Effects of the COVID-19 pandemic on senior dental students in Korea: Examining stress, burnout, and depression.

Background/purpose: The COVID-19 pandemic has had a profound and enduring impact on various aspects of society, including medical education and the training of dental students. The field of dentistry, given its nature, is particularly susceptible to the challenges posed by a pandemic. Prolonged exposure to the pandemic is believed to have increased stress and burnout among medical and dental students. This study aimed to investigate and analyze the relationship between COVID-19 and stress, burnout, and depression in Korean dental students. Materials and methods: A cross-sectional survey was conducted among 162 third and fourth-grade students from the School of Dentistry at Seoul National University. The survey comprised four main sections: general information, the Maslach Burnout Inventory (MBI), the Patient Health Questionnaire-9 (PHQ-9), and the Impact of Event Scale-Revised (IES-R). Results: The results indicated significant differences in age, study time, career satisfaction, and counseling needs between third and fourth-grade students. The fourth-grade students exhibited higher scores in the IES-R survey, PHQ-9 total score, emotional exhaustion, and depersonalization subscale items of the MBI. Furthermore, the group with abnormal responses to COVID-19 demonstrated lower levels of career satisfaction. Conclusion: Fourth-grade dental students experienced higher levels of depression, vulnerability to the effects of COVID-19, and burnout. These findings highlight the need for addressing the mental health challenges faced by dental students during the COVID-19 pandemic.

Association Between Physical Activity and the Risk of Burnout in Health Care Workers: Systematic Review.

BACKGROUND: Burnout is a multidimensional psychological syndrome that arises from chronic workplace stress. Health care workers (HCWs), who operate in physically and emotionally exhausting work contexts, constitute a vulnerable group. This, coupled with its subsequent impact on patients and public economic resources, makes burnout a significant public health concern. Various self-care practices have been suggested to have a positive effect on burnout among HCWs. Of these, physical activity stands out for its ability to combine psychological, physiological, and biochemical mechanisms. In fact, it promotes psychological detachment from work and increases self-efficacy by inhibiting neurotransmitters and neuromodulators, increasing endorphin levels, enhancing mitochondrial function, and attenuating the hypothalamic pituitary-adrenal axis response to stress. OBJECTIVE: Our objective was to conduct a systematic review of the evidence on the association between physical activity and burnout among HCWs. METHODS: We considered HCWs, physical activity, and burnout, framing them as population, exposure, and outcome, respectively. We searched APA PsycArticles, MEDLINE, and Scopus until July 2022. We extracted relevant data on study design, methods to measure exposure and outcome, and statistical approaches. RESULTS: Our analysis encompassed 21 independent studies. Although 10% (2/21) of the studies explicitly focused on physical activity, the remaining investigations were exploratory in nature and examined various predictors, including physical activity. The most commonly used questionnaire was the Maslach Burnout Inventory. Owing to the heterogeneity in definitions and cutoffs used, the reported prevalence of burnout varied widely, ranging from 7% to 83%. Heterogeneity was also observed in the measurement tools used to assess physical activity, with objective measures rarely used. In total, 14% (3/21) of the studies used structured questionnaires to assess different types of exercise, whereas most studies (18/21, 86%) only recorded the attainment of a benchmark or reported the frequency, intensity, or duration of exercise. The reported prevalence of physically active HCWs ranged from 44% to 87%. The analyses, through a variety of inferential approaches, indicated that physical activity is often associated with a reduced risk of burnout, particularly in the domains of emotional exhaustion and depersonalization. Furthermore, we compiled and classified a list of factors associated with burnout. CONCLUSIONS: Our comprehensive overview of studies investigating the association between physical activity and burnout in HCWs revealed significant heterogeneity in definitions, measurements, and analyses adopted in the literature. To address this issue, it is crucial to adopt a clear definition of physical activity and make thoughtful choices regarding measurement tools and methodologies for data analysis. Our considerations regarding the measurement of burnout and the comprehensive list of associated factors have the potential to improve future studies aimed at informing decision-makers, thus laying the foundation for more effective management measures to address burnout.

Burnout Syndrome Among Critical Care Health Providers in Saudi Arabia.

Background: Burnout Syndrome constitutes a critical concern in healthcare, particularly among practitioners operating in high-stress, critical care settings. Understanding the multifaceted factors contributing to burnout in this context is pivotal for devising effective interventions and promoting the well-being of critical care professionals. Objective: To investigate the prevalence, contributing factors, and potential interventions related to Burnout Syndrome among critical care health providers in Saudi Arabia. Methods: A cross-sectional research design was employed, gathering data from a sample of critical care health providers, including medical practitioners. A self-administered structured electronic questionnaire was used, incorporating the Maslach Burnout Inventory (MBI) with its three subscales: emotional exhaustion, depersonalization, and personal accomplishment. The target population was male and female critical care health providers over 18 years age, most participants lies between 25 years to 34 years. Results: Statistical analysis shows significant disparities in response distribution (p<0.05), highlighting the importance of understanding encounters with emotional exhaustion, personal accomplishment, and depersonalization. The Durbin-Watson statistic indicated limited autocorrelation, and collinearity tolerance values suggested nominal intercorrelations among predictors. A significant positive correlation was found between the "Depersonalization Loss of Empathy MBI" factor and the outcome variables, indicating complex relationships between emotional exhaustion, personal accomplishment, and depersonalization. Conclusion: The study highlights the multifaceted nature of burnout, revealing intricate relationships between emotional exhaustion, personal accomplishment, and depersonalization. These findings collectively form an important foundation for future guidelines and interventions to enhance the well-being of healthcare professionals.

Cortisol Reactivity to Acute Psychosocial Stress in Physician Burnout.

BACKGROUND: Physician burnout, characterized by chronic job-related stress leading to emotional exhaustion, depersonalization, and reduced personal accomplishment. This cross-sectional study investigates cortisol reactivity in male physicians with burnout compared to healthy controls during an acute psychosocial stress test. METHODS: Sixty male physicians (30 burnout, 30 healthy controls) participated between September 2019 and December 2021 to investigate the impact of burnout on cardiovascular health. Salivary cortisol levels were measured before and after a Trier Social Stress Test (TSST). Burnout was assessed with the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). Covariates included age, BMI, and physical activity. Data were analyzed using repeated measures analysis and area under the curve analysis. RESULTS: Male physicians with burnout exhibited significantly greater cortisol reactivity during the TSST, notably post-stress to 15 min post-stress. Emotional exhaustion correlated with reduced cortisol increase from pre-stress and smaller post-stress to 15- and 45-min declines. DISCUSSION: Findings suggest heightened cortisol reactivity in male physicians with burnout, possibly reflecting initial chronic stress stages. This study highlights the necessity for long-term research on cortisol's influence on cardiovascular health and stress responses across diverse groups. CONCLUSIONS: The findings contribute to comprehending physiological responses in burnout-afflicted physicians, emphasizing cortisol reactivity's pivotal role in stress-related research and its potential health implications, particularly within the burnout context.

Burnout syndrome in Spanish, Portuguese and Latin American ophthalmologists: a cross-sectional analysis.

PURPOSE: Despite the well-known consequences of burnout syndrome, there has been little research into this syndrome in the field of ophthalmology. Our objective is to determine the frequency of burnout syndrome between Spanish, Portugal and Latin-American ophthalmologists, as well as to analyse its relationship with different sociodemographic variables. METHODS: This is an observational cross-sectional descriptive study including ophthalmologists from Spain, Portugal and 15 Latin American countries. Burnout syndrome was evaluated by the Maslach Burnout Inventory-Human Services Survey. Burnout syndrome was defined as high emotional exhaustion, high depersonalization or low personal accomplishment. In addition, we recorded sociodemographic variables and aspects related to the type of work. A conditional backwards stepwise multivariate binomial logistic regression analysis was run to assess the variables associated with burnout syndrome, expressed as an odds ratio (OR). RESULTS: A total of 527 surveys were analysed, the majority from Spain (401; 76.1%), followed by Argentina (45; 8.5%), and Mexico (31; 5.9%). The number of ophthalmologists with burnout syndrome was 351 (66.6%). The results show the profile of a young ophthalmologist (age OR 0.985), carrying out a public activity (OR 2.118) and dedicated to general ophthalmology (OR 1.860). CONCLUSIONS: The frequency detected in this study confirms a steady increase in rates of burnout among ophthalmologists. As the consequences of this are well known, it is vital for health centre managers to develop a strategic plan to allow the causes to be understood better and to implement steps to improve the situation in each medical centre.

A Survey of Burnout Among Neurocritical Care Practitioners.

BACKGROUND: Burnout is a growing problem among medical professionals, reaching a crisis proportion. It is defined by emotional exhaustion, cynicism, and career dissatisfaction and is triggered by a mismatch between the values of the person and the demands of the workplace. Burnout has not previously been examined thoroughly in the Neurocritical Care Society (NCS). The purpose of this study is to assess the prevalence, contributing factors, and potential interventions to reduce burnout within the NCS. METHODS: A cross-sectional study of burnout was conducted using a survey distributed to members of the NCS. The electronic survey included personal and professional characteristic questions and the Maslach Burnout Inventory Human Services Survey for Medical Personnel (MBI). This validated measure assesses for emotional exhaustion (EE), depersonalization (DP), and personal achievement (PA). These subscales are scored as high, moderate, or low. Burnout (MBI) was defined as a high score in either EE or DP or a low score in PA. A Likert scale (0-6) was added to the MBI (which contained 22 questions) to provide summary data for the frequencies of each particular feeling. Categorical variables were compared using χ2 tests, and continuous variables were compared using t-tests. RESULTS: A total of 82% (204 of 248) of participants completed the entire questionnaire; 61% (124 of 204) were burned out by MBI criteria. A high score in EE was present in 46% (94 of 204), a high score in DP was present in 42% (85 of 204), and a low score in PA was present in 29% (60 of 204). The variables feeling burned out now, feeling burned out in the past, not having an effective/responsive supervisor, thinking about leaving one's job due to burnout, and leaving one's job due to burnout were significantly associated with burnout (MBI) (p < 0.05). Burnout (MBI) was also higher among respondents early in practice (currently training/post training 0-5 years) than among respondents post training 21 or more years. In addition, insufficient support staff contributed to burnout, whereas improved workplace autonomy was the most protective factor. CONCLUSIONS: Our study is the first to characterize burnout among a cross-section of physicians, pharmacists, nurses, and other practitioners in the NCS. A call to action and a genuine commitment by the hospital, organizational, local, and federal governmental leaders and society as a whole is essential to advocate for interventions to ameliorate burnout and care for our health care professionals.

A new look at an old well-being construct: evaluating the psychometric properties of 9, 5, and 1-item versions of emotional exhaustion metrics.

Objective: To compare the relative strengths (psychometric and convergent validity) of four emotional exhaustion (EE) measures: 9- and 5-item scales and two 1-item metrics. Patients and methods: This was a national cross-sectional survey study of 1409 US physicians in 2013. Psychometric properties were compared using Cronbach's alpha, Confirmatory Factor Analysis (CFA), Exploratory Factor Analysis (EFA), and Spearman's Correlations. Convergent validity with subjective happiness (SHS), depression (CES-D10), work-life integration (WLI), and intention to leave current position (ITL) was assessed using Spearman's Correlations and Fisher's R-to-Z. Results: The 5-item EE scale correlated highly with the 9-item scale (Spearman's rho = 0.828), demonstrated excellent internal reliability (alpha = 0.87), and relative to the 9-item, exhibited superior CFA model fit (RMSEA = 0.082, CFI = 0.986, TLI = 0.972). The 5-item EE scale correlated as highly as the 9-item scale with SHS, CES-D10, and WLI, and significantly stronger than the 9-item scale to ITL. Both 1-item EE metrics had significantly weaker correlation with SHS, CES-D10, WLI, and ITL (Fisher's R-to-Z; p < 0.05) than the 5- and 9-item EE scales. Conclusion: The 5-item EE scale was repeatedly found equivalent or superior to the 9-item version across analyses, particularly with respect to the CFA results. As there is no cost to using the briefer 5-item EE scale, the burden on respondents is smaller, and widespread access to administering and interpreting an excellent wellbeing metric is enhanced at a critical time in global wellbeing research. The single item EE metrics exhibited lower convergent validity than the 5- and 9-item scales, but are acceptable for detecting a signal of EE when using a validated EE scale is not feasible. Replication of psychometrics and open-access benchmarking results for use of the 5-tem EE scale further enhance access and utility of this metric.

Burnout Among Nursing Home Care Aides and the Effects on Resident Outcomes.

While burnout among health care workers has been well studied, little is known about the extent to which burnout among health care workers impacts the outcomes of their care recipients. To test this, we used a multi-year (2014-2020) survey of care aides working in approximately 90 nursing homes (NHs); the survey focused on work-life measures, including the Maslach Burnout Inventory (MBI) and work-unit identifier. Resident Assessment Instrument Minimum Data Set (RAI-MDS 2.0) data were obtained on all residents in the sampled NHs during this time and included a unit identifier for each resident. We used multi-level models to test associations between the MBI emotional exhaustion and cynicism sub-scales reported by care aides and the resident outcomes of antipsychotics without indication, depressive symptoms, and responsive behaviors among residents on units. In 2019/2020, our sample included 3,547 care aides and 10,117 residents in 282 units. The mean frequency of emotional exhaustion and cynicism across units was 43% and 50%, respectively. While residents frequently experienced antipsychotics without indication 1,852 (18.3%), depressive symptoms 2,089 (20.7%), and responsive behaviors 3,891 (38.5%), none were found to be associated with either emotional exhaustion or cynicism among care aides.

Reduced burnout in medical and health science students during the pandemic COVID-19 - a follow-up study of a single institution in Hungary.

BACKGROUND: The coronavirus pandemic has significantly impacted lives worldwide, especially of medical and health science students. In Hungary, education has been relegated to the online space, with a substantial proportion of students having to attend medical secondments. Increased stress, uncertainty, and the presence of medical secondments can have an impact on students' premature burnout. METHODS: In 2021, we conducted a follow-up survey among students of the University of Pécs studying medicine and health sciences in two data collection periods (from March to May and September to November). Our online questionnaire consisted of the Maslach Burnout Inventory General Survey for Students and our self-designed questionnaire. We used descriptive and paired two-sample t-tests for data analysis at a 95% confidence interval (p ≤ 0.05). RESULTS: We excluded from our survey respondents whose data we could not follow-up; finally, 183 students' responses were analyzed. The majority of students were female (n = 148; 80.9%). Overall, there was a significant decrease in both exhaustion (EX) and cynicism (CY) scores (p = 0.001; p = 0.004). Female respondents had higher EX scores, but a significant decrease was observed for both genders (p ≤ 0.05). Excluding paramedic students, a significant decrease in EX scores was observed for the specialties we studied (p ≤ 0.05). General medicine students' CY scores decreased; physiotherapy students' profesisonal efficacy (PE) scores increased significantly (p ≤ 0.05). Students who were on medical secondments (n = 127; 69. 4%) were found to be more affected by burnout, but in all cases, these scores significantly improved (p ≤ 0.05). Students serving in the National Ambulance Service (n = 76; 41.5%), Hospitals (n = 44; 24.0%), or both (n = 7; 3.8%) had a significant decrease in their burnout score (p ≤ 0.05). Students who served in either a hospital or a hospital and National Ambulance Service had significantly improved CY and PE scores (p ≤ 0.05). Students concerned about their health had elevated EX and CY scores, which also improved (p ≤ 0.05). CONCLUSIONS: In conclusion, medical secondments positively affected student burnout scores for medicine and health sciences students at our institution. This fact implies that it is necessary to have more internships in real-life settings during the training. TRIAL REGISTRATION: Our survey has been approved by the Medical Research Council (Case No IV/4573-1/2021/ECU).

Síndrome de Burnout en residentes y posgrados de Neonatología en un centro hospitalario de tercer nivel. Análisis situacional y seguimiento, período 2021 - 2023

Introducción: los residentes y posgrados son un eslabón central en los servicios hospitalarios. El síndrome de Burnout se define como el agotamiento físico y emocional resultado de la exposición crónica al estrés en el ámbito laboral. El Maslach Burnout Inventory (MBI-HSS) es un instrumento diseñado y validado para evaluarlo. El objetivo de este estudio es determinar la prevalencia del síndrome de Burnout en nuestro servicio y compararla entre los estudiantes de distintas generaciones para luego poner en marcha mecanismos que permitan realizar seguimiento, detección temprana e identificación de factores modificables. Material y método: estudio transversal, descriptivo, observacional, desarrollado en abril de 2021 a través de la realización del test MBI-HSS para el diagnóstico de situación. Este estudio continuará con una segunda etapa que consta de la aplicación del test cada cuatro meses, la cual no desarrollaremos en el presente trabajo. La población objetivo la constituyen todos los residentes y posgrados de la especialidad de Neonatología en un centro hospitalario de tercer nivel. Se aplicó el cuestionario MBI-HSS y un cuestionario general para caracterizar a la población. Resultados: se incluyeron un total de 22 participantes, de los cuales 13 presentaron puntajes altos de agotamiento emocional, 9 obtuvieron un valor alterado de despersonalización y 9 presentaron puntajes bajos de realización personal. Seis participantes (27%) presentaron puntajes alterados para las tres variables. Conclusiones: se evidenció una alta prevalencia de Burnout, el 27% en la población total. Se encontraron diferencias estadísticamente significativas para los ítems despersonalización y realización personal entre los distintos años de la especialidad, con mayor puntaje de despersonalización y menor puntaje de realización personal en los de segundo y tercer año. Esto constituye un elemento de alarma que exige la modificación inmediata del funcionamiento y de las actividades.

Introduction: Residents and postgraduates are a fundamental part of hospital services. Burnout Syndrome is defined as physical and emotional exhaustion resulting from chronic exposure to stress in the workplace. The Maslach Burnout Inventory (MBI-HSS) is an instrument designed and validated to evaluate it. The objective of this study is to determine the prevalence of Burnout Syndrome in our service and to compare it among students of different generations to then implement mechanisms that allow monitoring, early detection and identification of modifiable factors. Materials and methods: Cross-sectional, descriptive, observational study carried out in April 2021 through the Maslach Burnout Inventory - Human Services Survey (MBI-HSS) test to carry out a diagnosis of the situation. This study will continue with a 2nd stage consisting of the application of the test every 4 months, which we will not develop in this work. The target population is all residents and postgraduates in the neonatology specialty at a tertiary level hospital. The MBI-HSS questionnaire and a general questionnaire were applied to characterize the population. Results: A total of 22 participants were included, of which 13 presented high scores of emotional exhaustion, 9 obtained an altered value of depersonalization and 9 presented low scores of personal fulfillment. Six participants, 27%, presented altered scores for the three variables. Conclusions: A high prevalence of Burnout was evidenced, being 27% in the total population. Statistically significant differences were found for the items "depersonalization" and "personal fulfillment" between the different years of the specialty, with higher depersonalization scores and lower personal fulfillment scores in the second and third years. This constitutes an alarm element, which requires immediate modification of the operation and activities.

Introdução: Residentes e pós-graduandos constituem um elo central nos serviços hospitalares. A Síndrome de Burnout é definida como exaustão física e emocional resultante da exposição crônica ao estresse no ambiente de trabalho. O Maslach Burnout Inventory (MBI-HSS) é um instrumento elaborado e validado para avaliá-lo. Objetivo: O objetivo deste estudo é determinar a prevalência da Síndrome de Burnout no Serviço de Neonatologia do Centro Hospitalario Pereira Rossel e compará-la entre estudantes de diferentes gerações para então implementar mecanismos que permitam monitoramento, detecção precoce e identificação de fatores modificáveis. Materiais e métodos: Estudo transversal, descritivo, observacional realizado em abril de 2021 por meio do teste Maslach Burnout Inventory - Human Services Survey (MBI-HSS) para diagnóstico da situação. Este estudo continuará com uma 2ª etapa que consiste na aplicação do teste a cada 4 meses, que não desenvolveremos neste trabalho. A população-alvo são todos os residentes e pós-graduandos da especialidade de neonatologia de um hospital de nível terciário. O questionário MBI-HSS e um questionário geral foram aplicados para caracterizar a população. Resultados: Foram incluídos 22 participantes, dos quais 13 apresentaram escores elevados de exaustão emocional, 9 obtiveram valor alterado de despersonalização e 9 apresentaram escores baixos de realização pessoal. Seis participantes, 27%, apresentaram escores alterados nas três variáveis. Conclusões: Evidenciou-se uma alta prevalência de Burnout de 27% na população total. Foram encontradas diferenças estatisticamente significativas nos itens "despersonalização" e "realização pessoal" entre os diferentes anos da especialidade, com maiores pontuações de despersonalização e menores pontuações de realização pessoal no segundo e terceiro anos. Isto constitui um elemento de alarme, que requer modificação imediata do funcionamento e das atividades.

Burnout and perceived stress among Italian physical therapists during the COVID-19 pandemic: a cross-sectional study.

High levels of burnout and psychological distress have been reported for healthcare workers, with seemingly worse outcomes after the outbreak of the COVID-19 pandemic. However, to date, scarce evidence has been gathered about the condition of physical therapists. This cross-sectional study investigated the three burnout dimensions of emotional exhaustion, depersonalization, and personal accomplishment as measured by the Maslach Burnout Inventory (MBI) and assessed perceived stress with the 10-item Perceived Stress Scale (PSS) in a sample of Italian physical therapists with the aim of examining the relationships between these variables and demographic and work-related factors. An anonymous questionnaire was administered to a convenience sample of 671 professionals from the whole nation and associations between burnout, perceived stress, and work-related variables were investigated with descriptive and inferential statistical methods. Overall, 25% of the participants showed high burnout risk (40% scored high on emotional exhaustion, 36% scored high on depersonalization, and 19% scored low on personal accomplishment), whereas 50% reported high levels of perceived stress. Having been exposed to verbal or physical aggressive behaviors at work (OR = 4.06) was associated with high burnout risk, and participants at risk were significantly younger than those showing no burnout risk (d = 0.27). Having a partner (OR = 0.54) and having children (OR = 0.56) were associated on the other hand with reduced burnout risk. Regression models identified weekly working hours (ß = 0.16), exposure to aggressive behaviors at work (ß = 0.12), and perceived stress (ß = 0.66) as significant predictors of emotional exhaustion, gender (ß = 0.18), exposure to aggressive behaviors (ß = 0.09), and perceived stress (ß = 0.37) as predictors of depersonalization, and gender (ß=-0.1) and perceived stress (ß=-0.35) as predictors of personal accomplishment.In summary, this study found high rates of burnout and psychological distress among Italian physical therapists a year after the outbreak of COVID-19. Significant relations were found between burnout, psychological distress, and both socio-demographic and work-related variables.

Predictors of burnout among resident doctors in a Nigerian teaching hospital.

Background: Burnout is a psychological syndrome resulting from exposure to chronic work-related stress. There are, however, a few works of literature on burnout among trainee doctors in Nigeria. Aim: To determine the prevalence of burnout and its predictors among resident doctors across 16 medical specialties and/or subspecialties. Setting: The University of Ilorin Teaching Hospital (UITH), Ilorin, Nigeria. Methods: A cross-sectional study was conducted among 176 resident doctors between October 2020 and January 2021. The survey included the Proforma and Maslach Burnout Inventory-Human Services Survey for Medical Personnel (MBI-HSS MP). Results: The mean age of participants was 35.10 (SD 4.07) years. The prevalence of burnout was 21.6% for high emotional exhaustion (EE), 13.6% for high depersonalization (DP), and 30.7% for low personal accomplishment (PA). Being a younger resident doctor aged 31-35 (OR = 3.715, 95% CI [1.270 - 10.871]) was the only significant predictor for the EE. Predictors of DP included the age group 31-35 years (OR = 7.143, 95% CI [2.297 - 22.216]), duty hours >50 hours per week (OR = 2.984, 95% CI [1.203 - 7.401]), and presence of work-related stress (OR = 3.701, 95% CI [1.315 - 10.421]). A good relationship with colleagues negatively predicted low PA (OR = 0.221, 95% CI [0.086 - 0.572]). Conclusion: High levels of burnout are prevalent among resident doctors, comparable to international studies. Therefore, the government and other relevant stakeholders must drive legislation and formulate policies toward addressing the work-related factors associated with burnout in the Nigerian healthcare industry. Contribution: This study highlighted the determinants of burnout among Nigerian resident doctors, which necessitates targeted interventions to address them.

Psychometric properties of the arabic version of the maslach burnout inventory-human services survey (MBI-HSS) among lebanese dentists.

BACKGROUND: Dentists are at risk of burnout syndrome, which can have negative impacts on their work environment and productivity. Assessing burnout is crucial for maintaining the well-being and effectiveness of dentists in their profession. The present study aims to evaluate the psychometric properties of the Arabic version of the Maslach Burnout Inventory Human Services Survey (MBI-HSS) among dentists. METHODS: The original English version of the MBI-HSS was translated into Arabic, and then back-translated into English by experienced bilingual professionals. Lebanese dentists were asked to participate in the study between February and June 2019. Data collected included demographic information and items from the Arabic version of the MBI-HSS. RESULTS: A total of 441 people participated in the study, of whom 58.3% were men. The mean age of the sample was 39.6 years (SD = 12.8), with a range of 23 to 68 years old. Approximately 60% of dentists were specialists. Cronbach's alphas were as follows: emotional exhaustion (alpha = 0.855), depersonalization (alpha = 0.823), and personal achievement (alpha = 0.667). The results of the test-retest reliability assessment demonstrated the strong reproducibility of the MBI-HSS [EE, ICC = 0.927 (0.845, 0.966), p-value < 0.0001; PA, ICC = 0.963 (0.921-0.983), p-value < 0.001; DP, ICC = 0.764 (0.497-0.889), p-value < 0.0001]. The exploratory factor analysis of the MBI-HSS yielded three psychometrically robust sub-domains representing dimensions of "emotional exhaustion," "depersonalization," and "personal achievement," which explained 57.8% of the scale's total variance. The confirmatory factor analysis revealed that the 15-item model (excluding items 4, 5, 12, 13, 16, 20, and 22) was the most fitting for the data. CONCLUSIONS: The Arabic version of the MBI-HSS scale demonstrated good psychometric properties in Lebanese dentists. However, it would be important to conduct further research to confirm its reliability and validity in other Arab countries.

Assessment and Prevention of Burnout in Canadian Pharmacy Residency Programs.

Background: There is a paucity of literature describing the incidence of burnout among Canadian pharmacy residents, despite evidence that pharmacy professionals are at high risk of burnout. Objectives: To characterize Canadian pharmacy residents experiencing high levels of burnout, as defined by the Maslach Burnout Inventory (MBI), to describe existing interventions that Canadian pharmacy residents perceive to be effective in managing burnout, and to describe opportunities for Canadian pharmacy residency programs in managing resident burnout. Methods: An online survey, consisting of 22 validated questions from the MBI and 19 nonvalidated questions developed by the investigators, was distributed by email to 558 Canadian pharmacy residents from the 2020/21, 2019/20, and 2018/19 residency years. Results: A total of 115 partial or complete survey responses were included in the analysis, and 107 respondents completed the MBI section of the survey. Of these, 62% (66/107) were at high risk of burnout according to at least 1 MBI subscale, with a slight majority of the entire sample being at high risk of burnout on the emotional exhaustion subscale (55/107 [51%]). The most common interventions offered to pharmacy residents to reduce or prevent burnout were mentorship programs, schedule changes, and promotion of self-organization. Current interventions reported to be the most useful were self-care workshops, discussion groups, and workload adjustment. Potential future interventions perceived to be most useful for reducing and preventing burnout were schedule changes and workload adjustment. Conclusions: More than half of Canadian pharmacy residents who responded to the survey were at high risk of burnout. Canadian pharmacy residency programs should consider implementing additional interventions to help reduce and prevent resident burnout.

Contexte: Il y a peu de documentation qui décrit l'incidence de l'épuisement professionnel chez les résidents en pharmacie canadiens, malgré les preuves de risques élevés auxquels les professionnels en pharmacie sont exposés. Objectifs: Décrire les résidents canadiens en pharmacie qui connaissent des niveaux élevés d'épuisement professionnel, tels que définis par l'inventaire d'épuisement mis au point par Maslach et Jackson [en anglais Maslach Burnout Inventory (MBI)]; décrire les interventions existantes que ces personnes perçoivent comme efficaces pour le gérer; et décrire les possibilités de gestion de l'épuisement professionnel dans les programmes canadiens de résidence en pharmacie. Méthodes: Une enquête en ligne comprenant 22 questions validées du MBI et 19 questions non validées, préparées par les enquêteurs, a été envoyée par courriel à 558 résidents canadiens en pharmacie des années de résidence 2020­2021, 2019­2020 et 2018­2019. Résultats: Au total, 115 réponses partielles ou complètes ont été incluses dans l'analyse, et 107 répondants ont rempli la section MBI de l'enquête. Parmi ces derniers, 62 % (66/107) présentaient un risque élevé d'épuisement professionnel selon au moins 1 sous-échelle du MBI, une légère majorité de l'ensemble de l'échantillon présentant un risque élevé d'épuisement professionnel sur la sous-échelle d'épuisement émotionnel (55/107 [51 %]). Les interventions les plus courantes offertes aux résidents en pharmacie pour réduire ou prévenir l'épuisement professionnel étaient les programmes de mentorat, les changements d'horaire et la promotion de l'auto-organisation. Les interventions actuelles signalées comme étant les plus utiles étaient les ateliers d'autosoins, les groupes de discussion et l'adaptation de la charge de travail. Les interventions futures potentielles perçues comme les plus utiles pour réduire et prévenir l'épuisement professionnel étaient les changements d'horaire et l'adaptation de la charge de travail. Conclusions: Plus de la moitié des résidents canadiens en pharmacie qui ont répondu à l'enquête présentaient un risque élevé d'épuisement professionnel. Les programmes canadiens de résidence en pharmacie devraient envisager de mettre en œuvre des interventions supplémentaires pour aider à le réduire et à le prévenir.

[The prevalence of emotional burning-out syndrome of medical workers in the Russian Federation: Systematic review and meta-analysis].

The burnout is a syndrome that occurs as a result of chronic stress at workplace that is extremely difficult to successfully manage. Many epidemiological studies concerning professional burnout of health care workers were already implemented in Russia. The purpose of the study was to assess overall burnout prevalence rate among health care workers practicing in Russia. We carried out systematic review of original publications in Russian and English though from eLibrary/ MEDLINE/PubMed, Cochrane and Google Scholar databases. Out of 408 results obtained during primary databases search, 61 publications were selected with range of burnout prevalence from 4.2 to 96.7%. Out of them 29 publications that applied the Maslach Burnout Inventory technique as burnout assessment tool to implement meta-analysis were selected. The meta-analysis included data of 5 497 participants. At that, total prevalence rate of burnout among health care workers made up to 61% [95% CI; 52-69%]. Thereby, burnout syndrome is to be considered as important problem of the national health system that requires standardized approach in assessing, diagnosing and monitoring.

Use of the Maslach Burnout Inventory Among Public Health Care Professionals: Scoping Review.

BACKGROUND: Work can be considered a source of living, well-being, and socioeconomic development. When the work environment negatively influences individuals, it may trigger emotional disturbances, behavioral problems, chronic stress conditions, and illnesses such as burnout syndrome (BS). Recently, studies on BS have increased and placed a special focus on health care professionals. The prevalence of BS among health professionals is associated with their chronic exposure to human hardship and long working hours without proper rest. These factors have contributed to greater stress and high physical and emotional exhaustion levels. OBJECTIVE: This study aims to identify and map studies using the Maslach Burnout Inventory (MBI) scale to identify burnout syndrome in health professionals working in public health services. METHODS: This scoping review was developed based on the Joanna Briggs Institute (JBI) Reviewers Manual and reported according to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews). A total of 6 databases were searched to identify relevant studies: Embase, LILACS, MEDLINE or PubMed, PsycInfo, Scopus, and Web of Science. Gray literature was consulted on ProQuest Dissertations and Theses Global, Google Scholar, Brazilian Digital Library of Theses and Dissertations, and Open Access Theses and Dissertations. Additionally, the reference lists were searched to retrieve studies not previously selected. The steps followed in this study were proposed by Arskey and O'Malley and Levac, Colquhoun, and O'Brien: identification of research questions, identification of potential studies, study selection, data extraction and imputation, data analyses and interpretation, and consultation with stakeholders. The detailed methodology was published in a protocol. RESULTS: A total of 55 articles were identified after screening for eligibility criteria, published between 1999 and 2021 in 32 countries. Most reports were published in Brazil, Spain, and China. A total of 22 versions of the MBI were identified, presenting different items, scores, and cutoff points. The included studies had recommendations and implications for clinical practice. The consultation with stakeholders allowed knowledge translation for those interested in BS. CONCLUSIONS: Studies mostly included physicians (34/55, 61.8%) and nurses (24/55, 43.6%), and the original version of MBI was predominantly used. Divergences in BS classification were highlighted, which may be related to MBI cross-cultural adaptations and applications in other countries. This study contributes to the advancement of research regarding burnout syndrome as an occupational illness since it has harmful consequences for workers, health care services, and the quality of care provided to the population.

Variation in Experiences and Attainment in Surgery Between Ethnicities of UK Medical Students and Doctors (ATTAIN): Protocol for a Cross-Sectional Study.

BACKGROUND: The unequal distribution of academic and professional outcomes between different minority groups is a pervasive issue in many fields, including surgery. The implications of differential attainment remain significant, not only for the individuals affected but also for the wider health care system. An inclusive health care system is crucial in meeting the needs of an increasingly diverse patient population, thereby leading to better outcomes. One barrier to diversifying the workforce is the differential attainment in educational outcomes between Black and Minority Ethnic (BME) and White medical students and doctors in the United Kingdom. BME trainees are known to have lower performance rates in medical examinations, including undergraduate and postgraduate exams, Annual Review of Competence Progression, as well as training and consultant job applications. Studies have shown that BME candidates have a higher likelihood of failing both parts of the Membership of the Royal Colleges of Surgeons exams and are 10% less likely to be considered suitable for core surgical training. Several contributing factors have been identified; however, there has been limited evidence investigating surgical training experiences and their relationship to differential attainment. To understand the nature of differential attainment in surgery and to develop effective strategies to address it, it is essential to examine the underlying causes and contributing factors. The Variation in Experiences and Attainment in Surgery Between Ethnicities of UK Medical Students and Doctors (ATTAIN) study aims to describe and compare the factors and outcomes of attainment between different ethnicities of doctors and medical students. OBJECTIVE: The primary aim will be to compare the effect of experiences and perceptions of surgical education of students and doctors of different ethnicities. METHODS: This protocol describes a nationwide cross-sectional study of medical students and nonconsultant grade doctors in the United Kingdom. Participants will complete a web-based questionnaire collecting data on experiences and perceptions of surgical placements as well as self-reported academic attainment data. A comprehensive data collection strategy will be used to collect a representative sample of the population. A set of surrogate markers relevant to surgical training will be used to establish a primary outcome to determine variations in attainment. Regression analyses will be used to identify potential causes for the variation in attainment. RESULTS: Data collected between February 2022 and September 2022 yielded 1603 respondents. Data analysis is yet to be competed. The protocol was approved by the University College London Research Ethics Committee on September 16, 2021 (ethics approval reference 19071/004). The findings will be disseminated through peer-reviewed publications and conference presentations. CONCLUSIONS: Drawing upon the conclusions of this study, we aim to make recommendations on educational policy reforms. Additionally, the creation of a large, comprehensive data set can be used for further research. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/40545.

Psychometric properties of the Burnout Assessment Tool across four countries.

BACKGROUND: The Burnout Assessment Tool (BAT) is a new burnout measure developed to replace the Maslach Burnout Inventory (MBI). Studies have supported the psychometric properties and cross-cultural measurement invariance of the BAT. However, some unresolved questions remain. These questions are the appropriate level of score interpretation, convergent validity with the MBI, and measurement invariance using sample groups from countries outside of Europe. METHODS: We used a cross-sectional survey approach to obtain 794 participants from Australia (n = 200), the Netherlands (n = 199), South Africa (n = 197), and the United States (n = 198). In brief, we used bifactor modelling to investigate the appropriate score interpretation and convergent validity with the MBI. Hereafter, we used the Rasch model and ordinal logistic regression to investigate differential item functioning. RESULTS: The bifactor model showed a large general factor and four small group factors, which suggests calculating and interpreting a general burnout score. This model further shows that the BAT and MBI measure the same burnout construct but that the BAT is a more comprehensive burnout measure. Most items fit the Rasch model, and few showed non-negligible differential item functioning. CONCLUSIONS: Our results support the psychometric properties and cross-cultural measurement invariance of the BAT in Australia, the Netherlands, South Africa, and the United States. Furthermore, we provide some clarity on the three previously mentioned unresolved questions.

Euro-Burn I: Assessment of burnout syndrome in health workers in a mediterranean country during the SARS-CoV-2 pandemic.

BACKGROUND: Burnout syndrome (BS) has a negative impact among health professionals. AIMS: Our research objective is to quantify the level of burnout in health workers of the Spanish National Health System during the COVID-19 pandemic using and comparing two independent measurement instruments. METHODS: Cross-sectional, descriptive and multicenter study conducted through an anonymous online survey among health workers of the National Health System, measuring the level of burnout using the Maslach Burnout Inventory (MBI) and the Copenhagen Burnout Inventory (CBI). RESULTS: A total of 448 questionnaires were analyzed, the mean age of the participants was 43.53 years (range: 20-64), 365 (81.5%) women. 161 (35.9%) participants presented BS measured with the MBI and 304 (67.9%) measured with the CBI. Regarding work contract, those who had greater job stability presented a higher degree of cynicism with respect to the eventual ones (p = .010), the eventual ones presenting higher mean scores in professional efficacy (p = .034). Urban workers had higher scores of exhaustion (p < .001) and cynicism (p < .001) than those living in rural areas. When comparing both tests, a high predictive value for exhaustion and cynicism was found to measure BS through the CBI (AUC = 0.92 and 0.84, respectively) and a low AUC with respect to the predictive value for efficacy (AUC = 0, 59). CONCLUSIONS: The results obtained show a high level of BS among the health workers who participated in our study. Both tests have an excellent correlation in the degree of exhaustion and cynicism, but not in efficacy. The BS measurement must be performed with at least two validated instruments to increase its reliability.

Reliability and validity study of the Thai adaptation of the Maslach Burnout Inventory-Student Survey among preclinical medical students at a medical school in Thailand.

Burnout syndrome is characterized by emotional exhaustion, cynicism, and lack of professional efficacy. A considerable proportion of medical students experience burnout syndrome during their educational training. Therefore, this issue has become a major concern in the medical education community. The Maslach Burnout Inventory-Student Survey (MBI-SS) is the most widely used assessment of burnout syndrome among college students, including preclinical medical students. Therefore, our objective was to culturally modify and validate the MBI-SS in a Thai context for use with preclinical medical students. The MBI-SS comprises 16 items, including five items for emotional exhaustion, five items for cynicism, and six items for academic efficacy. Four hundred and twenty-six preclinical medical students participated in this study. We randomly divided the samples into two equivalent subsamples of 213 participants. The first subsample was used to calculate McDonald's omega coefficients to assess internal consistency and to perform exploratory factor analysis. McDonald's omega coefficients for exhaustion, cynicism, and academic efficacy were 0.877, 0.844, and 0.846, respectively. The scree plot from the unweighted least squares estimation and a direct oblimin rotation, supplemented with Horn's parallel analysis and the Hull method, revealed three major factors of the Thai MBI-SS. Due to the violation of the multivariate normality assumption in the second subsample, we performed a confirmatory factor analysis with the unweighted least squares with a mean and variance adjusted estimation approach. The results of the confirmatory factor analysis showed favorable goodness-of-fit indices. Data from 187 out of 426 participants (43.9%), who completed a second questionnaire, were utilized to evaluate test-retest reliability. The correlation coefficients for test-retest reliability with a three-week period between tests were 0.724, 0.760, and 0.769 for the exhaustion, cynicism, and academic efficacy domains, respectively (all p < 0.05). This indicates that the Thai MBI-SS is a valid and reliable instrument to assess burnout syndrome in our Thai preclinical medical student population.