scholarly journals Burnout and resilience among Canadian palliative care physicians

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Cindy Wang ◽  
Pamela Grassau ◽  
Peter G. Lawlor ◽  
Colleen Webber ◽  
Shirley H. Bush ◽  
...  
Keyword(s):  
Palliative Care ◽  
Regression Analysis ◽  
Linear Regression Analysis ◽  
Maslach Burnout Inventory ◽  
Personal Accomplishment ◽  
Multivariable Logistic Regression Analysis ◽  
Individual Level ◽  
Resilience Scale ◽  
Multivariable Linear Regression Analysis ◽  
High Degree

Abstract Background Physicians experience high rates of burnout, which may negatively impact patient care. Palliative care is an emotionally demanding specialty with high burnout rates reported in previous studies from other countries. We aimed to estimate the prevalence of burnout and degree of resilience among Canadian palliative care physicians and examine their associations with demographic and workplace factors in a national survey. Methods Physician members of the Canadian Society of Palliative Care Physicians and Société Québécoise des Médecins de Soins Palliatifs were invited to participate in an electronic survey about their demographic and practice arrangements and complete the Maslach Burnout Inventory for Medical Professionals (MBI-HSS (MP)), and Connor-Davidson Resilience Scale (CD-RISC). The association of categorical demographic and practice variables was examined in relation to burnout status, as defined by MBI-HSS (MP) score. In addition to bivariable analyses, a multivariable logistic regression analysis, reporting odds ratios (OR), was conducted. Mean CD-RISC score differences were examined in multivariable linear regression analysis. Results One hundred sixty five members (29%) completed the survey. On the MBI-HSS (MP), 36.4% of respondents reported high emotional exhaustion (EE), 15.1% reported high depersonalization (DP), and 7.9% reported low personal accomplishment (PA). Overall, 38.2% of respondents reported a high degree of burnout, based on having high EE or high DP. Median CD-RISC resilience score was 74, which falls in the 25th percentile of normative population. Age over 60 (OR = 0.05; CI, 0.01–0.38), compared to age ≤ 40, was independently associated with lower burnout. Mean CD-RISC resilience scores were lower in association with the presence of high burnout than when burnout was low (67.5 ± 11.8 vs 77.4 ± 11.2, respectively, p < 0.0001). Increased mean CD-RISC score differences (higher resilience) of 7.77 (95% CI, 1.97–13.57), 5.54 (CI, 0.81–10.28), and 8.26 (CI, 1.96–14.57) occurred in association with age > 60 as compared to ≤40, a predominantly palliative care focussed practice, and > 60 h worked per week as compared to ≤40 h worked, respectively. Conclusions One in three Canadian palliative care physicians demonstrate a high degree of burnout. Burnout prevention may benefit from increasing resilience skills on an individual level while also implementing systematic workplace interventions across organizational levels.

scholarly journals Influence of arterial stiffness on cardiovascular outcome in patients without high blood pressure

Heart ◽  
2017 ◽  
Vol 104 (4) ◽  
pp. 318-323 ◽  
Author(s):  
Keishi Ichikawa ◽  
Satoru Sakuragi ◽  
Takahiro Nishihara ◽  
Masahiro Tsuji ◽  
Atsushi Mori ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Regression Analysis ◽  
Coronary Artery ◽  
Arterial Stiffness ◽  
Multidetector Ct ◽  
Linear Regression Analysis ◽  
Peptide Hormone ◽  
Multivariable Logistic Regression Analysis ◽  
Multivariable Linear Regression Analysis

ObjectiveAlthough blood pressure (BP) is a major determinant of arterial stiffness, whether high pulse wave velocity (PWV) adversely influences cardiac parameters and cardiovascular (CV) outcome in patients without high BP remains unclear.MethodsOutpatients without high BP (n=320), defined as systolic BP ≥140 mm Hg, were enrolled in this retrospective study. At baseline, all patients underwent echocardiography and multidetector CT to determine the coronary artery calcification (CAC) score. Arterial stiffness was assessed based on brachial-ankle PWV (baPWV), from which patients were classified into two groups: those with high (≥18 m/s, n=89) and low baPWV (<18 m/s, n=231). Cardiac parameters and CV event incidence during the follow-up period were compared between these groups.ResultsIn multivariable linear regression analysis, baPWV was significantly associated with CAC score and serum N-terminal pro-brain natriuretic peptide hormone level, after adjustment for confounding factors. In multivariable logistic regression analysis, baPWV ≥18 m/s was significantly associated with CAC score ≥400 (OR 2.466, 95% CI 1.012 to 6.009, p=0.0471). Kaplan-Meier analysis showed that the high-baPWV group experienced more CV events during the 575 days of follow-up (20% vs 6%, p=0.0003).ConclusionsHigh baPWV was associated with greater CAC and a high risk of a future CV event, especially coronary artery disease, even in patients without high BP.

scholarly journals The role of extracurricular activities and lectures in mitigating medical student burnout

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Jennifer C. Sepede ◽  
Joanna Petrides ◽  
Philip B. Collins ◽  
Meredith C. Jones ◽  
Nicole Cantor ◽  
...  
Keyword(s):  
Medical Students ◽  
Extracurricular Activities ◽  
Maslach Burnout Inventory ◽  
Personal Accomplishment ◽  
Leadership Positions ◽  
Student Body ◽  
Individual Level ◽  
Rowan University ◽  
Survey Results ◽  
The Individual

Abstract Context Strong evidence throughout the literature highlights burnout as a significant and increasing problem among medical students, impacting students’ ability to effectively care for and empathize with patients. Objectives To examine how involvement in extracurricular activities and attendance at burnout lectures can impact burnout among medical students. Methods An anonymous digital survey including the Maslach Burnout Inventory (MBI) was sent to all students (n=765) at Rowan University School of Osteopathic Medicine. The survey included questions regarding the number of burnout/wellness lectures respondents had attended, the number of clubs in which the respondents participated, the number of hours spent in these clubs, and any leadership positions held by the respondents. Results Of the 765 students enrolled, 597 completed the survey. Results indicated that women participated in significantly more clubs than men (t[456]=−4.30; p<0.001). Men had higher scores on the depersonalization subscale of the MBI than women (t[463)=2.98; p<0.01]. There were no gender differences in emotional exhaustion or personal accomplishment. Linear regression analyses including gender and club participation as predictors of each of the burnout subscales indicated a significant interaction between gender and number of clubs (β=0.34; p<0.05), in that more club participation was associated with higher depersonalization scores for women, but lower depersonalization scores for men. The number of wellness/burnout prevention lectures attended was not predictive of scores on any of the burnout subscales. Conclusions Our results indicate the importance of understanding what drives burnout on the individual level and adapting interventions to suit the needs of individual students, rather than the student body as a whole.

scholarly journals Effect of Number of Clinics and Panel Size on Patient Continuity for Medical Residents

2009 ◽  
Vol 1 (2) ◽  
pp. 310-315 ◽  
Author(s):  
Maureen D. Francis ◽  
Whitney E. Zahnd ◽  
Andrew Varney ◽  
Steven L. Scaife ◽  
Mark L. Francis
Keyword(s):  
Regression Analysis ◽  
Linear Regression ◽  
Linear Regression Analysis ◽  
Medical Residents ◽  
Panel Size ◽  
Medical Education Program ◽  
Internal Medicine Residency Training ◽  
Multivariable Linear Regression Analysis ◽  
Linear Regression Modeling ◽  
Attending Physician

Abstract Background Accreditation Council for Graduate Medical Education program requirements for internal medicine residency training include a longitudinal, continuity experience with a panel of patients. Objective To determine whether the number of resident clinics, the resident panel size, and the supervising attending physician affect patient continuity. To determine the number of clinics and the panel size necessary to maximize patient continuity. Design We used linear regression modeling to assess the effect of number of attended clinics, the panel size, and the attending physician on patient continuity. Participants Forty medicine residents in an academic medicine clinic. Measurements Percent patient continuity by the usual provider of care method. Results Unadjusted linear regression analysis showed that patient continuity increased 2.3% ± 0.7% for each additional clinic per 9 weeks or 0.4% ± 0.1% for each additional clinic per year (P  =  .003). Conversely, patient continuity decreased 0.7% ± 0.4% for every additional 10 patients in the panel (P  =  .04). When simultaneously controlling for number of clinics, panel size, and attending physician, multivariable linear regression analysis showed that patient continuity increased 3.3% ± 0.5% for each additional clinic per 9 weeks or 0.6% ± 0.1% for each additional clinic per year (P &lt; .001). Conversely, patient continuity decreased 2.2% ± 0.4% for every additional 10 patients in the panel (P &lt; .001). Thus, residents who actually attend at least 1 clinic per week with a panel size less than 106 patients can achieve 50% patient continuity. Interestingly, the attending physician accounted for most of the variability in patient continuity (51%). Conclusions Patient continuity for residents significantly increased with increasing numbers of clinics and decreasing panel size and was significantly influenced by the attending physician.

Organizational Factors as Predictors of Teachers' Burnout

2001 ◽  
Vol 88 (3) ◽  
pp. 627-634 ◽  
Author(s):  
Athanasios Koustelios
Keyword(s):  
Regression Analysis ◽  
Role Conflict ◽  
Emotional Exhaustion ◽  
Role Ambiguity ◽  
Stepwise Regression ◽  
Maslach Burnout Inventory ◽  
Organizational Factors ◽  
Stepwise Regression Analysis ◽  
Personal Accomplishment ◽  
Highly Correlated

The purpose of this study was to examine the burnout experienced by a sample of Greek teachers and to explore the extent to which certain organizational factors predict teachers' scores on the Maslach Burnout Inventory. The sample consisted of 100 teachers, 28 to 59 years of age. Greek teachers' means were lower than those for burnout of U.S. teachers. Stepwise regression analysis identified satisfaction with the job itself was the only significant predictor for Depersonalization and Emotional Exhaustion subscales, while satisfaction with the job itself and satisfaction with promotion were significant predictors for the Personal Accomplishment subscale. These findings showed that stress, e.g., role conflict and role ambiguity, were not highly correlated with teachers' burnout.

scholarly journals Vascular Overload Index Predicts Cerebral Small Vessel Disease in a Neurologically Healthy Population

2021 ◽  
Vol 13 (2) ◽  
pp. 55-63
Author(s):  
Ki-Woong Nam ◽  
Hyung-Min Kwon ◽  
Jin-Ho Park ◽  
Hyuktae Kwon
Keyword(s):  
Blood Pressure ◽  
Regression Analysis ◽  
Arterial Stiffness ◽  
Confidence Interval ◽  
Linear Regression Analysis ◽  
University Hospital ◽  
Small Vessel ◽  
White Matter Hyperintensity ◽  
Multivariable Logistic Regression Analysis ◽  
Healthy Population

Background: Arterial stiffness has been suggested as one of the major pathological mechanisms of cerebral small vessel diseases (cSVDs). In this study, we confirmed this hypothesis by evaluating the association between vascular overload index (VOI), which is a physiologically good indicator of arterial stiffness, and cSVD.Methods: We evaluated participants who visited Seoul National University Hospital Health Promotion Center for health check-ups between 2006 and 2013. VOI was calculated by the following formula: VOI (mmHg)=1.33×systolic blood pressure -0.33×diastolic blood pressure-133.3. cSVDs were measured including white matter hyperintensity (WMH), lacunes, and cerebral microbleeds (CMBs). We quantitatively measured the WMH volume and rated the presence and number of lacunes and CMBs qualitatively.Results: A total of 3,231 participants were evaluated (mean age 57±9 years, male sex 53.9%). In multivariable linear regression analysis, VOI was significantly associated with WMH volume after adjusting confounders (β=0.004, 95% confidence interval=0.002–0.006). VOI also showed a close association with lacunes in multivariable logistic regression analysis (adjusted odds ratio=1.01, 95% confidence interval=1.00–1.02). There was no statistical association with CMBs. In subgroup analysis according to the presence of hypertension, VOI was closely associated with WMH volume/lacunes only in patients without hypertension. In patients with hypertension, these statistical associations disappeared.Conclusion: A high VOI was associated with cSVD in a neurologically healthy population, especially in patients without hypertension. This marker of arterial stiffness could be convenient and useful predictor of cSVD.

Burnout in Home Palliative Care: What Is the Role of Coping Strategies?

2019 ◽  
Vol 35 (1) ◽  
pp. 46-52 ◽  
Author(s):  
Giacomo Ercolani ◽  
Silvia Varani ◽  
Barbara Peghetti ◽  
Luca Franchini ◽  
Maria Beatrice Malerba ◽  
...  
Keyword(s):  
Palliative Care ◽  
Coping Strategies ◽  
Emotional Exhaustion ◽  
Health Care Professionals ◽  
Work Experience ◽  
General Health Questionnaire ◽  
Maslach Burnout Inventory ◽  
Personal Accomplishment ◽  
Cross Sectional ◽  
Palliative Care Teams

Objective: The study examines psychophysical distress of health-care professionals providing home-based palliative care. The aim is to investigate potential correlations between dimensions of burnout and different coping strategies. Methods: The present study is an observational cross-sectional investigation. The study involved all the home palliative care teams of an Italian nonprofit organization. Of a total of 275 practitioners working for the organization, 207 (75%) decided to participate in the study and complete questionnaires. Questionnaires employed were Maslach Burnout Inventory, General Health Questionnaire 12, Psychophysiological Questionnaire of CBA 2.0, and Coping Orientation to Problems Experienced. Professionals were physicians (50%), nurses (36%), and psychologists (14%). There were no exclusion criteria. Data were processed by SPSS 23 and analyses employed were Spearman ρ, Mann-Whitney U test, and 1-way analysis of variance on ranks. Results: Among participants, a low number of professionals were emotionally exhausted (11%) or not fulfilled at work (20%), whereas most of them complained of depersonalization symptoms (67%). Emotional exhaustion and depersonalization were found to be associated with avoidance coping strategies, whereas problem-solving and positive attitude were negatively associated with emotional exhaustion and positively with personal accomplishment. Moreover, using avoidance strategies was related to a worse psychological and physical condition. Conclusions: Findings suggest the need to provide professionals training programs about coping and communication skills tailored to fit the professionals’ needs according to their work experience in palliative care and aimed at improving the approach to patients and relatives.

Palliative care training and burnout in oncology fellows

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 9540-9540 ◽  
Author(s):  
S. Schellhorn ◽  
D. S. Lessen ◽  
R. L. Levine ◽  
G. Panagopoulos ◽  
R. M. Arnold ◽  
...  
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Multiple Testing ◽  
Multivariate Analyses ◽  
Maslach Burnout Inventory ◽  
Field Testing ◽  
Personal Accomplishment ◽  
Standard Patient ◽  
Care Training ◽  
Second Year

9540 Background: Burnout among physicians is associated with fatigue, exhaustion, and depression, and can result in increased medical errors and sub-standard patient care. We sought to determine rates and predictors of burnout in oncology fellows. Methods: As part of a larger study on fellows' attitudes, education, and experiences in palliative care, we administered the 22 item Maslach Burnout Inventory (MBI) to second year U.S. oncology fellows. The 104 item instrument, modified from a survey of medical students, was revised after field testing and a pilot survey. The MBI measures three domains: emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA); higher EE and DP scores and lower PA scores indicate burnout. Bivariate and multivariate analyses were used to find associations between burnout and fellow demographics, attitudes, and educational experiences. To accommodate for multiple testing, p<0.01 was considered statistically significant. Results: The response rate was 63.2% (254 of 402 eligible fellows). Gender, race, and location of medical school (U.S. vs. other) did not differ between respondents and non-respondents. Among respondents, 28.1% reported high EE, 30.0% reported high DP, and 26.8% reported low PA. Over half reported burnout in at least one domain (32.9% in one, 16.5% in two, and 5.5% in all three domains). The following associations were found on multivariate analyses. Fellows who identified as white had higher rates of EE (p=0.0006) while EE was lower in those who: 1) rated their program's overall teaching ‘very good‘ or ‘excellent‘ (p=0.005), 2) felt prepared to address spiritual issues around end-of-life care (p=0.002), and 3) felt prepared to manage their own feelings about illness and dying (p=0.008). Fellows who identified as white (p=0.008) or reported dreading encounters with emotionally distressed family members (p=0.0002) had higher DP. The only factor associated with higher PA scores was agreement that doctors have a responsibility to help patients prepare for death (p<0.0001). Conclusions: Over half of oncology fellows experience at least one domain of burnout. Higher quality teaching within their fellowship program and higher levels of self-assessed preparation to care for patients at the end of life are associated with lower levels of burnout. No significant financial relationships to disclose.

Using the health belief model to analyse nurses’ perception towards their behaviours for keeping surgical instruments moist

2020 ◽  
Author(s):  
Yanhua Chen ◽  
Juan Hu ◽  
Yan Huang ◽  
Liangying Yi ◽  
Ruixue Hu
Keyword(s):  
Regression Analysis ◽  
Linear Regression ◽  
Health Belief Model ◽  
Linear Regression Analysis ◽  
Health Belief ◽  
Surgical Instruments ◽  
Length Of Service ◽  
Multivariable Linear Regression Analysis ◽  
Belief Model ◽  
The Health Belief Model

Abstract Background Because of conflicts with work schedule of central sterile supply department (CSSD), surgical instruments might not be immediately cleaned or sterilized by CSSD staff members after use. If surgical instruments are not kept appropriately moist, tarnish or rusting may occur on the instruments, which will not only affect cleaning quality, but also shorten the normal service life of the instruments. Nurses’ perception towards their behaviours for keeping surgical instruments moist has been rarely studied. We aimed to use the health belief model to analyse nurses’ perception towards their behaviours for keeping surgical instruments moist. Methods The survey which utilised a questionnaire regarding respondent’s general information and a self-designed nurses’ perception-behaviour scale for keeping surgical instruments moist was conducted with 360 nurses from the West China Second University Hospital, Sichuan University. Data was gathered with cluster sampling, and analysed in SPSS20.0. T-test, variance analysis and multivariable linear regression analysis were performed. Results Total score of nurses’ perception-behaviour scale for keeping surgical instruments moist was 139.93 ± 15.145, among which mean score for perceived severity, perceived susceptibility, perceived benefits, perceived barriers, and self-efficacy was 4.49 ± 0.57, 4.62 ± 0.48, 4.57 ± 0.52, 3.47 ± 0.94 and 4.16 ± 0.66, respectively. Single factor analysis showed that score of nurses’ perception-behaviour scale for keeping surgical instruments moist varied with age, length of service, and job title, with a statistically significant difference (P < 0.05). Multivariable linear regression analysis showed that length of service was the main factor affecting nurses’ perception towards their behaviours for keeping surgical instruments moist. Conclusion Nurses should be offered intensive training on keeping surgical instruments moist due to their inadequate perception on it. However, an increase in knowledge does not necessarily bring behavior change. The nurses’ change in health beliefs and behaviours must be based upon developing the right attitude. As a result, they could realise the benefits of keeping surgical instruments moist, identify the barriers, and finally obtain the solutions.

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