On-call stress among Finnish anaesthetists
TL;DR: Being frequently on call correlates with severe stress symptoms and these symptoms are associated with sick leave, and the anaesthetists had the greatest on‐call workload among Finnish physicians.
Abstract: We investigated on-call stress and its consequences among anaesthetists. A questionnaire was sent to all working Finnish anaesthetists (n = 550), with a response rate of 60%. Four categories of on-call workload and a sum variable of stress symptoms were formed. The anaesthetists had the greatest on-call workload among Finnish physicians. In our sample, 68% felt stressed during the study. The most important causes of stress were work and combining work with family. The study showed a positive correlation between stress symptoms and on-call workload (p = 0.009). Moderate burnout was present in 18%vs 45% (p = 0.008) and exhaustion in 32% and 68% (p = 0.015), in the lowest vs highest workload category, respectively. The symptoms were significantly associated with stress, gender, perceived sleep deprivation, suicidal tendencies and sick leave. Being frequently on call correlates with severe stress symptoms and these symptoms are associated with sick leave.
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TL;DR: The most promising worktime-related means for decreasing the psychosocial workload and negative health effects of workhours would be to regulate overtime and excessive workhours, increase individual worktime control, and increase recovery from the introduction of sleep-promoting principles into shift rotation.
Abstract: This paper aims at describing the associations between workhours and psychosocial work characteristics and reviews the health effects of workhours and the related pathways. The role of insufficient sleep as a possible common pathway from workhours and work stress to cardiovascular illness is discussed. Finally, the key possibilities for improving recovery and health through changes in workhours are identified. Night work and shift work are related to a wide range of health effects, the evidence for the risk of cardiovascular morbidity being the strongest. Insufficient or poor sleep, related to insufficient recovery, can be a common pathway from long workhours, shift work, and work stress to cardiovascular illness. The most promising worktime-related means for decreasing the psychosocial workload and negative health effects of workhours would be (i) to regulate overtime and excessive workhours, (ii) increase individual worktime control, and (iii) increase recovery from the introduction of sleep-promoting principles into shift rotation.
355 citations
Cites background from "On-call stress among Finnish anaest..."
...For example, 68% of a representative group of anesthetists reported stress, and 18% had moderate burnout (75)....
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TL;DR: Physicians are an at-risk profession of suicide, with women particularly at risk, and the rate of suicide in physicians decreased over time, especially in Europe.
Abstract: Background :
Medical-related professions are at high suicide risk. However, data are contradictory and
comparisons were not made between gender, occupation and specialties, epochs of times.
Thus, we conducted a systematic review and meta-analysis on suicide risk among healthcare workers.
Method :
The PubMed, Cochrane Library, Science Direct and Embase databases were searched
without language restriction on April 2019, with the following keywords: suicide* AND
(« health care worker* » OR physician* OR nurse*). When possible, we stratified results by
gender, countries, time, and specialties. Estimates were pooled using random-effect metaanalysis. Differences by study-level characteristics were estimated using stratified metaanalysis and meta-regression. Suicides, suicidal attempts, and suicidal ideation were
retrieved from national or local specific registers or case records. In addition, suicide
attempts and suicidal ideation were also retrieved from questionnaires (paper or internet).
Results :
The overall SMR for suicide in physicians was 1.44 (95CI 1.16, 1.72) with an important heterogeneity (I2 = 93.9%, p<0.001). Female were at higher risk (SMR = 1.9; 95CI 1.49, 2.58;
and ES = 0.67; 95CI 0.19, 1.14; p<0.001 compared to male). US physicians were at higher
risk (ES = 1.34; 95CI 1.28, 1.55; p <0.001 vs Rest of the world). Suicide decreased over
time, especially in Europe (ES = -0.18; 95CI -0.37, -0.01; p = 0.044). Some specialties might
be at higher risk such as anesthesiologists, psychiatrists, general practitioners and general
surgeons. There were 1.0% (95CI 1.0, 2.0; p<0.001) of suicide attempts and 17% (95CI 12,
21; p<0.001) of suicidal ideation in physicians. Insufficient data precluded meta-analysis on
other health-care workers.
Conclusion :
Physicians are an at-risk profession of suicide, with women particularly at risk. The rate of
suicide in physicians decreased over time, especially in Europe. The high prevalence of physicians who committed suicide attempt as well as those with suicidal ideation should benefits
for preventive strategies at the workplace. Finally, the lack of data on other health-care
workers suggest to implement studies investigating those occupations.
249 citations
TL;DR: This article reviews the literature pertaining to the association between demographic variables with fatigue, and when feasible, accident risk, and recommends greater interdisciplinary collaborations, incorporation of multiple demographic variables as independent factors, and use of within-participant analyses.
167 citations
TL;DR: Evaluated stress and burnout in colorectal surgeons (surgeons) and coloreCTal clinical nurse specialists (nurses) working in the NHS.
Abstract: Background It has been suggested that changes to the organization of the National Health Service (NHS) and clinical practices in dealing with cancer are associated with increased stress and burnout in healthcare professionals. The aim of this study, therefore, was to evaluate stress and burnout in colorectal surgeons (surgeons) and colorectal clinical nurse specialists (nurses) working in the NHS.
Method A list of all consultant surgeons and nurses was obtained from The Association of Coloproctology of Great Britain and Ireland. Participants were sent a questionnaire booklet consisting of standardized measures [General Health Questionnaire (GHQ), Maslach Burnout Inventory (MBI), Coping Questionnaire] and various ad hoc questions to obtain information about demographics, cancer workload and job satisfaction. Independent predictors of clinically significant distress and burnout were identified using logistic regression.
Results Four hundred and fifty-five surgeons and 326 nurses were sent booklets. The response rate was 55.6% in surgeons and 54.3% in nurses. The mean age of the nurses was lower than that of surgeons (42.8 vs 47.7, P < 0.001). Psychiatric morbidity was similar in the surgeons and nurses as assessed using the GHQ (30.2% and 30.3% respectively). On the MBI, compared with nurses, surgeons had significantly higher levels of depersonalization (17.4%vs 7.4%, P = 0.003) and lower personal accomplishment (26.6%vs 14.2%, P = 0.002). Seventy-seven per cent of surgeons and 63.4% of nurses stated their intention to retire before the statutory retirement age.
Coping strategies, especially those in which respondents isolated themselves from friends and family, were associated with higher psychiatric morbidity and burnout. Dissatisfaction with work, intention to retire early, intention to retire as soon as affordable and poor training in communication and management skills were also significantly associated with high GHQ scores and burnout in both groups.
Discussion We found high levels of psychiatric morbidity and burnout in this national cohort of surgeons and nurses working in the NHS. However, psychiatric morbidity and burnout were unrelated to cancer workload. Nurses have lower burnout levels than surgeons and this may be related to their different working practices, responsibilities and management structure.
110 citations
TL;DR: Examination of the prevalence of burnout, levels of life satisfaction and job satisfaction in anaesthetists in France revealed differences between subgroups, and the implications to reduce burnout symptoms in anesthesia teams are discussed.
Abstract: The present study aimed to examine the prevalence of burnout, levels of life satisfaction and job satisfaction in anaesthetists in France. A cross-sectional study was conducted among 193 anaesthetists from eight French public hospitals. The results indicated low levels of emotional exhaustion and depersonalization scores, but high levels of reduced accomplishment. The results also revealed differences between subgroups: physician anaesthetists reported higher levels of depersonalization and reduced accomplishment than nurse anaesthetists, female and junior anaesthetists reported higher levels of emotional exhaustion and job dissatisfaction than male and senior anaesthetists. The results and the implications to reduce burnout symptoms in anesthesia teams are discussed.
75 citations
Cites background or result from "On-call stress among Finnish anaest..."
...…have shown that junior anaesthetists are generally more vulnerable to emotional exhaustion than the seniors, or physicians exercising high responsibilities (Lindfors et al., 2006; Morais, Maia, Azevedo, Amaral, & Tavares, 2006; Nyssen, Hansez, Baele, Lamy, & de Keyser, 2003; Seeley, 1996)....
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...…& Magnani, 2000; Kluger et al., 2003; Maslach et al., 2001; McManus et al., 2002; Ramirez et al., 1996) and in anaesthetists in other countries (Adam et al., 2008; Cooper et al., 1999; Lindfors et al., 2006;Morais et al., 2006; Nyssen et al., 2003, 2008) exists and enables us to make comparisons....
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...Thus, physician anaesthetists display the signs of stress to a greater degree than normative groups: use of drugs or of alcohol, marital difficulties and psychiatric disorders (Cooper, Clarke, & Rowbottom, 1999; Lindfors et al., 2006; Luck & Hedrick, 2004; Mérat & Mérat, 2008)....
[...]
...…studies related to occupational burnout among anaesthetists in other countries (Adam et al., 2008; Cooper et al., 1999; Kluger & Bryant, 2008; Lindfors et al., 2006; Morais et al., 2006; Nyssen et al., 2003; Nyssen & Hansez, 2008), we hypothesized that: (H1) Physician anaesthetists working…...
[...]
...These findings are consistent with previous studies that have shown a high prevalence of burnout syndrome among junior physicians (Lindfors et al., 2006; Morais et al., 2006; Nyssen et al., 2003; Seeley, 1996)....
[...]
References
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01 Jan 2000
TL;DR: Boken presenterer en helhetlig strategi for hvordan myndigheter, helsepersonell, industri og forbrukere kan redusere medisinske feil.
Abstract: Boken presenterer en helhetlig strategi for hvordan myndigheter, helsepersonell, industri og forbrukere kan redusere medisinske feil.
16,469 citations
TL;DR: The long-term effect of the physiologic response to stress is reviewed, which I refer to as allostatic load, which is the ability to achieve stability through change.
Abstract: Over 60 years ago, Selye1 recognized the paradox that the physiologic systems activated by stress can not only protect and restore but also damage the body. What links these seemingly contradictory roles? How does stress influence the pathogenesis of disease, and what accounts for the variation in vulnerability to stress-related diseases among people with similar life experiences? How can stress-induced damage be quantified? These and many other questions still challenge investigators. This article reviews the long-term effect of the physiologic response to stress, which I refer to as allostatic load.2 Allostasis — the ability to achieve stability through change3 — . . .
5,932 citations
TL;DR: The relationship of allostatic load to genetic and developmental predispositions to disease is considered and examples will be given from research pertaining to autonomic, CNS, neuroendocrine, and immune system activity.
Abstract: Adaptation in the face of potentially stressful challenges involves activation of neural, neuroendocrine and neuroendocrine-immune mechanisms. This has been called "allostasis" or "stability through change" by Sterling and Eyer (Fisher S., Reason J. (eds): Handbook of Life Stress, Cognition and Health. J. Wiley Ltd. 1988, p. 631), and allostasis is an essential component of maintaining homeostasis. When these adaptive systems are turned on and turned off again efficiently and not too frequently, the body is able to cope effectively with challenges that it might not otherwise survive. However, there are a number of circumstances in which allostatic systems may either be overstimulated or not perform normally, and this condition has been termed "allostatic load" or the price of adaptation (McEwen and Stellar, Arch. Int. Med. 1993; 153: 2093.). Allostatic load can lead to disease over long periods. Types of allostatic load include (1) frequent activation of allostatic systems; (2) failure to shut off allostatic activity after stress; (3) inadequate response of allostatic systems leading to elevated activity of other, normally counter-regulated allostatic systems after stress. Examples will be given for each type of allostatic load from research pertaining to autonomic, CNS, neuroendocrine, and immune system activity. The relationship of allostatic load to genetic and developmental predispositions to disease is also considered.
3,876 citations
Book•
23 Nov 1998TL;DR: This chapter discusses the search for a Unified Evolutionary Psychology through the lens of parenting, sexuality, and social Dominance.
Abstract: PART ONE - FOUNDATIONS OF EVOLUTIONARY PSYCHOLOGY Chapter 1. The Scientific Movements Leading to Evolutionary Psychology Chapter 2. The New Science of Evolutionary Psychology PART TWO - PROBLEMS OF SURVIVAL Chapter 3. Combating the Hostile Forces of Nature: Human Survival Problems PART THREE - CHALLENGES OF SEX AND MATING Chapter 4. Women's Long-Term Mating Strategies Chapter 5. Men's Long-Term Mating Strategies Chapter 6. Short-Term Sexual Strategies PART FOUR - CHALLENGES OF PARENTING AND KINSHIP Chapter 7. Problems of Parenting Chapter 8. Problems of Kinship PART FIVE - PROBLEMS OF GROUP LIVING Chapter 9. Cooperative Alliances Chapter 10. Aggression and Warfare Chapter 11. Conflict between the Sexes Chapter 12. Status, Prestige, and Social Dominance PART SIX - AN INTEGRATED PSYCHOLOGICAL SCIENCE Chapter 13. Toward a Unified Evolutionary Psychology
1,828 citations
TL;DR: The performance impairment caused by fatigue is compared with that due to alcohol intoxication, and it is shown that moderate levels of fatigue produce higher levels of impairment than the proscribed level of alcohol intoxication.
Abstract: Reduced opportunity for sleep and reduced sleep quality are frequently related to accidents involving shift-workers1,2,3 Poor-quality sleep and inadequate recovery leads to increased fatigue, decreased alertness and impaired performance in a variety of cognitive psychomotor tests4 However, the risks associated with fatigue are not well quantified Here we equate the performance impairment caused by fatigue with that due to alcohol intoxication, and show that moderate levels of fatigue produce higher levels of impairment than the proscribed level of alcohol intoxication
1,113 citations