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3.
Surg Clin North Am ; 99(5): 1029-1035, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31446908

RESUMO

Burnout is characterized by emotional exhaustion, depersonalization, and a reduced sense of personal accomplishment. All physicians, and especially surgeons, are at risk for developing burnout. The best strategies for mitigating burnout mimic a modern approach to medicine: the development of preventive practices to protect, promote, and maintain health and well-being. Job satisfaction, job engagement, and compassion satisfaction help protect from burnout. Individual commitment to self-care in conjunction with support from within health care organizations create the optimal framework in which burnout can be mitigated.


Assuntos
Esgotamento Profissional/prevenção & controle , Fadiga por Compaixão/prevenção & controle , Esgotamento Profissional/psicologia , Estilo de Vida Saudável , Humanos , Satisfação no Emprego , Fatores de Risco , Autocuidado
5.
J Nurs Adm ; 49(9): 404-410, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31425307

RESUMO

OBJECTIVE: To examine and report burnout, secondary trauma, and compassion satisfaction in acute care nurse leaders through a large mixed-methods research study. BACKGROUND: Although nurse leaders are removed from daily patient care activities, the pervasive challenges in the work environment create conditions for professional burnout. Nurse leaders must garner compassion satisfaction from different sources, including peer and staff interactions. METHODS: The Professional Quality of Life scale was given to nurse leaders at 29 hospitals in 1 health system. Sixteen leaders from 2 hospitals participated in qualitative interviews. RESULTS: Six hundred seventy-two nurse leaders from 29 hospitals reported similar levels of burnout across frontline, midlevel, and director-level leadership. Directors demonstrated higher levels of compassion satisfaction and lower levels of work-life balance. Four themes emerged representing areas of professional life that potentiate and alleviate compassion fatigue. CONCLUSIONS: All levels of nurse leaders must address the risk of burnout and can do so through individual and organizational resiliency strategies.


Assuntos
Esgotamento Profissional/psicologia , Esgotamento Psicológico , Satisfação no Emprego , Enfermeiras Administradoras/psicologia , Satisfação Pessoal , Equilíbrio Trabalho-Vida , Local de Trabalho/psicologia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários
6.
J Nurs Adm ; 49(9): 411-417, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31437855

RESUMO

OBJECTIVE: The purpose of this study was to assess the relationship between demographic factors (age, gender, race, ethnicity, work status, and experience), the professional practice environment, and work satisfaction to increase understanding of millennial nurses. BACKGROUND: Millennials comprise 30% of the nursing workforce and are more likely to experience burnout, stress, high turnover, and less dedication to their workplace than other counterparts. Understanding how to retain these nurses is important to ensure work satisfaction and high-quality patient outcomes. METHODS: This descriptive study was a secondary analysis of data using the Professional Practice Work Environment Inventory survey. Descriptive statistics were used to describe the variables. Descriptive statistics and standard t tests were used. RESULTS: Demographics accounted for only 2.6% of the variance in work satisfaction, whereas supportive leadership accounted for nearly 63%. CONCLUSION: Findings demonstrate that supportive leadership is the primary factor contributing to millennial nurses' work satisfaction. This suggests that efforts to retain millennial nurses should focus on developing supportive leaders.


Assuntos
Atitude do Pessoal de Saúde , Esgotamento Profissional/psicologia , Satisfação no Emprego , Recursos Humanos de Enfermagem no Hospital/psicologia , Recursos Humanos de Enfermagem no Hospital/estatística & dados numéricos , Local de Trabalho/psicologia , Local de Trabalho/estatística & dados numéricos , Adulto , Fatores Etários , Feminino , Humanos , Masculino , Fatores Socioeconômicos , Inquéritos e Questionários , Estados Unidos , Adulto Jovem
7.
S D Med ; 72(6): 279, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31461236
8.
S D Med ; 72(7): 306-308, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31461585

RESUMO

PURPOSE: Physician burnout is prevalent in family physicians. Burnout has been associated with an intent to leave practice location. This is especially concerning in many rural areas, which already have physician shortages. While other demographic characteristics of burnout have been assessed, no previously published studies were found that have specifically compared family physician burnout rates in rural versus metropolitan areas. We hypothesized that rural family physicians have higher burnout rates due to increased practice demands and lack of resources. METHODS: Three hundred and two graduates of a Midwest family medicine residency program were surveyed to assess burnout rates in rural (practicing in towns less than 10,000 people) versus medium-sized towns (10,000- 50,000 people) and metropolitan areas (greater than 50,000 people). Burnout was determined by a one question assessment tool that has been validated with the Maslach Burnout Inventory Emotional Exhaustion Index. FINDINGS: Ninety-nine surveys were completed. Twenty-five percent of rural respondents reported burnout, compared to 37.5 percent of respondents in medium-sized towns, and 51.4 percent of respondents practicing in metropolitan areas. These results were statistically significant (p value=0.0183). CONCLUSION: These results were unexpected and may indicate that a rural practice location has a positive effect on physician well-being, which could encourage physicians to pursue rural practice. A larger study of this issue would be beneficial.


Assuntos
Esgotamento Profissional , Médicos de Família , Esgotamento Psicológico , Humanos , Médicos de Família/psicologia , Projetos Piloto , Saúde da População Rural , População Rural
9.
JAMA ; 322(3): 216-228, 2019 07 16.
Artigo em Inglês | MEDLINE | ID: mdl-31310297

RESUMO

Importance: The effects of intensive care unit (ICU) visiting hours remain uncertain. Objective: To determine whether a flexible family visitation policy in the ICU reduces the incidence of delirium. Design, Setting and Participants: Cluster-crossover randomized clinical trial involving patients, family members, and clinicians from 36 adult ICUs with restricted visiting hours (<4.5 hours per day) in Brazil. Participants were recruited from April 2017 to June 2018, with follow-up until July 2018. Interventions: Flexible visitation (up to 12 hours per day) supported by family education (n = 837 patients, 652 family members, and 435 clinicians) or usual restricted visitation (median, 1.5 hours per day; n = 848 patients, 643 family members, and 391 clinicians). Nineteen ICUs started with flexible visitation, and 17 started with restricted visitation. Main Outcomes and Measures: Primary outcome was incidence of delirium during ICU stay, assessed using the CAM-ICU. Secondary outcomes included ICU-acquired infections for patients; symptoms of anxiety and depression assessed using the HADS (range, 0 [best] to 21 [worst]) for family members; and burnout for ICU staff (Maslach Burnout Inventory). Results: Among 1685 patients, 1295 family members, and 826 clinicians enrolled, 1685 patients (100%) (mean age, 58.5 years; 47.2% women), 1060 family members (81.8%) (mean age, 45.2 years; 70.3% women), and 737 clinicians (89.2%) (mean age, 35.5 years; 72.9% women) completed the trial. The mean daily duration of visits was significantly higher with flexible visitation (4.8 vs 1.4 hours; adjusted difference, 3.4 hours [95% CI, 2.8 to 3.9]; P < .001). The incidence of delirium during ICU stay was not significantly different between flexible and restricted visitation (18.9% vs 20.1%; adjusted difference, -1.7% [95% CI, -6.1% to 2.7%]; P = .44). Among 9 prespecified secondary outcomes, 6 did not differ significantly between flexible and restricted visitation, including ICU-acquired infections (3.7% vs 4.5%; adjusted difference, -0.8% [95% CI, -2.1% to 1.0%]; P = .38) and staff burnout (22.0% vs 24.8%; adjusted difference, -3.8% [95% CI, -4.8% to 12.5%]; P = .36). For family members, median anxiety (6.0 vs 7.0; adjusted difference, -1.6 [95% CI, -2.3 to -0.9]; P < .001) and depression scores (4.0 vs 5.0; adjusted difference, -1.2 [95% CI, -2.0 to -0.4]; P = .003) were significantly better with flexible visitation. Conclusions and Relevance: Among patients in the ICU, a flexible family visitation policy, vs standard restricted visiting hours, did not significantly reduce the incidence of delirium. Trial Registration: ClinicalTrials.gov Identifier: NCT02932358.


Assuntos
Delírio/prevenção & controle , Família/psicologia , Unidades de Terapia Intensiva/organização & administração , Visitas a Pacientes , Ansiedade , Brasil , Esgotamento Profissional , Cuidados Críticos/psicologia , Estudos Cross-Over , Depressão , Feminino , Educação em Saúde , Hospitalização , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Fatores de Tempo
11.
Rev Med Chil ; 147(4): 510-517, 2019 Apr.
Artigo em Espanhol | MEDLINE | ID: mdl-31344215

RESUMO

BACKGROUND: The burnout syndrome affects more than half of students and professionals involved in healthcare worldwide and is characterized by emotional exhaustion, depersonalization and a low perception of self-efficacy. Several studies indicate that when students are burnt-out, clinical work, professionalism and ethical behavior, as well as empathy, are negatively affected, while the risk of academic attrition, depression and suicidal ideation tend to increase. At a national level, recent information shows that one out of every two medical students suffer burnout at the beginning of the clinical cycle, a situation that does not improve after finishing undergraduate medical training. There is no consensus on which are the most appropriate strategies to face the problem of burnout in students and health-care professionals. Some studies indicate that the experience of medical and health educators may be key to the design of effective strategies to address this problem. AIM: To identify the burnout risk and protection factors of students at different medical schools. MATERIAL AND METHODS: In this study -in which 34 expert health educators from eight Chilean medical schools and other health-related schools participated- we used a qualitative methodology based on the appreciative inquiry to explore the key elements associated with the occurrence of burnout, identify protective and risk factors, as well as discuss possible effective interventions to prevent it. RESULTS: There are personal, academic and contextual elements that act as protective or risk factors of burnout. In addition, the educators identified key elements to design organizational and curricular interventions to face the problem of burnout at a local level. CONCLUSIONS: Burnout is a serious problem in the formation of health care professionals. Teacher training aimed at promoting student'well-being must include the teaching of communication skills that consider both the generation gap and the profile of the professional medical schools intend to form.


Assuntos
Esgotamento Profissional/etiologia , Esgotamento Profissional/prevenção & controle , Estudantes de Ciências da Saúde/psicologia , Chile , Humanos , Fatores de Proteção , Fatores de Risco , Faculdades de Medicina , Autocuidado
13.
Medicine (Baltimore) ; 98(30): e16352, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31348235

RESUMO

BACKGROUND: High-stress level affects students' health and many of them experiencing high levels of stress are at risk of burnout. School administrators are often concerned about the experiences and negative effects of burnout among students and staff. Burnout is described as a psychological reaction to chronic stress. The aim of the current study was to investigate the effect of a group-focused intervention (rational emotive behavior coaching, REBC) on academic burnout among undergraduate students attending public universities in Southeast Nigeria. METHODS: A group randomized controlled trial design was adopted for this study. A total of 52 convenient samples of undergraduate students (with a high degree of burnout symptoms) took part in the research. We used a group REBT program manual for the management of burnout which was complemented with REBC techniques. Data were gathered with the aid of the perceived stress scale (PSS-10) and Oldenburg Burnout inventory-student (OLBI-S). Data were analyzed using ANOVA and paired t test at .05 probability level. RESULTS: Results showed that the group-focused REBC program significantly alleviated burnout symptoms among students in the treatment group compared to students in the control group as measured by OLBI-S subscales: exhaustion (F(1,51) = 41.789, P = .000, (Equation is included in full-text article.), ΔR = 0.634, SE = 1.00), and disengagement (F(1,51) = 196.036, P = .000, (Equation is included in full-text article.), ΔR = 0.869, SE = 0.69). The students who benefitted from the group-focused REBC program maintained reduced symptoms of burnout after three months when the researchers conducted a follow-up as measured by OLBI-S subscales: exhaustion (F(1,51) = 34.012, P = .000, (Equation is included in full-text article.), ΔR = 0.467, SE = 1.21), and disengagement (F(1,51) = 108.941, P = .000, (Equation is included in full-text article.), ΔR = 0.765, SE = 0.85). CONCLUSION: This research indicates that group-focused REBC can be applied to reduce burnout symptoms among undergraduate students. The group-focused REBC intervention may be adapted to overcome employee burnout and school administrators' burnout. Researchers may need to investigate the possibility of storing and harnessing data from studies on REBC and burnout and delivering computer-based/internet REBC program following evidence-based computing strategies and principles.


Assuntos
Terapia Comportamental/métodos , Esgotamento Profissional/psicologia , Esgotamento Profissional/terapia , Estudantes/psicologia , Adolescente , Adulto , Esgotamento Profissional/epidemiologia , Feminino , Humanos , Masculino , Nigéria , Percepção , Fatores Socioeconômicos , Estresse Psicológico/epidemiologia , Universidades , Adulto Jovem
15.
Am Surg ; 85(6): 579-586, 2019 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-31267897

RESUMO

We aim to investigate the prevalence of posttraumatic stress disorder (PTSD), physician burnout (PBO), and work-life balance (WLB) among surgical residents, fellows, and attendings to illustrate the trends in surgeon wellness. A cross-sectional national survey of surgical residents, fellows, and attendings was conducted screening for PTSD, PBO, and WLB. The prevalence of screening positive for PTSD was more than two times that of the general population at all levels of experience, and more than half have an unhealthy WLB. The prevalence of PTSD, PBO, and unhealthy WLB declined with increasing level of experience (P < 0.001). One deviation in this trend was a lower prevalence of PBO among surgical fellows compared with residents and attendings (P < 0.001). Surgeon wellness improved with increasing level of experience. The incorporation of wellness programs into surgical residencies is essential to the professional development of young surgeons to cultivate healthy lasting habits for a well-balanced career and life.


Assuntos
Esgotamento Profissional/epidemiologia , Promoção da Saúde/organização & administração , Satisfação no Emprego , Satisfação Pessoal , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Cirurgiões/psicologia , Adulto , Esgotamento Profissional/psicologia , Estudos Transversais , Bolsas de Estudo/tendências , Feminino , Humanos , Internato e Residência/tendências , Masculino , Corpo Clínico Hospitalar/tendências , Pessoa de Meia-Idade , Determinação de Necessidades de Cuidados de Saúde , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Cirurgiões/educação , Estados Unidos , Adulto Jovem
16.
Am Surg ; 85(6): 638-644, 2019 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-31267906

RESUMO

As the roles of trauma/acute care surgeons continue to evolve, it is imperative that health-care systems adapt to meet workforce needs. Tailoring retention strategies that elicit workforce satisfaction ensure continued coverage that is mutually beneficial to surgeons and health-care systems. We sought to elicit factors related to career characteristics and expectations of the trauma/acute care surgery (ACS) workforce to assist with such future progress. In this study, 1552 Eastern Association for the Surgery of Trauma members were anonymously surveyed. Data collected included demographics, career expectations, and motivators of trauma/ACS. Four hundred eight (26%) Eastern Association for the Surgery of Trauma members responded. Respondents were 78 per cent male and had a median age of 47.3 years. Forty-six per cent of surgeons reported earning $351K-$475K and 23 per cent >$475K. At this point in their career, 49 per cent of surgeons felt quality of life was "most important", followed by 31 per cent career ambitions and 13 per cent salary. Prominent career satisfiers were patient care and teaching. Greatest detractors were burnout, bureaucracy, and work environment. Eighty per cent would change jobs in the final 10 years of practice, 31 per cent because of family/retirement, 29 per cent because of professional growth, 24 per cent because of workload, and 7 per cent because of salary. This study could be used to help develop trauma/ACS workforce strategies. This workforce remains mobile into late career; personal happiness and patient ownership overshadow financial rewards, and most prefer a total and shared patient care model compared with no patient ownership. Burnout, bureaucracy, and work environment are dominant detractors of job satisfaction among surveyed trauma/ACS surgeons.


Assuntos
Qualidade de Vida , Cirurgiões/psicologia , Inquéritos e Questionários , Recursos Humanos , Ferimentos e Lesões/cirurgia , Adulto , Fatores Etários , Atitude do Pessoal de Saúde , Esgotamento Profissional , Escolha da Profissão , Compreensão , Serviços Médicos de Emergência/métodos , Pesquisas sobre Serviços de Saúde , Humanos , Satisfação no Emprego , Masculino , Pessoa de Meia-Idade , Satisfação Pessoal , Medição de Risco , Fatores Sexuais , Estados Unidos , Carga de Trabalho
17.
Rev Med Suisse ; 15(657): 1323-1328, 2019 Jul 10.
Artigo em Francês | MEDLINE | ID: mdl-31290627

RESUMO

Adolescent athletes frequently complain of fatigue. Acute fatigue after intense training is physiological and necessary in order to develop capacity and increase performance. However, healthcare practitioners must question persistant fatigue, which causes are multiple, sometimes clear, though mostly multifactorial. A comprehensive and holistic approach is especially required in adolescents, with a complete somatic, psychosocial and athletic history. The role of healthcare professionals is to quickly identify specific signs and complex diagnoses, which can lead to physical and psychological consequences in the long term (overtraining, burnout, abuse, eating disorders). Finally, in a time where overweight and inactivity is rampant in the youth, we must imperatively avoid adolescents dropping out of sports and activity.


Assuntos
Atletas , Fadiga , Esportes , Adolescente , Esgotamento Profissional , Transtornos da Alimentação e da Ingestão de Alimentos , Humanos
18.
Health Qual Life Outcomes ; 17(1): 93, 2019 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-31146735

RESUMO

BACKGROUND: Workplace violence (WPV) is a global public health problem and has caused a serious threat to the physical and mental health of healthcare workers. Moreover, WPV also has an adverse effect on the workplace behavior of healthcare workers. This study has three purposes: (1) to identify the prevalence of workplace violence against physicians; (2) to examine the association between exposure to WPV, job satisfaction, job burnout and turnover intention of Chinese physicians and (3) to verify the mediating role of social support. METHODS: A cross-sectional study adopted a purposive sampling method to collect data from March 2017 through May 2017. A total of nine tertiary hospitals in four provinces, which provide healthcare from specialists in a large hospital after referral from primary and secondary care, were selected as research sites based on their geographical locations in the eastern, central and western regions of China. Descriptive analyses, a univariate analysis, a Pearson correlation, and a mediation regression analysis were used to estimate the prevalence of WPV and impact of WPV on job satisfaction, job burnout, and turnover intention. RESULTS: WPV was positively correlated with turnover intention (r = 0.238, P < 0.01) and job burnout (r = 0.150, P < 0.01), and was negatively associated with job satisfaction (r = - 0.228, P < 0.01) and social support (r = - 0.077, P < 0.01). Social support was a partial mediator between WPV and job satisfaction, as well as burnout and turnover intention. CONCLUSIONS: The results show a high prevalence of workplace violence in Chinese tertiary hospitals, which should not be ignored. The effects of social support on workplace behaviors suggest that it has practical implications for interventions to promote the stability of physicians' teams. TRIAL REGISTRATION: (Project Identification Code: HMUIRB2014005), Registered March 1, 2014.


Assuntos
Esgotamento Profissional/psicologia , Satisfação no Emprego , Médicos/psicologia , Violência no Trabalho/psicologia , Adulto , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Intenção , Masculino , Pessoa de Meia-Idade , Reorganização de Recursos Humanos/estatística & dados numéricos , Prevalência , Qualidade de Vida , Apoio Social , Centros de Atenção Terciária/estatística & dados numéricos , Violência no Trabalho/estatística & dados numéricos
19.
Sante Publique ; Vol. 31(1): 113-123, 2019 January February.
Artigo em Francês | MEDLINE | ID: mdl-31210507

RESUMO

INTRODUCTION: Prevalence of depression, suicidal ideation and burnout are higher among physicians than in general population. Young physicians seem more concerned and the beginning of career seems to be a period of greater risks for hospital practitioners. While this may be the case, in France, few studies have specifically evaluated the quality of the working conditions of this population. The objective of this study is to identify stress factors related to the organization of work and to social relationships at work, as they are perceived by the young hospital physicians. METHODS: A qualitative study through semi-structured interviews was conducted with hospital practitioners with less than 10 years of practice. Manual analysis of the interviews was carried out by three interviewers and supplemented by a computerized lexical analysis. RESULTS: Eighteen physicians were interviewed. Five categories of psychosocial and organizational factors have been identified. Teamwork and communication are generally associated with positive feelings. The pace of work, professional status, organizational factors and material conditions are considered unsatisfactory. Young physicians, however, are satisfied with the content of their work, particularly because of scientific emulation and skills development. CONCLUSION: The results of this study should help to better target prevention actions in order to improve the working conditions of young doctors. It seems a priority to reduce their workload or to regulate their working time, to offer greater stability to their work and to provide them with better material work conditions.


Assuntos
Esgotamento Profissional , Satisfação no Emprego , Médicos/psicologia , Estresse Psicológico , França , Hospitais , Humanos , Pesquisa Qualitativa
20.
Clin Nucl Med ; 44(7): 566-567, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31158104

RESUMO

Mentoring and coaching are activities that are quite helpful in having doctors become happy, engaged, and successful in their work and also help prevent burnout. Coaching helps promote a better balance between work, rest, family, and fun pursuits. Coaching also helps the one being coached develop better emotional awareness, become more cognizant of the good he/she has done, develop a positive outlook on life, find more meaning in work, and be better able to overcome obstacles. In ways such as these, the coach helps his/her client become more resilient and recover from burnout.


Assuntos
Fadiga de Alarmes do Pessoal de Saúde , Esgotamento Profissional/prevenção & controle , Tutoria/métodos , Médicos/psicologia , Feminino , Humanos , Masculino , Médicos/normas
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