Paramedical Professionals Research Articles

Prevalence and associated factors to Post-Traumatic Stress Disorder (PTSD) and Social Anxiety Disorder (SAD) among health workers in the emergency room

Introductionpost-traumatic stress disorder (PTSD) is a mental health illness that can develop after being exposed to one or more traumatic events. This is a serious, long-term emotional response to extreme psychological trauma. As for public health emergencies, it demands large-scale coordination among many staff, and participants, especially medical workers, are exposed to high levels of stress, which can easily lead to psychiatric illnesses such as social anxiety disorder (SAD). Posttraumatic stress disorder (PTSD) and social anxiety disorder (SAD) demonstrate a high degree of comorbidity, yet little is known regarding the nature of this relationship.ObjectivesThe aim of this study is to investigate the prevalence of PTSD and SAD among health workers in the emergency ward and study the relationship between PTSD and SAD and the associated factors to both disorders among health workers in the emergency ward to suggest some solutions to reduce their effects.MethodsThis is a quantitative descriptive cross-sectional study conducted among medical and paramedical health professionals in the emergency rooms of the university hospital of Sahloul and Hached and the regional hospital of Msaken in Tunisia. The data was collected by a questionnaire that included demographic questions and Yes/No questions, as well as several scales to assess the degree of social nxiety (Liebowitz Social Anxiety Scale) and posttraumatic stress disorder (Post-traumatic stress disorder checklist for DSM-5 (PCL-5)).ResultsIn our study, 81 healthcare workers completed the survey. Of the total responding participants 67.9% were females. We noticed that the example was young (58%), also 59.3% had <1 year of experience. The population was slightly predominated by paramedical staff (56.8%), it also had a low married percentage of 38.3. Among the participants 17.3% smoke tobacco, 12.3% drink alcohol, and 3.7% are under cannabis use. We found that 7.4% of the participants had a psychiatric illness. In our study, 38% scored positive for PTSD and for SAD 13.58% had marked social anxiety, 12.35% had severe social anxiety and 3.7% had very severe social anxiety, this is associated rather with the female gender, the younger (age range 20-30 years) and the paramedical staff.PTSD and SAD are more pronounced among those with the fewest years of experience.We obtained a positive Pearson Correlation between PTSD and SAD (r=0.513).ConclusionsPosttraumatic stress disorder (PTSD) and social anxiety disorder (SAD) demonstrate a high degree of comorbidity, especially in the healthcare field. Overall, researchers reveal that the link between PTSD and SAD is complicated, owing to a variety of factors such as a person’s genes, trauma history, and psychological vulnerabilities so large-scale epidemiological investigations are required.Disclosure of InterestNone Declared

Biomedical Waste Management: An Assessment of Knowledge, Attitude and Practice among Healthcare Workers in Tertiary Care Hospital, Chhattisgarh

In the current scenario, medical concern is fundamental for everyone’s existence in addition to well-being, but the waste produced as of healthcare facilities signifies an actual concern in our surroundings. One of the healthcare workers (HCWs) most crucial duties is to handle biomedical waste (BMW) created in a healthcare institution properly since inappropriate management of BMW not only puts both individuals and the environment at risk but might also lead to lawful act opposed to healthcare workers and hospital authority. Current research plan is intended to assess biomedical waste management in a tertiary care hospital in Raipur, Chhattisgarh. A facility-based cross-sectional observational study was conducted at Dr. Bhimrao Ambedkar Memorial Hospital, Raipur; Chhattisgarh from July 2021 to August 2021. Assessment of knowledge, attitude, and observation was done by interviewing 105 healthcare workers, selected by simple random sampling, using a predesigned, semi-structured questionnaire. The analysis revealed that medical staff had good knowledge, attitude and practice of biomedical waste management than the paramedical professionals or non-medical workers. There is an imperative need for orientation training to protect themselves, and citizens visiting this healthcare facility and close by communities.

The impact of legal and organizational regulations on the nutritional behavior of patients-consumers of spa treatment services in Poland.

Health resort treatment facilities, regardless of the ownership status (public, private), most often carry out their activities based on contracts with the Polish public payer of the health care system, therefore the operation of sanatoriums is a fully-fledged element of the health care system, such as inpatient treatment, outpatient treatment and basic health care. The system designed in this way is designed to improve the organization of benefits, including by incorporating new useful organizational and legal tools. Thus, health education, along with its nutritional aspect, which is its inseparable part, is a perfect example of how to positively influence the behavior of consumers of spa treatment services. The structure of the study included the desk research method related to the consolidation and processing of information on applicable legal regulations and an individual in-depth, structured interview, using an original interview scenario. Based on the deliberate selection of the sample, 14 interviews were conducted. The interlocutors were representatives of the management of spa treatment facilities, academics and representatives of non-governmental organizations. The interview included functional and organizational, financial, competence and substantive aspects related to the implementation of nutritional education in spa treatment facilities in Poland. The use of a structured interview with experts made it possible to present the area of health education, including nutrition, in a broad light of the knowledge and experience of health care practitioners and theorists. Opinions were obtained on the optimal methods of assessing the effectiveness of education in the conditions of spa treatment and a set of system and organizational recommendations. Reporting of the results was presented using the COREQ checklist. It is justified to consider broadly understood health education in spa treatment facilities as a kind of wholesome health service, which may constitute effective systemic support for health policy and, consequently, increase the importance of prophylaxis and improve the health condition of the population. Such a legislative change will force organizational changes that may ultimately lead to a change in eating habits. Moreover, it is highly useful to use the potential of paramedical professionals, including dieticians, health educators and health promotion specialists.

The Evolution of Effort-Reward Imbalance in Workers during the COVID-19 Pandemic in France-An Observational Study in More than 8000 Workers.

(1) Background: The effects of lockdown repetition on work-related stress, expressed through Effort-Reward Imbalance (ERI), during the COVID-19 pandemic are poorly documented. We investigated the effect of repetitive lockdowns on the ERI in French workers, its difference across occupations, and the change in its influencing factors across time. (2) Methods: Participants were included in a prospective cross-sectional observational study from 30 March 2020 to 28 May 2021. The primary outcome was the ERI score (visual analog scale). The ERI score of the population was examined via Generalized Estimating Equations. For each period, the factors influencing ERI were studied by multivariate linear regression. (3) Results: In 8121 participants, the ERI score decreased in the first 2 lockdowns (53.2 ± 0.3, p < 0.001; 50.5 ± 0.7, p < 0.001) and after lockdown 2 (54.8 ± 0.8, p = 0.004) compared with the pre-pandemic period (59 ± 0.4). ERI was higher in medical than in paramedical professionals in the pre-pandemic and the first 2 lockdowns. Higher workloads were associated with better ERI scores. (4) Conclusions: In a large French sample, Effort-Reward Imbalance worsened during the COVID-19 pandemic until the end of the 2nd lockdown. Paramedical professionals experienced a higher burden of stress compared with medical professionals.

Burden of illness of aromatic L-amino acid decarboxylase deficiency: a survey of physicians in Southern Europe

Background Aromatic L-amino acid decarboxylase deficiency (AADCd) is an ultra-rare genetic neurometabolic disorder caused by mutations in the DDC gene. Objective This retrospective, noninterventional study was designed to describe the burden of AADCd including the associated healthcare resource utilization in Southern Europe. Methods Eleven clinicians completed a patient case study survey for patients with AADCd currently or previously under their care, followed by an interview with each clinician to assess healthcare resource utilization, patient characteristics, and symptoms. Results Clinicians provided data for 20 patients with AADCd, of whom 60% were male. All patients experienced movement disorders, 90% exhibited developmental delay, 85% reported sleeping problems, and 80% experienced gastrointestinal problems. The symptoms varied with disease severity. Patients with AADCd received care from more than 16 different specialists including both medical and paramedical healthcare professionals. Hospitalizations and visits to accident and emergency departments were also frequent. Conclusion In terms of symptoms and healthcare resource utilization, the burden of illness of AADCd is substantial. This study provides insights into several aspects of the disease that are difficult to ascertain from published case reports.

Studying SARS-CoV-2 vaccine hesitancy among health professionals in Tunisia

BackgroundPeople's lives were seriously affected by the emergence and the spread of the COVID-19 disease. Several vaccines were developed in record time to overcome this pandemic. However, putting an end to this public health problem requires substantial vaccination coverage rate. This latter depends on the acceptance of these vaccines especially by health professionals; the leaders of the current war against COVID-19. In fact, they have a central role in promoting vaccination against the SARS-CoV-2. In the developed countries, hesitancy rates towards these vaccines among health professionals vary from 4.3% to 72%. In the developing countries, few studies focused on this issue.ObjectiveTo estimate the prevalence and the predictors of SARS-CoV-2 vaccine hesitancy among the Tunisian health professionals.MethodsA cross-sectional study was led online between the 7th and the 21th of January 2021 among Tunisian health professionals. At least 460 participants were required. Snowball sampling method served to recruit participants. Data were collected using a pre-established and pre-tested questionnaire recorded in a free Google form. The link of the questionnaire was disseminated online to be self-administered anonymously to the participants. The generated online Google Sheet was uploaded and exported to SPSS software for analysis.ResultsOf the 546 responses, 493 were retained. The mean age of participants was 37.4 (± 9.5) years. Females represented 70.2% of participants. Social media represented the most frequently used source of information about COVID-19. The prevalence of SARS-CoV-2 vaccine hesitancy among participants was 51.9% (95% CI: 47.5–56.3)). Female sex, working far from the capital and having concerns about the vaccines components predicted more hesitancy among participants. In contrast, the use of the national COVID-19 information website predicted less hesitancy among them.ConclusionsThe current Tunisian communication plan about COVID-19 vaccines must be reinforced. Social media represent a cost effective communication channel that can serve to reassure Tunisian health professionals regarding the safety of COVID-19 vaccines. Special interest should be paid to females, paramedical professionals and those working far from the capital.

Digital systems to support emergency medical service : AGermany-wide cross-sectional survey on current availability, utilization and existing challenges

Increasing requirements for documentation, cross-sectoral communication and quality management are leading to increased organizational effort in emergency medical services (EMS). On the one hand, the use of digital information systems in prehospital settings can help to support emergency physicians and paramedics in these tasks and on the other hand, it opens new treatment options such as telemedical care for patients. This work attempts to provide acomprehensive picture of the current use of digital systems for ambulance services in Germany. To do so, the study investigated how widespread various information and communication systems currently are at local EMS stations and ambulances, how they are used by emergency personnel, how they are assessed by users and what challenges currently exist for further expansion and greater acceptance of the users. The cross-sectional study was conducted as anationwide, exploratory online survey among emergency physicians and paramedic professionals in July and August 2020 covering 24different questions. Participation was called for on the Internet, at EMS stations and in hospital emergency departments. Subsequent data analysis was performed using descriptive statistical methods. Solutions considered included digital documentation and hospital prenotification, interdisciplinary care capacity notification, real-time telehealth services and digital radio units. In total, 821 responses of participants from 481 different EMS stations from 382 cities nationwide were included in the evaluation. The availability of the 16systems surveyed varies significantly throughout Germany, depending on the federal state and application. While basic equipment such as radio units or navigation devices are available on almost all surveyed ambulances, the share which has real-time telehealth applications at their disposal is just 6%. Aproportion of 72% reported the usage of any type of digital documentation and 41% used adigital tool for prenotification of emergency rooms in at least one hospital. The emergency staff surveyed were generally open to new technologies and resulting possibilities, such as having an electronic patient care record or transmitting patient data digitally to emergency room. Almost all participants see abenefit in the use of information technology in ambulance service, although slightly more than half considered current implementation as unsatisfactory. Challenges are particularly evident with regard to reliability, hardware, useability and interoperability with third parties, such as dispatch centres and hospitals. Although information technology systems in German EMS are no longer in their infancy, there is still along way to go before prehospital emergency care can be considered as extensively and adequately digitalized. Amore holistic perspective and networked implementation of all systems and processes involved in emergency response operations can help improve and further spread digital solutions for prehospital emergency care. Incorporating field experience into the development process could contribute to increasing functionality and user acceptance.

Surprising outcomes of general internal medicine care versus specialty care in acutely admitted medical patients

Biomedical knowledge, resulting in better treatment for patients, is accumulating at a breathtaking pace. As these developments occur, in some situations medicine gets increasingly complex, requiring highly specific and multifaceted infrastructure and demanding skills of medical and paramedical professionals. One of the responses of the medical professionals is increasing specialization, that is not only widely present in internal medicine, but in virtually all medical specialisms [1]. Moreover, as medicine is getting more and more complex and (bio)technology-driven, it is seeing a considerable increase in subspecialization [2].

Knowledge Hiding in Emergency Ambulance Healthcare Settings: Its Mediating Role in the Relationship between Organizational Support and Affective Commitment and Organizational Citizenship Behaviours

Knowledge hiding—an intentional attempt to withhold or conceal knowledge from others—has been reported by recent studies to be a negative phenomenon in the workplace. Considering the importance of knowledge for organizational performance, this study intends to advance understanding by investigating the mediating role of knowledge hiding on the relationship between perceived organizational support and affective commitment as predictors and organizational citizenship behaviors and turnover intentions as outcomes. Using a cross-sectional design, the study was conducted in emergency ambulance healthcare settings on 305 medical or paramedical professionals. As indicated by structural equation modeling results, perceived organizational support and affective commitment positively predicted organizational citizenship behaviors but negatively predicted turnover intentions. Also, knowledge hiding was negatively associated with perceived organizational support, affective commitment, and organizational citizenship behaviors and positively with turnover intentions. Moreover, knowledge hiding mediated the relationship between perceived organizational support and affective commitment as predictors and organizational citizenship behaviors, respectively turnover intentions, as dependent variables.

Rehabilitation and lumbar surgery: the French recommendations for clinical practice.

Indications and techniques of rehabilitation differ widely across types of lumbar surgery, including timing (before or after surgery) and prescriptions (surgeons but also medical or paramedical professionals). This project aimed to build consensual recommendations for practice in this context. The SOFMER methodology was used to establish recommendations for physical medicine and rehabilitation: a steering committee defined the types of lumbar surgery involved and developed the main questions to be addressed; a scientific committee performed a literature review for grading evidence and proposed the first version of recommendations, which were discussed during a dedicated session at the national Physical and Rehabilitation Medicine congress; then an e-Delphi method with cross-professional experts was used to finalise recommendations and reach a multidisciplinary consensus. The main questions developed were the value of rehabilitation before and after surgery, timing and type of rehabilitation, benefit of supervision and instrumental rehabilitation, value of patient education, and complementary interventions concerning rehabilitation for discectomy, fusion, and disc prosthesis (excluding decompression for spinal stenosis). The literature review identified 60 articles, but for several of the questions, no article in the literature addressed the issue. The multidisciplinary scientific committee analysed the literature and addressed the questions to propose the first version of a set of 23 recommendations. The congress session failed to answer all questions or to reach consensus for all items. After a three-step e-Delphi, 20 recommendations were retained, for which consensus among experts was reached. The recommendations are applicable only to patients without a neurological lesion. These recommendations provide important and consensual knowledge to assist clinicians in decision-making for rehabilitation in lumbar surgery. Despite many of the recommendations relying exclusively on expert opinion rather than published evidence, this approach is an important advance to improve concordance among healthcare professionals.

Representations of Research among Newly Graduated Paramedical Professionals: A Qualitative Study.

Despite a keen interest in clinical research, most paramedical professionals are unwilling to play an active role. Our objective was to explore paramedical professionals’ representations of research. Using an existing database of final year paramedical students (speech therapy, occupational therapy, psychomotricity, audiometry, physiotherapy, orthoptics), we deployed a qualitative approach composed of two successive steps: (1) a free word association task, and (2) semi-structured individual interviews. Out of the 54 students who agreed to be contacted, we received 21 responses to the free word association questionnaire, and 11 interviews were conducted. The hierarchical evocation matrix revealed that the scientific representation of research is based on words defining the research and the purpose of the research. “Collaboration” was identified as being an essential part of the research process. The central core of the representation is coherent with all its components perceived as positive. The content analysis of the interviews showed a polarization around two key points: (1) participants are interested in accessing and using evidence in their practice (2) but feel less confident about and/or motivated to generate evidence themselves. This study highlights the need to develop more research-friendly environments, especially in training institutions.

Coronavirus disease 2019 (COVID-19) vaccination uptake among healthcare workers.

To assess reasons for noncompliance with COVID-19 vaccination among healthcare workers (HCWs). Cohort observational and surveillance study. Sheba Medical Center, a 1,600-bed tertiary-care medical center in Israel. The study included 10,888 HCWs including all employees, students, and volunteers. The BNT162b2 mRNA COVID-19 vaccine was offered to all HCWs of the hospital. Noncompliance was assessed, and pre-rollout and post-rollout surveys were conducted. Data regarding uptake of the vaccine as well as demographic data and compliance with prior influenza vaccination were collected, and 2 surveys were distributed. The survey before the rollout pertained to the intention to receive the vaccine, and the survey after the rollout pertained to all unvaccinated HCWs regarding causes of hesitancy. In the pre-rollout survey, 1,673 (47%) of 3,563 HCWs declared their intent to receive the vaccine. Overall, 8,108 (79%) HCWs received the COVID-19 vaccine within 40 days of rollout. In a multivariate logistic regression model, the factors that were significant predictors of vaccine uptake were male sex, age 40-59 years, occupation (paramedical professionals and doctors), high socioeconomic level, and compliance with flu vaccine. Among 425 unvaccinated HCWs who answered the second survey, the most common cause for hesitancy was the risk during pregnancy (31%). Although vaccine uptake among HCWs was higher than expected, relatively low uptake was observed among young women and those from lower socioeconomic levels and educational backgrounds. Concerns regarding vaccine safety during pregnancy were common and more data about vaccine safety, especially during pregnancy, might improve compliance.

Association of dowry practices with perceived marital life and intimate partner violence

Objective: To understand the perceptions of women about the influence of dowry customs on their marital life and on intimate partner violence (IPV) in a marriage. Method: This was a cross-sectional study on married women of reproductive age in Karachi, Pakistan between 2008 and 2009. Data was collected through a reliable questionnaire developed by World Health Organization, which was validated at local context and has been translated in to Urdu and then back translated in to English. Results: This study found that women whose marriages were decided conditionally on the provision of dowry to the groom’s family reported it to have had a positive impact on marital life (aOR: 11.5). Consenting to a marriage was positively associated with positive marital life (aOR: 36.8), as was the case when the marriage was contingent on dowry to be given to the groom’s family (aOR: 10.4). Provision of a dowry was not protective from physical (aOR: 3.7), sexual (aOR: 3.7), or psychological violence (aOR: 8.9). Conclusion: Dowry practices exist in Pakistani culture, despite the fact that dowry wives experience IPV. However, women perceive that the provision of dowry to groom’s family has a positive impact on marital life. In the immediate future, to protect women in and entering into marriage, there should be a strengthening of women’s organizations to provide legal, social and medical supports to women in need as well as the training of medical and paramedical professionals to recognize and respond to IPV. Continuous...

Psychosocial Impact and Role of Resilience on Healthcare Workers during COVID-19 Pandemic

Italy was the first European country to be affected by the 2019 coronavirus epidemic (COVID-19). Several studies have shown the risk of developing depression, anxiety, and post-traumatic stress disorder in medical and paramedical staff. Causes included the high contagiousness of the virus, the fear of contracting it, the lack of adequate personal protective equipment, and physical and psychological fatigue. In this context, resilience represents a protective factor against adversity and stress burden. The aim of this research was to investigate if and how the resilience and personality profile is able to influence the response to stress and anxiety on a sample of Italian healthcare workers, during the COVID-19 outbreak. The sample consisted of 152 frontline healthcare workers, physicians, and paramedical professionals. Participants completed the online questionnaire measuring the Resilience Scale for Adults, the Big Five Inventory-10 Item, the State Anxiety Inventory, and the Perceived Stress Scale. Analyses of data aimed to show differences in the stress of healthcare workers due to gender and professional role, and at finding, by means of multidimensional scaling, the relations among anxiety, stress, resilience, and traits of personality. The findings gave some suggestions for implementing strategies useful to increase the resilience in healthcare workers and support them to cope with stressful events, typical of the pandemic emergency.

A STUDY OF AWARENESS OF CPCR AMONG POSTGRADUATE STUDENTS IN A TERTIARY HEALTHCARE CENTER OF WESTERN INDIA

INTRODUCTION: Cardiac arrest is an emergency situation in and outside hospital setup carrying high risk of mortality. But if early Cardio Pulmonary Cerebral Resuscitation (CPCR) is initiated, the survival rate can be improved. Therefore, the awareness and knowledge of CPCR in medical and paramedical professionals is an important factor deciding the outcome of CPCR and survival rate. MATERIALS AND METHODS: A cross sectional, questionnaire based study was conducted by assessing 10 questions each regarding awareness of CPCR and basic knowledge of practical skills of CPCR in all Postgraduate (PG) students of a medical college cum tertiary hospital. After applying exclusion criteria, the study was conducted in 233 PG students.The results were analyzed using an answer key based on 2015 guidelines of American Heart Association (AHA) for CPCR. RESULTS: 50.64% students secured &gt;60% marks, while 38.20% and11.16% students secured 40-60% and &lt;40% marks respectively in knowledge based questionnaire. 26.18% of students were familiar with the use of Automated External Debrillator (AED). All PG students (almost 100%) who participated in the study were interested in learning CPCR. Students who received previous CPCR training were17.16%. CONCLUSION: Though the knowledge score was excellent (&gt;60%) in 50% of the study population, it was not adequate. Training of CPCR should be emphasizedmore as PG students are at the forefront of the tertiary level of health care system.

Dépistage des troubles visuels à l’âge scolaire : les données du projet pilote PlanVue®

To assess the prevalence of visual disturbances among school-aged children in prioritized education zones in France. The PlanVue® pilot project was designed to detect and manage visual disturbances in school-aged children in the prioritized education areas of the city of Nanterre, France. During this pilot study, a cohort of 515 children aged 4 to 13 years underwent a school vision screening between January and March 2019, consisting of an overall evaluation of the child's visual behavior, measurement of uncorrected visual acuity in each eye, objective refraction with a photoscreener and strabismus screening. If the examination was abnormal as determined by impaired vision or an algorithm based on the abnormalities found, the children were referred to an ophthalmologist. Decreased visual acuity was found in 20% of school-aged children. Out of the 515 children screened, 22% were referred to an ophthalmologist. Among these children, 13% were diagnosed with amblyopia, 73% with spherical ametropia, 57% with astigmatism and 2% with strabismus. Of the entire population screened, 12% of the children needed optical correction but had not received glasses. This study confirms the high prevalence of uncorrected refractive errors among school-age children. A screening program carried out in a school environment by paramedical professionals might make it possible to considerably reduce the rate of uncorrected visual disorders and their consequences.

Information Seeking Behavior of Para Medical Professionals of Odisha, India: A Study

Information Seeking Behavior of Para Medical Professionals of Odisha, India: A Study

The Role of Educational Theory in the Future Development of Paramedicine as a Profession: An Integrative Review

Introduction Paramedicine is at a critical juncture in its history as a healthcare profession. The evolution of paramedic practice in Australia over recent decades has culminated in its inclusion as a nationally registered, accredited, healthcare profession, while similar development is also occurring worldwide. Although paramedic education has developed over time, it is now the moment to determine whether existing educational approaches can adequately support its ongoing evolution as a profession. This article shares findings of a systematic, integrative review of characteristics of professions, allied health education and paramedic education literature. Methods Due to too little current research on approaches to paramedic education, the review aimed to distil essential requirements of professional education in general, and paramedic education in particular. This distillation served as an initial point of comparison with existing educational approaches in paramedicine. Literature was iteratively searched using PubMed, ScienceDirect and EBSCOhost megafile ultimate search engines, and was complemented with manual searches via professional networks, reference searches and Google Scholar. Results The literature review highlighted consistent themes relevant to paramedic education such as, the socio-political definition of a profession, methods for the identification of a profession, paramedicine as a distinct healthcare profession and the contemporary paramedic education framework. Conclusion Based on findings from this integrative review, we conclude that there is a potential misalignment between existing paramedic curricula and the educational scaffolding required to develop practicing paramedic professionals. We recommend further investigation of this potential misalignment as part of conceptualising an effective, quality, educational framework that is fit-for-purpose.

Burn-out of the Medical Oncology Health Care Professionals and Associated Factors in Tunisia

Introduction: Burn-out is defined as a syndrome of emotional exhaustion, depersonalization and diminished self-achievement that affects individuals exposed to chronic occupational stress. Physicians and caregivers faced with the death of their patients, such as oncology, are particularly vulnerable to this syndrome.Objectives: To evaluate the burn-out of medical professionals in medical oncology, to research the predisposing factors and to analyze the functional complaints and the behavior of the staff associated with this syndrome.Methods: A descriptive and analytical cross-sectional study among medical oncology professionals practicing in public hospitals in the Tunisian territory who exercise more than two years in oncology; with the Maslach Burnout Inventory (MBI).Results: Our study population was predominantly female (81%). 53% are doctors and 47% are paramedical health care professionals. A high degree of emotional exhaustion, depersonalization and personal achievement were found in 63%, 53% and 59% in our population, respectively. With 21% global high burn-out. The female sex was associated with high emotional exhaustion and low personal accomplishment as well as global burn-out. This burn-out was attributed to factors associated with working conditions and professional climate, mainly: overwork, poor organization of service, lack of resources and time, lack of recognition, lack of communication, lack of respect, conflicts with colleagues, report unsatisfactory salary effort and aggressions by patients and their families. Functional complaints and health care professional’s behavior associated with burn-out were: feelings of sadness, blockage, and irritability, sleep disorders, unexplained pain, epigastralgia, addictive behaviors, psychotropic consumption, suicidal thoughts, decreased performance and desire for a job transfer.Conclusions: By its impact on professionals, burn-out in medical oncology represents a major threat to the quality of health care. Its etiologies, although complex and intricate, are well known. Its prevention and its support are possible, but involve mobilization at all levels.

Rôle de l’IDE en urologie fonctionnelle

The management of patients in functional urology is complex and requires the expertise of the medical team but also of the nurse team. The aim of this article is to detail the roles of the nurses in functional urology. Exchanges with the nurses of our unit, analysis of the literature using the terms "nurse", "urology", "urodynamics" in the PubMed search engine, and a search for regulatory texts relating to the practice of nurses in urology units were conducted. Since the creation of the Inter-University Diploma of Nurse Expert in Urology in 2002and the inter-professional cooperation protocols in 2009, the urologist can rely on the specific skills of nurses to optimise the patient's management: from endoscopic or urodynamic explorations, to stomatherapy or sexology, from therapeutic education to specialised treatments such as posterior tibial nerve stimulation, sacral neuromodulation or botulinum toxin injections. Their expertise is an undeniable asset in the patient support and for the quality of care. The cooperation protocols respond to the current problems of the healthcare system: attractiveness for paramedical professionals, medical demographics and ambulatory care. The increasingly frequent practice of multidisciplinary consultation meetings also gives them a coordinating role. Nurses in functional urology plays a major role in diagnostic and therapeutic management as the patient's privileged contact and collaborator with the referring urologist.