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BACKGROUND: The objective of the current study was to summarize current research on burnout among surgical trainees and surgeons during the COVID-19 pandemic. METHODS: PubMed, SCOPUS, Embase, and Psych INFO were systematically searched for studies that evaluated burnout during the COVID-19 pandemic among surgical trainees and surgeons. RESULTS: A total of 29 articles met inclusion criteria, most of which originated from the United States (n=18, 62.1%). Rates of burnout ranged from 6.0% to 86.0%. Personal factors responsible for burnout were fear of contracting/transmitting COVID-19 (8 studies, 27.6%), female gender (8, 27.6%), and younger age (5, 17.2%). Professional factors contributing to burnout included increased COVID-19 patient clinical load (6, 20.7%), limited work experience (6, 20.7%), reduction in operative cases (5, 17.2%) and redeployment to COVID-19 wards (4, 13.8%). The COVID-19 pandemic negatively impacted surgical education due to reduced number of operative cases (11, 37.9%), decreased hands-on experience (4, 13.8%), and not being able to complete case requirements (3, 10.34%). The shift of didactics to virtual formats (3, 10.3%), increased use of telemedicine (2, 6.9%), and improved camaraderie among residents (1, 3.4%) were viewed as positive consequences. CONCLUSION: COVID-19 related burnout was reported in as many as 1 in 2 surgical trainees and attending surgeons. Intrinsic- (i.e., gender, age), family- (i.e., family/being married/having children or being single/not having children), as well as work-related extrinsic- (i.e., work-force deployment, risk of infection/spread, changes in educational format) factors were strongly associated with risk of burnout. These factors should be considered when designing interventions to ameliorate burnout among surgical trainees and surgeons.

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Publicly Available
Burnout Assessment Among Surgeons and Surgical Trainees During the COVID-19 Pandemic: A Systematic Review
By
Shaikh, Chanza Fahim; Palmer Kelly, Elizabeth; Paro, Alessandro; Cloyd, Jordan; Ejaz, Aslam; Beal, Eliza W.; Pawlik, Timothy M.
Source:
Journal of Surgical Education

INTRODUCTION: Burnout among resident physicians has been an area of concern that predates the COVID-19 pandemic. With the significant turmoil during the pandemic, this study examined resident physicians’ burnout, depression, anxiety, and stress as well as the benefits of engaging in activities related to  wellness, mindfulness, or mental wellbeing.

METHODS:The authors conducted a cross-sectional survey of 298 residents from 13 residency programs sponsored by the University of Kansas School of Medicine-Wichita, in October and November 2021. Authors used a 31-item questionnaire to measure levels of burnout, depression, anxiety, and stress. A mixed method approach was used to collect, analyze, and interpret the data. Descriptive statistics, One-way ANOVA/Kruskal-Wallis tests, adjusted odds ratios (aOR), and immersion-crystallization methods were used to analyze the data.

RESULTS:There was a 52% response rate, with 65.8% (n=102) of the respondents reporting manifestations of burnout. Those who reported at least one manifestation of burnout experienced a higher level of emotional exhaustion (aOR=6.73; 95% CI, 2.66-16.99; P<.01), depression (aOR=1.21; 95% CI, 1.04-1.41; P=.01), anxiety (aOR=1.14; 95% CI, 1.00-1.30; P=.04), and stress (aOR=1.36; 95% CI, 1.13-1.64; P<.01). Some wellness activities respondents engaged in included regular physical activities, meditation and yoga, support from family and friends, religious activities, time away from work, and counseling sessions.

CONCLUSIONS:The findings suggest the COVID-19 pandemic continues to pose a significant and worsening prevalence of burnout and other negative mental health effects on residents. Appropriate wellness and mental health support initiatives are needed to help resident physicians thrive in the health care environment.

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Publicly Available
Burnout, Depression, Anxiety, and Stress among Resident Physicians 18 Months into the COVID-19 Pandemic: A Cross-Sectional Study
By
Ofei-Dodoo, Samuel; Wright, Brynn
Source:
Kansas Journal of Medicine

The COVID-19 pandemic also presents high mental health challenges for medical staff. The present study highlights how the COVID-19 pandemic has stressed Italian medical staff and how dehumanization of patients and colleagues has been associated with distress, alienation, and moral injury. The results show that the processes involved in humanizing care in medicine strengthen the patient-centered relationship but may have been affected by the impact of the pandemic. It is necessary to generate more indepth research on the relationship between dehumanization, humanization, and medical staff well-being. Regarding humanization of care in medicine, the results suggest that training needs to be both implemented to enable medical staff to learn how to properly manage relationships and communication with patients and colleagues and conducted by mental health professionals.

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Burnout Following Moral Injury and Dehumanization: A Study of Distress among Italian Medical Staff during the First COVID-19 Pandemic Period
By
Testoni, Ines; Brondolo, Elizabeth; Ronconi, Lucia; Petrini, Flavia; Navalesi, Paolo; Antonellini, Marco; Biancalani, Gianmarco; Crupi, Robert; Capozza, Dora
Source:
Psychological Trauma: Theory, Research, Practice, and Policy

BACKGROUND: In March of 2020 the World Health Organization declared the COVID-19 virus as a global pandemic. This has had vast effects on the healthcare systems around the world leaving workers feeling dejected and burnt out. This study seeks to describe the source and severity of burnout among respiratory therapists in central Ohio during the pandemic. METHODS: Researchers developed an electronic survey based on a review of literature. Once IRB approval was obtained, the survey was sent to central Ohio RT department managers, who were then asked to disseminate the survey to their staff. Participants provided information about their demographics, frequency and causes of burnout, levels of pre/post-pandemic burnout, which resources were offered by their institution and which resources were utilized by staff. Burnout being defined as an occupational stress related phenomenon, and is manifested by three dimensions, emotional exhaustion, depersonalization, and a reduced sense of personal accomplishment. RESULTS: Of the 102 responses, 58 responses were found to be complete. It was found that 81% of therapists believed that their burnout had increased since the onset of the pandemic and 53.4% were experiencing burnout often. The most common effects of burnout (Figure 1) were fatigue (82.8%), anxiety (69%), and personal health worries (60.3%). The main sources/causes of burnout were inadequate staffing (81%), increased patient acuity (79.3%) and poor patient outcomes (74.1%). When asked what resources were offered by institutions participants responses included: financial support/COVID leave (75.9%), educational sessions (44.8%) and staff feedback sessions (44.8%). Despite this there were much lower percentages of individuals who actually utilized these resources (Figure 2). CONCLUSIONS: An overwhelming majority of participants reported an increase in the frequency of RT burnout since the onset of the COVID-19 pandemic. Additionally, a majority of participants reported an increase in the severity of the burnout they were experiencing. While many hospitals have tried to adapt and offer different resources to help manage burnout, not every resource is being fully or equally utilized by RTs. RT departments should explore solutions to manage sources of burnout that are manageable and within their ability to change.

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Burnout in Healthcare Providers During the COVID-19 Global Pandemic: An Analysis of Burnout Presence in Central Ohio Respiratory Therapists
By
Fox, Rebecca; Varekojis, Sarah M.; Luby, Caitlin; Dahir, Abdullahi; Hazzard, Christiane; McPeak, Aaron; Gerwit, Grant; Haney, Samantha
Source:
Respiratory Care

Burnout is an impactful occupational health phenomenon to which doctors and nurses have been more exposed during the COVID-19 pandemic. The objectives of this study were to measure the dimensions of burnout—emotional exhaustion, depersonalization and personal accomplishment—in a hospital healthcare population after the second COVID-19 wave and to study their association with sociodemographic variables and previous COVID-19 infection. We invited 112 healthcare professionals (doctors and nurses) who attended the occupational health department of a tertiary hospital in March–July 2021. Emotional exhaustion, depersonalization and personal accomplishment were measured by the Maslach Burnout Inventory. Linear-regression analyses were conducted to explore relationships between burnout dimensions and sociodemographic variables. Differences between groups according to previous COVID-19 infection were verified using the t-test and when appropriate the Mann–Whitney test (for continuous variables), the chi-square test and when appropriate the Fisher exact test (for categorical variables). We surveyed 106 subjects (95% response rate). High emotional exhaustion and depersonalization were reported by 33.0 and 18.4% of participants, respectively; 21.4% reported low personal accomplishment. Job tenure was associated with depersonalization and personal accomplishment. For each 1-year increase in job tenure, depersonalization decreases 0.14 (95% CI [−0.23, −0.04]) and personal accomplishment increases 0.16 (95% CI [0.06, 0.25]). Gender was associated with emotional exhaustion (being male increases emotional exhaustion 5.62-fold [95% CI: 1.33; 9.92]). The prevalence of high emotional exhaustion, high depersonalization and low personal accomplishment after the second COVID-19 wave was relevant and should not be overlooked. Our findings suggest that job tenure may play a protective role in healthcare workers’ burnout.

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Burnout in Hospital Healthcare Workers after the Second COVID-19 Wave: Job Tenure as a Potential Protective Factor
By
Antao, Helena Sofia; Sacadura-Leite, Ema; Correia, Ana Isabel; Figueira, Maria Luisa
Source:
Frontiers in Psychology

BACKGROUND: The COVID-19 pandemic has strained hospitals and healthcare workers engaged in combating the virus with limited knowledge and resources. Intensive care unit (ICU) nurses are among the healthcare workers most affected by the pandemic and are at risk for developing burnout syndrome. OBJECTIVE: The present study aims to explore burnout symptoms prevalence among ICU nurses and to identify the individual, organizational, and contextual risk, and protective factors of burnout in ICU nurses during the COVID-19 pandemic. METHODS: A scoping review was conducted by searching PubMed, Scopus, and Web of Science. Only papers with empirical data and referred to ICU nurses were included. A total of 350 initial results were yielded, and 40 full texts were screened. Twelve papers constituted the final sample in the analysis. RESULTS: High levels of symptoms of burnout (emotional exhaustion, depersonalization, and reduced personal accomplishment) were registered among ICU nurses during the COVID-19 pandemic. Increased workload, lack of equipment, social stigma, and fear of contagion emerged as key risk factors. Social support from leaders and colleagues, professional recognition, use of personal protective tools, and witnessing patients’ successful recovery emerged as major protective factors. CONCLUSIONS: The results may inform the development of timely actions to counter burnout in ICU nurses during this COVID-19 pandemic and in a post-COVID-19 scenario.

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Burnout in Intensive Care Nurses during the COVID-19 Pandemic: A Scoping Review on Its Prevalence and Risk and Protective Factors
By
Toscano, Ferdinando; Tommasi, Francesco; Giusino, Davide
Source:
International Journal of Environmental Research and Public Health

PURPOSE OF REVIEW: Physician burnout is well-described in the literature. We analyze the effects of the COVID-19 pandemic on burnout in trauma and acute care surgeons (TACS). RECENT FINDINGS: Along with other healthcare workers and trainees, TACS faced unprecedented clinical, personal, and professional challenges in treating a novel pathogen and were uniquely affected due to their skillset as surgeons, intensivists, and leaders. The pandemic and its consequences have increased burnout and are suspected to have worsened PTSD and moral injury among TACS. The healthcare system is just beginning to grapple with these problems. SUMMARY: COVID-19 significantly added to the pre-existing burden of burnout among TACS. We offer prevention and mitigation strategies. Furthermore, to build upon the work done by individuals and organizations, we urge that national institutions address burnout from a regulatory standpoint.

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Burnout in Trauma Surgeons During the COVID-19 Pandemic: a Long-standing Problem Worsens
By
Ladha, Prerna; Lasinski, Alaina; Kara, Ali Mansoor; Relation, Theresa; Tseng, Esther
Source:
Current Trauma Reports

BACKGROUND: Healthcare professionals experience stressors in the workplace, putting them at elevated risk for burnout. The cardiac catheterization lab is a dynamic environment with high-acuity patients; however, little has been published investigating burnout syndrome among healthcare workers. The aim of the study was to identify the prevalence, demographic, and workload factors, which contribute to burnout syndrome among this population. METHODS: This is a multicenter cross-sectional study assessing burnout with the Maslach Burnout Inventory (MBI) among registered nurses and registered cardiac invasive specialists working in the catheterization/electrophysiology lab and cardiac observation unit at four hospital centers in the metro Detroit area. RESULTS: Of the 48 participants, 69% (n = 33) were female. The overall prevalence of burnout syndrome was 33% (n = 16). Significantly more males experienced burnout than females (P < 0.05). Of the participants experiencing burnout, a greater proportion worked in the catheterization lab compared to the cardiac observation unit (93.8% vs. 6.3%). Burned-out participants worked on average more day shifts, ST-segment elevation myocardial infarction (STEMI) call shifts, and extended day shifts per month compared to those not experiencing burnout. The rate of burnout was significantly higher for individuals reporting increased stress during the pandemic (69% vs. 18%, P < 0.05). CONCLUSIONS: Registered nurses and registered cardiac invasive specialists working in the cardiac catheterization or electrophysiology lab experience elevated levels of burnout. Greater attention should be placed in identifying and optimizing workplace variables which contribute to burnout among this population.

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Publicly Available
Burnout of Support Personnel in the Cardiac Catheterization Laboratory
By
Alex, Jacob; Patel, Hashil; Zughaib, Marc T.; Aggarwal, Ankita; Kommineni, Anudeep; Pietrowicz, Maja; Zughaib, Marcel
Source:
Cardiology Research

OBJECTIVES: To determine the prevalence of burnout among the midwifery workforce and the association between fixed personal and practice characteristics and modifiable organizational factors, specifically practice environment, to burnout among midwives in the United States. DATA SOURCE: Primary data collection was conducted via an online survey of the complete national roster of certified nurse-midwives and certified midwives over 3 weeks in April 2017. STUDY DESIGN: The study was a cross-sectional observational survey consisting of 95 items about personal and practice characteristics, respondents' practice environments, and professional burnout. DATA COLLECTION METHODS: The inclusion criterion was actively practicing midwifery in the United States. Data were analyzed with bivariate analyses to determine the association between personal and practice characteristics and burnout. A hierarchal multilinear regression evaluated the interrelationship between personal and practice characteristics, practice environment, and burnout. PRINCIPAL FINDINGS: Of the almost one third (30.9%) of certified nurse-midwives and certified midwives who responded to the survey, 40.6% met criteria for burnout. Weak negative correlations existed between burnout and indicators of career longevity: age (r(2256) = −0.09, p < 0.01), years as a midwife (r(2267) = −0.07, p = 0.01), and years with employer (r(2271) = −0.05, p = 0.02). There were significant relationships between burnout score and patient workload indicators: patients per day in outpatient setting (F(5,2292) = 13.995, p < 0.01), birth volume (F(3,1864) = 8.35, p < 0.01), and patient acuity (F(2,2295) = 20.21, p < 0.01). When the practice environment was entered into the model with personal and practice characteristics, the explained variance increased from 6.4% to 26.5% (F(20,1478) = 27.98, p < 0.01). CONCLUSIONS: Our findings suggested that a key driver of burnout among US midwives was the practice environment, specifically practice leadership and participation and support for the midwifery model of care. Structural and personal characteristics contributed less to burnout score than the practice environment, implying that prevention of burnout may be achieved through organizational support and does not require structural changes to the provision of perinatal health.

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Burnout of the US Midwifery Workforce and the Role of Practice Environment
By
Thumm, E. Brie; Smith, Denise C.; Squires, Allison P.; Breedlove, Ginger; Meek, Paula M.
Source:
Health Services Research

OBJECTIVE: To examine the prevalence of burnout among radiology trainees in the United States, and to study the relationships between burnout and professional fulfillment (PF), intent-to-leave (ITL), sleep-related impairment and self-compassion by gender. METHODS: This cross-sectional study was conducted via an anonymous electronic survey sent to 11 large academic medical centers (Physician Wellness Academic Consortium) between January 2017 and September 2018. The survey included the Professional Fulfillment Index (PFI) and an abbreviated form of the PROMIS Sleep-related impairment (SRI) scale. Two-sample t-tests and chi-square exact tests were used for analysis (p < 0.05). RESULTS: Two hundred forty-seven radiology residents responded to the survey. Out of these, 36.2% reported burnout, 37.4% endorsed PF, 64.8% reported sleep-related impairment, 7.6% expressed ITL. There were no significant differences between genders. Burnout was associated with reduced PF, increased sleep-impairment (p < 0.001 for both) and increased ITL (p = 0.02). Lower PF, peer support, perceived appreciation for and meaningfulness in work, alignment of organizational and personal values, self-compassion, and higher sleep impairment were associated with burnout (p < 0.001 for all). Burnout was associated with perceptions of less support from department leaders (p = 0.003), control over schedules (p = 0.001) and helpfulness of electronic health record systems (p = 0.01). ITL was associated with reduced PF, perceived work appreciation, and leadership support (p = 0.03, p = 0.04, and p = 0.007, respectively). DISCUSSION: Burnout is prevalent among radiology residents. Many demonstrate sleep-impairment and reduced professional fulfillment, with a lesser fraction desiring to leave their institution. Key factors to burnout included peer and organizational support, electronic health record systems helpfulness, and personal factors like self-compassion and work appreciation.

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Burnout, Professional Fulfillment, Intention to Leave, and Sleep-Related Impairment among Radiology Trainees across the United States (US): A Multisite Epidemiologic Study
By
Higgins, Mikhail C. S. S.; Siddiqui, Ali A.; Kosowsky, Tova; Unan, Lizz; Mete, Mihriye; Rowe, Susannah; Marchalik, Daniel
Source:
Academic Radiology

PURPOSE: To examine the prevalence of burnout, professional fulfillment, sleep impairment, and self-compassion within an academic medical center pharmacy department across varying job titles and practice settings. METHODS: In fall 2019, pharmacy staff completed a REDCap-based survey that consisted of a validated instrument relating to burnout, professional fulfilment, sleep-related impairment, and self-compassion. Burnout was measured by both single-item and extended 10-item questions on the survey. Survey outcomes from each domain were compared between pharmacists and pharmacy technicians/interns, as well as among practice settings (inpatient, ambulatory care, and infrastructure). RESULTS: A total of 593 surveys were completed by pharmacy personnel, representing a preliminary response rate of 71.8% (593/826). A total of 505 survey responses were analyzed (235 [46.5%] for pharmacists and 270 [53.5%] for pharmacy technicians/interns). Inpatient pharmacists reported the highest level of burnout (50.7%), followed by ambulatory care pharmacists (29.3%) and those working in infrastructure (24.3%). Pharmacy technicians working in infrastructure reported the highest level of burnout (36.4%), followed by inpatient (30.8%) and ambulatory care (28.3%) pharmacy technicians. There was no association between job type or location and burnout according to both single-item and 10-item burnout measures. A higher rate of burnout, sleep impairment, and decreased self-compassion and a lower rate of professional fulfillment were observed for inpatient pharmacists compared to pharmacists in ambulatory care or infrastructure. Except for higher rates of reported professional fulfillment, a similar trend was observed for pharmacy technicians. CONCLUSION: Burnout was reported across the pharmacy team regardless of practice site.

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Burnout, Professional Fulfillment, Sleep Impairment, and Self-Compassion within an Academic Medical Center Pharmacy Department
By
Raber, Hanna; May, Alisyn; Tingey, Ben; Qeadan, Fares; Morrow, Ellen; Mullin, Shantel; Nickman, Nancy A; Tyler, Linda S
Source:
American Journal of Health-System Pharmacy

Burnout among physicians is a syndrome of emotional exhaustion, de-personalization, and reduced sense of personal accomplishment that can negatively affect personal relationships, physician well-being, and patient outcomes. Although burnout rates of up to 50% to 60% among orthopedic surgeons have been reported, no studies have evaluated burnout among orthopedic generalists and subspecialists. The primary goal of this study was to examine the prevalence of burnout among orthopedic disciplines. We conducted a multicenter study from March 2019 through December 2019 involving 149 orthopedists. An abbreviated Maslach Burnout Inventory-Human Services Survey was used to measure burnout. Demographic information, personal characteristics, professional characteristics, family life and spousal support, and depression were also assessed. The mean rate of burnout among all respondents was 62%, whereas 16.77% screened positive for depression. Subspecialties with the highest rates of burnout were oncology (100%), sports medicine (68%), and trauma (63%). Similarly, trauma (50.00%), oncology (40.00%), and general orthopedics (20.00%) had the highest positive depression screening rates. In contrast, shoulder and elbow (50%), pediatric (52%), and foot and ankle (54%) specialists had the lowest rates of burnout, whereas shoulder and elbow (0.00%), spine (0.00%), and sports medicine (6.50%) specialists had the lowest rates of positive depression screening. Older age, higher debt load, and oncology subspecialty were associated with increased burnout risk. This study sought to determine burnout rates within each orthopedic discipline, with a secondary aim of disclosing contributing factors. Trauma and oncology had the highest rates of burnout and positive depression screening. Because this study represents a small orthopedic cohort, larger studies are needed to appropriately manage burnout in the future.

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Burnout Rates Among General Orthopedic Surgeons and Subspecialists: A Pilot Study
By
Gaston, Tara E.; Markowitz, Michael P.; Cheesman, Quincy T.; Herbst, Kristen A.; Radack, Tyler M.; Parekh, Selene G.; Daniel, Joseph N.
Source:
Orthopedics (Online)

[This is an excerpt.] The ongoing COVID-19 pandemic has led to significant burnout in all healthcare professionals. Burnout can be defined as a state of mental and emotional weariness, characterized by feelings of energy depletion or exhaustion, depersonalization, and a lack of accomplishment on a personal level.1 It is anticipated that the burnout amongst Canadian radiologists has increased from the 72% that experienced emotional exhaustion in the 2017 national survey. Exacerbation of preexisting systemic issues due to the COVID-19 pandemic, increased domestic responsibilities, fluctuating imaging volumes, increasingly complex patients, and emerging pressures including Radiology’s environmental responsibility and integration of artificial intelligence, are contributing to increasing burnout. [To read more, click View Resource.]

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Publicly Available
Burnout: Turning a Crisis Into an Opportunity
By
Yong-Hing, Charlotte J.; Vaqar, Maham; Sahi, Quratulain; Khosa, Faisal
Source:
Canadian Association of Radiologists Journal

OBJECTIVE: Due to the COVID-19 pandemic, burnout among healthcare workers has significantly increased. This study evaluated rates of burnout in neuropsychologists one year into the COVID-19 pandemic. METHOD: A survey invitation was sent across five neuropsychology-related listservs in April 2021. Burnout was assessed with the Copenhagen Burnout Inventory (CBI; Kristensen, T. S., Borritz, M., Villadsen, E., & Christensen, K. B. (2005). The Copenhagen Burnout Inventory: A new tool for the assessment of burnout. Work & Stress, 19 (3), 192–207) and differences in Personal, Work, and Client burnout scores were evaluated across patient population and work setting. RESULTS: 57.3% and 51.5% of respondents (N = 130) endorsed moderate-to-high levels of personal and work-related burnout, respectively. In the Personal domain, respondents working with pediatric patients had higher mean scores and a higher proportion of respondents endorsed moderate-to-high levels of burnout. CONCLUSION: More than half of the survey respondents endorsed elevated levels of personal and work-related burnout. This is concerning as burnout is associated with personal challenges and diminished patient care. Potential organizational interventions are discussed.

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Burnt Out: Rate of Burnout in Neuropsychology Survey Respondents During the COVID-19 Pandemic, Brief Communication
By
Marra, David E C; Simons, Mary U; Schwartz, Eben S; Marston, Elizabeth A; Hoelzle, James B
Source:
Archives of Clinical Neuropsychology

BACKGROUND: A telephone support hotline (PSU-HELPLINE) was established at the beginning of the pandemic due to the burden on health professionals and the lack of support at the workplace. The aim of this study was to evaluate the telephone support service for health professionals in terms of its burden, benefits, and mechanisms of action. METHODS: Data collection was conducted during and after calls by PSU-HELPLINE counsellors. In addition to the socio-demographic data evaluation, burdens of the callers and the benefits of the calls were collected. The content-analytical evaluation of the stresses as well as the effect factors were based on Mayring’s (2022). RESULTS: Most of the callers were highly to very highly stressed. The usefulness of the conversation was rated as strong to very strong by both callers and counsellors. The PSU-HELPLINE was used primarily for processing serious events and in phases of overload. The support work was carried out through the following aspects of so-called effect factors, among others: psychoeducation, change of perspective, resource activation, problem actualization, connectedness, information, problem solving, self-efficacy, and preservation of resources. CONCLUSIONS: The expansion of local peer support structures and the possibility of a telephone helpline are recommended. Further research is needed.

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Calling for Help—Peer-Based Psychosocial Support for Medical Staff by Telephone—A Best Practice Example from Germany
By
Hinzmann, Dominik; Forster, Andrea; Koll-Krüsmann, Marion; Schießl, Andreas; Schneider, Frederick; Sigl-Erkel, Tanja; Igl, Andreas; Heininger, Susanne Katharina
Source:
International Journal of Environmental Research and Public Health

A humanistic, personal, empathic, and patient-centered attitude towards the patient and family during the clinical encounter is often neglected in many settings. However, patients give it an utmost priority; moreover, the Institute of Medicine stressed it as a fundamental approach to improve the quality of care in the US, and the potential benefits accrued by its implementation are substantial. These benefits encompass patients (including increased satisfaction, trust, adherence, and ‘hard’ health outcomes), physicians (including rediscovering meaning and escaping burnout), and health care systems. Highlighting the quintessential value of humanism and patient-centeredness in the encounter, we discuss the cornerstones of adopting a 'personal' attitude that requires sincere friendly 'connecting' to the patient which can be accomplished with little loss of time, and their myriad advantages, to motivate clinicians to be more mindful of the patient and his or her circumstances.

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Can Humanism Be Infused Into Clinical Encounters in a Time-Constrained, Technology-Driven Era?
By
Ami, Schattner
Source:
Cureus

BACKGROUND: Empathic erosion and burnout represent crises within medicine. Psychological training has been used to promote empathy and personal resilience, yet some training useful within adjacent fields remain unexplored, e.g., Stoic training. Given recent research within psychology suggesting that Stoic training increases emotional wellbeing, exploring this type of training within health professions education is important. We therefore asked: What impact would a Stoicism informed online training package have on third year medical students’ resilience and empathy? METHODS: 24 third year medical students took part in 12 days of online training (SeRenE), based on Stoic philosophy, and co-developed with psychotherapists. A mixed-methods study was conducted to evaluate impact. Pre- and post-SeRenE students completed the Stoic Attitudes and Behaviours Scale (SABS), Brief Resilience Scale (BRS) and Jefferson Scale of Empathy (JSE). All students completed semi-structured interviews following training and 2 months post-SeRenE. Thematic analysis was employed to analyse qualitative data, whilst within subjects t-tests and correlational analyses were conducted on quantitative data. RESULTS: Quantitatively, stoic ideation, resilience and empathy increased post-training, with correlational analyses suggesting resilience and empathy increase in tandem. Qualitatively, four themes were identified: 1. Negative visualisation aids emotional and practical preparedness; 2. Stoic mindfulness encourages students to think about how they think and feel; 3. Stoic reflection develops the empathic imagination; and 4. Evaluating the accessibility of SeRenE. CONCLUSIONS: Our data lend support to the ability of Stoic-based psychological training to positively influence resilience and empathy. Although, quantitatively, results were mixed, qualitative data offers rich insight. The practice of negative visualisation, promoted by SeRenE, encourages student self-efficacy and planning, domains of resilience associated with academic success. Further, this study demonstrates a connection between Stoic practice and empathy, which manifests through development of the empathic imagination and a sense of empathic bravery.

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Can Stoic Training Develop Medical Student Empathy and Resilience? A Mixed-Methods Study
By
Brown, Megan E. L.; MacLellan, Alexander; Laughey, William; Omer, Usmaan; Himmi, Ghita; LeBon, Tim; Finn, Gabrielle M.
Source:
BMC Medical Education

PURPOSE: Interdisciplinary training is a critical part of pharmacy education, and often much of the interdisciplinary participation occurs during the advanced practice experiences of the final professional year of pharmacy education. Creation and maintenance of these experiences can be difficult for faculty members, especially faculty at community hospitals or those with multiple roles and responsibilities at their practice site. The purpose of this article is to reflect on the development process and student acceptance of a collaborative, three-day a week internal medicine rounding student experience. DESCRIPTION: Instead of a traditional five-day a week rounding schedule with a single, primary faculty preceptor, students participated in a three-day a week internal medicine rounding experience where their primary faculty preceptor had a faculty partner who functioned as a substitute. The student activities on the other days were adapted by each faculty preceptor based on their internal medicine subspecialty duties and needs of the practice site. ANALYSIS/INTERPRETATION: Results from a seven-question, anonymous survey to students who participated in the three-day a week internal medicine rounds found high impact on their reported confidence and knowledge. Those responding "positive impact" or "extreme positive impact" ranged from 67% to 100%. In addition, 78% indicated comfort with the substitute faculty preceptor. CONCLUSIONS: This collaborative, three-day a week rounding experience was well received by pharmacy students. IMPLICATIONS: Non-traditional rounding may be an option that could help decrease pharmacy student and faculty burnout, while still providing a positive learning experience for students.

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Can We Do It All? Reflections on the Development of a Collaborative, Three Day a Week Internal Medicine Rounding Experience
By
Hemenway, Alice N.; Meyer-Junco, Laura
Source:
Currents in Pharmacy Teaching & Learning

Secondary traumatic stress (STS) is the emotional duress caused by indirect exposure to distressing events experienced by others. Health care providers are particularly susceptible to secondary stress due to regular exposure to difficult and painful clinical situations that evoke intrinsic empathy necessary to provide effective care. Understanding STS as a normal stress response not only helps to make sense of the symptoms but also suggests a way forward. Opportunities for those in health care to address STS can be found among our colleagues and in our own settings and may provide a meaningful source of support if accessed effectively.

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Caring for Caregivers Experiencing Secondary Trauma: A Call to Action
By
Forkey, Heather C.; Schulte, Elaine; Thorndyke, Luanne
Source:
Clinical Pediatrics

OBJECTIVES: The coronavirus disease 2019 (COVID-19) pandemic globally impacted healthcare due to surges in infected patients and respiratory failure. The pandemic escalated nursing burnout syndrome (NBS) across the workforce, especially in critical care environments, potentially leading to long-term negative impact on nurse retention and patient care. To compare self-reported burnout scores of frontline nurses caring for COVID-19 infected patients with burnout scores captured before the pandemic and in non-COVID-19 units from two prior studies. METHODS: The descriptive study was conducted using frontline nurses working in eight critical care units based on exposure to COVID-19 infected patients. Nurses were surveyed in 2019 and in 2020 using Maslach Burnout Inventory (MBI), Well Being Instrument, and Stress-Arousal Adjective Checklist (SACL) instruments. Researchers explored relationships between survey scores and working in COVID-19 units. RESULTS: Nurses working in COVID-19 units experienced more emotional exhaustion (EE) and depersonalization (DP) than nurses working in non-COVID units (p= .0001). Pre-COVID nurse burnout scores across six critical care units (EE mean = 15.41; p= .59) were lower than burnout scores in the COVID-19 intensive care units (EE mean = 10.29; p= .74). Clinical significance (p= .08) was noted by an EE subscale increase from low prepandemic to moderate during the pandemic. CONCLUSION: Pinpointing associations between COVID-19 infection and nurse burnout may lead to innovative strategies to mitigate burnout in those caring for the most critically ill individuals during future pandemics. Further research is required to establish causal relationships between sociodemographic and work-related psychological predictors of NBS.

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Publicly Available
Caring for COVID-19 Infected Patients Admitted to Redesignated Coronavirus ICUs: Impact on Nurse Stress and Burnout
By
Roney, Jamie K.; Mihandoust, Sahar; Bazan, Gisele N.; Patterson, Tiffany; Dunkle, Stephanie; Whitley, Barbara E.; Long, JoAnn D.
Source:
Nursing Forum