Physicians’ Burnout: Can We Make a Difference?

IntroductionBurnout is a commonly observed syndrome in healthcare workers and it has been defined as a psychological condition involving a continuous exposure to stressful work events leading to adverse consequences both in physical and mental health. Persistent pressure can lead to exhaustion, psychological and/or physical distress and may increase the risk of medical errors and decrease job satisfaction, which incites early retirement.ObjectiveThe authors pretend to make a brief review regarding Physicians’ burnout, its prevention and management.AimsTo understand and to be capable of dealing with physicians’ burnout.MethodsThe review was based in papers published on PubMed using the following terms: “burnout”, “risk factors”, “healthcare professionals” and “physicians coaching”.ResultsTwenty-five to 60% of physicians report burnout across all specialties. Changes in the healthcare environment have created marked and growing external pressures. Numerous studies suggest that the difficulty that physicians face with balancing their personal and professional lives is a major contributor to distress. To reduce stress at work, one should consider two levels of intervention: the individual and the environmental. Multidisciplinary actions that include changes in the work environmental factors along with stress management programs that teach people how to cope better with stressful events showed promising solutions to manage burnout.Discussions/conclusionsBurnout among physicians is a common and serious issue with potentially devastating personal and professional consequences. More interventional research is needed in order to improve psychological well-being, professional career enjoyment as well as the quality of care provided to patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Sources of Stability and Instability in Rural Thai Society

The Journal of Asian Studies ◽

10.2307/2051579 ◽

1968 ◽

Vol 27 (4) ◽

pp. 777-790 ◽

Cited By ~ 8

Author(s):

Steven Piker

Keyword(s):

Well Being ◽

Complete Reduction ◽

External Pressures ◽

Stability And Instability ◽

The Social ◽

The Face ◽

Social Arrangements ◽

The Individual ◽

High Degree ◽

Social Level

Ongoing cultures, by virtue of the personalities they produce and the social arrangements they embody, create tensions or strains for their individual members; and they provide as well for the institutionalized expression and alleviation, if not complete reduction, of these tensions in culturally approved channels. In this view, cultural stability refers not to the absence of persisting conflict on the individual or social level; but rather to a high degree of complementarity between institutionalized sources of strain or conflict for the individual, and institutionalized arrangements for tension reduction or expression. This conception of stability does not assume that all relatively stable cultures are equally productive of psychological well-being, even assuming this nebulous condition could be specified. Nor does it assert that all stable cultures are equally adaptive in the face of external pressures. It does imply, however, that sources of conflict and channels for its expression will be sufficiently balanced to insure perpetuation of culturally standardized social arrangements and beliefs over many generations.

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Musculoskeletal Injury History Is Associated With Lower Physical and Mental Health in a Historical Cohort of Former National Football League Players

Journal of Sport Rehabilitation ◽

10.1123/jsr.2020-0231 ◽

2020 ◽

pp. 1-8

Author(s):

Zachary Y. Kerr ◽

Julianna Prim ◽

J.D. DeFreese ◽

Leah C. Thomas ◽

Janet E. Simon ◽

...

Keyword(s):

Mental Health ◽

National Football League ◽

Short Form ◽

Well Being ◽

Musculoskeletal Injury ◽

Musculoskeletal Injuries ◽

Physical And Mental Health ◽

Historical Cohort ◽

Professional Career ◽

Management Interventions

Context: Little research has examined health-related quality of life in former National Football League (NFL) players. Objective: Examine the association of musculoskeletal injury history and current self-reported physical and mental health in former NFL players. Setting: Cross-sectional questionnaire. Patients or Other Participants: Historical cohort of 2,103 former NFL players that played at least one season between 1940 and 2001. Intervention: Players were grouped by self-reported professional career musculoskeletal injury history and whether injuries affected current health: (1) no musculoskeletal injury history; (2) musculoskeletal injury history, currently affected by injuries; and (3) musculoskeletal injury history, not currently affected by injuries. Main Outcome Measure: The Short Form 36 Measurement Model for Functional Assessment of Health and Well-Being (SF-36) yielded physical and mental health composite scores (PCS and MCS, respectively); higher scores indicated better health. Multivariable linear regression computed mean differences (MD) among injury groups. Covariates included demographics, playing history characteristics, surgical intervention for musculoskeletal injuries, and whether injury resulted in premature end to career. MD with 95% CI excluding 0.00 were deemed significant. Results: Overall, 90.3% reported at least one musculoskeletal injury during their professional football careers, of which 74.8% reported being affected by their injuries at time of survey completion. Adjusting for covariates, mean PCS in the “injury and affected” group was lower than the “no injury” (MD = −3.2; 95% CI: −4.8, −1.7) and “injury and not affected” groups (MD = −4.3; 95% CI: −5.4, −3.3); mean MCS did not differ. Conclusion: Many players reported musculoskeletal injuries, highlighting the need for developing and evaluating injury management interventions.

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Safety Needs Mediate Stressful Events Induced Mental Disorders

Neural Plasticity ◽

10.1155/2016/8058093 ◽

2016 ◽

Vol 2016 ◽

pp. 1-6 ◽

Cited By ~ 14

Author(s):

Zheng Zheng ◽

Simeng Gu ◽

Yu Lei ◽

Shanshan Lu ◽

Wei Wang ◽

...

Keyword(s):

Mental Disorders ◽

Well Being ◽

Stressful Events ◽

Appraisal Theory ◽

Neural Basis ◽

Primary Appraisal ◽

Secondary Appraisal ◽

Behavior Function ◽

The Individual ◽

Safety First

“Safety first,” we say these words almost every day, but we all take this for granted for what Maslow proposed in his famous theory ofHierarchy of Needs: safety needs come second to physiological needs. Here we propose that safety needs come before physiological needs. Safety needs are personal security, financial security, and health and well-being, which are more fundamental than physiological needs. Safety worrying is the major reason for mental disorders, such as anxiety, phobia, depression, and PTSD. The neural basis for safety is amygdala, LC/NE system, and corticotrophin-releasing hormone system, which can be regarded as a “safety circuitry,” whose major behavior function is “fight or flight” and “fear and anger” emotions. This is similar to the Appraisal theory for emotions: fear is due to the primary appraisal, which is related to safety of individual, while anger is due to secondary appraisal, which is related to coping with the unsafe situations. If coping is good, the individual will be happy; if coping failed, the individual will be sad or depressed.

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The Impaired Surgeon

DeckerMed Surgery ◽

10.2310/surg.2081 ◽

2016 ◽

Author(s):

Krista L. Kaups ◽

David B. Hoyt

Keyword(s):

Substance Abuse ◽

Well Being ◽

Professional Career ◽

Age Related ◽

Personal Consequences ◽

Individual Surgeon ◽

Boundary Issues ◽

The Individual ◽

Health And Well Being ◽

Related Harm

Among the obligations and responsibilities of a surgeon is to practice in a competent manner. From a professional standpoint, competence is widely defined as the ability to practice with reasonable skill and safety, and a surgeon is impaired when she or he is not able to do so. There are a number of potential reasons leading to impairment, which may be temporary or a limitation throughout a surgeon’s professional career. Impairment may range from mild degradation of skills to complete incapacitation. The consequences of surgical practice with impairment are wide ranging and include patient-related harm and failure to provide exemplary care; personal consequences to the surgeon’s health and well-being; interpersonal issues with family, colleagues, and staff; and disciplinary and legal issues. This review covers substance abuse, personality issues (character impairment), medical school, residency, the practicing surgeon, the faculty member, boundary issues, aging, the individual surgeon, the department/hospital, burnout, prevention and recognition, individual/personal, organizational, the unprepared or "out-of-date" surgeon, prevention, and dealing with the unprepared surgeon. The figure shows an algorithm outlining the approach to the impaired surgeon. Tables list signs of substance abuse–related impairment, signs of character impairment, and signs of age-related impairment. This review contains 1 highly rendered figure, 3 tables, and 123 references

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Significance of the Dominant Psychological and Physiological Aspects of the Occupational Stress Models

Acta Medica Bulgarica ◽

10.2478/amb-2021-0046 ◽

2021 ◽

Vol 48 (4) ◽

pp. 33-42

Author(s):

S. Simeonova ◽

R. Nikolova

Keyword(s):

Occupational Stress ◽

Modern Society ◽

Well Being ◽

Quality Performance ◽

Work Related ◽

Healthy Working ◽

Related Stress ◽

Stress At Work ◽

The Individual ◽

Stress Models

Abstract The importance of the dominant psychological and physiological aspects of occupational stress models is a significant topic for researchers working in the field of medicine. Modern society faces significant problems in the detection and management of stress due to its growing impact on the functional state of working individuals. Ensuring safe and healthy working conditions is necessary to deal with the adverse effects of occupational stress on health. Controlling and reducing stress is possible by revealing the causal psychophysiological links in the mechanisms of work-related stress. Scientifically based stress management is based on the categories and concepts underlying occupational stress models. Modern work-related models of stress describe and study not only the adverse characteristics of the work process, but also the factors that stimulate the health and well-being of the individual. Monitoring occupational stress is part of the process of neutralizing and eliminating it. In today’s dynamic world, it is not enough to expect only quality performance of the professional duties of employees, but the commitment of managers working in the field of health care is needed to analyse and manage the dominant psychological and physiological aspects of occupational stress models and prevent adverse aspects of models of this type of stress at work.

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A Call to Action: Ethics Committee Roundtable Recommendations for Addressing Burnout and Moral Distress in Oncology

JCO Oncology Practice ◽

10.1200/jop.19.00806 ◽

2020 ◽

Vol 16 (4) ◽

pp. 191-199 ◽

Cited By ~ 6

Author(s):

Fay J. Hlubocky ◽

Lynne P. Taylor ◽

Jonathan M. Marron ◽

Rebecca A. Spence ◽

Molly M. McGinnis ◽

...

Keyword(s):

Moral Distress ◽

Well Being ◽

Patient Relationship ◽

Physical And Mental Health ◽

Physician Patient Relationship ◽

Call To Action ◽

Patient Dissatisfaction ◽

Quality Cancer Care ◽

The Individual ◽

Physician Patient

Oncologist well-being is critical to initiating and maintaining the physician-patient relationship, yet many oncologists suffer from symptoms of burnout. Burnout has been linked to poor physical and mental health, as well as increased medical errors, patient dissatisfaction, and workforce attrition. In this Call to Action article, we discuss causes of and interventions for burnout and moral distress in oncology, highlight existing interventions, and provide recommendations for addressing burnout and improving well-being at the individual and organizational levels to deliver ethical, quality cancer care.

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The Impact of the COVID-19 Pandemic on the Professional Lives of Women Academics: a Scoping Review

10.21203/rs.3.rs-698104/v1 ◽

2021 ◽

Author(s):

Lily O'Hara ◽

Bayan Fayiz AlNajjarb ◽

Diana Alsayed Hassan ◽

Ghadir Al Jayyousi-Alsalim ◽

Hanan Abdul Rahim ◽

...

Keyword(s):

Scoping Review ◽

Professional Lives ◽

Physical And Mental Health ◽

Women Academics ◽

Economic Class ◽

Mesh Terms ◽

Scoping Reviews ◽

The Individual ◽

Meta Analyses ◽

The Impact

Abstract BackgroundWomen academics face specific professional and personal challenges from the COVID-19 pandemic resulting from lack of access to adequate childcare, increased demands on women’s time to address the needs of family members, and physical and mental health concerns. Prior to the pandemic, women academics faced disparities regarding merit, tenure and promotion. The COVID-19 pandemic has exacerbated inequalities in paid and domestic work resulting in a disproportionate effect on the personal and professional lives of academic women. The burden is even heavier for women academics who face intersecting systems of oppression, such as those based on ethnicity, skin colour, body size, sexual orientation, gender, age, economic class, dependent status, and/or ability. The objectives of this scoping review are to (a) identify the impact of the COVID-19 pandemic on the professional lives of women academics, and (b) explore the individual, organisational, and systems levels strategies that can support women academics during the COVID-19 pandemic.MethodsThe scoping review will be conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR) following Joanna Briggs Institute scoping reviews guidelines. We will systematically search PubMed, EMBASE, CINAHL, medrxiv, Scopus, Web of Science, and Google Scholar for articles published from December 2019 to July 2021 in any language using key words and MESH terms, and search reference lists for additional studies. Two reviewers will screen articles using inclusion and exclusion criteria, review full articles, and extract data using a standardised form including study information, participant characteristics, effects of COVID-19 pandemic on professional life, and strategies to support women academics in a pandemic. A third reviewer will resolve conflicting decisions through discussion. Findings will be presented using narrative description, summary tables and illustrative quotes.DiscussionThe scoping review will provide evidence of how the COVID-19 pandemic has impacted on the professional lives of women in academia, and contribute to the development of strategies to reduce gender inequities. It is imperative that these issues be identified and strategies developed to address growing inequities in the professional wellbeing of women academics.Systematic review registrationOpen Science Framework: https://osf.io/9rxku, DOI: 10.17605/OSF.IO/9RXKU

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Progesterone, progestins and psychosomatic health of women

Hormone Molecular Biology and Clinical Investigation ◽

10.1515/hmbci.2010.070 ◽

2010 ◽

Vol 3 (3) ◽

Author(s):

Johannes Bitzer

Keyword(s):

Family Relationship ◽

Anxiolytic Effect ◽

Well Being ◽

Antidepressant Effect ◽

Physical And Mental Health ◽

Specific Symptom ◽

Psychosomatic Health ◽

The Central Nervous System ◽

The Individual ◽

The Brain

AbstractPsychosomatics as a medical perspective and discipline focuses on the interaction of physical and mental health in the specific life situation of a patient, taking into account the physical and emotional well-being, role functioning, satisfaction with the partner and family relationship, as well as sexual function and satisfaction. There are two important effects of progesterone on the combined physical, mental and sexual well-being of the climacteric patient. The first is the antiestrogenic effect of progesterone on the peripheral physical level which not only protects the endometrium against overstimulation but also reduces individual suffering from heavy bleeding, breast tension, bloating and general discomfort. The second effect is due to the complex action of progesterone in the brain. Studies using different progestins in different dosages and in different regimens show contradictory results. Some studies demonstrate an increase in depressed mood and reduced well-being while using synthetic progestins. Other studies, however, indicate an anxiolytic and sometimes antidepressant effect of progesterone and progesterone-like progestins with an improvement of emotional well-being and quality of life. In the individual patient, the positive or negative emotional and mental state can be conditioned by various pathways of progesterone and progestins. The antiestrogenic effect can attenuate the psychotropic effect of estradiol (E2) on the brain, thus reducing emotional well-being. Progesterone interacting with many brain areas can have a mood stabilizing and anxiolytic effect through the action on the GABA receptor. This effect seems to be strongest when using natural progesterone and the effect varies considerably among different progestins and different dosages due to metabolic pathways involving the production of allopregnanolone or other metabolites. In conclusion, the positive anxiolytic and sedative effects of progesterone on the central nervous system depend on the type of progestogen, the dosage, the timing of application, the combination with estrogen, etc. Progesterone and progestins have important potential to maintain or improve the psychosomatic health of women. Their use must, however, be tailored to specific symptom clusters and to the individual's pre-existing psychosomatic health status.

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The Impaired Surgeon

10.2310/7ccsp.2081 ◽

2016 ◽

Author(s):

Krista L. Kaups ◽

David B. Hoyt

Keyword(s):

Substance Abuse ◽

Well Being ◽

Professional Career ◽

Age Related ◽

Personal Consequences ◽

Individual Surgeon ◽

Boundary Issues ◽

The Individual ◽

Health And Well Being ◽

Related Harm

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Work health promotion (WHP) and salutogenesis: application of soc-13 in a company

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.378 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

C Serratore ◽

M Caricato ◽

E Abbafati ◽

G Masanotti

Keyword(s):

Health Promotion ◽

Workplace Health Promotion ◽

High Sensitivity ◽

Well Being ◽

Stressful Events ◽

Three Dimensions ◽

Workplace Health ◽

The Individual ◽

A Company

Abstract Background Workplace Health Promotion (WHP) is the combined efforts of employers, employees and society to improve the health and well-being of people at work. Sense of Coherence (SOC) is the ability to perceive and manage stressful events. The aims of this study are: to prove the SOC-13 scale sensitivity and, using this tool, to investigate employers' welfare in a company promoting ENWHP model. Methods We selected an Italian company, that, since 2017, is carrying out a WHP project. We sent to all the workers (n = 358) the SOC scale-13 items, which investigates three dimensions: comprehensibility (C), manageability (Ma) and meaningfulness (Me), at T0 (October 2018) and T1 (April 2019). Each item is scored on a 7-point Likert scale, ranging 13-91, with higher score corresponding to a more developed SOC. Total score for C, Ma and Me subscales were calculated. The scores were compared using paired “T” tests. Results The response rate was 29% (n = 104) and 25% (n = 89) at T0 and at T1, respectively. At T1 SOC score and its three dimensions were higher (mean SOC ± SD: T0 =57,23 ± 11,00 vs T1= 61,90 ± 12,03 p = 0,005; mean C ± SD: T0=21,97±4,46 vs T1=23,02±5,16 p = 0,124; mean Ma ± SD: T0=16,64± 4,27 vs T1=17,96±4,36 p = 0,033; mean Me ± SD: T0=18,62 ±5,01 vs T1=20,92±4,89 p = 0,002). Conclusions Our findings suggest that a WHP project can promote healthy workplace environments, enhance workers quality of life and improve the individual capacity to cope successfully with stress. We showed that SOC-13 scale is an easy and appropriate tool to evaluate the employers' wellbeing, thanks to its high sensitivity. Key messages SOC scale-13 can record the quality of workplace health promotion measures and continually improve them. WHP good practices enhance workers’ welfare.

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