Chronic Burnout Research Articles

A reverse perspective on emotion work and well-being: Connecting chronic burnout to emotion regulation from an antecedent perspective.

A reverse perspective on emotion work and well-being: Connecting chronic burnout to emotion regulation from an antecedent perspective.

Midwives' stress and burnout during the Omicron wave in Italy: An observational survey.

To evaluate midwives' level of stress and burnout during the COVID-19 Omicron phase in Italy. Secondary aims were to explore the impact of the pandemic on midwives' personal dimensions and professional activities and potential supporting strategies. A mixed-methods study was undertaken from July to December 2022. Data were collected using a national online observational survey. Descriptive and inferential analyses were performed to evaluate stress, burnout and the impact of the pandemic on personal and professional dimensions. A deductive qualitative approach was used to analyse open-ended responses, that were merged with quantitative data following a convergent mixed-methods approach. A total of 1944 midwives participated in the survey. The stress summary score mean was 10.34, and 562 midwives (28.91%) experienced burnout. The intention to reduce working hours was reported by 202 midwives (10.39%), with 60.40% (n = 122) of them experiencing burnout. The intention to leave clinical practice within the following 2 years was reported by 239 (12.29%), with 68.20% (n = 163) of them experiencing burnout. All the personal dimensions and professional activities considered were defined by more than half of midwives as being impacted 'Moderately' or 'To a great extent' by pandemic. Stress and burnout frequencies increased when the midwives' perception of the pandemic effects was higher. Potential supporting strategies described by midwives as the most important in increasing their ability to cope with the pandemic were 'Women's awareness of the midwives' role' (n = 1072; 55.14%) and 'Family and friends' emotional support' (n = 746; 38.38%). Our findings suggested strategies to support a positive and safe working environment for midwives during a pandemic emergency, with potential transferability to similar contexts when human resources are lacking. It is recommended that maternity services provide the necessary resources for a safe and supportive working environment to prevent high stress levels and chronic burnout. Studies conducted during the first COVID-19 pandemic wave showed an increased level of stress, anxiety, burnout, post-traumatic stress disorder and depression experienced by healthcare professionals; moreover, midwives experienced drastic changes in care pathways and policies with struggles identified when providing high-quality woman-centred care following pandemic restrictions. Although it is recommended, there is lack of knowledge about long-term psychological effects of COVID-19 for midwives. Our study highlights that during the Omicron wave midwives experienced a high level of stress and burnout with an impact on individual dimensions and professional activities. Their stress and burnout were influenced by several factors, including restrictions in place, lack of organizational acknowledgement, work overload and need for extra childcare cover. Maternity services should provide the necessary resources for a safe and supportive working environment to prevent high stress levels and chronic burnout. Recommendations on how to facilitate this are suggested. During the writing process, we referred to 'The Strengthening the Reporting of Observational Studies Epidemiology Statement', the guidelines for reporting observational studies from the Equator network. No patient or public contribution. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY?: Work overload conditions negatively impacted on the quality of maternity services. Improving organizational aspects, reducing working hours, promoting family and friends' emotional support and improving women's awareness of midwife's role were the main strategies reported by midwives. These suggestions for ensuring a positive and safe working environment for midwives during a pandemic emergency could potentially be applied to similar situations where human resources are lacking.

Beyond Burnout: Nurses’ Perspectives on Chronic Suffering During and After the COVID-19 Pandemic

Nurses around the globe have been impacted psychologically and emotionally during and after the COVID-19 pandemic. The purpose of this study was to describe nurses’ perspectives on the concepts of compassion fatigue, second victimhood, burnout, and moral injury. Eight nurses were interviewed either individually or in groups of two. Data were analyzed using conventional content analysis. The following themes were identified: waves of compassion fatigue, traumatization within second victimhood, never the same after chronic burnout, moral injury: nurses couldn’t do their best, and connections across concepts. Results showed nurses were most familiar with burnout and compassion fatigue, which remain chronic struggles. Second victimhood and moral injury were more distinct experiences related to traumatic or morally distressing events and likely contributed to experiencing burnout or compassion fatigue. Nurses’ suffering heightened during the COVID-19 pandemic and remains prominent three years later. Future research and interventions are urgently needed globally to reduce workplace stressors and promote nurse well-being.

How COVID-19 changed frontline healthcare workers’ experiences: A narrative inquiry into the impact of chronic burnout on a surgical physician assistant’s wellness

How COVID-19 changed frontline healthcare workers’ experiences: A narrative inquiry into the impact of chronic burnout on a surgical physician assistant’s wellness

Resilience, depression and their effect on nurse retention: a survey in rural Indonesia.

Health professionals' maldistribution and retention in underserved areas are global problems. Burnout drives health professionals to leave rural areas. Chronic burnout is linked to depression, and nurses have a higher risk for depression than the general population. Studies suggest that increasing resilience may reduce depression. However, little is known about the effect of resilience on nurses' depression and their rural retention. This study aims to understand the impact of resilience and depression on nurses' retention in rural areas. An online cross-sectional survey on registered nurses was conducted in July - August 2021 in a rural province in Indonesia. The survey measured the nurses' resilience, depression level, and work duration. A total of 1050 participants joined the study. The results suggest that resilience in nurses is negatively correlated to depression and retention. The mildly depressed group had the shortest retention. There was no difference in the work duration, depression, and resilience scores between the underserved and non-underserved regencies in the province. Although not all our hypotheses are supported, some interesting results were obtained. In a previous study, the more senior the doctor, the higher the resilience; in this nurse analysis, the opposite was true - senior nurses were the least resilient. As found in other studies, resilience is negatively correlated to depression. So, resilience training may still benefit the depressed group. Improvement of health professionals' rural retention requires approaches tailored to each profession. Resilience training may be beneficial to retain nurses through mild depression treatment.

Is it not over yet? – pandemic-induced ongoing burn out continues for students in Azerbaijan.

Abstract In a nagging pandemic, while there will be some regression when the dust from pandemic settles, online, remote and hybrid education seems to stay for good and is expected to maintain a substantial portion of education. Students chronic burnout continues with more questions raised every day than the answers and promises made. It is a known psychological fact that when a younger generation of students encounters life-threatening events, they tend to reflect on death and uncertainty and take stock of their lives with defining what to make of their lives and how to achieve that. We surveyed mental health, social life and its impact on academics of medical and engineering students in Azerbaijan and reported the following data. Out of 274 respondents were 51% female and 48.2% male. 86.5% were from the age group (18–25) and 12.5% from (25–35) years. Majority of the students found themselves juggling with too many balls at the same time, not everyone could keep the focus, skill set and training to succeed. Female students delayed their cultural-ordained marriageable age in pursuit of a well-settled career partner, while male students found themselves looking for an alternative career path. Majority of professional students burn-out by a loss of at least two years of their professional education. This seemed to play out more for medical students as they were not able to find experiential training and hospital residencies. This included medical and engineering students who were ambitious to seek western education but lockdowns and visa regulations held them hostage at their home countries. Azerbaijan students however, were resilient enough to withstand the dual trauma of war with their neighboring country while fighting a global war against COVID-19 pandemic.

How does chronic burnout affect dealing with weekly job demands? A test of central propositions in JD‐R and COR‐theories

AbstractThis study uses job demands–resources and conservation of resources theories to propose that chronic levels of job burnout may aggravate the positive relationship of weekly job demands with week‐level burnout symptoms, dysfunctional coping, and self‐undermining. Specifically, we hypothesize that weekly job demands (workload and emotional demands) relate positively to maladaptive behaviors through weekly burnout symptoms, particularly when chronic burnout is higher (vs. lower). We collected data among 84 employees from various occupational sectors, who first filled out a general survey, and then completed weekly diary surveys every Friday, for five consecutive weeks (total n = 415 occasions). Results of multilevel analyses generally supported the hypotheses. Weekly job demands were positively related to weekly burnout and self‐undermining only when employees scored higher on chronic burnout. Moreover, as predicted, the results showed that job demands were most strongly related to dysfunctional coping and self‐undermining through weekly burnout symptoms for individuals higher (vs. lower) in chronic burnout. These findings highlight the interplay between weekly job demands and chronic burnout in the process of resource loss.

Burnout and self-regulation failure: A diary study of self-undermining and job crafting among nurses.

The objective was to test how nurse burnout impairs day-to-day adaptive self-regulation strategies that link levels of regulatory resources with employee job performance. Regulatory resources help employees manage their thoughts, feelings, and behaviours on a daily basis. On days when these resources are low, employees may engage in maladaptive self-regulation: more self-undermining (i.e. creating additional obstacles) and less job crafting (i.e. optimizing job demands and resources), which debilitates their work performance. We expected that self-regulation is impaired especially when individuals exhibit low motivation and low ability to regulate their behaviour, that is, when they experience elevated burnout. This research used a daily diary design. Nurses responded to a general survey and then completed daily diary surveys in three different moments: before, during and after work for 10 consecutive workdays (total reports N=732). A sample of 81 nurses from Polish hospitals and primary healthcare centres completed self-reported questionnaires between January and March 2018. Hypotheses were tested using multilevel modelling in Mplus. Momentary self-regulatory capacity before work was negatively related to self-undermining and positively related to job crafting, and it indirectly predicted daily job performance. As hypothesized, these indirect relationships were moderated by general, chronic burnout. We found that only for employees with low levels of burnout, daily self-regulation was linked with better functioning via increased job crafting and decreased self-undermining. Chronic burnout disturbs day-to-day behaviour regulation. Individuals with elevated burnout symptoms have difficulty to translate momentary boosts in regulatory resources into adaptive strategies that are linked with higher performance. Our findings call for better recovery programmes, strategic Human Resource Management practices aimed at reducing factors that deplete daily self-regulatory resources, and finally top-down interventions preventing burnout among employees in the healthcare system.

University employees’ perceptions of health during the early stages of the Covid-19 pandemic

ABSTRACT The emergence of the novel coronavirus, or Covid-19, has had a major impact on higher education; however, little attention has been paid to how the virus and lockdown measures instituted to stop its spread have affected the health of faculty and staff. This study employed survey methodology to assess the impact of the coronavirus and ensuing quarantine measures in the US on employees at a private institution in the Mid-Atlantic. A total of N = 129 employees answered questions on self-perceptions of their physical and mental health, and results illustrated a wide range of responses. While some employees reported positive changes, a third struggled with physical activity, eating, sleep habits and weight management, and more than half had greater stress, anxiety and mood difficulties. No differences were found among genders or employment type, but employees ages 65 and older reported significantly greater negative mood change and less healthy eating habits. Colleges and universities should be mindful of the challenges that faculty and staff face during the ongoing pandemic and provide resources and support specifically targeting these groups; in particular, programming encouraging and supporting physical activity behaviours may be especially useful for promoting physical and mental health benefits, reducing risk of illness and preventing chronic burnout.

Role of Surgical Procedures (VP Shunt and ETV) in Tuberculous Meningitis with Hydrocephalus (TBMH): A Systematic Review.

ABSTRACTObjective:Hydrocephalus is one of the most common complications of tuberculous meningitis. Various cerebrospinal fluid diversion procedures, endoscopic third ventriculostomy (ETV) and shunt surgery, are performed for the management of the hydrocephalus associated with tuberculous bacterial meningitis (TBM). There is decreased clarity on the type of procedure to be done. So, this study aims at generating knowledge to understand the conditions in which either of the two procedures, ETV and shunt surgery, is a better option and to develop good practice guidelines for the treatment of tubercular meningitis hydrocephalus (TBMH).Materials and Methods:A systematic search of literature was performed by using PubMed and Cochrane Central Register of Controlled Trials (CENTRAL) for articles published from January 2001 to April 2020. A total of 15 studies were included irrespective of their design and having diagnosis with TBMH treated with ventriculoperitoneal shunt surgery (VPS) or ETV. Then, a systemic review was done regarding outcomes, complications, and recommendations made in different studies.Results:The total number of patients diagnosed with TBMH was 603; among them, 348 patients had VPS and 255 patients had ETV. In the VPS group, the patient’s good outcome varied from 25% to 68% and complication rate ranged from 10% to 43.8%. The average percentage of good outcome in the VPS group was 51.8%. In the ETV group, the patient’s good outcome varied from 41% to 77% and complication rate ranged from 10% to 23.5%. The average percentage of good outcome in the ETV group was 68%. There was a significant difference in the average percentage of good outcome in the ETV versus the VPS shunt group (P-value was 0.008).Conclusion:There was a significant difference in the average percentage of good outcome after ETV than VPS, and complication rate was also slightly lower after ETV than VPS during the chronic phase of illness. So during the acute phase of illness VPS placement is preferred whereas in the chronic burnout phase ETV is preferred because poor anatomy leads to more complications with ETV during the acute phase of the disease.

Burnout and cognitive impairment: Associated with serum BDNF in a Chinese Han population

BackgroundSome studies have demonstrated that subjects with chronic burnout showed cognitive impairments; however, cognitive performance in burnout has been under-investigated. Increasing evidence show that brain-derived neurotrophic factor (BDNF) plays a critical role in cognitive function. We hypothesized that decreased BDNF may be associated with cognitive impairments in burnout, which has not been investigated yet. The aim of the present study was to examine the association of BDNF with cognitive impairment in burnout. MethodUsing a cross-sectional design, 712 healthy subjects were recruited from a general hospital and they were all measured with the Maslach Burnout Inventory (MBI). We assessed part of subjects on the repeatable battery for the assessment of neuropsychological status (RBANS) (n=192) and serum BDNF levels (n=127). Results30.5% of the subjects had burnout. Compared to those non-burnout subjects, the burnout subjects were younger, had significant lower BDNF levels (p=0.003) and scored lower on immediate memory, RBANS total score and attention (all p<0.05). Interestingly, after the Bonferroni correction, there were negative correlations between BDNF and MBI total score or reduced professional accomplishment (PA). Moreover, BDNF was positively associated with immediate memory, attention and RBANS total score. Further multiple regression analysis showed that BDNF was an independent contributor to the RBANS total score and attention, and BDNF and MBI depersonalization (DP) were independent contributors to immediate memory. In addition, there was mediating effect of BDNF in the relation between burnout and cognitive impairments. ConclusionsOur results suggest that burnout is associated with significant cognitive impairments and decreased BDNF. Moreover, decreased BDNF is associated with cognitive impairments in burnout.

Chronic job burnout and daily functioning: A theoretical analysis

In this article, we discuss the individual employee's role in the development of his/her job burnout. We review the antecedents and consequences of burnout, and propose a model with chronic burnout as a moderator of daily functioning in the workplace. Specifically, we argue that chronic burnout strengthens the loss cycle of daily job demands, daily exhaustion, and daily self-undermining. Additionally, we argue that chronic burnout weakens the gain cycle of daily job resources, daily work engagement, and daily job crafting. We conclude that employees with high levels of burnout need help in structurally changing their working conditions and health status.

High frequency of the cancer-predisposing TP53 mutation R337H in the population of south Brazil – evidence for a founder effect

Some studies have demonstrated that subjects with chronic burnout showed cognitive impairments; however, cognitive performance in burnout has been under-investigated. Increasing evidence show that brain-derived neurotrophic factor (BDNF) plays a critical role in cognitive function. We hypothesized that decreased BDNF may be associated with cognitive impairments in burnout, which has not been investigated yet. The aim of the present study was to examine the association of BDNF with cognitive impairment in burnout.Using a cross-sectional design, 712 healthy subjects were recruited from a general hospital and they were all measured with the Maslach Burnout Inventory (MBI). We assessed part of subjects on the repeatable battery for the assessment of neuropsychological status (RBANS) (n = 192) and serum BDNF levels (n = 127).30.5% of the subjects had burnout. Compared to those non-burnout subjects, the burnout subjects were younger, had significant lower BDNF levels (p = 0.003) and scored lower on immediate memory, RBANS total score and attention (all p < 0.05). Interestingly, after the Bonferroni correction, there were negative correlations between BDNF and MBI total score or reduced professional accomplishment (PA). Moreover, BDNF was positively associated with immediate memory, attention and RBANS total score. Further multiple regression analysis showed that BDNF was an independent contributor to the RBANS total score and attention, and BDNF and MBI depersonalization (DP) were independent contributors to immediate memory. In addition, there was mediating effect of BDNF in the relation between burnout and cognitive impairments.Our results suggest that burnout is associated with significant cognitive impairments and decreased BDNF. Moreover, decreased BDNF is associated with cognitive impairments in burnout.

Burnout and Risk of Type 2 Diabetes: A Prospective Study of Apparently Healthy Employed Persons

This prospective study was designed to test the extent to which the onset of type 2 diabetes in apparently healthy individuals was predicted by burnout, a unique affective response to combined exposure to chronic stressors. The study participants were 677 employed men and women who were followed up for 3 to 5 years (mean = 3.6 years) for the onset of diagnosed type 2 diabetes. Burnout was assessed by the Shirom-Melamed Burnout Measure with its three subscales: emotional exhaustion, physical fatigue, and cognitive weariness. The burnout symptoms were remarkably consistent over the follow-up period irrespective of changes in place of work and in employment status. During the follow-up period, 17 workers developed type 2 diabetes. Logistic regression results indicated that burnout was associated with a 1.84-fold increased risk of diabetes (95% confidence interval [CI] = 1.19-2.85) even after adjusting for age, sex, body mass index, smoking, alcohol use, leisure time physical activity, initial job category, and follow-up duration. In a subsample of 507 workers, the relative risk of diabetes was found to be much higher after additional control for blood pressure levels (odds ratio = 4.32, 95% CI = 1.75-10.67), available only for this subsample. These findings suggest that chronic burnout might be a risk factor for the onset of type 2 diabetes in apparently healthy individuals.

Impaired cognitive performance in patients with chronic burnout syndrome

Chronic burnout refers to a syndrome caused by chronic stress. Clinical observations indicate that chronic burnout is associated with impaired cognitive functioning. However, there have been no systematic studies of the cognitive performance in chronic burnout patients. We have evaluated general cognitive ability, memory, and attention in 67 female patients treated for chronic burnout. The patients and 15 healthy control subjects were tested with standardized tests of verbal and nonverbal cognitive ability (WAIS), verbal (Claeson–Dahl) and nonverbal (Rey complex figures) memory, and visual and auditory attention (IVA). Significant reductions in nonverbal memory and auditory and visual attention were found for the patient group. These results indicate that patients with chronic burnout have specific cognitive impairments, which should be emphasized in the evaluation of symptoms and treatment regimes in this disorder.

Chronic burnout, somatic arousal and elevated salivary cortisol levels

Burnout syndrome, comprised of the symptoms of emotional exhaustion, physical fatigue, and cognitive weariness, is believed to be a result of ineffective coping with enduring stress. This study of 111 nonshift blue-collar workers free of cardiovascular disease (CVD) examined whether chronic burnout is associated with a state of somatic and physiological hyperarousal. Results showed that 37 workers exhibited symptoms of chronic burnout, with symptoms lasting at least 6 months. These workers, compared to those with no burnout symptoms (n=52) or nonchronic burnout symptoms (n=22), had higher levels of tension at work, postwork irritability, more sleep disturbances and complaints of waking up exhausted, and higher cortisol levels during the work day. These results suggest that chronic burnout is associated with heightened somatic arousal and elevated salivary cortisol levels. This may be part of the mechanism underlying the emerging association between burnout and risk of CVD.