scholarly journals An Examination of Burnout Predictors: Understanding the Influence of Job Attitudes and Environment

Healthcare ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 502
Author(s):  
Katelyn J. Cavanaugh ◽  
Hwa Young Lee ◽  
Diane Daum ◽  
Shine Chang ◽  
Julie G. Izzo ◽  
...  
Keyword(s):  
Response Rate ◽  
Job Attitudes ◽  
Group Level ◽  
Negative Consequences ◽  
Employee Survey ◽  
Single Item ◽  
Vacancy Rates ◽  
Post Hoc ◽  
Clinical Departments ◽  
Healthcare Employees

Burnout amongst healthcare employees is considered an epidemic; prior research indicates a host of associated negative consequences, though more research is needed to understand the predictors of burnout across healthcare employees. All employees in a cancer-focused academic healthcare institution were invited to participate in a bi-annual online confidential employee survey. A 72% response rate yielded 9979 complete responses. Participants completed demographic items, a validated single-item measure of burnout, and items measuring eight employee job attitudes toward their jobs and organization (agility, development, alignment, leadership, trust, resources, safety, and teamwork). Department-level characteristics, turnover, and vacancy were calculated for group level analyses. A univariate F test revealed differences in burnout level by department type (F (3, 9827) = 54.35, p < 0.05) and post hoc Scheffe’s tests showed employees in clinical departments reported more burnout than other departments. Hierarchical multiple regression revealed that employee demographic and job-related variables (including department type) explained 8% of the variance of burnout (F (19, 7880) = 37.95, p < 0.001), and employee job attitudes explained an additional 27% of the variance of burnout (F (8, 7872) = 393.18, p < 0.001). Relative weights analysis at the group level showed that, of the constructs measured, alignment is the strongest predictor of burnout, followed by trust and leadership. The relationships are inverse in nature, such that more alignment is related to less burnout. Turnover and vacancy rates did not predict group level burnout. The results reported here provide evidence supporting a shift in the focus of research and practice from detection to prevention of employee burnout and from individual-focused interventions to organization-wide interventions to prevent burnout.

scholarly journals The evaluation of information provided to patients about the disease and its course in hospitals

Medicina ◽  
2007 ◽  
Vol 43 (8) ◽  
pp. 664 ◽  
Author(s):  
Rytė Giedrikaitė ◽  
Irena Misevičienė ◽  
Irayda Jakušovaitė
Keyword(s):  
Decision Making ◽  
Response Rate ◽  
Medical Examination ◽  
Negative Consequences ◽  
General Hospitals ◽  
Treatment Methods ◽  
The Republic ◽  
Right To Information ◽  
Methods Of Treatment

The aim of the study was to evaluate and compare patients’ and physicians’ opinions about the assurance of patients’ right to information about the disease, the results of medical examination, treatment methods and their outcomes. Material and methods. The study was performed during November 2006 – February 2007 in two counties of Lithuania. Seven hospitals were randomly selected for the study. The participants of the study were all patients who on the day of the inquiry were treated in the departments of internal diseases and surgery and all physicians who worked in these departments on that day. Patients with severe conditions and those who were newly admitted were excluded from the study. In total, 494 questionnaires were distributed, of which 366 were distributed among patients (response rate – 71.3%) and 128 among physicians (response rate – 70.3%). Results. One-half of the inquired patients (50.9%) did not know what rights they are guaranteed by the Republic of Lithuania Law on the Rights of Patients and Compensation of the Damage to Their Health. However, the majority of patients thought that they were provided information about their disease (86.1%), the results of medical examination (76.2%), the methods of treatment (74.2%), and possible positive and negative consequences (65.2%). The comparison of patients’ and physicians’ evaluation of the provided information revealed certain differences. Physicians were inclined to evaluate themselves better. More than one-half (65.5%) of physicians stated that they provided patients with information concerning the possibility for their participation in treatment-related decision-making, but patients did not participate sufficiently actively (34.5% of positive responses) in making heath-related decisions. Conclusions. Patients are not very well informed about the Republic of Lithuania Law on the Rights of Patients and Compensation of the Damage to Their Health. The majority of patients in the studied general hospitals stated that they were provided with and understood information about their disease, the results of medical examination, and treatment methods and prognosis. The study showed that only one-third of patients expressed their opinion to the physician when making treatment-related decisions, and their opinion was taken into consideration.

scholarly journals ACTR-20. EFFICACY OF INITIAL TEMOZOLOMIDE FOR HIGH-RISK LOW GRADE GLIOMAS IN A PHASE II AINO (ITALIAN ASSOCIATION FOR NEURO-ONCOLOGY) STUDY: A POST-HOC ANALYSIS WITHIN MOLECULAR SUBGROUPS OF WHO 2016

2019 ◽  
Vol 21 (Supplement_6) ◽  
pp. vi16-vi17
Author(s):  
Roberta Rudà ◽  
Alessia Pellerino ◽  
Andrea Pace ◽  
Carmine Maria Carapella ◽  
Cristina Dealis ◽  
...  
Keyword(s):  
High Risk ◽  
Phase Ii ◽  
Response Rate ◽  
Long Term Results ◽  
Molecular Subgroups ◽  
Who Grade ◽  
Post Hoc Analysis ◽  
Grade Ii ◽  
Post Hoc ◽  
Who Grade Ii Gliomas

Abstract BACKGROUND The optimal management of high risk WHO grade II gliomas after surgery is still debated. The efficacy of initial temozolomide to delay radiotherapy and risk of cognitive defects could vary across the molecular subgroups of WHO 2016, but information on this issue are lacking. PATIENTS AND METHODS A post-hoc analysis has been performed on a cohort of high risk WHO grade II gliomas, who received initial temozolomide alone in phase II multicenter study, with the objective of re-evaluating the long-term results across the different molecular subgroups of the WHO 2016 classification. The primary endpoint of the study, carried out between 2007 and 2010, was response rate according to RANO, being seizure response, PFS and OS secondary endpoints. RESULTS Response rate (partial and minor responses) among oligodendrogliomas IDH-mutant and 1p/19q codeleted (76%) was significantly higher than that among diffuse astrocytomas either mutant (55%) or wild-type (36%). A reduction of seizure frequency >50% was observed in 87% patients and a seizure freedom in 72%. The probability of seizure reduction >50% was significantly associated with the presence of an IDH mutation. Median PFS, PFS at 5 and 10 years, median OS and OS at 5 and 10 years were all significantly longer in oligodendrogliomas IDH-mutant and 1p/19q codeleted. Of patients who did not recur or delay radiotherapy at recurrence for a median follow-up of 8.2 years, 67% and 59%, respectively, were oligodendrogliomas IDH-mutant and 1p/19q codeleted. CONCLUSIONS The post-hoc analysis of this phase II trial suggests that the beneficial effects of initial temozolomide prevail in oligodendrogliomas IDH-mutant and 1p/19q codeleted: thus, these tumors, when incompletely resected or progressive after surgery, especially when suffering from pharmacoresistant seizures, could receive temozolomide as initial treatment with radiotherapy and chemotherapy at recurrence. The trial was registered with EU Clinical Trials Register, EudraCT n. 2007/000386-38.

scholarly journals Awareness of the Basic Knowledge of Hand Hygiene in Chinese Medical Facilities: A Questionnaire-Based Survey

2020 ◽  
Author(s):  
Jing YANG ◽  
Li LONG ◽  
Shu FENG ◽  
Wei SUN ◽  
Lifang GAO ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Correct Response ◽  
Response Rate ◽  
Basic Knowledge ◽  
Healthcare Staff ◽  
Healthcare Associated Infection ◽  
Care Facilities ◽  
Healthcare Associated ◽  
Clinical Departments ◽  
Correct Response Rate

Abstract Background: Hand hygiene is a key measure for the prevention and control of healthcare-associated infection. We investigated the level of awareness of the basic concepts surrounding hand hygiene among healthcare staff in China in order to inform the development of future targeted hand hygiene promotion activities. Methods: A pre-tested questionnaire was used to obtain data from April to June 2018 in 30 provinces and municipalities in three regions of China. Ten single/multiple-choice questions investigated the level of awareness of the role of hands in germ transmission, the concept of hand hygiene, and the indications when it should be performed. Logistic analysis was performed to identify differences between regions, types of hospitals, healthcare staff categories, clinical departments and gender.Results: A total of 52,286 responses were received. Among these, 45,455 (86.94%) complete surveys were eligible to be included in the final analysis. The two highest correct response rates concerned the relationship between hand hygiene and healthcare-associated infection and the characteristics of microbiota and resident flora on hands (97.71% and 96.35%, respectively). These were followed by awareness of the World Health Organization’s “My 5 moments for hand hygiene” concept (91.61%), glove use (90.53%), hand hygiene materials (89.28%), characteristics of microbiota and transient flora on hands (84.60%), indications for hand hygiene and other aspects (71.00%), the basic concept of hand hygiene (65.20%), and the effectiveness of alcohol-based handrub on the hand microbiome (48.04%). The overall correct response rate was 26.53%. Eastern China demonstrated a better knowledge than other regions (adjusted odds ratio [aOR] 4.08; 95% CI 3.84–4.32). Respondents in primary care facilities had a higher correct response rate than other types of hospitals (aOR 2.33; 95% CI 2.05–2.66) and logistics staff had the highest correct response rate than other professional groups (aOR1.84; 95% CI 1.53–2.29). Among clinical departments, staff in the outpatient/emergency room had the highest rate of correct responses (aOR1.51; 95% 1.34-1.71).Conclusions: Large differences exist in the basic knowledge of hand hygiene across different regions in China. Knowledge levels need to be specifically strengthened among secondary care facilities, nurse professionals, gynaecology/obstetrics/paediatric departments and infection control units.

Evaluation of daily patch application duration for epicutaneous immunotherapy for peanut allergy

2020 ◽  
Vol 41 (4) ◽  
pp. 278-284
Author(s):  
David M. Fleischer ◽  
Jonathan M. Spergel ◽  
Edwin H. Kim ◽  
Dianne E. Campbell ◽  
Todd D. Green ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Peanut Allergy ◽  
Response Rate ◽  
Peanut Protein ◽  
Phase Iii ◽  
Application Time ◽  
Phase Iii Clinical Trial ◽  
Patch Application ◽  
Epicutaneous Immunotherapy ◽  
Post Hoc

Background: Epicutaneous immunotherapy is a potential novel immunotherapy that utilizes unique cutaneous immunologic properties. In a phase III, randomized, double-blind, placebo controlled clinical trial, an epicutaneous patch (DBV712) with 250 µg of peanut protein applied once daily for 12-months was statistically superior to placebo in desensitizing children with peanut allergy (ages 4‐11 years) (N = 356). Objective: To assess the relationship between the hours of daily application time and the efficacy of DBV712 250 µg. Methods: DBV712 250 µg was applied to 30 nonallergic volunteers for various durations from 2 to 24 hours and then assayed for residual peanut protein. Patch application data from the phase III clinical trial were analyzed post hoc according to prespecified responder rates and changes in the eliciting dose (ED), as measured by the geometric mean (GM) ED ratio (12 months/baseline). Results: Following application, there was a marked decrease in peanut protein on the patches from 2 to 12 hours. After 12 hours, the median peanut protein recovered was below quantification limits. The median daily patch application duration in subjects from the phase III clinical trial was 21.1 hours (DBV712 250 µg) and 22.4 hours (placebo). Ninety-five percent of the treated population achieved >10 hours per day mean application. Response rates and GM ED ratios were similar among subjects across a range of application durations; e.g., in those with a mean duration of >10 hours, the response rate was 36.6% and the GM ED ratio was 3.8, comparable with 42.6% and 4.0, respectively, in those with a mean duration of >20 hours. In DBV712 250 µg subjects with >16 hours mean application duration (84.5% of the treated population), the response rate was 38.8% versus 13.4% for placebo (difference, 24.4% [95% confidence interval, 15.5‐34.0%]; p < 0.001). Conclusion: An evaluation of residual peanut protein on patches following application and post hoc analysis of phase III data strongly suggest that allergen delivery is attained with 12‐16 hours of daily patch application time, sufficient to drive clinically meaningful desensitization to peanut after 12 months.

When the term “schizophrenia” is enough to modify the way you interact with others: Evidence for a motor synchrony task

2017 ◽  
Vol 41 (S1) ◽  
pp. s830-s830
Author(s):  
N. Rainteau ◽  
R. Salesse ◽  
S. Raffard ◽  
D. Capdevielle
Keyword(s):  
Social Interactions ◽  
Schizophrenia Patient ◽  
Negative Consequences ◽  
Post Hoc Analysis ◽  
Self Reports ◽  
Behavioural Research ◽  
Competing Interest ◽  
Post Hoc ◽  
Positive Effect ◽  
Social Behaviours

IntroductionMost individuals with schizophrenia will be confronted with some forms of stigmatization. In recent years, the term “schizophrenia” has been increasingly contested by clinicians and family members and many of them argue for a change of name. Surprisingly, most of the research has been explored though self-reports but behavioural research is still lacking. The aim of our study was to assess through an experimental design if the term “schizophrenia” was enough to modify social behaviours.MethodsEleven participants from the community were asked to engage in three coordination tasks with a simple dot displayed on a screen and moved by another person. Participants had to synchronize their movements with either a schizophrenia patient, a patient with neuro-emotional integration disorder (NEID) or a healthy subject, situated in different rooms. Each condition was counterbalanced between participants. In reality, the movements of the dot were pre-recorded (five trajectories) and were therefore identical for all three conditions.ResultsMeasuring the error between the displayed and performed trajectories, participants coordinate worse when they though interacting with a schizophrenia or NEID patient in comparison to the “healthy” (F(2.20) = 4.02; P = .034; n2P = 0.29) condition. Post-hoc analysis revealed an even higher difference between “schizophrenia” and “healthy” conditions (P = 0.01).ConclusionOur study is the first to demonstrate that the label “schizophrenia” directly impacts our behaviour, with negative consequences on social interactions. However, our results cannot confirm yet a positive effect induced by changing the name.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Anxiety Screening in Polytrauma Patients by Use of Single-Item Reporting With the Neurobehavioral Symptom Inventory: How Brief Is Too Brief?

2021 ◽  
pp. 003329412110317
Author(s):  
Glen A. Palmer ◽  
Daniel G. Palmer
Keyword(s):  
Mental Health ◽  
Roc Curve ◽  
Single Item ◽  
Symptom Inventory ◽  
Mental Health Referral ◽  
Minimum Score ◽  
Polytrauma Patients ◽  
Cutoff Scores ◽  
Anxiety Screening ◽  
Post Hoc

Purpose/Objective: This study examined the clinical utility of a single item for anxiety from the Neurobehavioral Symptom Inventory (NSI) in determining the need for mental health referral for veterans with traumatic brain injury (TBI). Research Method/Design: Three hundred eighty veterans referred for TBI evaluation were administered the NSI and a common anxiety screening measure (Beck Anxiety Inventory; BAI). Receiver Operating Characteristic (ROC) curve analyses were conducted to determine ideal BAI total cutoff scores for a single item of the NSI pertaining to anxiety (i.e., “anxious or tense”). Results Using multiclass ROC curve analyses, NSI scores of 3 and 4 for the sample were comparable to scores of 11 and 22 on the BAI, respectively. Post hoc ROC curve analyses were then conducted on the sample after removal of potentially invalid NSI protocols (i.e., Validity-10 scores greater than 22), and NSI scores 3 and 4 corresponded with scores of 11 and 20, respectively. Conclusion/Implications A minimum score of 3 (severe) on the NSI item was deemed sufficient to indicate the need for further mental health referral without warranting additional screening for anxiety. Further analyses also revealed that removal of positive Validity-10 protocols did not significantly change ROC curve findings, suggesting that the particular NSI item for anxiety can still be used for clinical purposes despite an otherwise invalid protocol. Implications for treatment and recommendations pertaining to when additional screening might be required are discussed.

scholarly journals Where There’s Smoke: Validating a Nonproprietary Single-Item Burnout-Impacting-Safety Scale

2021 ◽  
pp. 34-44
Author(s):  
Amanda Pearl ◽  
Steve Mrozowski ◽  
Daniel Shapiro
Keyword(s):  
Patient Safety ◽  
High Risk ◽  
Healthcare Providers ◽  
The United States ◽  
Cutoff Score ◽  
Single Item ◽  
Survey Item ◽  
Safety Event ◽  
Clinical Departments ◽  
The Impact

This study aimed to assess the utility of a single survey item to predict the impact of burnout on safety and quality of healthcare providers as perceived by their colleagues. The primary objective is to determine if the item predicts the frequency of patient safety event reports within certain clinical departments. The secondary objective will be to determine if there is an acceptable cutoff score for the item which predicts low versus high numbers of safety events reported by healthcare providers in each clinical department. Participants were 424 healthcare providers in an academic medical center in the mid-Atlantic region of the United States. The item was designed to assess for the perception of the impact of burnout on work in terms of quality or safety using a 5-point Likert scale. Data from a patient safety event reporting system was accessed for the year of survey completion (2017). A negative binomial regression was used to assess the ability of the item to predict reported patient safety event reports. The item was found to significantly predict objective safety event data. Sensitivity and specificity, as well as receiver operating characteristic (ROC) curve analyses, were conducted to determine appropriateness of cutoff scores to identify low- and high-risk clinical departments. The item was found to demonstrate adequate sensitivity (82%) using a cutoff score of 4 on the survey item. However, the area under the curves (AUCs) which assess diagnostic accuracy fell in the poor range. These results suggest that healthcare administrators could deploy this single item as a brief pulse or screener of teams of individuals who are within a work unit and use a cutoff score of 4 as a means to assess for hot spots where healthcare provider burnout may be putting patients at high risk in terms of safety.

scholarly journals Occupational Stress among Nigerian Orthodontists and Orthodontic Residents: A Cross-Sectional Study

2021 ◽  
pp. 195-204
Author(s):  
Elfleda A. Aikins ◽  
Adaeze N. Anosike ◽  
Tolulase Abosede Yemitan
Keyword(s):  
Occupational Stress ◽  
Time Management ◽  
Response Rate ◽  
Working Hours ◽  
Cross Sectional Study ◽  
Negative Consequences ◽  
Cross Sectional ◽  
Long Working Hours ◽  
Practice Characteristics ◽  
Severity Scores

Background: The job of the orthodontist involves long working hours and interaction with each patient for many years before the conclusion of treatment thus orthodontists may experience peculiar levels of stress.  Occupational stress has been proven to have negative consequences and can result in not only burnout but also hypertension and even suicide. The aim of this study was to assess the areas of orthodontic practice that cause stress among orthodontists and orthodontic residents practicing in Nigeria as well as to evaluate various personal and practice characteristics that affect these reports of occupational stress. Methods: Data was collected over a three-month period using an online self-administered modified version of the Occupational Stress Questionnaire which was sent through the Nigerian Association of Orthodontists WhatsApp group and to the personal emails of all members. Data was collated and analysed using SPSS version 21. Results: A total of 69 (71% response rate) responses were received. Males and older orthodontists experienced higher levels of stress. Seven items had mean severity scores equal to or greater than 3.75 and were considered the most concerning stressors in orthodontic practice. These included “Lack of patient compliance with treatment instructions is painful” and “Treating a case with an unfavorable prognosis is disturbing”. Conclusions: The most concerning stressors in orthodontic practice as perceived by Nigerian orthodontists and orthodontic residents are those related to time management and patient motivation.

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