Occupational stress and burnout experience among healthcare workers compounded by the COVID-19 pandemic in Africa: a scoping review protocol.

BACKGROUND: The emergence of coronavirus disease 2019 (COVID-19) pandemic has brought an unprecedented burden on health systems and personnel globally. This pandemic potentially can result in increased frequency of stress and burnout experienced among healthcare workers (HCWs), especially in lower-and-middle-income countries with inadequate health professionals, yet little is known about their experience. This study aims to describe the range of research evidence on occupational stress and/burnout among HCWs compounded by the COVID-19 pandemic in Africa, as well as identify research gaps for further investigations to inform health policy decisions towards stress and/burnout reduction in this era and when a future pandemic occurs. METHOD: Arksey and O'Malley's methodological framework will be used to guide this scoping review. Literature searches will be conducted in PubMed, CINAHL, SCOPUS, Web of Science, Science Direct, and Google Scholar for relevant articles published in any language from January 2020 to the last search date. The literature search strategy will include keywords and Boolean and medical subject heading terms. This study will include peer-reviewed papers about Africa, with a focus on stress and burnout among HCWs in the COVID-19 era. In addition to the database searches, we will manually search the reference list of included articles as well as the World Health Organization's website for relevant papers. Using the inclusion criteria as a guide, two reviewers will independently screen the abstracts and full-text articles. A narrative synthesis will be conducted, and a summary of the findings reported. DISCUSSION: This study will highlight the range of literature HCWs' experience of stress and/or burnout including the prevalence, associated factors, interventions/coping strategies, and reported effects on healthcare services during the COVID-19 era in Africa. This study's findings will be relevant to inform healthcare managers plan to mitigate stress and/or burnout as well prepare for such future pandemics. This study's findings will be disseminated in a peer-review journal, scientific conference, academic and research platforms, and social media.

Assessing the relationship between burnout syndrome and irritable bowel syndrome among medical health providers and medical students in Saudi Arabia.

Burnout syndrome, characterized by chronic unmanageable workplace stress, has been linked to lower gastrointestinal disorders, including irritable bowel syndrome. However, the relationship between burnout syndrome and irritable bowel syndrome among medical health providers and medical students in Saudi Arabia has not been fully explored. This cross-sectional correlational study was conducted in Southern Saudi Arabia from 2021 to 2022 and involved 931 medical health providers and medical students who completed an electronic questionnaire. The study assessed the presence and severity of burnout and irritable bowel syndrome and examined their relationship. Burnout syndrome was evaluated using the Maslach Burnout Inventory-Student Survey (MBI-SS), while irritable bowel syndrome criteria and severity were assessed using validated tools. The study found that 85% of medical health providers and medical students experienced high levels of burnout and irritable bowel syndrome severity, with physicians and nurses mainly affected. Occupational exhaustion was high in 44.4% of participants, while depersonalization was high in 53% of participants. Personal accomplishment was low in 73.5% of participants. Mild, moderate, and severe irritable bowel syndrome was reported in 25.6%, 23.8%, and 12% of participants, respectively. The study highlights a significant association between burnout syndrome and irritable bowel syndrome severity among medical health providers and medical students in Saudi Arabia. These findings underscore the importance of developing effective interventions to prevent and manage burnout syndrome and related health issues among healthcare professionals and medical students in the region.

'Caring for the helpers': factors associated with professional quality of life among Hong Kong nurses during the fifth wave of the COVID-19 pandemic.

BACKGROUND: Western studies have found that nurses are likely to experience both positive and negative emotions in their job, as a helping profession [professional quality of life (ProQoL)] during the coronavirus disease 2019 (COVID-19) pandemic, and that psychosocial and work-related variables (e.g. pandemic-related stressors, interpersonal and organizational support, coping strategies) are associated with such outcomes. However, relevant studies on nurses in the Asian context are limited. OBJECTIVE: This study examined the psychosocial correlates of three indicators of ProQoL, i.e. compassion satisfaction, secondary traumatic stress (STS), and burnout, among nurses during the fifth wave of the COVID-19 pandemic in Hong Kong. METHOD: Nurses in Hong Kong (N = 220) working in hospitals and community settings during the COVID-19 pandemic were recruited between 24 May and 27 June 2022 through nursing associations to complete an online survey measuring the aforementioned psychosocial variables. RESULTS: Hierarchical regression results found that stressors from clinical work environments, insufficient emotional support, and less positive reframing were associated with poorer ProQoL (i.e. lower compassion satisfaction; higher STS and burnout) (ß from 0.16, p > .05, to 0.44, p > .001). In addition, COVID-19-related worries/uncertainties and emotional processing were associated with higher STS (ß from 0.21 to 0.23, p < .01), whereas insufficient organizational support for communication with the healthcare system was associated with higher burnout (ß = 0.12, p < .05). CONCLUSIONS: Our findings identified the important psychosocial determinants in ProQoL among nurses in Hong Kong and provide recommendations for services supporting the mental health of these nurses. Providing workshops for nurses to train their skills in coping with COVID-19-related uncertainties, worries, and stressors from the clinical work environment, in using adaptive coping strategies (e.g. positive reframing), and in soliciting emotional support from important others could facilitate their ProQoL. Moreover, the provision of organizational support through timely and transparent communication with the healthcare system could reduce STS in nurses.

Stressors from clinical work environments, insufficient emotional support, and less positive reframing were associated with poorer professional quality of life among nurses in Hong Kong during the COVID-19 pandemic.COVID-19-related worries/uncertainties and emotional processing were associated with higher secondary traumatic stress.Insufficient organizational support for communication with the healthcare system was associated with higher burnout.

Physician's Burnout during the COVID-19 Pandemic: A Systematic Review and Meta-Analysis.

The burnout rate among physicians is expected to be higher during COVID-19 period due to the additional sources of physical and emotional stressors. Throughout the current COVID-19 pandemic, numerous studies have evaluated the impacts of COVID-19 on physicians' burnout, but the reported results have been inconsistent. This current systematic review and meta-analysis aims to assess and estimate the epidemiology of burnout and the associated risk factors during the COVID-19 pandemic among physicians. A systematic search for studies targeting physicians' burnout was conducted using PubMed, Scopus, ProQuest, Cochrane COVID-19 registry, and pre-print services (PsyArXiv and medRχiv) for English language studies published within the time period of 1 January 2020 to 1 September 2021. Search strategies resulted in 446 possible eligible studies. The titles and abstracts of these studies were screened, which resulted in 34 probable studies for inclusion, while 412 studies were excluded based on the predetermined inclusion criteria. These 34 studies went through a full-text screening for eligibility, which resulted in 30 studies being included in the final reviews and subsequent analyses. Among them, the prevalence of physicians' burnout rate ranged from 6.0-99.8%. This wide variation could be due to the heterogeneity among burnout definitions, different applied assessment tools, and even cultural factors. Further studies may consider other factors when assessing burnout (e.g., the presence of a psychiatric disorders, other work-related and cultural factors). In conclusion, a consistent diagnostic indices for the assessment of burnout is required to enable consistent methods of scoring and interpretation.

Evaluation of burnout and stress perception levels of Turkish dental laboratory technicians according to affecting factors during the COVID-19 pandemic.

BACKGROUND: The coronavirus disease-2019 (COVID-19) pandemic has caused healthcare professionals to face unequal acute workplace stress and burnout. This study aimed to analyze the potential impact of COVID-19 on the burnout and associated emotional stress conditions of Turkish dental technicians. METHODS: A 20-question demographic scale, Maslach Burnout Inventory (MBI), Sense of Coherence-13 (SoC-13), and Perceived Stress Scale-10 (PSS-10) were used to obtain data. A total of 152 participants answered these surveys directly and reported their stress burnout levels during the COVID-19 pandemic. RESULTS: Of all participants who agreed to participate in the survey, 39.5% were females and 60.5% were males. Regardless of demographic variables, the MBI-total (37.2 ± 11.71), SoC-13 total (53.81 ± 10.29), and PSS-10 total (21.25 ± 5.5) scores indicated moderate burnout, SoC, and perceived stress levels. According to sub-scores of the MBI; mean emotional exhaustion and depersonalization indicate low-level burnout, and mean personal accomplishment indicates moderate burnout. Long working hours increase burnout. No significant differences were observed according to demographic variables, except for work experience. A positive correlation was found between perceived stress and burnout. CONCLUSIONS: The findings showed that dental technicians working during the COVID-19 pandemic are influenced by emotional stress due to the outcomes of the pandemic. One reason for this situation might be the long working hours. Working arrangements, under-controlled disease risk factors, and lifestyle changes may improve stress levels.Key MessagesCOVID-19 outbreak exposed psychological returns to the general population, and especially to healthcare workers.Questionnaire method was applied to evaluate the burnout and stress levels among dental laboratory technicians during COVID-19 outbreak.Moderate levels of burnout and stress perception were detected. Long working time was one of the effective factors.

Well-being in the Workplace: A Book Club Among Health Care Workers During the COVID-19 Pandemic.

INTRODUCTION/OBJECTIVES: A culture of joy in the workplace supports well-being, but less is known about the effect of a shared experience on well-being and burnout in a health care setting. This pilot study investigated personal well-being and occupational burnout among primary care staff who participated in a 3-month virtual book club. METHODS: In December 2021, health care workers from a primary care practice were invited to participate in a 3-month virtual book club. Participants were emailed a preintervention survey with questions regarding well-being and burnout, the pandemic's influence on emotional health, and demographic information. The book club met virtually every month from January 2022 through March 2022. After the March 2022 book club meeting, a paired postintervention survey was sent to participants with additional questions regarding their participation in the book club. Well-being and burnout were measured with the 11-point Well-Being Index, and the pandemic's influence on emotional health was assessed with the 64-point Pandemic Emotional Impact Scale. RESULTS: Of 12 book club participants, 9 participants (6 physicians and 3 nurses) completed surveys before and after the intervention. Postintervention improvement in the median score of the Pandemic Emotional Impact Scale was significant (7 points, P = .04). Although Well-Being Index results uniformly favored improved well-being after book club participation, the median improvement of 1 point was not significant (P = .69). CONCLUSIONS: Social connection through a virtual workplace activity such as a book club may contribute to well-being and may decrease occupational burnout.

Satisfaction and attrition in Canadian surgical training program leadership: a survey of program directors.

BACKGROUND: Surgical program directors (PDs) play an integral role in the well-being and success of postgraduate trainees. Although studies about medical specialties have documented factors contributing to PD burnout, early attrition rates and contributory factors among surgical PDs have not yet been described. We aimed to evaluate Canadian surgical PD satisfaction, stressors in the role and areas institutions could target to improve PD support. METHODS: We administered a cross-sectional survey of postgraduate Canadian surgical PDs from all Royal College of Physicians and Surgeons of Canada accredited surgical specialties. Domains we assessed included PD demographics and compensation, availability of administrative support, satisfaction with the PD role and factors contributing to PD challenges and burnout. RESULTS: Sixty percent of eligible surgical PDs (81 out of 134) from all 12 surgical specialties responded to the survey. We found significant heterogeneity in PD tenure, compensation models and available administrative support. All respondents reported exceeding their weekly protected time for the PD position, and 66% received less than 0.8 full-time equivalent of administrative support. One-third of respondents were satisfied with overall compensation, whereas 43% were unhappy with compensatory models. Most respondents (70%) enjoyed many aspects of the PD role, including relationships with trainees and shaping the education of future surgeons. Significant stressors included insufficient administrative support, complexities in resident remediation and inadequate compensation, which contributed to 37% of PDs having considered leaving the post prematurely. INTERPRETATION: Most surgical PDs enjoyed the role. However, intersecting factors such as disproportionate time demands, lack of administrative support and inadequate compensation for the role contributed to significant stress and risk of early attrition.

Burnout among Physicians Working in Palliative Care During the COVID-19 Pandemic in Portugal: A Cross-Sectional Study.

INTRODUCTION: Physicians working in palliative care have a greater risk of burnout. Burnout has three dimensions: emotional exhaustion, depersonalization and reduction of personal accomplishments. Burnout is associated with different consequences for the professionals like less professional satisfaction and increase of overall levels of exhaustion. Burnout in healthcare professionals has an impact in the patients with increased probability of clinical erros. In order to monitor the quality of the care it is mandatory to assess overall levels of burnout. This study aimed to determine burnout levels and associated variables of physicians working in the Portuguese national network of palliative care. MATERIAL AND METHODS: A cross-sectional, exploratory and quantitative design was employed and participants were sampled using convenience and snowball technique. The Copenhagen Burnout Inventory was used to determine burnout levels of physicians working in the Portuguese National Network of Palliative Care. The contributions of personal, work and COVID-19 variables were evaluated in three subclasses: work, personal and patient-related burnout. The results obtained enabled the identification of healthcare professionals at risk, comparison with previous results published and to assess the impact of COVID-19 in their non COVID-19 activity. RESULTS: Seventy-five physicians participated. Socio-demographic characterization was conducted and the levels of burnout and determinants were explored. High levels of personal, work and patient-related burnout were present in 32 (43%), 39 (52%) and 16 (21%) physicians, respectively. The majority agreed that COVID-19 had an impact on their activities. Exclusive dedication to palliative care and type of palliative care unit were associated with lower levels of patient and work-related burnout. Weekly physical activity was associated with lower levels of work and personal burnout. Self-perceived health status was associated with lower levels of burnout for all subclasses. CONCLUSION: There was a high level of burnout among physicians working in the Portuguese National Network of Palliative Care. Measures to identify and prevent burnout are necessary in order to protect these professionals.

Introdução: Os médicos que trabalham em cuidados paliativos apresentam um risco mais elevado de burnout. Esta perturbação psicológica carateriza-se por três dimensões ­ exaustão emocional, despersonalização e redução da realização pessoal ­ e está associada a diversas consequências para os profissionais como a diminuição da satisfação profissional ou o aumento dos níveis de exaustão. Ao afetar os profissionais de saúde, o burnout tem também impacto nos utentes, visto causar um aumento da probabilidade de erros clínicos. Com vista a monitorizar a qualidade dos cuidados prestados é fundamental monitorizar os níveis de burnout. O objetivo deste estudo foi o de determinar os níveis de burnout e varíaveis associadas dos médicos que trabalham na Rede Nacional de Cuidados Paliativos em Portugal. Material e Métodos: Estudo transversal, exploratório e quantitativo com amostragem por conveniência e bola de neve. Foi utilizado o questionário Copenhagen Burnout Inventory para determinar os níveis de burnout de médicos que exercem funções na Rede Nacional de Cuidados Paliativos. As contribuições das varíaveis pessoais, laborais e decorrentes da pandemia de COVID-19 foram analisadas segundo três subclasses: burnout pessoal, burnout relacionado com a atividade profissional e burnout relacionado com o utente. Os resultados obtidos permitiram identificar profissionais em risco, fazer uma comparação com resultados prévios na literatura e determinar o impacto da COVID-19 na atividade assistencial não relacionada com COVID-19. Resultados: Setenta e cinco médicos participaram neste estudo. Foi realizada a caraterização socio-demográfica e determinados os níveis de burnout e variáveis associadas. Níveis elevados de burnout pessoal, relacionados com a atividade profissional e para com o utente estavam presentes, respetivamente, em 32 (43%), 39 (52%) e 16 (21%) dos participantes. A maioria considerou que a COVID-19 teve um impacto na sua atividade clínica. A dedicação exclusiva em cuidados paliativos e o tipo de unidade de cuidados paliativos estavam associados a menor nível de burnout relacionado com atividade profissional e para com o utente. A autopercepção de saúde estava associada a menores níveis de burnout em todas as subclasses. Conclusão: Foi observado um elevado nível de burnout nos médicos que trabalham na Rede Nacional de Cuidados Paliativos. São necessárias medidas para identificar e prevenir o burnout nestes profissionais,com vista à sua proteção.

Teacher Burnout in the Time of COVID-19: Antecedents and Psychological Consequences.

The important, frontline role of teachers during the COVID-19 pandemic has often gone unrecognized, and attention to their mental health and well-being is often only the focus of scholarly research. The unprecedented challenges that teachers faced during the COVID-19 pandemic and the stresses and strains associated with it have severely impacted their psychological well-being. This study examined the predictors and the psychological consequences of burnout. Participants (N = 355) were schoolteachers in South Africa who completed the Perceived Vulnerability to Disease Questionnaire, the Fear of COVID-19 Scale, the Role Orientation Questionnaire, the Maslach Burnout Inventory, the Centre for Epidemiological Depression Scale, the Beck Hopelessness Scale, the Satisfaction with Life Scale, and the trait scale of the State-Trait Anxiety Inventory. The results of a multiple regression showed that fear of COVID-19, role ambiguity, and role conflict were significant predictors of emotional exhaustion and depersonalization, while perceived infectability and role ambiguity significantly predicted personal accomplishment. Gender and age also predicted emotional exhaustion and depersonalization, respectively, and age was also a significant predictor of personal accomplishment. Generally, the dimensions of burnout were significant predictors of indices of psychological well-being-namely, depression, hopelessness, anxiety, and life satisfaction-with the exception of the association between depersonalization and life satisfaction. Our results suggest that intervention efforts to reduce burnout need to provide teachers with adequate job resources to buffer against the demands and stressors associated with their work.

Pressures in the Ivory Tower: An Empirical Study of Burnout Scores among Nursing Faculty.

(1) Background: The COVID-19 pandemic has exacerbated incidents of burnout among academics in various fields and disciplines. Although burnout has been the subject of extensive research, few studies have focused on nursing faculty. This study aimed to investigate the differences in burnout scores among nursing faculty members in Canada. (2) Method: Using a descriptive cross-sectional design, data were collected via an online survey in summer 2021 using the Maslach Burnout Inventory general survey and analyzed using the Kruskal-Wallis test. (3) Result: Faculty members (n = 645) with full-time employment status, worked more than 45 h, and taught 3-4 courses reported high burnout (score ≥ 3) compared to those teaching 1-2 courses. Although education levels, tenure status or rank, being on a graduate committee, or the percentage of hours dedicated to research and services were considered important personal and contextual factors, they were not associated with burnout. (4) Conclusions: Findings suggest that burnout manifests differently among faculty and at varying degrees. As such, targeted approaches based on individual and workload characteristics should be employed to address burnout and build resilience among faculty to improve retention and sustain the workforce.

Burnout syndrome among health care workers during the COVID-19 pandemic. A cross sectional study in Monastir, Tunisia.

BACKGROUND: Burnout syndrome may affect the safety of frontline healthcare care workers (HCW) and patients. We aimed to measure the prevalence of burnout among HCW in care facilities in Tunisia during the Covid-19 pandemic and to identify its associated factors. METHODS: We conducted a cross-sectional study among HCW practicing during the covid-19 pandemic in health care facilities in the governorate of Monastir. Data collection was carried out using an anonymous self-administered questionnaire composed by three sections: epidemiological and clinical characteristics, professional conditions and the Maslach Burn out Inventory (MBI-HSS). RESULTS: This study included 371 HCW. The prevalence of burnout was 77.9% (CI 95%: 73.6% - 82.1%). The severe level was found in 71 participants (19.1%), the moderate level in 115 (31%) and the low level in 103 (27.8%). The distribution of the levels of the burnout dimensions among the participants was as follows: high emotional exhaustion (EE) (57.4%), high depersonalization (DP) (39.4%) and low personal accomplishment (22.6%). The main determinants of burnout among healthcare professionals during COVID 19 pandemic were: working more than 6 hours per day (OR = 1.19; CI95% [1.06; 1.34]), physician function (OR = 1.17; CI 95% [1.05; 1.31]), feeling a negative impact of work on family life (OR = 1.40; 95% CI [1.13; 1.73]), and high personal estimation of COVID 19 exposure (OR = 1.15; CI95% [1.02; 1.29]). CONCLUSION: During the COVID19 pandemic, the prevalence of burnout among health professionals was high. It was related to hard implication in COVID 19 management. Interventions like adjusting working hours, reducing workload, and providing psychological support should be taken.

A cross-sectional study on burnout and its individual and environmental correlates among hepatological surgery nurses in Hunan Province, China.

BACKGROUND: Burnout is a widespread occupational phenomenon among nurses with significant adverse outcomes for nurses, patients, and society. It is thus important and urgent to understand burnout and its risk factors to guide interventions. This study aimed to examine the level of burnout and explore its individual and environmental correlates. METHODS: This cross-sectional study was conducted in Hunan, China. A total of 623 hepatological surgery nurses completed an online survey (response rate: 72.78%). Burnout was measured using the standard Maslach Burnout Inventory (MBI). Information on individual factors and environmental factors was collected by self-designed questionnaires. RESULTS: The scores of emotional exhaustion, depersonalization, and personal achievement in nurse burnout were 30 (26-34), 11 (8-14), and 23 (20-26) respectively. The prevalence of high burnout ranged from 52.81% for emotional exhaustion to 90.37% for decreased personal achievement. The three dimensions of burnout shared common correlates such as self-rated physical health and working environment, while also having additional unique correlates such as overwork, satisfaction with income, and age. CONCLUSION: Hepatological surgery nurses in Hunan Province are suffering from high levels of burnout, which requires public attention and urgent interventions. Improvement of the physical health and working environment of nurses may be the most beneficial intervention measures to tackle various dimensions of burnout, while other targeted measures are also needed for each specific dimension.

Academic burnout among master and doctoral students during the COVID-19 pandemic.

The COVID-19 outbreak has had an immense impact on academic life and public health. Graduate students had experienced obligatory curfews and quarantines due to the COVID-19 outbreak directly impacting their mental health and triggering academic burnout. In this cross-sectional study, we address the issue of mental health in graduate students by relating it to the factors associated with burnout syndrome during the COVID-19 pandemic. A total of 519 graduate students from master's and Ph.D./DLA degrees across universities in Hungary and other European countries participated in this study. The Copenhagen burnout inventory student version was used to evaluate burnout syndrome as an outcome. Our findings displayed burnout significantly lower among graduate students who had good sleep quality, receive high levels of support from their university, and were satisfied with how their university dealt with the pandemic. The excessive consumption of alcohol, the use of antidepressants, being single, and thinking about dropping out showed as predictive factors of burnout. The results add to emergent evidence on the impact of the COVID-19 pandemic on mental health and the predicted factors of academic burnout among master and doctoral students.

Job demands and resources as drivers of exhaustion and leaving intentions: a prospective analysis with geriatric nurses.

BACKGROUND: Nurses show a high prevalence of exhaustion and increased leaving intentions. With this study, we integrate established research about turnover intention with recent burnout literature and present a theoretical model that combines both. The aim of this study was to examine job demands (time pressure, social conflicts) and resources (job control, supervisor support, task identity, person-organisation fit) as drivers and health and age as moderators for the relationships between exhaustion and nurses' organisational and professional leaving intentions. METHODS: We analysed data from a standardised paper-pencil questionnaire survey with a prospective, two-wave (12 months apart) study design. In total, 584 nurses participated at Time 1 (t1). The final sample at Time 2 (t2) was n = 222 nurses (38%; age: M = 41.1 years, SD = 11.0; 88% females). RESULTS: We identified time pressure as job demand and job control, task identity, and person-organisation fit as resources that drive the relationships of exhaustion (mean between both times of measures) and organisational and professional leaving intentions. The relationships to organisational leaving intentions decreased with nurses' age and the relationships to professional leaving intentions increased for nurses who had poorer self-rated health. We found indirect effects of exhaustion for relationships between job demands and nurses' leaving intentions. Relationships to exhaustion remained significant after adjusting for depressive mood. CONCLUSION: Insights from this study can be used both by employers and employees. Redesigning work might be a promising approach to improve nurses' well-being and retention in this profession. Geriatric care facilities should include the concept of person-organisation fit into their personnel selection process.

Incidence of Burnout Syndrome among Anesthesiologists and Intensivists in France: The REPAR Study.

BACKGROUND: Burnout syndrome (BOS) impacts health workers and has become a real public health issue. The primary objective of this observational study was to re-evaluate the incidence of BOS among anesthesiologists and intensivists (AI) in France, ten years after the SESMAT study, a French Physician Health Survey carried out among burnout salaried AI. The secondary objective was to investigate risks factors. METHODS: The REPAR survey is an observational study carried in France among AI, residents, and seniors, whatever their main mode of practice, in the framework of a self-questionnaire distributed on the Internet from 11 April 2018 to 1 July 2018. BOS was assessed using the Copenhagen Burnout Inventory (CBI). A score above 50% on two of the dimensions (personal burnout and work-related burnout) indicated BOS, as a main criterion. In order to investigate risks factors, questions were about sociodemographic characteristics, professional and extraprofessional environments, personality and mood using the Major Depression Inventory (MDI). A significance threshold of p < 0.05 was retained. RESULTS: Among 1519 questionnaires received, 1500 completed questionnaires were analyzed. There were 775 men (52%) and 721 women (48%), aged 23 to 74 years. Among those, 24% suffered from BOS, 9% showed depressive symptoms (MDI > 25) and 35% were considering changing jobs or stopping their studies. There was no significant difference with the SESMAT study for the general BOS score. After multivariate analysis, 12 variables were significantly associated with the main criterion. CONCLUSIONS: Ten years after the SESMAT study, the incidence of BOS in AI has not decreased in the largest cohort of AI studied to date in France.

Professional Quality of Life, Work-Related Stress, and Job Satisfaction among Nurses in Saudi Arabia: A Structural Equation Modelling Approach.

Objective: To examine the interrelated impacts of work-related stress, compassion satisfaction (CS), and job satisfaction on burnout (BO) and secondary traumatic stress (STS) among nurses using structural equation modelling (SEM). Methods: A cross-sectional design was used to survey 727 nurses at a teaching hospital in eastern Saudi Arabia. Three scales were used: the Quality of Life (ProQOL) scale, the Nursing Stress Scale (NSS), and the Job Satisfaction Survey (JSS). Data were analysed using SPSS and Analysis of Moment Structures (AMOS), and SEM analysis was conducted to confirm the interrelations among variables. Results: The final model had a good fit for the obtained data (X 2 = 2.726, RMSEA = 0.032). Stress is directly related to BO and STS, and the following variables were directly related to STS: job satisfaction, BO, and CS. Lastly, BO mediated the relationship between stress and STS. Conclusion: It is crucial to analyze the effect of stress, CS, and job satisfaction which seems to have a positive and negative impact on nurses' BO and STS. Therefore, implementing a management strategy to manage stress and satisfaction can enhance nurses' quality of life, support the maintenance of positive attitudes, and enhance the standard of patient care.

Burnout, work engagement and work hours - how physicians' decision to work less is associated with work-related factors.

BACKGROUND: According to new estimates, the health care sector will suffer a shortage of physicians in primary and specialty care. In this context, work engagement and burnout are two constructs that have gained attention recently. The aim of this study was to investigate how these constructs are related to work hour preference. METHOD: The present study was based on the baseline survey of the long-term study of physicians with different specialties, in which 1,001 physicians took part (response rate: 33.4%). Burnout was measured using the Copenhagen Burnout Inventory adapted for health care professionals; work engagement was assessed using the Utrecht Work Engagement scale. Data analyses included regression and mediation models. RESULTS: Overall, 297 out of 725 physicians were planning to cut down work hours. Several reasons - such as burnout - are discussed. According to multiple regression analyses desire to work less hours was significantly linked to all three dimensions of burnout (p < 0.001), as well as work engagement (p = 0.001). In addition, work engagement significantly mediated the relationship between the burnout dimensions on work hour reduction (patient-related: b = - 0.135, p < 0.001; work-related: b = - 0.190, p < 0.001; personal: b = - 0.133, p < 0.001 ). DISCUSSION: Physicians tending to reduce work hours exhibited different levels of work engagement as well as burnout (personal, patient- and work-related). Moreover, work engagement influenced the relationship between burnout and work hour reduction. Therefore, interventions that increase work engagement may positively impact negative effects of burnout on work hour changes.

Compassion fatigue and anxiety in critical care emergency nurses: In between efficiency and humanity.

OBJECTIVES: To determine the emotional impact of permanent proximity to trauma and death in the Emergency and ICU's nurses establishing prevalence of Compassionate Fatigue (burnout and Secondary Traumatic Stress) and anxiety. Analyze its relationship with sociodemographic, training, workplace and psychological variables. METHODS: Descriptive, cross-sectional and multicentre study. The validated ProQOL v. IV and STAI scales and an ad-hoc questionnaire with the variables of the second objective were used in 710 nurses from nine highly complex hospitals in Catalonia (Spain). RESULTS: In both units, the prevalence of professionals affected with high scores of burnout was higher than 20%, on Secondary Traumatic Stress was 30% and, 12% on anxiety. Each subscale was significantly associated with the intention to leave units and the career. 97% of participants stated that they needed to be trained in emotional management. CONCLUSION: The prevalence of burnout and Secondary Traumatic Stress were higher in our study than those offered in the reference literature in emergency and ICU nurses. The prevalence of each construct was individually related to the desire to leave work units and career. This fact, together with the participants' desire to be better trained in emotional management exposes the need to establish educational plans, as well as institutional measures to prevent and support nurses for Compassion Fatigue.

The first wave of COVID-19 and mental distress of physician residents in Brazil: a comparison between two cohorts.

INTRODUCTION: The reorganization of healthcare systems to face the COVID-19 pandemic has led to concerns regarding psychological distress of healthcare workers, and training requirements of physician residents. OBJECTIVE: To assess the influence of COVID-19 pandemic on depression, anxiety, burnout and training schedules of residents. METHODS: Two independent cross-sectional studies (the first in November 2019 [control], the second in June 2020, during the first wave of COVID-19 pandemic) enrolling physician residents from Brazil, using online surveys. In each of them, we collected demographic and training program data, and assessed depression, anxiety and burnout through PHQ-2, GAD-2 and MBI (2-item version) scales, respectively. We controlled confounding variables with logistic regression analysis. RESULTS: The COVID-19 cohort (n = 524) presented a briefer workload and had at least 1 day off per week more frequently, in relation to the control cohort (n = 1 419). The majority of residents (464/524, 89.5%) had a reduction in their duty hours, and believed they would need an extra training period after the end of the pandemic (399/524, 76.2%). The frequency of depression increased (46.0% vs. 58.8%, aOR = 1.64, 95% CI = 1.32-2.05), anxiety did not change (56.5% vs. 56.5%, aOR = 1.24, 95% CI = 0.99-1.55) and burnout decreased (37.0% vs. 26.1%, aOR = 0.77, 95% CI = 0.60-0.99). Sensitivity analysis did not change these results. CONCLUSION: Mental distress is frequent among residents and associated with both training program and social environments. The consequences of the COVID-19 pandemic on training requirements should be specifically addressed by supervisors and policymakers, in a case-by-case basis. Psychological support must be provided to healthcare workers.

Job and life satisfaction among emergency physicians: A qualitative study.

The prevalence of burnout among emergency physicians is among the highest of any specialty. Multiple studies have described factors that contribute to physician burnout, such as age, institutional support, and the electronic medical record (EMR). However, there have been few studies that investigate those physicians who are satisfied with their career and their personal lives. This qualitative study evaluated emergency physicians who were satisfied with both their career and personal lives to propose a model for physician well-being. Physicians were recruited using email solicitation and referral by their peers from June-September 2020. Inclusion criteria involved those physicians who were satisfied with their life and their job and did not meet the criteria for burnout. A qualitative, non-structured interview with open-ended questions was performed with each participant. Emergent themes were identified using standard practice for qualitative studies. Twenty-three physicians participated with a mean age of 45.4 years old (range 32-65), 17 (73.9%) were men, 13 (56.5%) were Caucasian, 6 (26.0%) were Asian/South Asian, 1 (4.3%) were Latino, and 3 (13.0%) were another ethnicity. Several important themes emerged. Physicians satisfied with their lives and their jobs tended to be personally resilient, socially connected, with significant outside interests. These physicians self-identified their personality type as having both introverted and extroverted features. Threats to thriving included ineffective leadership and the EMR. This project proposes a model for job and life satisfaction among emergency physicians. Encouraging these qualities, while fostering supportive leadership, and optimizing the EMR, may improve satisfaction among physicians experiencing burnout.