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Healthcare professionals’ stress and burnout

Works Count: 46557

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This cluster of papers explores the prevalence, causes, and consequences of burnout among healthcare professionals and students, with a focus on physicians. It also delves into the impact of burnout on work-life balance, patient care, job satisfaction, mental health, and interventions to address burnout.

Keywords

Physician Burnout; Work-Life Balance; Medical Student Distress; Patient Care; Job Satisfaction; Depression; Anxiety; Professionalism; Well-being; Interventions

Quality of Life Enjoyment and Satisfaction Questionnaire: a new measure.

1993-01-01

Jane Endicott , J. Nee , Wilma Harrison +1 more

The Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q) is a self-report measure designed to enable investigators to easily obtain sensitive measures of the degree of enjoyment and satisfaction experienced … The Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q) is a self-report measure designed to enable investigators to easily obtain sensitive measures of the degree of enjoyment and satisfaction experienced by subjects in various areas of daily functioning. The summary scores were found to be reliable and valid measures of these dimensions in a group of depressed outpatients. The Q-LES-Q measures were related to, but not redundant with, measures of overall severity of illness or severity of depression within this sample. These findings suggest that the Q-LES-Q measures may be sensitive to important differences among depressed patients that are not detected by the measures usually employed.

Burnout in Organizational Life

2004-07-16

Jonathon R. B. Halbesleben , M. Ronald Buckley

Burnout is a psychological response to work stress that is characterized by emotional exhaustion, depersonalization, and reduced feelings of personal accomplishment. In this paper, we review the burnout literature from … Burnout is a psychological response to work stress that is characterized by emotional exhaustion, depersonalization, and reduced feelings of personal accomplishment. In this paper, we review the burnout literature from 1993 to present, identifying important trends that have characterized the literature. We focus our attention on theoretical models that explain the process of burnout, the measurement of burnout, means of reducing burnout, and directions for the future of burnout research.

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The Relaxation Response

1974-02-01

Herbert Benson , John F. Beary , Mark P. Carol

When Dr. Herbert Benson introduced this simple, effective, mind/body approach to relieving stress twenty-five years ag, his book became an instant national bestseller. Since that time, millions of people have … When Dr. Herbert Benson introduced this simple, effective, mind/body approach to relieving stress twenty-five years ag, his book became an instant national bestseller. Since that time, millions of people have learned the secret--without high-priced lectures or prescription medicines. The Relaxation Response has become the classic reference recommended by most health care professionals and authorities to treat the harmful effects of stress.Discovered by Dr. Benson and his colleagues in the laboratories of Harvard Medical School and its teaching hospitals, this revitalizing, therapeutic approach is now routinely recommended to treat patients suffering from heart conditions, high blood pressure, chronic pain, insomnia, and many other physical ailments. It requires only minutes to learn, and just ten to twenty minutes of practice twice a day.

Preliminary Psychometric Properties of the Acceptance and Action Questionnaire–II: A Revised Measure of Psychological Inflexibility and Experiential Avoidance

2011-05-26

Frank W. Bond , Steven C. Hayes , Ruth A. Baer +5 more

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Sources of social support and burnout: A meta-analytic test of the conservation of resources model.

2006-09-01

Jonathon R. B. Halbesleben

The Conservation of Resources (COR) model of burnout (Hobfoll & Freedy, 1993) suggests that resources are differentially related to burnout dimensions. In this paper, I provide a meta-analysis of the … The Conservation of Resources (COR) model of burnout (Hobfoll & Freedy, 1993) suggests that resources are differentially related to burnout dimensions. In this paper, I provide a meta-analysis of the social support and burnout literature, finding that social support, as a resource, did not yield different relationships across the 3 burnout dimensions (emotional exhaustion, depersonalization, and personal accomplishment), challenging the COR model. However, when considering the source of the social support (work vs. nonwork) as a moderator, I found that work-related sources of social support, because of their more direct relationship to work demands, were more closely associated with exhaustion than depersonalization or personal accomplishment; the opposite pattern was found with nonwork sources of support. I discuss the implications of this finding in relation to the COR model and suggest future research directions to clarify the relationship between resources and burnout dimensions.

Burnout: 35 years of research and practice

2009-06-06

Wilmar B. Schaufeli , Michael P. Leiter , Christina Maslach

Purpose The purpose of this paper is to focus on the career of the burnout concept itself, rather than reviewing research findings on burnout. Design/methodology/approach The paper presents an overview … Purpose The purpose of this paper is to focus on the career of the burnout concept itself, rather than reviewing research findings on burnout. Design/methodology/approach The paper presents an overview of the concept of burnout. Findings The roots of the burnout concept seem to be embedded within broad social, economic, and cultural developments that took place in the last quarter of the past century and signify the rapid and profound transformation from an industrial society into a service economy. This social transformation goes along with psychological pressures that may translate into burnout. After the turn of the century, burnout is increasingly considered as an erosion of a positive psychological state. Although burnout seems to be a global phenomenon, the meaning of the concept differs between countries. For instance, in some countries burnout is used as a medical diagnosis, whereas in other countries it is a non‐medical, socially accepted label that carries a minimum stigma in terms of a psychiatric diagnosis. Originality/value The paper documents that the exact meaning of the concept of burnout varies with its context and the intentions of those using the term.

A systematic review of studies of depression prevalence in university students

2012-12-27

Ahmed K. Ibrahim , Shona Kelly , Clive E Adams +1 more

Burnout and Self-Reported Patient Care in an Internal Medicine Residency Program

2002-03-05

Tait D. Shanafelt , Katharine A. Bradley , Joyce E. Wipf +1 more

Background: Burnout is a syndrome of depersonalization, emotional exhaustion, and a sense of low personal accomplishment. Little is known about burnout in residents or its relationship to patient care. Objective: … Background: Burnout is a syndrome of depersonalization, emotional exhaustion, and a sense of low personal accomplishment. Little is known about burnout in residents or its relationship to patient care. Objective: To determine the prevalence of burnout in medical residents and explore its relationship to self-reported patient care practices. Design: Cross-sectional study using an anonymous, mailed survey. Setting: University-based residency program in Seattle, Washington. Participants: 115 internal medicine residents. Measurements: Burnout was measured by using the Maslach Burnout Inventory and was defined as scores in the high range for medical professionals on the depersonalization or emotional exhaustion subscales. Five questions developed for this study assessed self-reported patient care practices that suggested suboptimal care (for example, "I did not fully discuss treatment options or answer a patient's questions" or "I made … errors that were not due to a lack of knowledge or inexperience"). Depression and at-risk alcohol use were assessed by using validated screening questionnaires. Results: Of 115 (76%) responding residents, 87 (76%) met the criteria for burnout. Compared with non–burned-out residents, burned-out residents were significantly more likely to self-report providing at least one type of suboptimal patient care at least monthly (53% vs. 21%; P = 0.004). In multivariate analyses, burnout—but not sex, depression, or at-risk alcohol use—was strongly associated with self-report of one or more suboptimal patient care practices at least monthly (odds ratio, 8.3 [95% CI, 2.6 to 26.5]). When each domain of burnout was evaluated separately, only a high score for depersonalization was associated with self-reported suboptimal patient care practices (in a dose–response relationship). Conclusion: Burnout was common among resident physicians and was associated with self-reported suboptimal patient care practices.

The prevalence and socio-demographic correlations of depression, anxiety and stress among a group of university students

2008-04-08

Nuran Bayram , Nazan Bilgel

Hospital Nurse Staffing and Patient Mortality, Nurse Burnout, and Job Dissatisfaction

2002-10-23

Linda H. Aiken , Sean P. Clarke , Douglas M. Sloane +2 more

ContextThe worsening hospital nurse shortage and recent California legislation mandating minimum hospital patient-to-nurse ratios demand an understanding of how nurse staffing levels affect patient outcomes and nurse retention in hospital … ContextThe worsening hospital nurse shortage and recent California legislation mandating minimum hospital patient-to-nurse ratios demand an understanding of how nurse staffing levels affect patient outcomes and nurse retention in hospital practice.ObjectiveTo determine the association between the patient-to-nurse ratio and patient mortality, failure-to-rescue (deaths following complications) among surgical patients, and factors related to nurse retention.Design, Setting, and ParticipantsCross-sectional analyses of linked data from 10 184 staff nurses surveyed, 232 342 general, orthopedic, and vascular surgery patients discharged from the hospital between April 1, 1998, and November 30, 1999, and administrative data from 168 nonfederal adult general hospitals in Pennsylvania.Main Outcome MeasuresRisk-adjusted patient mortality and failure-to-rescue within 30 days of admission, and nurse-reported job dissatisfaction and job-related burnout.ResultsAfter adjusting for patient and hospital characteristics (size, teaching status, and technology), each additional patient per nurse was associated with a 7% (odds ratio [OR], 1.07; 95% confidence interval [CI], 1.03-1.12) increase in the likelihood of dying within 30 days of admission and a 7% (OR, 1.07; 95% CI, 1.02-1.11) increase in the odds of failure-to-rescue. After adjusting for nurse and hospital characteristics, each additional patient per nurse was associated with a 23% (OR, 1.23; 95% CI, 1.13-1.34) increase in the odds of burnout and a 15% (OR, 1.15; 95% CI, 1.07-1.25) increase in the odds of job dissatisfaction.ConclusionsIn hospitals with high patient-to-nurse ratios, surgical patients experience higher risk-adjusted 30-day mortality and failure-to-rescue rates, and nurses are more likely to experience burnout and job dissatisfaction.

Burnout and Career Satisfaction Among American Surgeons

2009-08-28

Tait D. Shanafelt , Charles M. Balch , Gerald J. Béchamps +7 more

To determine the incidence of burnout among American surgeons and evaluate personal and professional characteristics associated with surgeon burnout.: Burnout is a syndrome of emotional exhaustion and depersonalization that leads … To determine the incidence of burnout among American surgeons and evaluate personal and professional characteristics associated with surgeon burnout.: Burnout is a syndrome of emotional exhaustion and depersonalization that leads to decreased effectiveness at work. A limited amount of information exists about the relationship between specific demographic and practice characteristics with burnout among American surgeons.Members of the American College of Surgeons (ACS) were sent an anonymous, cross-sectional survey in June 2008. The survey evaluated demographic variables, practice characteristics, career satisfaction, burnout, and quality of life (QOL). Burnout and QOL were measured using validated instruments.Of the approximately 24,922 surgeons sampled, 7905 (32%) returned surveys. Responders had been in practice 18 years, worked 60 hours per week, and were on call 2 nights/wk (median values). Overall, 40% of responding surgeons were burned out, 30% screened positive for symptoms of depression, and 28% had a mental QOL score >1/2 standard deviation below the population norm. Factors independently associated with burnout included younger age, having children, area of specialization, number of nights on call per week, hours worked per week, and having compensation determined entirely based on billing. Only 36% of surgeons felt their work schedule left enough time for personal/family life and only 51% would recommend their children pursue a career as a physician/surgeon.Burnout is common among American surgeons and is the single greatest predictor of surgeons' satisfaction with career and specialty choice. Additional research is needed to identify individual, organizational, and societal interventions that preserve and promote the mental health of American surgeons.

Systematic Review of Depression, Anxiety, and Other Indicators of Psychological Distress Among U.S. and Canadian Medical Students

2006-03-21

Liselotte N. Dyrbye , Matthew R. Thomas , Tait D. Shanafelt

To systematically review articles reporting on depression, anxiety, and burnout among U.S. and Canadian medical students.Medline and PubMed were searched to identify peer-reviewed English-language studies published between January 1980 and … To systematically review articles reporting on depression, anxiety, and burnout among U.S. and Canadian medical students.Medline and PubMed were searched to identify peer-reviewed English-language studies published between January 1980 and May 2005 reporting on depression, anxiety, and burnout among U.S. and Canadian medical students. Searches used combinations of the Medical Subject Heading terms medical student and depression, depressive disorder major, depressive disorder, professional burnout, mental health, depersonalization, distress, anxiety, or emotional exhaustion. Reference lists of retrieved articles were inspected to identify relevant additional articles. Demographic information, instruments used, prevalence data on student distress, and statistically significant associations were abstracted.The search identified 40 articles on medical student psychological distress (i.e., depression, anxiety, burnout, and related mental health problems) that met the authors' criteria. No studies of burnout among medical students were identified. The studies suggest a high prevalence of depression and anxiety among medical students, with levels of overall psychological distress consistently higher than in the general population and age-matched peers by the later years of training. Overall, the studies suggest psychological distress may be higher among female students. Limited data were available regarding the causes of student distress and its impact on academic performance, dropout rates, and professional development.Medical school is a time of significant psychological distress for physicians-in-training. Currently available information is insufficient to draw firm conclusions on the causes and consequences of student distress. Large, prospective, multicenter studies are needed to identify personal and training-related features that influence depression, anxiety, and burnout among students and explore relationships between distress and competency.

The prevalence and correlates of depression, anxiety, and stress in a sample of college students

2014-11-08

Rebecca M. Beiter , Rebekah P. Nash , M. McCrady +4 more

Compassion fatigue: Psychotherapists' chronic lack of self care

2002-10-29

Charles R. Figley

Psychotherapists who work with the chronic illness tend to disregard their own self-care needs when focusing on the needs of clients. The article discusses the concept of compassion fatigue, a … Psychotherapists who work with the chronic illness tend to disregard their own self-care needs when focusing on the needs of clients. The article discusses the concept of compassion fatigue, a form of caregiver burnout among psychotherapists and contrasts it with simple burnout and countertransference. It includes a multi-factor model of compassion fatigue that emphasizes the costs of caring, empathy, and emotional investment in helping the suffering. The model suggests that psychotherapists that limiting compassion stress, dealing with traumatic memories, and more effectively managing case loads are effective ways of avoiding compassion fatigue. The model also suggests that, to limit compassion stress, psychotherapists with chronic illness need to development methods for both enhancing satisfaction and learning to separate from the work emotionally and physically in order to feel renewed. A case study illustrates how to help someone with compassion fatigue.

Stress and depression among medical students: a cross-sectional study

2005-05-27

Marie Dahlin , Nils Joneborg , Bo Runeson

To assess the exposure to different stressors and the prevalence of depression among medical students at different levels of education, taking gender differences into account.Students were asked to complete a … To assess the exposure to different stressors and the prevalence of depression among medical students at different levels of education, taking gender differences into account.Students were asked to complete a new stress inventory called the Higher Education Stress Inventory (HESI), the Major Depression Inventory (MDI), slightly modified, and questions on suicidal ideation developed by Meehan.The study was carried out at the Karolinska Institute Medical University, Stockholm, Sweden. Matched controls from the general population were used.All registered students in Years 1, 3 and 6 were enrolled in the study (n = 342). The response rate was 90.4%.Year 1 students gave high ratings to the workload and lack of feedback stressors. Year 3 students gave high ratings to 'Worries about future endurance/competence' and 'Pedagogical shortcomings'. In Year 6, both the latter factors were rated highly, but Year 6 students also gave higher ratings than the 2 other groups to 'Non-supportive climate'. In all 3 cohorts students complained of lack of feedback. Female students gave higher ratings than males to 4 out of 7 factors. Several stress factors were identified as being associated with depression. The prevalence of depressive symptoms among students was 12.9%, significantly higher than in the general population, and was 16.1% among female students versus 8.1% among males. A total of 2.7% of students had made suicide attempts, but none during the previous year.Year 1 students indicated experiencing the highest degree of pressure from studies. A gender difference regarding stress levels was also seen, where women reported higher levels of stress than men. Medical students had higher depression rates than the general population, and women students had higher rates than men.

Using the job demands‐resources model to predict burnout and performance

2004-03-01

Arnold B. Bakker , Evangelia Demerouti , Willem Verbeke

Abstract The job demands‐resources (JD‐R) model was used to examine the relationship between job characteristics, burnout, and (other‐ratings of) performance ( N = 146). We hypothesized that job demands (e.g., … Abstract The job demands‐resources (JD‐R) model was used to examine the relationship between job characteristics, burnout, and (other‐ratings of) performance ( N = 146). We hypothesized that job demands (e.g., work pressure and emotional demands) would be the most important antecedents of the exhaustion component of burnout, which, in turn, would predict in‐role performance (hypothesis 1). In contrast, job resources (e.g., autonomy and social support) were hypothesized to be the most important predictors of extra‐role performance, through their relationship with the disengagement component of burnout (hypothesis 2). In addition, we predicted that job resources would buffer the relationship between job demands and exhaustion (hypothesis 3), and that exhaustion would be positively related to disengagement (hypothesis 4). The results of structural equation modeling analyses provided strong support for hypotheses 1, 2, and 4, but rejected hypothesis 3. These findings support the JD‐R model's claim that job demands and job resources initiate two psychological processes, which eventually affect organizational outcomes. © 2004 Wiley Periodicals, Inc.

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A meta-analytic examination of the correlates of the three dimensions of job burnout.

1996-04-01

Raymond T. Lee , Blake E. Ashforth

This meta-analysis examined how demand and resource correlates and behavioral and attitudinal correlates were related to each of the 3 dimensions of job burnout. Both the demand and resource correlates … This meta-analysis examined how demand and resource correlates and behavioral and attitudinal correlates were related to each of the 3 dimensions of job burnout. Both the demand and resource correlates were more strongly related to emotional exhaustion than to either depersonalization or personal accomplishment. Consistent with the conservation of resources theory of stress, emotional exhaustion was more strongly related to the demand correlates than to the resource correlates, suggesting that workers might have been sensitive to the possibility of resource loss. The 3 burnout dimensions were differentially related to turnover intentions, organizational commitment, and control coping. Implications for research and the amelioration of burnout are discussed.

Burnout and Engagement in University Students

2002-09-01

Wilmar B. Schaufeli , Isabel M. Martínez , Alexandra Marques‐Pinto +2 more

This study examines burnout and engagement—the hypothesized opposite of burnout—in university students from Spain ( n = 623), Portugal ( n = 727), and the Netherlands ( n = 311). … This study examines burnout and engagement—the hypothesized opposite of burnout—in university students from Spain ( n = 623), Portugal ( n = 727), and the Netherlands ( n = 311). Confirmatory factor analyses showed that the expected three-factor structures of the adapted versions of the Maslach Burnout Inventory (MBI) for students (including Exhaustion, Cynicism, and Reduced Efficacy) and the Utrecht Work Engagement Scale (UWES) for students (including Vigor, Dedication, and Absorption) fitted to the data of each sample. However, a rigorous test revealed that most factor loadings of the MBI were not invariant across all samples. Results with the UWES were slightly better, indicating invariance of factor loadings of Absorption in all samples and of Vigor in two of the three samples. Furthermore, as hypothesized, the burnout and engagement subscales were negatively correlated. Finally, irrespective of country, Efficacy and Vigor were positively related to academic performance, that is, the number of passed exams relative to the total number of exams in the previous term.

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Burnout and Satisfaction With Work-Life Balance Among US Physicians Relative to the General US Population

2012-08-28

Tait D. Shanafelt , Sonja Boone , Litjen Tan +6 more

Despite extensive data about physician burnout, to our knowledge, no national study has evaluated rates of burnout among US physicians, explored differences by specialty, or compared physicians with US workers … Despite extensive data about physician burnout, to our knowledge, no national study has evaluated rates of burnout among US physicians, explored differences by specialty, or compared physicians with US workers in other fields.We conducted a national study of burnout in a large sample of US physicians from all specialty disciplines using the American Medical Association Physician Masterfile and surveyed a probability-based sample of the general US population for comparison. Burnout was measured using validated instruments. Satisfaction with work-life balance was explored.Of 27 276 physicians who received an invitation to participate, 7288 (26.7%) completed surveys. When assessed using the Maslach Burnout Inventory, 45.8% of physicians reported at least 1 symptom of burnout. Substantial differences in burnout were observed by specialty, with the highest rates among physicians at the front line of care access (family medicine, general internal medicine, and emergency medicine). Compared with a probability-based sample of 3442 working US adults, physicians were more likely to have symptoms of burnout (37.9% vs 27.8%) and to be dissatisfied with work-life balance (40.2% vs 23.2%) (P < .001 for both). Highest level of education completed also related to burnout in a pooled multivariate analysis adjusted for age, sex, relationship status, and hours worked per week. Compared with high school graduates, individuals with an MD or DO degree were at increased risk for burnout (odds ratio [OR], 1.36; P < .001), whereas individuals with a bachelor's degree (OR, 0.80; P = .048), master's degree (OR, 0.71; P = .01), or professional or doctoral degree other than an MD or DO degree (OR, 0.64; P = .04) were at lower risk for burnout.Burnout is more common among physicians than among other US workers. Physicians in specialties at the front line of care access seem to be at greatest risk.

Physician wellness: a missing quality indicator

2009-11-01

Jean E. Wallace , Jane B Lemaire , William A. Ghali

Burnout and Work Engagement: The JD–R Approach

2014-01-14

Arnold B. Bakker , Evangelia Demerouti , Ana Isabel Sanz‐Vergel

Whereas burnout refers to a state of exhaustion and cynicism toward work, engagement is defined as a positive motivational state of vigor, dedication, and absorption. In this article, we discuss … Whereas burnout refers to a state of exhaustion and cynicism toward work, engagement is defined as a positive motivational state of vigor, dedication, and absorption. In this article, we discuss the main definitions and conceptualizations of both concepts used in the literature. In addition, we review the most important antecedents of burnout and work engagement by examining situational and individual predictors. We also review the possible consequences of burnout and engagement and integrate the research findings using job demands–resources theory. Although both burnout and work engagement are related to important job-related outcomes, burnout seems to be more strongly related to health outcomes, whereas work engagement is more strongly related to motivational outcomes. We discuss daily and momentary fluctuations in burnout and work engagement as possibilities for future research.

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Patient safety, satisfaction, and quality of hospital care: cross sectional surveys of nurses and patients in 12 countries in Europe and the United States

2012-03-20

Linda H. Aiken , Walter Sermeus , Koen Van den Heede +7 more

Objective To determine whether hospitals with a good organisation of care (such as improved nurse staffing and work environments) can affect patient care and nurse workforce stability in European countries. … Objective To determine whether hospitals with a good organisation of care (such as improved nurse staffing and work environments) can affect patient care and nurse workforce stability in European countries. Design Cross sectional surveys of patients and nurses. Setting Nurses were surveyed in general acute care hospitals (488 in 12 European countries; 617 in the United States); patients were surveyed in 210 European hospitals and 430 US hospitals. Participants 33 659 nurses and 11 318 patients in Europe; 27 509 nurses and more than 120 000 patients in the US. Main outcome measures Nurse outcomes (hospital staffing, work environments, burnout, dissatisfaction, intention to leave job in the next year, patient safety, quality of care), patient outcomes (satisfaction overall and with nursing care, willingness to recommend hospitals). Results The percentage of nurses reporting poor or fair quality of patient care varied substantially by country (from 11% (Ireland) to 47% (Greece)), as did rates for nurses who gave their hospital a poor or failing safety grade (4% (Switzerland) to 18% (Poland)). We found high rates of nurse burnout (10% (Netherlands) to 78% (Greece)), job dissatisfaction (11% (Netherlands) to 56% (Greece)), and intention to leave (14% (US) to 49% (Finland, Greece)). Patients' high ratings of their hospitals also varied considerably (35% (Spain) to 61% (Finland, Ireland)), as did rates of patients willing to recommend their hospital (53% (Greece) to 78% (Switzerland)). Improved work environments and reduced ratios of patients to nurses were associated with increased care quality and patient satisfaction. In European hospitals, after adjusting for hospital and nurse characteristics, nurses with better work environments were half as likely to report poor or fair care quality (adjusted odds ratio 0.56, 95% confidence interval 0.51 to 0.61) and give their hospitals poor or failing grades on patient safety (0.50, 0.44 to 0.56). Each additional patient per nurse increased the odds of nurses reporting poor or fair quality care (1.11, 1.07 to 1.15) and poor or failing safety grades (1.10, 1.05 to 1.16). Patients in hospitals with better work environments were more likely to rate their hospital highly (1.16, 1.03 to 1.32) and recommend their hospitals (1.20, 1.05 to 1.37), whereas those with higher ratios of patients to nurses were less likely to rate them highly (0.94, 0.91 to 0.97) or recommend them (0.95, 0.91 to 0.98). Results were similar in the US. Nurses and patients agreed on which hospitals provided good care and could be recommended. Conclusions Deficits in hospital care quality were common in all countries. Improvement of hospital work environments might be a relatively low cost strategy to improve safety and quality in hospital care and to increase patient satisfaction.

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The job demands-resources model of burnout.

2001-06-01

Evangelia Demerouti , Arnold B. Bakker , Friedhelm Nachreiner +1 more

The job demands-resources (JD-R) model proposes that working conditions can be categorized into 2 broad categories, job demands and job resources. that are differentially related to specific outcomes. A series … The job demands-resources (JD-R) model proposes that working conditions can be categorized into 2 broad categories, job demands and job resources. that are differentially related to specific outcomes. A series of LISREL analyses using self-reports as well as observer ratings of the working conditions provided strong evidence for the JD-R model: Job demands are primarily related to the exhaustion component of burnout, whereas (lack of) job resources are primarily related to disengagement. Highly similar patterns were observed in each of 3 occupational groups: human services, industry, and transport (total N = 374). In addition, results confirmed the 2-factor structure (exhaustion and disengagement) of a new burnout instrument--the Oldenburg Burnout Inventory--and suggested that this structure is essentially invariant across occupational groups.

Job Burnout

2003-09-17

Christina Maslach

Job burnout is a prolonged response to chronic emotional and interpersonal stressors on the job and is defined here by the three dimensions of exhaustion, cynicism, and sense of inefficacy. … Job burnout is a prolonged response to chronic emotional and interpersonal stressors on the job and is defined here by the three dimensions of exhaustion, cynicism, and sense of inefficacy. Its presence as a social problem in many human services professions was the impetus for the research that is now taking place in many countries. That research has established the complexity of the problem and has examined the individual stress experience within a larger social and organizational context of people's response to their work. The framework, which focuses attention on the interpersonal dynamics between the worker and other people in the workplace, has yielded new insights into the sources of stress, but effective interventions have yet to be developed and evaluated.

Job Resources Buffer the Impact of Job Demands on Burnout.

2005-04-01

Arnold B. Bakker , Evangelia Demerouti , Martin Euwema

This study tested and refined the job demands-resources model, demonstrating that several job resources play a role in buffering the impact of several job demands on burnout. A total of … This study tested and refined the job demands-resources model, demonstrating that several job resources play a role in buffering the impact of several job demands on burnout. A total of 1,012 employees of a large institute for higher education participated in the study. Four demanding aspects of the job (e.g., work overload, emotional demands) and 4 job resources (e.g., autonomy, performance feedback) were used to test the central hypothesis that the interaction between (high) demands and (low) resources produces the highest levels of burnout (exhaustion, cynicism, reduced professional efficacy). The hypothesis was rejected for (reduced) professional efficacy but confirmed for exhaustion and cynicism regarding 18 out of 32 possible 2-way interactions (i.e., combinations of specific job demands and resources).

The measurement of experienced burnout

1981-04-01

Christina Maslach , Sue Jackson

A scale designed to assess various aspects of the burnout syndrome was administered to a wide range of human services professionals. Three subscales emerged from the data analysis: emotional exhaustion, … A scale designed to assess various aspects of the burnout syndrome was administered to a wide range of human services professionals. Three subscales emerged from the data analysis: emotional exhaustion, depersonalization, and personal accomplishment. Various psychometric analyses showed that the scale has both high reliability and validity as a measure of burnout.

Job demands, job resources, and their relationship with burnout and engagement: a multi‐sample study

2004-03-30

Wilmar B. Schaufeli , Arnold B. Bakker

Abstract This study focuses on burnout and its positive antipode—engagement. A model is tested in which burnout and engagement have different predictors and different possible consequences. Structural equation modeling was … Abstract This study focuses on burnout and its positive antipode—engagement. A model is tested in which burnout and engagement have different predictors and different possible consequences. Structural equation modeling was used to simultaneously analyze data from four independent occupational samples (total N = 1698). Results confirm the hypothesized model indicating that: (1) burnout and engagement are negatively related, sharing between 10 per cent and 25 per cent of their variances; (2) burnout is mainly predicted by job demands but also by lack of job resources, whereas engagement is exclusively predicted by available job resources; (3) burnout is related to health problems as well as to turnover intention, whereas engagement is related only to the latter; (4) burnout mediates the relationship between job demands and health problems, whereas engagement mediates the relationship between job resources and turnover intention. The fact that burnout and engagement exhibit different patterns of possible causes and consequences implies that different intervention strategies should be used when burnout is to be reduced or engagement is to be enhanced. Copyright © 2004 John Wiley & Sons, Ltd.

The Job Demands-Resources model: A three-year cross-lagged study of burnout, depression, commitment, and work engagement

2008-07-01

Jari Hakanen , Wilmar B. Schaufeli , Kirsi Ahola

Abstract By using a full panel design in a representative sample of Finnish dentists (N=2555), the present study aimed to test longitudinally the motivational and health impairment processes as proposed … Abstract By using a full panel design in a representative sample of Finnish dentists (N=2555), the present study aimed to test longitudinally the motivational and health impairment processes as proposed in the Job Demands-Resources (JD-R) model. The second aim was to investigate whether home resources and home demands have an additional influence on both processes over time. The hypotheses were tested with cross-lagged analyses based on two waves over a three-year period. The results supported both the motivational process and the health impairment process. Job resources influenced future work engagement, which, in turn, predicted organizational commitment, whereas job demands predicted burnout over time, which, in turn, predicted future depression. In addition, job resources had a weak negative impact on burnout. Home demands and home resources did not influence the motivational or health impairment process over time. The results support the central role of work characteristics for health and well-being. By integrating both human thriving and ill-health in the same model, the JD-R model may help to bridge the gap between "negative" and "positive" psychology.

A Review and an Integration of Research on Job Burnout

1993-10-01

Cynthia L. Cordes , Thomas W. Dougherty

Burnout is a unique type of stress syndrome, characterized by emotional exhaustion, depersonalization, and diminished personal accomplishment. Although burnout has been shown to be potentially very costly in the helping … Burnout is a unique type of stress syndrome, characterized by emotional exhaustion, depersonalization, and diminished personal accomplishment. Although burnout has been shown to be potentially very costly in the helping professions, such as nursing, education, and social work, little work has been done thus far to establish its generalizability to industry. This article reviews the literature on burnout and provides a conceptual framework designed to improve the understanding of burnout. Propositions are presented that are aimed at clarifying the dynamics of burnout, including determinants of and interrelationships among the three burnout components.

Association of an Educational Program in Mindful Communication With Burnout, Empathy, and Attitudes Among Primary Care Physicians

2009-09-22

Michael S. Krasner

Primary care physicians report high levels of distress, which is linked to burnout, attrition, and poorer quality of care. Programs to reduce burnout before it results in impairment are rare; … Primary care physicians report high levels of distress, which is linked to burnout, attrition, and poorer quality of care. Programs to reduce burnout before it results in impairment are rare; data on these programs are scarce.To determine whether an intensive educational program in mindfulness, communication, and self-awareness is associated with improvement in primary care physicians' well-being, psychological distress, burnout, and capacity for relating to patients.Before-and-after study of 70 primary care physicians in Rochester, New York, in a continuing medical education (CME) course in 2007-2008. The course included mindfulness meditation, self-awareness exercises, narratives about meaningful clinical experiences, appreciative interviews, didactic material, and discussion. An 8-week intensive phase (2.5 h/wk, 7-hour retreat) was followed by a 10-month maintenance phase (2.5 h/mo).Mindfulness (2 subscales), burnout (3 subscales), empathy (3 subscales), psychosocial orientation, personality (5 factors), and mood (6 subscales) measured at baseline and at 2, 12, and 15 months.Over the course of the program and follow-up, participants demonstrated improvements in mindfulness (raw score, 45.2 to 54.1; raw score change [Delta], 8.9; 95% confidence interval [CI], 7.0 to 10.8); burnout (emotional exhaustion, 26.8 to 20.0; Delta = -6.8; 95% CI, -4.8 to -8.8; depersonalization, 8.4 to 5.9; Delta = -2.5; 95% CI, -1.4 to -3.6; and personal accomplishment, 40.2 to 42.6; Delta = 2.4; 95% CI, 1.2 to 3.6); empathy (116.6 to 121.2; Delta = 4.6; 95% CI, 2.2 to 7.0); physician belief scale (76.7 to 72.6; Delta = -4.1; 95% CI, -1.8 to -6.4); total mood disturbance (33.2 to 16.1; Delta = -17.1; 95% CI, -11 to -23.2), and personality (conscientiousness, 6.5 to 6.8; Delta = 0.3; 95% CI, 0.1 to 5 and emotional stability, 6.1 to 6.6; Delta = 0.5; 95% CI, 0.3 to 0.7). Improvements in mindfulness were correlated with improvements in total mood disturbance (r = -0.39, P < .001), perspective taking subscale of physician empathy (r = 0.31, P < .001), burnout (emotional exhaustion and personal accomplishment subscales, r = -0.32 and 0.33, respectively; P < .001), and personality factors (conscientiousness and emotional stability, r = 0.29 and 0.25, respectively; P < .001).Participation in a mindful communication program was associated with short-term and sustained improvements in well-being and attitudes associated with patient-centered care. Because before-and-after designs limit inferences about intervention effects, these findings warrant randomized trials involving a variety of practicing physicians.

Burnout Among U.S. Medical Students, Residents, and Early Career Physicians Relative to the General U.S. Population

2014-01-21

Liselotte N. Dyrbye , Colin P. West , Daniel Satele +4 more

To compare the prevalence of burnout and other forms of distress across career stages and the experiences of trainees and early career (EC) physicians versus those of similarly aged college … To compare the prevalence of burnout and other forms of distress across career stages and the experiences of trainees and early career (EC) physicians versus those of similarly aged college graduates pursuing other careers.In 2011 and 2012, the authors conducted a national survey of medical students, residents/fellows, and EC physicians (≤ 5 years in practice) and of a probability-based sample of the general U.S. population. All surveys assessed burnout, symptoms of depression and suicidal ideation, quality of life, and fatigue.Response rates were 35.2% (4,402/12,500) for medical students, 22.5% (1,701/7,560) for residents/fellows, and 26.7% (7,288/27,276) for EC physicians. In multivariate models that controlled for relationship status, sex, age, and career stage, being a resident/fellow was associated with increased odds of burnout and being a medical student with increased odds of depressive symptoms, whereas EC physicians had the lowest odds of high fatigue. Compared with the population control samples, medical students, residents/fellows, and EC physicians were more likely to be burned out (all P < .0001). Medical students and residents/fellows were more likely to exhibit symptoms of depression than the population control samples (both P < .0001) but not more likely to have experienced recent suicidal ideation.Training appears to be the peak time for distress among physicians, but differences in the prevalence of burnout, depressive symptoms, and recent suicidal ideation are relatively small. At each stage, burnout is more prevalent among physicians than among their peers in the U.S. population.

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The Copenhagen Burnout Inventory: A new tool for the assessment of burnout

2005-07-01

Tage S. Kristensen , Marianne Borritz , Ebbe Villadsen +1 more

Abstract Abstract So far, the large majority of studies on burnout in the international literature have employed the Maslach Burnout Inventory (MBI). In this paper we criticize the MBI on … Abstract Abstract So far, the large majority of studies on burnout in the international literature have employed the Maslach Burnout Inventory (MBI). In this paper we criticize the MBI on a number of points and present a new tool for the measurement of burnout: the Copenhagen Burnout Inventory (CBI). The CBI consists of three scales measuring personal burnout, work-related burnout, and client-related burnout, for use in different domains. On the basis of an ongoing prospective study of burnout in employees in the human service sector, the PUMA study (Project on Burnout, Motivation and Job Satisfaction; N=1914 at baseline), we analysed the validity and reliability of the CBI. All three scales were found to have very high internal reliability, and non-response rates were small. The scales differentiated well between occupational groups in the human service sector, and the expected pattern with regard to correlations with other measures of fatigue and psychological well-being was found. Furthermore, the three scales predicted future sickness absence, sleep problems, use of pain-killers, and intention to quit. Analyses of changes over time showed that substantial proportions of the employees changed with regard to burnout levels. It is concluded that the analyses indicate very satisfactory reliability and validity for the CBI instrument. The CBI is being used in a number of countries and translations into eight languages are available. Keywords: BurnoutCBICopenhagen Burnout Inventoryexhaustionfatiguehuman service workpsychosocial work environmentPUMA studyquestionnaire validity The PUMA study was supported by the Danish Work Environment Fund, the Danish Work Environment Service, the Work Environment Council, and the Health Insurance Foundation.

Burnout and Suicidal Ideation among U.S. Medical Students

2008-09-02

Liselotte N. Dyrbye , Matthew R. Thomas , F. Stanford Massie +7 more

Background: Little is known about the prevalence of suicidal ideation among U.S. medical students or how it relates to burnout. Objective: To assess the frequency of suicidal ideation among medical … Background: Little is known about the prevalence of suicidal ideation among U.S. medical students or how it relates to burnout. Objective: To assess the frequency of suicidal ideation among medical students and explore its relationship with burnout. Design: Cross-sectional 2007 and longitudinal 2006 to 2007 cohort study. Setting: 7 medical schools in the United States. Participants: 4287 medical students at 7 medical schools, with students at 5 institutions studied longitudinally. Measurements: Prevalence of suicidal ideation in the past year and its relationship to burnout, demographic characteristics, and quality of life. Results: Burnout was reported by 49.6% (95% CI, 47.5% to 51.8%) of students, and 11.2% (CI, 9.9% to 12.6%) reported suicidal ideation within the past year. In a sensitivity analysis that assumed all nonresponders did not have suicidal ideation, the prevalence of suicidal ideation in the past 12 months would be 5.8%. In the longitudinal cohort, burnout (P < 0.001 for all domains), quality of life (P < 0.002 for each domain), and depressive symptoms (P < 0.001) at baseline predicted suicidal ideation over the following year. In multivariable analysis, burnout and low mental quality of life at baseline were independent predictors of suicidal ideation over the following year. Of the 370 students who met criteria for burnout in 2006, 99 (26.8%) recovered. Recovery from burnout was associated with markedly less suicidal ideation, which suggests that recovery from burnout decreased suicide risk. Limitation: Although response rates (52% for the cross-sectional study and 65% for the longitudinal cohort study) are typical of physician surveys, nonresponse by some students reduces the precision of the estimated frequency of suicidal ideation and burnout. Conclusion: Approximately 50% of students experience burnout and 10% experience suicidal ideation during medical school. Burnout seems to be associated with increased likelihood of subsequent suicidal ideation, whereas recovery from burnout is associated with less suicidal ideation.

The immediate psychological and occupational impact of the 2003 SARS outbreak in a teaching hospital.

2003-05-13

Robert Maunder , Jonathan Hunter , Leslie Vincent +7 more

The outbreak of severe acute respiratory syndrome (SARS) in Toronto, which began on Mar. 7, 2003, resulted in extraordinary public health and infection control measures. We aimed to describe the … The outbreak of severe acute respiratory syndrome (SARS) in Toronto, which began on Mar. 7, 2003, resulted in extraordinary public health and infection control measures. We aimed to describe the psychological and occupational impact of this event within a large hospital in the first 4 weeks of the outbreak and the subsequent administrative and mental health response.Two principal authors met with core team members and mental health care providers at Mount Sinai Hospital, Toronto, to compile retrospectively descriptions of the experiences of staff and patients based on informal observation. All authors reviewed and analyzed the descriptions in an iterative process between Apr. 3 and Apr. 13, 2003.In a 4-week period, 19 individuals developed SARS, including 11 health care workers. The hospital's response included establishing a leadership command team and a SARS isolation unit, implementing mental health support interventions for patients and staff, overcoming problems with logistics and communication, and overcoming resistance to directives. Patients with SARS reported fear, loneliness, boredom and anger, and they worried about the effects of quarantine and contagion on family members and friends. They experienced anxiety about fever and the effects of insomnia. Staff were adversely affected by fear of contagion and of infecting family, friends and colleagues. Caring for health care workers as patients and colleagues was emotionally difficult. Uncertainty and stigmatization were prominent themes for both staff and patients.The hospital's response required clear communication, sensitivity to individual responses to stress, collaboration between disciplines, authoritative leadership and provision of relevant support. The emotional and behavioural reactions of patients and staff are understood to be a normal, adaptive response to stress in the face of an overwhelming event.

Changes in Burnout and Satisfaction With Work-Life Balance in Physicians and the General US Working Population Between 2011 and 2014

2015-12-01

Tait D. Shanafelt , Omar Hasan , Liselotte N. Dyrbye +4 more

Healthcare Staff Wellbeing, Burnout, and Patient Safety: A Systematic Review

2016-07-08

Louise Hall , Judith Johnson , Ian Watt +2 more

Objective To determine whether there is an association between healthcare professionals' wellbeing and burnout, with patient safety. Design Systematic research review. Data Sources PsychInfo (1806 to July 2015), Medline (1946 … Objective To determine whether there is an association between healthcare professionals' wellbeing and burnout, with patient safety. Design Systematic research review. Data Sources PsychInfo (1806 to July 2015), Medline (1946 to July 2015), Embase (1947 to July 2015) and Scopus (1823 to July 2015) were searched, along with reference lists of eligible articles. Eligibility Criteria for Selecting Studies Quantitative, empirical studies that included i) either a measure of wellbeing or burnout, and ii) patient safety, in healthcare staff populations. Results Forty-six studies were identified. Sixteen out of the 27 studies that measured wellbeing found a significant correlation between poor wellbeing and worse patient safety, with six additional studies finding an association with some but not all scales used, and one study finding a significant association but in the opposite direction to the majority of studies. Twenty-one out of the 30 studies that measured burnout found a significant association between burnout and patient safety, whilst a further four studies found an association between one or more (but not all) subscales of the burnout measures employed, and patient safety. Conclusions Poor wellbeing and moderate to high levels of burnout are associated, in the majority of studies reviewed, with poor patient safety outcomes such as medical errors, however the lack of prospective studies reduces the ability to determine causality. Further prospective studies, research in primary care, conducted within the UK, and a clearer definition of healthcare staff wellbeing are needed. Implications This review illustrates the need for healthcare organisations to consider improving employees' mental health as well as creating safer work environments when planning interventions to improve patient safety. Systematic Review Registration PROSPERO registration number: CRD42015023340.

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Understanding the burnout experience: recent research and its implications for psychiatry

2016-06-01

Christina Maslach , Michael P. Leiter

The experience of burnout has been the focus of much research during the past few decades. Measures have been developed, as have various theoretical models, and research studies from many … The experience of burnout has been the focus of much research during the past few decades. Measures have been developed, as have various theoretical models, and research studies from many countries have contributed to a better understanding of the causes and consequences of this occupationally-specific dysphoria. The majority of this work has focused on human service occupations, and particularly health care. Research on the burnout experience for psychiatrists mirrors much of the broader literature, in terms of both sources and outcomes of burnout. But it has also identified some of the unique stressors that mental health professionals face when they are dealing with especially difficult or violent clients. Current issues of particular relevance for psychiatry include the links between burnout and mental illness, the attempts to redefine burnout as simply exhaustion, and the relative dearth of evaluative research on potential interventions to treat and/or prevent burnout. Given that the treatment goal for burnout is usually to enable people to return to their job, and to be successful in their work, psychiatry could make an important contribution by identifying the treatment strategies that would be most effective in achieving that goal.

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Interventions to prevent and reduce physician burnout: a systematic review and meta-analysis

2016-09-30

Colin P. West , Liselotte N. Dyrbye , Patricia J. Erwin +1 more

Executive Leadership and Physician Well-being

2016-11-18

Tait D. Shanafelt , John H. Noseworthy

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Prevalence of Depression, Depressive Symptoms, and Suicidal Ideation Among Medical Students

2016-12-06

Lisa S. Rotenstein , Marco A. Ramos , Matthew Torre +5 more

Medical students are at high risk for depression and suicidal ideation. However, the prevalence estimates of these disorders vary between studies.To estimate the prevalence of depression, depressive symptoms, and suicidal … Medical students are at high risk for depression and suicidal ideation. However, the prevalence estimates of these disorders vary between studies.To estimate the prevalence of depression, depressive symptoms, and suicidal ideation in medical students.Systematic search of EMBASE, ERIC, MEDLINE, psycARTICLES, and psycINFO without language restriction for studies on the prevalence of depression, depressive symptoms, or suicidal ideation in medical students published before September 17, 2016. Studies that were published in the peer-reviewed literature and used validated assessment methods were included.Information on study characteristics; prevalence of depression or depressive symptoms and suicidal ideation; and whether students who screened positive for depression sought treatment was extracted independently by 3 investigators. Estimates were pooled using random-effects meta-analysis. Differences by study-level characteristics were estimated using stratified meta-analysis and meta-regression.Point or period prevalence of depression, depressive symptoms, or suicidal ideation as assessed by validated questionnaire or structured interview.Depression or depressive symptom prevalence data were extracted from 167 cross-sectional studies (n = 116 628) and 16 longitudinal studies (n = 5728) from 43 countries. All but 1 study used self-report instruments. The overall pooled crude prevalence of depression or depressive symptoms was 27.2% (37 933/122 356 individuals; 95% CI, 24.7% to 29.9%, I2 = 98.9%). Summary prevalence estimates ranged across assessment modalities from 9.3% to 55.9%. Depressive symptom prevalence remained relatively constant over the period studied (baseline survey year range of 1982-2015; slope, 0.2% increase per year [95% CI, -0.2% to 0.7%]). In the 9 longitudinal studies that assessed depressive symptoms before and during medical school (n = 2432), the median absolute increase in symptoms was 13.5% (range, 0.6% to 35.3%). Prevalence estimates did not significantly differ between studies of only preclinical students and studies of only clinical students (23.7% [95% CI, 19.5% to 28.5%] vs 22.4% [95% CI, 17.6% to 28.2%]; P = .72). The percentage of medical students screening positive for depression who sought psychiatric treatment was 15.7% (110/954 individuals; 95% CI, 10.2% to 23.4%, I2 = 70.1%). Suicidal ideation prevalence data were extracted from 24 cross-sectional studies (n = 21 002) from 15 countries. All but 1 study used self-report instruments. The overall pooled crude prevalence of suicidal ideation was 11.1% (2043/21 002 individuals; 95% CI, 9.0% to 13.7%, I2 = 95.8%). Summary prevalence estimates ranged across assessment modalities from 7.4% to 24.2%.In this systematic review, the summary estimate of the prevalence of depression or depressive symptoms among medical students was 27.2% and that of suicidal ideation was 11.1%. Further research is needed to identify strategies for preventing and treating these disorders in this population.

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Physical, psychological and occupational consequences of job burnout: A systematic review of prospective studies

2017-10-04

Denise Albieri Jodas Salvagioni , Francine Nesello Melanda , Arthur Eumann Mesas +3 more

Burnout is a syndrome that results from chronic stress at work, with several consequences to workers' well-being and health. This systematic review aimed to summarize the evidence of the physical, … Burnout is a syndrome that results from chronic stress at work, with several consequences to workers' well-being and health. This systematic review aimed to summarize the evidence of the physical, psychological and occupational consequences of job burnout in prospective studies. The PubMed, Science Direct, PsycInfo, SciELO, LILACS and Web of Science databases were searched without language or date restrictions. The Transparent Reporting of Systematic Reviews and Meta-Analyses guidelines were followed. Prospective studies that analyzed burnout as the exposure condition were included. Among the 993 articles initially identified, 61 fulfilled the inclusion criteria, and 36 were analyzed because they met three criteria that must be followed in prospective studies. Burnout was a significant predictor of the following physical consequences: hypercholesterolemia, type 2 diabetes, coronary heart disease, hospitalization due to cardiovascular disorder, musculoskeletal pain, changes in pain experiences, prolonged fatigue, headaches, gastrointestinal issues, respiratory problems, severe injuries and mortality below the age of 45 years. The psychological effects were insomnia, depressive symptoms, use of psychotropic and antidepressant medications, hospitalization for mental disorders and psychological ill-health symptoms. Job dissatisfaction, absenteeism, new disability pension, job demands, job resources and presenteeism were identified as professional outcomes. Conflicting findings were observed. In conclusion, several prospective and high-quality studies showed physical, psychological and occupational consequences of job burnout. The individual and social impacts of burnout highlight the need for preventive interventions and early identification of this health condition in the work environment.

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Physician burnout: contributors, consequences and solutions

2018-03-05

Colin P. West , Liselotte N. Dyrbye , Tait D. Shanafelt

Abstract Physician burnout, a work‐related syndrome involving emotional exhaustion, depersonalization and a sense of reduced personal accomplishment, is prevalent internationally. Rates of burnout symptoms that have been associated with adverse … Abstract Physician burnout, a work‐related syndrome involving emotional exhaustion, depersonalization and a sense of reduced personal accomplishment, is prevalent internationally. Rates of burnout symptoms that have been associated with adverse effects on patients, the healthcare workforce, costs and physician health exceed 50% in studies of both physicians‐in‐training and practicing physicians. This problem represents a public health crisis with negative impacts on individual physicians, patients and healthcare organizations and systems. Drivers of this epidemic are largely rooted within healthcare organizations and systems and include excessive workloads, inefficient work processes, clerical burdens, work–home conflicts, lack of input or control for physicians with respect to issues affecting their work lives, organizational support structures and leadership culture. Individual physician‐level factors also play a role, with higher rates of burnout commonly reported in female and younger physicians. Effective solutions align with these drivers. For example, organizational efforts such as locally developed practice modifications and increased support for clinical work have demonstrated benefits in reducing burnout. Individually focused solutions such as mindfulness‐based stress reduction and small‐group programmes to promote community, connectedness and meaning have also been shown to be effective. Regardless of the specific approach taken, the problem of physician burnout is best addressed when viewed as a shared responsibility of both healthcare systems and individual physicians. Although our understanding of physician burnout has advanced considerably in recent years, many gaps in our knowledge remain. Longitudinal studies of burnout's effects and the impact of interventions on both burnout and its effects are needed, as are studies of effective solutions implemented in combination. For medicine to fulfil its mission for patients and for public health, all stakeholders in healthcare delivery must work together to develop and implement effective remedies for physician burnout.

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Evidence for a mental health crisis in graduate education

2018-03-01

Teresa M. Evans , Lindsay Bira , Jazmin Beltran Gastelum +2 more

Prevalence of Burnout Among Physicians

2018-09-18

Lisa S. Rotenstein , Matthew Torre , Marco A. Ramos +4 more

Burnout is a self-reported job-related syndrome increasingly recognized as a critical factor affecting physicians and their patients. An accurate estimate of burnout prevalence among physicians would have important health policy … Burnout is a self-reported job-related syndrome increasingly recognized as a critical factor affecting physicians and their patients. An accurate estimate of burnout prevalence among physicians would have important health policy implications, but the overall prevalence is unknown.To characterize the methods used to assess burnout and provide an estimate of the prevalence of physician burnout.Systematic search of EMBASE, ERIC, MEDLINE/PubMed, psycARTICLES, and psycINFO for studies on the prevalence of burnout in practicing physicians (ie, excluding physicians in training) published before June 1, 2018.Burnout prevalence and study characteristics were extracted independently by 3 investigators. Although meta-analytic pooling was planned, variation in study designs and burnout ascertainment methods, as well as statistical heterogeneity, made quantitative pooling inappropriate. Therefore, studies were summarized descriptively and assessed qualitatively.Point or period prevalence of burnout assessed by questionnaire.Burnout prevalence data were extracted from 182 studies involving 109 628 individuals in 45 countries published between 1991 and 2018. In all, 85.7% (156/182) of studies used a version of the Maslach Burnout Inventory (MBI) to assess burnout. Studies variably reported prevalence estimates of overall burnout or burnout subcomponents: 67.0% (122/182) on overall burnout, 72.0% (131/182) on emotional exhaustion, 68.1% (124/182) on depersonalization, and 63.2% (115/182) on low personal accomplishment. Studies used at least 142 unique definitions for meeting overall burnout or burnout subscale criteria, indicating substantial disagreement in the literature on what constituted burnout. Studies variably defined burnout based on predefined cutoff scores or sample quantiles and used markedly different cutoff definitions. Among studies using instruments based on the MBI, there were at least 47 distinct definitions of overall burnout prevalence and 29, 26, and 26 definitions of emotional exhaustion, depersonalization, and low personal accomplishment prevalence, respectively. Overall burnout prevalence ranged from 0% to 80.5%. Emotional exhaustion, depersonalization, and low personal accomplishment prevalence ranged from 0% to 86.2%, 0% to 89.9%, and 0% to 87.1%, respectively. Because of inconsistencies in definitions of and assessment methods for burnout across studies, associations between burnout and sex, age, geography, time, specialty, and depressive symptoms could not be reliably determined.In this systematic review, there was substantial variability in prevalence estimates of burnout among practicing physicians and marked variation in burnout definitions, assessment methods, and study quality. These findings preclude definitive conclusions about the prevalence of burnout and highlight the importance of developing a consensus definition of burnout and of standardizing measurement tools to assess the effects of chronic occupational stress on physicians.

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Understanding and Addressing Sources of Anxiety Among Health Care Professionals During the COVID-19 Pandemic

2020-04-07

Tait D. Shanafelt , Jonathan Ripp , Mickey Trockel

Howard Bauchner, MD; Thomas J. Easley; on behalf of the entire editorial and publishing staff of JAMA and the JAMA Network Howard Bauchner, MD; Thomas J. Easley; on behalf of the entire editorial and publishing staff of JAMA and the JAMA Network

The consequences of the COVID-19 pandemic on mental health and implications for clinical practice

2020-01-01

Andrea Fiorillo , Philip Gorwood

An abstract is not available for this content. As you have access to this content, full HTML content is provided on this page. A PDF of this content is also … An abstract is not available for this content. As you have access to this content, full HTML content is provided on this page. A PDF of this content is also available in through the 'Save PDF' action button.

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Psychological status of medical workforce during the COVID-19 pandemic: A cross-sectional study

2020-04-04

Wen Lu , Hang Wang , Yuxing Lin +1 more

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Job Burnout

2001-02-01

Christina Maslach , Wilmar B. Schaufeli , Michael P. Leiter

▪ Abstract Burnout is a prolonged response to chronic emotional and interpersonal stressors on the job, and is defined by the three dimensions of exhaustion, cynicism, and inefficacy. The past … ▪ Abstract Burnout is a prolonged response to chronic emotional and interpersonal stressors on the job, and is defined by the three dimensions of exhaustion, cynicism, and inefficacy. The past 25 years of research has established the complexity of the construct, and places the individual stress experience within a larger organizational context of people's relation to their work. Recently, the work on burnout has expanded internationally and has led to new conceptual models. The focus on engagement, the positive antithesis of burnout, promises to yield new perspectives on interventions to alleviate burnout. The social focus of burnout, the solid research basis concerning the syndrome, and its specific ties to the work domain make a distinct and valuable contribution to people's health and well-being.

An inventory for measuring clinical anxiety: Psychometric properties.

1988-01-01

Aaron T. Beck , Norman Epstein , Gary Brown +1 more

Do Not Let Your Primal World Beliefs Burn You Out: An Initial Unravelling of the Role of Primal World Beliefs and PsyCap in Core Burnout Symptoms Experience

2025-06-25

Pavol Kačmár , Peter Babinčák , Gabriela Mikulášková +1 more | Studia Psychologica

More on the Current Climate in Psychiatry

2025-06-24

Robert B. Dudas , Elizabeth Fistein | Cambridge University Press eBooks

Psychological Health of Professors

2025-06-24

Valerie Peters , Teryl L. Dobbs , Janet R Barrett +1 more | Oxford University Press eBooks

Abstract This chapter interrogates how the current culture of universities in North America impacts the psychological health of professors. The personal narrative of the first author and vignettes of the … Abstract This chapter interrogates how the current culture of universities in North America impacts the psychological health of professors. The personal narrative of the first author and vignettes of the other co-authors describe how fragmentation and the nonsense of research-teaching-collegiality have impacted their trajectories in higher education. These stories are framed through the lens of a feminist politics of resistance, a feminist ethics of care, and slow scholarship. The authors invite readers to (re)claim themselves in relation to their work in healthful and mindful ways and to push back against the corporatization of higher education to adopt a model of collective and careful slow scholarship.

Insight into the emotional well-being of South African diagnostic radiography students during workplace learning

2025-06-24

Shantel Lewis , Gerhardus George Visser Koch , Kathleen Naidoo +3 more | Radiography

Workplace learning is a significant component of radiography education. While studies about the structure, characteristics and coping mechanisms of workplace learning exist, diagnostic radiography students' emotional well-being during workplace learning … Workplace learning is a significant component of radiography education. While studies about the structure, characteristics and coping mechanisms of workplace learning exist, diagnostic radiography students' emotional well-being during workplace learning remains unexplored. Therefore, this study investigated South African diagnostic radiography students' emotional well-being during workplace learning. A quantitative approach using a cross-sectional survey design was used to collect data through an online questionnaire from undergraduate diagnostic radiography students at five randomly selected higher education institutions in South Africa. Data were analysed statistically. The survey received 265 responses (24.2 % response rate). Most participants (39.6 %) were in their second year of study, 21 years old (28.1 %) and attended public workplace learning centers (52.7 %). The majority of participants (77.7 %) experienced emotionally challenging situations during workplace learning, with the highest levels of emotional distress in forensic radiography (28.6 %), interactions with doctors (19.5 %), and working with burn patients (48.6 %). To cope, 15 % focused on the tasks at hand, and 23.8 % wanted more support. Participants viewed challenges as opportunities for growth, with 65.8 % feeling more confident as they progressed in their degree and 77.2 % gaining awareness of their responses and resilience in the face of emotional challenges. South African diagnostic radiography students experience workplace learning challenges that affect their emotional well-being during workplace learning. While participants shared the need for more support, others saw it as an opportunity to grow and reflect on their responses and resilience. The stressors identified in the study can be addressed to ensure diagnostic radiography students' emotional well-being, which impacts their cognition and quality of patient care.

Effects of a positive psychological intervention on psychological states and functional brain imaging of nurses in transition training: a quasi-experimental study

2025-06-24

Li He , Haiyan Wang , Zhiwei Guo +5 more | Frontiers in Human Neuroscience

Objective To explore the effects of a positive psychological intervention on the psychological state and brain function of trained nurses during the transition period. Methods Randomization was used to assign … Objective To explore the effects of a positive psychological intervention on the psychological state and brain function of trained nurses during the transition period. Methods Randomization was used to assign 130 trained nurses to the observation and control groups. The control group underwent routine training, while the observation group underwent a 12-week positive psychological intervention based on the “Three Good Things” program. The Core Self-Evaluation Scale, Patient Health Questionnaire Depressive Symptom Cluster Scale, Generalized Anxiety Disorder Scale, and resting-state functional magnetic resonance imaging were used for data collection pre- and post-intervention. The amplitude of low-frequency fluctuation, fractional amplitude of low-frequency fluctuation, and regional heterogeneity indices were calculated to assess the functional brain activity of the participants. Pearson’s correlation coefficient was used to assess the relationship between the changes in brain function and behavior. Results There was no difference in the general information of the two groups pre-intervention. Post-intervention, the observation group reported higher self-evaluation scores and lower anxiety and depression scores than the control group. The amplitudes of low-frequency fluctuation of the observation group were significantly higher than those of the control group in the bilateral calcarine gyrus, left cuneus lobe, left supramarginal gyrus, left middle temporal gyrus, left inferior frontal gyrus, left inferior parietal lobe, right superior parietal lobe, right angular gyrus, and right middle temporal gyrus. The observation group displayed significantly higher regional heterogeneity values in the bilateral superior parietal lobe, bilateral supramarginal gyrus, and bilateral inferior parietal lobe ( p &lt; 0.05). Conclusion Positive psychological interventions based on the “Three Good Things” program can assist nurses in training during the transition period to enhance their core self-assessment ability, alleviate their anxiety and depression, and improve their sense of occupational identity and mental health.

Do Oral and Maxillofacial Surgeons have any Coping Strategies to Encounter Mental Health Challenges?

2025-06-24

Manish Bhagania , Vasantha Dhara , Jennifer Monisha Rajan | International Journal of Oral and Maxillofacial Surgery

Barriers and facilitators to implementation of interventions to mitigate moral injury among nurses

2025-06-23

Cassandra M. Godzik , Jennifer DiBenedetto , Timothy J. Usset +7 more | Frontiers in Health Services

Background In the post-pandemic recovery era, addressing moral injury is critical due to high prevalence and impact on mental and occupational health. Interventions that address moral injury in hospital settings … Background In the post-pandemic recovery era, addressing moral injury is critical due to high prevalence and impact on mental and occupational health. Interventions that address moral injury in hospital settings are limited. Further, engaging HCWs in any mental health interventions has proven challenging for a variety of reasons and exacerbated by factors such as a rural setting. Implementation science aimed at understanding barriers and facilitators to interventions is needed in order to build and offer interventions that are usable, feasible, acceptable, and effective. The current study aimed to understand such barriers and facilitators to building moral injury interventions for nurses on the medical intensive care unit (MICU). Methods We conducted semi-structured qualitative interviews using the Consolidated Framework for Implementation Science Research (CFIR) and Peer and Academic Model of Community Engagement with 25 participants in a rural hospital system, 19 nurses currently working in the MICU and six nurses who left their MICU employment. Interviews were transcribed and analyzed using a thematic analysis approach. Results There were five CFIR domains and 14 associated CFIR constructs that impacted intervention implementation in this population. Barriers included resource costs, skepticism regarding the effectiveness of new resources, lack of support from leaders, concerns that emotions affect professional image, inability to take breaks, and a disconnect between nurses' lived experiences and community perceptions. Facilitators included interventions specifically tailored for the MICU, strengths in teaming and social support among fellow nurses, and a desire for change because of factors such as a high turnover rate. Participants also highlighted a strong motivation to provide the best care possible and a desire to build resilience by supporting each other. Conclusion Analysis of barriers and facilitators suggests value in improving the opportunities for HCWs to process morally injurious experiences with interventions specific to a particular unit and resources such as peer support and chaplains. There is a demonstrated need for high-level organizational change to address the dynamic needs of our nurses.

Supplemental Material for Feasibility, Acceptability, and Outcomes: A Pilot Trial of the Enhancing Social Function in Older Veterans With PTSD (ESVP) Group Intervention

2025-06-23

| Psychological Services

Physiological and Perceived Stress, Anxiety, Depression and Burnout Among <scp>ICU</scp> Staff During the <scp>COVID</scp>‐19 Pandemic in Sweden—An Observational Study

2025-06-23

Henrik Andersson , Tomas Faresjö , Helén Didriksson +3 more | Acta Anaesthesiologica Scandinavica

To measure chronic, physiological stress using hair cortisol concentrations (HCC) among ICU staff working during the COVID-19 pandemic in Sweden, and to evaluate its relationship with perceived stress (PS), anxiety, … To measure chronic, physiological stress using hair cortisol concentrations (HCC) among ICU staff working during the COVID-19 pandemic in Sweden, and to evaluate its relationship with perceived stress (PS), anxiety, and depression, and burnout. HCC was measured in hair samples of 274 individuals. We tested for differences between females versus males, nurses versus non-nursing, and ordinary versus deployed staff. PS, anxiety, depression, and burnout were measured using validated questionnaires. Median HCC was 32.6 pg/mg [IQR 21.3-62.3] reflecting physiological stress over 3 months. There were no differences due to sex, profession, and deployment status. Anxiety was detected in 19% and depression in 4% of participants. PS score (23.5 [18.25-29.0]) was higher than previously reported normative data. Burnout was driven by low personal accomplishment. No correlations were found between HCC and PS, anxiety, depression, and burnout. Chronic, physiological stress measured as HCC was not different due to sex, profession or deployment status. Anxiety and burnout were frequent and depression was reported by a minority. HCC did not correlate with PS, anxiety, depression or burnout.

Learning Health System study designs for the evaluation of workforce interventions to cultivate eudaimonia (flourishing)

2025-06-23

Michael Cauley , Anna E. Berry , Carolyn M. Porta +6 more | Learning Health Systems

Abstract Background The Learning Health System (LHS) framework is designed to enhance healthcare by systematically integrating internal data and external evidence to promote quality, safety, and efficiency, aligning science, informatics, … Abstract Background The Learning Health System (LHS) framework is designed to enhance healthcare by systematically integrating internal data and external evidence to promote quality, safety, and efficiency, aligning science, informatics, incentives, and culture for continuous improvement, innovation, and equity. Methods The Agency for Healthcare Research and Quality (AHRQ) also outlined key LHS learning goals structured around four interconnected approaches: (1) evidence generation to create new knowledge, (2) evidence adoption to translate findings into practice, (3) evidence dissemination to share best practices across systems, and (4) evidence management to integrate internal and external insights using technology and informatics. We propose this model can also enhance workforce well‐being (also termed “flourishing” or eudaimonia by Aristotle) through system‐level changes informed by rigorously collected local data. Findings Healthcare workers who flourish realize their purpose, improve patient health, and align themselves through daily decisions and actions toward this end. However, excessive workload, documentation burden, and unsupported caregiving responsibilities can detract from this goal. A wide range of LHS methods can be applied to address healthcare worker well‐being and result in LHS cycles of learning and improvement. We present four examples demonstrating how LHS‐concordant research methods align with AHRQ's learning goals to transition from mitigating burnout to actively promoting flourishing. Contribution Together, the application of the AHRQ learning goals forms a continuous feedback loop that facilitates mutual enhancement between healthcare delivery and research, advancing clinician well‐being and system‐wide improvement. This change in focus offers a new method for the design and evaluation of workforce well‐being interventions, can restore excellence in patient care, and contributes to creating sustainable, human‐centered healthcare systems.

Demographic Factors and Burnout Outcomes Associated With Disability Status Uncertainty in U.S. Medical Students

2025-06-23

Karina Pereira‐Lima , Lisa M. Meeks , Mytien Nguyen +6 more | Academic Medicine

Studies suggest that medical trainees often experience uncertainty regarding their alignment with institutional and legal definitions of disability, which is exacerbated by barriers to documentation, stigma-related concerns, and ableist societal … Studies suggest that medical trainees often experience uncertainty regarding their alignment with institutional and legal definitions of disability, which is exacerbated by barriers to documentation, stigma-related concerns, and ableist societal perceptions. This study examines demographic characteristics and burnout outcomes among medical students uncertain about their disability status compared to those identifying as a person with a disability. The authors analyzed data from second-year medical students identifying as having a disability (N = 2438) or reporting not knowing if they had a disability (N = 496) among the 27,009 participants in the 2019 and 2020 Association of American Medical Colleges Year-Two Questionnaire cohorts (AAMC-Y2Q). Burnout was measured using the Oldenburg Burnout Inventory for Medical Students. Demographic associations with disability status uncertainty and its relationship with burnout were examined through multivariable logistic regression. Compared to White students, those identifying as Asian (OR: 3.36; 95% CI, 2.56-4.39), Black/African American (OR: 2.49; 95% CI, 1.71-3.59), Hispanic/Latino/Spanish origin (OR: 1.65; 95% CI, 1.14-2.36), and Multiracial (OR: 1.66; 95% CI, 1.22-2.24) had significantly higher odds of reporting disability status uncertainty. Asian students also had significantly higher odds than Hispanic/Latino/Spanish origin (OR: 2.03; 95% CI, 1.37-3.05), Multiracial (OR: 2.02; 95% CI, 1.44-2.86), or Other (OR: 2.64; 95% CI, 1.31-5.92) students. Male students had significantly higher uncertainty odds than females (OR: 1.31, 95% CI, 1.06-1.61). Disability status uncertainty associated with significantly greater odds of high burnout (OR: 1.28; 95% CI, 1.03-1.59). Medical students uncertain about their disability status showed increased risk of burnout with differences by race, ethnicity, and gender underscoring the need for institutions to address structural and cultural barriers to seeking disability resources. Further research should investigate strategies for mitigating differences for medical students navigating disability and promoting well-being for all learners.

Working with the socially vulnerable – an observational cross-sectional study investigating the association between exposure to socially vulnerable patients and symptoms of burnout in ambulance personnel

2025-06-23

Nanna Lindekilde , Pernille Melander-Nyboe , Maria Louison Vang +4 more | Prehospital Emergency Care

In Scandinavia, ambulance operations involving socially vulnerable patients, i.e. mentally ill, neglected or marginalized patients, have been highlighted as one of the most demanding challenges for the future prehospital work. … In Scandinavia, ambulance operations involving socially vulnerable patients, i.e. mentally ill, neglected or marginalized patients, have been highlighted as one of the most demanding challenges for the future prehospital work. However, little is known about the mental health implications of working extensively with this patient group. This study aims to investigate the proportion of operational tasks within the Danish prehospital setting that involve working with socially vulnerable patients, and whether there is a significant positive association between the workload involving socially vulnerable patients and the level of burnout symptoms among ambulance personnel. This observational cross-sectional study is based on data from the project "You Don't Stand Alone," using baseline data collected through validated questionnaires completed by a sample of 451 ambulance personnel. Descriptive analyses were conducted to investigate the proportion of operational tasks involving socially vulnerable patients, and linear regression models were utilized to analyze the associations between exposure to socially vulnerable patients and burnout. In this study, we found that 98.5% of the ambulance personnel were involved in operational tasks with socially vulnerable patients, and that 24% of the participants had experienced more than 20 incidents with at least one of the three subgroups of socially vulnerable patients throughout the past year. Furthermore, we found that workload involving socially vulnerable patients was positively associated with the level of burnout (B = 2.05, SE = .28, t(432) = 7.31, 95% CI: 1.50-2.60), and that age and bonding social capital were protective factors, whereas specific work functions were associated with an increased level of burnout. We also found that the significant association between workload involving socially vulnerable patients and levels of burnout attenuated to a non-significant level when adjusting for overall workload of additional critical incidents. The load of socially vulnerable patients in the operational work of ambulance personnel is important to consider due to its potential mental strain. The findings from this study emphasize the relevance of the potential strain of working with these groups of patients, but also highlights that this type of operational tasks is just one of many demanding exposures in ambulance work.

Exploring the role of creative arts in recovery following a suicide attempt amongst healthcare staff

2025-06-23

Caitlin Thompson , Paras Patel , Angela Kennedy | Arts & Health

Research has evidenced the role of creative arts and culture in positive mental health of individuals and communities. There is more limited research into its significance for those who have … Research has evidenced the role of creative arts and culture in positive mental health of individuals and communities. There is more limited research into its significance for those who have felt life is not worth living at some point. The current study aims to explore the role of creative arts in recovery following a suicide attempt in healthcare workers, a population at high risk of work-related stress, and greater risk of poorer mental health. Using secondary data from 25 healthcare staff who have reported a previous suicide attempt(s), the study uses content and thematic analysis to analyse responses to a survey question regarding the role of creative arts in recovery. Content analysis identified genres of chosen art pieces, including music, poetry, literature, film, and artwork. Key themes of hope, self-acceptance, connection with others, and representation of experience offered by the arts were identified as influential in recovery. This study uses a novel approach to enhance understanding in an under-researched area. Findings offer a unique insight into the protective factors which can be provided through engagement with the arts and the role creative arts can play in promoting recovery from a suicide attempt in healthcare workers.

Letter to the Editor on ‘Faculty Development for the People: Workplace‐Based Solutions for Busy Clinicians’

2025-06-22

Cara Haberman , Jaspal Kaur Singh , Julie K. Silver +3 more | The Clinical Teacher

A Cross-Sectional Study to Assess the Prevalence of Burnout Syndrome among Nurses Working in Critical Care Units of a Quaternary Care Hospital in a Metropolitan City

2025-06-22

Laure Thomas , L. C. | International Journal of Advanced Research in Science Communication and Technology

This study aims to assess the prevalence of burnout syndrome among nurses working in critical care units. A cross-sectional study to assess the prevalence of burnout syndrome among nurses working … This study aims to assess the prevalence of burnout syndrome among nurses working in critical care units. A cross-sectional study to assess the prevalence of burnout syndrome among nurses working in critical care units of a quaternary care hospital in a metropolitan city. The sampling technique used was nonprobability purposive sampling. The tool consists of questionnaires t assess demographic data ana a modified Copenhagen burnout inventory which consisted of 20 items. The results related to burnout score were seen that majority of the nurses,53.3%, were having moderate level of burnout, whereas only 20% were having severe level of burnout and 26.6% had mild burnout. It was seen that there was a significant association of demographic variable, years of experience (p=0.007%) according to chi square test

Longitudinal associations between perceived campus mental health climate and changes in college students’ psychological distress and help-seeking intentions

2025-06-21

Michael S. Dunbar , Lisa Sontag-Padilla , Abigail Torbatian +3 more | Journal of American College Health

To examine longitudinal associations between perceived campus mental health climate and students' psychological distress and help-seeking intentions. Participants: College and university students (n = 576) across six Pennsylvania campuses were … To examine longitudinal associations between perceived campus mental health climate and students' psychological distress and help-seeking intentions. Participants: College and university students (n = 576) across six Pennsylvania campuses were recruited in Fall 2022 and completed online surveys at baseline, 1-month, and 6-month follow-up. Methods: Separate fixed-effects regression analyses examined within-person associations between perceived campus mental health climate and psychological distress (K6) and help-seeking intentions over time, adjusting for covariates. Results: Increases in perceived campus mental health climate were associated with decreases in K6 scores (B = -0.46, SE= 0.19, p = 0.01) and increased intentions to seek help from a friend (B = 0.14, SE = 0.04, p = .0008) and mental health professional (B = 0.22, SE = 0.05, p < .0001) over time. Conclusions: Improved perceptions of campus mental health climate were associated with reductions in students' psychological distress and increases in help-seeking intentions within a single academic year.

The Nursing Practice Environment and Job Satisfaction, Intention to Leave, and Burnout Among Primary Healthcare Nurses: A Cross-Sectional Study

2025-06-21

Pedro Lucas , Élvio Jesus , Sofia Almeida +4 more | Nursing Reports

Background: The nursing practice environment significantly influences nurses’ job satisfaction, turnover, and burnout; therefore, it is essential to promote favorable environments to ensure the retention of qualified professionals. Improving the … Background: The nursing practice environment significantly influences nurses’ job satisfaction, turnover, and burnout; therefore, it is essential to promote favorable environments to ensure the retention of qualified professionals. Improving the nursing practice environment is a low-cost organizational strategy associated with satisfaction, retaining professionals, and reducing burnout. The aim of this study was to assess the relationship between the nursing practice environment and job satisfaction, turnover, and burnout among primary healthcare nurses in Portugal. Methods: A descriptive, cross-sectional, and correlational study was carried out based on data from the RN4CAST Portugal Project. The Nurse Survey Instrument (Core Nurse Survey) of the RN4Cast Project (2018) was used for data collection. The sample consisted of 1059 nurses from fifty-five health center groups in mainland Portugal, fifteen health centers in the Autonomous Region of Madeira, and six health centers in the Autonomous Region of the Azores. Results: Primary healthcare nurses in Portugal rated the nursing practice environment as unfavorable or mixed, with an average (x¯) of 2.5 (standard deviation (SD) = 0.4), which is associated with lower job satisfaction, with an average of 2.0 (SD = 0.4), moderate intention to leave, with 40.3%, and low levels of burnout, with an average of 1.6 (SD = 0.8). There was also a negative correlation between the nursing practice environment and burnout (r = −0.28) and its dimensions. Emotional exhaustion (r = −0.35) represents the individual dimension of stress and physical exhaustion, corresponding to feelings regarding the depletion of emotional and physical resources, depersonalization (r = −0.18) represents the interpersonal context dimension of burnout, and a lack of personal accomplishment (r = −0.15) represents the self-assessment dimension of burnout and refers to feelings of incompetence and a lack of confidence and self-efficacy at work. Conclusions: The quality of the work environment is associated with greater job satisfaction and a reduction in burnout. For this reason, improving the work environment has therefore been associated with increased job satisfaction and reduced burnout among primary healthcare nurses, promoting nurse retention and the well-being of healthcare teams.

Empathy-Driven Humanization: Employment Instability,Burnout, and Work Engagement Among Temporary Nurses in a Sustainable Workforce Model

2025-06-20

S. Benito , Carlos Ruíz-Núñez , Juan Pablo Hervás Pérez +4 more | Nursing Reports

Background/Objectives: Employment instability is increasingly recognized as an organizational stressor, yet its combined effect on nurse burnout, humanized care, and work engagement is poorly quantified. This study investigates those relationships … Background/Objectives: Employment instability is increasingly recognized as an organizational stressor, yet its combined effect on nurse burnout, humanized care, and work engagement is poorly quantified. This study investigates those relationships and tests a serial mediation model linking contract instability, burnout, humanization, and engagement in Spanish hospital nurses. Methods: A nationwide cross-sectional survey was completed by 400 fixed-term nurses between February and May 2025. The data included demographics, number of contracts signed during 2024, and scores on the Maslach Burnout Inventory (MBI), Utrecht Work Engagement Scale (UWES), and Health Professionals’ Humanization Scale (HUMAS). Spearman coefficients described the bivariate relations. Results: Burnout correlated positively with both contract count (r = 0.42, p = 0.039) and years of experience (r = 0.74, p = 0.040). Work engagement was inversely associated with instability (r = –0.62, p = 0.018). Humanized care was strongly and negatively related to burnout (r = –0.61, p = 0.032), particularly in sociability and self-efficacy dimensions. Discussion: Contractual precarity elevates burnout, erodes perceptions of humanized care, and, through this erosion, suppresses nurse engagement. Stabilizing workforce arrangements and strengthening empathy-centered skills may mitigate these effects and foster a socially sustainable nursing workforce.

Nurse Burnout: A Critical Health Care Issue

2025-06-20

Melissa Lyder | Journal of Clinical Engineering

Exploring turnover among first-line managers in healthcare: a cohort study of span of control, management performance and stress indicators

2025-06-20

Jonas Svanström , Maria Lindberg , Bernice Skytt +1 more | Leadership in health services

The purpose of this study is to examine if and how an expanded span of control, management performance and work-related stress indicators (control, support and relationships) influence the time until … The purpose of this study is to examine if and how an expanded span of control, management performance and work-related stress indicators (control, support and relationships) influence the time until first-line managers leave their position. A prospective longitudinal cohort design involving 87 first-line managers in a Swedish health-care region. Cox proportional hazards regression was used to analyse expanded span of control, work-related stress indicators and management performance as predictors of turnover. The findings indicate that first-line managers who were categorized as having moderate concern and a need for improvement in the work-related stress indicators control and manager support had a significantly higher risk of turnover. In contrast, expanded span of control and the number of employees managed per first-line manager did not significantly influence turnover risk. In addition, the work-related stress indicator relationships was not significantly associated with risk of turnover. This study expands the understanding of actual turnover among first-line managers in health care by exploring how organizational factors influence the decision to leave. Unlike previous research, which primarily examines turnover intentions, this study takes a longitudinal perspective, capturing real turnover events over time. The findings contribute to future research on organizational conditions, providing a basis for developing strategies to improve retention and working conditions for first-line managers in health care.

Evaluation of Work‐Related Stress, Moral Reward and Job Satisfaction Among Healthcare Professionals in the Postpandemic Era

2025-06-20

Αngeliki Fydanidou , Ourania S. Kotsiou | Journal of Advanced Nursing

ABSTRACT Aim This study investigates work‐related stress, moral reward and job satisfaction among healthcare professionals in the postpandemic era, focusing on the psychological and professional challenges they face. The study … ABSTRACT Aim This study investigates work‐related stress, moral reward and job satisfaction among healthcare professionals in the postpandemic era, focusing on the psychological and professional challenges they face. The study examines the role of excessive demands, inadequate support and reward imbalances, and explores the impact on healthcare workers' well‐being and patient care quality. Design Utilising a quantitative research design, the study involved Greek healthcare professionals across various specialities. Methods Data were gathered via standardised questionnaires: the Perceived Stress Scale (PSS‐14), Effort–Reward Imbalance (ERI) Questionnaire and Employee Satisfaction Index (ESI). The instruments assessed stress levels, effort–reward balance and job satisfaction, with analysis conducted using SPSS to identify key stressors and their correlation with job satisfaction. Results The findings indicated high levels of perceived stress among participants without significant gender differences. Nurses particularly reported higher efforts and reward imbalances. Overall job satisfaction was moderate, with specific dissatisfaction with rewards, benefits and career advancement opportunities. Statistical analyses revealed significant correlations between increased stress, ERI and emotional overcommitment. Conclusions The study highlights the critical need for interventions that address ERIs and improve psychosocial support and working conditions, especially for nursing staff. It emphasises the importance of equitable compensation, professional advancement opportunities and a supportive work environment to enhance job satisfaction and reduce stress among healthcare professionals in a postpandemic context. Impact This study underscores the need for systemic interventions to alleviate work‐related stress, ensuring better work‐life balance and improved job satisfaction among healthcare professionals. Patient or Public Contribution No public or patient involvement.

The causal relationship between academic burnout and emotional regulation affecting undergraduate students' learning performance in the faculty of technical education, Rajamangala university of technology Thanyaburi, Thailand

2025-06-20

Withawat Penphu , Sukanya Boonsri , Watcharaporn Khuanwang +2 more | International Journal of Innovative Research and Scientific Studies

This research aims to develop the causal relationship model between academic burnout and emotional regulation affecting undergraduate students' learning performance in the Faculty of Technical Education at Rajamangala University of … This research aims to develop the causal relationship model between academic burnout and emotional regulation affecting undergraduate students' learning performance in the Faculty of Technical Education at Rajamangala University of Technology Thanyaburi, Thailand, and to examine the consistency of the developed model with empirical data. The study sampled 260 undergraduate students using stratified sampling. The instruments used were the academic burnout and emotional regulation questionnaires, and the model was developed using Structural Equation Modeling (SEM) and path analysis with the AMOS software. The results of the model analysis indicate that the developed model is consistent with empirical data, with χ² = 0.12, χ²/df = 1.20, TLI = 0.99, CFI = 0.99, AGFI = 0.93, RMSEA = 0.017, SRMR = 0.018, and RMR = 0.006. According to the path analysis results, it was found that 1) academic burnout has a significant negative direct effect on learning performance. 2) Academic burnout has a significant negative direct effect on emotional regulation. 3) Emotional regulation has a significant positive direct effect on learning performance. And 4) academic burnout has a significant negative indirect effect on learning performance through emotional regulation. In conclusion, the results of this study extend the understanding of the causal relationship between academic burnout and emotional regulation on learning performance by demonstrating that academic burnout has a negative effect on learning performance, while emotional regulation reduces the effects of academic burnout and significantly improves learning performance. The findings of this study can be utilized to develop activities or programs aimed at enhancing emotional control and fostering motivation among university students to sustainably prevent academic burnout.

Exploring the impact of depression, stress, and sleep disturbances on academic success in international college students

2025-06-19

Kruti S. Chaliawala , Rebecca A. Vidourek , Keith A. King | Journal of International Students

Depression, stress, and sleep issues significantly affect international college students' success. This study examines the link between depression and various academic, mental health, and demographic factors. Data from the American … Depression, stress, and sleep issues significantly affect international college students' success. This study examines the link between depression and various academic, mental health, and demographic factors. Data from the American College Health Association's 2022 National College Health Assessment of 13,242 international students were analyzed. 92.7% of students with moderate to high stress reported depression (χ² = 677.038, p < 0.001), and 52.2% reported sleep issues linked to depression (χ² = 2075.076, p < 0.001). Academic stress affected 82.7%, and anxiety affected 79.8% of students (p < 0.001). Higher depression rates were found among female students (67.9% vs. 32.1% for males; p <0.001), and 20.9% of those facing COVID-19 challenges reported depression. The study highlights the need for culturally sensitive mental health interventions to support international students' stress, sleep issues, and academic pressures, promoting their success and well-being.

Evaluation of the impact of COVID-19 on the occupational burnout among shift workers in Hong Kong

2025-06-19

S. Wong , Anthony Kwok | Hong Kong Journal of Occupational Therapy

During the COVID-19 pandemic, workforce across the globe had experienced an unprecedent change in work mode under the quarantine and social distancing policies. Shift work workers, who were at higher … During the COVID-19 pandemic, workforce across the globe had experienced an unprecedent change in work mode under the quarantine and social distancing policies. Shift work workers, who were at higher risk of burnout, upheld their roles and kept the essential operation of society maintained amidst the pandemic time. The objectives of this study are to evaluate the association between impact of COVID-19 and burnout among shift workers in Hong Kong, and to investigate if there is any association between the infection history and burnout among shift workers. Five hundred and thirty eight shift workers (297 males and 241 females of age 33+9) were recruited in this cross-sectional study. Self-administered questionnaire addressing respondents' demographic information, shift characteristic, anxiety level, perception towards COVID-19 and the burnout situation of the respondent were distributed. The prevalence of burnout among shift workers during pandemic was 39.4%. Engagement in more shifts (aOR = 2.608), 9 to 15-night shift/month (aOR = 1.654), history of frequent infection of COVID-19 (aOR = 2.076), high anxiety level (aOR = 8.599) was associated with higher probability of burnout. Increase in anxiety level correlated to increase in exhaustion (β 0 = 0.042) and decrease in personal efficacy. ( β 0 = -0.081). Impacts by COVID-19 were associated with burnout of shift workers in terms of older age, single status, long shift pattern, night shift, anxiety level as well as infection history. Although World Health Organization has declared the end of COVID-19 pandemic, the post-pandemic burnout situation emerged as an alarming occupational hazard.

3. Medizinische Evaluation: Achtsamkeitstraining für Studierende (MBST®) führt zu nachhaltiger Reduzierung von stressassoziierten Biomarkern

2025-06-19

Andreas Voss , Martin Bogdanski , Mario Walther +4 more | transcript Verlag eBooks

2. Medizinische Evaluation: Achtsamkeitstraining für Studierende (MBST®) führt zu einer physiologischen Stressreduktion

2025-06-19

Andreas Voss , Martin Bogdanski , Mike Sandbothe +1 more | transcript Verlag eBooks

Emotional Intelligence, Perceived Stress, and Burnout in Undergraduate Medical Students: A Cross-Sectional Correlational Study

2025-06-19

Marwa Schumann , Hossam M. Ghorab , Azza Baraka | International Medical Education

Medical education is inherently demanding, requiring students to balance intense academic workload, clinical training, and emotional resilience. High levels of stress and burnout among medical students have been associated with … Medical education is inherently demanding, requiring students to balance intense academic workload, clinical training, and emotional resilience. High levels of stress and burnout among medical students have been associated with decreased empathy, poorer academic performance, and increased risk of mental health problems. This cross-sectional, correlational study examined the relationships between emotional intelligence (EI), perceived stress, and burnout among undergraduate medical students at the Alexandria Faculty of Medicine. Participants completed self-report questionnaires: the Mind Tools Emotional Intelligence Test, the Perceived Stress Scale, and the Maslach Burnout Inventory. Descriptive statistics, bivariate correlations, and multivariate regression models were used for analysis. Among the 264 participants (88% response rate), the majority (73.4%) demonstrated average EI with no statistically significant differences across gender and academic year. Higher perceived stress was strongly correlated with emotional exhaustion and depersonalization, and it was also inversely correlated with personal accomplishment. Regression analysis indicated that gender, academic year, and academic grade were not independent predictors of stress or burnout (R2 = 0.054). Approximately 30.3% of the students met the criteria for burnout. These findings highlight the complex interplay between emotional functioning and burnout, and they also suggest that interventions targeting emotional regulation and resilience may be beneficial in reducing stress and promoting well-being among medical students.

‘Worth … the Nightmares’? A Qualitative Study of Early‐Career Healthcare Workers' Wellbeing and Career Decisions After Starting Work During Covid‐19

2025-06-19

Megan E. L. Brown , Bryan Burford , Christopher Price +2 more | The Clinical Teacher

The Covid-19 pandemic placed unprecedented pressure on healthcare systems, education and individual professionals-notably, newly qualified front line nurses and paramedics. While we know wellbeing was negatively affected, qualitative exploration of … The Covid-19 pandemic placed unprecedented pressure on healthcare systems, education and individual professionals-notably, newly qualified front line nurses and paramedics. While we know wellbeing was negatively affected, qualitative exploration of workplace experiences and how these impact wellbeing and shape career decision making is lacking. This is a critical gap in the literature, given the current healthcare workforce crisis and a need for evidence-based educational reform to better support learners in the workplace. This study explores the experiences of nurses and paramedics during the pandemic and how these influenced wellbeing and career decision-making. We adopted an interpretivist, qualitative approach, and conducted semi-structured interviews with seven newly qualified nurses and two senior paramedics. We utilised reflexive thematic analysis to explore and analyse data, considering the impact of starting work during Covid-19. Our findings demonstrated the significant impact of the pandemic on wellbeing and career decision-making. Key issues included a turbulent transition into practice, shaped by increased clinical pressures (including high patient numbers, and workforce shortages) and reduced support at organisational and interpersonal levels. Participants described a shift in career values, with greater emphasis on wellbeing as a determinant for job decisions. Many reported re-evaluating their careers, prioritising roles or teams that offered better support and manageable workloads, or considering leaving healthcare altogether. This study suggests a need for educational policy and practice to consider how workplace experience impacts wellbeing and career decision-making. Beyond indicating the need for further research, this study acts as a critical conversation regarding future workforce planning.

Addressing substance use challenges and interventions for emergency department nurses

2025-06-19

John Skinner , Mel Steer , Kevin Murphy +1 more | British Journal of Nursing

Several areas of the UK face significant challenges related to substance use, placing considerable pressure on emergency departments (EDs). This article examines the impact of these challenges on ED nurses … Several areas of the UK face significant challenges related to substance use, placing considerable pressure on emergency departments (EDs). This article examines the impact of these challenges on ED nurses in the north-east region of England, highlighting the prevalence of alcohol and substance use, its effects on healthcare services, and the resulting strain on staff. The literature indicates high rates of substance-related incidents, increased ED admissions, and extended wait times, all contributing to nurse burnout and compromised patient care. By reviewing current research, key themes such as staffing issues, managerial support and the need for targeted interventions are identified. Recommendations include enhanced training, improved support systems, and policy changes aimed at promoting nurse wellbeing and patient outcomes.

Trauma Support Services for Healthcare Workers

2025-06-19

Kenneth R. Yeager , Diana L. McMahon | Oxford University Press eBooks

Abstract This chapter examines the complex nature of taking care of the mental wellness of healthcare workers, who, on a consistent basis, see things no one should ever have to … Abstract This chapter examines the complex nature of taking care of the mental wellness of healthcare workers, who, on a consistent basis, see things no one should ever have to see and take actions that no one should ever have to take. It outlines the delicate balance of maintaining emotional wellness and functionality in an environment that is by its very nature fraught with patient loss and family and staff distress following a seemingly endless stream of challenging cases. It examines a matrix of factors contributing to stress, traumatic stress, vicarious trauma, moral distress, and burnout and how these contribute to staff turnover. It provides a framework for managing stress and avoiding burnout. Next the chapter describes how to establish and apply brief emotional support teams (BEST) and concludes with a review of the impact of the COVID-19 pandemic on hospital nursing staff emotional well-being.

Letter to the editor: addressing sample size and methodological considerations in burnout research among Italian internists

2025-06-19

Shoaib Majeed | Internal and Emergency Medicine

Trajectories of Emotional Exhaustion and Their Contribution to Depression: Optimism as a Buffer in Young People

2025-06-18

Martha Cruz‐Soto , Emmanuel Said Baeza-Torres , Luis Castañeda-Pelaez +2 more | Brain Sciences

In Mexico, depression is one of the main mental health problems, with university students being particularly susceptible. Recent studies have explored the relationship between emotional factors and depression in young … In Mexico, depression is one of the main mental health problems, with university students being particularly susceptible. Recent studies have explored the relationship between emotional factors and depression in young people. Our study investigates whether optimism buffers the indirect relationship between burnout, stress and coping in mitigating the negative effects on depressive symptoms in young university students. We hypothesized that optimism would moderate the negative impacts of stress and emotional exhaustion on depression. In total, 497 students of a university in Mexico participated (63% female and 36.6% male), ranging in age from 18 to 29. Students completed screenings for depression, emotional scales and optimism measures. Emotional exhaustion and stress are direct predictors of depression. Although coping strategies did not have a direct effect, optimism mediated the relationship between stress and depression. These findings suggest that promoting optimism in university students could be an effective strategy to reduce depressive symptoms, especially in the context of socioemotional vulnerability.

Identifying, managing and preventing nurse burnout in the emergency department

2025-06-18

Emmett Brennan | Emergency Nurse

Burnout is a prevalent and escalating issue in emergency nursing, driven by factors such as increased patient demand, overcrowding, staffing shortages, workplace violence and critical incident exposure. This article explores … Burnout is a prevalent and escalating issue in emergency nursing, driven by factors such as increased patient demand, overcrowding, staffing shortages, workplace violence and critical incident exposure. This article explores the systemic, environmental and psychological causes of burnout, and examines its detrimental effects on nurses' well-being and patient safety. Strategies for identifying, managing and preventing burnout are discussed, including recognising early symptoms, managing the emotional effect of trauma, supporting personal resilience and the importance of organisational measures such as improved staffing, leadership support and workplace safety initiatives. Practical interventions to develop resilience, enhance emotional regulation and mitigate the effect of shiftwork are explored. The article emphasises that while individual strategies are valuable, systemic changes are essential to address the root causes of burnout. By implementing multilevel approaches, emergency nurses and healthcare organisations can protect staff well-being and sustain the delivery of safe, high-quality care.

Promoting the joy in academic medicine: A scoping review

2025-06-18

Marghalara Rashid , Nick Firth , Liz Dennett +3 more | Medical Teacher

As academic medical leaders, we aimed to improve the workplace by promoting joy at work. Unlike deficit-based approaches that focus on burnout or disengagement, joy is a strength-based approach. Nurturing … As academic medical leaders, we aimed to improve the workplace by promoting joy at work. Unlike deficit-based approaches that focus on burnout or disengagement, joy is a strength-based approach. Nurturing joy increases productivity, creativity, and happiness. To achieve our aim, we performed a scoping review on how leaders can better support joy at work for individuals in the academic medical setting. We searched seven databases, including peer-reviewed studies, books, book chapters, conference abstracts, and dissertations with no restriction on study design or country. Initial screen was abstract and title. Two reviewers screened, two extracted information, and a third reviewed entries. Discrepancies were resolved by consensus. 4649 publications were found (2465 after duplicate removal), 123 had full-text review, 25 met the inclusion criteria and were published between 1997 and 2023, conducted in the United States (n = 22), the United Kingdom (n = 2), and Canada (n = 1). Themes included shifting to a strengths-based focus on joy at work, implementing programs to prioritize it, and the key role of leaders in championing joy. Making system-level changes and adopting evidence-based programs that promote joy at work for academic physicians is effective. Ensuring that leaders are competent in using evidence-based approaches to improve joy is key.

The Sacred Space of Surrender: Transforming Physician-Patient Vulnerability Into Healing Power – a Framework for Medical Practice

2025-06-18

| Journal of Psychology and Neuroscience

Modern medicine operates within paradigms that often emphasize physician control and emotional detachment, potentially limiting therapeutic effectiveness and contributing to clinician burnout. This article proposes a framework integrating Rami Shapiro’s … Modern medicine operates within paradigms that often emphasize physician control and emotional detachment, potentially limiting therapeutic effectiveness and contributing to clinician burnout. This article proposes a framework integrating Rami Shapiro’s concept of “surrendered living” with clinical practice to transform physician vulnerability from perceived weakness into therapeutic strength. This theoretical framework synthesizes concepts from Rami Shapiro’s “Surrendered—The Sacred Art”1 with evidence-based medical literature on physician-patient relationships, empathy, trust, and communication. A comprehensive literature review examines empirical support for vulnerability-based approaches in healthcare. Evidence demonstrates that authentic physician vulnerability, when consciously applied, enhances therapeutic relationships, reduces burnout, and improves patient outcomes. The surrendered physician approach offers three core principles: acknowledging professional limitations, recognizing healing forces beyond medical intervention, and maintaining therapeutic presence without attachment to specific outcomes. The integration of surrendered vulnerability into medical practice represents a paradigm shift from control-based to relationship-based healing, with implications for medical education, clinical practice, and physician wellness programs.

Personality, cognitive, and emotional factors in the emergency department: complementary physicians’ profiles

2025-06-18

Silvia Riva , Alessandro Antonietti , Paola Iannello | Emergency Care Journal

In the realm of medical education, the escalating challenges faced by emergency healthcare services have brought into focus the retention and recruitment of hospital emergency physicians. This study delves into … In the realm of medical education, the escalating challenges faced by emergency healthcare services have brought into focus the retention and recruitment of hospital emergency physicians. This study delves into the intricate dynamics of personality traits, cognitive abilities, and emotional resilience within emergency physicians, which shape their decision-making processes within hospital environments characterised by uncertainty. By administering a comprehensive battery of personality, cognitive, and emotional assessments to 40 emergency physicians in Italy, the study unveils distinct profiles. It identifies two clusters: Cluster 1, termed "Risk-Sensitive Evaluators," characterised by a cautious, analytical approach, and Cluster 2, labelled "Timely Outcome Oriented," demonstrating adaptability and intuitive decision-making processes. The research underscores the pivotal role played by these diverse yet complementary approaches in emergency care, offering insights into the significant factors influencing occupational preferences and responses to stress among emergency physicians.

Vicarious post-traumatic growth in Chinese oncology nurses: A cross-sectional study

2025-06-18

Jinghan Xu , Dandan Chen , Blandine Lucrece Jongo Fouelefack +1 more | PLoS ONE

In the traditional Chinese culture, vicarious trauma poses a significant threat to oncology nurses who are frequently exposed to death and illness. This exposure can undermine both the physical and … In the traditional Chinese culture, vicarious trauma poses a significant threat to oncology nurses who are frequently exposed to death and illness. This exposure can undermine both the physical and mental health of these nurses, potentially affecting team retention. Vicarious post-traumatic growth, a positive outcome of trauma exposure, has been shown to mitigate the adverse effects of vicarious trauma. As a result, fostering vicarious post-traumatic growth is an important area of focus. However, the prevalence of vicarious post-traumatic growth and its influencing factors is limited. The relationship between vicarious post-traumatic growth and vicarious trauma also remains unclear. This study used a cross-sectional survey design. A total of 445 questionnaire were collected between October and December 2023, with 401 valid responses retained for analysis. Participants completed questionnaires that included demographic and work-related variables questionnaire, the Vicarious Trauma Questionnaire (VTQ) and the Chinese-Post Traumatic Growth Inventory (C-PTGI). Descriptive statistics, Pearson correlation analysis, t-tests or ANOVA (F-tests) and multiple regression analysis were conducted to investigate the level of vicarious post-traumatic growth and the modifiable factors among oncology nurses. Multicollinearity diagnostics confirmed no significant collinearity among variables. This study found that Chinese oncology nurses developed high levels of vicarious post-traumatic growth (n = 401,68.67 ± 18.88) based on medium levels of vicarious trauma (n = 401,66.32 ± 22.50). In the multiple regression analysis, vicarious trauma (B = −0.129, 95%CI −0.211 ~ −0.046), social support (B = 7.963, 95%CI 4.680 ~ 11.247), and job satisfaction (B = 7.418, 95%CI 5.444 ~ 9.391) were independently associated with vicarious post-traumatic growth. These findings have important implications for the future implementation of effective interventions to improve the level of vicarious post-traumatic growth. Recommendations include death education, emotional labor strategies training, mindfulness therapy, psychological counseling, and Balint groups, which can improve the level of vicarious post-traumatic growth in Chinese oncology nurses.

Addressing mental health in university students: a call for action

2025-06-18

Qiang Li , Jiayi Li , Yao Fan | Frontiers in Public Health

Mental health has been a growing concern in universities worldwide, with an increasing number of students experiencing psychological problems impacting their academic and personal performance. The transition to university life … Mental health has been a growing concern in universities worldwide, with an increasing number of students experiencing psychological problems impacting their academic and personal performance. The transition to university life is often accompanied by an increase in stress, including the need for independence, academic pressure, and social adjustment. For many students, this period can exacerbate pre-existing mental health conditions or trigger new struggles. This perspective mainly focuses on the vital part of mental health in education, and calls for the indispensable role that universities should play in supporting their students’ psychological well-being and integrating mental health education into the academic environment. The future of mental health in universities lies in continued innovation, collaboration, and dedication to ensuring that every student has access to the resources they need to thrive academically and personally.

Occupational stress and social support among nurses

2025-06-18

Beata Dziedzic , Karolina Łodziana , Miłosz Marcysiak +1 more | Frontiers in Public Health

Introduction Nursing is a profession that involves a significant emotional, physical, and intellectual load. Nurses frequently encounter various stressors, not only due to the nature of their responsibilities but also … Introduction Nursing is a profession that involves a significant emotional, physical, and intellectual load. Nurses frequently encounter various stressors, not only due to the nature of their responsibilities but also resulting from organizational factors and interpersonal relationships in the workplace. In this context, social support plays a crucial role in helping individuals cope with stress. It may serve as a protective buffer, promoting positive emotional outcomes and reducing the level of perceived stress. The aim of this study was to analyze stress levels and perceived social support among actively working nurses and to assess the relationship between these two variables. Methods The survey included 321 nurses employed at medical facilities. Data collection took place between November 2022 and February 2023. The study was based on a Polish-language survey questionnaire developed through Google Forms, which was distributed via nursing association websites to reach the target audience. Stress levels were measured using the Perceived Stress at Work (PSWP) Questionnaire. Support level was assessed using the Multidimensional Scale of Perceived Social Support (MSPSS). Results The average stress level on the PSWP scale was 18.45 ± 5.89, while the average general support score on the MSPSS scale was 63.18 ± 14.78, with the highest support reported from family (21.35 ± 5.3). Analyses revealed a statistically significant negative correlation between MSPSS and PSWP scores ( r = −0.21; p = 0.002). Conclusion The findings of this study suggest that most nurses experience moderate levels of perceived stress alongside relatively high levels of social support. Notably, both stress and social support were significantly associated with nurses’ age and workplace setting, indicating that demographic and organizational factors may influence their psychological well-being. These results underscore the need for targeted interventions to reduce stress and strengthen support systems, particularly for younger nurses and those working in high-intensity clinical settings. Further research is warranted to examine causal relationships and to inform the development of tailored support programs within healthcare institutions.

Associations between burnout and career disengagement factors among general practitioners: a path analysis

2025-06-18

Christos Grigoroglou , Mark Hann , Alexander Hodkinson +7 more | Frontiers in Public Health

Background Burnout is associated with career disengagement among general practitioners (GPs), but the underlying mechanisms of this association remain poorly understood. Objective This study examined the pathways linking burnout to … Background Burnout is associated with career disengagement among general practitioners (GPs), but the underlying mechanisms of this association remain poorly understood. Objective This study examined the pathways linking burnout to career disengagement factors among GPs. Methods An 11-item online questionnaire, including validated abbreviated measures of burnout outcomes (single items on emotional exhaustion (EE) and depersonalisation), career disengagement factors (intention to quit patient care, work–life balance, presenteeism and job satisfaction), and demographic information, was distributed to a random sample of GPs in England between December 2019 and April 2020. Correlations between burnout outcomes and disengagement factors were assessed, followed by a path analysis using a generalized structural equation model, to examine directional relationships between burnout outcomes and survey variables. Results A total of 351 GPs from 57 different medical practices completed the questionnaire. Up to one in four GPs (22.5%) experienced emotional exhaustion, while up to one in three (27.4%) experienced depersonalisation on a weekly basis. In addition, one in three GPs (33.3%) expressed a moderate-to-high intention to quit patient care within the next 5 years. Moreover, one in five GPs (18.8%) reported job dissatisfaction, two in five GPs (40.7%) indicated poor work–life balance, and up to one in two GPs (27.4%) reported presenteeism in the past year. In the path analysis, intention to quit patient care had significant direct associations with both job satisfaction and burnout and significant indirect associations (via burnout) with work–life balance and presenteeism. GP demographics were excluded from the path analysis because they exhibited very weak correlations with dimensions of burnout and work engagement factors. Conclusion These findings highlight the urgent need for interventions and policies aimed at addressing burnout and improving job satisfaction to retain GPs. In addition, improving work–life balance and reducing presenteeism could serve as effective early preventative measures to reduce burnout and job dissatisfaction and, in turn, retain GPs.

Prevalence of suicidal ideation, depression, and family dysfunction in first-year students of the Bachelor’s Degree in Medical Surgery at the Universidad Regional del Sureste

2025-06-18

Brenda Lucila Reymundo-Sánchez , Diana Matías-Pérez , César Alejandro Mendoza-García +1 more | Frontiers in Education

Suicidal ideation is a process that is intertwined with suicidal behavior, beginning with the development of thoughts about the value of life. These thoughts can transform and trigger a chain … Suicidal ideation is a process that is intertwined with suicidal behavior, beginning with the development of thoughts about the value of life. These thoughts can transform and trigger a chain of events ranging from planning to execute a suicide attempt. The study was conducted using a descriptive observational approach, which involved collecting numerical data and statistical analysis to determine the characteristic patterns of the investigated phenomenon. Several specific instruments were used to collect the data: the Beck Suicidal Ideation Scale, the Beck Depression Inventory, the Questionnaire for the Identification of Drug Dependence, and the Family Apgar Scale. The prevalence of suicidal ideation was 15.3%; in addition, 15.9% presented mild family dysfunction, moderate in 10.6% and severe with 21.8%; depression was recorded in mild degree with 26.5%, followed by moderate in 10.6% of the cases and severe with 7.6%. Suicidal ideation among medical students is an issue of great concern that should be addressed holistically. It is critical to create a supportive environment that promotes both the mental health and well-being of medical students.

Mental health and well-being in Chinese nurses: Relationship with psychological flexibility and night shifts

2025-06-17

Ying Wu , Liang Dong , Xiaofang Jiang +3 more | Chronobiology International

The purpose of this study was to investigate whether the relationship between mental health and well-being among Chinese nurses could be mediated by factors such as night shift frequency and … The purpose of this study was to investigate whether the relationship between mental health and well-being among Chinese nurses could be mediated by factors such as night shift frequency and psychological flexibility. A total of 421 nurses were selected from 10 Grade secondary public hospitals in Shanghai, China. The 12-item General Health Questionnaire (GHQ-12) was used to assess mental health status. Additionally, psychological flexibility and well-being were assessed using the Chinese version of Personalized Psychological Flexibility Index and Chinese version of the 5-item WHO Well-Being Index, respectively. Correlation analysis showed that psychological flexibility was positively associated with well-being (r = 0.220, p < 0.05) and negatively correlated with mental health issues (r = ‒0.225, p < 0.05). Night shift frequency was linked to mental health issues (r = 0.276, p < 0.05) and lower psychological flexibility (r = ‒0.165, p < 0.05). Structural equation modeling demonstrated that age had direct positive effects on psychological flexibility (β = 0.130) and mental health (β = 0.541), while night shift frequency directly worsened mental health (β = 0.618) and reduced psychological flexibility (β = ‒0.198). Psychological flexibility significantly influenced both mental health (β = ‒0.674) and well-being (β = 0.418), with indirect effects on well-being (β = 0.268). Mental health was the strongest predictor of well-being (β = 0.718). These findings highlight the importance of psychological flexibility, night shifts and age in nurses' mental health well-being, though the study's cross-sectional design limits causal inferences.

A meta-analysis of burnout and suicidal ideation among medical professionals: Insights on occupational vulnerabilities

2025-06-17

Matt C. Howard , Brittany Siefert | Archives of Environmental & Occupational Health

We assess whether the amount of experienced burnout and its relation to suicidal ideation differs between medical professionals and non-medical professionals. In December 2023, we performed searches in EBSCO, PubMed, … We assess whether the amount of experienced burnout and its relation to suicidal ideation differs between medical professionals and non-medical professionals. In December 2023, we performed searches in EBSCO, PubMed, Google Scholar, and ProQuest. We used a random effects samples-size weighted approach for our meta-analysis of 92 sources. Our meta-regressions did not identify a statistically significant difference between medical professionals and non-medical professionals in their mean levels of the burnout dimensions (all p > .05). Our meta-regressions did not identify a significant difference in the relation of burnout and suicidal ideation between medical professionals and non-medical professionals (β = -0.06, S.E. = .05, 95%C.I. [-0.15, .03], p = .21, k = 53, n = 68,454), and similar results were found for all burnout dimensions (all p > .05). Our results suggest that burnout is no more important for medical professionals than non-medical professionals.

Correlation between job burnout, psychological status, and job satisfaction among anesthesiologists in the post-COVID-19 era: a cross-sectional study in China

2025-06-17

Xuemeng Chen , Rui Zhou , Xianjie Zhang +4 more | Frontiers in Public Health

Background Burnout is a prevalent issue among healthcare professionals, particularly anesthesiologists, with significant repercussions for patient safety, personal well-being, and institutional efficiency. The post-COVID-19 era has introduced additional psychological and … Background Burnout is a prevalent issue among healthcare professionals, particularly anesthesiologists, with significant repercussions for patient safety, personal well-being, and institutional efficiency. The post-COVID-19 era has introduced additional psychological and socioemotional stressors, which individuals perceive differently. This study aims to assess burnout levels among anesthesiologists in this era, explore its relationship with psychological status and job satisfaction, and propose potential intervention strategies. Methods Four hundred electronic questionnaires were distributed to anesthesiologists licensed in 2024 with over 1 year of clinical experience. Three hundred twenty-six responses were collected, yielding an 81.5% response rate. The survey instruments included the Maslach Burnout Inventory-Human Services Survey (MBI-HSS), The Depression, Anxiety and Stress Scale – 21 Items (DASS-21), and Minnesota Satisfaction Questionnaire-Short Form (MSQ-SF). Descriptive statistics and adjusted linear regression were employed to analyze the data and examine the relationships between burnout, psychological status, and job satisfaction. Results The study revealed a high prevalence of burnout, with 30.67% of participants at high risk and 24.85% exhibiting burnout syndrome, resulting in an overall burnout rate of 55.52%. Demographic factors were significantly associated with burnout ( p &lt; 0.05). Anesthesiologists aged 30–34 reported higher levels of anxiety and depression, while those aged over 35 showed lower levels of depersonalization and higher personal accomplishment ( p &lt; 0.001). Job satisfaction was inversely correlated with burnout ( p &lt; 0.001). Psychological status was positively correlated with burnout (p &lt; 0.001). Multiple linear regression analysis explained 55.00% of the variance in burnout, with anxiety, stress, and intrinsic and extrinsic satisfaction as significant predictors ( p &lt; 0.05). Conclusion Burnout is widespread among anesthesiologists in the post-COVID-19 era, with burnout levels strongly associated with mental health and job satisfaction. Increased negative emotions and reduced job satisfaction contribute to higher burnout. Addressing the well-being of anesthesiologists, fostering a supportive work environment, and improving compensation mechanisms could alleviate burnout and enhance the quality of medical practice.

Professional Quality of Life for Psychiatric Nurses in Saudi Arabia

2025-06-17

Abdulrahman Abed Aloufi | Journal of Posthumanism

This systematic review investigates the professional quality of life (ProQoL) among psychiatric nurses in Saudi Arabia, focusing on three central dimensions: Compassion Satisfaction (CS), Burnout (BO), and Secondary Traumatic Stress … This systematic review investigates the professional quality of life (ProQoL) among psychiatric nurses in Saudi Arabia, focusing on three central dimensions: Compassion Satisfaction (CS), Burnout (BO), and Secondary Traumatic Stress (STS). With the growing demands on mental health services and the unique occupational challenges psychiatric nurses face, understanding the variables influencing their well-being has become critical for healthcare sustainability and staff retention. A thematic meta-synthesis was conducted on fifty peer-reviewed studies published between 2019 and 2024. Inclusion criteria were limited to studies focused exclusively on psychiatric nurses working in Saudi Arabia, utilizing validated instruments such as the ProQoL Scale and Maslach Burnout Inventory. The analysis categorized findings thematically and synthesized statistical outcomes including Pearson correlations and regression models to examine ProQoL predictors. The results reveal that CS is positively associated with institutional support, participatory leadership, and resilience training. In contrast, BO and STS are elevated in settings marked by high workload, role ambiguity, lack of supervision, and exposure to patient trauma. Temporal trends indicate that COVID-19 significantly intensified BO and STS while reducing CS, especially among early-career nurses. Notably, private institutions were more likely to report higher CS and lower BO, suggesting that organizational culture plays a pivotal role in shaping ProQoL outcomes. These findings underscore the urgent need for trauma-informed care frameworks, emotional safety protocols, and systemic reforms in public psychiatric institutions to improve nurses’ well-being and enhance the quality of mental health services.