Abbreviated Maslach Burnout Inventory Research Articles

Prevalence of Burnout and Psychiatric Illness among Postgraduate Trainee Doctors of a Tertiary Care Hospital

Objective: Burnout is a state of physical and emotional depletion, and it is a result of prolonged exposure to the stressful working environment. Burnout has three primary symptoms: (a) emotional exhaustion (EE) occurs due to a depletion of emotional resources, feeling no longer to give any more to their job; (b) depersonalization (DP) occurs in response to EE, making employees detached from their job and developing uncaring attitudes to their work; and (c) reduced personal accomplishment (PA) with perceiving less enjoyment from their work. Psychological distress is also higher among medical students and doctors than that in the general population. In this study, we intended to study the prevalence of burnout and various psychological problems among postgraduate trainee (PGT) doctors of a tertiary care hospital. Methods: In this cross-sectional study of one year, we recruited postgraduate training doctors whoever gave valid and informed consent. Results: We included 170 PGTs from various clinical departments at the time of our study, but 126 PGTs were included as the sample population. They were assessed for sociodemographic determinants first. Then received assessment using sociodemographic pro forma and Abbreviated Maslach Burnout Inventory and International Classification of Diseases 10 for screening psychiatric morbidity among them. Results: In this study, 31.7% of PGTs had high EE, 34.9% of them higher DP, and 30.2% of them a high burnout rate. Of them, 31.7% of PGTs had a reduced PA with a score ≤ 25 percentile. In this study, 83.3% had no psychiatric illness and 16.7% had a psychiatric disorder. Among psychiatric disorders, 4% had harmful use of tobacco, 4% had mild depression, 1.6% had panic disorder, 4.8% had mixed anxiety depression, 1.6% had obsessive-compulsive disorder, 0.8% had harmful use of alcohol. Highest EE was noted among PGTs from the Department of Anesthesiology, followed by those from the Departments of Pulmonary Medicine and then Radiotherapy. Conclusion: One-third of PGTs suffered from burnout. Psychiatric diseases were also increased with a higher burnout rate.

333 Prevalence of Moral Injury and its Clinical Consequences Among Filipino Emergency Physicians During the COVID-19 Pandemic: A Cross-Sectional Study

BackgroundMoral Injury is defined as the distress experienced by an individual when circumstances are discordant with one’s ethical code. If left unaddressed, it can become a risk factor for a range of mental health issues. The COVID-19 pandemic has recently been regarded as a cause of moral injury for Filipino health care workers but to date, has not been formally investigated.Study ObjectivesWe aimed to determine the prevalence of moral injury, identify risk factors and clinical consequences on mental health among Filipino emergency physicians who worked during the COVID-19 pandemic.Method: Our cross-sectional study utilized a nationwide survey of Emergency Medicine Residents and Consultants from accredited training programs in the Philippines. The online questionnaire comprised of 4 validated tools for mental health evaluation: Moral Injury Symptom Scale-Health Professionals, Belief Into Action Scale, Abbreviated Maslach Burnout Inventory and Kessler Psychological Distress Scale. The survey was conducted from August to October 2021.ResultsA total of 129 emergency physicians responded to the survey, which revealed high prevalence of moral injury at 96.9%. Concurrent with this, respondents were found to suffer from burnout causing emotional exhaustion (p=0.007) and depersonalization (p=0.044) as well as anxiety and depression (p=0.002). Females and those that do not have any children were more likely to experience moral injury.ConclusionThere is high prevalence of moral injury among Filipino emergency physicians during the period of study, which coincided with the second wave of the COVID-19 pandemic in the country. Moral injury was also associated with the co-occurrence of burnout, anxiety and depression.No, authors do not have interests to disclose BackgroundMoral Injury is defined as the distress experienced by an individual when circumstances are discordant with one’s ethical code. If left unaddressed, it can become a risk factor for a range of mental health issues. The COVID-19 pandemic has recently been regarded as a cause of moral injury for Filipino health care workers but to date, has not been formally investigated. Moral Injury is defined as the distress experienced by an individual when circumstances are discordant with one’s ethical code. If left unaddressed, it can become a risk factor for a range of mental health issues. The COVID-19 pandemic has recently been regarded as a cause of moral injury for Filipino health care workers but to date, has not been formally investigated. Study ObjectivesWe aimed to determine the prevalence of moral injury, identify risk factors and clinical consequences on mental health among Filipino emergency physicians who worked during the COVID-19 pandemic.Method: Our cross-sectional study utilized a nationwide survey of Emergency Medicine Residents and Consultants from accredited training programs in the Philippines. The online questionnaire comprised of 4 validated tools for mental health evaluation: Moral Injury Symptom Scale-Health Professionals, Belief Into Action Scale, Abbreviated Maslach Burnout Inventory and Kessler Psychological Distress Scale. The survey was conducted from August to October 2021. We aimed to determine the prevalence of moral injury, identify risk factors and clinical consequences on mental health among Filipino emergency physicians who worked during the COVID-19 pandemic. Method: Our cross-sectional study utilized a nationwide survey of Emergency Medicine Residents and Consultants from accredited training programs in the Philippines. The online questionnaire comprised of 4 validated tools for mental health evaluation: Moral Injury Symptom Scale-Health Professionals, Belief Into Action Scale, Abbreviated Maslach Burnout Inventory and Kessler Psychological Distress Scale. The survey was conducted from August to October 2021. ResultsA total of 129 emergency physicians responded to the survey, which revealed high prevalence of moral injury at 96.9%. Concurrent with this, respondents were found to suffer from burnout causing emotional exhaustion (p=0.007) and depersonalization (p=0.044) as well as anxiety and depression (p=0.002). Females and those that do not have any children were more likely to experience moral injury. A total of 129 emergency physicians responded to the survey, which revealed high prevalence of moral injury at 96.9%. Concurrent with this, respondents were found to suffer from burnout causing emotional exhaustion (p=0.007) and depersonalization (p=0.044) as well as anxiety and depression (p=0.002). Females and those that do not have any children were more likely to experience moral injury. ConclusionThere is high prevalence of moral injury among Filipino emergency physicians during the period of study, which coincided with the second wave of the COVID-19 pandemic in the country. Moral injury was also associated with the co-occurrence of burnout, anxiety and depression.No, authors do not have interests to disclose There is high prevalence of moral injury among Filipino emergency physicians during the period of study, which coincided with the second wave of the COVID-19 pandemic in the country. Moral injury was also associated with the co-occurrence of burnout, anxiety and depression.

Emotion Dysregulation and Workplace Satisfaction in Direct Care Worker Burnout and Abuse Risk.

Direct care workers frequently encounter difficult interactions with the patients they serve and experience frustration and burnout. The current study tested a hypothesized model in which predictors of caregiver abuse risk (emotional dysregulation, difficulty managing patient behavior, and workplace satisfaction) were mediated by symptoms of burnout. The study used an online cross-sectional survey design. The study was implemented online via Qualtrics. Participants were 206 direct care workers (eg, certified nursing assistants, patient care technicians, home health aides, and medical assistants). All respondents completed the Caregiver Abuse Screen (CASE), Difficulty with Emotional Regulation Scale (DERS-SF), and the Abbreviated Maslach Burnout Inventory. Demographic data and employment history were also collected. Correlational methods, including path analysis, were used to assess associations between study variables. More than half of this heterogenous sample endorsed significant risk for engaging in patient abuse. Path analysis suggested emotional dysregulation and low workplace satisfaction were associated with greater risk of patient abuse, and these associations were partially and simultaneously mediated by burnout facets of depersonalization and emotional exhaustion. This study provided preliminary support for a model of caregiver abuse in which underlying difficulties regulating emotions convey risk for caregiver abuse via burnout facets including emotional exhaustion and depersonalization. Enhancing basic emotion regulation skills and reducing burnout in direct care staff may reduce the risk of abuse for older adults. Thus, providing training necessary to help direct care workers manage their own emotions in order to better recognize, understand, and respond effectively to the needs of older adults may reduce staff burnout and, consequently, lower the risk of abuse for older adults.

Prevalence of burn out in clinical residents and its contributing factors – A cross sectional survey.

Objective: To identify the prevalence, contributing factors and coping mechanisms for burnout in clinical residents of a tertiary care centre. Study Design: Cross Sectional Survey. Setting: Islamic International Medical College, Railway Hospital, Rawalpindi. Period: April 2019 to August 2020. Material & Methods: A survey questionnaire consisting of the abbreviated Maslach burnout inventory along with questions on contributing factors and coping mechanisms for burnout was distributed among clinical residents at Pakistan Railway Hospital, Rawalpindi. Data was collected and analyzed using SPSS. Burnout score was calculated for each resident along with the subscale analysis. Chi square was used to identify significant contributing factors to the burnout (P ≤ 0.05). Percentages were calculated for the coping mechanisms used by the residents. Results: Seventy seven residents participated in the survey. Mean Maslach score was 31.79, SD=7.22 for the whole group. 47(61%) residents were categorized as having significant burnout. No risk factor was found to be associated significantly with burnout (p-value ≤ 0.05). Work hours (Mean=2.43, SD=1.56), working conditions (Mean=2.82, SD=1.62) and senior consultant bullying (Mean=2.98, SD=1.96) were considered to be the most important factors contributing to the burnout. The main coping mechanisms identified were staying optimistic (58%), sleeping more (49.4%) and spending time with family (49.4%). Only 5.2% residents had any departmental support. Conclusion: Burn out is commonly present in clinical residents. No significant association with specific factors contributing to burnout was found however residents rate work hours, working conditions and senior consultant bullying as contributing the most.

A systemic look at professional burnout and well-being within an urban cancer center as a roadmap to recovery.

11017 Background: As the U.S. health care system’s vulnerabilities have been laid bare by an unremitting pandemic, it behooves us to build in resiliency as we look towards recovery. The “burnout epidemic” facing oncology clinicians has been well documented prior to the pandemic. From a systemic perspective, however, data across the cancer service line is scant. In an effort to identify the stress points and strengths of an oncology service line, we present cross-sectional data from 2018 examining burnout, physical and emotional well-being, and self-care needs across all primary cancer center roles within a major urban cancer center in NYC. Methods: An anonymous online survey was completed by 310 of 646 (48%) cancer service providers comprised of physicians, nurses, clinical support staff, managers, and clerical staff. The abbreviated Maslach Burnout Inventory (MBI-9), the Mental Health Inventory (MHI), and the brief COPE were included. Results: Respondents ranged from nurses (15%) to clinical support staff (29%), with 79% identifying as female. In a snapshot view, 25% of the sample endorsed feeling burned out from work. Rates of emotional exhaustion were highest among nurses (41%) and lowest among physicians (14%), p < 0.06. Depersonalization rates ranged from 1% for physicians to 11% for nurses and clerical staff (p < 0.003). A breakdown of those who would not choose the same career over again: clerical (36%), management (28%), nurses/clinical support staff (23%) and physicians (11%), p < 0.053). Clinical levels of distress ranged from 20% (clerical staff) to 30% (nurses). Self-reported health (1-5) was lower among clerical staff and nurses (3.1) compared to physicians (3.9), p < 0.001. The majority of staff utilized adaptive coping strategies including positive reframing and planning, with religion and humor often endorsed. Interest in counseling and communication skills training ranged from 56%/57% among physicians to 84%/88% among clerical staff, respectively. Conclusions: This panoramic view of one cancer service line just prior to the pandemic points to particular systemic stresses in areas of emotional exhaustion, career choice questioning, and psychological and physical health. While levels of burnout fall within and below rates reported in the literature, it also points to fault lines affecting key service line positions, particularly nurses and clerical staff. At the same time, it highlights an underlying resiliency in coping and receptivity to self-care and development. In response to this internal needs assessment, our cancer center is working towards building a stronger foundation in which staff will not only survive the expected and unexpected stresses of working in health care but find meaning and joy in work. While we cannot predict the future, we can learn from the past. In this vein, a Well-Being Committee that includes representatives across the cancer service line was launched in 2022.

Burnout in Pediatric Nephrology Fellows and Faculty: Lessons From the Sustainable Pediatric Nephrology Workforce Project (SUPERPOWER).

Physician well-being is an important contributor to both job satisfaction and patient outcomes. Rates of burnout among physicians vary by specialty, ranging from 35 to 70%. Among pediatric residents, longitudinal data demonstrates consistent rates of burnout around 50-60%, although little is known about burnout among pediatric subspecialty fellows. Specifically, the degree of burnout among pediatric nephrologists remains unknown, as does the impact faculty burnout may have on trainee burnout. We sought to evaluate prevalence and predictors of burnout among US pediatric nephrology fellows and faculty, and assess for interactions between groups. In this multi-center pilot survey of all United States pediatric nephrology training programs from February to April 2020, burnout was assessed through abbreviated Maslach Burnout Inventory and predictors were explored through survey items devoted to demographic, personal characteristics, and job and career satisfaction questions. A total of 30/34 available fellows and 86/102 faculty from 11 institutions completed the survey (overall response rate 85%). The prevalence of burnout was 13% among fellows and 16% among faculty. Demographic (age, gender, year of training, faculty rank, marital status) and program factors (fellowship size, faculty size, current block/rotation, vacation or weekend off timing) were not significantly associated with burnout. Faculty and fellows with burnout reported significantly lower quality of life (5.3 vs. 7.9, p < 0.05), higher perceived stress (2.4 vs. 1.4, p < 0.05) and lower satisfaction with career choice (66 vs. 22%) and work life balance (28 vs. 0%), compared to those without burnout (p < 0.05 for all). Other important factors positively associated with burnout included lower institutional support for wellness programs and lower satisfaction with both colleague and faculty support. Larger studies are needed to explore if burnout is truly less prevalent among pediatric nephrology fellows and faculty compared to pediatric residents and graduate physicians. A larger sample size is also necessary to determine whether any interactions exist between the faculty and trainee roles in the developments of burnout. Future studies should also explore how to promote well-being through addressing key factors such as overall learning/working environment, stress reduction, and building personal resilience.

MO1031: Burnout Syndrome Among Paediatric Nephrologists—Report on its Prevalence, Severity and Predisposing Factors

Abstract BACKGROUND AND AIMS Burnout is an occupational-related syndrome comprising emotional exhaustion, depersonalization and reduced feelings of work-related personal accomplishments. Addressing and mitigating burnout is essential for avoiding high workforce turnover, patient dissatisfaction and a lower quality of care. There are some reports on burnout among adult nephrologists and general paediatricians, but little has been known about burnout among paediatric nephrologists. The aim of our study was to assess the prevalence and severity of burnout syndrome among Polish paediatric nephrologists. METHOD A 25-items online survey consisting of abbreviated Maslach Burnout Inventory and additional self-created questions about work-related factors was completed by 97 physicians affiliated with the Polish Society of Paediatric Nephrology. 75.3% of them were women, the median time of professional experience in the study group was 15 years. RESULTS High level of emotional exhaustion, depersonalization and reduced feeling of personal accomplishments was observed in 39.2%, 38.1% and 21.6% of participants, respectively. 26.8% of participants presented at least a medium level of burnout in all three dimensions and 8.2% of them presented high three-dimensional burnout. No associations of burnout intensity and gender, job seniority and the use of holiday leave were found. 41.2% of participants stated, that they would like to take part in burnout prevention and support programme. According to the study participants, excessive bureaucracy in healthcare systems, rush and working overtime were the main job-related problems that can influence burnout intensity. CONCLUSION Burnout is an important factor in the professional landscape of paediatric nephrology. Actions aiming at reducing the risk of occupational burnout among paediatric nephrologists should be applied both at personal and institutional levels.

The Impact of COVID-19 on Burnout, Psychological Well-being, and Work Satisfaction in Psychiatry Trainees in Ireland

ObjectivePrior to the pandemic, trainee doctors were at higher risk of psychological ill health. There is limited evidence measuring the impact of COVID-19 on psychiatry trainees. This study evaluates levels of burnout, work satisfaction, and psychological well-being in psychiatry junior doctors in Ireland and identifies potential contributing factors.MethodsThe authors carried out a cross-sectional online survey measuring demographic and work-related variables. Questions including exposure to COVID-19 and stress-related factors were included. We evaluated burnout, work satisfaction, and psychological well-being using the Abbreviated-Maslach Burnout Inventory, Basic Needs Satisfaction at Work Scale, and WHO-5 Well-being Index.ResultsOne hundred and five doctors responded (21%). The biggest stressor reported was reduced face-to-face contact with family and friends (73%). Forty one percent reported weekly supervision changes. Sixty five percent met the criteria for burnout, compared with 36.2% in 2018. Significant factors associated with burnout included staff shortages, longer hours, and less experience. Changes in supervision and working in non-European Working Time Directive compliant rotas were associated with lower scores across all subdomains of the BNSW Scale. The WHO-5 Well-being Index identified 48% scored low in personal well-being, indicating these trainees met the threshold for depression. Changes in regular supervision (p=0.010) were a significant predictor of low personal well-being.ConclusionsHigh prevalence of burnout and low levels of well-being in this vulnerable cohort, particularly those who are inexperienced, have changes in supervision, and working longer hours is concerning. This study highlights the importance of regular supervision and support for this group.

Prevalence and correlates of burnout among pharmacists in varying areas of practice in South East Nigeria

Background: Burnout has received a lot of attention in high-income countries with awareness and intervention programs designed to cope with burnout symptoms, however, it has not received the needed attention in low-income settings such as Nigeria. The current study aims to assess the prevalence and correlates of burn out among pharmacists in varying practice in South-East Nigeria. Methods: A cross-sectional descriptive survey was carried out among pharmacists in academic, community pharmacy, and hospital settings in Enugu State, Nigeria. The abbreviated Maslach Burnout Inventory (aMBI) tool was used to assess burnout. Descriptive statistics, Spearman's correlation, and independent sample t-tests were carried out. Results: The overall response rate was 55.95% (n = 235). Low scores of Emotional exhaustions (Academic- 4.81 ± 3.94, community- 5.45 ± 3.96, hospital -7.19 ±4.83), Depersonalizations (Academic- 1.28 ± 2.52, community- 1.17 ± 2.03, hospital -1.36 ± 2.68) and high scores of PA (Academic- 13.74 ± 3.91, community-15.64 ± 3.07, hospital -14.25 ± 4.11). For academic pharmacists, Satisfaction with renumeration (r = -0.453, p= 0.001) was associated with burnout. Marital status (r = -0.321, p = 0.008) was associated with burnout for community pharmacists while, age (r = - 0.276, p = 0.003) was associated with burnout for Hospital pharmacists. Conclusion: The prevalence of burnout among Pharmacists in the academic setting, community and hospital settings was low. Age, marital status, and satisfaction with remuneration were common factors associated with burn out among pharmacists. Culturally sensitive strategies to proactively develop and implement interventions to minimize pharmacist burnout are needed.

The Effect of the COVID-19 Pandemic on Pediatric Physician Wellness: A Cross-Sectional Study.

The COVID-19 pandemic has provided challenges to all healthcare workers. While the brunt of treating COVID-19 patients fell upon adult providers, pediatricians also experienced significant stressors and disruptions. Academic pediatricians and trainees (fellows and residents) were redeployed to manage adult patients in hospitalist and intensive care settings and/or had major changes to their clinical schedules. In this study, we aimed to describe levels of self-reported depression, anxiety, and burnout in pediatric physicians following the initial wave of the pandemic at the largest integrated health system in New York State. A cross-sectional study was conducted among pediatric physicians who cared for patients during the COVID-19 pandemic within the Northwell Health System as part of the Northwell Wellbeing Registry, a longitudinal registry assessing the psychological impact of COVID-19 on healthcare providers. A total of 99 pediatric physician respondents were included in this study; 72% of whom were attendings, 28% of whom were trainees. Compared to attendings, trainees reported significantly higher proportions of burnout–emotional exhaustion (p = 0.0007) and burnout–depersonalization (p = 0.0011) on the Abbreviated Maslach Burnout Inventory. There was not a similar trend in probable depression or probable anxiety using the Patient Health Questionnaire. In a multivariable logistic regression model, being a trainee was significantly associated with increased odds of burnout–emotional exhaustion (OR 5.94, 95% Confidence Interval: 1.85–19.02). These findings suggest that fellows and residents were a vulnerable population during the COVID-19 pandemic. Training programs should pay special attention to their trainees during times of crisis, and future studies can help to identify protective factors to reduce the risk of burnout during these times.

Burnout Syndrome among Pediatric Nephrologists-Report on Its Prevalence, Severity, and Predisposing Factors.

Background and Objectives: Burnout is an occupation-related syndrome comprising emotional exhaustion, depersonalization, and reduced feelings of work-related personal accomplishments. There are reports on burnout among adult nephrologists and general pediatricians, but little is known about burnout among pediatric nephrologists. The aim of our study was to assess the prevalence and severity of burnout syndrome among Polish pediatric nephrologists. Materials and Methods: A 25-item study survey consisting of abbreviated Maslach Burnout Inventory and additional self-created questions about work-related factors was completed by 97 physicians affiliated with the Polish Society of Pediatric Nephrology. Women comprised 75.3%, with median time of professional experience in the study group was 15 years. Results: A high level of emotional exhaustion, depersonalization, and reduced feeling of personal accomplishments were observed in 39.2%, 38.1%, and 21.6% of the participants, respectively. At least a medium level of burnout in all three dimensions were observed in 26.8% of the participants and 8.2% of them presented high three-dimensional burnout. About 41.2% of the participants stated that they would like to take part in burnout prevention and support programs. According to the study participants, excessive bureaucracy in healthcare systems, rush at work, and overtime work were the main job-related problems that could influence burnout intensity. Conclusions: Burnout is an important factor in the professional landscape of pediatric nephrology. Actions aimed at reducing the risk of occupational burnout among pediatric nephrologists should be applied, both at the personal and institutional levels.

Brief Mindfulness Intervention for Emotional Distress, Resilience, and Compassion in Family Physicians During COVID-19: A Pilot Study.

There are high rates of professional burnout among family physicians and trainees. We undertook this study to investigate whether a brief mindfulness intervention could help manage burnout and improve well-being among family physicians in a residency program. A total of 21 family physicians participated in a brief, 8-week mindfulness program. We used a single-sample, pre/post design at a Midwestern family medicine residency program. At two points in time (baseline and postintervention), participants completed an online survey measuring burnout, depression, anxiety, stress, perceived resilience, and compassion. We used linear mixed models to estimate the effect of the intervention on the outcome measures. Participants had improvements after the 8-week intervention. At postintervention, they had significantly better scores on anxiety (P<.004), stress (P<.001), perceived resilience (P<.001), and compassion (P<.001). There were no significant changes on the personal accomplishment, emotional exhaustion, and depersonalization subscales of either the abbreviated Maslach Burnout Inventory or the depression subscale of the Depression Anxiety Stress Scales-21. This brief mindfulness program was associated with significant reduction in the scores of anxiety and stress as well as significant improvement in perceived resilience and compassion scores. Brief mindfulness interventions may be a convenient and effective approach to support and improve health and well-being among family physicians.

The association of distress tolerance and mindful awareness with mental health in first responders.

Mindful awareness (MA) and distress tolerance are emerging as robust predictors of mental health in populations with high levels of stress and trauma exposure, such as first responders. The combination of both protective factors may have potentiating benefits for mental health. First responders might especially benefit from high levels of MA if they are able to tolerate distressing present-moment experiences as needed. In this study, cross-sectional data were used to test whether distress intolerance (DI) moderated the relationship between MA and mental health. First responders (N = 176) completed an online assessment battery including measures of MA (Mindful Attention Awareness Scale), DI (Distress Intolerance Index), and mental health outcomes (i.e., Depression, Anxiety, and Stress Scale; Posttraumatic Stress Disorder [PTSD] Checklist for Diagnostic and Statistical Manual of Mental Disorders, 5th edition [DSM-5]; Secondary Traumatic Stress Scale; abbreviated Maslach Burnout Inventory; compassion satisfaction subscale of the Professional Quality of Life Scale; Satisfaction with Life Scale; and Brief Resilience Scale). Multiple regression models demonstrated that among first responders with higher DI, MA had a stronger association with lower anxiety and depression symptoms. Interactions between MA and DI were not significant for other outcome measures. However, higher MA and lower DI each independently predicted lower stress (lower posttraumatic stress, secondary traumatic stress, and general stress); higher MA independently predicted better occupational health (lower burnout and higher compassion satisfaction); and lower DI independently predicted positive mental health (greater resilience and life satisfaction). Results highlight the independent associations of high MA and low DI with first responders' mental health and underscore the importance of studying of interventions that promote both of these protective factors in first responders. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Workplace burnout and psychological health of military personnel in a Nigerian barrack

Background: Burnout is an adverse response to job stressor with antecedents, correlates, and consequences. Well-managed burnout brings about stable mental health and increased productivity. Aim: This study examined the prevalence of burnout and psychological health among Nigerian military personnel in Abakpa Cantonment Enugu; and the effect of demographic variables on their mental health. Materials and Methods: The study was a cross-sectional analytical study carried out between July and August 2020 using a multistage sampling method. The data collection instrument was a self-administered questionnaire with three different sections – demography, abbreviated Maslach Burnout Inventory, and the general health questionnaire-12 (GHQ-12). Analytical tools were frequency distribution tables and regression analysis. Results: A total of 261 military personnel were studied: 80.5% were males, while 19.5% were females. The age range was 18–57 years with a mean age of 38 years ± 10 and more than half of the participants are between 28 and 42 years. Most respondents had at least secondary level of education and 63.2% had worked for <20 years. Burnout and psychological distress were both of mild degree with prevalence at 55.2% and 65.1%, respectively. Severe psychological distress was observed in males (1.9%), single (1.9%), noncommissioned (1.7%), and personnel working 10–14 h/day (4.2%). Higher status/rank is associated with less degree of burnout across subscales. Years of service were positively predictive of burnout, while age had a negative effect on burnout. Increasing levels of education predicted a reverse effect on average burnout. Conclusion: The burnout level in the assessed personnel was mild. This is associated with a corresponding mild psychological distress implying these personnel burnout is very well handled. Periodic and regular screening for psychological health is, therefore, advised. It will enable any deviation to be detected on time, for prompt management. This is also to ensure that only psychologically fit army officers carry out their duties.

Aggression towards clinicians within Opiate Substitution Treatment (OST) services: A survey of service providers

BackgroundHigh levels of aggression towards staff in healthcare settings have been reported. It seems likely that workers in Opioid Substitution Therapy (OST) would be at increased risk of adverse events and their consequences. ObjectivesThis study aimed to establish if practitioners who provide OST are experiencing negative outcomes, specifically aggression, distress, and burnout, and to identify if workload and professional affiliation were associated with these risks. MethodsA survey was conducted of OST practitioners in a single geographical region of New Zealand (population approx. 344,000). The survey asked for demographics (including caseloads), Perception of Patient Aggression Scale New Zealand Revision (POPAS-NZ), Kessler 10 (K10), Short Post-Traumatic Stress Disorder Rating Interview (SPRINT), and Abbreviated Maslach Burnout Inventory (aMBI) and two qualitative questions asking about the best and worst aspects of working in OST. ResultsAll recorded OST workers in the region (n = 181) were invited to participate, 95 practitioners responded to the survey (52.4%). This group included pharmacists, doctors, nurses, social workers and addiction workers. Results indicated aggression, distress, and burnout were being experienced by practitioners. Number of patients seen by a practitioner significantly increased risk of aggression (F(1,90) = 14.14, p < 0.001). Psychiatrists were the most at risk profession (p = 0.016). Burnout responses were high for around 20% of practitioners, with low numbers meeting criteria for distress and PTSD. Positive things about working in OST were relationships with patients, appreciating patient outcomes and positive team environments. Negative aspects were patient behaviours, maintaining empathy, and, administration tasks. ConclusionsAggression was a workplace hazard for OST clinicians. Low rates of distress and PTSD symptoms were reported and some evidence of practitioner burnout. Practitioners reported positive relationships, making a difference and teamwork may have been improving this area of mental health work.

Risk Factors for Physician Burnout in Early Career Arthroplasty Surgeons

Introduction We sought to identify the prevalence and risk factors for physician burnout and job satisfaction among arthroplasty surgeons within their first five years of practice. Methods The American Association of Hip and Knee Surgeons (AAHKS) Young Arthroplasty Group was surveyed for this study. The survey collected data regarding surgeon demographics, extracurricular activities, and job satisfaction. The abbreviated Maslach Burnout Inventory (aMBI) was utilized to evaluate emotional exhaustion, depersonalization, and personal accomplishment. Demographic and practice variables were analyzed to identify any association with aMBI scores. Results 82 surgeons (35%) responded to the survey with 78% satisfied with their current job. Surgeons who were satisfied with their current job were more likely to have hobbies outside of orthopedics (OR = 7.50, p = 0.005), be younger (OR = 11.11, p = 0.047), and to be employed in a physician-owned practice type (OR = 9.09, practice, p = 0.019). The median personal accomplishment score was higher for those reporting hobbies outside of orthopedics (16 vs. 13.5, p = 0.040), performing research (16.5 vs. 16, p = 0.006), and having less call (17 vs. 14.5, p = 0.001). Depersonalization and emotional exhaustion scores were not related to any characteristic measured. Conclusion Emotional exhaustion, depersonalization, and sense of personal accomplishment varied greatly amongst early career arthroplasty surgeons. Having hobbies outside of orthopedics was most strongly associated with a sense of greater personal accomplishment and job satisfaction. Understanding risk factors related to burnout may help improve identification and prevention of this potential cause of job dissatisfaction and turnover.

Factors influencing resilience and burnout among resident physicians - a National Survey

BackgroundResidency training exposes young physicians to a challenging and high-stress environment, making them vulnerable to burnout. Burnout syndrome not only compromises the health and wellness of resident physicians but has also been linked to prescription errors, reduction in the quality of medical care, and decreased professionalism. This study explored burnout and factors influencing resilience among U.S. resident physicians.MethodsA cross-sectional study was conducted through an online survey, which was distributed to all accredited residency programs by Accreditation Council of Graduate Medical Education (ACGME). The survey included the Connor-Davidson Resilience Scale (CD-RISC 25), Abbreviated Maslach Burnout Inventory, and socio-demographic characteristics questions. The association between burnout, resilience, and socio-demographic characteristics were examined.ResultsThe 682 respondents had a mean CD-RISC score of 72.41 (Standard Deviation = 12.1), which was equivalent to the bottom 25th percentile of the general population. Males and upper-level trainees were more resilient than females and junior residents. No significant differences in resilience were found associated with age, race, marital status, or training program type. Resilience positively correlated with personal achievement, family, and institutional support (p < 0.001) and negatively associated with emotional exhaustion and depersonalization (p < 0.001).ConclusionsHigh resilience, family, and institutional support were associated with a lower risk of burnout, supporting the need for developing a resilience training program to promote a lifetime of mental wellness for future physicians.

Burnout among medical students interested in neurosurgery during the COVID-19 era

ObjectiveThe novel Coronavirus Disease 2019 (COVID-19) pandemic has posed unprecedented new stressors to medical student education. This national survey investigated the prevalence of burnout in U.S. medical students interested in pursuing neurosurgical residency during the COVID-19 pandemic. MethodsA 24-question survey was sent to all American Association of Neurological Surgeons (AANS) medical student chapter members. The abbreviated Maslach Burnout Inventory (aMBI) was used to measure the following burnout metrics: emotional exhaustion, depersonalization, and personal accomplishment. Bivariate analyses were conducted and multivariate analyses were performed using a logistic regression models. Results254 medical students were included (response rate of 14.5%). The majority were male (55.1%), White (66.1%), and between their 2nd and 3rd years in medical school (62.6%). Burnout was identified in 38 (15.0%) respondents, a rate lower than reported in the pre-COVID era. In multivariate analysis, burnout was significantly associated with choosing not to pursue, or feeling uncertain about pursuing, a medical career again if given the choice (OR = 3.40, p = 0.0075), having second thoughts about choosing to pursue neurosurgery (OR = 3.47, p = 0.0025), attending a medical program in the Northeast compared to the Southeast (OR = 0.32, p = 0.027) or Southwest U.S. (OR = 0.30, p = 0.046), and indicating that one’s future clinical performance will have worsened due to COVID-19 (OR = 2.71, p = 0.025). ConclusionsOur study demonstrates relatively low rates of burnout among U.S. medical students interested in pursuing neurosurgery during the COVID-19 pandemic. Our findings also demonstrate multiple factors may aid in early identification of burnout, highlighting potential opportunities for intervention.

The impact of a smartphone meditation application on anesthesia trainee well-being

Study objectivePhysician burnout is a pervasive problem in the United States. The goal of this study was to investigate use of the smartphone meditation application Headspace® as a well-being improvement tool in anesthesia trainees. DesignProspective self-controlled observational study. SettingAnesthesia training program in an academic hospital. SubjectsResident and fellow trainees in the Department of Anesthesiology and Perioperative Medicine at the University of Pittsburgh Medical Center. InterventionsResident and fellow trainees were given a free 1-year subscription to the mindfulness application. Participation was voluntary and included questionnaires at baseline, 1 month, and 4 months for assessment of burnout and well-being. Questionnaires were linked with the use of de-identified codes and completed via REDCap. Questionnaires included the abbreviated Maslach Burnout Inventory, Becks Depression Index, Cohens Stress Score, Pittsburgh Sleep Quality Index, and a Headspace® Self-Reporting Questionnaire. MeasurementsDepression, stress, sleep quality, emotional exhaustion, depersonalization, and personal achievement. Main resultsOf 112 trainees eligible to participate, 71 completed baseline questionnaires, 54 created application accounts, and 29 completed the entire questionnaire protocol with 4 months of app use. Application use was associated with reduced depression scores and increased feelings of personal achievement at both 1 month (p = 0.003, p = 0.066) and 4 months (p = 0.011, p = 0.005). Burnout from feelings of depersonalization and emotional exhaustion did not improve with application use. Over the study period, trainees completed 786 meditation sessions, accounting for 6123 min of app engagement. ConclusionsFindings of decreased depression scores and improved feelings of personal achievement suggest that Headspace® could serve as a mindfulness tool for incorporating meditation into the daily practice of anesthesia trainees in an effort to improve well-being.

National Evaluation of the Association Between Resident Labor Union Participation and Surgical Resident Well-being

Labor unions are purported to improve working conditions; however, little evidence exists regarding the effect of resident physician unions. To evaluate the association of resident unions with well-being, educational environment, salary, and benefits among surgical residents in the US. This national cross-sectional survey study was based on a survey administered in January 2019 after the American Board of Surgery In-Training Examination (ABSITE). Clinically active residents at all nonmilitary US general surgery residency programs accredited by the American Council of Graduate Medical Education who completed the 2019 ABSITE were eligible for participation. Data were analyzed from December 5, 2020, to March 16, 2021. Presence of a general surgery resident labor union. Rates of labor union coverage among non-health care employees within a region were used as an instrumental variable (IV) for the presence of a labor union at a residency program. The primary outcome was burnout, which was assessed using a modified version of the abbreviated Maslach Burnout Inventory and was defined as experiencing any symptom of depersonalization or emotional exhaustion at least weekly. Secondary outcomes included suicidality, measures of job satisfaction, duty hour violations, mistreatment, educational environment, salary, and benefits. A total of 5701 residents at 285 programs completed the pertinent survey questions (response rate, 85.6%), of whom 3219 (56.5%) were male, 3779 (66.3%) were White individuals, 449 (7.9%) were of Hispanic ethnicity, 4239 (74.4%) were married or in a relationship, and 1304 (22.9%) had or were expecting children. Among respondents, 690 residents were from 30 unionized programs (10.5% of programs). There was no difference in burnout for residents at unionized vs nonunionized programs (297 [43.0%] vs 2175 [43.4%]; odds ratio [OR], 0.92 [95% CI, 0.75-1.13]; IV difference in probability, 0.15 [95% CI, -0.11 to 0.42]). There were no significant differences in suicidality, job satisfaction, duty hour violations, mistreatment, educational environment, salary, or benefits except that unionized programs more frequently offered 4 weeks instead of 2 to 3 weeks of vacation (27 [93.1%] vs 52 [30.6%]; OR, 19.18 [95% CI, 3.92-93.81]; IV difference in probability, 0.77 [95% CI, 0.09-1.45]) and more frequently offered housing stipends (10 [38.5%] vs 9 [16.1%]; OR, 2.15 [95% CI, 0.58-7.95]; IV difference in probability, 0.62 [95% CI 0.04-1.20]). In this evaluation of surgical residency programs in the US, unionized programs offered improved vacation and housing stipend benefits, but resident unions were not associated with improved burnout, suicidality, job satisfaction, duty hour violations, mistreatment, educational environment, or salary.