What do clinicians derive from partnering with their patients?: A reliable and valid measure of “personal meaning in patient care”

Objective

Burnout is high among clinicians and may relate to loss of “meaning” in patient care. We sought to develop and validate a measure of “personal meaning” that practitioners derive from patient care.

Methods

As part of a larger study of well-being among genetics professionals, we conducted three focus groups of clinical genetics professionals: physicians, nurses and genetic counselors (N = 29). Participants were asked: “What gives you meaning in patient care?” Eight themes were identified, converted into Likert items, and included in a questionnaire. Next, we mailed the questionnaire to clinical geneticists, genetic counselors and genetic nurses (N = 480) randomly selected from mailing lists of their professional associations. Results were subjected to exploratory factor analysis. The survey also included validated scales of burnout and professional satisfaction, and a 1-item measure of gratitude, to assess predictive validity.

Results

214 eligible providers completed the survey out of an estimated 348 eligible (61% response rate). Factor analysis resulted in a unidimensional scale consisting of 6-items with an alpha of 0.82 and an eigen value of 3.2. Factor loadings ranged from 0.69–0.77. The mean total score was 18.1 (S.D. 3.7) out of a possible high score of 24. Higher meaning scores were associated with being female (p = 0.044), a nurse (p < 0.001), and in practice longer (p = 0.006). Meaning scores were inversely correlated with burnout (p < 0.001), and positively correlated with gratitude (p < 0.001) and professional satisfaction (p < 0.022).

Conclusion

The 6-item “personal meaning in patient care” scale demonstrates high reliability and predictive validity in a select group of health professionals. Future research should validate this scale in a broader population of clinicians.

Practice implications

The scale could be useful in identifying providers at risk of burnout, and in evaluating interventions designed to counteract burnout, enhance meaning and improve communication and partnership between providers and patients.     

Burnout syndrome in surgical oncology and general surgery nurses: A cross-sectional study

Purpose

The occurrence of burnout syndrome is strongly associated with and modulated by multiple personality and environmental factors. In Poland, nurses experience a discrepancy between the demands, expectations and social status of the position of their profession and low salaries. Such a situation provokes frustration and depression, and further leads to problems of adaptation including burnout syndrome. The aim of this study was to evaluate the occurrence of burnout syndrome among nurses working in general surgery and surgical oncology specialties.

Methods

The study was designed as a cross-sectional questionnaire survey. It was undertaken in the largest Hospital in the Pomeranian region of Poland. The participants included 60 nurses working in two departments: General Surgery and Surgical Oncology. The study was based upon an anonymous self-test composed of a questionnaire and three psychological measures: Maslach Burnout Inventory (MBI), Psychological Burden Scale and a self-constructed questionnaire on job satisfaction.

Results

Intensity of burnout syndrome was significantly higher among oncology nurses than among surgical ones. There was also a strong but not significant trend towards higher Psychological Burden Scale in the group of oncology nurses.

Conclusions

The study revealed a high degree of emotional burden and burnout in nurses working in the study hospital suggesting that nurses are at great occupational risk. The findings of the study provide evidence of the potential need to restructure the system and suggest that nurses need more control of their work including a higher degree of involvement in clinical decision-making.     

如何破解医生的“职业倦怠症”

职业倦怠症困扰着医生,不少医生在职业压力的紧迫之下,有极端不良反应。医生心理健康问题已成为当前我国医生的普遍性问题,认知结构重组,有效时间管理,身体健康措施,社交技能提高,不断学习进取,精神恢复疗法等可以有效缓解医生职业倦怠。     

武警某部医院护士职业倦怠状态的调查分析

目的 了解武警某部医院护士职业倦怠的状况.方法 便利抽取武警某部医院护士126名作为主要研究对象,便利抽取地方某二级甲等医院各科室护士142名作为对比研究对象.采用Maslach职业调查通用量表(MBI-GS)进行调查.结果 武警某部医院护士在情绪衰竭和情感疏离维度上存在中等程度的倦怠水平,但在低自我价值感维度上未达到倦怠水平.在低自我价值感维度上,部队医院护士倦怠水平低于地方护士(P＜0.05);而在情感疏离维度上,部队护士倦怠水平高于地方护士(P＜0.05).不同岗位、工龄、职称的部队医院护士职业倦怠比较,差异有统计学意义;临床科护士在情绪衰竭和情感疏离维度上的倦怠水平高于非临床科室(P＜0.05);在低个人成就感维度上,小于5年工龄的护士职业倦怠水平高于其他工龄组的护士(P＜0.05);在情感衰竭及低自我价值感维度上,初级职称的护士职业倦怠水平高于高级职称的护士(P＜0.05).结论 针对武警部队医院护士职业倦怠水平的状况,应该有针对性地采取干预措施解决护士的职业倦怠问题,从而提高护士的心理健康水平.     

共情培养对改善急诊护士职业倦怠及护患关系的研究

目的探讨共情能力的培养对改善急诊护士职业倦怠及护患关系的效果。方法通过共情理论知识与技能的培训,使用中文版杰弗逊共情量表与护士职业倦怠调查表对急诊科21名参加共情能力的培训的护士进行调查。结果通过共情能力培训后护士共情能力与患者就诊满意率得分均高于参加共情能力培训前,护士职业倦怠感降低,差异具有统计学意义(P<0.01或P<0.05)。结论通过培训,共情能力的增强和技能的提高可促进护士身心健康,缓解护士职业倦怠;促进护患沟通,促进良好护患关系的建立和发展。     

Prevalencia de burnout entre las enfermeras de cuidados intensivos en Argentina

PurposeBurnout syndrome among intensive care professionals has been widely documented internationally. Few studies address the incidence and prevalence in Latin America. And there are no validated studies about the situation in Argentina. Our goal was to determine burnout prevalence among intensive care nurses in Argentina and related risk factors.Materials and methodsOnline self-administered survey evaluating demographic variables and the Maslach Burnout Inventory in 486 critical care nurses between June and September 2016.ResultsA percentage of 84.4 of participants show moderate or high levels of burnout syndrome (95% CI 80.8 to 87.4). No significant association was found between burnout and gender, age, years of practice, academic degree, role or multiplicity of jobs. There was no statistical difference in burnout prevalence among different types of populations of care (neonatal, paediatric or adult care). Nurse to patient ratios of 1:3 or higher was found to be a statistically significant risk factor for emotional exhaustion and depersonalization sub-scales (P = .002 and .0039, respectively).ConclusionMore than 80% of nurses caring for critically ill patients in Argentina show moderate or high levels of burnout syndrome and this is related to a high nurse:patient ratio (1:3 or higher).     

The impact of program-driven wellness initiatives on burnout and depression among surgical trainees

BackgroundThe prevalence of burnout and depression are high among surgical trainees. This study examined the impact of program-driven initiatives to improve surgical trainee wellness.MethodsA survey was administered to residents and fellows at all surgical training programs across an urban academic health system. The survey measured burnout, depressive symptoms, and perceptions of program-driven wellness initiatives.ResultsThe response rate was 44% among 369 residents. Of these, 63.2% screened positively for burnout, and 36.7% for depression. Residents who were burned out were more likely to work >80 h per week, have greater clerical duties, and miss educational activities more frequently. Conversely, having opportunities for wellness activities, dedicated faculty and housestaff wellness champions, and assistance with clerical burden were all associated with lower rates of burnout and depression.ConclusionThe presence of wellness support was associated with better outcomes, suggesting the value of initiatives to manage workload and support the well-being of surgical resident physicians.