Incidence and Factors Associated with Burnout in Anesthesiology: A Systematic Review

Background. Burnout syndrome has reached epidemic levels among physicians (reported around 50%). Anesthesiology is among the most stressful medical disciplines but there is paucity of literature as compared with others. Analysis of burnout is essential because it is associated with safety and quality of care. We summarize evidence on burnout in anesthesiology. Methods. We conducted a systematic review (MEDLINE up to 30.06.2017). We included studies reporting burnout in anesthesiology with no restriction on role or screening test used. Results. Fifteen surveys/studies described burnout in anesthesiology, including different workers profiles (nurses, residents, consultants, and directors). All studies used the Maslach Burnout Inventory test but with significant differences for risk stratification. Burnout prevalence greatly varied across studies (10%–41% high risk, up to 59% at least moderate risk). Factors most consistently associated with burnout were strained working pattern, working as younger consultant, and having children. There was no consistent relationship between burnout and hospital characteristics, gender, or marital status. Conclusions. Burnout prevalence among anesthesiologists is relatively high across career stages, and some risk factors are reported frequently. However, the small number of studies as well as the large differences in their methodology and in reporting approach warrants further research in this field.

Download Full-text

Pressure From Superiors and Older Age Increase the Risk of Burnout Syndrome Among Psychiatric Trainees: A Nation-wide Survey in Turkey

European Psychiatry ◽

10.1016/j.eurpsy.2017.02.179 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S298-S298 ◽

Cited By ~ 1

Author(s):

N. Capraz ◽

D. Ceylan Tufan Ozalp ◽

M. Yalcin ◽

E. Tellioglu Can ◽

T. Alkin

Keyword(s):

Risk Factors ◽

Maslach Burnout Inventory ◽

Older Age ◽

Burnout Syndrome ◽

Personal Factors ◽

Factors Associated ◽

Personal Rights ◽

Dichotomous Variable ◽

Competing Interest ◽

Nation Wide Survey

IntroductionPrevious studies reported high burnout rates and indicated significant factors associated with burnout syndrome among psychiatric trainees, such as hard working conditions, lack of supervision and not opting for psychiatry as a first career choice.ObjectivesA substantial amount of variance was reported in psychiatry training across countries. However, there is not sufficient national data regarding the rates and risk factors of burnout syndrome among psychiatric trainees in Turkey.AimsTo determine the burnout syndrome rates and the risk factors associated with burnout syndrome among psychiatric trainees.MethodsA questionnaire of occupational, educational and personal factors and Maslach burnout inventory (MBI) were answered by 180 of 450 psychiatric trainees in Turkey. The data was collected from 167 (56% females) trainees who completed the survey material. Converting the scores of three subscales by using MBI manual, a dichotomous variable (severe/non-severe burnout) was obtained for each participant and the data was analyzed using descriptive statistics and regression models.ResultsMean age was 28.85 ± 2.99-year-old and mean duration of residency was 2.61 ± 1.31 years. Severe burnout was found in 38.3% of the trainees. Logistic regression confirmed that older age (P = 0.02) and pressure from superiors (P = 0.04) are predictive factors associated with severe burnout. The high number of patient visits (P = 0.001), violation of employee personal rights (P = 0.04) and pressure from superiors (P = 0.01) were significantly associated with the “wish working in another institution”.ConclusionsPressure from superiors and older age can be described as risk factors associated with burnout syndrome among psychiatric trainees in Turkey.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Download Full-text

Nurses’ burnout and associated risk factors during the COVID-19 pandemic: a systematic review and meta-analysis

10.1101/2020.11.24.20237750 ◽

2020 ◽

Author(s):

Petros Galanis ◽

Irene Vraka ◽

Despoina Fragkou ◽

Angeliki Bilali ◽

Daphne Kaitelidou

Keyword(s):

Mental Health ◽

Risk Factors ◽

Social Support ◽

Systematic Review ◽

Health Care ◽

High Risk ◽

Meta Analysis ◽

Maslach Burnout Inventory ◽

Self Confidence ◽

Associated Risk Factors

AbstractBackgroundDuring the COVID-19 pandemic, physical and mental health of the nurses is greatly challenged since they work under unprecedented pressure and they are more vulnerable to the harmful effects of the disease.AimTo examine the impact of the COVID-19 pandemic on nurses’ burnout and to identify associated risk factors.MethodsWe followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines for this systematic review and meta-analysis. PubMed, Scopus, ProQuest and pre-print services (medRχiv and PsyArXiv) were searched from January 1, 2020 to November 15, 2020 and we removed duplicates. We applied a random effect model to estimate pooled effects since the heterogeneity between results was very high.FindingsFourteen studies, including 17,390 nurses met the inclusion criteria. Five standardized and valid questionnaires were used to measure burnout among nurses; Maslach Burnout Inventory, Copenhagen Burnout Inventory, Professional Quality of Life Scale version 5, Mini-Z, and Spanish Burnout Inventory. The overall prevalence of emotional exhaustion was 34.1% (95% confidence interval [CI]: 22.5-46.6%), of depersonalization was 12.6% (95% CI: 6.9-19.7%), and of lack of personal accomplishment was 15.2% (95% CI: 1.4-39.8%). The following factors were associated with increased nurses’ burnout: younger age, higher educational level, higher degree, decreased social support, having a relative/friend diagnosed with COVID-19, low family and colleagues readiness to cope with COVID-19 outbreak, increased perceived threat of Covid-19, longer working time in quarantine areas, working in a high-risk environment (a COVID-19 designated hospital, a COVID-19 unit, etc.), working in hospitals with inadequate and insufficient material and human resources, decreased working safety while caring for COVID-19 patients, increased workload, decreased self-confidence in self-protection, and lower levels of specialized training regarding COVID-19, job experience, and self-confidence in caring for COVID-19.ConclusionNurses experience high levels of burnout during the COVID-19 pandemic, while several sociodemographic, social and occupational factors affect this burnout. Several interventions need to be implemented to mitigate mental health impact of the COVID-19 pandemic on nurses, e.g. screening for mental health illness and early supportive interventions for high-risk nurses, immediate access to mental health care services, social support to reduce feelings of isolation, sufficient personal protective equipment for all nurses to provide security etc. Governments, health care organizations and policy makers should act in this direction to prepare health care systems, individuals and nurses for a better response against the COVID-19 pandemic.

Download Full-text

Factors associated with burnout syndrome in medical residents of a university hospital

Revista da Associação Médica Brasileira ◽

10.1590/1806-9282.63.06.504 ◽

2017 ◽

Vol 63 (6) ◽

pp. 504-511 ◽

Cited By ~ 9

Author(s):

Pedro Alves da Cruz Gouveia ◽

Maria Hosana Chaves Ribeiro Neta ◽

Carlos Alberto de Moura Aschoff ◽

Doris Pires Gomes ◽

Nadine Anita Fonseca da Silva ◽

...

Keyword(s):

Risk Factors ◽

Emotional Exhaustion ◽

Maslach Burnout Inventory ◽

Burnout Syndrome ◽

Stressful Event ◽

Factors Associated ◽

Resident Physicians ◽

Study Results ◽

Professional Achievement ◽

High Level

Summary Objective: To determine the prevalence of burnout syndrome among resident physicians of various specialties and to evaluate associated factors. Method: The Maslach Burnout Inventory questionnaire and a sociodemographic questionnaire were used to evaluate factors associated with the syndrome. Burnout was defined as the association of high emotional exhaustion, depersonalization and low professional achievement. Multivariate analysis was performed after adjustment of the Poisson model with the identification of risk factors and calculation of prevalence ratios (PR). Of the 250 resident physicians registered with Hospital das Clínicas of Pernambuco, 129 participated in the study. Results: In the three domains that characterize burnout syndrome, we found a low level of professional achievement in 94.6% of resident physicians interviewed, a high level of depersonalization in 31.8%, and 59.7% with a high level of emotional exhaustion. The prevalence of burnout was 27.9%. Having suffered a stressful event in the last six months (PR: 8.10; 95CI 1.2-57.2) and being a student of surgical specialty (PR: 1.99; 95CI 1.2-3.3) were independently associated with burnout. Conclusion: The prevalence of burnout found in resident physicians is in accordance with previous Brazilian studies. Residents of surgical specialties and those who suffered some stressful event were identified as susceptible in this study. The early identification of risk factors is fundamental for the implementation of preventive measures against burnout syndrome.

Download Full-text

BMI trajectories and risk factors among 2-11-year-old children by their immigrant status: evidence from the Longitudinal Study of Australian Children

BMJ Open ◽

10.1136/bmjopen-2018-026845 ◽

2019 ◽

Vol 9 (7) ◽

pp. e026845

Author(s):

Tehzeeb Zulfiqar ◽

Richard A Burns ◽

Catherine D’Este ◽

Lyndall Strazdins

Keyword(s):

Risk Factors ◽

Longitudinal Study ◽

High Risk ◽

Children Of Immigrants ◽

Immigrant Children ◽

Immigrant Status ◽

Moderate Risk ◽

Factors Associated ◽

Bmi Trajectories ◽

Bmi Trajectory

ObjectiveThis study aimed to identify body mass index (BMI) trajectories and their predictors in Australian children by their maternal immigrant status.MethodsData on 4142 children aged 2–3 years were drawn from the birth cohort of the Longitudinal Study of Australian Children. BMI was calculated according to the International Obesity Task Force cut-off points. Immigrant status was determined by the Australian Bureau of Statistics and the United Nations Development Programme, Human Development Index criteria. Latent class growth analysis estimated distinct BMI trajectories, and multinomial logistic regression analysis examined factors associated with these BMI trajectories.ResultsTwo BMI groups and six BMI trajectories were identified. The stable trajectories group included high-risk (10%, n=375), moderate-risk (5%, n=215) and low-risk (68%, n=2861) BMI trajectories. The changing trajectories group included delayed-risk (6%, n=234), gradual-risk (8%, n=314) and declining-risk (3%, n=143) BMI trajectories. We found some evidence that children of immigrants from low-and middle-income countries were more likely to have moderate-risk and high-risk BMI trajectories compared with low-risk BMI trajectory. However, these associations were insignificant in fully adjusted models. The explanatory risk factors for moderate-risk and high-risk BMI trajectory were birth weight, family socioeconomic position, and organised sports participation. Our results also suggest that 4–7 years of age may be important for the prevention of overweight/obesity in children.DiscussionA better understanding of the risk factors associated with distinct BMI trajectories in immigrant children will inform effective preventive strategies. Some of these risk factors such as non-participation in organised sports, and high screen time, may also impede the integration of immigrant children into the host culture. Obesity prevention strategies aimed at increasing physical activities in immigrant children could help deliver a social and health benefit by increasing social integration among children of immigrants and Australians.

Download Full-text

Prevalence and risk factors associated with preterm birth in India: Systematic review and meta-analysis

Authorea ◽

10.22541/au.158758076.65534162 ◽

2020 ◽

Author(s):

Thangjam Devi ◽

Huidrom Singh

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Preterm Birth ◽

Meta Analysis ◽

Factors Associated

Download Full-text

Proposal for the use of echocardiography in bloodstream infections due to different streptococcal species

BMC Infectious Diseases ◽

10.1186/s12879-021-06391-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Sandra Chamat-Hedemand ◽

Niels Eske Bruun ◽

Lauge Østergaard ◽

Magnus Arpi ◽

Emil Fosbøl ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

High Risk ◽

Blood Culture ◽

Positive Blood Culture ◽

Bloodstream Infections ◽

Low Risk ◽

Moderate Risk ◽

Streptococcal Species ◽

Very High

Abstract Background Infective endocarditis (IE) is diagnosed in 7–8% of streptococcal bloodstream infections (BSIs), yet it is unclear when to perform transthoracic (TTE) and transoesophageal echocardiography (TOE) according to different streptococcal species. The aim of this sub-study was to propose a flowchart for the use of echocardiography in streptococcal BSIs. Methods In a population-based setup, we investigated all patients admitted with streptococcal BSIs and crosslinked data with nationwide registries to identify comorbidities and concomitant hospitalization with IE. Streptococcal species were divided in four groups based on the crude risk of being diagnosed with IE (low-risk < 3%, moderate-risk 3–10%, high-risk 10–30% and very high-risk > 30%). Based on number of positive blood culture (BC) bottles and IE risk factors (prosthetic valve, previous IE, native valve disease, and cardiac device), we further stratified cases according to probability of concomitant IE diagnosis to create a flowchart suggesting TTE plus TOE (IE > 10%), TTE (IE 3–10%), or “wait & see” (IE < 3%). Results We included 6393 cases with streptococcal BSIs (mean age 68.1 years [SD 16.2], 52.8% men). BSIs with low-risk streptococci (S. pneumoniae, S. pyogenes, S. intermedius) are not initially recommended echocardiography, unless they have ≥3 positive BC bottles and an IE risk factor. Moderate-risk streptococci (S. agalactiae, S. anginosus, S. constellatus, S. dysgalactiae, S. salivarius, S. thermophilus) are guided to “wait & see” strategy if they neither have a risk factor nor ≥3 positive BC bottles, while a TTE is recommended if they have either ≥3 positive BC bottles or a risk factor. Further, a TTE and TOE are recommended if they present with both. High-risk streptococci (S. mitis/oralis, S. parasanguinis, G. adiacens) are directed to a TTE if they neither have a risk factor nor ≥3 positive BC bottles, but to TTE and TOE if they have either ≥3 positive BC bottles or a risk factor. Very high-risk streptococci (S. gordonii, S. gallolyticus, S. mutans, S. sanguinis) are guided directly to TTE and TOE due to a high baseline IE prevalence. Conclusion In addition to the clinical picture, this flowchart based on streptococcal species, number of positive blood culture bottles, and risk factors, can help guide the use of echocardiography in streptococcal bloodstream infections. Since echocardiography results are not available the findings should be confirmed prospectively with the use of systematic echocardiography.

Download Full-text

A systematic review of the factors associated with the course of borderline personality disorder symptoms in adolescence

Borderline Personality Disorder and Emotion Dysregulation ◽

10.1186/s40479-021-00151-z ◽

2021 ◽

Vol 8 (1) ◽

Author(s):

Gabriele Skabeikyte ◽

Rasa Barkauskiene

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Borderline Personality Disorder ◽

Personality Disorder ◽

Strong Support ◽

Borderline Personality ◽

Developmental Pathways ◽

Eligibility Criteria ◽

Factors Associated ◽

Prospective Longitudinal

Abstract Background Research on personality pathology in adolescence has accelerated during the last decade. Among all of the personality disorders, there is strong support for the validity of borderline personality disorder (BPD) diagnosis in adolescence with comparable stability as seen in adulthood. Researchers have put much effort in the analysis of the developmental pathways and etiology of the disorder and currently are relocating their attention to the identification of the possible risk factors associated with the course of BPD symptoms during adolescence. The risk profile provided in previous systematic reviews did not address the possible development and course of BPD features across time. Having this in mind, the purpose of this systematic review is to identify the factors that are associated with the course of BPD symptoms during adolescence. Methods Electronic databases were systematically searched for prospective longitudinal studies with at least two assessments of BPD as an outcome of the examined risk factors. A total number of 14 articles from the period of almost 40 years were identified as fitting the eligibility criteria. Conclusions Factors associated with the course of BPD symptoms include childhood temperament, comorbid psychopathology, and current interpersonal experiences. The current review adds up to the knowledge base about factors that are associated with the persistence or worsening of BPD symptoms in adolescence, describing the factors congruent to different developmental periods.

Download Full-text

Systematic Review and Meta-Analysis of the Dose-Response and Risk Factors for Obliteration of Arteriovenous Malformations Following Radiosurgery: An Update Based on the Last 20 Years of Published Clinical Evidence

Neurosurgery Open ◽

10.1093/neuopn/okab004 ◽

2021 ◽

Vol 2 (1) ◽

Author(s):

Shaoyu Zhu ◽

N Patrik Brodin ◽

Madhur K Garg ◽

Patrick A LaSala ◽

Wolfgang A Tomé

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Dose Response ◽

Meta Analysis ◽

Gamma Knife Radiosurgery ◽

Lesion Size ◽

Intracranial Arteriovenous Malformation ◽

Factors Associated ◽

Obliteration Rate ◽

Inverse Variance

ABSTRACT BACKGROUND Intracranial arteriovenous malformation (AVM) is a congenital lesion that can potentially lead to devastating consequences if not treated. Many institutional cohort studies have reported on the outcomes after radiosurgery and factors associated with successful obliteration in the last few decades. OBJECTIVE To quantitatively assess the dose-response relationship and risk factors associated with AVM obliteration using a systematic review and meta-analysis approach. METHODS Data were extracted from reports published within the last 20 yr. The dose-response fit for obliteration as a function of marginal dose was performed using inverse-variance weighting. Risk factors for AVM obliteration were assessed by combining odds ratios from individual studies using inverse-variance weighting. RESULTS The logistic model fit showed a clear association between higher marginal dose and higher rates of obliteration. There appeared to be a difference in the steepness in dose-response when comparing studies with patients treated using Gamma Knife radiosurgery (Elekta), compared to linear accelerators (LINACs), and when stratifying studies based on the size of treated AVMs. In the risk-factor analysis, AVM obliteration rate decreases with larger AVM volume or AVM diameter, higher AVM score or Spetzler-Martin (SM) grade, and prior embolization, and increases with compact AVM nidus. No statistically significant associations were found between obliteration rate and age, sex, prior hemorrhage, prior aneurysm, and location eloquence. CONCLUSION A marginal dose above 18 Gy was generally associated with AVM obliteration rates greater than 60%, although lesion size, AVM score, SM grade, prior embolization, and nidus compactness all have significant impact on AVM obliteration rate.

Download Full-text