Prevalence of burnout and its relationship to health status and social support in more than 1000 subspecialty anesthesiologists.

BACKGROUND: Physician burnout may be at 'epidemic' proportions due to factors associated with modern healthcare practice and technology. Practice attributes vary appreciably among subspecialists. Understanding burnout incidence and its associated factors could illuminate potential causes and interventions. We evaluated burnFout, mental and physical health, and social support and coping skills in acute and chronic pain physicians and pediatric and cardiac anesthesiologists. METHODS: We administered the Maslach Burnout Inventory Human Services Survey (MBI-HSS), a two-item self-identified burnout measure, the Veterans RAND 12-item Health Survey and the Social Support and Personal Coping Survey to subspecialty society members practicing acute and chronic pain management, pediatric anesthesiology and cardiac anesthesiology. Multivariable regression analysis compared the groups, and adjusted burnout prevalence was compared with an all-physician and an employed general population sample. RESULTS: Among 1303 participants (response rates 21.6%-35.6% among the subspecialty groups), 43.4% met established burnout criteria (range 30.0%-62.3%). Chronic pain physicians had significantly worse scores (unadjusted) than the other three groups of subspecialty anesthesiologists, the all-physician comparator group and the general population comparator group. Mental health inversely correlated with emotional exhaustion and depersonalization in all groups. Self-identified burnout correlated with the full MBI-HSS (R=0.54; positive predictive value of 0.939 (0.917, 0.955)). Physicians' scores for personal accomplishment were higher than population norms. CONCLUSIONS: This study provides data on burnout prevalence and associated demographic, health and social factors in subspecialist anesthesiologists. Chronic pain anesthesiologists had significantly greater burnout than the other groups. The self-identified burnout metric performed well and may be an attractive alternative to the full MBI-HSS.

Perianesthesia Nurses Pain Management Practices: Findings and Recommendations From a National Descriptive Study of Members of the American Society of Perianesthesia Nurses.

PURPOSE: The purpose of this study was to identify current individual practice of perianesthesia nurses regarding assessment and documentation of pain. DESIGN: Descriptive cross-sectional design using vignette technique. METHODS: Vignettes with questions available via electronic survey offered to attendees of the 2017 American Society of PeriAnesthesia Nurses National Conference. FINDINGS: Total of 1,680 perianesthesia nurses participated; 41.4% reported assessment of pain compared with 36.7% who reported documentation of pain assessment. The numeric (0 to 10) pain intensity score was the most commonly used assessment method. Only 16.4% assessed for and documented pain location, 14.4% assessed for and documented quality of pain. CONCLUSIONS: Pain assessment should include intensity, location, quality, and functional impact. The gap between nurses' practices in assessment and documention of pain may be related to system barriers. Embedding evidence-based best practice within electronic health records may improve both. Prior literature, as well as our findings, indicate these trends (missed documentation and assessment) are more global than only perianesthesia nursing.

Uses of Complementary and Alternative Medicine for Perioperative and Other Patients.

The efficacy of using complementary and alternative medicine (CAM) is supported by the literature to decrease preoperative anxiety, postoperative pain and opioid requirements, as well as nausea and vomiting and to improve severity of headaches and increase wound healing. Nursing care includes interventions using CAs for treatment of a range of patient needs. Being supportive while educating parents and patients demonstrates altruism, which also is beneficial for improving health outcomes with CAM.

Burnout and Resiliency in Perianesthesia Nurses: Findings and Recommendations From a National Study of Members of the American Society of PeriAnesthesia Nurses.

PURPOSE: Describe prevalence of burnout in perianesthesia nurses, explore risks, mitigating factors. DESIGN: Cross-sectional descriptive. METHODS: Survey containing Maslach Burnout Inventory, Short Form-12, and Social Support and Personal Coping was emailed to American Society of PeriAnesthesia Nurses. Regression analysis examined relationships between burnout and health, social support, personal coping, substance use, and demographics. FINDINGS: Of 2,837 respondents, 18% were currently and 35% were formerly burned out, with lower incidence in those >40 years. Currently burned out nurses had worse health and also perceived a lack of advancement opportunities and organizational investment in the individual. Lower burnout was associated with regular participation in physical (P < .001), creative (P = .004), or mindfulness hobbies (P < .001) and ease in discussing work problems with spouse or partner (P = .001). CONCLUSIONS: Despite burnout nurses' empathy for their patients is maintained. Interests outside of work, personal and work support, healthy work environment, and regular physical activities can improve burnout.

A Survey Evaluating Burnout, Health Status, Depression, Reported Alcohol and Substance Use, and Social Support of Anesthesiologists.

BACKGROUND: Burnout affects all medical specialists, and concern about it has become common in today's health care environment. The gold standard of burnout measurement in health care professionals is the Maslach Burnout Inventory-Human Services Survey (MBI-HSS), which measures emotional exhaustion, depersonalization (DP), and personal accomplishment. Besides affecting work quality, burnout is thought to affect health problems, mental health issues, and substance use negatively, although confirmatory data are lacking. This study evaluates some of these effects. METHODS: In 2011, the American Society of Anesthesiologists and the journal Anesthesiology cosponsored a webinar on burnout. As part of the webinar experience, we included access to a survey using MBI-HSS, 12-item Short Form Health Survey (SF-12), Social Support and Personal Coping (SSPC-14) survey, and substance use questions. Results were summarized using sample statistics, including mean, standard deviation, count, proportion, and 95% confidence intervals. Adjusted linear regression methods examined associations between burnout and substance use, SF-12, SSPC-14, and respondent demographics. RESULTS: Two hundred twenty-one respondents began the survey, and 170 (76.9%) completed all questions. There were 266 registrants total (31 registrants for the live webinar and 235 for the archive event), yielding an 83% response rate. Among respondents providing job titles, 206 (98.6%) were physicians and 2 (0.96%) were registered nurses. The frequency of high-risk responses ranged from 26% to 59% across the 3 MBI-HSS categories, but only about 15% had unfavorable scores in all 3. Mean mental composite score of the SF-12 was 1 standard deviation below normative values and was significantly associated with all MBI-HSS components. With SSPC-14, respondents scored better in work satisfaction and professional support than in personal support and workload. Males scored worse on DP and personal accomplishment and, relative to attending physicians, residents scored worse on DP. There was no significant association between MBI-HSS and substance use. CONCLUSIONS: Many anesthesiologists exhibit some high-risk burnout characteristics, and these are associated with lower mental health scores. Personal and professional support were associated with less emotional exhaustion, but overall burnout scores were associated with work satisfaction and professional support. Respondents were generally economically satisfied but also felt less in control at work and that their job kept them from friends and family. The association between burnout and substance use may not be as strong as previously believed. Additional work, perhaps with other survey instruments, is needed to confirm our results.