Showing papers on "Burnout published in 2018"

Physician burnout: contributors, consequences and solutions

Abstract: Physician burnout, a work-related syndrome involving emotional exhaustion, depersonalization and a sense of reduced personal accomplishment, is prevalent internationally. Rates of burnout symptoms that have been associated with adverse effects on patients, the healthcare workforce, costs and physician health exceed 50% in studies of both physicians-in-training and practicing physicians. This problem represents a public health crisis with negative impacts on individual physicians, patients and healthcare organizations and systems. Drivers of this epidemic are largely rooted within healthcare organizations and systems and include excessive workloads, inefficient work processes, clerical burdens, work-home conflicts, lack of input or control for physicians with respect to issues affecting their work lives, organizational support structures and leadership culture. Individual physician-level factors also play a role, with higher rates of burnout commonly reported in female and younger physicians. Effective solutions align with these drivers. For example, organizational efforts such as locally developed practice modifications and increased support for clinical work have demonstrated benefits in reducing burnout. Individually focused solutions such as mindfulness-based stress reduction and small-group programmes to promote community, connectedness and meaning have also been shown to be effective. Regardless of the specific approach taken, the problem of physician burnout is best addressed when viewed as a shared responsibility of both healthcare systems and individual physicians. Although our understanding of physician burnout has advanced considerably in recent years, many gaps in our knowledge remain. Longitudinal studies of burnout's effects and the impact of interventions on both burnout and its effects are needed, as are studies of effective solutions implemented in combination. For medicine to fulfil its mission for patients and for public health, all stakeholders in healthcare delivery must work together to develop and implement effective remedies for physician burnout.

Prevalence of Burnout Among Physicians: A Systematic Review

Abstract: Importance Burnout is a self-reported job-related syndrome increasingly recognized as a critical factor affecting physicians and their patients An accurate estimate of burnout prevalence among physicians would have important health policy implications, but the overall prevalence is unknown Objective To characterize the methods used to assess burnout and provide an estimate of the prevalence of physician burnout Data Sources and Study Selection Systematic search of EMBASE, ERIC, MEDLINE/PubMed, psycARTICLES, and psycINFO for studies on the prevalence of burnout in practicing physicians (ie, excluding physicians in training) published before June 1, 2018 Data Extraction and Synthesis Burnout prevalence and study characteristics were extracted independently by 3 investigators Although meta-analytic pooling was planned, variation in study designs and burnout ascertainment methods, as well as statistical heterogeneity, made quantitative pooling inappropriate Therefore, studies were summarized descriptively and assessed qualitatively Main Outcomes and Measures Point or period prevalence of burnout assessed by questionnaire Results Burnout prevalence data were extracted from 182 studies involving 109 628 individuals in 45 countries published between 1991 and 2018 In all, 857% (156/182) of studies used a version of the Maslach Burnout Inventory (MBI) to assess burnout Studies variably reported prevalence estimates of overall burnout or burnout subcomponents: 670% (122/182) on overall burnout, 720% (131/182) on emotional exhaustion, 681% (124/182) on depersonalization, and 632% (115/182) on low personal accomplishment Studies used at least 142 unique definitions for meeting overall burnout or burnout subscale criteria, indicating substantial disagreement in the literature on what constituted burnout Studies variably defined burnout based on predefined cutoff scores or sample quantiles and used markedly different cutoff definitions Among studies using instruments based on the MBI, there were at least 47 distinct definitions of overall burnout prevalence and 29, 26, and 26 definitions of emotional exhaustion, depersonalization, and low personal accomplishment prevalence, respectively Overall burnout prevalence ranged from 0% to 805% Emotional exhaustion, depersonalization, and low personal accomplishment prevalence ranged from 0% to 862%, 0% to 899%, and 0% to 871%, respectively Because of inconsistencies in definitions of and assessment methods for burnout across studies, associations between burnout and sex, age, geography, time, specialty, and depressive symptoms could not be reliably determined Conclusions and Relevance In this systematic review, there was substantial variability in prevalence estimates of burnout among practicing physicians and marked variation in burnout definitions, assessment methods, and study quality These findings preclude definitive conclusions about the prevalence of burnout and highlight the importance of developing a consensus definition of burnout and of standardizing measurement tools to assess the effects of chronic occupational stress on physicians

Association Between Physician Burnout and Patient Safety, Professionalism, and Patient Satisfaction: A Systematic Review and Meta-analysis

Abstract: Importance Physician burnout has taken the form of an epidemic that may affect core domains of health care delivery, including patient safety, quality of care, and patient satisfaction However, this evidence has not been systematically quantified Objective To examine whether physician burnout is associated with an increased risk of patient safety incidents, suboptimal care outcomes due to low professionalism, and lower patient satisfaction Data Sources MEDLINE, EMBASE, PsycInfo, and CINAHL databases were searched until October 22, 2017, using combinations of the key termsphysicians,burnout, andpatient care Detailed standardized searches with no language restriction were undertaken The reference lists of eligible studies and other relevant systematic reviews were hand-searched Study Selection Quantitative observational studies Data Extraction and Synthesis Two independent reviewers were involved The main meta-analysis was followed by subgroup and sensitivity analyses All analyses were performed using random-effects models Formal tests for heterogeneity (I2) and publication bias were performed Main Outcomes and Measures The core outcomes were the quantitative associations between burnout and patient safety, professionalism, and patient satisfaction reported as odds ratios (ORs) with their 95% CIs Results Of the 5234 records identified, 47 studies on 42 473 physicians (25 059 [590%] men; median age, 38 years [range, 27-53 years]) were included in the meta-analysis Physician burnout was associated with an increased risk of patient safety incidents (OR, 196; 95% CI, 159-240), poorer quality of care due to low professionalism (OR, 231; 95% CI, 187-285), and reduced patient satisfaction (OR, 228; 95% CI, 142-368) The heterogeneity was high and the study quality was low to moderate The links between burnout and low professionalism were larger in residents and early-career (≤5 years post residency) physicians compared with middle- and late-career physicians (CohenQ = 727;P = 003) The reporting method of patient safety incidents and professionalism (physician-reported vs system-recorded) significantly influenced the main results (CohenQ = 814;P = 007) Conclusions and Relevance This meta-analysis provides evidence that physician burnout may jeopardize patient care; reversal of this risk has to be viewed as a fundamental health care policy goal across the globe Health care organizations are encouraged to invest in efforts to improve physician wellness, particularly for early-career physicians The methods of recording patient care quality and safety outcomes require improvements to concisely capture the outcome of burnout on the performance of health care organizations

Factors Related to Physician Burnout and Its Consequences: A Review

Abstract: Physician burnout is a universal dilemma that is seen in healthcare professionals, particularly physicians, and is characterized by emotional exhaustion, depersonalization, and a feeling of low personal accomplishment. In this review, we discuss the contributing factors leading to physician burnout and its consequences for the physician’s health, patient outcomes, and the healthcare system. Physicians face daily challenges in providing care to their patients, and burnout may be from increased stress levels in overworked physicians. Additionally, the healthcare system mandates physicians to keep a meticulous record of their physician-patient encounters along with clerical responsibilities. Physicians are not well-trained in managing clerical duties, and this might shift their focus from solely caring for their patients. This can be addressed by the systematic application of evidence-based interventions, including but not limited to group interventions, mindfulness training, assertiveness training, facilitated discussion groups, and promoting a healthy work environment.

Physician Burnout, Well-being, and Work Unit Safety Grades in Relationship to Reported Medical Errors

Abstract: Objective To evaluate physician burnout, well-being, and work unit safety grades in relationship to perceived major medical errors. Participants and Methods From August 28, 2014, to October 6, 2014, we conducted a population-based survey of US physicians in active practice regarding burnout, fatigue, suicidal ideation, work unit safety grade, and recent medical errors. Multivariate logistic regression and mixed-effects hierarchical models evaluated the associations among burnout, well-being measures, work unit safety grades, and medical errors. Results Of 6695 responding physicians in active practice, 6586 provided information on the areas of interest: 3574 (54.3%) reported symptoms of burnout, 2163 (32.8%) reported excessive fatigue, and 427 (6.5%) reported recent suicidal ideation, with 255 of 6563 (3.9%) reporting a poor or failing patient safety grade in their primary work area and 691 of 6586 (10.5%) reporting a major medical error in the prior 3 months. Physicians reporting errors were more likely to have symptoms of burnout (77.6% vs 51.5%; P Conclusion In this large national study, physician burnout, fatigue, and work unit safety grades were independently associated with major medical errors. Interventions to reduce rates of medical errors must address both physician well-being and work unit safety.

Association of clinical specialty with symptoms of burnout and career choice regret among US resident physicians

Abstract: Importance Burnout among physicians is common and has been associated with medical errors and lapses in professionalism. It is unknown whether rates for symptoms of burnout among resident physicians vary by clinical specialty and if individual factors measured during medical school relate to the risk of burnout and career choice regret during residency. Objective To explore factors associated with symptoms of burnout and career choice regret during residency. Design, Setting, and Participants Prospective cohort study of 4732 US resident physicians. First-year medical students were enrolled between October 2010 and January 2011 and completed the baseline questionnaire. Participants were invited to respond to 2 questionnaires; one during year 4 of medical school (January-March 2014) and the other during the second year of residency (spring of 2016). The last follow-up was on July 31, 2016. Exposures Clinical specialty, demographic characteristics, educational debt, US Medical Licensing Examination Step 1 score, and reported levels of anxiety, empathy, and social support during medical school. Main Outcomes and Measures Prevalence during second year of residency of reported symptoms of burnout measured by 2 single-item measures (adapted from the Maslach Burnout Inventory) and an additional item that evaluated career choice regret (defined as whether, if able to revisit career choice, the resident would choose to become a physician again). Results Among 4696 resident physicians, 3588 (76.4%) completed the questionnaire during the second year of residency (median age, 29 [interquartile range, 28.0-31.0] years in 2016; 1822 [50.9%] were women). Symptoms of burnout were reported by 1615 of 3574 resident physicians (45.2%; 95% CI, 43.6% to 46.8%). Career choice regret was reported by 502 of 3571 resident physicians (14.1%; 95% CI, 12.9% to 15.2%). In a multivariable analysis, training in urology, neurology, emergency medicine, and general surgery were associated with higher relative risks (RRs) of reported symptoms of burnout (range of RRs, 1.24 to 1.48) relative to training in internal medicine. Characteristics associated with higher risk of reported symptoms of burnout included female sex (RR, 1.17 [95% CI, 1.07 to 1.28]; risk difference [RD], 7.2% [95% CI, 3.1% to 11.3%]) and higher reported levels of anxiety during medical school (RR, 1.08 per 1-point increase [95% CI, 1.06 to 1.11]; RD, 1.8% per 1-point increase [95% CI, 1.6% to 2.0%]). A higher reported level of empathy during medical school was associated with a lower risk of reported symptoms of burnout during residency (RR, 0.99 per 1-point increase [95% CI, 0.99 to 0.99]; RD, −0.5% per 1-point increase [95% CI, −0.6% to −0.3%]). Reported symptoms of burnout (RR, 3.20 [95% CI, 2.58 to 3.82]; RD, 15.0% [95% CI, 12.8% to 17.3%]) and clinical specialty (range of RRs, 1.66 to 2.60) were both significantly associated with career choice regret. Conclusions and Relevance Among US resident physicians, symptoms of burnout and career choice regret were prevalent, but varied substantially by clinical specialty. Further research is needed to better understand these differences and to address these issues.

A Brief Instrument to Assess Both Burnout and Professional Fulfillment in Physicians: Reliability and Validity, Including Correlation with Self-Reported Medical Errors, in a Sample of Resident and Practicing Physicians

Abstract: The objective of this study was to evaluate the performance of the Professional Fulfillment Index (PFI), a 16-item instrument to assess physicians’ professional fulfillment and burnout, designed for sensitivity to change attributable to interventions or other factors affecting physician well-being. A sample of 250 physicians completed the PFI, a measure of self-reported medical errors, and previously validated measures including the Maslach Burnout Inventory (MBI), a one-item burnout measure, the World Health Organization’s abbreviated quality of life assessment (WHOQOL-BREF), and PROMIS short-form depression, anxiety, and sleep-related impairment scales. Between 2 and 3 weeks later, 227 (91%) repeated the PFI and the sleep-related impairment scale. Principal components analysis justified PFI subscales for professional fulfillment, work exhaustion, and interpersonal disengagement. Test-retest reliability estimates were 0.82 for professional fulfillment (α = 0.91), 0.80 for work exhaustion (α = 0.86), 0.71 for interpersonal disengagement (α = 0.92), and 0.80 for overall burnout (α = 0.92). PFI burnout measures correlated highly (r ≥ 0.50) with their closest related MBI equivalents. Cohen’s d effect size differences in self-reported medical errors for high versus low burnout classified using the PFI and the MBI were 0.55 and 0.44, respectively. PFI scales correlated in expected directions with sleep-related impairment, depression, anxiety, and WHOQOL-BREF scores. PFI scales demonstrated sufficient sensitivity to detect expected effects of a two-point (range 8–40) change in sleep-related impairment. PFI scales have good performance characteristics including sensitivity to change and offer a novel contribution by assessing professional fulfillment in addition to burnout.

Empirically Derived Profiles of Teacher Stress, Burnout, Self-Efficacy, and Coping and Associated Student Outcomes:

Abstract: Understanding how teacher stress, burnout, coping, and self-efficacy are interrelated can inform preventive and intervention efforts to support teachers. In this study, we explored these constructs to determine their relation to student outcomes, including disruptive behaviors and academic achievement. Participants in this study were 121 teachers and 1,817 students in grades kindergarten to fourth from nine elementary schools in an urban Midwestern school district. Latent profile analysis was used to determine patterns of teacher adjustment in relation to stress, coping, efficacy, and burnout. These profiles were then linked to student behavioral and academic outcomes. Four profiles of teacher adjustment were identified. Three classes were characterized by high levels of stress and were distinguished by variations in coping and burnout ranging from (a) high coping/low burnout (60%) to (b) moderate coping and burnout (30%), to (c) low coping/high burnout (3%). The fourth class was distinguished by low stre...

Burnout and Stress Among US Surgery Residents: Psychological Distress and Resilience.

Abstract: Background Burnout among physicians affects mental health, performance, and patient outcomes. Surgery residency is a high-risk time for burnout. We examined burnout and the psychological characteristics that can contribute to burnout vulnerability and resilience in a group of surgical trainees. Study Design An online survey was distributed in September 2016 to all ACGME-accredited general surgery programs. Burnout was assessed with an abbreviated Maslach Burnout Inventory. Stress, anxiety, depression, resilience, mindfulness, and alcohol use were assessed and analyzed for prevalence. Odds ratios (ORs) were used to determine the magnitude of presumed risk and resilience factors. Results Among 566 surgical residents who participated in the survey, prevalence of burnout was 69%, equally driven by emotional exhaustion and depersonalization. Perceived stress and distress symptoms (depression, suicidal ideation, and anxiety) were notably high across training levels, but improved during lab years. Higher burnout was associated with high stress (OR 7.8; p Conclusions High levels of burnout, severe stress, and distress symptoms are experienced throughout general surgery training, with some improvement during lab years. In this cross-sectional study, trainees with burnout and high stress were at increased risk for depression and suicidal ideation. Higher dispositional mindfulness was associated with lower risk of burnout, severe stress, and distress symptoms, supporting the potential of mindfulness training to promote resilience during surgery residency.

Physician Burnout in the Electronic Health Record Era: Are We Ignoring the Real Cause?

Abstract: The widespread adoption of electronic health records (EHRs) has been perceived as driving physician dissatisfaction and burnout. The authors of this essay present data comparing EHR use in other co...

Burnout syndrome among medical residents: A systematic review and meta-analysis.

Abstract: Background Burnout is a psychological syndrome that is very common among medical residents. It consists of emotional exhaustion (EE), depersonalization (DP) and reduced personal accomplishment (PA). Objective To estimate burnout among different medical residency specialties. Methods A systematic review with meta-analysis was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A search of bibliographic databases and grey literature was conducted, from inception to March 2018. The following databases were accessed: Embase, PubMed, Web of Science, Google Scholar and Scopus, and 3,575 studies were found. Methodological quality was evaluated by Agency for Healthcare Research and Quality Methodology Checklist for Cross-Sectional/Prevalence Study. In the final analysis, 26 papers were included. Their references were checked for additional studies, but none were included. Results 4,664 medical residents were included. High DP, EE and low PA proportions were compared. Specialties were distributed into three groups of different levels of burnout prevalence: general surgery, anesthesiology, obstetrics/gynecology and orthopedics (40.8%); internal medicine, plastic surgery and pediatrics (30.0%); and otolaryngology and neurology (15.4%). Overall burnout prevalence found for all specialties was 35.7%. Conclusion The prevalence of burnout syndrome was significantly higher among surgical/urgency residencies than in clinical specialties. Prospero registration CRD42018090270.

In their own words: stressors facing medical students in the millennial generation.

Abstract: Background: Medical student exposure to stressors is associated with depression, burnout, somatic distress, decreases in empathy, serious thoughts about dropping out of medical school, suicidal ide...

Burnout syndrome among healthcare professionals

Abstract: The well-being of healthcare providers and the influence of healthcare provider mental health and wellness on patient safety have garnered national interest and attention, though the concept of burnout among healthcare professionals is not new.[1][1],[2][2] Healthcare, as an industry, places

A Step Forward in the Conceptualization and Measurement of Parental Burnout: The Parental Burnout Assessment (PBA)

Abstract: So far, the conceptualization and measurement of parental burnout have been deduced from those of job burnout. As a result, it is unclear whether current measures of parental burnout constitute the best representation of the parental burnout construct/syndrome: the possibility cannot be excluded that some dimensions ought to be added, which would change the structure and definition of parental burnout. In this study, the conceptualization and measurement of parental burnout were approached using an inductive method, in which the parental burnout phenomenon was (re)constructed based solely on the testimonies of burned-out parents. Items extracted from their testimonies were presented to a sample of French-speaking and English-speaking parents (N = 901) and submitted to factor analyses. An identifiable parental burnout syndrome including four dimensions was found (exhaustion in one's parental role, contrast with previous parental self, feelings of being fed up with one's parental role and emotional distancing from one's children). The resulting instrument, the Parental Burnout Assessment (PBA) presents good validity. Factorial invariance across gender and languages was also found. Finally, the results of this study replicate previous findings that psychological traits of the parents, parenting factors, and family functioning account for more variance in parental burnout than sociodemographic factors.

Mental healthcare staff well-being and burnout: A narrative review of trends, causes, implications, and recommendations for future interventions.

Abstract: Rising levels of burnout and poor well-being in healthcare staff are an international concern for health systems. The need to improve well-being and reduce burnout has long been acknowledged, but few interventions target mental healthcare staff, and minimal improvements have been seen in services. This review aimed to examine the problem of burnout and well-being in mental healthcare staff and to present recommendations for future research and interventions. A discursive review was undertaken examining trends, causes, implications, and interventions in burnout and well-being in healthcare staff working in mental health services. Data were drawn from national surveys, reports, and peer-reviewed journal articles. These show that staff in mental healthcare report poorer well-being than staff in other healthcare sectors. Poorer well-being and higher burnout are associated with poorer quality and safety of patient care, higher absenteeism, and higher turnover rates. Interventions are effective, but effect sizes are small. The review concludes that grounding interventions in the research literature, emphasizing the positive aspects of interventions to staff, building stronger links between healthcare organizations and universities, and designing interventions targeting burnout and improved patient care together may improve the effectiveness and uptake of interventions by staff.

Exhausted Parents: Sociodemographic, Child-Related, Parent-Related, Parenting and Family-Functioning Correlates of Parental Burnout

Abstract: Parental burnout is a specific syndrome resulting from enduring exposure to chronic parenting stress. It encompasses three dimensions: an overwhelming exhaustion related to one’s parental role, an emotional distancing with one’s children and a sense of ineffectiveness in one’s parental role. This study aims to facilitate further identification of antecedents/risk factors for parental burnout in order to inform prevention and intervention practices. In a sample of 1723 french-speaking parents, we examined the relationship between parental burnout and 38 factors belonging to five categories: sociodemographics, particularities of the child, stable traits of the parent, parenting and family-functioning. In 862 parents, we first examined how far these theoretically relevant risk factors correlate with burnout. We then examined their relative weight in predicting burnout and the amount of total explained variance. We kept only the significant factors to draw a preliminary model of risk factors for burnout and tested this model on another sample of 861 parents. The results suggested that parental burnout is a multi-determined syndrome mainly predicted by three sets of factors: parent’s stable traits, parenting and family-functioning.

Burnout and its association with resilience in nurses: A cross-sectional study.

Abstract: Aims and objectives To investigate the prevalence and extent of burnout on nurses and its association with personal resilience. Background With the worldwide shortage of nurses, nurse burnout is considered one of the main contributing factors and has been the focus of studies in recent years. Given the well-documented high level of burnout among nurses, resilience is expected to be a significant predictor of nurse burnout. The association between burnout and resilience has not previously been investigated extensively. Design A cross-sectional survey design was selected. Methods A total of 1,061 nurses from six separate three-level hospitals in Hunan Province, China, returned self-reported questionnaires from March-June 2015. Data were collected using a socio-demographic sheet, Maslach Burnout Inventory-General Survey and the Connor-Davidson Resilience Scale. Results Nurses experienced severe burnout symptoms and showed a moderate level of resilience. Three metrics of burnout had significantly negative correlations with the total score and following variables of resilience. Linear regression analysis showed resilience, especially strength, demographic characteristics (exercise, alcohol use and marital status) and job characteristics (income per month, ratio of patients to nurses, shift work and professional rank) were the main predictors of the three metrics of burnout. Conclusion The findings of this study may help nurse managers and hospital administrators to have a better understanding of nurse burnout and resilience. The significantly negative relationship between burnout symptoms and resilience has been demonstrated, and this informs the role of resilience in influencing burnout. Relevance to clinical practice Adaptable and effective interventions for improving resilience are needed to relieve nurses' burnout and reduce workplace stress. Moreover, nurse managers and hospital administrators should establish an effective management system to cultivate a healthy workplace and adopt positive attitudes and harmonious relationships.

Workplace violence, job satisfaction, burnout, perceived organisational support and their effects on turnover intention among Chinese nurses in tertiary hospitals: a cross-sectional study.

Abstract: Objectives Our aims were to assess the relationship between workplace violence, job satisfaction, burnout, organisational support and turnover intention, and to explore factors associated with turnover intention among nurses in Chinese tertiary hospitals. Methods The purposive sampling method was used to collect data from August 2016 through January 2017. A total of 1761 nurses from 9 public tertiary hospitals in 4 provinces (municipalities) located in eastern (Beijing), central (Heilongjiang, Anhui) and western (Shaanxi) regions of China completed the questionnaires (effective response rate=85.20%). A cross-sectional study was conducted using the Workplace Violence Scale, Chinese Maslach Burnout Inventory General Survey, Minnesota Job Satisfaction Questionnaire Revised Short Version, Perceived Organizational Support-Simplified Version Scale and Turnover Intention Scale. Results A total of 1216 of 1706 (69.1%) participants had high turnover intention. During the previous 12 months, the prevalence of physical violence and psychological violence towards nurses was 9.60% and 59.64%, respectively. As expected, the level of turnover intention was negatively correlated with participants’ scores on job satisfaction (r=−0.367, p Conclusions Perceived organisational support served as a mediator between workplace violence, job satisfaction, burnout and turnover intention, and it had a significantly negative impact on turnover intention. Therefore, nursing managers should understand the importance of the organisation’s support and establish a reasonable incentive system to decrease turnover intention.

Burnout in United States Healthcare Professionals: A Narrative Review

Abstract: Burnout has reached rampant levels among United States (US) healthcare professionals, with over one-half of physicians and one-third of nurses experiencing symptoms. The burnout epidemic is detrimental to patient care and may exacerbate the impending physician shortage. This review gives a brief history of burnout and summarizes its main causes, effects, and prevalence among US healthcare workers. It also lists some strategies that physicians, organizations, and medical schools can employ to counter the epidemic.

Extent of compassion satisfaction, compassion fatigue and burnout in nursing: A meta-analysis.

Abstract: Aims A meta-analysis was conducted of the prevalence rates of compassion satisfaction, compassion fatigue and burnout to identify the factors influencing these rates. Background The extents of compassion fatigue and burnout adversely affect nursing efficiency. However, the reported prevalence rates vary considerably. Methods Data were acquired from electronic databases. Random effects meta-analyses were performed to obtain pooled estimates of the prevalence rates of compassion satisfaction, compassion fatigue and burnout and their respective instrumental scores. Meta-regression analyses were performed to identify factors influencing these rates. Results Data from 21 studies were used for the meta-analysis. The prevalence rates of compassion satisfaction, compassion fatigue and burnout were 47.55%, 52.55% and 51.98%, respectively. The possession of Bachelor's or Master's degrees by the nurses was significantly inversely associated with the percent prevalence of compassion fatigue (coefficient: -1.187) and burnout (coefficient: -0.810). The compassion fatigue score was also significantly inversely associated with nursing status as registered or licensed practical nurse (coefficient: -0.135). Conclusion In nursing, the prevalence rates of compassion fatigue and burnout are high. Better education and training may have a moderating effect on compassion fatigue and burnout and could improve the quality of life of nurses.

Factors predicting Registered Nurses’ intentions to leave their organization and profession: A job demands-resources framework

Abstract: Aims To develop a comprehensive model of nursing turnover intention by examining the effects of job demands, job resources, personal demands and personal resources on burnout and work engagement and subsequently on the intention to leave the organization and profession. Background The ageing population and a growing prevalence of multimorbidity are placing increasing strain on an ageing nursing workforce. Solutions that address the anticipated nursing shortage should focus on reducing burnout and enhancing the engagement of Registered Nurses (RNs) to improve retention. Design A cross-sectional survey design. Method Data were collected in 2014–2015 via an e-survey from 2,876 RNs working in New Zealand. Data were analysed with structural equation modelling. Results Higher engagement results in lower intention to leave the organization and profession. Burnout has significant effects on intentions to leave through lower engagement. While most of the demands and resources’ variables (except professional development) have effects on intentions to leave, greater workload and greater work-life interference result in higher burnout and are the strongest predictors of intentions to leave. Greater emotional demands (challenges) and greater self-efficacy also have strong effects in lowering intentions to leave through higher engagement. Conclusions Employee burnout and work engagement play an important role in transmitting the impacts of job demands, job resources, personal demands and personal resources into RN intention to leave the organization and profession. Work-life interference and high workloads are major threats to nursing retention while challenge demands and higher levels of self-efficacy support better retention.

A Theoretical and Clinical Framework for Parental Burnout: The Balance Between Risks and Resources (BR2).

Abstract: Parental burnout is a specific syndrome resulting from enduring exposure to chronic parenting stress. But why do some parents burn out while others, facing the same stressors, do not? The main aim of this paper was to propose a theory of parental burnout capable of predicting who is at risk of burnout, explaining why a particular parent burned out and why at that specific point in time, and providing directions for intervention. The secondary goal was to operationalize this theory in a tool that would be easy to use for both researchers and clinicians. The results of this two-wave longitudinal study conducted on 923 parents suggest that the Balance between Risks and Resources (BR2) theory proposed here is a relevant framework to predict and explain parental burnout. More specifically, the results show that (1) the BR2 instrument reliably measures parents' balance between risks (parental stress-enhancing factors) and resources (parental stress-alleviating factors), (2) there is a strong linear relationship between BR2 score and parental burnout, (3) parental burnout results from a chronic imbalance of risks over resources, (4) BR2 predicts parental burnout better than job burnout and (5) among the risk and resource factors measured in BR2, risks and resources non-specific to parenting (e.g., low stress-management abilities, perfectionism) equally predict parental and job burnout, while risks and resources specific to parenting (e.g., childrearing practices, coparenting) uniquely predict parental burnout.

Estimating institutional physician turnover attributable to self-reported burnout and associated financial burden: a case study.

Abstract: Awareness of the economic cost of physician attrition due to burnout in academic medical centers may help motivate organizational level efforts to improve physician wellbeing and reduce turnover. Our objectives are: 1) to use a recent longitudinal data as a case example to examine the associations between physician self-reported burnout, intent to leave (ITL) and actual turnover within two years, and 2) to estimate the cost of physician turnover attributable to burnout. We used de-identified data from 472 physicians who completed a quality improvement survey conducted in 2013 at two Stanford University affiliated hospitals to assess physician wellness. To maintain the confidentially of survey responders, potentially identifiable demographic variables were not used in this analysis. A third party custodian of the data compiled turnover data in 2015 using medical staff roster. We used logistic regression to adjust for potentially confounding factors. At baseline, 26% of physicians reported experiencing burnout and 28% reported ITL within the next 2 years. Two years later, 13% of surveyed physicians had actually left. Those who reported ITL were more than three times as likely to have left. Physicians who reported experiencing burnout were more than twice as likely to have left the institution within the two-year period (Relative Risk (RR) = 2.1; 95% CI = 1.3–3.3). After adjusting for surgical specialty, work hour categories, sleep-related impairment, anxiety, and depression in a logistic regression model, physicians who experienced burnout in 2013 had 168% higher odds (Odds Ratio = 2.68, 95% CI: 1.34–5.38) of leaving Stanford by 2015 compared to those who did not experience burnout. The estimated two-year recruitment cost incurred due to departure attributable to burnout was between $15,544,000 and $55,506,000. Risk of ITL attributable to burnout was 3.7 times risk of actual turnover attributable to burnout. Institutions interested in the economic cost of turnover attributable to burnout can readily calculate this parameter using survey data linked to a subsequent indicator of departure from the institution. ITL data in cross-sectional studies can also be used with an adjustment factor to correct for overestimation of risk of intent to leave attributable to burnout.