Shirom-Melamed Burnout Measure Research Articles

Can the different versions of the Shirom-Melamed Burnout Measure be used to measure burnout among healthcare professionals? A systematic review of psychometric properties

BackgroundThe prevalence of Occupational Burnout is high among healthcare professionals (HCP). Hence, it is crucial to have robust measures for ascertaining burnout in this population. The Shirom-Melamed Burnout Measure is a prevalent tool used in the diagnosis of burnout, and in the delivery planning of mental health services. The 14-item Shirom-Melamed Burnout Measure (SMBM) was developed after a methodological revision of the 22-item Shirom-Melamed Burnout Questionnaire (SMBQ). Studies on the psychometric properties of the SMBM and SMBQ exist, but there remains a need for thorough evaluation to assess the methodological quality of individual studies. To address this gap, this systematic review aimed to critically appraise the measurement properties of the different versions of the Shirom-Melamed Burnout Measure/Questionnaire (SMBM/Q) used among healthcare professionals.MethodologyFour databases (PubMed, CINAHL, PsychINFO, and Scopus) were searched for studies on the psychometric properties of all versions of the SMBM/Q among HCP. The methodological quality of the studies was evaluated using the COSMIN Risk of Bias checklist. Evidence supporting the measurement properties (EMP) of the SMBM was synthesized using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach.ResultsOur final pool consisted of five research articles. One study on the 12-item SMBM was included to estimate content validity, two studies reported on the 14-item SMBM, while the other two employed the 22-item version. Interestingly, each study used the SMBM in a different language, namely English/Hebrew, Chinese, French, Serbian, and Swedish. Structural validity, internal consistency, and construct validity are the SMBM’s most assessed measurement properties. The Hebrew and French versions demonstrated high levels of structural validity and internal consistency, and the remaining reports on validity demonstrated low levels due to methodological flaws.ConclusionsPer COSMIN guidelines, the SMBM should not be utilized for clinical purposes due to insufficient content validity, but has promising potential with ongoing research. Engaging critical stakeholders for concept elicitation will ensure the relevance, comprehensiveness, and comprehensibility of the PRO items. Likewise, establishing an MIC will allow capturing change over time, which will benefit longitudinal experimental studies.Plain English summaryOccupational burnout is a significant problem among healthcare professionals, and it is crucial to have a reliable tool to measure it. The Shirom-Melamed Burnout Measure (SMBM) is commonly used to diagnose burnout and plan mental health services. Studies on the psychometric properties of the SMBM exist, but there remains a need for thorough evaluation to assess the methodological quality of individual studies. To address this gap, this systematic review critically appraised the measurement properties of the different versions of the Shirom-Melamed Burnout Measure (SMBM) used among healthcare professionals. Our findings indicate that only a few studies have examined the SMBM, and they have used the tool in different languages. Structural validity, internal consistency, and construct validity are the SMBM’s most assessed measurement properties. We recommend that more research is needed to assess the content validity of the SMBM. We also suggest that critical stakeholders should be involved in the development of the SMBM to ensure that it is relevant, comprehensive, and understandable.

The Impact of Social Support on Burnout among Lecturers: A Systematic Literature Review.

Interest and concern regarding the social support and burnout of college lecturers have grown over the past decades. Maintaining good mental health is critical for university lecturers. Social support has been identified as an effective resource against burnout. However, few studies have comprehensively examined the connection between social support and burnout specifically among college lecturers. Therefore, this review aims to explore how social support influences the burnout of college lecturers. This study employed the systematic literature review (SLR) methodology. A thorough systematic review of 20 studies was conducted between 2015 and 2024, drawn from five major databases: Web of Science, Scopus, APA PsycINFO, PubMed, and Eric. The review indicates that burnout is measured through the Maslach Burnout Inventory, Maslach Burnout Inventory-Educators Survey (MBI-ES), Maslach Burnout Inventory-General Survey (MBI-GS), Burnout Syndrome Evaluation Questionnaire, Copenhagen Burnout Inventory (CBI), Shirom-Melamed Burnout Measure (SMBM), and the Oldenburg Burnout Inventory (OLBI). While social support is measured through the Multidimensional Scale of Perceived Social Support (MSPSS) and Perceived Organizational Support (SPOS) survey. Individual and occupational factors contribute to lecturers' burnout. This study reveals the association between social support and burnout among lecturers and it emphasizes the multifaceted role of social support in alleviating burnout among lecturers. The findings suggest that educational institutions should strengthen support systems and increase the emotional support available among lecturers to relieve burnout.

Preliminary evaluation of behavior technician burnout when working with boarded and traditional psychiatric inpatients diagnosed with developmental disabilities.

The COVID-19 pandemic has led to a youth mental health crisis, with research demonstrating an increased prevalence of depression, anxiety, and disruptive behavior in youth compared to pre-pandemic years. Consequently, the insurgence of emergency psychiatric evaluations has increased the demands for extended inpatient stay (or patient boarding) at various licensed treatment facilities. Questions remain about the extent of burnout being experienced by behavior technicians who are caring for these patients. The Shirom-Melamed Burnout Measure was used to evaluate symptoms of burnout of behavior technicians practicing at a specialized psychiatric inpatient unit. Comparisons were made for instances of caring for boarded (meeting criteria for discharge but unable to be discharged due to disposition) and traditional patients (short-term treatment). Behavior technicians caring for boarded patients reported significantly higher scores in overall stress, physical exhaustion, cognitive fatigue, and emotional exhaustion than those managing patients getting traditional care. Extensive burnout can have adverse impacts at both the personal level (staff well-being, individual staff-patient interactions) and clinic level (daily operations and service, general quality of care). Efforts need to be made to address this issue to prevent staff turnover.

Physical work environment and burnout among primary care physicians in Israel: a cross-sectional study

BackgroundPhysician burnout remains a prevalent issue globally, negatively affecting work satisfaction and patient care. However, exploration of the physical work environments of physicians, a potential influencing factor for burnout, remains scarce. The physical work environment is everything that surrounds the physician, including the doctor’s office, the clinic, the clinic’s building, the waiting, and staff rooms. The aims of this study were to describe aspects of the physical work environment of primary care physicians (PCPs) and to explore the association between the physical work environment and burnout.MethodsIn this cross-sectional study, we emailed questionnaires to an online community of PCPs in Israel in October 2021. We asked physicians about their satisfaction with their physical work environment, evaluated elements of the work environment, and assessed burnout status (with the Shirom-Melamed Burnout Measure, SMBM). We used the Chi-square and Mann-Witney tests to compare categorical and continuous variables and used logistic regression for the final model.ResultsTwo hundred twenty-one PCPs answered the questionnaire (27.6% response rate). Over a third (35.7%) of respondents reported high burnout. PCPs who were satisfied with their general physical environment had lower burnout rates than those who were unsatisfied (28.1% vs. 47.8%, p-value < 0.001). We found positive correlations between general satisfaction with the physical work environment and the scores achieved for the doctor’s office, the clinic, the clinic’s building, and the waiting room. In the multivariate analysis, high satisfaction with the general physical work environment was associated with decreased odds for burnout (OR-0.50, 95% CI 0.25–0.99, p-value-0.048).ConclusionThe doctor’s office, the clinic, the clinic’s building, and the waiting room affected general satisfaction from the physical work environment. High satisfaction with the physical work environment reduced burnout rates. Future studies are needed to determine whether PCPs and managers should invest in the physical work environment to decrease burnout and increase satisfaction.

Coach-athlete relationship and burnout symptoms among young elite athletes and the role of mental toughness as a moderator

Abstract: Introduction: Social and contextual factors play an important role for elite athletes’ mental health. In the present study, we examined how young elite athletes’ coach-athlete relationship appraisals are associated with and longitudinally predict general and athlete-specific burnout symptoms and whether mental toughness moderates the association between the coach-athlete relationship and burnout symptoms. Methods: In this prospective study, data were collected twice within a 6 to 10-month interval. The sample consisted of 295 athletes attending Swiss Olympic Partner Schools (186 boys, 109 girls), with a mean age of 16.73±1.38 years. The following instruments were applied: Coach-Athlete Relationship Questionnaire (CART-Q), Athlete Burnout Questionnaire (ABQ), Shirom-Melamed Burnout Measure (SMBM), and Mental Toughness Questionnaire (MTQ). Cross-lagged panel analyses were performed to examine reciprocal relationships across time. Interaction effects were tested via hierarchical regression analyses. Results: Cross-sectionally, athletes who perceived their coach-athlete relationship as negative reported more general and athlete-specific burnout symptoms. Burnout symptoms were relatively stable across time, which made it difficult to explain further variance via coach-athlete relationship appraisals in the prospective analyses. While higher mental toughness scores were associated with fewer burnout symptoms in the cross-sectional analyses, higher mental toughness did not moderate the association between the coach-athlete relationship and burnout symptoms. Conclusion: The coach-athlete relationship plays an important role in athletes’ mental health. Therefore, coaches need the ability to develop effective relationships with their athletes, including thoughtful and respectful communication about issues specific to sport and life generally.

Burnout in early year medical students: experiences, drivers and the perceived value of a reflection-based intervention

IntroductionAccording to the 11th Revision of the International Classification of Diseases, burnout is defined as a syndrome resulting from chronic work-related stress that has not been successfully managed. Burnout is increasingly prevalent amongst medical students and has been shown to lead to worsened academic engagement, feelings of inadequacy, poor mental health and increased risk of withdrawal from the course. The aim of this study was to explore the experience of burnout amongst early year medical students and evaluate the perceived impact of a reflection-based intervention on their awareness and experience of burnout.MethodsThe reflection-based intervention comprised two tutorials covering the presentation, drivers, impact and management strategies for burnout syndrome. These were introduced into the second-year medical curriculum at Imperial College London. As part of the reflection-based intervention, students were invited to complete an anonymous Qualtrics form three times during the academic year. This included the Shirom-Melamed Burnout Measure (SMBM) and a free-text question prompting the student to consider their stressors at the time of completing the intervention. The former is composed of 14-questions measuring the extent of feelings or behaviours suggestive of burnout, divided into three categories: physical fatigue, cognitive weariness and emotional exhaustion. At the end of the academic year, students were invited to participate in an online focus group to further explore their experience of burnout and their perceived value of the reflection-based intervention. Results of the SMBM were explored descriptively; free-text questions and the focus group transcript were analysed using inductive thematic analysis.ResultsA total of 59 submissions for the reflection-based intervention were analysed: 26 students participated and consented in the first round, 8 in the second and 25 in the third round. Overall median burnout scores were 4 (IQR 3–5), 2 (IQR 1–4) and 3 (IQR 2–5) in each round of the SMBM, respectively. A total of 8 (30.8%) met the threshold for severe burnout (≥ 4.4) in round 1 of the questionnaire, zero in the second round and 4 (16%) in the third round. Physical and cognitive fatigue showed higher median scores than emotional exhaustion in every round. Four students participated in the focus group, which had two sections. The first was reflecting on burnout in medical school and the intervention, which revealed four themes: (1) indicators of burnout (often insidious, but may involve lack of energy and motivation, or changes in perceived personality); (2) perceived drivers of burnout (perceived expectation that medical school is supposed to be challenging and consistent prioritisation of work over wellbeing); (3) working habits of medical students (unachievable self-expectations and feelings of guilt when not working); (4) value of the intervention (the teaching and reflection-based intervention prompted students to identify signs of burnout in themselves and consider management strategies). The second section included considerations for implementing burnout interventions into the medical school curriculum, which revealed three themes: (1) desire to learn about burnout (students hoped to gain insight into burnout and methods of prevention as part of their curriculum); (2) importance of community (group interventions and the involvement of Faculty helped students feel less isolated in their experiences); (3) feasibility of interventions (sustainable interventions are likely to be those that are efficient, such as using multiple-choice questions, and with allocated periods in their timetable).ConclusionSecond-year medical students demonstrated symptoms and signs of burnout, including exhaustion, lack of motivation and changes in personality. They also expressed a desire to gain greater awareness of burnout and insight into preventative strategies within the medical curriculum. Whilst certain drivers of burnout can be prevented by students themselves through adequate prevention strategies, many remain systemic issues which require curriculum-level change to be effectively addressed. The students found that the reflection-based intervention was effective at improving their perception of burnout and a convenient tool to use, which could be implemented more widely and continued longer-term throughout medical school.

Étude exploratoire de profils d’enseignants à risque de burnout : association avec les processus de coping et le sentiment d’auto-efficacité

IntroductionBurnout and its predictors are an increasingly important health issue in the teaching profession. ObjectiveThe present study aimed at identifying teacher profiles at risk of burnout, and to explore their associations with coping processes and sense of self-efficacy using a dual variable and person-centered approach. MethodA sample of 171 teachers (58.50% female) from a French-speaking canton of Switzerland completed the Shirom-Melamed Burnout Measure (i.e., physical fatigue, cognitive weariness, emotional exhaustion), the Teachers’ Sense of Efficacy Scale (i.e., instructional strategies, student engagement, classroom management) and the Coping Scale by Dewe (i.e., need to communicate, traditional style of teaching, problem-focused and avoidant coping). ResultsProblem-focused coping was the only variable that negatively predicted all three dimensions of burnout. Avoidant coping negatively predicted physical fatigue and cognitive weariness while classroom management self-efficacy negatively predicted emotional exhaustion. Additional findings suggested the moderating role of the number of students with special educational needs (SEN) in the relationship between some variables. Three profiles were identified based on a hierarchical cluster analysis. Multinomial logistic regression analysis showed that a higher number of students with SEN, as well as low levels of coping (i.e., problem-focused and avoidant) and sense of self-efficacy in classroom management were associated with a greater likelihood of belonging to the burnout risk profile (representing 21.64% of the total sample). ConclusionFindings from this study not only highlight a relatively large proportion of teachers at risk of burnout, but also a possible co-action of some coping processes and sense of self-efficacy.

Modeling the facets of burnout in Lisbon airport border officers using PLSc-SEM estimator

Border officers experience stressful moments during the working day at the border point at Lisbon airport (Portugal) that can lead to “emotional exhaustion,” which is the core component of burnout, and relates with “cognitive fatigue (weariness)” and “physical fatigue.” These theoretical concepts cannot be measured (or observed) directly by what are considered latent variables/constructs that are available in Shirom-Melamed Burnout Measure (SMBM). These constructs are, however, operationalized by the questions available in the SMBM, which correspond to observed variables (or manifest variables) expressed in an ordinal scale of seven categories. This questionnaire, reliable and internationally validated, was used in our research and considering the specialized literature, we proposed a hypothetical structural path model that expresses a priori perceptions about the causal relationships between the mentioned latent constructs, where “physical fatigue” is the target construct. A reflective model was estimated based on the sample of primary data and using a Variance-Covariance estimator of Structural Equations Modeling (VB-SEM), the consistent Partial Least Squares (PLSc), that corrects for bias to consistently estimate SEM’s with common factors. The results obtained allow a better understanding of the profile and characteristics of Portuguese border officers who work at Lisbon airport, as well as reveal that the latent exogenous construct “emotional exhaustion” has a high positive direct effect on the “cognitive fatigue,” and through this latter (mediator construct), an indirect effect on the endogenous construct “physical fatigue.” In turn, “cognitive fatigue” has the greatest positive direct effect on “physical fatigue.” The biggest difference identified was between the direct effect of “Emotional exhaustion” on “Physical fatigue,” which is higher for workers with more years of service, as expected. However, the multigroup analysis (using the nonparametric Permutation test) showed that this difference was not statistically significant.

Mental Health of Healthcare Professionals: Two Years of the COVID-19 Pandemic in Portugal.

The COVID-19 pandemic increased psychosocial risk factors among healthcare professionals (HCPs). Objective: To characterize Portuguese HCPs mental health (MH), estimate anxiety, depression, post-traumatic stress disorder (PTSD) and burnout symptoms, and identify risk/protective factors. A cross-sectional online survey and a longitudinal assessment were conducted in 2020 (T0) and 2021 (T1). Sociodemographic and occupational variables, COVID-19-related experiences and protective behavior data were collected from a non-probabilistic sample of HCPs in Portugal. Symptoms of anxiety, depression, PTSD, burnout and resilience were assessed using the Portuguese versions of the Generalized Anxiety Disorder Scale (GAD-7), the Patient Health Questionnaire (PHQ-9), the Post-traumatic Stress Disorder Checklist (PCL-5), the Shirom-Melamed Burnout Measure (MBSM) and the Connor-Davidson Resilience Scale (CD-RISC-10), respectively. Risk and protective factors were identified through simple and multiple logistic regression models. Overall, 2027 participants answered the survey in T0 and 1843 in T1. The percentage of moderate-to-severe symptoms decreased from T0 to T1; however, a considerable proportion of HCPs reported symptoms of distress in both years. Being a woman, working in a COVID-19-treatment frontline position and work-life balance increased the odds of distress. High resilience, good social/family support, and hobbies/lifestyle maintenance were found to be protective factors. Globally, our results show that performing as a HCP during the pandemic may result in long-term effects on MH.

Effect of patient COVID-19 vaccine hesitancy on hospital care team perceptions.

The coronavirus disease 2019 (COVID-19) pandemic posed new challenges in patient care worldwide. Vaccinations, which have proven efficacious in lowering the COVID-19 hospital burden, are still avoided by large populations. We, therefore, hypothesized that hospital care teams would have worse perceptions regarding the characteristics and care of patients with vaccine hesitancy. To evaluate whether patient vaccine hesitancy affected the hospital care team (HCT) perceptions. We performed a prospective clinical study using structured questionnaires. We approached physicians and nurses with previous experience caring for COVID-19 patients from 11 medical centers across Israel during the fourth COVID-19 surge (September and October 2021). The participants completed a questionnaire with the following parts: (1) Sociodemographic characteristics; (2) Assessment of anger (STAXI instrument) and chronic workplace stress (Shirom-Melamed burnout measure); and (3) Three tools to assess the effect of patient vaccine hesitancy on the HCT perceptions (the difficult doctor-patient relation questionnaire, the medical staff perception of patient's responsibility questionnaire and the characterological derogation questionnaire). Results were evaluated according to each part of the questionnaire and the questionnaire as a whole. Associations between HCT perceptions and their baseline characteristics, anger or chronic workplace stress were assessed. The HCT experienced their relationship with unvaccinated patients as more difficult (P < 0.001, Cohen's d = 0.85), perceived unvaccinated patients as responsible for their medical condition (P < 0.001, d = 1.39) and perceived vaccinated patients as having a higher character value (P < 0.001, d = 1.03). Unvaccinated patients were considered selfish (P < 0.001), less mature (P < 0.001) and less satisfying to care for (P < 0.001). The relationship with unvaccinated patients was more difficult among HCT with higher burnout (r = 0.37, n = 66, P = 0.002). No correlations with baseline characteristics were found. All three study tools showed high internal consistency (α between 0.72 and 0.845). Our results should raise awareness of the possible effects of vaccine hesitancy on HCT perceptions regarding unvaccinated patients. In order to minimize the potential negative impact on patient care, designated departments should promote specific patient-centered preparations. Further investigations should assess whether vaccine hesitancy directly affects patient quality of care.

A meta-analytic validation study of the Shirom-Melamed burnout measure: Examining variable relationships from a job demands-resources perspective.

Job-related burnout has become a central construct in occupational health psychology. Given the considerable emphasis on burnout in both basic research and organizational initiatives, affirming the validity of inferences from commonly used measures is imperative to explore this phenomenon. The Shirom-Melamed burnout measure (SMBM) is well grounded with strong theoretical roots stemming from conservation of resources theory to assess exhaustion across physical, cognitive, and emotional subscales. However, despite its strong theoretical foundation and consistent use to measure burnout across various disciplines, there have been no meta-analytic validation efforts of the SMBM. The goal of the present meta-analysis is to fill this gap and provide a comprehensive evaluation of the SMBM using 564 effect sizes retrieved from 100 samples (N = 53,484). Results revealed that the three subscales of physical fatigue, cognitive weariness, and emotional exhaustion all displayed strong intercorrelations and that the SMBM was stable over time, as suggested by high test-retest estimates. Relationships with demographic controls, such as age, sex, and hours worked, were low in magnitude or nonsignificant. Following a job demands-resources perspective, we examined the nomological network of the SMBM, finding strong support for associations with job and personal predictors, motivational covariates, and job and personal outcomes. These findings, inferring the construct validity of the SMBM, hold implications for future research and practice, including support for its use in organizational research and applied settings. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Stress, cognitive appraisal, and burnout in social workers of residential child care

Stress and burnout are global epidemics that may cause negative consequences for workers and organizations. Social workers of residential child care are especially at risk, due to the inherent characteristics of their work. Subsequently, this study aimed to analyse these professional’s stress, cognitive appraisal, and burnout. The sample included 92 social workers (90.2% female and 9.8% male) with ages between 25 and 64 years old (M = 38.08; SD = 7.91). The evaluation protocol included a sociodemographic questionnaire, the Stress Questionnaire for Health Professionals, the Primary and Secondary Cognitive Appraisal Scale, and the Shirom-Melamed Burnout Measure. Results indicated that 58% of professionals assumed high levels of general stress, and that physical fatigue and cognitive weariness were the burnout dimensions with higher values. The combination of sociodemographic variables, stress factors and cognitive appraisal were important to explain the burnout experience and can contribute to design interventions directed to these professionals.

Perceived recovery and stress states as predictors of depressive, burnout, and insomnia symptoms among adolescent elite athletes

Abstract: Introduction: Finding ways to efficiently monitor the balance between recovery and stress is one of the most frequent requests from coaches and athletes and probably one of the best ways to prevent maladaptive psychological and physiological states. Therefore, the purpose of the present study was to monitor recovery-stress states of adolescent elite athletes across an entire school year using the 32-item Acute Recovery and Stress Scale (ARSS), and to examine the predictive value of recovery and stress states for depressive symptoms, burnout symptoms, and insomnia symptoms. Methods: Data are based on a 10-month longitudinal observational study. The sample consisted of 135 adolescent elite athletes ( Mage=16.8 years) recruited from Swiss Olympic Partner Schools. The participants completed the ARSS 19 times (every second week), the Patient Health Questionnaire (PHQ-9), the Shirom-Melamed Burnout Measure (SMBM) and the Insomnia Severity Index (ISI) at baseline and follow-up. Results: Participants reported higher recovery than stress states across the entire school year. However, lower recovery and higher stress states significantly predicted mental health problems as indexed by depressive, burnout and insomnia symptoms. The predictive power of recovery and stress states was similar for depressive and burnout symptoms. For insomnia symptoms, only recovery state was a significant predictor. Conclusion: Our study highlights that a short psychometric instrument allows longitudinal monitoring of recovery-stress states. Coaches are encouraged to implement such an instrument to identify periods that are characterized by high stress and/or low recovery. Continuous monitoring may allow the timely implementation of prevention and intervention strategies in the training process.

Are Australian teachers burned-out or depressed? A confirmatory factor analytic study involving the Occupational Depression Inventory

ObjectiveThere is mounting evidence that burnout problematically overlaps with depression. However, the generalizability of this finding remains debated. This study examined the burnout-depression distinction based on a recently developed measure of work-attributed depressive symptoms—the Occupational Depression Inventory (ODI). MethodsWe relied on a sample of 891 Australian teachers. The ODI was employed to assess work-attributed depressive symptoms. The Shirom-Melamed Burnout Measure (SMBM) and the Oldenburg Burnout Inventory (OLBI) were employed to assess burnout symptoms. The SMBM assesses burnout as a syndrome combining physical fatigue, cognitive weariness, and emotional exhaustion. The OLBI assesses burnout as a syndrome of exhaustion and disengagement. ResultsConfirmatory factor analysis indicated that the factors underlying burnout's components correlated more highly with the Occupational Depression factor than with each other, calling into question the syndromal unity of burnout. Moreover, the factors underlying burnout's components and the Occupational Depression factor were reflective of a common higher-order factor. ConclusionsOur findings are consistent with the view that burnout symptoms are part of a depressive syndrome and do not reflect a unique or distinct entity. Conducted in the Australian context, this study strengthens the generalizability of the finding that burnout problematically overlaps with depression. Given the profound problems affecting the burnout construct, we recommend a paradigm shift from burnout to occupational depression. Such a shift raises the prospects of more reliably and validly assessing severity and prevalence of job-related distress and, consequently, of reaching more psychologically meaningful and productive conclusions regarding treatment, prevention, and public health decision-making.

Social Accountability of Medical Schools Toward Their Students

Social accountability refers to the role of institutions, including medical schools, as contributors to an evolving society. The COVID-19 pandemic and global health crisis have exacerbated challenges and difficulties of medical schools to adopt the social accountability paradigm. This exploratory study aims to identify weaknesses and demands of medical students during the COVID-19 pandemic with the intention of developing interventional, socially accountable educational programs. An online questionnaire was sent to medical students in year one to three for collecting data about students’ perception of preparedness to cope with sudden changes from in-person to online teaching due to COVID-19 measures. In addition, data about students’ well-being was collected according to the Shirom-Melamed Burnout Measure and the Connor-Davidson Resilience Scale. 221 of 376 students completed the questionnaire (58.7%). During the COVID-19 pandemic, most medical students kept up with new educational technologies and adjusted to online learning. However, most students suffered from poor time and learning management, poor quality of life and burnout. Data analysis on wellbeing variables showed: a) poor quality of life (52%); b) medium to high level of burnout (65.1%), with the highest number of students with burnout (70%) in third year; c) medium level (73.8%) to high level (23%) of resilience across all years. Our study indicates that medical schools need to be socially accountable towards their students and allocate additional resources into programs for the support of the cognitive and emotional needs of medical students, with the emphasis of improving students’ learning management and cognitive skills, and by doing so, reducing burnout and improving quality of life. Finally, social accountability should also include students’ wellbeing, in addition to activities related to patients, health system and society.

Otolaryngology Resident Wellness, Training, and Education in the Early Phase of the COVID-19 Pandemic.

To determine changes in the residency experience early in the COVID-19 pandemic and evaluate wellness measures among otolaryngology residents. A web-based survey was administered to U.S. otolaryngology residents. Responses to the Shirom-Melamed Burnout Measure (SMBM) and the Generalized Anxiety Disorder-7 scale were recorded along with data on burnout, demographics, wellness, sleep, training, and education. 119 U.S. otolaryngology residents representing 27 of 42 states with otolaryngology residency programs responded to the survey. 24.4% (95% CI 17.0-31.8%) self-reported some level of burnout, while 10.9% met SMBM criteria for "clinically relevant" burnout. 51.3% experienced more stress, and 58.8% reported more anxiety during the COVID-19 pandemic. Compared to males, females had a higher prevalence of burnout (38.9% vs 12.3%, P = .001) and anxiety (75.9% vs 43.8%, P < .001). PGY-2s had a greater mean SMBM index (3.64) and higher rates of self-reported burnout (54.2%) than their counterparts at other levels of training. Residents reported less time spent in the hospital, lower surgical volume, and less procedural independence. Educational didactics, primarily via videoconference, were more frequent for 63.9% of respondents. While burnout among otolaryngology residents was low early in the COVID-19 pandemic, likely due to separation from the workplace environment, trainees had higher levels of anxiety and stress. The surgical experience was negatively impacted by the pandemic, but remote didactics and educational opportunities increased. These findings may inform otolaryngology residency programs on the need to promote resident wellness and aid in devising strategies to improve the educational experience during this unique global health crisis as well as in the long term.

Strategie zvládání stresu vyučujícími v základních školách

The paper is focused on the coping strategies used by elementary school teachers to handle stress. The aim is to find out what the prevalence of positive, negative and neutral coping strategies is and if they correlate with burnout syndrome. The typology of coping strategies was developed by Janke and Erdmann (2003) and use in the measurement SVF78. The positive coping changes the source of stress, while the negative coping helps just to overcome negative emotions without any change of stressor; the neutral coping can work in both ways. The study consists of survey, including SVF78 and Shirom-Melamed Burnout Measure (n = 2394), and of interviews (n = 59). The analysis shows that teachers report preference of positive coping over negative coping. The most frequent strategy was Substitutional satisfaction (37%), other three positive coping strategies were used by one quarter teachers. The burnout syndrome correlates with coping, especially negative coping. The correlation between burnout syndrome and positive coping was weaker but still statistically significant.

Do Low Self-Esteem and High Stress Lead to Burnout Among Health-Care Workers? Evidence From a Tertiary Hospital in Bangalore, India.

BackgroundLow self-esteem can be an issue among health-care workers due to the hierarchical medical system. Health-care workers are also in a high pressure environment that can lead to stress and burnout. This study was conducted to estimate the proportion of health-care workers with low self-esteem, high stress, and burnout and the factors associated with these in a private hospital in Bangalore city.MethodsThis cross-sectional study included a random sample of health-care workers of various cadres – doctors, nurses, nursing aides, technicians, and workers in ancillary departments such as laundry, dietary, central sterile supply department, and pharmacy, with probability proportional to size. Rosenberg Scale for Self-esteem, Cohen's Perceived Stress Scale, and Shirom–Melamed Burnout Measure were used as study tools.ResultsAmong the 306 health-care workers, there were high levels of low self-esteem (48.4%), stress (38.6%), and burnout (48.7%), with the lowest levels being among doctors. Those aged younger than 30 years had significantly lower self-esteem and greater stress.ConclusionsHealth-care workers with low self-esteem were nearly thrice more likely to suffer high stress, Odds Ratio (OR) = 2.84 (1.36–5.92), and those who were stressed had more than three times higher chance of experiencing burnout, OR = 3.6 (2.02–6.55). Path analysis showed that low self-esteem among health-care workers had a direct effect on burnout, as well as an indirect effect through stress (mediator variable). This study indicates the need for screening and counseling for low self-esteem, stress, and burnout as part of a periodic medical examination of all cadres of health workers.

Burnout, but not job strain, is associated with irritable bowel syndrome in working adults

ObjectiveAlthough stress is an important component of irritable bowel syndrome (IBS) pathophysiology, the possibility that work-related stress is implicated in the pathophysiology of IBS has not been widely studied. This study aimed to examine whether job strain (a combination of high job demands and low control at work) and/or burnout, the outcome of a gradual depletion of energetic resources resulting from chronic exposure to work-related stress, are associated with IBS. MethodsFifty-five patients fulfilling the Rome III criteria for IBS and 214 matched healthy controls (HC) participated in this cross-sectional study. All participants completed a job strain measure, the Shirom - Melamed Burnout Measure (SMBM), and dietary and health questionnaires. ResultsThere was no significant difference in the prevalence of job strain between IBS patients and HC (25.5% vs. 23.0%, respectively). Job strain was not associated with increased IBS prevalence (adjusted OR = 1.99, 95% CI: 0.54–7.33). In contrast, the mean burnout score in the IBS group was significantly higher than in HC (2.9 ± 1.1 vs. 2.1 ± 0.8, p < .001). Burnout was associated with a 2.41-fold elevated prevalence of IBS (95% CI: 1.16–5.02), after adjusting for potential confounding variables including job strain. Moreover, the odds of having IBS increased in patients with a high burnout level (adjusted OR = 3.3, 95% CI:1.09–10.03). ConclusionBurnout, but not job strain, is associated with the prevalence of IBS in working adults.

Do burnout and depressive symptoms form a single syndrome? Confirmatory factor analysis and exploratory structural equation modeling bifactor analysis

ObjectiveThe issue of burnout-depression overlap remains contentious. In this study, the question of whether burnout symptoms form a syndrome that is distinct from depression was reexamined. MethodsThe study involved 332 employed individuals (65% female; mean age: 34). Burnout symptoms were assessed with the Shirom-Melamed Burnout Measure (SMBM). The SMBM operationalizes burnout based on three interconnected components, namely, physical fatigue, cognitive weariness, and emotional exhaustion. Depressive symptoms were assessed with the PHQ-9, a scale that covers the main manifestations of major depression. Confirmatory factor analysis (CFA) and exploratory structural equation modeling (ESEM) bifactor analysis were conducted. ResultsOn average, the factors underlying burnout's components correlated more strongly with the Depressive Symptom factor than with each other. Remarkably, such results were obtained even when fatigue-related items were excluded from the depression scale. Second-order CFA revealed that the factors underlying burnout's components and the Depressive Symptom factor were reflective of the same higher-order factor. ESEM bifactor analysis indicated that the general factor accounted for about 2/3 of the common variance extracted. ConclusionConsistent with a growing corpus of research, this study suggests that the burnout-depression distinction is untenable. Because the burnout-depression distinction tends to convey the idea that burnout is not as serious a problem as depression, many people struggling with depression might underestimate the gravity of their condition and not seek help when self-identifying as “burned out.” Maintaining a line of demarcation between burnout and depression may thus be problematic from both a scientific and a health management standpoint.