High Levels Of Exhaustion Research Articles

Parental burnout and coparental cooperation in Chile during lockdown for COVID-19

Under usual circumstances, without a global pandemic, numerous parents might encounter stress associated with their roles as caregivers. However, with the added impact of the health crisis and the widespread adoption of lockdown measures, family routines were disrupted as many parents found themselves spending more time at home. Most caregivers had to juggle remote work while simultaneously providing care for their children. This situation has raised concerns about the potential for parental burnout. The objective of this study was to describe parental burnout in mothers and fathers during the COVID-19 lockdowns in Chile and analyze its relationship with possible risk factors such as days in quarantine, perceived impact of COVID-19 on parenting, hours dedicated to weekly paid work, and caregivers’ perception of the need for care of their children. Furthermore, we sought to describe the relationship between parental burnout and coparental cooperation, evaluating the latter as a possible protective factor. An online cross-sectional survey design was used. The sample consisted of 599 people (78.5% mothers) over 18 years old who live in Chile with at least one child. Through a quantitative methodology and using R, multiple regression models were performed with predictive modeling to contrast the hypotheses. The results indicate that the variables related to lockdown, such as days in quarantine and level of involvement of fathers and mothers in parenting due to the pandemic, predict parental burnout. Caregivers’ perception of the need for care of their children also has a significant impact on this phenomenon. In addition, mothers have higher levels of exhaustion than fathers. The number of hours of paid work does not predict parental burnout. Coparenting cooperation in this context can represent a protective factor against chronic stress.

Burnout and attachment in oncology and palliative care healthcare professionals

ObjectivesExamine the prevalence of burn-out in health professionals working in a hospital dedicated to patients with cancer. Explore the relationship between attachment style and burn-out in healthcare professionals working in...

The Validity of the EuroQol Health and Wellbeing Short Version (EQ-HWB-S) Instrument in Parents of Children With and Without Health Conditions.

The EuroQol Health and Wellbeing Short Version (EQ-HWB-S) instrument has been developed to measure the health and wellbeing of care-recipients and their caregivers for use in economic evaluation.The EQ-HWB-S has nine items, and pilot UK preference weights have now been developed. We aimed to investigate the validity of the instrument in parents of children with and without health conditions. EQ-HWB-S data were sourced from an Australian paediatric multi-instrument comparison study. We analysed the baseline characteristics and response distribution of the EQ-HWB-S items. Assessment of known-group validity was conducted for EQ-HWB-S items, level sum-scores and preference-weighted scores, including partial effects. Known-group analyses included three child health variables and where caregivers reported coronavirus disease 2019 (COVID-19) had impacted their wellbeing. We included analyses across gender, controlled for child and parent demographic variables, and compared scores across child health conditions. Item responses were distributed as expected, with higher skew for mobility and activities. Parents experienced high levels of exhaustion. We detected significant differences between groups for level sum-scores and preference-weighted scores, as hypothesised; all tests were significant (p < 0.001), with moderate effect sizes (effect sizes were slightly higher for female than male parents). The regression analysis identified significantly different EQ-HWB-S scores for child health samples compared with the general population after controlling for demographic variables. Differences were observed between child health conditions. The EQ-HWB-S is a useful instrument to measure parent quality of life for economic evaluation in this population. Data were limited to one time point; further research should investigate the instrument's sensitivity to change and test-retest reliability in this population.

The lived experiences of nurse preceptors in training new nurses in Qatar: qualitative study

BackgroundThe role of preceptors is vital in the successful integration of new graduate nurses in hospital settings. This study aimed to explore the experiences of nurse preceptors in training newly joined nurses in Qatar.MethodsQualitative study was conducted between May 2022 and May 2023. Online semi-structured interviews were conducted through MS Teams with 13 nurse preceptors who had completed preceptorship training and trained at least one newly joined nurse. Participants were recruited until data saturation was obtained and data were analyzed using qualitative thematic analysis.ResultsThe results of the study revealed several main themes: teaching strategies and progressive skill development in preceptorship, challenges faced by the preceptor and preceptor better supported in training new nurses. The preceptors utilized different techniques to support new nurses including demonstration, discussion, use of technology, application of real-life clinical scenarios, simulations, and a gradual decrease in supervision to promote independence. However, a significant challenge was also reported including preceptors experienced high levels of exhaustion from the dual responsibilities of training new staff while also performing their regular care duties.ConclusionsThe study underscores the fundamental role preceptors play in the training and development of newly joined nurses. While the challenges are considerable, particularly related to managing workload, the sense of achievement following the successful completion of training a new nurse suggests a strong commitment to this role. Despite the challenges, preceptors demonstrated innovative strategies to ensure the successful development of their preceptees, highlighting the importance of preceptorship in nursing education and practice.

Does Educational Status Influence Parents' Response to Bad News in the NICU?

Communication in neonatal intensive care units and the relationship between families and staff have been reported to influence parental mental well-being. Research has also shown an impact of parental educational level on their well-being. However, whether different educational levels result in different reactions to breaking bad news (BBN) by physicians remains unanswered so far. We therefore examined the impact of parental level of education on their mental state after a BBN conversation and their relation to physicians. A prospective quantitative survey was conducted amongst 54 parents whose preterm or term infants were hospitalized in three German neonatal units. Parental education was classified as low (lower secondary/less (1), n: 23) or high (higher secondary/more (2), n: 31). Parents answered questions about certain aspects of and their mental state after BBN and their trust in physicians. The two groups did not differ significantly in their mental condition after BBN, with both reporting high levels of exhaustion and worries, each (median (min;max): (1): 16 (6;20) vs. (2): 14 (5;20), (scaling: 5-20)). However, lower-educated parents reported a lower trust in physicians (median (min;max): (1): 2 (0;9) vs. (2): 1 (0;6), p < 0.05 (scaling: 0-10)) and felt less safe during BBN (median (min;max): (1): 15 (9;35) vs. (2): 13 (9;33), p < 0.05). Only among higher-educated parents was trust in physicians significantly correlated with the safety and orientation provided during BBN (r: 0.583, p < 0.05, r: 0.584, p < 0.01). Concurrently, only among less-educated parents was safety correlated with the hope conveyed during BBN (r: 0.763, p < 0.01). Therefore, in BBN discussions with less-educated parents, physicians should focus more on giving them hope to promote safety.

Burnout and quality of life in Portuguese healthcare professionals working in oncology and palliative care—a preliminary study

BackgroundPalliative care is an approach that improves the quality of life of patients and their families who are facing challenges associated with life-threatening illness, through the prevention and relief of suffering. Palliative care health professionals are considered a risk group for the development of burnout, since they live with severe disease and death, on a daily basis. With this work, the authors intend to evaluate the quality of life and risk of burnout in a group of health professionals, who work in a tertiary hospital dedicated to cancer patients.Material and methodsThe authors conducted a quantitative, descriptive, correlational and transversal study on palliative care professionals working with cancer patients. The evaluation protocol used to collect data included a sociodemographic questionnaire, WHO Quality of life Assessment instrument and Maslach Burnout Inventory. Statistical analysis was performed using the SPSS®Statistics program.ResultsIn the sample, there is a predominance of female gender (79,4%) with a mean age of 43,2 ± 10,8 years. The most representative professional group was nursing (47,1%). The sample response rate was 91.9%. Analyzing Maslach Burnout Inventory score, it appears that physicians and nurses have higher levels of exhaustion when compared to the other groups. In relation to quality of life (QoL), it was observed that in all dimensions, there was a homogeneous distribution of responses. It was verified that it was not possible to establish any relationship between the dimensions of burnout and QoL. Thus, the various dimensions behaved independently.DiscussionPhysicians and nurses had the highest burnout levels in the most dimensions of Burnout score, in which they were followed by the operational assistants, who had moderate scores. Despite hight prevalence of Burnout, there is no correlation between Burnout and quality of life in this population. The perception of QoL is very satisfactory in the sample studied may result from the fact that these individuals have developed adequate self-protection strategies, thus preventing QoL from being affected by Burnout.ConclusionPrevention, diagnosis and intervention at burnout level is an important measure to be taken in health organizations, since the consequences that come from the experiences experienced by professionals will be reflected both in the quality of services provided to patients and in the QoL and well-being of professionals. Interventions are needed to promote better coping mechanisms when dealing with stress in this population. After this study, a Burnout Consultation was created at the Institution, to support professionals at risk or already affected.

The Prevalence of the Burnout Syndrome and Factors Associated in the Students of Dentistry in Integral Clinic: A Cross-Sectional Study.

Burnout syndrome (BS) is composed of three interrelated dimensions (emotional exhaustion, depersonalization, and personal fulfillment), and it has been documented that it affects health professionals from an early age. Determine the prevalence of BS and associated factors in the integral clinic of the Dentistry Pilot School. Material and Methods. Two instruments were applied: (1) Maslach Burnout Inventory, which measures the degree of professional burnout through 22 items that describe the professional's attitudes and feelings toward work, as well as symptoms associated with this phenomenon; (2) the second questionnaire determines the possible symptoms of BS and consists of 14 questions that describe tiredness, sleep problems, digestive problems, respiratory problems and headaches, temporomandibular joint (TMJ), neck pain, back pain, and upper and lower extremity pain. The instruments were answered anonymously by a total of 300 students who participated in the study. The emotional exhaustion of the participants was 48.3% at a higher level, the depersonalization was 46.7% at a higher level, and the low perception of personal fulfillment was 73%. In addition, it was shown that BS is significantly related to marital status (p < 0.001∗), with single people reporting being more exhausted, with the 6-month level (p = 0.011) and with the following symptoms: non-neck pain, head, TMJ, back, waist, upper and lower body pain. It was found that the BS had a prevalence of high levels of exhaustion and depersonalization correlated with the marital status and level of preparation (academic degree) of the person, finding a prevalence of symptoms such as pain in the neck, head, TMJ, and back.

Modeling Pathways to Describe How Maternal Health Care Providers' Mental Health Influences the Provision of Respectful Maternity Care in Malawi.

Maternal health (MH) providers may experience traumatic events, such as maternal or fetal death, that can contribute to stress and burnout. Past trauma, poor working relationships, and under-resourced environments not only affect providers' own emotional well-being but also reduce their ability to provide respectful maternity care (RMC). Data were collected in mid-2021 as a cross-sectional survey with 302 MH providers working in 25 maternities in 3 districts in Malawi to measure burnout, depression, and post-traumatic stress disorder (PTSD). We present a pathway model describing how these factors interact and influence RMC. We used the provider-reported person-centered maternity care scale to measure RMC; the Maslach Burnout Inventory, which examines emotional exhaustion, depersonalization, and professional accomplishment; and standard validated screening tools to measure the prevalence of depression and PTSD. Although levels of burnout varied, 30% of MH providers reported high levels of exhaustion, feelings of cynicism manifesting as depersonalization toward their clients (17%), and low levels of professional accomplishment (42%). Moderate to severe depression (9%) and suicidal ideation within the past 2 weeks (10%) were also recorded. Many (70%) reported experiencing an event that could trigger PTSD, and 12% reported at least 4 of 5 symptoms in the PTSD scale. Path analysis suggests that depression and emotional exhaustion negatively influence RMC, and depersonalization is mediated through depression. PTSD has no direct effect on RMC, but increased PTSD scores were associated with increased burnout and depression scores. Positive relationships with facility managers were significantly associated with increased RMC and decreased emotional exhaustion and depersonalization. Burnout will continue to be a challenge among MH providers. However, pragmatic approaches for improving teamwork, psychosocial, and managerial support for MH providers working in challenging environments may help mitigate burnout, improve MH provider well-being, and, in turn, RMC for women seeking MH services.

Analysis of Risk of Burn Out at Workers in the Field ff Social Services and Health Care

Aim. The aim of the research was to analyse the burnout rate of these social workers and nurses, as well as to determine the relationship between burnout syndrome and other important factors, including lifestyle, stress, resistance to stress and other selected demographic indicators. Methods. The Maslach Burnout Inventory was used to collect burnout data in 2021 during the second wave of the Covid-19 pandemic. The research sample consisted of 623 women aged 35-55 who work in social services facilities for the elderly and nurses working in the geriatrics department at a hospital in the western part of Slovakia. Results. Research has shown that lifestyle has a significant impact on the development of burnout syndrome in connection with the quality of work and personal relationships, which can help eliminate feelings of frustration, exhaustion and personal failure in the workplace. Burnout affects social workers regardless of age and education, but with older age and length of practice in the same facility, the risk of manifestations of burnout increases. Significant differences in burnout rates between social workers and nurses in the individual dimensions of exhaustion, depersonalisation and professional attitudes were confirmed. High levels of exhaustion have even shown an increased risk of alcohol consumption among these workers. Conclusion. The development of chronic stress in health care workers can put them at risk of burnout, which is characterized by emotional exhaustion (EE), depersonalization (DP) in interactions with patients and social clients, and low levels of personal accomplishment (PA) in social work and health care.

Emotional Exhaustion and Engagement in Higher Education Students during a Crisis, Lessons Learned from COVID-19 Experience in Italian Universities

Italian university students face an uncertain future characterised by a competitive neoliberal academic environment with high demands and a weak labour market that often cannot hire those who are best qualified. The COVID-19 pandemic has exacerbated students’ uncertainty and negatively affected their well-being. The purpose of this study is to explore perceptions of academic life during the pandemic and to examine the relationship between study load, reduced academic performance, internet addiction, academic self-efficacy, and engagement and emotional exhaustion. A sample of university students (N = 10,298) from 11 Italian universities completed a self-report questionnaire about their academic and personal lives between May and June 2021. We performed two multiple linear regressions and one ANOVA to highlight gender differences. Results indicate that female students reported lower levels of engagement and academic self-efficacy, and higher levels of exhaustion and study demands compared to male students, while older students generally appear to exhibit higher levels of well-being. Study load, reduced academic performance, and internet addiction showed a negative association with engagement, particularly the first two, and a positive association with exhaustion, while self-efficacy was positively associated with engagement and negatively associated with exhaustion. The results suggest the need to introduce additional forms of support, such as psychological support, internet addiction awareness courses or counseling services.

Burnout and optimism among health workers during the period of COVID-19

Aim: The investigation of the level of burnout and optimism as well as the effect of socio-demographic and other factors on the above two variables among health workers during the period of covid-19. Methods: The following two psychometric tools were used to collect the research data: the Maslach Burnout Inventory to assess burnout and the Revised Life Orientation Test (LOT-R) to assess the level of optimism. Results: In the present study 10 men (24.4%) and 31 women (75.6%) participated. The majority of them were between 36-45 years (36.6%), married and unmarried (48.8% and 48.8% respectively), holding bachelor degree (61.0%) and with 11-25 years of work experience (53.7%). Very high levels of exhaustion and especially emotional exhaustion and depersonalization were observed with also a high degree of personal achievement. The levels of optimism were high. There were statistically significant differences between the two genders in terms of burnout (only the dimension of emotional exhaustion) with women showing higher rates. Employees aged 25-35 years and those who had 1-10 years of work seemed to have higher levels of emotional exhaustion (all differences were considered statistically significant for p&lt;0.05). Finally, a statistically significant correlation took place between burnout and optimism (p&lt;0.05). Conclusions: The level of burnout among health workers seems to be high during the period of covid-19. In addition, various socio-demographic and occupational factors appear to influence burnout.

Fear of making a mistake: a prominent cause of stress for COVID-19 ICU staff—a mixed-methods study

IntroductionThe COVID-19 pandemic has had a profound effect on many domains of healthcare. Even in high-income countries such as Sweden, the number of patients has vastly outnumbered the resources in...

Prevalencia y factores asociados al síndrome de burnout y engagement en estudiantes de ciencias de la salud en una universidad pública (2019)

ObjectiveTo estimate the prevalence and factors associated with burnout syndrome and engagement in health sciences students at a public university in the different semesters of their career. MethodsA cross-sectional study was carried out and included university students of health sciences. A stratified random sampling with proportional allocation was carried out. A descriptive analysis was carried out calculating frequencies, proportions and percentages, as well as measures of central tendency. The proportions of burnout and engagement were estimated with their corresponding 95% Confidence Interval (95% CI). For the bivariate analysis, the Chi2 test was performed and a p value <0.05 was considered statistically significant. Results314 students were included (220 undergraduate and 94 graduate) with a mean age of 25±5 years (18-48 years), 112 were men (35.7%) and 202 women (64.3%). The presence of burnout was detected in 26 students (8.3%, 95% CI 5.2-11.4%). 73.9% presented high levels of exhaustion. A lower percentage of classification between high, medium-high and very high was found in those with a job (p=0.02); and greater evidence of exhaustion (high and very high) in the medicine and postgraduate programs (p=0.01). There were no significant differences for the cynicism subscale. In the engagement evaluation, 29.4% presented high levels in the three subscales, 56.2% medium levels and 14.4% low levels. In the vigor subscale, there was a lower percentage of classification between low and very low in graduate students (p=0.01), along with similar values in high and very high. In the absorption subscale, there was a lower percentage of classification between high and very high in graduate students (p=0.04). ConclusionsThere was a low prevalence of burnout and a high prevalence of engagement in our population (total, undergraduate and graduate). However, a large proportion of students are at risk due to high levels of exhaustion. It is necessary to employ measures to reduce the levels of burnout and exhaustion, and to promote engagement, as well as to increase the investigation of the syndrome in university students.

Burnout status, occupational satisfaction, and intention to leave the profession of nurses during the COVID-19 pandemic period; The Case of Turkey

We examined the burnout status, professional satisfaction and intention to leave the profession of nurses who are actively working in Turkey during the COVID-19 pandemic period. We conducted the descriptive study with 371 nurses and collected using Copenhagen Burnout Scale (CBS), Occupational satisfaction scale (OSS) and Intention to leave the profession scale (ILPS). In this study, nurses showed a high level of exhaustion and intention to leave work, and a low level of occupational satisfaction. In the fight against COVID-19, the continuity of health services, at the same time, in order to provide adequate quality and safe health care, reducing working hours, bringing the shifts to an appropriate and reasonable time, improving the working environment and approaches that will increase their motivation and professional satisfaction are important to prevent nurses from experiencing burnout and to keep them in their professions and workplaces.

Acute effects of a 60-min time trial on power-related parameters in trained endurance runners

BackgroundThe advent of power meters for running has raised the interest of athletes and coaches in new ways of assessing changes in running performance. The aim of this study is to determine the changes in power-related variables during and after a strenuous endurance running time trial.MethodsTwenty-one healthy male endurance runners, with a personal record of 37.2 ± 1.2 min in a 10-km race, completed a 1-h run on a motorized treadmill trying to cover as much distance as they could. Before and after the time trial the athletes were asked to perform a 3-min run at 12 km h−1. Normalized mean power output, step frequency, form power and running effectiveness were calculated using the Stryd™ power meter. Heart rate (HR) and rating of perceived exertion (RPE) were monitored, and data averaged every 5 min.ResultsDespite high levels of exhaustion were reached during the time trial (HRpeak = 176.5 ± 9.8 bpm; RPE = 19.2 ± 0.8), the repeated measures ANOVA resulted in no significant differences (p ≥ 0.05), between each pair of periods for any of the power-related variables. The pairwise comparison (T test) between the non-fatigued and fatigued constant 3-min runs showed an increase in step frequency (p = 0.012) and a decrease in form power (p < 0.001) under fatigue conditions, with no meaningful changes in normalized mean power output and running effectiveness.ConclusionsTrained athletes are able to maintain power output and running effectiveness during a high demanding extended run. However, they preferred to reduce the intensity of vertical impacts under fatigue conditions by increasing their step frequency.

Did Personality Type Influence Burn Out Syndrome Manifestations During Covid-19 Pandemic?

IntroductionEmergency department (ED) health care providers had one of the highest incidences of burnout just before the pandemic. Personality type influences the way we communicate and relate to others, as well as our reaction to stress. In evaluating the causes of burnout, we take into account several factors, the most important of which being the conditions of the professional environment, interpersonal relationships and personality traits. This study aims to identify and analyze the relationships between personality traits and burnout syndrome in medical staff in the Emergency Department.Material and MethodsA descriptive, multicenter cross-sectional study project was used to collect data from 60 physicians and nurses from the Emergency Department of the County Emergency Clinical Hospital Galati. The tools used, distributed to participants to collect socio-demographic details, included the Eysenck Personality Inventory (EPI), and a pilot questionnaire. The questionnaire consisted of 11 questions, concerning exhaustion level, and focused on stress-generating elements and emotional management in the Emergency Department during the pandemic.ResultsA large percentage of doctors in ED (45.8%) (n = 24) indicated a high level of exhaustion, while only 30.6% (n = 36) of nurses indicated a high level of exhaustion. Physicians displayed a higher level of stress than nurses, with 66.6% (n = 24) of physicians indicating an increased level of stress, compared to only 36.1% (n = 36) of nurses. A large percentage of nurses indicated a high level of depression (36.1%), whereas only 25% of Emergency Department physicians indicated a high level of depression.DiscussionThe individuals with a melancholic and choleric temperament, as rated by the EPI, appeared more susceptible to developing burnout syndrome. The indication of instability or neuroticism appears to enhance the occurrence of burnout syndrome. There was also a correlation between extraversion and a high level of burnout, with extraverted individuals more easily reaching a high level of burnout.ConclusionThe results indicate a greater occurrence of exhaustion and stress in Emergency Department physicians compared to nurses in the Emergency Department. From the results, we can propose that there is a relationship between the personality traits as measured by the EPI and the occurrence of burnout syndrome. These findings may help to understand the vulnerability of medical staff to burnout, and to pre-emptively support them to deal effectively with stressors in the work environment.

Determination of the Relationship between Stress and Burnout Levels in Nurses in the Covid-19 Pandemic

Objectives: This research was conducted as a descriptive cross-sectional study to determine the perceived stress and burnout levels of nurses in the Covid-19 pandemic. Methodology: The universe of the research consists of 140 nurses working in the pandemic service and intensive care units of a city hospital. No sample calculation was made in the study, and all nurses who agreed to participate in the study were included in the sample. Number of nurses participating in the present study was 121 and the participation rate in the study was 86.42%. The data were collected between 01-31 May 2020 and the study was completed between 3 May and 30 July 2020. The data were collected from the participants using a personal information form, Maslach Burnout Inventory and Perceived Stress Scale. Results: When the burnout score averages of the nurses were evaluated in the study, emotional high levels of exhaustion, depersonalization and personal achievement and nurses experienced severe emotional exhaustion. The mean score of the perceived stress scale of the nurses participating in the study was 32.96±4.76. In this study, a positive and moderately significant relationship was found between perceived stress and burnout level. Conclusions: It was found as a result of the present study that nurses perceived stress and burnout levels were also high in the Covid-19 pandemic. It is important to measure the stress and burnout among nurses because their well-being has effects on the stability of the health work force and the quality of care provided.

Síndrome de Burnout em Profissionais de Saúde Angolanos durante a Pandemia da Covid-19

Introduction According to the World Health Organization, "Burnout syndrome occurs due to chronic stress in the workplace” and includes physical and psychological symptoms. The current COVID-19 pandemic has created an overload of work for health professionals worldwide, sometimes exceeding their capacities and even leading to suicide. Angola is a developing country and its health system is still fragile, for this reason the pandemic could have a serious impact. In March the first cases of COVID-19 were registered and their incidence progressively increased. Objective To determine the prevalence of Burnout Syndrome in Health Professionals who assisted suspected and confirmed cases with COVID-19 in Angola, between May and September 2020. Methodology An observational, descriptive and transversal study was carried out with 250 professionals (196 from Luanda and 54 from Benguela) who work in health institutions that care suspected and confirmed cases with COVID-19. The Maslach Burnout Inventory (MBI-HSS) was applied, which includes three subscales: emotional exhaustion or fatigue, depersonalization and personal fulfillment. High levels of the first two and low levels of the third are indicative of the situation. The professionals' sociodemographic information was also obtained. Results It was found that 60% of participants were female, mean age 35 years, with a predominance of nurses (50%). Professionals from Luanda assisted an average of 61 patients per week while those from Benguela assisted 12. The average score on the three behavior subscales was high in both genders and provinces, with significantly higher values of emotional fatigue in women and greater personal fulfillment among professionals in Luanda. Burnout Syndrome was diagnosed in 9.3% of professionals in Luanda and 4.6% in Benguela, with no statistical differences found between women and men (6.2 vs 4.5) Conclusions Despite the low frequency of Burnout syndrome and the fact that there are high levels of exhaustion and depersonalization at the beginning of the pandemic, it leads to believe that there will be an increase in the number of cases of Burnout due to a greater demand for work, triggered by the worsening of the pandemic. This finding should be taken into account by health system managers to safeguard the well-being of their professionals and patients, namely Work shifts with shorter periods; Integration of more professionals in understaffed service teams; encouraging breaks throughout the day; Adequate food/ nutrients according to the time of day; creation of social support programs; encouragement to practice physical exercises and relaxation; monthly payment of COVID-19 epidemiological risk subsidies; Personal Protective Equipment; greater availability of drugs and materials for clinical monitoring of critically ill patients; presence of a physician specialized in intensive care in each work shift; as psychological support. Keywords: Burnout syndrome, health professionals, COVID-19, occupational health, Angola

'Never waste a crisis': a commentary on the COVID-19 pandemic as a driver for innovation in maternity care.

The coronavirus (COVID-19) pandemic has resulted in rapid changes in many areas of health care worldwide.1 Some organisational and governance controls on innovation have been relaxed, to enable rapid adaptation to changing circumstances. The speed of innovation raises a range of ethical, governance and organisational issues. It is important to assess what changes have been instituted, which ones should be maintained, and how to encourage effective innovations in future.

The slippery slope of parental exhaustion: A process model of parental burnout

The goal of this research was to investigate the developmental process of parental burnout by testing whether there were systematic prospective relations between the dimensions of parental burnout as measured with the Parental Burnout Inventory (PBI). We investigated this question in two cross-lagged three-wave longitudinal studies with French- and English-speaking parents (N1 = 918, 78.8% mothers, Mage_mothers = 39.38, Mage_fathers = 43.02; N2 = 822, 59.2% mothers, Mage_mothers = 38.68, Mage_fathers = 38.02). High levels of exhaustion were found to predict increases in emotional distancing and feelings of inefficacy, which then mutually reinforce. Since emotional distancing elicits the most damaging consequences of parental burnout for children (i.e., parental neglect and violence), the current study suggests that prevention efforts will be most beneficial in the exhaustion phase of parental burnout.