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Burnout syndrome and engagement among critical care providers: a cross-sectional study.

ABSTRACT: OBJECTIVE:To evaluate the frequency of severe burnout syndrome among critical care providers and to correlate it with work engagement. METHODS:A self-administered survey including the Maslach Burnout Inventory, Depression Anxiety and Stress Scales, and Gallup questionnaire was distributed. All analyses were stratified by setting (intensive care unit or step-down unit) and by professional group (nurses versus physicians versus physiotherapists). RESULTS:Between February 2017 and June 2017, 206 out of 325 invited professionals (63.4%) answered the questionnaires. Of these, 55 were physicians (26.7%), 88 were physiotherapists (42.7%) and 63 were nurses (30.6%). The frequency of severe burnout was 34.3% (27.9 - 41.4%), and no difference was found between professional groups or settings. The frequency of severe or very severe cases of depression, anxiety or stress was 12.9%, 11.4% and 10.5%, respectively. The median (interquartile range) score observed on the Gallup questionnaire was 41 (34 - 48), and no differences were found between professional groups or settings. There was a negative correlation between burnout and work engagement (r = -0.148; p = 0.035). CONCLUSION:There is a high frequency of severe burnout among critical care providers working in the intensive care unit and step-down unit. There was a negative correlation between burnout and work engagement.

SUBMITTER: Castro CSAA

PROVIDER: S-EPMC7595714 | biostudies-literature | 2020 Jul-Sep

REPOSITORIES: biostudies-literature

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Burnout syndrome and engagement among critical care providers: a cross-sectional study.

Castro Carolina Sant'Anna Antunes Azevedo CSAA Timenetsky Karina Tavares KT Katz Marcelo M Corrêa Thiago Domingos TD Felício Andre Carvalho AC Moriyama Tais T Kernkraut Ana Merzel AM Ferraz Leonardo José Rolim LJR Serpa Neto Ary A

Revista Brasileira de terapia intensiva 20200701 3

<h4>Objective</h4>To evaluate the frequency of severe burnout syndrome among critical care providers and to correlate it with work engagement.<h4>Methods</h4>A self-administered survey including the Maslach Burnout Inventory, Depression Anxiety and Stress Scales, and Gallup questionnaire was distributed. All analyses were stratified by setting (intensive care unit or step-down unit) and by professional group (nurses versus physicians versus physiotherapists).<h4>Results</h4>Between February 2017 ...[more]

PMID: 33053027

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Project description:Burnout appears to be common among critical care providers. It is characterized by three components: emotional exhaustion, depersonalization and personal accomplishment. Moral distress is the inability of a moral agent to act according to his or her core values and perceived obligations due to internal and external constraints. We aimed to estimate the correlation between moral distress and burnout among all intensive care unit (ICU) and the step-down unit (SDU) providers (physicians, nurses, nurse technicians and respiratory therapists).A survey was conducted from August to September 2015. For data collection, a self-administered questionnaire for each critical care provider was used including basic demographic data, the Maslach Burnout Inventory (MBI) and the Moral Distress Scale-Revised (MDS-R). Correlation analysis between MBI domains and moral distress score and regression analysis to assess independent variables associated with burnout were performed.A total of 283 out of 389 (72.7%) critical care providers agreed to participate. The same team of physicians attended both ICU and SDU, and severe burnout was identified in 18.2% of them. Considering all others critical care providers of both units, we identified that overall 23.1% (95% CI 18.0-28.8%) presented severe burnout, and it did not differ between professional categories. The mean MDS-R rate for all ICU and SDU respondents was 111.5 and 104.5, respectively, p = 0.446. Many questions from MDS-R questionnaire were significantly associated with burnout, and those respondents with high MDS-R score (>100 points) were more likely to suffer from burnout (28.9 vs 14.4%, p = 0.010). After regression analysis, moral distress was independently associated with burnout (OR 2.4, CI 1.19-4.82, p = 0.014).Moral distress, resulting from therapeutic obstinacy and the provision of futile care, is an important issue among critical care providers' team, and it was significantly associated with severe burnout.

Project description:ObjectivesTo assess the prevalence of burnout syndrome among intensive care physicians working in a tertiary private hospital as well as their perceived impact of the COVID-19 pandemic on their life.DesignA cross-sectional study.SettingIntensive care units dedicated to the care of COVID-19 in Hospital Sirio-Libanes, Sao Paulo, Southeastern part of Brazil.ParticipantsIntensive care physicians.InterventionsEach participant received an envelope with a questionnaire composed of demographic and occupational variables, information related to their personal and professional experiences facing the COVID-19 pandemic and the Maslach Burnout Inventory questionnaire.Primary and secondary outcomes measuresThe primary outcome was to assess the prevalence of burnout syndrome among physicians working in an intensive care unit dedicated to the care of COVID-19.ResultsA total of 51 from the universe of 63 (82%) intensive care physicians participated in the study. Nineteen (37.2%) met the criteria for burnout syndrome. In the three domains that characterise burnout syndrome, we found a low level of personal achievement in 96.1% of physicians interviewed, a high level of depersonalisation in 51.0% and 51.0% with a high level of emotional exhaustion. Decision-making conflicts between the intensive care unit team and other attending physicians were frequent (50% of all conflicts). A third of the participants had been diagnosed with COVID-19, 22 (43.1%) reported having a family member infected and 8 (15.7%) lost someone close to the COVID-19 pandemic. Participants felt that fear of infecting their loved ones was the aspect of their lives that changed most as compared with the prepandemic period.ConclusionsBurnout syndrome was frequent among intensive care unit physicians treating patients with COVID-19 in a large tertiary private hospital. Future studies should expand our results to other private and public hospitals and test strategies to promote intensive care unit physicians' mental health.

Project description:BackgroundIn acute-care hospitals, patients treated in an ICU for surgical reasons or sudden deterioration are treated in an outpatient ward, ICU, and other multiple departments. It is unclear how healthcare providers are initiating advance care planning (ACP) for such patients and assisting them with it. The purpose of this study is to clarify healthcare providers' perceptions of the ACP support provided to patients receiving critical care in acute-care hospitals.MethodsA cross-sectional study was conducted using questionnaires. In this study, 400 acute-care hospitals with ICUs in Japan were randomly selected, and 1490 subjects, including intensivists, surgeons, ICU nurses, surgical floor nurses, and surgical outpatient nurses, participated. Survey items examined whether ICU patients received ACP support, the participants' degree of confidence in providing ACP support, the patients' treatment preferences, and the decision-making process, and whether any discussion was conducted on change of values.ResultsResponses were obtained from 598 participants from 157 hospitals, 41.4% of which reportedly supported ACP provision to ICU patients. The subjects with the highest level of ACP understanding were surgeons (45.8%), and differences in understanding were observed across specialties (P < 0.001). Among the respondents, physicians and nurses expressed high levels of confidence in providing ACP support to patients requiring critical care. However, 15.2% of all the subjects mentioned that they would not attempt to resuscitate the patients. In addition, 25.7% of the participants handed over patients' values to other departments or hospitals, whereas 25.3% handed over the decision-making process.ConclusionsAmong the participating hospitals, 40% provided ACP support to patients receiving critical care. The low number is possibly because support providers lack understanding of the content of patients' ACP or about how to support and use ACP. Second, it is sometimes too late to start providing ACP support after ICU admission. Third, healthcare providers differ in their perception of ACP, widely considered an ambiguous concept. Finally, in acute-care hospitals with different healthcare settings, it is necessary to confirm and integrate the changes in feelings and thoughts of patients.

Project description:OBJECTIVES:Chinese neurosurgery has made great progress during the past decades; yet, little is known about the working status of neurosurgeons. This study aimed to evaluate the difference between academic and non-academic neurosurgeons, focusing on their professional burnout, job satisfaction and work engagement. DESIGN:Cross-sectional nationwide survey. STUDY SETTING:The survey was conducted in China between 2017 and 2018. PARTICIPANTS:A total number of 823 academic neurosurgeons and 379 non-academic neurosurgeons participated in this study. OUTCOME MEASURES:Professional burnout, job satisfaction and work engagement were assessed using the Maslach Burnout Inventory, the Job Descriptive Index and the Utrecht Work Engagement Scale, respectively. RESULTS:The majority of respondents were male (92.93%), less than 45 years old (85.27%) and married (79.53%). Chinese neurosurgeons worked 63.91±11.04 hours per week, and approximately 45% experienced burnout. Compared with non-academic respondents, academic neurosurgeons had longer working hours (p<0.01), higher income (p<0.01) and were less willing to get married (p<0.01). In addition, they showed a lower degree of burnout (p<0.01), a higher level of job satisfaction (p<0.01) and were more enthusiastic at work (p=0.015). Multivariate regression analyses indicated that divorced (OR 7.02, 95% CI 2.37 to 15.08) and workplace violence (OR 1.52, 95% CI 1.18 to 2.24) were associated with burnout for both academic and non-academic respondents. Long working hours (≥71 hours per week) and low annual income (<1 00 000 RMB) were risk factors for burnout among academic neurosurgeons. For non-academic neurosurgical surgeons (age 36-45 years), working as attending doctors, serving in public hospitals and having the first house-living child were all closely related to the incidence of burnout. CONCLUSION:Chinese neurosurgeons are under significant stress particularly for the non-academic neurosurgeons. Offering better opportunities for training, promotion, higher income and safer working environments could be solutions to relieve burnout and improve career satisfaction and engagement. TRIAL REGISTRATION NUMBER:ChiCTR1800014762. This article is not linked to a clinical trial.

Project description:BACKGROUND: In South Africa, providers are trained on post-rape care by a multitude of organisations, resulting in varied knowledge and skills. In 2007, a national training curriculum was developed and piloted in the country. The objectives of this paper are to identify the factors associated with higher knowledge and confidence in providers at the commencement of the training and to reflect on the implications of this for training and other efforts being made to improve services. METHODS: A cross-sectional study using questionnaires was conducted. Providers who attended the training provided information on socio-demographic background, service provision, training, attitudes, and confidence. Knowledge was measured through multiple choice questions. Bi-variable analysis was carried out in order to test for factors associated with high knowledge and confidence. Variables with a p value of <0.20 were then included in backward selection to develop the final multivariable models. RESULTS: Of the 124 providers, 70% were female and 68% were nurses. The mean age of the providers was 41.7 (24 - 64) years. About 60% of providers were trained in providing post-rape care. The median percentage knowledge score was 37.3% (0% - 65.3%) and the median percentage confidence score was 75.4% (10% - 100%). Having a more appropriate attitude towards rape was associated with higher knowledge, while older providers and nurses had lower odds of having high knowledge levels. Working in a crisis centre in the facility, having examined a survivor in the last 3 months, and seeing more than 60% of survivors who came to the facility were associated with higher confidence. Higher confidence was not associated with greater knowledge. CONCLUSION: The study indicated that although confidence was high, there was poor knowledge in providers, even in those who were previously trained. Knowledge seems to be critically dependant on attitude, which highlights the need for educating providers on rape and the seriousness of the problem. There is a need to train more providers in post-rape care in country, and to ensure that training is comprehensive, and that providers who are trained remain knowledgeable and skilled in current best practices.

Project description:BackgroundPrimary care physician (PCP) burnout is prevalent and on the rise. Physician burnout may negatively affect patient experience of care.ObjectiveTo identify the direct impact of PCP burnout on patient experience in various domains of care.DesignA cross-sectional observational study using physician well-being (PWB) surveys collected in 2016-2017, linked to responses from patient experience of care surveys. Patient demographics and practice characteristics were derived from the electronic health record. Linked data were analyzed at the physician level.SettingA large non-profit multi-specialty ambulatory healthcare organization in northern California.ParticipantsA total of 244 physicians practicing internal medicine or family medicine who responded to the PWB survey (response rate 72%), and 30,701 completed experience surveys from patients seeing these physicians.MeasurementsBurnout was measured with a validated single-item question with a 5-point scale ranging from (1) enjoy work to (5) completely burned out and seeking help. Patient experience of patient-provider communication, access, and overall rating of provider was measured with Clinician & Group Consumer Assessment of Healthcare Providers & Systems (CG-CAHPS) survey. Patient experience scores (0-100 scale) were adjusted for age, gender, race/ethnicity, and English proficiency.ResultsPhysician burnout had a negative impact on patient-reported experience of patient-provider communication but not on access or overall rating of providers. A one-level increase in burnout was associated with 0.43 decrease in adjusted patient-provider communication experience score (P < 0.01).LimitationsData came from a single large healthcare organization. Patterns may differ for small- and mid-sized practices.ConclusionPhysician burnout adversely affects patient-provider communication in primary care visits. Efforts to improve physician work environments could have a meaningful positive impact on patient experience as well as physician well-being.

Dataset Information

Burnout syndrome and engagement among critical care providers: a cross-sectional study.

Publications

Burnout syndrome and engagement among critical care providers: a cross-sectional study.

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