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Health care providers (HCPs) with histories of adverse childhood experiences (ACEs) are at increased risk for burnout, which can threaten healthcare quality. This study examines the relation between ACEs and burnout among HCPs in primary care clinics at a safety-net hospital and whether this association is buffered by resilience. Sixty-seven HCPs (68.7% women; 44.8% White; Mage = 36.7 years, SDage = 9.8) recruited from a large, public U.S. healthcare system participated in an anonymous study assessing their ACE history, resilience, and burnout symptoms. ACE scores were positively correlated with burnout, r =.25, p =.048. A moderation analysis revealed main effects of ACEs, B = .17, SE = .07, p = .013, and resilience, B = −.34, SE = .08, p = .000, on HCP burnout, when controlling for years in healthcare. ACEs and resilience interacted to predict burnout, n = 55, B = −.11, SE=.05, p = .029. A positive relation was found between ACEs and burnout for HCPs who reported low, t = 3.21, p = .002, and average, t = 2.57, p = .013, resilience levels. Resilience appears to mitigate, or even prevent, burnout among HCPs, although it may be most helpful for those with ACE histories. Healthcare systems can build a more resilient workforce by offering routine, system-wide exposure to trauma-informed professional development or self-care opportunities to their HCPs.
To report on a volunteer-led program supporting local healthcare providers (L-HCPs) and disaster responders after the 2024 Noto Peninsula Earthquake, focusing on its implementation and immediate outcomes.
Methods
A volunteer-led initiative established by university alumni deployed medical teams to a local hospital on weekends following the earthquake, providing onsite support to relieve L-HCPs from prolonged strain. The program integrated information and communication technology (ICT) platforms to enable remote support, communication, and structured debriefing sessions for volunteers, facilitating assistance from a wider network.
Results
The project effectively sustained the local health care institution’s capacity by managing diverse patient needs, including a surge in internal medical conditions. It provided essential respite, allowing local physicians crucial personal time, for which they expressed profound gratitude. Volunteer doctors reported effective stress management through the onsite and ICT-based support structure, and the initiative concluded safely without injury.
Conclusions
The project demonstrated that combining onsite medical assistance with strategically implemented ICT effectively mitigates burnout among L-HCPs, providing essential psychological support for deployed volunteers. The findings highlight the significance of sustained recovery-phase support, professional networks, and ICT in disaster response. These experiences highlight the need for comprehensive, system-wide support strategies for all frontline personnel in future disasters.
Gardens and other fresh air spaces are associated with better physical, social, and mental health. Evidence suggests an association between exposure to fresh air spaces and perceived well-being stress, and physical activity for patients, loved ones, and clinical teams. Increasing numbers of intensive care departments are optimizing their clinical environments by giving their patients, loved ones, and staff access to fresh air spaces. This chapter describes the evidence base on the impact of fresh air spaces within intensive care and makes recommendations for how to incorporate fresh air exposure in the care of critically ill patients.
The literature on the health-promoting effects of community work has primarily dealt with the population in retirement age, yet the vast majority of volunteers are people still in the workforce. The aim of this study is to observe the relationship between volunteering and health within the context of working life, considering paid work conditions and motives to volunteer as moderating variables. We conducted an online survey with a sample of Swiss workers employed in different industries. Results show that volunteers with self-determined motives (but not with controlled motives) report lower levels of stress and burnout than non-volunteers. Moreover, volunteers in general (regardless of the quality of motivation) report higher levels of work engagement and well-being. Analyses further reveal an interaction effect for burnout and stress, where the difference between self-determined volunteers and non-volunteers becomes larger with unfavorable working conditions at their paid job, hinting at potential compensatory effects. Implications for future research and the voluntary sector are discussed.
Voluntary work in Charities is a constantly growing reality: in particular, in the last few years, voluntary work in hospitals has become of great importance, marking a substantial increase of commitment in social issues. However, at the same time, volunteering Charities have been plagued by the increase of the phenomenon of dropout, that is, volunteers abandoning the Charitable Association they’re working in, often after a relatively short period of activity. In this study, we attempted to verify if and how active and dropped out volunteers perceive their own activity as a source of anxiety and stress. Our data show that both active and dropped out volunteers show high levels of burnout; in fact, dropped out volunteers show higher levels of burnout, especially of emotional exhaustion, in comparison with active volunteers. Subsequently, we identified the factors potentially assuming the role of mediators or moderators in the direct relation involving the status of voluntary work activity and the levels of anxiety and burnout. Our study demonstrates that coping strategies and the relationship established with hospital workers can be considered good moderators.
According to the basic psychological need theory, satisfaction and frustration of basic psychological needs are related to different psychological correlates. The present study aimed to test this tenet in volunteers for a national sport event using a person-centered approach. Specifically, the present study was undertaken to (a) identify the optimal number of need profiles and (b) to examine the associations between identified need profiles and potential correlates including work climate, intrinsic motivation, emotional exhaustion, and continuance intention. Data were collected from 924 volunteers (age range: 18–25 years) for a national sporting event. Results of latent profile analysis showed three need profiles, and the “High Satisfaction, Low Frustration” profile had higher levels of work climate and continuance intention, and a lower level of emotional exhaustion than the other two profiles. These findings enhance the understanding of the basic psychological needs and their relevance to psychological functioning in the context of sport volunteering.
Volunteering leads to many positive outcomes, especially when one’s reasons for volunteering are satisfied by one’s volunteer experience. But does this match between motive and experience mitigate against negative outcomes? This study examined whether congruence between reasons for volunteering (i.e., Volunteer Functions) and outcomes of volunteering (i.e., Volunteer Outcome Satisfaction) predicted lower levels of volunteer-related burnout in a sample of 512 adult volunteers. Congruence predicted significantly lower levels of burnout only for the Understanding and Values functions. Volunteers who were highly motivated to volunteer for Understanding and Values functions and experienced satisfaction in these domains reported significantly lower levels of burnout than their counterparts. Contrary to hypotheses, participants who reported low motivation for Enhancement or Social functions but who endorsed high satisfaction of these functions reported lower levels of burnout than those who reported congruence between these motivations and outcomes. Additionally, the congruence hypothesis did not hold true for the Protective or Career functions. Volunteer organizations are urged to attend to the importance of satisfying desired functions of volunteering and to help volunteers identify best-fitting opportunities.
Volunteers’ intention to leave is a relevant issue for organizations. Thus, it is critical to advance knowledge on its determinants. This study proposes that burnout symptoms mediate the relationship of work–home interference with leaving intentions. In addition, we hypothesize that job resources, namely organizational appreciation and organizational task support, buffer the positive indirect relationship of work–home interference with volunteers’ leaving intentions through burnout symptoms. To this end, we rely on the job demands–resources theory, a theoretical framework first conceived for the paid work context that has been widely applied in volunteering settings. Consistent with our predictions, (moderated) mediation analyses on a sample of 220 Italian volunteers showed that only cynicism, and not emotional exhaustion, significantly mediated the positive relationship between work–home interference and leaving intentions and that organizational appreciation and task support weakened this indirect relationship. We discuss how these findings contribute to theory and practice for the volunteering sector.
Rural primary care providers report increasing rates of professional burnout, which can further exacerbate rural provider shortages and health disparities. From 2023 to 2025, the Project ECHO team at Penn State University developed and delivered an educational rural health telementoring program, collaboratively with stakeholders, to disseminate guideline-concordant care to rural primary care clinicians. The program focused on key rural topics and created a professional learning community aimed at decreasing participant burnout. Self-reported results of the pilot program’s participants (n = 106) demonstrate increased knowledge (p < .001) and reduced professional isolation. Future programing will expand data collection to explore longer-term impact.
The Association of Otolaryngologists in Training wanted to assess trainee well-being.
Methods
A survey was developed that incorporated the Copenhagen Burnout Inventory, the short Warwick–Edinburgh Mental Wellbeing Scale and the Brief Resilience Scale plus questions on working conditions.
Results
There were 190 responses and while most respondents had low or moderate levels of burnout, 15 per cent had high personal burnout and 13 per cent had high work-related burnout. The mean well-being score for respondents was lower than for the whole population mean. In addition, 39 per cent of respondents reported their mental well-being had been slightly affected in a negative way by their working environment and conditions in the last 6 months, and 26 per cent reported it being significantly affected negatively. Of these, 43 respondents reported an impact on patient safety.
Conclusion
This first-ever survey of ENT trainees in the UK identified several areas of concern, including how the working environment and conditions affect trainee well-being and impact patient safety.
Extended reality may offer a convenient and effective method of increasing well-being within the wider healthcare workforce and particularly for those working in the mental health sector who are subject to high levels of stress because of increased workload, high levels of staff turnover and limited resources.
Aims
This scoping review aims to identify and assimilate relevant literature pertaining to the use of extended reality to improve healthcare practitioners’ well-being.
Method
Databases (MEDLINE, CINAHL, Cochrane and PubMed) and grey literature were searched for relevant articles using established methodology and reported as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews.
Results
A total of 280 articles were yielded by the search strategy, with 13 relevant articles selected by two independent reviewers in a blinded process. Studies demonstrated a heterogenous pool of outcome measurement modalities, intervention modalities and duration and frequency of the interventions. Of all the studies, 85% note a positive impact on healthcare practitioner well-being but studies have limited comparability because of heterogeneity. Interventions were engaging but the practicality of implementing such technologies into a finance- and time-limited healthcare environment will be a challenge.
Conclusions
Whilst extended reality is a promising well-being intervention, there is a paucity of literature relating to its effect on mental health practitioners’ well-being, and further studies in this area are required.
Workaholism and overcommitment are often defined as irrational or obsessive attachments to work, characterized by excessive work investment with negative consequences for health and well-being. However, the relationship between these constructs remains underexplored. In this study, we hypothesized that workaholism and overcommitment represent different stages of the same work addiction dynamic, with overcommitment mediating the relationship between workaholism and burnout. Additionally, we proposed that job satisfaction reinforces this addiction dynamic, strengthening the relationship between workaholism and overcommitment over time. Utilizing data from a three-wave longitudinal study (time-lag = 1 month) involving Italian employees, we tested a moderated mediation model. Our findings indicated that overcommitment at T2 fully mediated the relationship between workaholism at T1 and job burnout at T3. Moreover, job satisfaction at T2 significantly moderated this pathway, suggesting that higher job satisfaction leads to a stronger relationship between workaholism and overcommitment over time. In conclusion, our study highlights the exacerbating effect of job satisfaction on the link between workaholism and overcommitment, which can, in turn, increase employees’ burnout. This research represents the first longitudinal examination of workaholism and overcommitment as stages within the same process, rather than as distinct constructs.
This chapter focuses on resilience and compassion, starting by examining the relevance of resilience in healthcare, especially during the Covid-19 pandemic. The chapter notes that while a certain amount of resilience is helpful and even essential, resilience depends on not only the personal characteristics of each healthcare worker, but also the conditions in which they work. Relevant factors include the structure and function of teams, models of organisation, quality of leadership, and resources. These matters have an enormous influence on individual experiences, attitudes, and behaviour, and on the levels of resilience that are required and accessible in the workplace, as well as compassion. This chapter considers the concepts of ‘compassion fatigue’ and ‘burnout’, and outlines barriers to, and facilitators of, compassionate care. Systemic challenges include competing system demands, time constraints, inadequate resources, communication issues, poor emotional connections with the broader healthcare system, and the perception and/or reality of staff not being valued for the care they provide. These are themes that resonate with many people who work in large healthcare systems where organisational challenges loom large, often distracting focus from day-to-day patient care. This chapter also examines the roles of mindfulness and meditation in navigating these challenges.
Early career researchers have unique demands, many of which contribute to increased stress, decreased professional fulfillment, and burnout. Consequently, academic institutions and government organizations, such as the National Institutes of Health, are beginning to embrace structured coaching as a tool to support physician wellbeing. To date, such coaching programs have demonstrated promising results, but little is known about whether early career research faculty find coaching feasible, accessible, or helpful. To explore this question further, we developed a novel group coaching intervention for clinician researchers and scientific faculty at the University of Texas Southwestern Medical Center based on the concept of appreciative inquiry, grounding the program in a positive and hopeful approach to the challenges faced by clinicians and researchers. Results from our program indicate this intervention is feasible, satisfactory, and helpful, with participants reporting enhanced self-reflection and empowerment. Effective for a wide array of research faculty, our program brought together diverse faculty, fostered connections, and encouraged future collaborations among this translational group. This suggests that our program provides a foundational blueprint that can be used by other academic medical centers who aim to develop group coaching efforts.
from
Section 4
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Walking the Walk (and Talking the Talk)
William Fawcett, Royal Surrey County Hospital, Guildford and University of Surrey,Olivia Dow, Guy's and St Thomas' NHS Foundation Trust, London,Judith Dinsmore, St George's Hospital, London
Training as an anaesthetist can be very demanding and self-care and the wellbeing of the anaesthetist are of essence. Demanding work schedules include night shifts which can be particularly difficult to adjust to for some. Practical advice is stated on how to overcome and adapt to these. Green anaesthesia has gained large importance in ensuring sustainability in healthcare. In the UK anaesthetic cases and Nitrous Oxide contribute around 2% of all NHS greenhouse gas emissions. Steps to reduce the individual anaesthetists’ carbon footprint are discussed.
An overview of the anaesthetic training program is stated in addition to practical advice on enhancing portfolio work. Departments are required to run morbidity and mortality meetings which can be a good opportunity for the anaesthetic trainee. These meetings focus on a specific patient case and may lead to an action plan within the department. This chapter focuses on ways to make the most out of anaesthetic training and offers guidance to the training structure and requirements.
Objective. Witnessing existential suffering in patients is associated with increased risks of compassion fatigue and burnout in palliative care physicians. Finding meaning is a protective factor for burnout and is associated with increased job satisfaction and a sense of purpose.
While the significance of finding meaning through the doctor-patient relationship is widely recognized, less is known about the subjective experience of palliative care physicians, how they ascribe meaning, and how meaning sustains them. The aim of this study was to describe and interpret how palliative care physicians experience meaning when caring for patients.
Method. Hermeneutic-phenomenology, inspired by the philosophy of Heidegger and Gadamer, informed the methodological approach. Ten palliative care physicians, caring for adult patients, completed semi-structured interviews. Van Manen’s “lifeworld existentials” supported our reflexive hermeneutic analysis to interpret participants’ moments of meaning-making.
Results. Our analysis identified two interpretive concepts for meaning-making: moments of connection and moments of transformation. Meaningful connection occurred when physicians and patients together acknowledged existential suffering in death and dying and experienced it on a personal, human level. Often, experiences were fleeting but had a lasting impact. Experiences of connection had a transformational effect on physicians and were associated with a sense of reward and purpose in palliative care work.
Significance of results. Findings are discussed in relation to philosophical literature on the experience of time, contrasting man-made time with the existential experience of time. Moments of connection and transformation experienced by palliative care physicians fueled their commitment to their profession. At a time when burn-out is rife, identifying, describing, and understanding moments of meaning may offer protective benefits for physicians working in palliative care.
COVID-19 saw many career health officials retire early and seasoned health practitioners simply quit due to burnout. This chapter explores various qualities that leaders can utilize to provide and receive support when faced with stressors and challenges in both their work and personal lives. Personal assessments like Myers–Briggs, DISC, the Gallup Strengths Finder, and the Enneagram offer practical tools for members of leadership to identify their strengths and areas for growth. Identifying stressors and engaging in self-regulation ensure public health leaders can mitigate burnout. Leadership qualities are outlined and described. By cultivating leadership qualities, crisis leaders can stay focused and grounded during health emergencies. Transformation leadership theory is described. A student case study uses the Crisis and Emergency Risk Communication framework to analyze former Prime Minister of New Zealand Jacinda Ardern’s communication during the COVID-19 outbreak. End-of-chapter reflection questions and activities are included.
The study objective was to identify the specific challenges experienced by nurses, assess the mental health impacts, and evaluate their role adaptation in response to the ongoing conflict.
Methods
A quantitative, descriptive study was conducted involving 202 nurses from 3 hospitals in the South West Bank. Data were collected through a structured questionnaire addressing socio-demographic information, psychological challenges, and role adaptation during the conflict.
Results
The study surveyed 300 nurses, revealing critical findings regarding their psychological well-being and professional challenges. Approximately 65% of respondents reported experiencing symptoms consistent with PTSD, indicating a significant psychological toll due to their work conditions. In terms of workload, 78% of nurses reported an increased patient influx, leading to higher stress levels and burnout. The analysis indicated that nurses faced severe resource shortages, with 60% reporting inadequate medical supplies and 55% citing insufficient staffing.
Conclusions
The findings underscore the urgent need for enhanced training programs, mental health support, and improved disaster management protocols. Educational background and marital status significantly influence nurses’ resilience and adaptability in conflict zones. Addressing these challenges is essential to improving the well-being of nurses and enhancing the quality of care in conflict-affected areas.
Edited by
Richard Pinder, Imperial College of Science, Technology and Medicine, London,Christopher-James Harvey, Imperial College of Science, Technology and Medicine, London,Ellen Fallows, British Society of Lifestyle Medicine
Healthy clinicians are more likely to provide better care for their patients.
However, they often face serious health challenges themselves, which often stem from both personal lifestyle behaviours and work-related factors. Some of the common problems include burnout, stress, fatigue, musculoskeletal disorders, and cardiovascular diseases. To address these issues, interventions need to adopt a comprehensive approach that incorporates Lifestyle Medicine principles, such as nutrition, physical activity, stress management, and social support. These principles can help healthcare workers improve their health behaviours and cope with the demands of their work. However, personal interventions are not enough. There is also a need for organisational support and policy changes that create a healthier work environment for healthcare workers. This includes supportive leadership, flexible work schedules, adequate staffing, and access to wellness programmes. By improving the health of healthcare workers, interventions can also have positive impacts on patient care and healthcare costs.
This study assessed compassion satisfaction, compassion fatigue, and burnout in health care providers from public health care institutions in Ecuador during the COVID-19 pandemic.
Methods
A cross-sectional survey was conducted in 2022, involving 111 different public health care institutions in 23 provinces in Ecuador, with 2873 participants recruited via convenience sampling. The survey instrument was the revised Stamm’s Professional Quality of Life Scale Version-5 tool, designed to measure self-reported compassion fatigue, work satisfaction, and burnout among providers. Kruskall-Wallis test assessed subscale score differences by gender, professional role, region, and health care facility level. Dunn’s test was then applied to determine whether groups differed from each other.
Results
On average, health care providers from all facilities had a high rate of compassion satisfaction (84.9%). However, the majority presented moderate levels of burnout (57.1%), and moderate levels of secondary traumatic stress (59.6%). Higher burnout levels were observed in the Amazon regions compared to Coastal regions.
Conclusions
Despite high compassion satisfaction, most surveyed health care providers from Ecuador’s public health institutions experienced moderate burnout and secondary traumatic stress, with higher burnout levels in the Amazon region. Ecuador, similarly to other LMICs, requires mental health policy and legislation targeted to the mental health workforce and these needs. More research is needed on burnout factors among health care providers in resource-challenged low- and middle-income countries.