Burnout among staff on specialized eating disorder units in Norway

Abstract Objective Burnout is commonly associated with low workplace wellbeing. Patients with eating disorders are frequently referred to as a particularly challenging group to treat. It is therefore important to study healthcare providers´ workplace wellbeing in settings which treat eating disorders. The aims of the current study were to (a) measure burnout among healthcare providers working on specialized eating disorder units in Norway, and (b) explore factors predicting burnout. Methods 186 participants from 11 specialized eating disorder units in Norway completed an online survey including the Mashlach Burnout Inventory, and eating disorder-specific factors related to burnout, job satisfaction, work environment, emotional dissonance and stress. Multiple regression analysis was used to identify predictors of burnout. Results Overall, low levels of burnout were found among the participants. Eating disorder-specific factors and emotional dissonance predicted the three central aspects of burnout, namely, emotional exhaustion, depersonalization, and a diminished sense of personal accomplishment. Conclusions Findings suggest a relatively low level of burnout across age, gender, and professional categories working at specialized eating disorder units, contrary to commonly-held assumptions pertaining to the challenges involved in treating individuals with eating disorders.

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Influence of thrombectomy volume on non-physician staff burnout and attrition in neurointerventional teams

Journal of NeuroInterventional Surgery ◽

10.1136/neurintsurg-2020-015825 ◽

2020 ◽

pp. neurintsurg-2020-015825 ◽

Cited By ~ 6

Author(s):

Kyle M Fargen ◽

Sameer A Ansari ◽

Alejandro Spiotta ◽

Guilherme Dabus ◽

Maxim Mokin ◽

...

Keyword(s):

Online Survey ◽

Multiple Logistic Regression Analysis ◽

Healthcare Providers ◽

Maslach Burnout Inventory ◽

Medical Personnel ◽

Personal Accomplishment ◽

Hospital Leadership ◽

Staff Burnout ◽

Procedural Volume ◽

Composite Scores

BackgroundBurnout takes a heavy toll on healthcare providers. We sought to assess the prevalence and risk factors for burnout among neurointerventional (NI) non-physician procedural staff (nurses and technologists) given increasing thrombectomy demands.MethodsA 41-question online survey containing questions including the Maslach Burnout Inventory-Human Services Survey for Medical Personnel was distributed to NI nurses and radiology technologists at 20 US endovascular capable stroke centers.Results244 responses were received (64% response rate). Median (IQR) composite scores for emotional exhaustion were 25 (15–35), depersonalization 6 (2–11), and personal accomplishment 39 (35–43). Fifty-one percent of respondents met established criteria for burnout. There was no significant relationship between hospital thrombectomy volume, call frequency, call cases covered, or length of commute. On multiple logistic regression analysis, feeling under-appreciated by hospital leadership (OR 4.1; P<0.001) and working with difficult/unpleasant physicians (OR 1.2; P=0.05) were strongly associated with burnout. At participating centers, nurse and technologist attrition was 25% over the previous year. Over 50% of respondents indicated they had strongly considered leaving their position over the last 2 years.ConclusionsThis survey of US NI non-physician procedural staff demonstrates a self-reported burnout prevalence of 51%. This was driven more by interaction with leadership and physician staff than by thrombectomy procedural volume and stroke call. Attrition among NI non-physician procedural staff is high.

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“It is the only constant in what feels like a completely upside down and scary world”: Living with an Eating Disorder during COVID-19 and the importance of perceived control for recovery and relapse.

10.31234/osf.io/tqfsz ◽

2021 ◽

Author(s):

Dawn Branley-Bell ◽

Catherine V. Talbot

Keyword(s):

Eating Disorders ◽

Eating Disorder ◽

Perceived Control ◽

Online Survey ◽

Negative Impact ◽

Significant Risk ◽

Study Data ◽

External Control ◽

Time Points ◽

The Impact

Background: The COVID-19 pandemic has had a profound, negative impact on the lives and wellbeing of the population, and it can raise additional challenges for individuals with eating disorders. During early stages of the UK lockdown, individuals reported disruptions to many aspects of their lives, including reduced feelings of control and serious concerns over the impact of the pandemic on eating disorder symptoms and/or recovery. This study compares data from two time points to explore the ongoing impacts of the pandemic on this population. Method: A mixed-methods online survey was developed for the purpose of this study. Data was collected at the two key time points: First, soon after the start of the first UK lockdown (April 2020) and second, as the first lockdown restrictions began to be lifted (June 2020). The sample consisted of 58 individuals currently experiencing, or in recovery from, an eating disorder. Participants were aged between 16-65 years; 57 identified as female, and 1 male. Results: Higher perceptions of general, external control were associated with recovery between the time points. Individuals who experienced less perceived control reported a tendency to rely upon eating disorder behaviours as an auxiliary coping mechanism, i.e., diminished external control was directed inwards and replaced with controlling their own behaviour. Conclusions: Perceived control is a significant factor in eating disorder recovery. As a result of the pandemic’s negative impact upon peoples’ sense of control, individuals with eating disorders are at significant risk of detrimental impacts on their recovery and wellbeing. The results have implications for future treatments based on strengthening individuals’ perceptions of control to promote recovery.

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RISK FACTORS FOR BURNOUT IN PHYSICIANS

The International Journal of Person Centered Medicine ◽

10.5750/ijpcm.v9i1.961 ◽

2021 ◽

Vol 9 (1) ◽

pp. 27-44

Author(s):

Gabriela Massaro Carneiro Monteiro ◽

Glen Owens Gabbard ◽

Simone Hauck

Keyword(s):

Risk Factors ◽

Suicidal Ideation ◽

Alcohol Abuse ◽

Work Environment ◽

Online Survey ◽

Psychological Treatment ◽

Personal Accomplishment ◽

Individual Risk ◽

Cross Sectional ◽

Work Related

Objective: To evaluate factors potentially associated with burnout in Brazilian physicians and medical students. Methods: In this cross-sectional online survey, participants were evaluated in October 2019 regarding sociodemographic, personal, work-related, and mental health factors. Different phases of medical careers and work settings were represented. Burnout symptoms were assessed by means of the Maslach Burnout Inventory. The most common cut-off points were used for emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA). The total scores of these dimensions were used as dependent variables in order to assess the risk factors for each burnout dimension. Results: 2,486 participants were included in the study. The mean age was 38.92 years (SD = 12.64), 62.8% were female, and 39.9% declared themselves as burned out. EE was present in 59.3%, DP in 45.5%, and low PA in 33.1% of the sample. Workload, age, sex, work environment, psychiatric history, quality of the relationships with family and friends, leisure and physical activity were all associated with burnout. Those participants who reported that they were not undergoing any type of psychological treatment, but nevertheless felt like they should be in treatment, actually had more symptoms. Burnout was also related to having suicidal ideation in the last month and to alcohol abuse. Conclusion: In addition to individual risk factors, this study shows the importance of characteristics of the work environment such as fostering cooperation, empathy and shared values between superiors, institutions, and physicians. Also, stigma and the barriers to seeking care appear as an important issue, as well as the association between burnout, alcohol abuse, and suicidal ideation.

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Modesty, Objectification, and Disordered Eating Patterns: A Comparative Study between Veiled and Unveiled Muslim Women Residing in Kuwait

Medical Principles and Practice ◽

10.1159/000495567 ◽

2018 ◽

Vol 28 (1) ◽

pp. 41-47

Author(s):

Naif Al-Mutawa ◽

Susannah-Joy Schuilenberg ◽

Rumia Justine ◽

Sarah Kulsoom Taher

Keyword(s):

Eating Disorders ◽

Eating Disorder ◽

Online Survey ◽

Negative Relationship ◽

Muslim Women ◽

The Self ◽

Body Parts ◽

Self Objectification ◽

Disordered Eating Patterns ◽

The Impact

Background: The common thread running through all forms of sexual objectification is the experience of being treated as a body (or collection of body parts) valued predominantly for its use to (or consumption by) others. If girls and women adopt a peculiar view of the self, an effect called self-objectification, this may contribute to depression, sexual dysfunction, and eating disorders. The objective of this study is to investigate the impact of modesty (in terms of veiling, i.e., hijab) on objectification, by others and by the self, body image, and behaviors indicative of eating disturbance in veiled and unveiled Muslim women in Kuwait. Methods: This is a community-based, cross-sectional study conducted through an online survey. The respondents were females living in Kuwait. Results: Unveiled women experienced more objectification by others than veiled women. There were no significant differences found between veiled and unveiled women in self-objectification and eating disorder symptomatology. There is a significant negative relationship between modesty of clothing and objectification by others. No significant relationship was found between modesty of clothing and the self-objectification and eating disorder scales. For the objectification by others scale, data show that there is a positive relationship between this scale and eating disorders. Eating disorders were found to have a negative relationship with self-objectification. Conclusion: The results of the study are significant as they clearly demonstrate a weak negative relationship between clothing preferences/affiliations and eating disorders.

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The classification of bulimic eating disorders: a community-based cluster analysis study

Psychological Medicine ◽

10.1017/s003329170003782x ◽

1996 ◽

Vol 26 (4) ◽

pp. 801-812 ◽

Cited By ~ 58

Author(s):

P. J. Hay ◽

C. G. Fairburn ◽

H. A. Doll

Keyword(s):

Cluster Analysis ◽

Eating Disorders ◽

Eating Disorder ◽

Bulimia Nervosa ◽

Binge Eating ◽

Predictive Validity ◽

Population Sample ◽

Cluster Solution ◽

Dsm Iv ◽

Low Levels

SynopsisThere is controversy over how best to classify eating disorders in which there is recurrent binge eating. Many patients with recurrent binge eating do not meet diagnostic criteria for either of the two established eating disorders, anorexia nervosa or bulimia nervosa. The present study was designed to derive an empirically based, and clinically meaningful, diagnostic scheme by identifying subgroups from among those with recurrent binge eating, testing the validity of these subgroups and comparing their predictive validity with that of the DSM-IV scheme.A general population sample of 250 young women with recurrent binge eating was recruited using a two-stage design. Four subgroups among the sample were identified using a Ward's cluster analysis. The first subgroup had either objective or subjective bulimic episodes and vomiting or laxative misuse; the second had objective bulimic episodes and low levels of vomiting or laxative misuse; the third had subjective bulimic episodes and low levels of vomiting or laxative misuse; and the fourth was heterogeneous in character. This cluster solution was robust to replication. It had good descriptive and predictive validity and partial construct validity.The results support the concept of bulimia nervosa and its division into purging and non-purging subtypes. They also suggest a possible new binge eating syndrome. Binge eating disorder, listed as an example of Eating Disorder Not Otherwise Specified within DSM-IV, did not emerge from the cluster analysis.

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Life is different now – impacts of eating disorders on Carers in New Zealand: a qualitative study

Journal of Eating Disorders ◽

10.1186/s40337-021-00447-z ◽

2021 ◽

Vol 9 (1) ◽

Author(s):

Louise Fletcher ◽

Henrietta Trip ◽

Rachel Lawson ◽

Nicki Wilson ◽

Jennifer Jordan

Keyword(s):

Eating Disorders ◽

Eating Disorder ◽

New Zealand ◽

Thematic Analysis ◽

Online Survey ◽

Family Members ◽

Qualitative Interview ◽

Eating Disorder Treatment ◽

Disorder Treatment ◽

Inductive Thematic Analysis

Abstract Background Eating disorders are widely recognized as serious illnesses, with complex psychological and physiological comorbidities. Affected individuals face a protracted and challenging treatment journey which, particularly for children and adolescents, requires significant input from family members as carers. This study investigated the perspectives and experiences of those caring for family members with an eating disorder diagnosis. Method Participants were carers of affected individuals with an eating disorder, and were recruited from an online survey, subsequently consenting to a semi-structured qualitative interview. Inductive thematic analysis was undertaken to identify themes. Results Most participants in the sample were parents of affected individuals. Significant and ongoing psychological and emotional impacts were identified across the sample. The diagnosis, treatment journey and overall impact of the carer role created a situation captured by the over-arching theme ‘life is different now’. Impacts profoundly influenced relationships and were felt across all aspects of life by carers, affected individuals and other family members. Heightened worry and vigilance experienced by carers continued beyond improvement or recovery. Conclusions This research highlighted challenging and often exhausting impacts felt by carers due to their pivotal role in eating disorder treatment. Inadequate support for most carers in this sample has clear implications for families as well as service and funding providers. Further research should more fully investigate carer experience with different eating disorders to explore the type of support necessary to build capacity and resilience to reduce carer burden.

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Parental and Adult Attachment and Eating Symptomology in Eating Disorder Patients and Sine Morbo Individuals

International Journal of Social Science Studies ◽

10.11114/ijsss.v5i6.2420 ◽

2017 ◽

Vol 5 (6) ◽

pp. 43 ◽

Cited By ~ 1

Author(s):

Tamás Dömötör Szalai ◽

Edit Czeglédi M.A.

Keyword(s):

Eating Disorders ◽

Eating Disorder ◽

Parental Care ◽

Adult Attachment ◽

Emotional Eating ◽

Online Survey ◽

Attachment Security ◽

Cross Sectional ◽

Eating Disorder Symptoms ◽

The Relationship

Attachment can contribute to eating disorder symptomology through various paths, including emotion regulation. However, the relationship between parental and adult attachment and emotional eating and other eating disorder symptoms have been barely investigated on comparative samples. This cross-sectional, questionnaire-based online survey aimed to assess the relationship between parental and adult attachment qualities with the eating behavior severity, emotional eating, and the level of depression in 67 female anorexia nervosa, bulimia nervosa, and binge eating disorder patients, compared to 67 female sine morbo individuals. Eating disorder patients less frequently had secure attachment, and were more often fearful or preoccupied than sine morbo individuals. In sine morbo individuals lower adult attachment security, but in patients, lower parental care was related to eating disorder symptoms. In sine morbo individuals, higher preoccupation, but in patients, higher fearfulness and lower care was related to emotional eating. Lower attachment security (OR = 0.54), younger age (OR = 0.93) and higher depression (OR = 1.04) explained 36.6% of the variance of diagnosed eating disorders. A complex interplay could be highlighted between dysfunctional attachment dimensions and eating symptomology in both groups—but with different patterns. Perceived parental care may be influential for eating disorder patients, whilst the degree of adult attachment security can be influential for sine morbo individuals. Lower attachment security was a predictor of eating disorders, which suggests the protective value of enhancing attachment security. However, further attachment-based interventions are required.

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The experiential perspectives of parents caring for a loved one with a restrictive eating disorder in the UK

BJPsych Open ◽

10.1192/bjo.2021.1019 ◽

2021 ◽

Vol 7 (6) ◽

Author(s):

Hannah Cribben ◽

Pamela Macdonald ◽

Janet Treasure ◽

Erica Cini ◽

Dasha Nicholls ◽

...

Keyword(s):

Eating Disorders ◽

Anorexia Nervosa ◽

Eating Disorder ◽

Focus Groups ◽

Service Providers ◽

Healthcare Providers ◽

Transition Process ◽

Loved One ◽

Experience Of Care ◽

The Uk

Background Parents of a loved one with an eating disorder report high levels of unmet needs. Research is needed to understand whether clinical guidance designed to improve the experience of parents has been effective. Aims To establish parents’ experiential perspectives of eating disorder care in the UK, compared with guidance published by Beat, a UK eating disorders charity, and Academy for Eating Disorders, the leading international eating disorders professional association. Method A total of six focus groups (one online and five face-to-face) were held throughout the UK. A total of 32 parents attended. All participants were parents of a loved one with a diagnosis of anorexia nervosa or atypical anorexia nervosa (mean age 22 years; mean duration of illness 4.4 years). Focus groups were transcribed, and the text was analysed with an inductive approach, to identify emerging themes. Results Four key themes were identified: (a) impact of eating disorder on one's life, (b) current service provisions, (c) navigating the transition process and (d) suggestions for improvement. Conclusions Current experiences of parents in the UK do not align with the guidelines published by Beat and Academy of Eating Disorders. Parents identified a number of changes that healthcare providers could make, including improved information and support for parents, enhanced training of professionals, consistent care across all UK service providers, policy changes and greater involvement of families in their loved one's care. Findings from this project informed the design of a national web-survey on loved ones’ experience of care in eating disorders.

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Food Addiction in Eating Disorders and Obesity: Analysis of Clusters and Implications for Treatment

Nutrients ◽

10.3390/nu11112633 ◽

2019 ◽

Vol 11 (11) ◽

pp. 2633 ◽

Cited By ~ 10

Author(s):

Susana Jiménez-Murcia ◽

Zaida Agüera ◽

Georgios Paslakis ◽

Lucero Munguia ◽

Roser Granero ◽

...

Keyword(s):

Eating Disorders ◽

Eating Disorder ◽

Personality Traits ◽

Food Addiction ◽

Total Sample ◽

Phenotypic Characterization ◽

Yale Food Addiction Scale ◽

High Prevalence ◽

Low Levels

Food addiction (FA) has been associated with greater psychopathology in individuals with eating disorders (ED) and obesity (OBE). The current study aims to provide a better phenotypic characterization of the FA construct by conducting a clustering analysis of FA in both conditions (ED and OBE). The total sample was comprised of 234 participants that scored positive on the Yale Food Addiction Scale 2.0. (YFAS-2) (119 bulimia nervosa (BN), 50 binge eating disorder (BED), 49 other specified feeding or eating disorder (OSFED) and 16 OBE). All participants completed a comprehensive battery of questionnaires. Three clusters of FA participants were identified. Cluster 1 (dysfunctional) was characterized by the highest prevalence of OSFED and BN, the highest ED severity and psychopathology, and more dysfunctional personality traits. Cluster 2 (moderate) showed a high prevalence of BN and BED and moderate levels of ED psychopathology. Finally, cluster 3 (adaptive) was characterized by a high prevalence of OBE and BED, low levels of ED psychopathology, and more functional personality traits. In conclusion, this study identified three distinct clusters of ED-OBE patients with FA and provides some insight into a better phenotypic characterization of the FA construct when considering psychopathology, personality and ED pathology. Future studies should address whether these three food addiction categories are indicative of therapy outcome.

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How do lean and non-lean female collegiate athletes view the eating disorder education they receive from their coaches?

International Journal of Sports Science & Coaching ◽

10.1177/1747954118825060 ◽

2019 ◽

Vol 14 (2) ◽

pp. 169-178 ◽

Cited By ~ 1

Author(s):

Jarrod C Hines ◽

Whitney L Wendorf ◽

Alexes N Hennen ◽

Kelsey L Hauser ◽

Madeline M Mitchell ◽

...

Keyword(s):

Eating Disorders ◽

Eating Disorder ◽

Student Athletes ◽

Online Survey ◽

National Collegiate Athletic Association ◽

Collegiate Athletes ◽

Or Education ◽

Female Collegiate Athletes ◽

Education Status

Extant research indicates that collegiate coaches often lack the knowledge or confidence required to provide their student–athletes with effective educational experiences related to eating disorders. The current study investigates the prevalence and quality of such experiences from the perspective of lean and non-lean female student–athletes at a National Collegiate Athletic Association Division III institution. Participants were asked closed- and open-ended questions in an anonymous online survey. Lean and non-lean participants reported similar rates of education despite differential risk for eating disorders. Approximately 70% of student–athletes expressed a desire for a more comprehensive and long-term program of study. Participants’ confidence in identifying an eating disorder in a peer did not differ based on type of sport or education status, but those who were educated identified more appropriate potential symptoms than did those who were uneducated. This indicates some degree of educational effectiveness. However, education status and type of sport had no bearing on the likelihood of a participant speaking with their coach about their own or a peer’s potential disorder. Educational attempts were therefore insufficient to help student–athletes overcome the shame and consequential secrecy associated with eating disorders. Our results underscore the need for effective education for at-risk student–athletes while also clarifying that both lean and non-lean student–athletes often want to receive more comprehensive education about eating disorders. Current findings highlight specific areas of student–athlete interest about the topic and could be used to help coaches revise their educational efforts to enhance engagement and long-term retention of information.

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