基层药师职业倦怠调查和分析

目的:了解基层药师职业倦怠的现状和相关因素影响的情况。方法:采用自编问卷和MBI-HSS,对海宁市174名药师进行调查。结果:有55.2%被试者有一定程度的情感衰竭现象,有7.5%的被试者有一定程度的去人性化现象,共有90.3%的被试者没有个人成就感,有职业倦怠感的比例为53.45%,轻度、中度、高度倦怠率分别为32.76%、16.10%、4.6%。在情感衰竭和去人性化上,工龄小于5年组显著高于工龄20年组,已婚显著高于未婚组;门诊西药房情感衰竭显著高于中药房,上夜班药师情感衰竭显著高于不上组;在去人性化上大专组显著比中专组得分高,门诊西药房得分显著高于中药房和办公室,上夜班药师显著高于不上组,收入2 000~3 000元组显著高于3 000~4 000元组;在个人成就感上,男性药师显著高于女性药师,收入4 000元以上组显著高于其他组。结论:一定数量的药师有不同程度的职业倦怠,应重点关注年轻和未婚药师,以及在上夜班和门诊西药房上班的药师。     

Clinician burnout during the COVID-19 pandemic before vaccine administration

BackgroundCoronavirus disease 2019 (COVID-19) has disrupted pharmacy practice. Little research has been done to assess how COVID-19 has affected pharmacists’ employment, workload, and feelings of burnout.ObjectivesThe objectives of this study were to characterize the impact of COVID-19 on pharmacists’ employment status, workload, and feelings of burnout, as well as to examine emotional health concerns related to COVID-19.MethodsWisconsin pharmacists were surveyed using an online instrument between August 25, 2020, and September 22, 2020. The data analysis, performed in December 2020, examined employment status, 3 common burnout risk factors (workload, rewards, and social depersonalization), and emotional health concerns related to COVID-19.ResultsOf the 1300 pharmacists, 439 completed the survey (33.8%). The study analysis included pharmacists in community (n = 127) and hospital or health system (n = 107) settings. With regard to employment changes and workload, hospital pharmacists (36%) were more likely to have their hours reduced than community pharmacists (13%) (P < 0.01), and, conversely, community pharmacists (19%) were more likely to have their hours increased than hospital pharmacists (8%) (P = 0.01). For the burnout domain of workload, 45% of the pharmacists reported increased feelings of physical exhaustion at work, and 53% reported increased feelings of emotional exhaustion at work, with no difference between settings. Regarding the burnout domain of rewards, 6% of the hospital pharmacists and 1% of the community pharmacists experienced a reduction in hourly wages or salaries as a result of COVID-19. For the burnout domain of depersonalization, 25% of the pharmacists reported that their ability to connect with colleagues and patients decreased during the COVID-19 pandemic. Additional emotional health concerns reported by the pharmacists included 40% experiencing more anxiety and 25% experiencing more sadness or depression during the COVID-19 pandemic, with no difference between settings.ConclusionThis study found that the burnout domains related to workload, rewards, and depersonalization were negatively affected by COVID-19. Pharmacy managers need to proactively combat burnout as well as be reactive when employees show signs of burnout to maintain their workforce and meet the COVID-19–associated challenges.     

Mental health,burnout and resilience in community pharmacists during the COVID-19 pandemic: A cross-sectional study

BackgroundThe study aimed to assess burnout, resilience, and levels of depression, anxiety, stress and fear among community pharmacists during the pandemic, and examine if fear of COVID-19 is associated with these outcomes of interest.MethodsA cross-sectional survey of community pharmacists in Qatar was conducted. Pharmacists’ burnout was measured by the Maslach Burnout Inventory: Human Services Survey for Medical Personnel (MBI-HSS? for MP-Mindgarden). Resilience was assessed using the Connor-Davidson Resilience Scale-10 (CD-RISC-10). Depression, anxiety, and stress were measured by the Depression, Anxiety, and Stress Scale (DASS-21). Fear of COVID-19 was assessed by the Fear of COVID-19 Scale (FCV-19S).Results256 respondents completed the survey and were included in the final study analysis (response rate: 42.7%). Overall, participants reported a moderate level of burnout as illustrated in the mean scores of the three burnout dimensions; 20.54 (SD = 12.37) for emotional exhaustion, 6.76 (SD = 6.22) for depersonalization, and 36.57 (SD = 9.95) for personal accomplishment. Moreover, depression, anxiety and stress were reported by 44.8%, 53.2% and 25.4% of particiants respectively. Participants had shown moderate resilience (mean score: 27.64 (SD = 8.31)) and their mean score fear of COVID19 was 15.67 (SD = 6.54). Fear of COVID-19 was a statistically significant and an independent predictor of depression, anxiety, and stress levels.ConclusionsThe pharmacists experienced moderate burnout but moderate resilience, which indicates their potential to overcome difficulties. Future interventions at the personal, national and organizational levels are required to enhance the pharmacists’ wellbeing by decreasing stress, improving self-efficacy and resilience, and preventing burnout.     

Community pharmacists�� burnout levels and related factors: an example from Turkey

Objective To determine community pharmacists?? burnout levels and prevalences as well as factors associated with burnout. Setting Study was conducted in Ankara, the capital of Turkey. Method In this cross-sectional study, 251 pharmacists were randomly selected from 1,504 community pharmacists registered in Ankara Chamber of Pharmacists. A questionnaire including questions related to pharmacists?? individual and professional characteristics and Maslach Burnout Inventory was administered. The data was collected between February 27 and May 25, 2007. Main outcome measure Three Maslach Burnout Inventory subscales (emotional exhaustion-EE, depersonalization-D, and personal accomplishment-PA) scores. Results Pharmacists?? mean emotional exhaustion score was found to be 16.84 (SD: 6.25), depersonalization score was 4 (Range: 0?C14), and personal accomplishment score was 22 (Range: 9?C32). Of the pharmacists, 1.2% had high level of EE, .8% had high level of D, and 71.3% had high level of inefficacy. Age, marital status, work experience, work contentment, workload, time pressure, stress, and satisfaction with customers were found to be related with pharmacists?? burnout levels. Conclusion It can be useful to monitor pharmacists?? burnout levels and prevalences periodically. Interventions on individual and organizational basis were needed to cope with burnout, respond to job demands, minimize the level of chronic stress, and increase work contentment and satisfaction.     

Cross-sectional study to evaluate burnout among pharmacy staff in Saudi Arabia during COVID-19 pandemic

BackgroundCoronavirus disease 2019 (COVID-19) has placed healthcare workers, including pharmacists, at an increased risk of infection and has increased their workload, which could lead to burnout. Therefore, the present study aimed to measure the levels of burnout among hospital and community pharmacists in Saudi Arabia during the COVID-19 pandemic and to identify the risk factors associated with burnout.MethodsIn the present cross-sectional study, an online survey was distributed among community and hospital (inpatient, outpatient, clinical, and administration) pharmacists in Saudi Arabia. The Copenhagen Burnout Inventory (CBI) survey was used to measure burnout levels. This 19-item survey covered three aspects: personal, work, and patient-related burnout. The survey included questions about socio-demographic factors and the major causes of psychological distress among pharmacists during the COVID-19 pandemic. Inferential statistics were used for data analysis.ResultsA total of 502 pharmacists were included in the present study. Of these, 59.1% were categorized as having clinically relevant burnout levels (scores ≥ 50).Univariate analysis revealed that the burnout level was significantly higher (p < 0.05) among pharmacists who were younger, were females, had lesser years of experience, or worked in the community pharmacy. The main factors associated with high burnout levels among community pharmacists were younger age, lesser years of experience, male gender, non-Saudi nationality, and higher numbers of customers. In the COVID-19 part of the survey, burnout was found to be strongly related to the COVID-19 pandemic. Fears of getting infected or of a family member getting infected, fears of the pandemic lasting for too long, and increased working hours were factors contributing to increased burnout levels during the COVID-19 pandemic with unadjusted β of 8.336 and (95% CI 7.082–9.589, p value < 0.001). A lack of supportive work culture and sleeping disturbances were also found to be related to high burnout levels (p < 0.001).ConclusionsPharmacy staff in Saudi Arabia were found to experience high levels of burnout. The major risk factors causing burnout included younger age, female gender, lesser years of experience, a lack of supportive work culture, sleep disturbances, worries associated with increased workload during the pandemic, fears of getting infected, and increased working hours.     

临床护士心理健康与职业倦怠调查分析

目的调查临床护士心理健康与职业倦怠状况,了解两者之间的关系,为护理管理提供依据。方法采用症状自评量表（SCL-90）和职业倦怠量表（MBI-HSS）对60名临床护士进行调查,分析SCL-90与MBI-HSS之间的相关性。结果临床护士中有心理问题者检出率为58．3％;38．3％的临床护士出现不同程度的情感衰退,56．7％临床护士出现不同程度的去人情味,60．0％的临床护士表现出不同程度的低成就感;MBI-HSS量表分值与SCL-90存在正相关性。结论临床护士存在不同程度的心理问题和职业倦怠感,心理健康是影响职业倦怠的重要因素,提高心理健康水平能够降低职业倦怠感。     

The “affected” pharmacist and the “business as usual” pharmacist: Exploring the experiences of pharmacists during COVID-19 through cluster analysis

BackgroundThe global coronavirus disease 2019 (COVID-19) pandemic has necessitated considerable changes in the delivery of pharmacy services, with pharmacists experiencing increasing demands and a high rate of burnout. The ability to categorize pharmacists based on their burnout risk and associated factors could be used to tailor burnout interventions.ObjectiveThis study aimed to identify subgroups (profiles) of pharmacists and use these profiles to describe interventions tailored to improve pharmacist’s well-being.MethodsA survey was disseminated to pharmacists working in Australia during April and June 2020. The survey measured demographics, burnout, and psychosocial factors associated with working during COVID-19. A two-step cluster analysis was used to categorize pharmacists based on burnout and other variables.ResultsA total of 647 survey responses contained data that were used for analysis. Participants were mostly female (75.7%) and working full time (65.2%). The final cluster analysis yielded an acceptable two-cluster model describing 2 very different pharmacist experiences, using 10 variables. Cluster 2 (representing 53.1% of participants) describes the “affected” pharmacist, who has a high degree of burnout, works in community pharmacy, experiences incivility, is less likely to report sufficient precautionary measures in their workplace, and has had an increase in workload and overtime. In contrast, cluster 1 (representing 46.9% of participants) describes the profile of a “business as usual” hospital pharmacist with the opposite experiences.Interventions focused on the “affected” pharmacist such as financial support to employ specialized staff and equitable access to personal protective equipment should be available to community pharmacists, to reduce the risk to these frontline workers.ConclusionThe use of cluster analysis has identified 2 distinct profiles of pharmacists working during COVID-19. The “affected” pharmacist warrants targeted interventions to address the high burnout experienced in this group.     

Use of the job demands-resource model to understand community pharmacists’ burnout during the COVID-19 pandemic

BackgroundCommunity pharmacists are one of the most accessible healthcare providers during the COVID-19 pandemic. Whilst playing a vital role in medication supply and patient education, exposure to the pandemic demands and prolonged stressors increase their risk of burnout.ObjectivesUsing the Job Demands-Resources model, this study aims to understand the factors that led to community pharmacists’ burnout and to identify their coping strategies and perceived recommendations on interventions to mitigate burnout during the COVID-19 pandemic.MethodsA qualitative phenomenological approach was used with focus groups and interviews of community pharmacists in Qatar who were recruited using purposeful, convenience, and snowballing sampling methods. Interviews were conducted between February and April 2021, were audio-recorded and transcribed verbatim. Using thematic analysis methodology, manual inductive and deductive (based on the model) codes from the interviews were used for synthesis of themes. 11 themes emerged from six focus groups, six dyadic interviews and mini focus groups, and four individual interviews with community pharmacists.ResultsThe contributing factors to community pharmacists’ burnout have been identified as practical job demands, and emotional demands including fear of infection. On the other hand, government and workplace-specific resources, personal characteristics such as resiliency and optimism, as well as the implementation of coping strategies, have reduced their stress and burnout.ConclusionsThe use of the Job Demands-Resources model was appropriate to identify the contributing factors to community pharmacists’ burnout during the COVID-19 pandemic. Based on these factors, individual, organizational, and national strategies can be implemented to mitigate burnout in community pharmacists during the pandemic and future emergencies.     

外科医师职业倦怠的现状调查与分析

目的 了解临床外科医师职业倦怠的总体现状。方法 依据随机抽样原则,采用工作倦怠问卷中国版量表对中国东部、中部、西部三个地区不同省市的9家医院602名临床外科医师进行职业倦怠调查及分析。结果 外科医师中有33.89%(204/602)轻度倦怠,32.06%(193/602)中度倦怠,5.48%(33/602)重度倦怠;各维度,27.41%(165/602)情感耗竭,45.18%(272/602)人格解体,41.86%(252/602)成就感降低。外科医师的职业倦怠在性别、年龄、职称、工作年限之间差异无统计学意义(P> 0.05);而在地区、婚姻、学历、医院等级之间差异有统计学意义(P< 0.05)。结论 外科医师的总体职业倦怠情况严重,防治工作应关注高学历、三级医院及离婚、丧偶的单身外科医师,并根据不同地区的外科医师特点制定相关政策。     

Burnout and resilience among pharmacy technicians: A Singapore study

BackgroundBurnout describes emotional exhaustion (EE), depersonalization (DP), and low personal achievement caused by work and is known to bring about negative consequences to practitioners, patients, and health systems. Various organizational and personal factors, such as organizational strategies and resilience, have been associated with this phenomenon. However, there is a paucity of data describing the prevalence of burnout among pharmacy staff within Singapore and Asia, especially in the pharmacy technician (PT) population.ObjectivesThis study aimed to (1) quantify burnout in PTs in patient-care sectors in Singapore and (2) explore factors that may be associated with burnout.MethodsA cross-sectional survey among PTs in patient-care areas in Singapore, which includes hospitals, primary and secondary care institutions, and retail pharmacies, across both public and private sectors was conducted from February to April 2020. The Maslach Burnout Inventory – Human Services Survey and Brief Resilience Scale were used to assess burnout and resilience among participants. Demographic, employment, and well-being information were also collected and summarized. Univariate analysis and multivariate logistic regression were used to assess associations between burnout and potential risk and impact factors.ResultsSlightly more than half (52.0%) of PTs reported burnout (EE score ≥27 or DP ≥10 or both). Statistically significant factors associated with burnout include resilience, age, years of experience, ethnicity, marital status, nationality, highest qualifications, pharmacy-related certification, full-time employment status, and work hours. Impact associated with burnout includes intent for job change, job satisfaction, sleep, and presence of mental conditions. Statistically significant reported reasons for burnout and ways to build resilience were also elucidated.ConclusionBurnout affects most PTs in Singapore and is primarily driven by workload and nature of their work, low resilience, and poor social support structures. National and organizational efforts are needed to arrest the vicious cycle that propagates burnout in PTs.     

临床药师职业倦怠与积极心理健康状况调查研究

目的调查临床药师职业倦怠与积极心理健康状况,了解两者的关系,为医院管理提供依据。方法采用职业倦怠感量表（MBI）和幸福进取者问卷（HEIQ）对86名临床药师进行调查,了解其职业倦怠和积极心理健康状况。结果临床药师情绪衰竭感得分为（26.39±11.16）分,工作冷漠感得分为（8.61±2.58）分,均为中度倦怠,个人成就感得分为（14.47±3.59）分,为低个人成就感;临床药师的HEIQ总分为（85.46±8.43）分,得分率为56.7%,为中等水平。相关分析显示,MBI与HEIQ存在高度相关性（P〈0.05）。结论临床药师存在不同程度的职业倦怠感,积极心理健康水平不高,加强积极心理健康教育能够降低其职业倦怠,提高临床药学服务质量。     

The impact of faculty and student pharmacist relationships on burnout

BackgroundStudents in health professions, including student pharmacist, are at an increased risk of psychological distress. Unfortunately, effective efforts to combat burnout for student pharmacists are still lacking in the literature and create a void in schools and colleges of pharmacy that seek to assist their students.ObjectivesThe objective of this study was to explore how increasing positive out-of-class interactions between the student pharmacists and faculty members affect burnout, especially in work exhaustion and interpersonal disengagement. Professional fulfillment was also assessed as a primary outcome.MethodsThe institutional review board approved this study consisting of 4 faculty members and 12 students. After providing informed consent, the participants were assigned to one of 4 groups. Each group included 1 faculty member and 3 students. At the start of the study, each participant completed a modified Stanford Professional Fulfillment Index questionnaire to measure baseline burnout characteristics and initial level of professional fulfillment. For 8 weeks, the groups met weekly to discuss a topic related to burnout and professional fulfillment. After 8 weeks, each participant completed the postquestionnaire. Wilcoxon signed-rank tests were performed to the mean scores (pre vs. post) in each of the 3 constructs. The statistical significance was set at P < 0.05.ResultsThe results of the Wilcoxon signed-rank analysis showed a statistically significant difference in the burnout constructs, work exhaustion and interpersonal disengagement. There was not a statistically significant change in professional fulfillment.ConclusionsImproving relationships between student pharmacist and faculty through increasing out-of-class interactions benefits individuals who are at risk of experiencing burnout. Future initiatives can focus on effective strategies that target work exhaustion and interpersonal disengagement and build on the social networks that develop in pharmacy school.     

Know your diabetes risk project: Student pharmacists educating adults about diabetes risk in a community pharmacy setting

ObjectivesTo determine the feasibility of educating adults about their risk of prediabetes/diabetes in a community pharmacy, to determine the common risk factors for prediabetes/diabetes in adults visiting a community pharmacy, and to assess any association between risk factors and age.DesignCross sectional.SettingOklahoma community pharmacies between April 1 and December 31, 2008.Participants1,852 patients aged 18 to 80 years.InterventionStudent pharmacists invited adults to complete a survey to assess their risk for diabetes/prediabetes. Students reviewed participants’ risk and educated them on lifestyle changes to lower diabetes risk.Main outcome measuresPatient risk factors, pharmacy identifier, and pharmacy type (independent, chain, or clinic pharmacy) and location (rural, suburban, or city).ResultsDiabetes risk assessment and education of 1,852 adults was performed by 110 student pharmacists in 52 community pharmacies located in 27 cities across 13 (of 77) Oklahoma counties. Obesity/overweight was the most common risk factor (57%), with positive family history, hypertension, elevated cholesterol, member of high-risk ethnic group, and sedentary lifestyle being reported by at least 20% of participants. The number of risk factors increased with age, with a significant increase occurring in participants older than 40 years of age.ConclusionThis project demonstrated that it is feasible to perform diabetes risk assessment and to provide education on lowering that risk through community pharmacies.     

专科护士专业自我概念与职业倦怠感的关系研究

目的 探讨专科护士专业自我概念及职业倦怠感的现状并分析两者的关系.方法 运用Arthur教授的护士专业自我概念量表中文版的Maslach工作倦怠感量表,对安徽省参加培训的277名专科护士进行面对面的问卷调查.结果 专科护士的专业自我概念得分(89.71 ±10.11)分,不同年龄、工作年限、职称、医院等级和有无编制的专科护士专业自我概念得分差异有统计学意义.相关分析显示,专科护士专业自我概念与情绪耗竭及去人格化呈负相关(r=-0.514、r=-0.380,P<0.01),与个人成就感呈正相关(r=0.649,P<0.01).回归分析显示,情绪耗竭和个人成就感是专科护士专业自我概念的影响因素(t=-5.838、t=11.882,P<0.001).结论 专科护士的专业自我概念处于中等偏积极水平,有待于进一步提高,护理管理者及相关部门可以采取有效措施,降低专科护士的情绪耗竭,提高其个人成就感,进一步巩固和提升其专业自我概念水平,以稳定专科护士队伍.     

The experiences of pharmacists during the global COVID-19 pandemic: A thematic analysis using the jobs demands-resources framework

BackgroundCOVID-19 has necessitated a change to the way pharmacists are providing healthcare and has impacted the psychological wellbeing of these frontline healthcare workers.ObjectiveTo use the job demands-resources framework of burnout to describe the experiences of pharmacists working during COVID-19.MethodsAn online survey investigating burnout, psychosocial, and work-related factors affecting pharmacists during COVID-19 was distributed to a convenience sample of pharmacists practising in Australia during April and June 2020. The survey was distributed via social media and professional organisations. This study was a thematic analysis of the free-text question of the survey that asked participants to provide comment on anything they considered important. The job demands-resources framework of burnout was applied to the themes.ResultsOf 647 total survey responses, 215 (33.2%) participants responded to the free text question. Thematic analysis explored the increase in demands on pharmacists with a decreased availability of resources during COVID-19. Themes associated with high demands included an increased workload, provision of education and support to the community, taking on roles traditionally performed by others, managing medication and stock supply issues, and poor consumer behaviour. Themes representing resources, which were inadequate, included feeling supported by management and colleagues, feeling adequately trained, receiving clear and consistent communication, feeling valued and appreciated, personal safety, and recovery time.ConclusionsPharmacists have experienced increased demands and reduced resources during COVID-19 which is associated with burnout. Knowledge of these demands and resources can inform interventions at an individual, workplace, and external level. Recommendations made in this paper are aimed at increasing resources available to pharmacists.     

Factors associated with how often community pharmacists offer and dispense naloxone

BackgroundA recent Surgeon General's report encourages people to ask pharmacists about naloxone, but whether pharmacists are well-prepared to respond to these requests is unclear.ObjectivesDetermine factors that are associated with how often pharmacists offer and dispense naloxone.MethodsA convenience sample of 457 community pharmacists in North Carolina completed a 5-min online survey. Linear regressions were conducted to identify factors that are associated with how often pharmacists offer and dispense naloxone. Pharmacists' self-reported barriers to teaching naloxone administration were identified.ResultsMost pharmacists (81.2%) worked in pharmacies that stocked naloxone, but many never offered (36.6%) or dispensed (19.4%) naloxone. Pharmacists offered (β = 0.15, p < 0.01) and dispensed (β = 0.15, p < 0.01) naloxone more often when their pharmacy stocked more naloxone formulations. Pharmacists who were more comfortable discussing naloxone offered it more often (β = 0.26, p = 0.001). Pharmacists who worked in regional/local/grocery chain pharmacies dispensed and offered naloxone less often than other pharmacy types. Barriers to teaching naloxone administration included: time constraints, inadequate training, and perceived lack of patient comprehension.ConclusionsMany community pharmacists do not offer or dispense naloxone. Pharmacists who are uncomfortable discussing naloxone or work at smaller chain pharmacies may benefit from targeted naloxone training.     

Categorizing and understanding medication errors in hospital pharmacy in relation to human factors

BackgroundMedication errors (MEs) in hospital settings are attributed to various factors including the human factors. Human factors researches are aiming to implement the knowledge regarding human nature and their interaction with surrounding equipment and environment to design efficient and safe systems. Human Factors Frameworks (HFF) developed awareness regarding main system's components that influence healthcare system and patients' safety. An in-depth evaluation of human factors contributing to medication errors in the hospital pharmacy is crucial to prevent such errors.ObjectiveThis study, therefore, aims to identify and categorize the human factors of MEs in hospital pharmacy using the Human Factors Framework (HFF).MethodA qualitative study conducted in King Saud Medical City, Riyadh, Kingdom of Saudi Arabia. Data collection was carried out in two stages; the first stage was the semi-structured interview with the pharmacist or technician involved in the medication error. Then, occupational burnout and personal fatigue scores of participants were assessed. Data analysis was done using thematic analysis.ResultsA total of 19 interviews were done with pharmacists and technicians. Themes were categorized using HFF into five categories; individual, organization and management, task, work, and team factors. Examples of these themes are poor staff competency, insufficient staff support, Lack of standardization, workload, and prescriber behaviour respectively. Scores of fatigue, work disengagement, and emotional exhaustion are correlating with medium fatigue, high work disengagement, and high emotional exhaustion, respectively.ConclusionsThe study provided a unique insight into the contributing factors to MEs in the hospital pharmacy. Emotional stress, lack of motivation, high workload, poor communication, and missed patient information on the information system, are examples of the human factors contributing to medication errors. Our study found that among those factors, organizational factors had a major contribution to medication safety and staff wellbeing.     

Burnout in substance abuse counselors. Impact of environment, attitudes, and clients with HIV

Due to associations between acquired immunodeficiency sydnrome (AIDS) and substance abuse, many substance abuse treatment counselors have clients with human immunodeficiency virus (HIV)/AIDS. We assess the contribution of various hypothesized predictors of burnout among 134 substance abuse counselors working with clients with HIV/AIDS. Counselors reported practice-related variables, including support from coworkers and supervisors, caseload, percentage of HIV-positive clients, and whether they worked at a methadone clinic, and personal characteristics of job efficacy and education. The three burnout dimensions were emotional exhaustion, depersonalization, and personal accomplishment. Emotional exhaustion was significantly predicted by less support, less efficacy, and working in a methadone clinic. Depersonalization was predicted by less efficacy, less support, and working in a methadone clinic. Personal accomplishment was predicted by having a lower percentage of clients with HIV/AIDS, and more efficacy, support, and education. We present empirically based suggestions for interventions that can prevent or limit burnout.