Assessment of cognitive factors and their relationship with burnout syndrome at different levels of medical education

Consecutive completion of specialist and residency training is an important stage in the development of a young physician. Therapeutic activity implies emotional intensity and a great number of factors, causing stress. The syndrome of emotional burnout is not only a result of neuropsychological stress, but also a consequence of uncontrolled stress. The aim of the research was to determine influence of thinking styles, types of thinking and creativity level on factors of cognitive appraisal as predictors of burnout syndrome development in higher education trainees (specialist and postgraduate training programmes). The search of predictors of a burnout syndrome was carried out for a sample of 330 medical students and 50 physicians of the control group. As a result of research it has been revealed that trainees as well as practitioners have a practical style of thinking; postgraduate trainees more often use the combined one, students, figurative; and physicians, sign type of thinking; higher parameters of creativity are marked in postgraduate trainees over physicians. In general, students on specialty and postgraduate training programmes have less difficulty with most of the cognitive assessment factors. The correlation analysis showed as follows: for students, there were direct links of medium strength between the sign type of thinking and “strong emotionsˮ, emotional detachment, and “future perspectiveˮ; for postgraduate trainees, there were direct and inverse links of very weak and weak strength, which could be neglected. However, further factor analysis is required in order to assess the influence of certain factor on the development of emotional burnout syndrome in medical trainees.

Collective Mindfulness: The Key to Organizational Resilience in Megaprojects

The complexity, internal and external risks, and significant social impact of megaprojects make their organizational resilience particularly important. To survive potential adversities, megaproject organizational resilience depends on collective mindfulness. Drawing on an attention-based view, this study investigates the mechanisms of collective mindfulness for megaproject organizational resilience as a process that functions prior to, during, and after recovery from crises. The results from analyzing six embedded crisis events in two megaprojects indicate that collective mindfulness influences organizational resilience processes through the mechanisms of awareness allocation, emotional detachment, and attention alignment. The study's theoretical and practical implications are discussed.

Features of the emotional burnout of teachers and medical professionals

В статье описаны исследования синдрома эмоционального выгорания и тревожности педагогов и медицинских работников. Выборку исследования составили преподаватели Астраханского государственного медицинского университета в количестве 26 человек и средний медицинский персонал учреждения здравоохранения «Медико-санитарная часть» в количестве 23 человек (г. Астрахань). Были применены следующие психодиагностические методики: 1) методика диагностики уровня эмоционального выгорания. (В.В. Бойко); 2) методика «шкала тревожности» Ч.Б. Спилбергера (State-Trait Anxiety Inventory, STAI) (в росс. адаптации Ю.Л. Ханина). Статический анализ данных осуществлялся с помощью U-критерия Манна-Уитни для независимых выборок, пакета прикладных программ Статистика 10.0. В ходе исследования установлено, что педагоги в значительной степени тревожны, чем медицинские работники. Выявлено, что у педагогов сформирован синдром эмоционального выгорания, у среднего медицинского персонала диагностирована вторая стадия эмоционального выгорания (фаза резистентности). Были зафиксированы следующие доминирующие симптомы в фазе «истощение» у педагогов: «симптом эмоционального дефицита» и «симптом эмоциональной отстраненности». Доминирующими симптомами эмоционального выгорания у медицинских работников были: «неадекватное выборочное эмоциональное реагирование» и «расширение сферы экономии эмоций». Полученные данные могут быть использованы психологами, работающие в системах здравоохранения и образования при составлении программ психологического сопровождения в целях улучшения психологического здоровья педагогов и медицинского персонала. The article describes the studies of the syndrome of emotional burnout and anxiety of teachers and medical workers. The sample of the study consisted of 26 teachers of the Astrakhan State Medical University and 23 nursing staff of the “Medical-Sanitary Unit” health care institution (Astrakhan). The following psychodiagnostic techniques were used: 1) a technique for diagnosing the level of emotional burnout. (V.V. Boyko); 2) methodology "scale of anxiety" Ch.B. Spielberger (State-Trait Anxiety Inventory, STAI) (in Russian adaptation by Yu.L. Khanin). Static data analysis was performed using the Mann-Whitney U-test for independent samples, the Statistics 10.0 application package. The study found that educators are significantly more anxious than healthcare professionals. It was revealed that the teachers developed a syndrome of emotional burnout, the second stage of emotional burnout (the phase of resistance) was diagnosed for nurses. The following dominant symptoms were recorded in the "exhaustion" phase among teachers: "a symptom of emotional deficiency" and "a symptom of emotional detachment". The dominant symptoms of burnout in health care workers were: "inadequate selective emotional response" and "expansion of the sphere of saving emotions." The data obtained can be used by psychologists working in the health care and education systems when drawing up psychological support programs in order to improve the psychological health of teachers and medical personnel

ANALYSIS OF RELATIONSHIPS OF EMOTIONAL BURN OUT FEATURES AND INDICATORS OF EMOTIONAL INTELLIGENCE AMONG MEDICAL WORKERS

Purpose - the aim of this article is to present the results of a statistical analysis of the relationship between the features of emotional burnout and indicators of emotional intelligence among medical workers. Material and methods - 4 groups of respondents (110 medical workers) took part in the study: surgical doctors, therapeutic doctors, surgical nurses, therapeutic nurses. Evaluation of the features of emotional burnout and emotional intelligence was carried out using diagnostic methods of emotional burnout (V.Boyko), the questionnaire of emotional burnout by K. Maslach and S. Jackson (adaptation by N. Vodopyanova) and the method of emotional intelligence (N. Hall). The study consisted of two stages. The purpose of the first stage was to determine the level and characteristics of the manifestation of emotional burnout of medical workers according to the following symptoms: (emotional exhaustion; depersonalization; reduction of personal achievements; "stress" (experiencing traumatic circumstances, dissatisfaction with oneself, caged, anxiety and depression); "resistance" (inadequate selective emotional response, emotional and moral disorientation, expansion of the sphere of saving emotions, reduction of professional duties); "exhaustion" (emotional deficit, emotional detachment, psychosomatic and psychovegetative disorders). The level of manifestation of emotional intelligence of medical workers was also assessed according to the following indicators: emotional awareness, emotion management, self-motivation, empathy, recognition of other people's emotions The second stage of the study was aimed at determining the characteristics of the relationship of individual indicators of emotional benefit screaming with specific indicators of the emotional intelligence of health care workers. Mathematical processing of the research results was carried out using Spearman's correlation coefficient by means of the SPSS 17 computer program. Results and discussion. The results of our research have shown that: 1) the overwhelming majority of the test subjects have high and medium levels of reduction of personal achievements, and such a phase of emotional burnout as resistance” (inadequate selective emotional response, emotional and moral disorientation, expansion of the sphere of economy of emotions, reduction of professional duties); 2) half of respondents have high and medium levels of emotional exhaustion, depersonalization; 3) a quarter of the respondents formed such a phase of emotional burnout as “exhaustion” (emotional deficit, emotional and personal detachment, psychosomatic and psychovegetative disorders). The following levels of development of emotional intelligence were revealed in different groups of medical workers: a) high and medium - among doctors of a surgical profile and doctors of a therapeutic profile; medium - for surgical nurses; low - for therapeutic nurses. Conclusion. Medical workers with high and medium levels of emotional intelligence have a low level of manifestation of symptoms of emotional burnout (dissatisfaction with oneself; feelings of being caged; anxiety and depression; reduction of professional duties; emotional deficit; personal detachment; psychosomatic and psychovegetative disorders), as well as a low level of development phases of tension, resistance, exhaustion, depersonalization and reduction of personal achievements.

Psychotherapy Dropout: Using the Adolescent Psychotherapy Q-Set to Explore the Early In-Session Process of Short-Term Psychodynamic Psychotherapy

Research suggests that short-term psychodynamic psychotherapy (STPP) is an effective treatment for depression in adolescence, yet treatment dropout is a major concern and what leads to dropout is poorly understood. Whilst studies have begun to explore the role of patient and therapist variables, there is a dearth of research on the actual therapy process and investigation of the interaction between patient and therapist. This study aims to address this paucity through the utilisation of the Adolescent Psychotherapy Q-set (APQ) to examine the early treatment period. The sample includes 69 adolescents aged 16–18 years with major depressive disorder receiving STPP as part of the First Experimental Study of Transference Work–in Teenagers (FEST-IT) trial. Of these, 21 were identified as dropouts and were compared to completers on pre-treatment patient characteristics, symptomatology, functioning, and working alliance. APQ ratings available for an early session from 16 of these drop out cases were analysed to explore the patient-therapist interaction structure. Results from the Q-factor analysis revealed three distinct interaction structures that explained 54.3% of the total variance. The first described a process of mutual trust and collaboration, the second was characterised by patient resistance and emotional detachment, the third by a mismatch and incongruence between therapist and adolescent. Comparison between the three revealed interesting differences which taken together provide further evidence that the reasons why adolescents drop out of therapy vary and are multidimensional in nature.

Starting ambulance care professionals and critical incidents: a qualitative study on experiences, consequences and coping strategies

Background Ambulance care professionals are regularly confronted with critical incidents that increase risks for mental health disorders. To minimize these risks, it is important that ambulance care professionals adequately cope with critical incidents. Especially from the perspective of starting ambulance care professionals it is unknown which coping styles they use when experiencing a critical incident and how they are trained to cope with critical incidents. The aim of this study was to gain insight in (a) what starting ambulance care professionals describe as critical incidents, (b) how they experience these critical incidents and their consequences, (c) how they cope with these incidents, and (d) how they are trained and guided to cope with these incidents. Methods A qualitative design with individual, semi-structured interviews was used. The data was analyzed by using inductive thematic analysis. Results Twenty-two starting ambulance care professionals were interviewed of which, 11 were male. The age ranged from 23 to 31 years, with 11 participants being 27 years or younger. Three key-themes emerged that make an incident critical: (1) emotional connection versus emotional detachment, (2) feeling loss of control, and (3) incomprehension. All participants experienced several short to middle term physical, psychological and social consequences after encountering a critical incident. Starting ambulance care professionals applied different coping strategies during different phases of the ambulance care process: a mix of depersonification, focus on the medical task, support from colleagues and their own network, seeking confirmation, and distraction. Most starting ambulance care professionals don’t actively remember they received education about coping with critical incidents during their initial educational program. During and after traineeships, the workplace preceptor has a crucial role for starting ambulance care professionals to learn them how to cope with critical incidents. Conclusions Three key-themes interact to make an incident more critical for starting ambulance care professionals. To cope with these critical incidents, starting ambulance care professionals use a variety of coping strategies. These results can be used to develop training and coaching for starting ambulance care professionals so they can adequately cope with critical incidents.

Defining clinical empathy: a grounded theory approach from the perspective of healthcare workers and patients in a multicultural setting

ObjectiveTo define clinical empathy from the perspective of healthcare workers and patients from a multicultural setting.DesignGrounded theory approach using focus group discussions.SettingA health cluster in Singapore consisting of an acute hospital, a community hospital, ambulatory care teams, a medical school and a nursing school.Participants69 participants including doctors, nurses, medical students, nursing students, patients and allied health workers.Main outcome measuresA robust definition of clinical empathy.ResultsThe construct of clinical empathy is consistent across doctors, nurses, students, allied health and students. Medical empathy consists of an inner sense of empathy (imaginative, affective and cognitive), empathy behaviour (genuine concern and empathic communication) and a sense of connection (trust and rapport). This construct of clinical empathy is similar to definitions by neuroscientists but challenges a common definition of clinical empathy as a cognitive process with emotional detachment.ConclusionsThis paper has defined clinical empathy as ‘a sense of connection between the healthcare worker and the patient as a result of perspective taking arising from imaginative, affective and cognitive processes, which are expressed through behaviours and good communication skills that convey genuine concern’. A clear and multidimensional definition of clinical empathy will improve future education and research efforts in the application and impact of clinical empathy.

“A Dress of Fire”: Reading Sándor Ferenczi's Clinical Diary

Ferenczi's Clinical Diary reveals an exceptional analyst who honestly and bravely documented radical clinical experiences and theoretical insights about the tragic impacts of trauma. The author follows Ferenczi's thinking from his falling out with Freud and his view of the classical psychoanalyst's objectivity and emotional detachment as triggers of the original trauma, through the use of the countertransference to lay bare trauma, eventually issuing in his radical experiment in mutual analysis. The Diary's fate in the history of psychoanalysis reflects that of its thinking on trauma: Beginning with Ferenczi's decades-long silencing and exclusion from the main psychoanalytic community, together with the silencing of actual trauma, this history evolved into the revival and dissemination of Ferenczi's thinking and the reappraisal of the role of actual trauma.

Adolescents’ Modern Media Use and Beliefs About Masculine Gender Roles and Norms

In the current study, cultivation theory is used to examine associations among amount of time spent with television (including Netflix or other streaming services), video games, and YouTube and beliefs about masculine roles and norms within a diverse sample of 307 13- to 18-year-olds from the United States. Heavy users of television, video games, and YouTube outscored lighter users on endorsement of views of masculinity that favor emotional detachment, dominance, toughness, and/or avoidance of femininity among boys and girls in the sample. For boys only, heavy exposure to violence in favorite games also played a role.