A mixed methods study of emotional exhaustion: Energizing and depleting work within an innovative healthcare team

PURPOSE: Burnout is a syndrome of emotional exhaustion, depersonalization, and reduced personal accomplishment because of chronic occupational stress. Approximately one third of pediatric hematology-oncology physicians experience burnout. The goal of this mixed methods study was to determine the prevalence and drivers of burnout among physicians caring for pediatric hematology-oncology patients at our institution. MATERIALS AND METHODS: This mixed methods, cross-sectional study was conducted at a large academic cancer center. Validated survey instruments were used to measure burnout, job demands, experience with patient safety events, and workplace culture. Quantitative data informed development of a semistructured interview guide, and physicians were randomly selected to participate in individual interviews. Interviews were transcribed and analyzed via content analysis based on a priori codes. RESULTS: The survey was distributed to 132 physicians, and 53 complete responses were received (response rate 40%). Of the 53 respondents, 15 (28%) met criteria for burnout. Experiencing burnout was associated with increased temporal demand. Twenty-six interviews were conducted. Qualitative themes revealed that frequent meetings, insufficient support staff, and workflow interruptions were key drivers of temporal demand and that temporal demand contributed to burnout through emotional exhaustion and reduced personal accomplishment. CONCLUSION: Nearly one-third of participating physicians met criteria for burnout, and burnout was associated with increased temporal demand. Qualitative interviews identified specific drivers of temporal demand and burnout, which can be targeted for intervention. This methodology can be easily adapted for broad use and may represent an effective strategy for identifying and mitigating institution-specific drivers of burnout.

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The challenge of Burnout in Public Medical Teachers in Pakistan: A mixed methods study

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.37.5.4429 ◽

2021 ◽

Vol 37 (5) ◽

Author(s):

Ali Madeeh Hashmi

Keyword(s):

Mixed Methods ◽

Emotional Exhaustion ◽

Significant Proportion ◽

Maslach Burnout Inventory ◽

Clinical Science ◽

Mixed Methods Study ◽

Science Faculty ◽

Medical Education And Training ◽

Medical University ◽

Medical Teachers

Background and Objectives: Burnout is common in healthcare workers and affects multiple domains of functioning. The objective of this study was to assess burnout in medical teachers in a large public medical university in Lahore, Pakistan and explore the factors behind it. Methods: Using an explanatory sequential mixed methods design, we first sent out the abbreviated Maslach Burnout Inventory (aMBI) to all teaching faculty of basic and clinical science at King Edward Medical University (KEMU) Lahore. Descriptive analysis was performed on the 203 respondents who returned the survey. Of those who scored higher on the aMBI, 10 respondents (8 clinical science faculty and two basic science faculty) were selected for detailed semi-structured interviews exploring possible reasons for burnout. Thematic analysis of interview transcripts was performed using Interpretive Phenomenological Analysis. Triangulation and member checking was used for validation. Results: About 38.9% of respondents scored high on the Emotional Exhaustion subscale and 31.5% scored high on the Depersonalization subscale. There were statistically significant differences on the mean Emotional Exhaustion scores (p <0.001) between Basic and Clinical Sciences Departments with respondents from the Clinical Departments having higher scores (7.84 ± 4.32). Four main themes and multiple sub-themes emerged around burnout after qualitative analysis of the data. These included 1. Work-related factors 2. Family and social factors including challenges related specifically to women 3. Feelings and emotions and 4. Personal Qualities. Conclusion: A significant proportion of medical faculty experiences burnout related to their professional and personal responsibilities. The reasons are varied. Policy planners and University/College administrators must acknowledge the negative effects of burnout on medical teachers and take steps to ameliorate it in the interests of improving medical education and training. doi: https://doi.org/10.12669/pjms.37.5.4429 How to cite this:Hashmi AM. The challenge of Burnout in Public Medical Teachers in Pakistan: A mixed methods study. Pak J Med Sci. 2021;37(5):---------. doi: https://doi.org/10.12669/pjms.37.5.4429 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Differential Use of Pediatric Video Visits by a Diverse Population During the COVID-19 Pandemic: A Mixed-Methods Study

Frontiers in Pediatrics ◽

10.3389/fped.2021.645236 ◽

2021 ◽

Vol 9 ◽

Author(s):

Jennifer L. Rosenthal ◽

Christina O'Neal ◽

April Sanders ◽

Erik Fernandez y Garcia

Keyword(s):

Mixed Methods ◽

Health System ◽

Patient Characteristics ◽

Mixed Methods Study ◽

Healthcare Team ◽

Lower Odds ◽

Factors Associated ◽

Patient Families ◽

English Speaking ◽

Insured Patients

Objective: To describe and explore pediatric ambulatory video visit use by patient characteristics during the coronavirus disease 2019 (COVID-19) pandemic.Methods: We conducted an explanatory sequential mixed methods study with integration at the design and methods level. Phase 1 was a cross-sectional analysis of general and specialty pediatric ambulatory encounters to profile the use of video visits by patient characteristics. We performed descriptive analyses for each variable of interest and estimated a multivariable logistic regression model to analyze factors associated with the odds of having a video visit. Phase 2 was a qualitative exploration using semi-structured interviews with healthcare team members to understand the contextual factors influencing video visit usage. We used an interview guide to solicit information related to general perceptions about ambulatory video visits, reactions to the quantitative phase data, and strategies for optimizing equitable reach of video visits. Data were analyzed using a combination of deductive and inductive analysis.Results: Among the 5,464 pediatric ambulatory encounters completed between March 11 and June 30, 2020, 2,127 were video visits. Patient factors associated with lower odds of having a video visit rather than an in-person visit included being Spanish-speaking (aOR 0.27, 95% CI 0.20–0.37) and other non-English-speaking (aOR 0.50, 95% CI 0.34–0.75) in comparison to English-speaking. Patients with public insurance also had a lower odds of having a video visit in comparison to privately insured patients (aOR 0.77, 95% CI 0.67–0.88). Qualitative interviews identified five solution-based themes: (1) Promoting video visits in a way that reaches all patient families; (2) Offering video visits to all patient families; (3) Mitigating digital literacy barriers; (4) Expanding health system resources to support families' specific needs; and (5) Engaging and empowering health system personnel to expand video visit access.Conclusion: We identified differences in pediatric ambulatory video visit use by patient characteristics, with lower odds of video visit use among non-English-speaking and publicly insured patients. The mixed-methods approach allowed for the perspectives of our interview participants to contextualize the finding and lead to suggestions for improvement. Both our findings and the approach can be used by other health systems to ensure that all patients and families receive equal video visit access.

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Determining Emotional Tone and Verbal Behavior in Patients With Tinnitus and Hyperacusis: An Exploratory Mixed-Methods Study

American Journal of Audiology ◽

10.1044/2019_aja-18-0136 ◽

2019 ◽

Vol 28 (3) ◽

pp. 660-672

Author(s):

Suzanne H. Kimball ◽

Toby Hamilton ◽

Erin Benear ◽

Jonathan Baldwin

Keyword(s):

Mixed Methods ◽

Verbal Behavior ◽

Coping Strategies ◽

Mixed Methods Study ◽

Self Report ◽

Anxiety And Depression ◽

Negative Consequences ◽

Emotional Tone ◽

Explanatory Mixed Methods ◽

Quantitative Results

Purpose The purpose of this study was to evaluate the emotional tone and verbal behavior of social media users who self-identified as having tinnitus and/or hyperacusis that caused self-described negative consequences on daily life or health. Research Design and Method An explanatory mixed-methods design was utilized. Two hundred “initial” and 200 “reply” Facebook posts were collected from members of a tinnitus group and a hyperacusis group. Data were analyzed via the LIWC 2015 software program and compared to typical bloggers. As this was an explanatory mixed-methods study, we used qualitative thematic analyses to explain, interpret, and illustrate the quantitative results. Results Overall, quantitative results indicated lower overall emotional tone for all categories (tinnitus and hyperacusis, initial and reply), which was mostly influenced by higher negative emotion. Higher levels of authenticity or truth were found in the hyperacusis sample but not in the tinnitus sample. Lower levels of clout (social standing) were indicated in all groups, and a lower level of analytical thinking style (concepts and complex categories rather than narratives) was found in the hyperacusis sample. Additional analysis of the language indicated higher levels of sadness and anxiety in all groups and lower levels of anger, particularly for initial replies. These data support prior findings indicating higher levels of anxiety and depression in this patient population based on the actual words in blog posts and not from self-report questionnaires. Qualitative results identified 3 major themes from both the tinnitus and hyperacusis texts: suffering, negative emotional tone, and coping strategies. Conclusions Results from this study suggest support for the predominant clinical view that patients with tinnitus and hyperacusis have higher levels of anxiety and depression than the general population. The extent of the suffering described and patterns of coping strategies suggest clinical practice patterns and the need for research in implementing improved practice plans.

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Self-contradicting attitudes and beliefs by emerging teachers on textbook use: A sequential explanatory mixed methods study

PsycEXTRA Dataset ◽

10.1037/e522252014-015 ◽

2014 ◽

Author(s):

Abel Diaz

Keyword(s):

Mixed Methods ◽

Mixed Methods Study ◽

Attitudes And Beliefs ◽

Textbook Use ◽

Explanatory Mixed Methods ◽

Sequential Explanatory

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Efficacy of the flipped classroom to teach play therapy: A mixed-methods study.

International Journal of Play Therapy ◽

10.1037/pla0000076 ◽

2018 ◽

Vol 27 (3) ◽

pp. 146-156 ◽

Cited By ~ 3

Author(s):

Elisabeth A. Counselman-Carpenter

Keyword(s):

Mixed Methods ◽

Play Therapy ◽

Flipped Classroom ◽

Mixed Methods Study

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EXPERIENCES, FRUSTRATIONS, AND BARRIERS, OF IPAD USAGE IN THE SPECIAL EDUCATION: LIFE SKILLS CLASSROOM FROM EDUCATORS PERSPECTIVE

Informatics and Education ◽

10.32517/0234-0453-2018-33-8-61-67 ◽

2018 ◽

pp. 61-67

Author(s):

D. J. Sullivan ◽

S. Labby ◽

A. Koptelov ◽

S. L. Sullivan

Keyword(s):

Special Education ◽

Mixed Methods ◽

Communication Systems ◽

Life Skills ◽

Mixed Methods Study ◽

Educational Tool ◽

Special Educator ◽

Communications Systems ◽

Communication Device ◽

Communication Devices

The purpose of this mixed methods study was to determine the barriers that special educator teachers encounter when using iPads within the Life Skills classroom. The research investigates the experiences, frustrations, and barriers through educators’ perceptions of iPad implementation. The influence of these issues suggests why iPad usage is not a device that special education classrooms are using in a widespread daily manner. Exploration of iPads as an educational tool and as a communication device is also discussed, along with considerations of other communications systems such as Picture Exchange Communication Systems and Alternative and Augmented Communication Devices is considered. Recommendations for further possible research are also discussed.

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