unsafe working conditions and compromised care quality (theme 3: license always on the line); workplace violence on a patient-to-nurse, clinician-to-nurse, and systems level (theme 4: multidimensional workplace violence); and nurse reports of being undervalued by hospital management and unfulfilled at work in delivering suboptimal care to patients in unsafe working conditions (theme 5: undervalued and unfulfilled). Conclusions and Relevance: This study found that emergency department nurses did not recommend their workplace to other clinicians as a good place to work because of poor nurse and ancillary staffing, nonresponsive hospital leadership, unsafe working conditions, workplace violence, and a lack of feeling valued. These findings inform aspects of the work environment that employers can address to improve nurse recruitment and retention.

Top Factors in Nurses Ending Health Care Employment Between 2018 and 2021.

Importance: The increase in new registered nurses is expected to outpace retirements, yet health care systems continue to struggle with recruiting and retaining nurses. Objective: To examine the top contributing factors to nurses ending health care employment between 2018 and 2021 in New York and Illinois. Design, Setting, and Participants: This cross-sectional study analyzed survey data (RN4CAST-NY/IL) from registered nurses in New York and Illinois from April 13 to June 22, 2021. Differences in contributing factors to ending health care employment are described by nurses' age, employment status, and prior setting of employment and through exemplar nurse quotes. Main Outcomes and Measures: Nurses were asked to select all that apply from a list of contributing factors for ending health care employment, and the percentage of nurse respondents per contributing factor were reported. Results: A total of 7887 nurses (mean [SD] age, 60.1 [12.9] years; 7372 [93%] female) who recently ended health care employment after a mean (SD) of 30.8 (15.1) years of experience were included in the study. Although planned retirement was the leading factor (3047 [39%]), nurses also cited burnout or emotional exhaustion (2039 [26%]), insufficient staffing (1687 [21%]), and family obligations (1456 [18%]) as other top contributing factors. Among retired nurses, 2022 (41%) ended health care employment for reasons other than planned retirement, including burnout or emotional exhaustion (1099 [22%]) and insufficient staffing (888 [18%]). The age distribution of nurses not employed in health care was similar to that of nurses currently employed in health care, suggesting that a demographically similar, already existing supply of nurses could be attracted back into health care employment. Conclusions and Relevance: In this cross-sectional study, nurses primarily ended health care employment due to systemic features of their employer. Reducing and preventing burnout, improving nurse staffing levels, and supporting nurses' work-life balance (eg, childcare needs, weekday schedules, and shorter shift lengths) are within the scope of employers and may improve nurse retention.

Perceived stress, burnout, and resilience among healthcare workers in a multiple disaster-impacted setting during the COVID-19 pandemic.

OBJECTIVE: Current literature on coronavirus disease 2019 (COVID-19) research presents gaps and opportunities to investigate the psychological experiences of healthcare workers (HCWs) serving in mass trauma situations. We aimed to measure perceived stress, burnout, and resilience in Kashmiri HCWs and explore the relationship of burnout with sociodemographic, work-related, and pandemic-related factors. DESIGN, SETTING, AND PARTICIPANTS: This was a cross-sectional descriptive study. Data were collected by circulating a web-based questionnaire among HCWs across primary, secondary, and tertiary healthcare levels in Kashmir, India. The questionnaire consisted of sections on personal, work-related, and pandemic-related variables as well as validated instruments to measure perceived stress, burnout, and resilience. RESULTS: A total of 514 valid responses were received. More than 80 percent of HCWs had moderate to high perceived stress. The prevalence of personal, work-related, and client-related burnouts was 68, 48.6, and 46 percent, respectively. Resilience was negatively correlated with stress and burnout. Younger (18-28 years), unmarried HCWs, especially junior residents and nurses, had higher burnout levels. Redeployment to deliver COVID-19 duties, unpredictability in work schedule, tested positive for COVID-19, and spending time in isolation/quarantine were also found to be significant risk factors for developing burnout. CONCLUSIONS: Nearly half of the HCWs suffered from burnout, and more than half had moderate to high perceived stress. In addition to pre-existing risk factors of burnout, the pandemic seems to have introduced more occupational risk factors in this disaster-affected area. Lessons learnt from COVID-19 pandemic may help guide need-based intervention strategies designed for specific target population rather than a one size fits all approach.

[NEGATIVE AND POSITIVE ASPECTS OF PROFESSIONAL QUALITY OF LIFE AMONG PEDIATRIC RESIDENTS IN ER ROTATION: COMPASSION FATIGUE AND COMPASSION SATISFACTION FROM THE RESIDENTS' PERSPECTIVE].

INTRODUCTION: The article focuses on the professional quality of life of medical residents, and specifically on compassion fatigue and compassion satisfaction. Previous studies have indicated high levels of emotional stress among residents. Most of these studies were conducted within the positivistic paradigm. The qualitative study concentrates on pediatric residents during ER rotations in both routine and pandemic times. AIMS: The research goal is to explore how compassion fatigue and compassion satisfaction are manifested among the residents. METHODS: Conducted in the phenomenological genre, the study included 14 pediatric residents in a large Israeli hospital. The research tool was a semi-structured interview. RESULTS: All residents reported substantial work overloads. About half of the participants indicated signs of compassion fatigue, manifested in negative emotions and diminished empathy and sensitivity, especially towards patients' families. Some exhibited a combination of compassion fatigue and compassion satisfaction. About half of the residents clearly expressed feelings of compassion satisfaction or empathy for patients (without direct expressions of compassion satisfaction). CONCLUSIONS: The research gave pediatric residents a platform to express their voices, shedding light on the complexity of their work. While a substantial number of participants reported compassion fatigue, the findings are encouraging. Despite the reported work overload, most of them maintained their sense of commitment and compassion, which are crucial for their work. However, participants' senses of stress and burnout have negative consequences both individually and organizationally. The study suggests that residents might gain from systematic intervention and recommendations have been offered to hospital administrations.

Factors associated with burnout among frontline nurses in the post-COVID-19 epidemic era: a multicenter cross-sectional study.

BACKGROUND: The COVID-19 pandemic has significantly increased the risk of burnout among frontline nurses. However, the prevalence of burnout and its associated factors in the post-pandemic era remain unclear. This research aims to investigate burnout prevalence among frontline nurses in the post-pandemic period and pinpoint associated determinants in China. METHODS: From April to July 2023, a cross-sectional study was carried out across multiple centers, focusing on frontline nurses who had been actively involved in the COVID-19 pandemic. The data collection was done via an online platform. The Maslach Burnout Inventory-Human Services Survey was utilized to evaluate symptoms of burnout. A multivariable logistic regression analysis was used to pinpoint factors associated with burnout. RESULTS: Of the 2210 frontline nurses who participated, 75.38% scored over the cut-off for burnout. Multivariable logistic regression revealed that factors like being female [odds ratio (OR) = 0.41, 95%CI = 0.29-0.58] and exercising 1-2 times weekly[OR = 0.53, 95%CI = 0.42-0.67] were protective factors against burnout. Conversely, having 10 or more night shifts per month[OR = 1.99, 95%CI = 1.39-2.84], holding a master's degree or higher[OR = 2.86, 95% CI = 1.59-5.15], poor health status[OR = 2.43, 95% CI = 1.93-3.08] and [OR = 2.82, 95%CI = 1.80-4.43], under virus infection[OR = 7.12, 95%CI = 2.10-24.17], and elevated work-related stress[OR = 1.53, 95% CI = 1.17-2.00] were all associated with an elevated risk of burnout. CONCLUSION: Our findings indicate that post-pandemic burnout among frontline nurses is influenced by several factors, including gender, monthly night shift frequency, academic qualifications, weekly exercise frequency, health condition, and viral infection history. These insights can inform interventions aimed at safeguarding the mental well-being of frontline nurses in the post-pandemic period.

Accelerated Education Intervention: A Pilot Study to Assess the Effectiveness of a Brief, Self-Paced Intervention to Prevent Burnout in Physician Assistant Students.

PURPOSE: Physician assistant (PA) programs have an academically rigorous curriculum, which places a myriad of pressures on students and contributes to burnout. The benefits of optimal quality and quantity of sleep are well documented, yet students still view sacrificing sleep as a necessary step in academic success. The purpose of this pilot study was to create behavior changes to promote optimal sleep hygiene in PA school and decrease measurements of burnout. METHODS: 39 PA students from a single institution volunteered to take part in an 8-week study. Wrist actigraphy was used to measure students' sleeping habits, resting heart rate, and physical activity. Additionally, the students completed a questionnaire regarding stimulant and sleep aid use and burnout (Maslach Burnout Inventory) at two time points. The intervention was 8 weeks in duration split into 2, 4-week blocks separated by a 1-hour, evidence-based education intervention to promote beneficial behavior change and sleep hygiene. RESULTS: Sleep duration, wake time, and bedtime remained consistent across the study period with no changes post-intervention (p > 0.05). Moderate to high levels of cynicism and emotional exhaustion were seen in more than three-quarters of students. There was no relationship between sleep duration and exam scores, heart rate, or steps. Shorter sleep duration predicted increased emotional exhaustion and cynicism (p < 0.05). CONCLUSION: Sleeping habits influence emotional well-being and are likely minimally affected by educational interventions alone. Combatting the high prevalence of burnout in PA schools can begin with targeting environmental and policy-level changes that can influence student recovery and well-being opportunities throughout the academic year.

The Role of Personal Demands and Personal Resources in Enhancing Study Engagement and Preventing Study Burnout.

Using a 1-year longitudinal design, we examined the role of personal demands and personal resources in long-term health impairment and motivational processes among master students. Based on the job demands-resources theory and transactional model of stress, we hypothesized that students' personal demands (i.e., irrational performance demands, awfulizing and irrational need for control) predict perceived study demands one year later, and indirectly relate to burnout. Furthermore, we predicted that personal resources indirectly associate with study engagement via students' perceived study resources one year later. These hypotheses were tested in a sample of Dutch master students (N = 220 at T1 and T2) using structural equation modelling. As hypothesized, personal demands and personal resources at T1 predicted study demands and study resources one year later (T2, ß = .25-.42, p <. 05), respectively. Study-home interference [study demand] mediated the association between personal demands and burnout (ß = .08, p = .029), whereas opportunities for development [study resource] mediated the association between personal resources and study engagement (ß = .08, p = .014). Hence, personal demands and personal resources relate indirectly to students' burnout and engagement one year later via a heightened level of specific study demands and study resources. Accordingly, the present research expands the propositions of the JD-R Theory by proposing personal demands as a relevant factor for students' long-term well-being.

Physician and Advanced Practice Clinician Burnout in Rural and Urban Settings.

INTRODUCTION: Recruiting rural-practicing clinicians is a high priority. In this study, we explored burnout and contributing work conditions among rural, urban, and family practice physicians and advanced practice clinicians (APCs) in an Upper Midwestern health care system. METHODS: The Mini Z burnout reduction measure was administered by anonymous electronic survey in March 2022. We conducted bivariate analyses of study variables, then assessed relationships of study variables to burnout with multivariate binary logistic regression. RESULTS: Of 1118 clinicians (63% response rate), 589 physicians and 496 APCs were included in this study (n = 1085). Most were female (56%), physicians (54%), and White (86%), while 21% were in family practice, 46% reported burnout, and 349 practiced rurally. Rural and urban clinician burnout rates were comparable (45% vs 47%). Part-time work protected against burnout for family practice and rural clinicians, but not urban clinicians. In multivariate models for rural clinicians, stress (OR: 8.53, 95% CI: 4.09 to 17.78, P < .001), lack of workload control (OR: 3.06, 95% CI: 1.47-6.36, P = .003), busy/chaotic environments (OR: 2.53, 95% CI: 1.29-4.99, P = .007), and intent to leave (OR: 2.18, 95% CI: 1.06-4.45, P = .033) increased burnout odds. In family practice clinicians, stress (OR: 13.43 95% CI: 4.90-36.79, P < .001) also significantly increased burnout odds. CONCLUSIONS: Burnout was comparable between rural and urban physicians and APCs. Part-time work was associated with decreased burnout in rural and family practice clinicians. Addressing burnout drivers (stress, workload control, chaos) may improve rural work environments, reduce turnover, and aid rural clinician recruitment. Addressing stress may be particularly impactful in family practice.

Association between body mass index and burnout among nurses in China: a cross-sectional study.

OBJECTIVES: Body mass index (BMI) can affect an individual's health. The night shift is a characteristic of the nursing profession, which is associated with an abnormal BMI. However, few studies have investigated the association between BMI and burnout in Chinese nurses. This study examined the association between BMI and burnout among Chinese nurses. METHODS: A total of 1863 nurses from 12 tertiary hospitals in Shandong Province of China were selected. BMI was calculated as body weight divided by height squared. The Maslach Burnout Service Inventory General Survey (MBI-GS) was used to measure the level of burnout among nurses. Ordinal logistic regression was used to analyse the association between BMI and burnout. RESULTS: In this study, the prevalence of normal BMI, underweight, overweight, and obesity was 69.2%, 7.5%, 18.2%, and 5.2%, respectively. The prevalence of high emotional exhaustion, high cynicism, and low personal accomplishment among nurses was 26.1%, 38.7%, and 35.6%, respectively. Nurses who were obese were more likely to have high levels of emotional exhaustion (OR=1.493, 95% CI: 1.011 to 2.206) and cynicism (OR=1.511, 95% CI: 1.014 to 2.253), and nurses who were underweight were more likely to have high levels of cynicism (OR=1.593, 95% CI: 1.137 to 2.232) compared with those who were normal weight. CONCLUSIONS: Obesity was positively associated with emotional exhaustion and cynicism, and being underweight was only positively associated with cynicism among Chinese nurses. Hospital administrators should consider BMI when taking effective measures to reduce burnout among nurses.

[The Effects of Stress Vulnerability and Parental Burnout on Mental Health in Women with Early School-Age Children during the COVID-19 Pandemic: Mediating Effect of Spirituality].

PURPOSE: This study examined the effects of stress vulnerability and parental burnout on the mental health of women with early school-aged children, with a focus on the mediating role of spirituality. METHODS: A survey was conducted among 171 women with early school-aged children in Gyeonggi Province, Gangwon Province, and Seoul. Data were collected from September to December 2022 using the Korean-Symptom Check List 95, the Parental Burnout Assessment, and the Spirituality Assessment Scale. The data were analyzed using structural equation modeling with SPSS/WIN 22.0 and AMOS 20.0. RESULTS: The study model demonstrated a good fit, explaining 40.5% of the variance in mental health through stress vulnerability, parental burnout, and spirituality. Spirituality had a significant direct impact on mental health. Additionally, participants' spirituality directly influenced their mental health, while stress vulnerability and parental burnout indirectly affected their mental health and were mediated through spirituality. CONCLUSION: Stress vulnerability and parental burnout are negatively associated with mental health, while spirituality partially mediates these effects. Implementing a program to promote spirituality is suggested to assist mothers in recognizing the value and meaning of parenting activities during nursing interventions for mental health.

Academic Burnout, Stress, and the Role of Resilience in a Sample of Saudi Arabian Medical Students.

Background: Medical school can be difficult and stressful. Academic burnout is described as exhaustion from curricular activities. Medical students are more likely to experience anxiety. Objective: This study investigated the level of academic burnout and stress as well as their level of resilience. Methods: Saudi medical students were surveyed in a cross-sectional questionnaire-based study. We used the following scales: Perceived Stress Scale, Maslach Burnout Inventory-Student Survey, and the Connor-Davidson Brief Resilience Scale to assess stress, academic burnout, and resilience respectively. Results: The mean score for emotional exhaustion, 20.23 ± 6.8, indicated a high level of burnout among students. The students reported a moderate level of stress. Females, students who were single or lived away from home had higher levels of burnout in certain domains. Students with a higher level of resilience experienced less stress and burnout. Conclusion: Academic burnout has a negative impact on mental health. Effective interventions should be designed to assist students to cope better with stress and also identify solutions to avoid burnout. More research is needed to investigate the social and environmental factors contributing to medical student burnout.