Prevalence of burnout among German radiologists: a call to action.

OBJECTIVES: In the presence of escalating global concerns regarding physician burnout, this study aims to analyze the prevalence and associated factors of burnout among radiologists in Germany. METHODS: A comprehensive online survey, inclusive of 73 targeted questions including a German-modified version of the Maslach Burnout Inventory, was distributed among all members of the German Radiological Society and the German Interventional Radiological Society between May and August 2023. The survey encompassed aspects of employment, workload, well-being, and coping mechanisms. Data from 172 completed surveys were analyzed, with correlations explored via crosstabs and the Pearson-chi-square test. RESULTS: In total, 76.7% of participating radiologists were identified to be burnt out. The prevalence was significantly associated with increased workload, reduced sleep quality, suboptimal working conditions, reduced job satisfaction, and the negative interplay between work, family life, and health. Median work satisfaction was described as "satisfied" while median workload was assessed as "frequently overwhelming of work." A total of 41.9% of respondents noted facing daily time pressure. Radiologists' concerns about work interfering with private family life were voiced by approximately 70%, and 73.3% highlighted the perceived negative effects on their health. CONCLUSION: The pronounced prevalence of burnout among German radiologists demonstrates an urgent, unmet need for comprehensive interventions and systemic changes. Our findings act as a catalyst for initiating targeted, multifaceted strategies and dialogs, essential for fostering a resilient and effective healthcare ecosystem. Further large-scale systematic studies should follow to analyze the findings in broad. CLINICAL RELEVANCE STATEMENT: Consistent with other countries, there is a high prevalence of burnout among radiologists in Germany. A call for further investigation is recommended to help mitigate adverse outcomes associated with physician burnout. KEY POINTS: • The prevalence of burnout has yet not been evaluated for German radiologists. • German radiologists have a high prevalence of burnout. • Steps must be implemented to engage this problem to prevent worsening.

Professional Burnout and Career Choice Regret in Urology Residents.

PURPOSE OF REVIEW: High rates of professional burnout and career choice regret among urology residents may increase professional dissatisfaction, shorten career longevity, and exacerbate urology workforce shortages. Understanding the prevalence of and risk factors for burnout may help develop interventions. RECENT FINDINGS: Up to 48% of contemporary U.S. urology residents experience burnout symptoms, including up to 70% of second-year residents. Among overlapping personal, professional, institutional, and lifestyle risk factors, barriers to accessing medical and mental health care are frequently cited as an important association in residents. Limited intervention studies suggest that providing basic needs, such as on-call meals, and facilitating physical wellness and social engagement among residents may result in sustained reductions in burnout. Urology residents continue to experience high rates of burnout and career choice regret among medical specialties. Evidence-based interventions and sustainable policies that address primary risk factors are urgently needed.

Exploring staff experiences and perceptions of patient-perpetrated violence in hospital settings: A qualitative study.

AIMS: To explore hospital staff experiences and perceptions of patient-perpetrated violence. DESIGN: Descriptive qualitative study. METHODS: Twelve semi-structured interviews (June-August 2022) were held with a diverse sample of hospital nurses, doctors, allied health professionals, security and a non-clinical manager. The framework approach was used to organise and analyse data, using Attribution Theory as a theoretical lens. RESULTS: Three themes were identified: violence as (un)predictable, violence as (un)preventable and the cumulative toll of violence. In making sense of why patients become violent, participants described different 'types' of aggressive patients and variably attributed behaviours to situation, disposition or a combination of both. Regardless of perceived causal factors, staff overwhelmingly appeared to view violence as predictable. Participants also reflected on the wider structural problems underpinning violence, frequently alluding to their sense of relative powerlessness to initiate change. The cumulative toll of violence was a common thread, with staff describing their acquisition of 'resilience' and reflecting on its role in their responses to escalating situations. CONCLUSIONS: Many hospital staff are resigned to the inevitability of violence. The concept of staff 'resilience' following violence is not unproblematic, having the potential to serve as a guise for acceptance and as an additional variable for which staff are held accountable. When designing strategies, organisations should ensure that accountability for violence reduction is distributed across multiple levels. This study makes a novel contribution by exploring the perspectives of multiple staff groups working across diverse hospital settings, and adds to a sparse literature on this subject in the UK. IMPLICATIONS FOR THE PROFESSION: Efforts to address violence against healthcare staff need to be power-conscious, ensuring that accountability is distributed across multiple levels. REPORTING METHOD: This study is reported in line with the Consolidated Criteria for Reporting Qualitative Studies (COREQ). PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Professional burnout of nurses and the level of rationing of nursing care: an observational preliminary study.

BACKGROUND: Nurses are one of the professional groups most exposed to experiencing professional burnout. Professional burnout has a negative impact on the quality of nursing care, including causing care rationing. Therefore, it is very important to understand the determinants of both professional burnout and care rationing, as well as their mutual relationships. The aim of the study was to understand the impact of professional burnout among nurses on the level of rationing of nursing care. METHODS: The study was conducted among 100 nurses at the Glogów County Hospital (Poland) from November 14, 2011, to November 18, 2022. The following Polish version of the standardized research tools were utilized: the Basel Extent of Rationing of Nursing Care- Revised (BERNCA-R) questionnaire and the Oldenburg Burnout Inventory (OLBI). Additionally, a survey designed by the authors was employed. RESULTS: The BERNCA-R significantly correlates (p < 0.05) and positively (r > 0) with OLBI (disengagement), resulting in a higher degree of care rationing. The average overall BERNCA-R score was 1.56 points (SD = 0.62), indicating that the frequency of care rationing among respondents ranged from "never" to "rarely." Among participants in the OLBI questionnaire, 63% of respondents had a moderate level of work exhaustion, 36% had a high level of work exhaustion, and 1% had a low level of work exhaustion. In turn, 58% of respondents had a moderate level of disengagement, 38% had a high level of disengagement, and 4% had a low level of disengagement. Moreover, a statistically significant association with the BERNCA-R score concerning the workplace (ward) and participation in training on preventing professional burnout was shown. CONCLUSIONS: The rationing of nursing care was found to be at a low level. The higher the level of disengagement, the greater the level of care rationing was observed. In conservative units, nurses demonstrated a higher level of care rationing. Nurses' expectations regarding the reduction of professional burnout include, among other things, higher remuneration, an increase in the number of staff, and an improvement in the work atmosphere.

The Social Ecology of Burnout: A framework for research on nurse practitioner burnout.

BACKGROUND: The U.S. health system is burdened by rising costs, workforce shortages, and unremitting burnout. Well-being interventions have emerged in response, yet data suggest that the work environment is the problem. Nurse practitioner (NP) burnout is associated with structural and relational factors in the work environment, practice autonomy, and hierarchical leadership. PURPOSE: We explore the unique social, cultural, and political environment in which NPs work through the lens of social ecology and present the Social Ecology of Burnout (SEB) framework. METHODS: We review current burnout frameworks in the context of the NP practice environment and discuss the SEB, specifically exploring psychological safety and its influence on burnout. FINDINGS: Psychological safety, work environment, and policy are presented within the SEB and solutions which empower NPs are considered. DISCUSSION: Our framework can serve as a guide for future nursing research, practice, and policy.

Examination of workload perception, burnout, and perceived organizational support in emergency healthcare professionals: A structural equation model.

Job stress is one of the important factors affecting employee behavior. One of the most important factors in reducing burnout caused by stress is organizational support. In this context, the aim of this study is to identify the moderating role of perceived organizational support in the effect of workload perception on burnout within the emergency healthcare professionals' universe. The data for this study were collected from 703 health professionals working in emergency health services in three major cities of Turkey. The relationships and the model of the study is analyzed by the Structural Equation Model technique. The results indicate that perceived workload is a factor that causes employee burnout, and perceived organizational support is a factor that reduces employee burnout. This study contributes to researchers and health managers by revealing the importance of workload planning and organizational activities that support employees to reduce burnout in health workers.

[The professional burnout of medical workers and its determining factors].

The study was carried out using survey technique applied to sampling of workers of the first three polyclinics of Moscow. The method was based on international questionnaire Maslach Burnout Inventory (MBI) that permitted to consider characteristics of activity of medical professionals. The analysis of results of study demonstrated that overall prevalence of burnout among doctors is 17%,among nursing personnel - 21%, among non-medical personnel - 19%. The average age of workers with professional burnout is 34-49 years. Among workers with burnout more than half of them had higher education and 30% had specialized secondary education. The workers consider as main factors of professional burnout necessity to spend most of working time at the computer (up to 92%), unrealistic expectations of patients from received medical care (up to 88%), deficiency of time for reception of patients and personal life. The majority of employees had an average (35%) and low (43%) level of reduction in personal achievements that testifies well-being of work environment. The conclusion is made that in polyclinic section of Moscow health care there are no serious conflicts in collectives and existing conflicts are within limits of working relationships.

Moving Away from Chaos: Intentional and Adaptive Management of the Non-visit Care River.

In modern primary care practice, clinicians face increasing volumes of asynchronous, electronic, non-visit care (NVC). Systems for completing this work, however, remain under-developed and often lack definition around patient and practice expectations for work completion and team member contributions. The resulting reactive, unstructured, and unscheduled NVC workflows cause and exacerbate physicians' cognitive overload, distraction, and dissatisfaction. Herein, we propose that primary care practices take an intentional, holistic approach to managing systems of NVC and offer a conceptual model for managing NVC work, analogizing the flow of these tasks to the flow of water through a river system: (1) by carefully controlling the inputs into the NVC system (the tributaries entering the river system); (2) by carefully defining the workflows, roles and responsibilities for completion of common tasks (the direction of river flow); (3) by improving the interface of the electronic health record (obstacles encountered in the river); and (4) by optimizing effectiveness of primary care teams (the contours of the river determining rate of flow). This framework for managing NVC, viewed from a broader system perspective, has the potential to improve productivity, quality of care, and clinician work experience.

"Anxiety, COVID, Burnout and Now Depression": a Qualitative Study of Primary Care Clinicians' Perceptions of Burnout.

BACKGROUND: Clinician burnout has become a major issue in the USA, contributing to increased mental health challenges and problems with quality of care, productivity, and retention. OBJECTIVE: The objective of this study was to understand primary care clinicians' perspectives on burnout during the COVID-19 pandemic as well as their perspectives on the causes of burnout and strategies to improve clinician well-being. APPROACH: This qualitative research involved in-depth interviews with 27 primary care clinicians practicing in a range of settings across the USA. Semi-structured interviews lasted between 60 and 90 min and were conducted using Zoom video conferencing software between July 2021 and February 2023. Transcripts were analyzed in NVivo software using multiple cycles of coding. KEY RESULTS: Clinicians shared their experiences with burnout and mental health challenges during the COVID-19 pandemic. Contributors to burnout included high levels of documentation, inefficiencies of electronic health record (EHR) systems, high patient volume, staffing shortages, and expectations for responding to patient emails and telephone calls. The majority of participants described the need to work after clinic hours to complete documentation. Many clinicians also discussed the need for health system leaders to make sincere efforts to enhance work-life balance and create a culture of health and well-being for health professionals. Suggested strategies to address these issues included supportive leadership, accessible mental health services, and additional administrative time to complete documentation. CONCLUSIONS: The results of this study provide an in-depth view of participating primary care clinicians' experiences and perceptions of burnout and other mental health challenges. These viewpoints can improve awareness of the issues and strategies to improve the health and well-being of our clinician workforce. Strategies include aligning payment models with the best approaches for delivering quality patient care, reducing administrative burden related to documentation, and redesigning EHR systems with a human factors approach.

Feasibility of RESTORE: An online Acceptance and Commitment Therapy intervention to improve palliative care staff wellbeing.

BACKGROUND: Acceptance and Commitment Therapy is a form of Cognitive Behavioural Therapy which uses behavioural psychology, values, acceptance and mindfulness techniques to improve mental health and wellbeing. Acceptance and Commitment Therapy is efficacious in treating stress, anxiety and depression in a broad range of settings including occupational contexts where emotional labour is high. This approach could help palliative care staff to manage work-related stress and promote wellbeing. AIM: To develop, and feasibility test, an online Acceptance and Commitment Therapy intervention to improve wellbeing of palliative care staff. DESIGN: A single-arm feasibility trial of an 8-week Acceptance and Commitment Therapy based intervention for staff, consisting of three online facilitated group workshops and five online individual self-directed learning modules. Data was collected via online questionnaire at four time-points and online focus groups at follow-up. SETTING/PARTICIPANTS: Participants were recruited from Marie Curie hospice and nursing services in Scotland. RESULTS: Twenty five staff commenced and 23 completed the intervention (93%). Fifteen participated in focus groups. Twelve (48%) completed questionnaires at follow-up. Participants found the intervention enjoyable, informative and beneficial. There was preliminary evidence for improvements in psychological flexibility (Cohen's d = 0.7) and mental wellbeing (Cohen's d = 0.49) between baseline and follow-up, but minimal change in perceived stress, burnout or compassion satisfaction. CONCLUSION: Online Acceptance and Commitment Therapy for wellbeing is acceptable to palliative care staff and feasible to implement using Microsoft Teams in a palliative care setting. Incorporating ways to promote long-term maintenance of behaviour changes, and strategies to optimise data collection at follow-up are key considerations for future intervention refinement and evaluation.

Burnout in South Asian rheumatologists in the COVID-19 pandemic: an online survey.

Physician burnout is recognized as a global crisis and an epidemic. However, burnout in rheumatology is an understudied phenomenon. We explored the prevalence of physician burnout among rheumatologists from South Asia in the peri-pandemic period (2021-2022). Rheumatologists from Asian countries were invited to participate in an anonymized, validated, and pilot-tested e-survey via social media platforms from December 2021 to April 2022. Demographic information, social aspects (marital status, income, vacation time, daily exercise), substance abuse, EHR (electronic health record) use, and years in practice were obtained. In addition, burnout was estimated using Maslach Burnout Inventory-Human Services Survey for Medical Personnel (MBI-HSS) in three domains: emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA), and intergroup comparisons were made using independent t test and one-way ANOVA using SPSS v27. Of 146 respondents who participated in the survey, 134 belonged to Asian nations. The highest number of respondents was from Pakistan (56/134, 38.36%), followed by India (49/134, 33.56%). Slightly more respondents were male, 75 (51.4%), than females, 71 (48.6%). Over two-thirds of our respondents (99/134, 67.8%) reported burnout in at least one domain. Notably, we found statistically significant increased depersonalization scores in males. (P < 0.05). Females scored significantly higher on the following items: #5 (I feel I treat some patients as if they were impersonal objects), item# 10 (I've become more insensitive toward people since I took this job and item#22 (I feel patients blame me for some of their problems) (P < 0.05). We found differences in monthly salaries among South Asian (1484 ± 2717 USD) and non-South Asian respondents (5672 ± 8874 USD) (P < 0.01). A substantial proportion of rheumatologists in our survey report burnout, suggesting a felt need to introduce organizational measures to prevent and mitigate burnout and preserve the rheumatology workforce.

The prevalence of professional burnout among dentists: a systematic review and meta-analysis.

Professional burnout refers to mental weariness caused by occupational stress. However, there is a lack of systematic studies on the prevalence of professional burnout among dentists. The purpose of this study was to investigate the prevalence of professional burnout among dentists. Databases including PubMed, PsycINFO, Embase, Cochrane, and Web of Science were systematically searched from inception to 28 October 2021. The random-effects model and forest plots were used to assess the pooled prevalence of professional burnout among dentists. A total of 15 studies with a total of 6038 study subjects were included in the meta-analysis, and the overall professional burnout among dentists was 13% (95%CI: 6-23). Subgroup analysis suggested a high prevalence of burnout in Europe, and the least in the Americas. The pooled burnout prevalence in cross-sectional surveys was significantly lower than that in longitudinal studies. In addition, the overall burnout prevalence in the last decade was significantly lower than that of a decade ago. This meta-analysis demonstrated that the prevalence of burnout was relatively low among dentists, and there was a downward trend. Therefore, it is important to continue to pay close attention to the mental health of dentists and effectively prevent and treat professional burnout to better maintain the provision of health care services.

The overall prevalence of professional burnout among dentists was 13%.Subgroup analysis revealed that the prevalence of burnout differed in geographical regions, with the highest in Europe, followed by Asia, and the lowest in America.The pooled burnout prevalence in cross-sectional surveys was significantly lower than that in longitudinal studies. In addition, the overall burnout prevalence in the last decade was significantly lower than that of a decade ago.More attention should be paid to professional burnout among dentists to improve the provision of health care services.

A mixed-methods exploration of nurse loneliness and burnout during COVID-19.

AIM: This study investigated the phenomenon of nurse loneliness as a potential contributor to burnout. BACKGROUND: Nurse wellbeing is critical for safe and efficient healthcare delivery. However, evidence indicates nurses' wellbeing is at risk. The levels of burnout, the most commonly measured symptom of suboptimal wellbeing, are rising and may relate to a largely unexplored phenomenon: loneliness. METHODS: A mixed-methods approach was used to investigate burnout and loneliness in direct-care nurses in four diverse hospitals in the midwestern and southeastern United States. Burnout and loneliness were measured, prevalence was estimated, and correlation was examined. Interpretive descriptive inquiry and analysis was used to develop a richer understanding of nurse loneliness in the context of burnout. While this study did not explicitly explore the impact of the global pandemic, data was collected in late 2021 and early 2022, during the Delta variant wave. RESULTS: In the study population (n = 117), rates of burnout are high and positively correlate with loneliness. Qualitative interviews (n = 11) revealed that nurses feel unseen, emotionally detached from their work, and dehumanized. However, social connection with peers is protective and nurses still report a strong sense of devotion to the profession and solidarity with peers. CONCLUSIONS: This study offers insight into nurse loneliness, highlighting the importance of social connectedness to improve nurse wellbeing.

Middle Eastern nurses' views/experiences of work and well-being with the support measures during past disease outbreaks and COVID-19: a qualitative systematic review.

BACKGROUND: The potential psychological health impact of pandemics on nurses has been increasingly widely recognised, as have recommendations to establish support measures for nurses' well-being. Despite the availability of support measures significant number of nurses still experienced burnout and mental distress during Covid-19. Few efforts have been made in the wider literature to understand how nurses experience well-being support or how they perceive it affects their well-being during pandemics. In the Middle East, understanding and exploring well-being support measures during pandemics from nurses' perspectives has not received significant attention. OBJECTIVE: To investigate nurses' perspectives and experiences of well-being support measures during prior pandemics and the Covid-19 pandemic in the Middle East. METHODS: A systematic qualitative review was undertaken utilising the JBI model as a framework. Searches were carried out in databases comprised CINAHL, MEDLINE, NUsearch Library of Nottingham University and Google Scholar. Moreover, a manual search through reference lists for relevant studies were carried out. DATA EXTRACTION AND SYNTHESIS: Eleven studies were included in the review. The findings from the included qualitative studies were extracted using the JBI-QARI data extraction tool for qualitative research. The results were synthesised using a meta-synthesis in line with the JBI approach. RESULTS: The included studies yielded an aggregate of 111 findings and were categorised into 14 categories, followed by four synthesised findings. These were: [1] nurses experienced challenges during MERS, yet different strategies were implemented by leaders and nurses to manage these challenges; [2] some well-being support measures were unfulfilled during Covid-19; [3] additional aspects compounded negatively on nurses' well- being; and [4] nurses showed maturity during Covid-19. CONCLUSION: In comparison to prior health emergencies, well-being support measures during Covid-19 were not sufficiently adopted. Nurse policymakers and managers should consider these support measures to correspond with nurses' needs and explore the contextual factors that affect their implementation. TRIAL REGISTRATION: PROSPERO (CRD42022344005).

Burnout among Brazilian Dentists during the COVID-19 Pandemic: A Cross-sectional Study.

Background: This article identifies the factors associated with burnout among dentists in the state of Bahia, Brazil, during the COVID-19 pandemic. Methods: A cross-sectional study, conducted between November 2020 and February 2021, of 251 dentists, selected by snowball sampling. Sociodemographic, occupational, and epidemiological information was collected in an electronic form. Burnout was evaluated through the Maslach Burnout Inventory; anxiety through the Beck Anxiety Inventory; and quality of life through the WHOQol-BREF questionnaire. Multiple linear regression was used to identify factors associated with variations in levels of the three burnout dimensions. Results: The mean levels of the burnout dimensions were: Emotional Exhaustion: 28.9 ± 8.9 (SD); Depersonalization = 8.2 ± 6.3; and Personal Accomplishment: 28.0 ± 6.2. The proportion of professionals with high Emotional Exhaustion (≥ 30 cut-off score), high Depersonalization (≥ 12 cut-off score), and low Personal Accomplishment (≤ 33 cut-off score) were 43.4%, 26.3% and 81.3%, respectively. Burnout components were associated with high anxiety; lower levels of the physical, psychological, social relations, and environmental dimensions of quality of life; less time working as a dentist; increased alcohol consumption during the pandemic, feeling safe when using personal protective equipment, and support from work fellows. Conclusion: The dentists investigated showed moderate levels of Emotional Exhaustion and Depersonalization, and very low levels of Personal Accomplishment. The prevention and mitigation of burnout syndrome among dentists during a pandemic should consider several factors, such as quality of life, amount of time in the profession, use of personal protective equipment, support from fellow dentists, and alcohol consumption.

Social Insurance Physician Burnout-Stress Factors and Coping Strategies.

Background and Objective Burnout syndrome is well-documented and highly prevalent among healthcare professionals. The literature search found studies mainly aimed at front-line medical specialties, cardiologists, or physicians working in intensive care units. Workload and work conditions favor the occurrence of burnout syndrome among social insurance physicians, with many consequences on health status and a decrease in the quality of their work. We aimed to assess the degree of vulnerability to developing burnout syndrome, factors associated with stress, and coping strategies at social insurance physicians. Materials and Methods: Social insurance physicians working in territorial services for medical assessment of work capacity from Romania participated in the study. An observational study was performed to describe the extent of the exhaustion syndrome among social insurance physicians (SIPhs). Three questionnaires were filled out by the participants: a short version of MBI-HSS to analyze the degree of burnout, an interview with specific questions for the source of stress and Brief-COPE for stress control. Brief demographic data were also collected. Data were statistically analyzed with appropriate tests using PSPP software. Results: Seventy-four physicians were included in the study. Fifty-six were females (75.7%) and twenty-eight (38%) had moderate or high burnout and cognitive distortions with depression resulting as a major side-effect (p < 0.001). Professional factors, mainly deadline pressure (p < 0.001) and high workload (p = 0.012), have emerged as contributing factors to burnout syndrome. Mental disengagement (p = 0.001), active coping (p = 0.006), and acceptance (p = 0.014) would improve stress control. Conclusion: More than two-thirds of social insurance physicians had moderate and high burnout syndrome. The development of strategies to standardize workload was identified as an important action area, along with the long-term preservation of health status and professional performance.

THE DENTAL PROFESSION EXPERIENCES HIGH PREVALENCE RATES OF BURNOUT AND EMOTIONAL EXHAUSTION.

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: Moro JDS, Soares JP, Massignan C, Oliveira LB, Ribeiro DM, Cardoso M, Canto GL, Bolan M. Burnout syndrome among dentists: a systematic review and meta-analysis. J Evid Based Dent Pract. 2022 Sep;22(3):101,724. doi: 10.1016/j.jebdp.2022.101724. Epub 2022 Apr 2. PMID: 36162888 SOURCE OF FUNDING: University funds. TYPE OF STUDY/DESIGN: Systematic review with meta-analysis.

[The loyalty of patients during coronavirus period: investigation experience in the metropolitan children polyclinic].

Two years after COVID-19 pandemic starting, the studies of patient satisfaction with medical services quality become topical again. The article presents the results of three-year project (2019-2022) of studying level of loyalty (Net Promoter Score) of legal representatives of patients of one of municipal children polyclinics. It is established that in Moscow, with implementation of first restrictive measures level of loyalty in the children polyclinic increased from 45% to 70%. In following years, level of loyalty was fixed at the level of 60%. The four groups of factors determining such changes as high level of panic moods due to pandemic, changes in organization of polyclinic functioning, energetic activity of mass media and users of social networks in glorifying image of medical workers and cultural psychological characteristics of Russians. The "optimistic", "realistic" and "pessimistic" prognoses concerning further dynamics of level of loyalty are proposed. The conclusion was made that COVID-19 pandemic served as key factor of positive changes in assessments of patients (and their legal representatives) of functioning both of particular polyclinic and the Russian health care in general. As far as each following time coronavirus infection will cause less and less concern among Russians it can be expected the requirements presented to medical services will soon increase, that means workload of medical personnel will only intensify. The following prospective directions of organizing functioning of medical institutions are proposed: monitoring of psycho-social indicators of medical personnel, implementation of telemedicine technologies, transfer of part of functionality of physicians and nurses to specialists without medical education.

Impact of the COVID-19 pandemic on the burnout rates of graduating Canadian Urology residents.

OBJECTIVE: To assess the impact of coronavirus disease 2019 (COVID-19) on burnout rates in Canadian Urology trainees. SUBJECTS AND METHODS: A total of 37 chief residents representing all 12 Canadian Urology residency programmes attended a preparatory examination in December 2019 pre-pandemic and 39 chief residents attended virtually in November 2020 during the pandemic. The Maslach Burnout Inventory (MBI) for medical professionals' questionnaire was administered anonymously to both groups. The MBI covers emotional exhaustion, depersonalisation, and personal accomplishment. Descriptive statistics were used to analyse the data. RESULTS: There was a 100% response rate in the convenience sample (n = 37) in 2019 and 64.1% response rate (n = 25) in 2020. Overall, 70% of chief residents in Canadian Urology programmes showed evidence of burnout in 2019 compared to 88% in 2020 (P = 0.101). There was a statistically significant difference between the two cohorts in emotional exhaustion (mean [sd] 16.2 [5.6] in 2019 and 20.2 [6.2] in 2020, P = 0.011) and personal accomplishment scores (mean [sd] 32.2 [4.5] in 2019 and 30.6 [3.6] in 2020, P = 0.039). CONCLUSIONS: This study is the first to examine the impact of the pandemic on burnout rates in Urology trainees. Burnout rates are high in trainees at baseline, and the pandemic appears to have exacerbated emotional exhaustion, and personal accomplishment, but not overall burnout rates. Vigilance and proactive steps need to be implemented to alleviate this crisis.

Work environment, resilience, burnout, intent to leave during COVID pandemic among nurse leaders: A cross-sectional study.

AIMS: The aims of this work are to (1) investigate the work environment, resilience, burnout, and turnover intention and (2) examine how work environment and personal resilience impact burnout and turnover intention among nurse leaders in the midst of the COVID-19 crisis. BACKGROUND: The COVID-19 pandemic introduced tremendous stressors to nurse leaders, for example, managing the complex staffing situation while balancing patients' and family's needs. METHODS: During May to September 2021, an electronic survey was sent out to nurse leaders in Birmingham, Alabama, USA, and surrounding areas. RESULTS: Fifty-six respondents were included in the study. The composite score of the work environment measure was moderately to highly related to resilience [ρ (rho) = .59] and burnout [ρ = -.63 to -.68] but had small association to intent to leave [ρ = -.30]. The resilience was highly correlated to burnout [ρ = -.53 to -.59] and moderately associated to intent to leave [ρ = -.32]. CONCLUSIONS: A better work environment for nurse leaders is related to higher resilience, lower burnout, and lower turnover intention. Resilience impacts burnout and turnover intention among nurse leaders. IMPLICATIONS FOR NURSING MANAGEMENT: Health care organizations and stakeholders should implement effective strategies to improve the work environment, which could lead to enhanced resilience, reduced burnout, and lower turnover intention of their nurse leaders especially during and following this pandemic.