Evaluation of burnout in physician members of the American Brachytherapy Society

PURPOSETo evaluate the prevalence of burnout among brachytherapy specialists and to identify factors associated with burnout.METHODS AND MATERIALSAn anonymous, online, cross-sectional survey was administered to non-trainee physician members of the American Brachytherapy Society. Burnout was evaluated using the validated Maslach Burnout Inventory-Human Services Survey (MBI-HSS). Demographic and practice-specific questions were collected from respondents. Univariate and multivariable analysis of outcomes were performed using probabilistic index models.RESULTSOverall, 51 of 400 physicians responded (13% response rate). Fifty-seven percent of respondents demonstrated at least one symptom of professional burnout. However, only 6% of respondents met strict criteria for high burnout. Analysis of the individual MBI-HSS subdomains demonstrated higher subscale scores for emotional exhaustion and depersonalization, but also higher scores for personal accomplishment. On multivariable analysis after adjusting for increased feelings of burnout due to the COVID-19 pandemic or total hours of work per week, younger age was associated with both increased subscale scores for emotional exhaustion (p = 0.026) and lower personal accomplishment (p = 0.010). Lastly, nearly half of all respondents (47%) reported increased feelings of burnout due to the COVID-19 pandemic. Respondents from academic facilities were significantly more likely to report increased burnout due to COVID-19 compared to those from non-academic facilities (odds ratio, 7.04; 95% CI 1.60–31.0; p = 0.010).CONCLUSIONSNearly 60% of brachytherapists demonstrated symptoms of professional burnout, which is higher than other radiation oncology groups (academic chairs, program directors, residents). Managing stressors related to workload, COVID and support for junior physicians are potential areas for improving feelings of burnout.     

Impact of the COVID-19 pandemic on clinical radiography practice in low resource settings: The Ghanaian radiographers’ perspective

IntroductionThe COVID-19 pandemic has altered the professional practice of all healthcare workers, including radiographers. In the pandemic, clinical practice of radiographers was centred mostly on chest imaging of COVID-19 patients and radiotherapy treatment care delivery to those with cancer. This study aimed to assess the radiographers’ perspective on the impact of the pandemic on their wellbeing and imaging service delivery in Ghana.MethodsA cross-sectional survey of practising radiographers in Ghana was conducted online from March 26th to May 6th, 2020. A previously validated questionnaire that sought information regarding demographics, general perspectives on personal and professional impact of the pandemic was used as the research instrument. Data obtained was analysed using Microsoft Excel® 2016.ResultsA response rate of 57.3% (134/234) was obtained. Of the respondents, 75.4% (n = 101) reported to have started experiencing high levels of workplace-related stress after the outbreak. Three-quarters (n = 98, 73.1%) of respondents reported limited access to any form of psychosocial support systems at work during the study period. Half (n = 67, 50%) of the respondents reported a decline in general workload during the study period while only a minority (n = 18, 13.4%) reported an increase in workload due to COVID-19 cases.ConclusionThis national survey indicated that majority of the workforce started experiencing coronavirus-specific workplace-related stress after the outbreak. Albeit speculative, low patient confidence and fear of contracting the COVID-19 infection on hospital attendance contributed to the decline in general workload during the study period.Implications for practiceIn order to mitigate the burden of workplace-related stress on frontline workers, including radiographers, and in keeping to standard practices for staff mental wellbeing and patient safety, institutional support structures are necessary in similar future pandemics.     

The impact of the Covid-19 pandemic on the mental health and work morale of radiographers within a conventional X-ray department

IntroductionThere is a plethora of literature that has described the negative impact of the COVID-19 pandemic on the mental health of healthcare staff worldwide. Our aim was to investigate the physical and mental demands of mobile x-ray imaging on radiographers during the first wave of the COVID-19 pandemic, within a local NHS Trust.MethodsA total of 16 participants from 1 NHS Trust took part within this study. Both quantitative and qualitative data was obtained through an online survey. Statistical data was obtained via the Trust Radiology Information System (RIS). Data was gathered for the thirteen weeks from 23rd March to 21st June 2020 (the first wave); direct comparison was made to the same period in 2019.ResultsThree key themes emerged from the data. These include mental health challenges/work morale in Radiology, demand of mobile imaging and departmental and Trust-wide mental health support. Results indicate a high demand in mobile imaging which has made a significant difference in the working life of some radiographers.ConclusionThe COVID-19 pandemic has significantly affected the mental health of a proportion of radiographers at this Trust. Results indicate high workload and demand in mobile imaging has made a significant difference to the working life of radiographers, specifically the ones who were relatively newly qualified.Implications for practiceTwo key interventions are proposed from this study. The first one is to provide and promote mental health support within radiology departments. The second is to encourage dual working on mobile x-ray examinations to help manage the emotional and physical burden.     

Prevalencia y factores de desgaste profesional en radiólogos durante la pandemia COVID-19

BackgroundThe coronavirus 2019 (COVID-19) epidemic spread throughout the world from the beginning of 2020, increasing healthcare professionals’ workloads and levels of physical and emotional stress.AimsTo determine the prevalence of burnout syndrome in Spanish radiologists during the COVID-19 pandemic and the factors associated with the development of this syndrome, and to compare these findings with those obtained before the pandemic.MethodsThis observation study took place between April 2020 and August 2020 (during the pandemic) through an online survey. A total of 150 responses were obtained. Demographic and work-related information was compiled. Burnout syndrome was measured with the Maslach Burnout Inventory Human Services Survey (MBI-HSS). The prevalence and characteristics of burnout syndrome obtained in this survey were compared with those of the same survey done in 2019. We performed a statistical analysis to identify possible risk factors and protective factors associated with this syndrome and to determine the homogeneity of the two samples.ResultsThe prevalence of burnout syndrome increased during the COVID-19 pandemic (49.3% vs. 33.6%, p = 0.002). No risk factors or protective factors that were valid both before and after the pandemic were identified. No correlations were identified between sociodemographic or work-related characteristics and burnout syndrome.ConclusionThis study demonstrates that burnout syndrome increased significantly in radiologists during the COVID-19 pandemic, affecting nearly half of all those who responded to the survey. These results underline the need to assess support for professional wellbeing of radiologists in Spain. No correlations were identified between burnout and gender, age, number of calls, years in the job, annual income, teaching, marital status, number of children, or type of contract.     

Spanish radiographers’ concerns about the COVID-19 pandemic

IntroductionThe current outbreak of COVID-19 has caused worldwide healthcare and social emergency in which healthcare professionals were under extreme work conditions while being fearful of becoming infected or spreading the disease to their relatives. The perceived threat of COVID-19 has the potential to cause severe psychological maladjustment. The aim of the study is to explore Spanish radiographers’ concerns about the COVID-19 pandemic.MethodsThis study was quantitative, observational and cross-sectional. The sample was made up of 546 radiographers working in Spain during the outbreak. The instrument used for analysis was an ad hoc questionnaire with socio-demographic questions and the questionnaire on perception of threat from COVID-19 validate to spanish healthcare professionals.ResultsThe sample consisted of 70.1% of female, 29.7% of male and 0.2% undeclare sex participants. The results showed a high level of a perceived threat from COVID-19 (7.57 ± 0.088), furthermore we observed a high level of threat about the possibility of infecting family members (8.49 ± 0.25), patients (8.33 ± 0.086), and coworkers (8.35 ± 0.084). Furthermore, females have a higher level of a perception of threat to spread infection between patients (r = ?0.136; p = 0.001) and coworkers (r = ?0.118; p = 0.006), than males.ConclusionCOVID-19 pandemic is perceived as a serious threat, being especially concerned about the threat of spreading the infection to family, coworkers, and patients. The perception of risk depends partly on professionals’ gender and family responsibilities.Implications for practiceOur findings suggest that it is recommended that healthcare professionals receive formation to reinforce and improve their emotional competencies for coping successfully with potentially stressful situations like COVI19 pandemic.     

The global impact of the COVID-19 pandemic on clinical radiography practice: A systematic literature review and recommendations for future services planning

IntroductionWorldwide, reports and experiences indicate that there has been extensive re-organisation within diagnostic imaging and radiotherapy departments in response to the COVID-19 pandemic. This was necessary due to changes in workload and working practice guidelines that have evolved during the pandemic. This review provides a comprehensive summary of the global impact of the COVID-19 pandemic on radiography practice, service delivery and workforce wellbeing.MethodsA systematic review methodology was adopted to obtain data from primary studies of qualitative, quantitative, and mixed methods designs from databases (PubMed, Science Direct, Cumulative Index of Nursing and Allied Health Literature [CINAHL], and SCOPUS: all 2020 to present). The included articles were subjected to information extraction and results-based convergent synthesis.ResultsThe electronic database search yielded 10,420 articles after removal of duplicates. Of these, 31 articles met the final inclusion criteria with some (n = 8) fully focussed on radiotherapy workforce and service delivery. The pandemic impact on radiography practice is broadly themed around: training, communication, and information dissemination; infrastructure, technology, and clinical workflow; and workforce mental health and well-being.ConclusionGlobally, most radiographers received inadequate training for managing COVID-19 patients during the initial acute phase of the pandemic. Additionally, there were significant changes to clinical practice, working patterns and perceived increase in workload due to surges in COVID-19 patients and the consequent strict adherence to new infection protocols. These changes, coupled with fear emanating from the increased risk of the workforce to contracting the infection, contributed to anxiety and workplace-related stress during the pandemic.Implications for practiceLocal pandemic response strategies must be appropriately developed from standard protocols in readiness for safe clinical practice and well-being management training of practitioners.     

Wellness Program Implementation in an Academic Radiology Department: Determination of Need,Organizational Buy-in,and Outcomes

ObjectiveTo implement a multifaceted wellness program in an academic radiology department to prevent burnout and to assess initial outcomes with special focus on the challenges related to the coronavirus disease 2019 (COVID-19) pandemic.MethodsA wellness program was established to address institutional and personal factors of burnout. The program focused on interventions to improve efficiency of practice, provide personal and career support, and create a culture of wellness. The components of the program were designed with input from radiology faculty, and the program was financially supported by the hospital’s physician organization. A survey was performed 6 months after the initiation of the program to determine radiologist engagement and satisfaction. With the onset of the COVID-19 pandemic, a new survey was administered to identify needs of faculty and adjust initiatives. This study was exempt from institutional review board approval.ResultsThe majority of radiologists (79%) agreed or strongly agreed that the wellness program provided opportunities to connect with coworkers. All radiologists agreed that the program was helpful and should be continued. During the COVID-19 pandemic, 49% of physicians requested initiatives focused on well-being, emotional health, and mindfulness to support them during the crisis.ConclusionsThe implementation of a faculty wellness program in an academic radiology department addressed institutional and personal factors of burnout, allowed faculty to connect with coworkers, and was found to be helpful by all radiologists. The COVID-19 pandemic shifted needs to well-being and emotional health initiatives. Follow-up data are necessary to assess its effect on burnout reduction.     

The radiology workforce's response to the COVID-19 pandemic in the Middle East,North Africa and India

IntroductionThis study aimed to investigate the response of the radiology workforce to the impact of the coronavirus disease 2019 (COVID-19) pandemic on professional practice in India and eight other Middle Eastern and North African countries. It further investigated the levels of fear and anxiety among this workforce during the pandemic.MethodsA quantitative cross-sectional study was conducted using an online survey from 22 May-2 June 2020 among radiology workers employed during the COVID-19 pandemic. The survey collected information related to the following themes: (1) demographic characteristics, (2) the impact of COVID-19 on radiology practice, and (3) fear and (4) anxiety emanating from the global pandemic.ResultsWe received 903 responses. Fifty-eight percent had completed training on infection control required for handling COVID-19 patients. A large proportion (79.5%) of the respondents strongly agreed or agreed that personal protective equipment (PPE) was adequately available at work during the pandemic. The respondents reported experiences of work-related stress (42.9%), high COVID-19 fear score (83.3%) and anxiety (10%) during the study period.ConclusionThere was a perceived workload increase in general x-ray and Computed Tomography imaging procedures because they were the key modalities for the initial and follow-up investigations of COVID-19. However, there was adequate availability of PPE during the study period. Most radiology workers were afraid of being infected with the virus. Fear was predominant among workers younger than 30 years of age and also in temporary staff. Anxiety occurred completely independent of gender, age, experience, country, place of work, and work status.Implications for practiceIt is important to provide training and regular mental health support and evaluations for healthcare professionals, including radiology workers, during similar future pandemics.     

The impact of COVID-19 upon student radiographers and clinical training

IntroductionTo investigate student clinical placement concerns and opinions, during the initial COVID-19 pandemic outbreak and to inform educational institution support planning.MethodsBetween mid-June to mid-July 2020, educational institutions from 12 countries were invited to participate in an online survey designed to gain student radiographer opinion from a wide geographical spread and countries with varying levels of COVID-19 cases.Results1277 respondents participated, of these 592 had completed clinical placements during January to June 2020. Accommodation and cohabiting risks were identified as challenging, as was isolation from family, travel to clinical placements, and to a lesser extent childcare. Students stated they had been affected by the feeling of isolation and concerns about the virus whilst on placement. Overall 35.4% of all respondents were ‘Not at all worried’ about being a radiographer, however, 64.6% expressed varying levels of concern and individual domestic or health situations significantly impacted responses (p ≤ 0.05). Year 4 students and recent graduates were significantly more likely to be ‘Not worried at all’ compared to Year 2 and 3 students (p ≤ 0.05). The need for improved communication regarding clinical placements scheduling was identified as almost 50% of students on clinical placements between January to June 2020 identified the completion of assessments as challenging. Furthermore, only 66% of respondents with COVID-19 imaging experience stated being confident with personal protective equipment (PPE) use.ConclusionStudent radiographers identified key challenges which require consideration to ensure appropriate measures are in place to support their ongoing needs. Importantly PPE training is required before placement regardless of prior COVID-19 imaging experience.Implications for practiceAs the next academic year commences, the study findings identify important matters to be considered by education institutions with responsibility for Radiography training and as students commence clinical placements during the on-going global COVID-19 pandemic.     

Assessment and correlation between job satisfaction and burnout among radiographers

IntroductionPrevious research on job satisfaction (JS) and burnout has focused on physicians and nurses. However, limited work has evaluated radiographers’ JS and burnout, factors affecting them and the correlation between them. The aim of this study is to assess the level and specific factors affecting burnout and JS among radiographers and to examine the correlation between them.MethodsA questionnaire consisting of socio-demographic information and two validated instruments (Maslach Burnout Inventory-Human Services Survey for Medical Personnel (MBI-HSS (MP)) and JS Survey (JSS)) was distributed to radiographers. The MBI included 22 questions and JSS consisted of 36 questions. Mean scores were used to compare responses between participants according to demographic characteristics. Correlation between JS and burnout was examined using Pearson correlation test, with P < 0.05 determining statistical significance.Results308 radiographers returned a completed questionnaire, 48.4% of participants were male, 48.7% had 1–6 years of experience and 61.4% examined >25 patients per day. Total emotional exhaustion, depersonalization and personal accomplishment scores were 28.7, 11.3 and 35.8 respectively. Most participants felt dissatisfied with pay (n = 221, 71.8%), opportunities for promotion (n = 202, 65.6%), fringe benefits (n = 239, 77.6%), contingent rewards (n = 231, 75.0%), operating procedures (n = 190, 61.7%) and communication (n = 162, 52.6%). Burnout was associated with work experience and caseload and JS was associated with section of work. Most of the JS domains were significantly inversely related to emotional exhaustion and depersonalisation domains. Emotional exhaustion and depersonalization drew a significant positive correlation. Emotional exhaustion and depersonalization drew a significant positive correlation.ConclusionParticipating radiographers are mostly dissatisfied about their jobs and they suffer a high level of emotional exhaustion.Implications for practiceTo avoid the consequences of burnout and decreased JS on individuals and organizations, efforts should be done in alleviating the main factors affecting them.     

Impact of COVID-19 pandemic on radiographers in the Republic of Cyprus. A questionnaire survey

IntroductionImaging is essential for the initial diagnosis and monitoring of the novel coronavirus, which emerged in Wuhan, China. This study aims to assess the insight of radiographers on how the COVID-19 pandemic has affected their work routine and if protective measures are applied.MethodA prospective observational study was conducted among radiographers registered in the Cyprus Society of Registered Radiologic Technologists & Radiation Therapy Technologists. A questionnaire composed of 28 multiple choice questions was utilised, and the data analysis was performed using SPSS software with the statistical significance assumed as p-value < 0.05.ResultsOut of 350 registered radiographers, 101 responses were received. The results showed that there are statistically significant differences regarding the working hours, the feeling of stress, the work effectiveness, the average examination time, the presence of a protocol used among the different workplaces of the participants; a private radiology centre, a private hospital or a public hospital, with a p-value 0.0022, 0.015, 0.027, 0.001, 0.0001 respectively. Also, statistically significant differences were observed in the decontamination methods used for equipment (p-value 0.007), for air (p-value 0.04) and when decontamination takes place (p-value 0.00032) among the different workplaces of the participants. Nonetheless, the majority of radiographers believe that their workplace is sufficiently provided with PPE, cleaning supplies, equipment, and with cleaning personnel and are optimistic regarding the adequacy of these provisions in the next three months.ConclusionThis study showed that in the Republic of Cyprus, there are protocols regarding protective measures against COVID-19, and the radiographers are adequately trained on how to face an infectious disease outbreak. However, work is needed in order to develop protocols that reassure the safety of patients and medical personnel while managing the excess workload effectively.Implications for practiceThis study indicates the importance of applying protective measures and protocols in the radiology departments in order to minimise the spread of the virus.     

The 12-hour shift: radiographers’ perspectives and its applicability during a pandemic

IntroductionTraditionally, shift work for radiographers at our institution comprised of three shift patterns – morning (8am-2pm), afternoon (2pm–9pm) and night (9pm-8am). However, when COVID-19 was first detected in Singapore in January 2020, the 12-h shift was introduced for better team segregation and deployment to meet the service needs of the Emergency Department. The 12-h shift consisted of the day (9am-9pm) and night (9pm-9am) shifts. While the 12-h shift is common to nursing practices, it is new to the radiography profession within the study centre. This study explores the radiographers' perspectives of the new shift and the impact of shift patterns on radiographers' wellness and work performance compared to the original three shift patterns.MethodsA mixed-methods design study was adopted for this single-centre evaluation. An anonymous online questionnaire was administered to radiographers who had experienced both shift types. Additionally, the number of radiographers who had taken sick leave, and images rejected and accepted from the X-ray consoles were retrospectively collected to measure the impact of the new shift.ResultsRadiographers experienced fatigue and appreciated the longer rest days associated with the 12-h shift. Additionally, the sick leave rates and image reject counts were more favourable with the 12-h shift pattern.ConclusionThe findings indicate that the extended shift hours are effective during a pandemic but may result in radiographer burnout during a prolonged outbreak.Implications for practiceStudying these variables will provide an effective starting point in understanding the efficacy and applicability of a 12-h shift system during pandemic periods.     

Experiences of diagnostic radiographers through the Covid-19 pandemic

IntroductionDiagnostic Radiography plays a major role in the diagnosis and management of patients with Covid-19. This has seen an increase in the demand for imaging services, putting pressure on the workforce. Diagnostic radiographers, as with many other healthcare professions, have been on the frontline, dealing with an unprecedented situation. This research aimed to explore the experience of diagnostic radiographers working clinically during the Covid-19 pandemic.MethodsInfluenced by interpretative phenomenology, this study explored the experiences of diagnostic radiographers using virtual focus group interviews as a method of data collection.ResultsData were analysed independently by four researchers and five themes emerged from the data. Adapting to new ways of working, feelings and emotions, support mechanisms, self-protection and resilience, and professional recognition.ConclusionThe adaptability of radiographers came across strongly in this study. Anxieties attributed to the provision of personal protective equipment (PPE), fear of contracting the virus and spreading it to family members were evident. The resilience of radiographers working throughout this pandemic came across strongly throughout this study. A significant factor for coping has been peer support from colleagues within the workplace. The study highlighted the lack of understanding of the role of the radiographer and how the profession is perceived by other health care professionals.Implications for practiceThis study highlights the importance of interprofessional working and that further work is required in the promotion of the profession.     

Diagnostic radiographers’ experience of COVID-19, Gauteng South Africa

IntroductionAs of July 2020, South Africa (SA) had the fifth highest number of COVID-19 infections in the world, with the greatest contributor of these infections, being the province of Gauteng. Diagnostic radiographers in Gauteng providing chest CT, chest radiograph and MRI services are frontline workers experiencing these unprecedented times. Therefore, this study undertook to explore diagnostic radiographers’ experiences of COVID-19.MethodsA qualitative approach using an asynchronous opened-ended online questionnaire was used to explore diagnostic radiographers’ experiences of COVID-19. Responses from purposively sampled diagnostic radiographers in Gauteng SA, underwent thematic analysis.ResultsSixty diagnostic radiographers representing both the private and public health sector responded to the questionnaire. Thematic analysis revealed three themes: new work flow and operations, effect on radiographer well-being and radiographer resilience.ConclusionBesides experiencing a shift in their professional work routine and home/family dynamics, diagnostic radiographers’ well-being has also been impacted by COVID-19. Adapting to the “new way of work” has been challenging yet their resilience and dedication to their profession, providing quality patient care and skill expertise is their arsenal to combat these challenges.Implications for practiceUnderstanding the impact of COVID-19 on diagnostic radiographers will allow radiology departments’ management, hospital management, professional bodies and educational institutions to re-evaluate provision of resources, training, employee wellness programs as well as policies and procedures.     

Impact of the COVID-19 pandemic on corticosteroid injection services: A National Survey of Members of the British Society of Skeletal Radiologists (BSSR)

ObjectiveTo describe the restructuring of services by British radiologists in response to evolving national guidelines and highlight the impact of the COVID-19 pandemic on the treatment of musculoskeletal (MSK) conditions.MethodsAn online anonymised survey was distributed via the British Society of Skeletal Radiology (BSSR) members forum in November 2020. Responses were collated using a standardised Google form including 21 questions.Results135 members of the BSSR completed the survey. 85% of respondents stopped performing corticosteroid injections (CSI) during the initial lockdown of the pandemic. This was primarily influenced by national guidelines. The majority of respondents initially abstained from offered CSI procedures, then by November 2020, 69% of respondents were providing CSI for high and low risk patients, 23% were only providing CSI for low-risk patients with 8% still not performing any CSI. 40% of respondents reported routinely obtaining specific written consent regarding the risk of COVID-19. Approximately, 11,000 CSI were performed by respondents between March and November 2020 with no reported significant COVID-19-related complications. Over 80% of BSSR members reported that the number of CSI procedures that they performed dropped by more than 80% compared to usual. 73% of respondents reported an increased backlog of patients awaiting treatment. The average waiting time for routine outpatient CSI treatment was > 12 weeks in 53% of responses, compared to 34% the previous year.ConclusionThe COVID-19 pandemic has had a significant impact on the clinical practices of MSK radiologists in the UK. Our survey highlights the rapid response of BSSR members as national guidelines evolved. Currently, the majority of respondents are performing CSI for musculoskeletal conditions when clinically indicated, with enhanced consent. However, the pandemic has resulted in increased waiting times – delaying the treatment of patients who may be suffering with significant pain and disability. Further research is warranted to provide guidance around both service recovery and provision of CSI around COVID-19 vaccination schedules.Advances in knowledgeBSSR members responded rapidly to changing guidelines during the COVID-19 pandemic. The majority of respondents are currently performing CSI when clinically indicated. The pandemic has resulted in a significant increase in waiting times which will have a significant impact on UK musculoskeletal services.