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1.
J Nurs Adm ; 50(2): 109-114, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31929346

RESUMEN

OBJECTIVE: Evaluate the use of the Innovation Studio on interprofessional collaboration and attitudes toward interprofessional learning, job satisfaction, and intent to stay. BACKGROUND: The healthcare workforce is experiencing high burnout rates, and providers are unsatisfied with their work. Evidence supports that interprofessional collaboration is a key strategy to increase job satisfaction and intent to stay in healthcare professionals. The Innovation Studio is a tool to engage healthcare providers in interprofessional collaboration. METHODS: A pretest/posttest evaluation of the Innovation Studio with 14 healthcare professionals was conducted with self-reported scores on job satisfaction, readiness for interprofessional learning, and intent to stay as outcomes. RESULTS: Positive effects were found on interprofessional learning and intent to stay, but not job satisfaction. Eleven interprofessional projects were developed. Responses to open-ended questions indicated satisfaction with the Innovation Studio. CONCLUSIONS: The Innovation Studio was successful in stimulating numerous interprofessional projects and had a positive effect on interprofessional learning and intent to stay.


Asunto(s)
Actitud del Personal de Salud , Agotamiento Profesional/psicología , Personal de Salud/psicología , Relaciones Interprofesionales , Satisfacción en el Trabajo , Personal de Enfermería en Hospital/psicología , Reorganización del Personal , Adulto , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios
2.
BMC Public Health ; 20(1): 21, 2020 Jan 07.
Artículo en Inglés | MEDLINE | ID: mdl-31910832

RESUMEN

BACKGROUND: Professional caregivers working in child and youth welfare institutions are frequently faced with the complex mental health issues, emotional needs and challenging coping strategies of clients with cumulated traumatic experiences, leaving them prone to developing high levels of stress, burn-out and compassion fatigue. Trauma-informed care (TIC) is a milieu-therapeutic approach that aims to promote the self-efficacy and self-care of youth welfare staff by guiding them to a better understanding of their own and their clients' stress symptoms and countertransference. Despite increasing efforts to implement TIC practices, and more widespread recognition of their value in youth welfare systems, there is a lack of studies evaluating the effectiveness of this approach. The aim of this study was to assess the effects of TIC practices in youth welfare institutions on both the physiological stress of staff members and clients' physical aggression towards their caregivers. . METHODS: Data was obtained from a longitudinal study investigating the effectiveness of TIC in 14 residential youth welfare institutions. Our sample consisted of 47 youth welfare employees (66.0% female) aged from 23 to 60 years (M = 37.4, SD = 10.4 years). Hair cortisol concentration (HCC) and occurrences of client physical aggression were assessed at four annual measurement time points (T1 to T4). RESULTS: Participants in five institutions employing TIC practices (intervention group) showed significantly lower HCC at T4 than staff members from institutions who did not receive training in TIC (control group), indicating reduced physiological stress levels. At T4, the intervention group reported significantly less physical aggression than the control group. CONCLUSIONS: TIC might be a promising approach for reducing the emotional burden of employees and institutions should invest in training their staff in TIC practices. More research is necessary, to investigate the benefits and efficacy of TIC, both to youths and staff members, and to foster a better understanding of which specific factors may contribute to stress reduction.


Asunto(s)
Adaptación Psicológica , Agresión/psicología , Agotamiento Profesional/psicología , Cabello/química , Personal de Salud/psicología , Hidrocortisona/análisis , Estrés Psicológico , Adolescente , Adulto , Niño , Femenino , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Adulto Joven
5.
J Clin Nurs ; 29(1-2): 184-194, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31609523

RESUMEN

AIMS AND OBJECTIVES: To explore newly graduated nurses' strategies for, and experiences of, sleep problems and fatigue when starting shiftwork. A more comprehensive insight into nurses' strategies, sleep problems, fatigue experiences and contributing factors is needed to understand what support should be provided. BACKGROUND: For graduate nurses, the first years of practice are often stressful, with many reporting high levels of burnout symptoms. Usually, starting working as a nurse also means an introduction to shiftwork, which is related to sleep problems. Sleep problems may impair stress management and, at the same time, stress may cause sleep problems. Previously, sleep problems and fatigue have been associated with burnout, poor health and increased accident risk. DESIGN AND METHODS: Semi-structured interviews were conducted with nurses (N = 11) from four different Swedish hospitals, and qualitative inductive content analysis was used. The study was approved by the Regional Ethical Review Board in Stockholm. The COREQ checklist was followed. RESULTS: Many nurses lacked effective strategies for managing sleep and fatigue in relation to shiftwork. Various strategies were used, of which some might interfere with factors regulating and promoting sleep such as the homeostatic drive. Sleep problems were common during quick returns, often due to difficulties unwinding before sleep, and high workloads exacerbated the problems. The described consequences of fatigue in a clinical work context indicated impaired executive and nonexecutive cognitive function. CONCLUSION: The findings indicate that supporting strategies and behaviours for sleep and fatigue in an intervention for newly graduated nurses starting shiftwork may be of importance to improve well-being among nurses and increase patient safety. RELEVANCE TO CLINICAL PRACTICE: This study highlights the importance of addressing sleep and fatigue issues in nursing education and work introduction programmes to increase patient safety and improve well-being among nurses.


Asunto(s)
Agotamiento Profesional/psicología , Fatiga/etiología , Enfermeras y Enfermeros/psicología , Sueño/fisiología , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Investigación Cualitativa , Tolerancia al Trabajo Programado
6.
Int J Occup Med Environ Health ; 32(6): 841-851, 2019 Nov 15.
Artículo en Inglés | MEDLINE | ID: mdl-31680689

RESUMEN

OBJECTIVES: The aim of this exploratory study was to analyze the association between emotional dissonance and emotional exhaustion among healthcare professionals, and the mediating role of the perceived quality of care in this relationship. MATERIAL AND METHODS: Self-report questionnaires were administered to 724 healthcare workers. The measurement model was tested and the mediation hypothesis was verified through hierarchical multiple regression analyses. Bootstrapping was used to construct confidence intervals to evaluate the mediation effects. RESULTS: Emotional dissonance was significantly related to emotional exhaustion, and the perceived quality of care was negatively related to emotional exhaustion. The perceived quality of care had a partial mediating effect on the relationship between emotional dissonance and emotional exhaustion. Emotional dissonance had a significant effect on emotional exhaustion, and the perceived quality of care was a mediating factor in this relationship among healthcare professionals. CONCLUSIONS: The management of the perceived quality of care may be helpful in the prevention of burnout and distress in the workplace. Int J Occup Med Environ Health. 2019;32(6):841-51.


Asunto(s)
Emociones , Personal de Salud/psicología , Calidad de la Atención de Salud , Lugar de Trabajo/psicología , Adulto , Agotamiento Profesional/psicología , Estudios Transversales , Femenino , Humanos , Italia/epidemiología , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios
7.
Psychiatr Danub ; 31(4): 483-486, 2019 Dec.
Artículo en Alemán | MEDLINE | ID: mdl-31698406

RESUMEN

Emergency personnel, but also medical personnel and other assisting groups have a significantly increased risk of developing trauma disorder after extreme work-related experiences. In order to counter these, Germany offers extensive preventive measures for primary, secondary and tertiary prevention. The aim of this article is to outline the most important elements of psychosocial support for second victims. Psychoeducation is an important and effective component of these concepts. Finally, the most frequently formulated question, why conversations about critical incidents are helpful, is revisited.


Asunto(s)
Agotamiento Profesional/prevención & control , Servicios Médicos de Urgencia , Medicina de Emergencia , Personal de Salud/psicología , Apoyo Social , Trastornos por Estrés Postraumático/prevención & control , Agotamiento Profesional/psicología , Alemania , Humanos , Trastornos por Estrés Postraumático/psicología
8.
N Engl J Med ; 381(18): 1741-1752, 2019 10 31.
Artículo en Inglés | MEDLINE | ID: mdl-31657887

RESUMEN

BACKGROUND: Physicians, particularly trainees and those in surgical subspecialties, are at risk for burnout. Mistreatment (i.e., discrimination, verbal or physical abuse, and sexual harassment) may contribute to burnout and suicidal thoughts. METHODS: A cross-sectional national survey of general surgery residents administered with the 2018 American Board of Surgery In-Training Examination assessed mistreatment, burnout (evaluated with the use of the modified Maslach Burnout Inventory), and suicidal thoughts during the past year. We used multivariable logistic-regression models to assess the association of mistreatment with burnout and suicidal thoughts. The survey asked residents to report their gender. RESULTS: Among 7409 residents (99.3% of the eligible residents) from all 262 surgical residency programs, 31.9% reported discrimination based on their self-identified gender, 16.6% reported racial discrimination, 30.3% reported verbal or physical abuse (or both), and 10.3% reported sexual harassment. Rates of all mistreatment measures were higher among women; 65.1% of the women reported gender discrimination and 19.9% reported sexual harassment. Patients and patients' families were the most frequent sources of gender discrimination (as reported by 43.6% of residents) and racial discrimination (47.4%), whereas attending surgeons were the most frequent sources of sexual harassment (27.2%) and abuse (51.9%). Proportion of residents reporting mistreatment varied considerably among residency programs (e.g., ranging from 0 to 66.7% for verbal abuse). Weekly burnout symptoms were reported by 38.5% of residents, and 4.5% reported having had suicidal thoughts during the past year. Residents who reported exposure to discrimination, abuse, or harassment at least a few times per month were more likely than residents with no reported mistreatment exposures to have symptoms of burnout (odds ratio, 2.94; 95% confidence interval [CI], 2.58 to 3.36) and suicidal thoughts (odds ratio, 3.07; 95% CI, 2.25 to 4.19). Although models that were not adjusted for mistreatment showed that women were more likely than men to report burnout symptoms (42.4% vs. 35.9%; odds ratio, 1.33; 95% CI, 1.20 to 1.48), the difference was no longer evident after the models were adjusted for mistreatment (odds ratio, 0.90; 95% CI, 0.80 to 1.00). CONCLUSIONS: Mistreatment occurs frequently among general surgery residents, especially women, and is associated with burnout and suicidal thoughts.


Asunto(s)
Agotamiento Profesional/epidemiología , Cirugía General/educación , Internado y Residencia , Abuso Físico/estadística & datos numéricos , Acoso Sexual/estadística & datos numéricos , Discriminación Social/estadística & datos numéricos , Agotamiento Profesional/psicología , Femenino , Humanos , Masculino , Estado Civil , Cuerpo Médico de Hospitales , Personal de Hospital , Abuso Físico/psicología , Relaciones Médico-Paciente , Relaciones Profesional-Familia , Factores Sexuales , Acoso Sexual/psicología , Discriminación Social/psicología , Ideación Suicida , Encuestas y Cuestionarios , Estados Unidos/epidemiología
9.
J Bone Joint Surg Am ; 101(19): e102, 2019 Oct 02.
Artículo en Inglés | MEDLINE | ID: mdl-31577687

RESUMEN

BACKGROUND: Resident burnout-the state of exhaustion, maladaptive detachment, and low sense of accomplishment-is a widely documented phenomenon that affects between 27% and 75% of residents in the United States. To our knowledge, no previous study has examined the relationship between resident burnout and performance on the Orthopaedic In-Training Examination (OITE). The current investigation sought to evaluate whether an association exists between indices of orthopaedic surgery resident burnout as assessed by the Maslach Burnout Inventory (MBI) and performance on the OITE. METHODS: In a cross-sectional study of the orthopaedic surgery residents at a single large academic institution, the MBI was completed by all trainees in May 2016. The results of the 2016 OITE were documented for each resident, including the percentage of correctly answered questions and OITE percentile ranking. To control for individual test-taking skills, United States Medical Licensing Examination (USMLE) Step-1 and Step-2 scores also were documented for each resident. The relationship between the MBI subscale scores and OITE performance was evaluated. RESULTS: The analysis included 100% of the 62 orthopaedic surgery residents in training at our institution. Sixteen (25.8%) of the residents experienced at least moderate emotional exhaustion, while 32 (51.6%) of the residents experienced at least moderate depersonalization and 8 (12.9%) of the residents experienced a moderate sense of impaired personal accomplishment. Postgraduate year (PGY)-2 residents had the highest emotional exhaustion and depersonalization scores compared with residents in other years of training. Each of the 3 MBI indices of burnout was associated with worse OITE performance when controlling for general test-taking ability. CONCLUSIONS: In this study of orthopaedic surgery residents at a large academic training program, burnout was present among residents in all PGYs of training; it was most prevalent during the second year of training. Increased levels of the 3 components of burnout were associated with worse performance on the OITE. While there is a lack of consensus in the existing literature, this study provides additional evidence that burnout is negatively associated with 1 aspect of overall resident performance. CLINICAL RELEVANCE: Orthopaedic surgery residency training is challenging; residents are tasked to acquire a considerable amount of knowledge, develop complex surgical skills, and hone critical clinical thinking in a relatively short period of time. Identifying modifiable contributors to resident burnout and the development of strategies to promote resident wellness during training are important as we strive toward developing the next generation of capable, competent, and well-balanced orthopaedic surgeons.


Asunto(s)
Agotamiento Profesional/psicología , Competencia Clínica/normas , Internado y Residencia/normas , Ortopedia/educación , Éxito Académico , Estudios Transversales , Evaluación Educacional , Humanos , Cirujanos Ortopédicos/educación , Cirujanos Ortopédicos/psicología , Cirujanos Ortopédicos/normas , Encuestas y Cuestionarios , Estados Unidos
11.
Artículo en Inglés | MEDLINE | ID: mdl-31614684

RESUMEN

Extensive evidence indicates that burnout can have detrimental consequences for individuals as well as organizations; therefore, there is a great need for burnout prevention. While burnout prevention interventions initiated by the employer have previously been studied, the proactive behaviors employees deploy themselves to prevent burnout have received less research attention. The purpose of this exploratory qualitative interview study was to enhance our understanding of the self-initiated actions employees undertake to prevent burnout, using the model of proactive motivation and conservation of resources theory as theoretical frameworks. Findings indicated that most participants reported to engage in specific kinds of proactive burnout prevention behaviors. The reported self-initiated proactive actions were aimed at maintaining and/or increasing resources and/or reducing demands in the work, home, and personal domain. The study contributes to the literature by linking the proactive motivation process to the prevention of burnout and by focusing on both work and non-work factors. Results of this study can be used in further research into the (effectiveness of) employees' proactive burnout prevention behaviors and serve as a starting point for developing interventions aimed at enhancing proactive burnout prevention.


Asunto(s)
Agotamiento Profesional/prevención & control , Conductas Relacionadas con la Salud , Trabajo/psicología , Agotamiento Profesional/psicología , Humanos , Encuestas y Cuestionarios
12.
Rev Lat Am Enfermagem ; 27: e3175, 2019.
Artículo en Portugués, Inglés, Español | MEDLINE | ID: mdl-31596410

RESUMEN

OBJECTIVE: to assess compassion fatigue levels among nurses and its variation according socio-demographic and professional characteristics. METHOD: quantitative, descriptive and cross-sectional study, with 87 nurses from an emergency and urgent care unit for adults from a university hospital. A socio-demographic and professional questionnaire, along with the Professional Quality of Life Scale 5 were used. Data analysis was performed using descriptive and inferential statistics. RESULTS: compassion satisfaction presents the highest means, followed by burnout and secondary traumatic stress. Among the participants, 51% presented a high level of compassion satisfaction, 54% a high level of burnout, and 59% a high level of secondary traumatic stress. Older participants presented higher score of compassion satisfaction, and younger nurses, women, nurses having less job experience and nurses without leisure activities showed higher means of secondary traumatic stress. CONCLUSION: we found compassion fatigue, expressed in the large percentage of nurses with high levels of burnout and secondary traumatic stress. Fatigue is related to individual factors such as age, gender, job experience and leisure activities. Doing research and understanding this phenomenon allow the development of health promotion strategies at work.


Asunto(s)
Agotamiento Profesional/psicología , Desgaste por Empatía/psicología , Personal de Enfermería en Hospital/psicología , Calidad de Vida/psicología , Adulto , Estudios Transversales , Demografía , Enfermería de Urgencia , Femenino , Humanos , Satisfacción en el Trabajo , Masculino , Persona de Mediana Edad , Factores Sexuales , Encuestas y Cuestionarios
13.
J Leg Med ; 39(3): 235-246, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31626578

RESUMEN

We surveyed New York physicians to study their perceptions of reporting requirements related to their own mental health care on professional applications, including whether they were experiencing symptoms of burnout. Over half of the responding physicians reported experiencing symptoms of burnout and these physicians were at increased odds of perceiving a barrier to seeking mental health care if they had to report such care on professional applications and renewals for medical licensure, malpractice, and hospital privileges and credentialing compared to physicians not experiencing symptoms of burnout. As state medical boards, hospitals, and insurers seek information to help assess risks posed by physicians, it is essential to strike an appropriate balance between their duty to protect the public and the physician's right to confidentiality. This balance can be assessed based on the questions that are asked on various professional applications and how information gleaned through physician responses is used. Overly intrusive questions, though well intentioned to protect the public, may run counter to current interpretations of federal law and may inhibit care-seeking among physicians, which is critical to both patient safety and physician health.


Asunto(s)
Actitud del Personal de Salud , Agotamiento Profesional/psicología , Notificación Obligatoria , Salud Mental , Médicos/psicología , Habilitación Profesional , Encuestas de Atención de la Salud , Humanos , Solicitud de Empleo , Licencia Médica , New York/epidemiología , Sociedades Médicas
14.
Ned Tijdschr Geneeskd ; 1632019 10 01.
Artículo en Holandés | MEDLINE | ID: mdl-31580034

RESUMEN

Burnout is a serious health problem and the cause of career disruption in 15% of women and 9% of men who quit their job. Of all work-related complaints, 37% is attributable to workload and stress. Many workers visit their general practitioner with work-related complaints. Recently, the Dutch College of General Practitioners (NederlandsHuisartsenGenootschap) published a guideline on burnout. While the guideline provides a good framework for managing patients with a burnout, additional attention could be paid to prevention and how to distinguish burnout from depression.


Asunto(s)
Agotamiento Profesional/diagnóstico , Depresión/diagnóstico , Medicina Familiar y Comunitaria/normas , Enfermedades Profesionales/diagnóstico , Agotamiento Profesional/psicología , Depresión/psicología , Medicina Familiar y Comunitaria/métodos , Femenino , Humanos , Masculino , Países Bajos , Enfermedades Profesionales/psicología , Guías de Práctica Clínica como Asunto , Carga de Trabajo/psicología
15.
J Nurs Adm ; 49(10): 487-495, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31517756

RESUMEN

OBJECTIVE: The purpose of this study was to evaluate the effects of the MINDBODYSTRONG for Healthcare Professionals Program on stress, anxiety, depressive symptoms, healthy lifestyle behaviors, and job satisfaction on newly licensed RNs (NLRNs) participating in a nurse residency program. BACKGROUND: The constellation of burnout, depression, and suicide in clinicians is a public health epidemic that affects the quality and safety of healthcare. The National Academy of Medicine's Action Collaborative on Clinician Well-being and Resilience has called for an increase in evidence-based interventions to combat this alarming problem. The MINDBODYSTRONG Program is a novel adaptation of an evidence-based cognitive behavioral skills-building intervention that provides a theory-based approach to improve the mental health, healthy lifestyle beliefs and behaviors, and job satisfaction of NLRNs. METHODS: A 2-group, cluster randomized controlled trial was used with 89 new nurses participating in a new-graduate nurse residency program. The experimental intervention, MINDBODYSTRONG, consisted of 8 manualized weekly 45-minute sessions. Data were collected at baseline, immediately following, and 3 months after intervention that measured stress, depressive symptoms, anxiety, healthy lifestyle beliefs and behaviors, and job satisfaction. Repeated-measures analysis of variance was used for data analysis. RESULTS: The intervention group scored significantly better with moderate to large positive effects on the mental health variables as well as healthy lifestyle beliefs and healthy lifestyle behaviors at both follow-up time points compared with the attention control group. Moderate to large positive effects also were found for job satisfaction. CONCLUSIONS: The MINDBODYSTRONG Program has excellent potential as an evidence-based intervention for improving the mental health, healthy lifestyle beliefs and behaviors, and job satisfaction, in NLRNs.


Asunto(s)
Terapia Conductista/métodos , Agotamiento Profesional/prevención & control , Agotamiento Profesional/psicología , Estilo de Vida Saludable , Trastornos Mentales/prevención & control , Trastornos Mentales/psicología , Personal de Enfermería en Hospital/psicología , Adulto , Actitud del Personal de Salud , Femenino , Humanos , Satisfacción en el Trabajo , Masculino , Adulto Joven
16.
Medicine (Baltimore) ; 98(37): e17117, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31517849

RESUMEN

BACKGROUND: Burnout negatively impacts the mental and physical health doctors. More seriously, it leads to poor patient care. In China, the situation is severe and more efforts are needed to reveal the epidemiological characteristics of doctor burnout to develop improved strategies of alleviating it. Due to the large number of heterogeneous and sample size-restricted surveys currently published, meta-analysis and systematic reviews are critical to a thorough understanding of burnout among Chinese doctors. METHODS: The Cochrane Collaboration criteria and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) will be followed to conduct and report the systematic review. We will conduct a comprehensive search on the data bases of China National Knowledge Infrastructure (CNKI), WanFang, PubMed, EMBASE, PsycINFO, and the Cochrane Library from their inception to December 2018. Prospective cohort and cross-sectional studies that described the prevalence of Chinese doctors' prevalence will be eligible for inclusion. The risk of bias and methodological quality of the included studies will be assessed using a risk of bias tool and the Cochrane guidelines for observational studies. A generalized linear mixed model framework with the Poisson likelihood and the log link function will be used to access the incidence rate ratio. Multivariate Poisson regression framework will be conducted to adjust modeling heterogeneity and confounders, like difference regions and time periods. The risk of bias, heterogeneity, and quality of evidence will be assessed in accordance with the aforementioned guidelines. RESULTS: The primary outcome will be the prevalence and distribution of 3 dimension of burnout in Chinese doctors, and the second will be the difference of prevalence between difference regions and time periods. DISCUSSION: This systematic review and meta-analysis will help us to reveal the prevalence, characteristics, timeline, and correlation between these factors in burnout; we expect our work may provide a scientific basis for further prevention and intervention of burnout in Chinese doctors, eventually to improve the quality of health care. PROSPERO REGISTRATION NUMBER: CRD42018104249.


Asunto(s)
Agotamiento Profesional/complicaciones , Médicos/psicología , Agotamiento Profesional/psicología , China , Humanos , Médicos/estadística & datos numéricos
19.
BMC Public Health ; 19(1): 1247, 2019 Sep 11.
Artículo en Inglés | MEDLINE | ID: mdl-31510975

RESUMEN

BACKGROUND: Burnout is characterized by physical and emotional exhaustion from long-term exposure to emotionally demanding work. Burnout affects interpersonal skills, job performance, career satisfaction, and psychological health. However, little is known about the burden of burnout among healthcare providers in sub-Saharan Africa. METHODS: Relevant articles were identified through a systematic review of PubMed, Web of Science (Thomson Reuters), and PsycINFO (EBSCO). Studies were selected for inclusion if they examined a quantitative measure of burnout among healthcare providers in sub-Saharan Africa. RESULTS: A total of 65 articles met our inclusion criteria for this systematic review. Previous studies have examined burnout in sub-Saharan Africa among physicians (N = 12 articles), nurses (N = 26), combined populations of healthcare providers (N = 18), midwives (N = 2), and medical or nursing students (N = 7). The majority of studies assessed burnout using the Maslach Burnout Inventory. The highest levels of burnout were reported among nurses, although all healthcare providers showed high burnout. Burnout among healthcare providers is associated with their work environments, interpersonal and professional conflicts, emotional distress, and low social support. CONCLUSIONS: Available studies on this topic are limited by several methodological challenges. More rigorously designed epidemiologic studies of burnout among healthcare providers are warranted. Health infrastructure improvements will eventually be essential, though difficult to achieve, in under-resourced settings. Programs aimed at raising awareness and coping with burnout symptoms through stress management and resilience enhancement trainings are also needed.


Asunto(s)
Agotamiento Profesional/psicología , Personal de Salud/psicología , Satisfacción en el Trabajo , Lugar de Trabajo/psicología , Adaptación Psicológica , Adulto , África del Sur del Sahara , Agotamiento Profesional/epidemiología , Femenino , Personal de Salud/estadística & datos numéricos , Humanos , Masculino , Estrés Laboral/psicología , Médicos/psicología , Lugar de Trabajo/estadística & datos numéricos
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