Caring Advanced Cancer Patients at Home During COVID-19 Outbreak: Burnout and Psychological Morbidity Among Palliative Care Professionals in Italy

ContextProviding palliative care (PC) at home for patients with advanced cancer has become essential during the COVID-19 emergency. Nevertheless, the home PC professionals (PCPs) faced a challenging situation because of increased number of discharged patients, reduced availability of health-care facilities, and physical/relational barriers between them and patients.ObjectivesThis study aimed to investigate the impact of COVID-19 pandemic on burnout and psychological morbidity among home PCPs in Italy.MethodsOne hundred and ninety-eight PC physicians and nurses working in home assistance in Italy were invited to participate. The results obtained by the investigation conducted during the COVID-19 emergency (COVID2020) were compared with data collected in 2016 in the same setting (BURNOUT2016). The questionnaires (socio-demographics, Maslach Burnout Inventory and General Health Questionnaire-12) were the same for both the surveys. The PCPs participating in COVID2020 survey (n = 145) were mostly the same (70%) who participated in the BURNOUT2016 study (n = 179).ResultsOne hundred and forty-five PCPs participated in the study (response rate 73.2%). During the COVID-19 emergency, home PCPs presented a lower burnout frequency (P < .001) and higher level of personal accomplishment than in 2016 (P = .047). Conversely, the risk for psychological morbidity was significantly higher during the pandemic (P < .001).ConclusionsIn the age of COVID-19, the awareness of being at the forefront of containing the pandemic along with the sense of responsibility toward their high-risk patients may arouse PCPs' psychological distress, but, on the other hand, this condition may improve their sense of professional satisfaction and personal accomplishment.     

The Bulle: Support and Prevention of Psychological Decompensation of Health Care Workers During the Trauma of the COVID-19 Epidemic

The coronavirus disease 2019 pandemic presents unprecedented challenges for the health care system. The pressure on health care staff continues to intensify, accentuated by the confinement (lockdown) of the population and the unprecedented duration of this emergency. Separately and especially together, overwork, degraded conditions of care because of the never-ending emergency, and the risk of exposure to the virus can lead to acute psychological distress or signs of burnout.This original program was developed at Cochin Hospital in Paris, France to prevent these potentially dramatic psychological consequences, support the medical staff, and identify those most affected to offer them specific care. A program and a space for relaxation and support for hospital caregivers by hospital caregivers, the Port Royal Bulle (the Bubble) offers these workers help in decompression and relaxation. It combines a warm and caring welcome that promotes attention, listening, conversations, and exchanges as needed, empathetic support, and the ability to participate in soothing, relaxing, or low-impact physical activities. It takes care of caregivers. The Bubble is a program that is simple to set up and that appears to meet professionals' expectations. Making it permanent and enlarging its scale, as a complement to existing programs, might help to support health care personnel in their work.     

大学生学习倦怠的综合干预效果分析

目的设计出一套心理教育、团体辅导和个别辅导相结合的综合干预方案,并考察其对学习倦怠的干预效果。方法对10名存在学习倦怠的大学生进行干预实验,采用李永鑫等的《大学生学习倦怠问卷》和自编《干预效果反馈表》对干预效果进行评估。结果实验组后测在情绪耗竭（t=2．465,P〈0．05）、成就感低（t=3．161,P〈0．05）上低于前测,追测在情绪耗竭（t=2．313,P〈0．05）、成就感低（t=2．555,P〈0．05）上低于前测;实验组与对照组在前测中不存在差异,但两组的后测在情绪耗竭（t=-2．422,P〈0．05）、成就感低（t=-2．746,P〈0．05）上,追测在情绪耗竭（t=-2．149,P〈0．05）、成就感低（t=-2．337,P〈0．05）上存在显著差异;被试对干预的主观评价较好。结论干预方案较为有效,但尚需改进和完善。     

精神科护士心理资本对工作倦怠的影响

目的探讨精神科护士心理资本与工作倦怠的关系,改善护士身心健康,降低其工作倦怠,提高精神科护士工作效率和改进招聘选拔标准。方法通过随机取样,采用一般情况调查表,Luthans心理资本问卷（PCQ-24）及工作倦怠量表（MBI—Gs）,对某地区精神卫生中心的103名护士进行问卷调查。结果不同学历,职称和工作年限的精神科护士自我价值维度得分,组间比较具有统计学差异（F=3．95,P〈0．05;F=4．47,5．37;P〈0．01）,月收入不同的护士之间的希望维度组间比较差异有统计学意义（F=5．74,P〈0．01）,职称不同护士的韧性维度得分,组间比较具有统计学差异（F=4．96,P〈0．01）。工作年限不同的精神科护士心理资本中疲劳感维度,组间比较有统计学差异（F=5．36,P〈0．01）,职称和月收入不同的精神科护士的成就感降低维度,组间比较有统计学差异（F=5．84,6．83,P〈0．01）。除了心理资本的希望维度与工作倦怠的人际关系敏感维度之间相关不显著外,精神科护士心理资本的其他维度与工作倦怠的其他维度都呈负性相关（P〈0．01）。结论精神科护士的心理资本与工作倦怠程度密切相关,心理资本可以显著改善工作倦怠的负面影响作用。     

What effect does increasing inpatient time have on outpatient-oriented internist satisfaction?

OBJECTIVE: Because career satisfaction among general internists is relatively low, we sought to understand the impact on satisfaction of general internists managing patients both in and outside of the hospital. Using data from a national survey, we asked, “Among outpatient-oriented general internists (i.e., internists who spend less than 50% of their clinical time caring for inpatients), what effect does time spent in the hospital have on physician satisfaction, stress, and burnout?” DESIGN/PARTICIPANTS: The Physician Worklife Study, in which 5,704 physicians in primary and specialty nonsurgical care selected from the American Medical Association’s Masterfile were surveyed (adjusted response rate=52%), was used. Our analyses focused on clinically active outpatient-oriented general internists (N=339). MEASUREMENTS AND MAIN RESULTS: We constructed multivariate linear models to test for statistically significant associations between the amount of time spent seeing inpatients and physician satisfaction as measured by several satisfaction scales. Even after controlling for total hours worked and other possible confounding variables, we found that increased time working in the hospital was significantly associated with decreases in satisfaction with administration, specialty, autonomy, and personal time, and significantly associated with an increase in life stress. There was also a significant association between increased time spent in the hospital and burnout. CONCLUSIONS: Our findings imply that there may be a tension between the practice of inpatient and outpatient medicine by general internists, and suggest that fewer hospital duties may increase career satisfaction for outpatient-oriented internists. Although additional studies are warranted in order to better understand why these relationships exist, our data suggest that the hospitalist model of inpatient care might be one approach to alleviate stress and improve satisfaction for many general internists.     

The Reciprocal Relationship Between Work Characteristics and Employee Burnout and Engagement: A Longitudinal Study of Firefighters

The paradigm of this study is positive occupational psychology, with the job demands‐resources model as the research model and the Conservation of Resources theory as the general stress theory. The research design analyses the job demands‐resources model's dynamic nature with normal and reversed causation effects between work characteristics and psychological well‐being among Portuguese firefighters. In addition, we analyse a positive (engagement) dimension and a negative (burnout) dimension in the firefighters' well‐being, because previously, studies have merely focused on the strain or stress of these professionals. The research questionnaire was distributed to a sample of 651 firefighters, and a two‐wave full panel design was used. Cross‐lagged panel analyses indicated that the causal direction of the relationship between organizational demands and burnout is reciprocal. Also, we found that the reciprocal model, including cross‐lagged reciprocal relationships between organizational demands/supervisory support and burnout/engagement, respectively, is what fits the data best. Practical implications to develop organizational change programmes and suggestions for future research regarding the promotion of occupational health are discussed. Copyright © 2013 John Wiley & Sons, Ltd.     

Stress in the Courtroom: Call for research

Recent acts of violence against judges highlight the growing number of occupational stressors that judges encounter. In addition to threats of violence, judges often deal with substantial workloads, traumatic cases, and the pressure of making significant decisions. It is important to understand these stressors, because they could negatively affect judges' abilities to handle evidence, protect jurors, and make decisions. Approaches (work-related burnout, compassion fatigue, and vicarious traumatization) to assessing work-related stress, and their corresponding scales (Maslach Burnout Inventory, Compassion Fatigue Self-Test, Traumatic Stress Institute Belief Scale), are presented, as a first step in developing a scale to assess the extent and prevalence of judge stress. Following assessment research, researchers should develop intervention strategies to alleviate problematic sources of stress for judges.