Community pharmacists' perceptions of their work-related quality-of-life: Implications for pharmacists' well-being, compassionate patient care, and relationships.

When resuscitation fails-Nurses' emotions and coping mechanisms after unsuccessful cardiopulmonary resuscitation: An integrative review.

Teacher burnout is a well-documented issue that is becoming widespread in modern education, yet its effects on manifested classroom behavior have not been properly studied. The present research examined the connection between teacher burnout and pedagogical flexibility in classroom teaching in terms of the ability to adjust the process of teaching and respond to the needs of learners and contextual requirements. The correlational research design was used to gather data of 300 secondary school teachers in District Haripur. Teacher burnout was assessed using the Maslach Burnout Inventory, which included emotional exhaustion, depersonalization and diminished personal accomplishment whereas pedagogical flexibility was measured through a structured classroom observation tool that comprised of several facets of adaptive instruction. The results of descriptive statistics showed that the level of emotional exhaustion among teachers is moderate to high, the level of depersonalization is lower, and the variability of observed pedagogical flexibility is limited. Pearson correlation showed emotional exhaustion had a moderate negative relationship with pedagogical flexibility, while depersonalization had a significant negative relationship with responsive instructional behaviors. Reduced personal accomplishment was positively related to instructional adaptation. Multiple regression confirmed emotional exhaustion as a significant negative predictor of composite.

The full-scale war and mass forced migration of Ukrainians have formed a new configuration of psychological, social and integration challenges, which are especially evident in the host countries, including the UK. The relevance of the topic is due to the need for a deeper understanding of how the combination of military experience, external institutional barriers and cultural adaptation affects the psycho-emotional state of Ukrainian migrants. The aim of the study is to study the interaction of psychological states, socio-systemic barriers and adaptive strategies of Ukrainian migrants, the object of which is the process of their psychological and social adaptation in the UK. The methodology is based on a mixed approach, combining in-depth interviews and online surveys with subsequent quantitative analysis of integral indicators and correlations. The results showed that anxiety, emotional exhaustion and sleep disturbances are the most common manifestations, the intensity of which is increased by the influence of difficulties in accessing health services, problems with renting housing, information opacity and the complexity of university or administrative procedures. It was found that social support from the Ukrainian community, regular contact with family, physical activity and structured routine are the most effective adaptive strategies, while self-regulation techniques demonstrate lower effectiveness in high-stress conditions. Correlation analysis confirmed the close relationship between psychological stressors and external barriers, as well as the positive impact of adaptive strategies on the level of subjective integration. The practical significance lies in the possibility of using the obtained data by universities, migration organizations and public services to develop more personalized support programs, optimize access to medical and information services and create conditions for more effective social integration of Ukrainian migrants in the UK.

When nursing leadership turns toxic: mediating, amplifying, and buffering effects of emotional exhaustion, job insecurity, and coworker support.

Male labor migration from rural Nepal has become a defining socio-economic phenomenon that simultaneously promotes household prosperity and disrupts family structures. While remittances enhance financial security, the emotional cost borne by wives left behind remains profound yet under-researched. This study investigates the psychosocial and emotional distress experienced by left-behind wives in rural Nepal, exploring the interplay between patriarchal norms, socio-cultural pressures, economic dependencies, and limited access to mental health support. Drawing on a synthesis of recent empirical and theoretical studies from 2010–2025, the research reveals that prolonged spousal separation contributes to chronic loneliness, anxiety, and depression among women, exacerbated by increased domestic burdens and societal stigma. Consistent remittance flow and frequent communication with migrant husbands serve as partial buffers, though they rarely mitigate the deeper emotional void or social isolation. The review identifies remittance reliability, communication frequency, and community support as key mediators of psychosocial well-being. Findings further highlight that while migration-induced role shifts can increase women’s autonomy in financial and household decision-making, they also intensify workloads and emotional exhaustion. The study concludes that sustainable interventions must integrate mental health services with gender-sensitive development and empowerment initiatives. Policies focusing solely on economic remittances fail to address the complex emotional dimensions of migration. A holistic, multi-sectoral approach-combining psychosocial counseling, community awareness, and digital connectivity-can enhance resilience and ensure the well-being of left-behind wives, thereby promoting both family and national development.

Purpose This study aims to disentangle the underlying mechanisms among customer incivility, service recovery performance and service employee creativity using conservation of resources theory. It also examines the moderating effects of regulatory focus (i.e. promotion and prevention focus) on the relationship between customer incivility and customer orientation. Design/methodology/approach Data were obtained from 323 full-time frontline employees in high-contact service industries in Japan. Participants were recruited using an online research panel and administered a three-wave survey with a one-month lag. Findings The results of partial least squares equation modeling revealed that customer orientation was a critical mediator of the effects of customer incivility. Notably, these results remained consistent even when controlling for emotional exhaustion and intrinsic motivation as alternative mediators. Moreover, prevention focus moderated the relationship between customer incivility and customer orientation, whereas promotion focus did not. Research limitations/implications Data collection using an online research panel constrained the generalizability of findings. Practical implications The findings offer service and human resource (HR) managers insights into effectively handling customer incivility in terms of HR practices. Originality/value This study identifies the mediating role of customer orientation in the context of service recovery performance and service employee creativity while ruling out emotional exhaustion and intrinsic motivation.

Background: Emergency department (ED) nurses are routinely exposed to high-stress clinical environments, increasing their risk for burnout and emotional exhaustion. In holistic nursing, self-care is viewed as a professional and ethical responsibility essential to delivering whole-person care. This pilot study, guided by the Integrative Nursing Framework, explored the use of a mobile mindfulness app as a holistic intervention to support nurse well-being. Purpose: To explore how ED nurses experience and manage stress and burnout and to evaluate the effects of a mobile mindfulness app on these outcomes. Methods: An explanatory sequential mixed-methods design was used. Eleven ED nurses used the Headspace app for 4 weeks and completed pre- and post-intervention surveys measuring perceived stress, burnout, mindfulness, and well-being. Nine participants also completed post-intervention interviews. Quantitative data were analyzed using Wilcoxon signed-rank tests; qualitative data were analyzed using thematic analysis. Results: Perceived stress significantly decreased, while mindfulness and well-being significantly increased. Burnout scores showed no significant change. Themes included usability, personal impact, barriers to engagement, and recommendations for improvement. Conclusions: This study demonstrates the feasibility of mobile mindfulness as a holistic, self-directed intervention that aligns with holistic nursing values and supports ED nurses' well-being in demanding care environments.

Burnout is a widely recognised occupational phenomenon, with emergency department (ED) healthcare workers globally facing a heightened risk. Despite this, data on the burden of burnout among ED healthcare workers, especially in low-resource settings, are limited. Our study sought to establish the prevalence and factors associated with burnout and workplace stressors among ED healthcare workers in Uganda. An online-based survey was conducted among ED professionals across four private and public hospitals. Burnout was assessed using the Maslach Burnout Inventory-Human Services Survey tool. Data were analysed using univariable and multivariable logistic regression analyses. Data from 82 participants were analysed (response rate of 88%), with approximately equal numbers of males and females, just over half providing care to both adult and paediatric patients and 61% working in public facilities. Overall, 9.7% of participants met the criteria for burnout. In total, 48.7% (n=40) reported high emotional exhaustion, 21.9% (n=18) reported high depersonalisation and 35.4% (n=29) reported low personal accomplishment. At least 80% of participants identified key ED stressors including work-related fatigue, patients' financial problems, work overload, equipment shortages and challenges in balancing professional and personal responsibilities. After adjusting for covariates such as overload of health professional literature needed to be read, patients' financial problems, educational issues, lack of sufficient clinical skills and ED violence, burnout was positively associated with poor communication with colleagues in the ED (adjusted OR (AOR) 9.90; 95% CI 1.60 to 61.17; p=0.014) and with caring for the old and terminally ill patients (AOR 7.54; 95% CI 1.38 to 41.29; p=0.020). These associations were consistent with the high depersonalisation domain of burnout. Burnout, particularly in the emotional exhaustion domain, is notably prevalent among ED healthcare workers in Uganda. There is a pressing need for context-specific interventions aimed at improving early recognition of burnout and addressing persistent ED stressors. Such measures are essential to enhance ED healthcare workers' well-being, and ultimately improve in-hospital emergency care in Uganda.

Substance abuse among secondary school learners has emerged as a critical challenge confronting educators in rural South African contexts, yet the voices and experiences of teachers navigating this complex phenomenon remain underexplored in scholarly literature. This qualitative study investigates the multifaceted challenges teachers encounter when working with learners who abuse substances at School A Secondary School in Thohoyandou (pseudonym), Limpopo Province. Through semi-structured interviews with five educators, the research reveals a disturbing landscape characterised by classroom disruptions, aggressive learner behaviour, emotional exhaustion among teaching staff, and systemic gaps in professional support structures. The findings illuminate how substances such as cannabis, chove, nyaupe, and alcohol, among others, profoundly compromise the teaching-learning environment, whilst teachers themselves, lacking specialised training in addiction counselling, struggle to balance disciplinary responsibilities with pastoral care obligations. Peer pressure, familial dysfunction, and easy accessibility to drugs near school premises emerged as primary drivers of substance abuse, compounded by parental denial and weak community oversight. The study underscores the urgent need for comprehensive intervention frameworks that incorporate professional counsellors, law enforcement collaboration, parental engagement programmes, and sustained teacher capacity-building initiatives. By foregrounding teachers' authentic narratives, this research contributes empirically grounded insights that challenge current educational policies whilst offering practical recommendations for creating safer, more supportive learning environments in resource-constrained rural contexts.

Continuous stress, emotional tension, the pace of work, and constant contact with sick people exposes nurses and midwives to professional burnout. Until now, the level of burnout among nurses has been assessed, but research among midwives with an analysis of sociodemographic determinants, including attitudes toward work and life, is still limited. The aim of the study was to assess factors influencing the level of professional burnout among midwives, taking into account job satisfaction, life satisfaction, and dispositional optimism. This cross-sectional observational study was conducted on a group of 98 midwives. Standardized research tools were used to assess professional burnout (Maslach Burnout Inventory, MBI), dispositional optimism (Life Orientation Test, LOT-R), life satisfaction (Satisfaction with Life Scale, SWLS), and job satisfaction (Job Satisfaction Scale, JSS). Depersonalization was significantly higher in individuals with 21 years or more of work experience than in midwives with 0-5 years of seniority (p = 0.023). Lack of job satisfaction was significantly higher among individuals with low life satisfaction than among those with medium and high levels of life satisfaction (p < 0.001), among pessimists compared with neutral individuals (p < 0.001), among those working in a shift system (p = 0.045), and among individuals with less than 21h of free time per week (p = 0.013). Independent predictors of lower emotional exhaustion burnout were employment in two workplaces (17.98 points). Independent predictors of lower reduced personal accomplishment were job satisfaction (1.638 points) and life satisfaction (24.385 points). An optimistic outlook on life reduced the overall level of professional burnout (13.449 points). The study found that the overall level of professional burnout among midwives was moderate. Professional burnout was associated with individual, interpersonal, and organizational factors. Higher levels of burnout were observed among midwives with a pessimistic outlook.

Burnout and adverse mental health outcomes are increasingly reported by health professionals, affecting work engagement or collaboration, with negative effects on staff retention and healthcare quality. This cross-sectional study assessed the prevalence and correlates of work-related emotional exhaustion among health professionals in paediatric cardiac care. Health professionals (153 nurses, 37 medical doctors, 22 allied and mental health professionals, 17 research/administrative staff; 55% response rate, 85% women) at a large quaternary paediatric hospital in Australia completed validated measures within the WithCare Health Professional Survey (June 2020-February 2021). Emotional exhaustion, depersonalisation, and personal accomplishment at work were measured using the Maslach Burnout Inventory. Hierarchical linear regression was used to identify correlates of tested emotional exhaustion, with calculation of 95% confidence intervals (CI). Two-thirds (68%) of participants endorsed feeling "used up at the end of the workday," while 65% felt "emotionally drained from work" at least a few times a month. Correlates of emotional exhaustion included higher anxiety (ß = 1.41, CI: 0.46, 2.35), greater avoidance-based coping (ß = 4.15, CI: 0.22,8.08), greater work-family conflict (ß = 0.55, CI: 0.38, 0.71), lower compassion satisfaction (ß = -0.55, CI: -0.81, -0.30), and lower approach-based coping (e.g., positive reframing or acceptance, ß = -3.44, CI: -6.24, -0.65). Demographics, clinical role characteristics, physical health, and psychosocial factors accounted for 62% of the variance in emotional exhaustion (p < 0.0001). Health professionals providing paediatric cardiac care report emotional exhaustion, which can adversely affect both personal and professional well-being. Identification of correlates can inform the design of targeted initiatives to address mental health needs.

This study examines the effect of work-family conflict on job satisfaction, with emotional exhaustion as a mediator and emotional intelligence as a moderator, among Generation Z sandwich workers in start-up companies in DKI Jakarta. Using a quantitative approach, data were collected from 350 respondents and analyzed with SEM-PLS using SmartPLS 4.0. The results show that work-family conflict negatively affects job satisfaction and positively affects emotional exhaustion. Emotional exhaustion partially mediates the relationship, while emotional intelligence does not moderate the effect of emotional exhaustion on job satisfaction. These findings highlight the importance of managing employee well-being to sustain job satisfaction.

This paper examines how business communication culture influences work-related stress and burnout across diverse organizational sectors. Using a quantitative survey of 107 employees and validated instruments such as the Maslach Burnout Inventory (MBI) and the Perceived Stress Scale (PSS), the study analyzes the effects of open, hierarchical, and disorganized communication practices on emotional exhaustion, depersonalization, and perceived control. Results show that open and transparent communication serves as a protective factor, while hierarchical and disorganized patterns significantly increase misunderstanding frequency, reduce perceived autonomy, and elevate stress. Emotional exhaustion was the most pronounced burnout dimension, particularly in sectors with high interpersonal demands. Findings highlight the mediating role of perceived control and confirm that communication quality is a central predictor of psychological well-being at work. The study contributes to organizational communication research by offering evidence-based recommendations for leadership communication training and structured communication protocols.

BackgroundUse of physical restraints in intensive care units (ICUs) creates ethical challenges for nurses and often causes moral distress as they balance patient safety with autonomy and dignity.Research aimTo explore Iranian ICU nurses' experiences of moral distress related to decisions about PR use.Research designAn exploratory qualitative approach was used.Participants and research contextTwenty Persian-speaking ICU nurses with at least two years' clinical experience were purposively recruited from hospitals affiliated with Shahid Beheshti University of Medical Sciences between September 10 and November 14, 2025. In-depth semi-structured interviews were audio-recorded, transcribed verbatim, and analyzed using Elo and Kyngäs's three-phase content analysis. Trustworthiness was ensured via Lincoln and Guba's criteria of credibility, dependability, confirmability, and transferability.Ethical considerationsApproved by the Medical Ethics and Law Research Center of Shahid Beheshti University of Medical Sciences (IR.SBMU.RETECH.REC.1404.397). Written informed consent and reconfirmed verbal consent were obtained.ResultsAnalysis generated 323 initial codes; 201 remained after refinement. Two principal categories emerged: (1) Moral suffering in clinical decision-making-ethical conflicts, negative emotions, consequences for the patient, and for nurses; and (2) Adaptation and efforts to reduce moral distress-contextual factors, coping strategies, and suggestions for reducing moral distress. Participants described emotional exhaustion, guilt, reduced motivation, and compromised quality of care. Key contributing factors included staff shortages, workload pressure, and unilateral physician orders. Coping strategies comprised peer support, temporary distancing from the situation, and spiritual or self-soothing practices. Suggestions for reducing moral distress emphasized education on restraint alternatives, clear clinical guidelines, and strengthened interprofessional decision-making.ConclusionMoral distress related to PR use among ICU nurses stems from tensions between patient safety and dignity and is shaped by organizational and contextual factors. While nurses described individual strategies to cope, organizational support, clearer guidance, and collaborative decision-making may reduce ethical burden. Further research should examine applicability in other clinical and cultural contexts.

How does emotional labor relate to emotional exhaustion among university counselors? the differential moderating roles of psychological detachment.

Burnout is a pervasive challenge among healthcare professionals in training, with significant implications for both well-being and quality of care. This qualitative study, using a phenomenological design, explored the experiences of nursing residents regarding sources of stress, coping strategies, and organisational challenges, and how these factors contribute to the development of burnout. Three focus groups were conducted with 24 nursing residents. Data were analysed using reflexive thematic analysis. Five themes were constructed: peer solidarity as a protective shield, navigating institutional abandonment, the crushing weight of unmanaged demands, the “lottery of learning,” and the sacrifice of personal identity. Participants described residency as a demanding and disorganised stage, characterised by heavy workloads, inconsistent educational opportunities, and scarce institutional support. These conditions fostered emotional exhaustion and frustration, but peer networks were identified as a crucial protective factor, providing informal learning, solidarity, and resilience. The findings highlight the need for organisational reform in residency programmes, including greater educational equity, improved leadership, and spaces for dialogue and mentoring. Recognising the role of peer support alongside institutional responsibility can contribute to building more humane, sustainable, and ethically grounded training environments.

Causation and Burnout Among Correctional Nurses

BackgroundStroke is a leading cause of death and long-term disability worldwide, with low-income and middle-income countries accounting for about 87% of stroke-related deaths and disability-adjusted life-years. Among poststroke complications, poststroke fatigue is a common but often under-recognised condition characterised by emotional, cognitive and physical exhaustion unrelated to exertion and not relieved by rest. Poststroke fatigue can hinder functional recovery, yet it remains underassessed in the study area. So this study investigates the prevalence, associated factors and impact of poststroke fatigue on self-efficacy and activities of daily living.MethodsA hospital-based cross-sectional study was conducted through a systematic random sampling technique on 370 study participants. The Fatigue Severity Scale, Nottingham Extended Activities of Daily Living and Stroke Self-efficacy Questionnaire were used to collect questionnaires related to fatigue and its impact. The data were analysed on SPSS using binary logistic regression to assess associated factors and ordinal logistic regression to assess impacts of fatigue on self-efficacy and activities of daily living.ResultFatigue was reported by 65.4% of participants (95% CI 60.30% to 70.20%) during the subacute and chronic rehabilitation phases. Older age, both overweight and underweight body mass index, National Institutes of Health Stroke Scale ≥12, lacked physiotherapy follow-up and experiencing depression were associated with poststroke fatigue with 95% CI and p<0.05. Moreover, individuals with poststroke fatigue were approximately 5.4 times less likely to report higher functional levels and 3.6 times less likely to demonstrate greater self-efficacy compared with those without fatigue.ConclusionsPoststroke fatigue is highly prevalent among stroke survivors and negatively impacts both self-efficacy and functional ability. These findings highlight the need for early identification and targeted management of fatigue to improve rehabilitation outcomes and quality of life in stroke survivors.

ABSTRACT This collaborative autoethnography explores the lived experiences of Heba Bashir, a certified prosthetist, orthotist, and physiotherapist working in the Gaza Strip amid ongoing conflict. Through reflective narratives and critical incident analyses, Heba reveals the emotional, ethical, and professional challenges faced in delivering prosthetic and orthotic care under extreme conditions. Themes of ethical dilemmas, emotional exhaustion, resilience, and balancing professional duties with personal and familial obligations emerge strongly. The study highlights critical gaps in the sustainability of humanitarian aid approaches related to prosthetic and orthotic services in Gaza and advocates for greater consideration of implementation realities. Heba’s story underscores the resilience of prosthetic, orthotic and rehabilitation professionals and the urgent need for sustained global support for trauma rehabilitation services in conflict-affected regions.