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Emotional influence not only depends on a person’s group membership, but also on their particular position within the group’s structured interpersonal relations. When the group is part of a wider organisation, additional regulatory regimes may constrain or afford particular forms of emotional conduct. This chapter focuses on how work roles shape emotion communication and regulation. Team leaders’ emotions can set the emotional tone of work-groups, encouraging solidarity and common purpose. In the service sector, clients and customers impose different kinds of emotional demand on employees. Workers whose jobs involve interacting with consumers present the company’s outward face, and are encouraged to regulate their emotional presentations accordingly (emotional labour). Caring professionals need to manage the potential personal costs of empathising with clients undergoing potentially devastating life changes. In all of these cases, employees’ emotions influence and are influenced by the people they deal with in their working lives.
The aim of this study was to assess whether burnout and empathy levels among general practitioners (GPs) might influence prescribing performance assessed using pharmaceutical prescription quality standard indicators.
Design and Setting:
Cross-sectional descriptive study of 108 GPs from 22 primary care centers in Lleida, Spain, and of centralized data corresponding to 183 600 patients under their care. The study was conducted between May and July 2014.
Main Outcome Measures:
Burnout and empathy were measured using the Spanish versions of the Maslach Burnout Inventory and the Jefferson Scale for Physician Empathy, and prescribing quality was measured using the Catalan Pharmaceutical Prescription Quality Standard (EQPF). Normal distribution of scores was verified using the Chi-square and Kolmogorov–Smirnov–Lilliefors tests. The effect of each of the variables was evaluated using crude odds ratios.
Older GPs scored significantly higher in the EQPF (P < 0.05). High empathy scores were positively associated with high EQPF scores. GPs with low burnout also performed better in the EQPF.
More empathic, less burned-out, older GPs showed better prescribing performance according to quality indicators. However, further studies are needed to evaluate other factors influencing prescribing habits. The promotion of communication skills may increase empathy and reduce burnout, thus benefiting patients.
The primary objective of this study was to evaluate feasibility and acceptability of Mindfulness-based Wellness and Resilience (MBWR): a brief mindfulness-based intervention designed to enhance resilience and is delivered to interdisciplinary primary care teams.
Burnout is a pervasive, international problem affecting the healthcare workforce, characterized by emotional exhaustion, depersonalization, and decreased professional effectiveness. Delivery models of mindfulness-based resilience interventions that enhance feasibility for onsite delivery, consider cultural considerations specific to primary care, and utilize team processes that are integral to primary care are now needed.
We conducted a mixed-methods feasibility and acceptability trial of MBWR. Primary feasibility and acceptability outcomes were assessed by number of participants recruited, percent of MBWR treatment completer, and attrition rate during the 8-week intervention, and four items on a Likert-type scale. Secondary outcomes of perceived effects were measured by focus groups, an online survey, and self-reported questionnaires, including the Brief Resilience Scale, the Five Facet Mindfulness Questionnaire-Short Form, and the Self-Compassion Scale-Short Form. Participants included 31 healthcare providers on interdisciplinary primary care teams employed a safety-net medical center. In the MBWR group, 68% identified as Latinx, compared to 64% in the control group.
All criteria for feasibility were met and participants endorsed high levels of satisfaction and acceptability. The results of this study suggest that MBWR provides multiple perceived benefits to the individual healthcare provider, cohesion of the healthcare team, and enhanced patient care. MBWR may be a feasible and acceptable method to integrate mindfulness, resilience, and teamwork training into the primary care setting.
In the emotionally intense field of healthcare, the ability to peacefully inhabit one's body, maintain good boundaries, and be fully present during care is essential. This study aimed to validate the recently developed Mindful Self-Care Scale (MSCS) among hospice and healthcare professionals and develop a brief version of the 33-item MSCS.
A sample of hospice and healthcare professionals from all 50 states (n = 858) was used. A confirmatory factor analysis was run using a rigorous methodology for validation and item reduction to develop a brief version of the 33-item MSCS. The brief MSCS (B-MSCS) was developed by identifying items for exclusion through examination of conceptual overlap, descriptive statistics by detecting sources of improvement model fit using confirmatory factor analysis. Model modifications were done sequentially and with regard to theoretical considerations.
The existing model, 33-item MSCS with six subscales, had good fit to the data with all indicators in acceptable ranges (chi-square/df = 3.08, df (480), p < 0.01, root mean square error of approximation = 0.059, comparative fit index = 0.915, Tucker and Lewis's index of fit = 0.907). Nine items were excluded on the basis of very low loadings and conceptual and empirical overlap with other items.
Significance of results
The final 24-item, B-MSCS model was consistent with the original conceptual model and had a closer fit to the data (chi-square/df = 1.85, df (215), p < 0.01, root mean square error of approximation = 0.041, comparative fit index = 0.961, Tucker and Lewis's index of fit = 0.955). In addition, the reliability, construct, and concurrent validity of the MSCS and B-MSCS were in the acceptable and good ranges, respectively. Mean and standard deviation of the MSCS and B-MSCS scores were similar; B-MSCS mean scores well approximated the MSCS scores. Informal mindful self-care, in the process of everyday life, was practiced more regularly and associated with increased wellness and reduced burnout risk than formal mind-body practices.
Introduction: Burnout includes emotional exhaustion (EE), depersonalization (DP) and personal accomplishment (PA). Emergency Department (ED) staff have high levels of burnout that may be responsive to communication skills training. We surveyed ED staff perception of need and efficacy before and after an intervention using an established conflict resolution methodology. Methods: ED physicians, nurses and support staff were surveyed at two regional hospitals using the Maslach Burnout Inventory (MBI) and a communications questionnaire to establish the perceived need for communication skill training. Participants from one center were provided with a communications intervention (Crucial Conversations®, VitalSmarts®), and a refresher course 6-15 months later. The survey was then repeated at both sites and course participant feedback was elicited. Results: MBI results were high (mean EE = 25.25 (high > 25), 95% CI = 22.5-28; DP = 11.6 (high > 8), 95% CI = 10.1-13.2; PA = 35.85 (low <34), 95% CI = 34.3-37.4). Initially 82% of intervention and 77% of control site participants responded that “attending an educational session about ways to communicate better would help the participants at work”. Post intervention group responses to “The program will be helpful to me in communicating more effectively in my work environment” were: 75% “strongly agree” and 25% “agree”. No rating below “agree” was assigned by any of the participants. Participants preferred facilitated small group simulations and advocated for earlier career implementation. Conclusion: There was a perceived need for and impact from communication skills training for ED staff with high measured burnout. Training may be best implemented in small group simulated encounters and in health professional education curriculum or as part of work orientation.
Introduction: Emergency department (ED) staff carry a high risk for the burnout syndrome of increased emotional exhaustion, depersonalization and decreased personal accomplishment. Previous research has shown that task-oriented coping skills were associated with reduced levels of burnout compared to emotion-oriented coping. ED staff at one hospital participated in an intervention to teach task-oriented coping skills. We hypothesized that the intervention would alter staff coping behaviors and ultimately reduce burnout. Methods: ED physicians, nurses and support staff at two regional hospitals were surveyed using the Maslach Burnout Inventory (MBI) and the Coping Inventory for Stressful Situations (CISS). Surveys were performed before and after the implementation of communication and conflict resolution skills training at the intervention facility (I) consisting of a one-day course and a small group refresher 6 to 15 months later. Descriptive statistics and multivariate analysis assessed differences in staff burnout and coping styles compared to the control facility (C) and over time. Results: 85/143 (I) and 42/110 (C) ED staff responded to the initial survey. Post intervention 46 (I) and 23(C) responded. During the two year study period there was no statistically significant difference in CISS or MBI scores between hospitals (CISS: (Pillai's trace = .02, F(3,63) = .47, p = .71, partial η2 = .02); MBI: (Pillai's trace = .01, F(3,63) = .11, p = .95, partial η2 = .01)) or between pre- and post-intervention groups (CISS: (Pillai's trace = .01, F(3,63) = .22, p = .88, partial η2 = .01); MBI: (Pillai's trace = .09, F(3,63) = 2.15, p = .10, partial η2 = .01)). Conclusion: We were not able to measure improvement in staff coping or burnout in ED staff receiving communication skills intervention over a two year period. Burnout is a multifactorial problem and environmental rather than individual factors may be more important to address. Alternatively, to demonstrate a measurable effect on burnout may require more robust or inclusive interventions.
Introduction: In recent years, there has been growing interest in the field of physician wellness and burnout. Past research has shown that the prevalence of burnout is non-uniform between specialties and is most prevalent amongst emergency medicine physicians. Additionally, burnout can be observed amongst individuals early in their medical careers, including medical students and residents. To date, there is no national perspective of burnout amongst Canadian Royal College of Emergency Medicine (EM) residents. Our study looks to provide a national survey of burnout in this population as well as characterize mentorship programs at training sites. Methods: An anonymous electronic survey was e-mailed to Canadian EM residents via local program directors. Characteristics of mentor-mentee relationships and quality of residents’ mentorship experiences were assessed on a 6-point Likert scale. The Maslach Burnout Inventory – Human Services Survey (MBI-HSS) for medical personnel was used to assess burnout on three dimensions (emotional exhaustion, depersonalization and personal accomplishment). Burnout was dichotomized as present or absent if the MBI criteria are met (emotional exhaustion score > 26 or depersonalization score > 9 or personal accomplishment <34). Results: To date, 52 responses have been collected. Respondents are primarily male (63%) and in their PGY year 1-3 (71%). Responses were collected from 6/14 (43%) of eligible programs. 84% of residents currently had an emergency medicine mentor. Of these, 8% were dissatisfied with their residency's mentorship program and 55% were satisfied/very satisfied. 72% of residents met the threshold for burnout in at least one dimension of the MBI (3 dimensions = 17%; 2 dimensions = 17%; 1 dimension = 38%) and 13% cited considering suicide during their training. Conclusion: Results thus far suggest significant burnout amongst Royal College of Emergency Medicine residents. Alarmingly, 13% of responders cited having contemplated suicide during their training. These results point to an important opportunity to better support EM residents during their training to improve wellness and reduce burnout. Our findings suggest a high prevalence of residents with established mentors and future analyses will examine the correlation between mentorship characteristics and resident burnout levels.
The concept of personal resilience is relevant to physician well-being, recruitment and retention, and to delivering compassionate patient care. This systematic review aims to explore factors affecting personal resilience among psychiatrists, in particular, those that may impair well-being and those that facilitate resilience practice. A literature search was performed of the Ovid®, Embase®, CINAHL and PsycINFO databases, using keywords to identify empirical studies involving psychiatrists that examined resilience, stress and burnout from the past 15 years.
Thirty-three international English language studies were included, showing that a combination of workplace, personal and non-workplace factors negatively and positively influenced well-being and resilience.
Given that workplace factors were the most commonly cited, it would appear that any resilience package that predominantly targets interventions at the workplace level would be particularly fruitful. Future research, however, needs to address the absence of a universal measurement of well-being and its moderators so that any potential interventions are better evaluated.
The present study examines an important contemporary stressor: Job insecurity, both in terms of losing one’s job as such (i.e. quantitative job insecurity) and losing one’s valued job aspects (i.e., qualitative job insecurity). Moreover, we study whether humor assists in offsetting the negative associations of these types of job insecurity with employee well-being. Specifically, by drawing up the conservation of resources theory, self-enhancing and affiliative humor are framed as personal resources buffering the detrimental relationship of both types of job insecurity with burnout (i.e., exhaustion and cynicism) and work engagement (i.e., vigor and dedication) in a large heterogeneous sample of Belgian employees (N = 3,254). Results evidenced the detrimental main effects of quantitative and qualitative job insecurity as well as the beneficial relations of self-enhancing and affilitative humor on burnout and work engagement. In addition, the buffering role of affiliative humor was supported in the relationships of both quantitative and qualitative job insecurity with burnout. Self-enhancing humor only interacted with qualitative job insecurity in the prediction of exhaustion. The discussion centers around the importance of personal resources attenuating the negative associations of quantitative and quantitative job insecurity, and highlights the different roles of humor for employees’ work-related well-being.
The average expected lifespan in Canadian long-term care (LTC) homes is now less than two years post-admission, making LTC a palliative care setting. As little is known about the readiness of LTC staff in Canada to embrace a palliative care mandate, the main objective of this study was to assess qualities relevant to palliative care, including personal emotional wellbeing, palliative care self-efficacy and person-centred practices (e.g. knowing the person, comfort care). A convenience sample of 228 professional and non-professional staff (e.g. nurses and nursing assistants) across four Canadian LTC homes participated in a survey. Burnout, secondary traumatic stress and poor job satisfaction were well below accepted thresholds, e.g. burnout: mean = 20.49 (standard deviation (SD) = 5.39) for professionals; mean = 22.09 (SD = 4.98) for non-professionals; cut score = 42. Furthermore, only 0–1 per cent of each group showed a score above cut-off for any of these variables. Reported self-efficacy was moderate, e.g. efficacy in delivery: mean = 18.63 (SD = 6.29) for professionals; mean = 15.33 (SD = 7.52) for non-professionals; maximum = 32. The same was true of self-reported person-centred care, e.g. knowing the person; mean = 22.05 (SD = 6.55) for professionals; mean = 22.91 (SD = 6.16) for non-professionals; maximum = 35. t-Tests showed that non-professional staff reported relatively higher levels of burnout, while professional staff reported greater job satisfaction and self-efficacy (p < 0.05). There was no difference in secondary traumatic stress or person-centred care (p > 0.05). Overall, these results suggest that the emotional wellbeing of the Canadian LTC workforce is unlikely to impede effective palliative care. However, palliative care self-efficacy and person-centred care can be further cultivated in this context.
Care home staff stress and burnout may be related to high turnover and associated with poorer quality care. We systematically reviewed and meta-analyzed studies reporting stress and burnout and associated factors in staff for people living with dementia in long-term care.
We searched MEDLINE, PsycINFO, Web of Science databases, and CINAHL database from January 2009 to August 2017. Two raters independently rated study validity using standardized criteria. We meta-analyzed burnout scores across comparable studies using a random effects model.
17/2854 identified studies met inclusion criteria. Eight of the nine studies reporting mean Maslach Burnout Inventory (MBI) scores found low or moderate burnout levels. Meta-analysis of four studies using the 22-item MBI (n = 598) found moderate emotional exhaustion levels (mean 18.34, 95% Confidence Intervals 14.59–22.10), low depersonalization (6.29, 2.39–10.19), and moderate personal accomplishment (33.29, 20.13–46.46). All three studies examining mental health-related quality of life reported lower levels in carer age and sex matched populations. Staff factors associated with higher burnout and stress included: lower job satisfaction, lower perceived adequacy of staffing levels, poor care home environment, feeling unsupported, rating home leadership as poor and caring for residents exhibiting agitated behavior. There was preliminary evidence that speaking English as a first language and working shifts were associated with lower burnout levels.
Most care staff for long-term care residents with dementia experience low or moderate burnout levels. Prospective studies of care staff burnout and stress are required to clarify its relationship to staff turnover and potentially modifiable risk factors.
Studies have investigated the prevalence of compassion satisfaction and compassion fatigue in various healthcare professions. However, the majority of evidence is linked to the nursing profession and little is known about paramedical professions such as radiography and even less is known about its prevalence in students. The purpose of this study was to describe the levels of compassion satisfaction and compassion fatigue in the student population and how they varied in time.
Students undertaking radiotherapy training at the researcher’s host sites were surveyed using the Professional Quality of Life questionnaire at the end of each final clinical block in each year of their training.
Results and conclusion
During the 3 years of training compassion satisfaction falls and burnout increases in the student population, although the change is not significant. Secondary traumatic stress increases significantly during the 3 years of training, F=5·725, p=0·005. Considerable variation also exists in the three scores dependent on the student’s clinical training site. Relationships are also observed between some personality traits, particularly conscientiousness and neuroticism and compassion scores.
The nature of the turnover process calls for the study of more complex relationships among variables beyond simple bivariate or multiple associations between predictors and turnover intentions. The present article aims to examine the predictive value of job demands and resources in the explanation of nurses’ intention to leave the organization and to test the mediating roles of professional burnout and engagement in these relationships, within a Portuguese nursing population. The research models were tested within the scope of the Registered Nurse Forecasting project. Data included the self-report questionnaires of 2,235 Portuguese nurses from 31 hospitals, collected through stratified random sampling procedures. The statistical analyses of the structural models showed that nurses’ participation in hospital affairs, a job resource at the work organization level, was the only significant predictor of nurses´ intention to leave the organization (β = –.45, p < .001). Analyses of the mediation models revealed that the emotional exhaustion symptoms of burnout (β = –.11, p < .001) and job engagement feelings (β = –.15, p < .001) were both significant mediators between nurses’ decisional involvement and their intentions to leave the organization. Results suggest that including nurses in decision-making processes regarding their professional practice policy and environment, and improving nurses’ professional well-being are two crucial strategies to reduce nurses’ turnover intentions.
Emergency medicine (EM) requires physicians to deal with acutely ill patients in a fast-paced and dynamic environment, which creates a barrier to debriefing after critical events. These unique challenges can negatively impact wellness. We sought to adapt and implement a peer-support wellness program called ‘Ice Cream Rounds’ in an EM residency setting.
A needs assessment survey was conducted among EM residents at The University of Ottawa to gauge interest and obtain resident input regarding program design. The structure of the sessions was adapted from similar initiatives in Canadian Pediatric Residency programs.
Curriculum, Tool or Material
Confidential peer-support sessions were created and piloted. Residents preferred peer facilitators, rather than staff, so two residents obtained training the Faculty of Medicine’s Wellness Program to lead sessions. Attendance at rounds was voluntary; however, overall attendance was recorded along with feedback from pilot sessions. Discussion topics included difficult patient encounters, poor patient outcomes, challenges in residency, and ethical issues. Post implementation feedback demonstrated that Ice Cream Rounds was a helpful forum for residents to discuss important issues with colleagues.
This is the first Canadian EM training program to adapt, implement, and evaluate peer-support wellness rounds for debriefing, and this initiative can be easily adopted by any EM training program.
Introduction: Emergency Department (ED) staff burnout correlates with psychological coping strategies used by Emergency department health professionals (EDHPs). Staff at two urban referral EDs in New Brunswick took part in a survey of burnout and coping strategies after one ED experienced an influx of new physicians and a newly renovated ED in 2011. Six years later, ED crowding and EDHP staffing problems became prevalent at both EDs. We compared levels of burnout at two urban referral EDs to determine if burnout and coping worsened over time. Methods: An anonymous survey of all EDHPs at 2 urban referral EDs was performed in 2011 and in 2017. A demographics questionnaire, the Maslach Burnout Inventory (MBI, measuring emotional exhaustion, depersonalization and personal accomplishment), and the Coping Inventory for Stressful Situations (CISS, measuring task-oriented, emotion-oriented, and avoidance-oriented coping styles) were collected. Descriptive statistics and linear regression models examined relationships over time and between the two hospitals. Results: Burnout scores were similar both at the two facilities and in 2011 (n=153) and 2017 (n=127). There were no differences between samples or EDs for important factors. Emotion-oriented coping was associated with higher levels of burnout, while task-oriented coping was inversely correlated with burnout. Experiencing professional stress was a significant predictor of emotional exhaustion, while those working longer years in their current department had higher emotional exhaustion and depersonalization. By 2017, both EDs had experienced significant nursing staff turnover (50%) compared to 2011. Conclusion: Burnout scores remained consistent after 6 years at these two urban referral EDs. Given the evidence that increased years of service is associated with increased burnout, high staff turnover rate at both EDs could explain how scores remained constant. Staff turnover may represent a way these ED systems cope in a challenging environment. In 2017, task-oriented copers continued to score lower while emotionally-oriented copers showed higher burnout risk, and experiencing professional stress remains a strong predictor of burnout.
Introduction: Emergency medicine (EM) is known to be a high-stress specialty. Work related stress and burnout have been reported to negatively impact physician-patient interactions, collaboration and ultimately overall physician mental and physical health. We sought to assess the rates of burnout among emergency physicians working at a single large Canadian tertiary care center and to identify higher risk groups. We hypothesized burnout rates to be uniformly high. Methods: We conducted a local cross-sectional study to assess burnout among adult and pediatric emergency physicians, fellows and residents at London Health Sciences Centre (LHSC). A total of 118 participants were invited to complete an anonymous online survey encompassing demographics, the validated MBI tool (Maslach Burnout Inventory) with additional questions aimed at identifying determinants of emergency physician burnout at LHSC. Each respondents three MBI scale scores for Emotional Exhaustion, Depersonalization and Personal Accomplishment were recorded with a possible range of 0-6. Descriptive statistics were calculated and relationships between risk factors (age, gender, years of practice, marital status, and credentials) and burnout scores were examined using t-tests, one-way ANOVAs, and/or regression analyses where appropriate. Results: To date the survey had a 50% (59/118) response rate. Of the 59 respondents 24 (40%) were female, the mean (SD) age was 40.6 years (10.5) and years of practice ranged from 1 to 35, with a mean of 13. Survey results indicated a high degree of burnout among LHSC EM physicians with a mean (SD) Emotional Exhaustion Score of 2.9 (1.3) and Depersonalization score of 2.4 (1.3), indicating that physicians felt burnt out from work between once a day to once a week. Inversely, the protective variable of Personal Accomplishment, with a score of 4.7 (0.9), indicated daily to weekly feelings of accomplishment. Female physicians (independent samples t-test, p=0.003) and those having fewer years of practice (linear regression, R2=0.188, p=0.04) were identified to have higher burnout. We did not identify any factors associated with Personal Accomplishment. Conclusion: Consistent with previous literature, LHSC emergency physicians were shown to be at risk for moderate to severe burnout. High risk groups identified included gender (female) and fewer years of practice. We did not identify any factors to be protective. Despite this, LHSC emergency physicians showed a high degree of personal accomplishment. While all physicians experience burnout, targeted interventions to newer female staff could have the highest benefit.
Introduction: Emergency medicine (EM) is a demanding specialty with high rates of physician burnout. As emergency physicians, we must stay healthy to promote healthy living, optimize our ability to care for our patients, extend our careers, and be there for our families. While we all desire a healthy lifestyle, maintaining one in practice can be difficult. We sought to investigate the strategies emergency physician employ to maintain and improve health and wellness while mitigating the professions stressors. Methods: From April 2015 to July 2017, forty-three wellness champions from Canada, the USA, and Australia were identified using a snowball sampling technique. Each participant answered 5 introductory questions and 8 productivity questions pertaining to health and wellness. These were transcribed and loaded to a publicly accessible blog, ALiEM.com, as part of the Healthy in EM series. Two investigators reviewed the transcripts using inductive methods and a grounded theory approach to generate themes and subthemes using coding software, NVivo (Burlington, Massachusetts), until saturation was achieved. Consensus between investigators (JC, ZP) established the master code and audit trail. An external audit by investigators (TC, BT) not involved with the initial analysis was performed to ensure reliability. Results: Major themes including diet, sleep, exercise and social activities were coded and further subcategorized along with perspectives, habits, personal philosophies, and career diversity. These themes translated across both professional and personal aspects of participants lives. For example, the pre-shift and post-shift strategies often included some form of regimented activities-of-daily-living that required discipline to adhere to at work and home. Conclusion: Our findings show the importance of homeostasis in the professional and personal realm among expert emergency medicine physicians. Among healthy emergency physicians, diet, sleep, and exercise patterns intertwined with perspectives, habits, personal philosophies, and social activities contributed to maintenance of wellness.
To explore, for the first time, whether a modified mindfulness-based cognitive therapy (MBCT) course has the potential to reduce stress and burnout among National Health Service (NHS) General Practitioners.
There is a crisis of low morale among NHS GPs, with most describing their workload as ‘unmanageable’. MBCT has been demonstrated to improve stress and burnout in other populations, but has not yet been evaluated in a cohort of NHS GPs.
NHS GPs in South East England (n=22) attended a modified version of the MBCT course approved by National Institute for Health and Care Excellence for prevention of depressive relapse. This comprised eight weekly 2-h sessions with homework (mindfulness practice) between sessions. Participants completed the Maslach Burnout Inventory (MBI) and Perceived Stress Scale (PSS) before (baseline) and then again one month (T2) and three months (T3) after attending the course. We also obtained qualitative data on participants’ experiences of the course.
Compliance with the intervention was very high. All GPs attended at least six sessions and all completed baseline questionnaires. At T2, data were obtained from 21 participants (95%); PSS scores were significantly lower than at baseline (P<0.001), as were MBI emotional exhaustion (P<0.001) and depersonalization scores (P=0.0421). At T3 we obtained data for 13 participants (59%); PSS scores and MBI emotional exhaustion scores were significantly lower (P<0.001; P=0.0024, respectively) and personal accomplishment scores were significantly higher (P<0.001) than at baseline. Participants reported that the course helped them to manage work pressures, feel more relaxed, enjoy their work and experience greater empathy and compassion (for self, colleagues and patients). Findings of this preliminary evaluation are promising. Further research is needed to evaluate this approach within a larger randomized-controlled trial.
School counsellors play an important role in supporting student mental health but face several challenges that may increase their vulnerability to burnout. This study aimed to explore the factors associated with burnout among school counsellors in secondary schools in New South Wales (NSW), Australia. A cross-sectional, online survey was conducted to measure demographics, school counsellor background, school context, school counselling practice, openness towards evidence-based practices, and use of online resources. The final sample consisted of the 125 participants who responded they had (n = 65) or had not (n = 60) experienced burnout. Most participants were female (86%), with an average of 9 years’ experience (SD = 7.0). Burnout was associated with lower workload manageability, lower satisfaction with school mental healthcare, greater impact of work stress upon wellbeing, and greater frequency of providing care outside of school hours. No other significant associations were found. This study reinforces that school counsellors are vulnerable to burnout and that measuring job overload may help to identify those at increased risk. School counsellors may also benefit from additional support for students who require care beyond school hours. Greater awareness about the risks of burnout, coupled with efforts to improve resource allocation within the school setting, may improve school counsellors’ sustainability and optimise the mental healthcare available to students.
Compassion fatigue (CF) is secondary traumatic distress experienced by providers from contact with patients' suffering. Burnout (BO) is job-related distress resulting from uncontrollable workplace factors that manifest in career dissatisfaction. Compassion satisfaction (CS) is emotional fulfillment derived from caring for others. The literature on BO in healthcare providers is extensive, whereas CF and CS have not been comprehensively studied. Because of ongoing exposure to patient and family distress, pediatric palliative care (PPC) providers may be at particular risk for CF. We conducted a cross-sectional pilot study of CF, BO, and CS among PPC providers across the United States.
The Compassion Fatigue and Satisfaction Self-Test for Helpers and a questionnaire of professional and personal characteristics were distributed electronically and anonymously to PPC physicians and nurses. Logistic and linear regression models for CF, BO, and CS as a function of potential risk factors were constructed.
The survey response rate was 39%, primarily consisting of female, Caucasian providers. The prevalence of CF, BO, and CS was 18%, 12%, and 25%, respectively. Distress about a “clinical situation,” physical exhaustion, and personal loss were identified as significant determinants of CF. Distress about “coworkers,” emotional depletion, social isolation, and “recent involvement in a clinical situation in which life-prolonging activities were not introduced” were significant determinants of BO. Physical exhaustion, personal history of trauma, “recent involvement in a clinical situation in which life-prolonging activities were not introduced,” and not discussing distressing issues were significant predictors of lower CS scores.
Significance of results
CF and BO directly influence the well-being and professional performance of PPC providers. To provide effective compassionate care to patients, PPC providers must be attentive to predictors of these phenomena. Further work is needed to explore additional causes of CF, BO, and CS in PPC providers as well as potential interventions.