Search

Physicians are experiencing epidemic levels of work-related stress and burnout. Determine efficacy of mindfulness meditation delivered as a hybrid (in-person and digital) format to reduce perceived stress in pediatric residents. Pediatric residents (n = 66) were block randomized to a hybrid Mindful Awareness Practices (MAPs) intervention, comprised of one in-person 60–min session and 6-week access to a digitally delivered MAPs curriculum (n = 27) or wait-list control (n = 39). Perceived Stress Scale (PSS) was administered at baseline and post-intervention as the primary outcome measure. A priori secondary outcomes were measured using the Abbreviated Maslach Burnout Inventory-9, Beck Depression Inventory, Beck Anxiety Inventory, UCLA Loneliness Scale, and Pittsburgh Sleep Quality Index. After the first session, 58% participated at least one digital session (M = 2.0; SD = 1.3). MAPs participants showed significant decrease in PSS compared to controls, with between-group mean difference of 2.20 (95% CI 0.47–3.93) at post-intervention (effect size 0.91; 0.19–1.62). No secondary outcome group differences were detected. Exposure to a hybrid mindfulness intervention was associated with improvement in perceived stress among pediatric residents.Trial Registration: NCT03613441.

Primary care clerical staff may experience burnout if not adequately prepared and supported for patient-facing customer service tasks. Guided by the Job Demands-Resources (JD-R) model, we use national survey data from 707 primary care clerks at 349 VA clinics (2018; response rate: 12%) to evaluate associations between clerks' perceptions of tasks, work environment, training, and burnout. We found challenges with customer-facing tasks contribute to higher burnout, and supportive work environment was associated with lower burnout. Although perceptions of training were not associated with burnout, our results combined with the JD-R model suggest that customer service training may protect against burnout.

Purpose This study investigated whether the professional values of nursing students can predict their ethical decision-making levels. Design and Methods The study used a descriptive and cross-sectional research design. The study sample consisted of 130 senior nursing students. The data were collected from the Student Information Form, Nursing Professional Values Scale, and Nursing Dilemma Test (NDT). The data were evaluated using Pearson correlation analysis and multiple linear regression analysis. Findings A significant correlation was found between students' professional values and their mean PLT total scores (p < 0.01). Also, a negative correlation was found between students' professional values and the total mean practical thinking scores (p < 0.01). Professional values of the students explained 21.2% of the total PLT score and 0.08% of the total practical thinking score. Conclusion The professional values of the students affect their principal and practical thinking skills in ethical dilemmas. Implications for Nursing Practice It is recommended to discuss the ethical dilemmas observed or experienced by the students in their clinical practice in the field, increase the awareness of the students, and teach them how to deal with ethical dilemmas.

Background Coronavirus disease 2019 (COVID-19) has placed healthcare workers, including pharmacists, at an increased risk of infection and has increased their workload, which could lead to burnout. Therefore, the present study aimed to measure the levels of burnout among hospital and community pharmacists in Saudi Arabia during the COVID-19 pandemic and to identify the risk factors associated with burnout. Methods In the present cross-sectional study, an online survey was distributed among community and hospital (inpatient, outpatient, clinical, and administration) pharmacists in Saudi Arabia. The Copenhagen Burnout Inventory(CBI) survey was used to measure burnout levels. This 19-item survey covered three aspects: personal, work, and patient-related burnout. The survey included questions about socio-demographic factors and the major causes of psychological distress among pharmacists during the COVID-19 pandemic. Inferential statistics were used for data analysis. Results A total of 502 pharmacists were included in the present study. Of these, 59.1% were categorized as having clinically relevant burnout levels(scores≥50). Univariate analysis revealed that the burnout level was significantly higher(p

BACKGROUND: Healthcare professionals, including nurses, have a vital role in protecting patient confidentiality. However, evidence shows that breaches of confidentiality are common in hospitals for various reasons, including the ward design and issues related to healthcare staff's professionalism. The situation can be complicated further in paediatric care because of the age range of patients and their associated needs and rights about information sharing, confidentiality and consent.AIM: To explore the views and experiences of young people admitted to hospital, and their parents and related caregivers, about the effects of confidentiality breaches.METHOD: A descriptive questionnaire-based survey was conducted in 2018 in two regional hospitals in Denmark over two weeks. A total of 214 surveys were completed by parents and related caregivers (n=173) and by young people (n=41).FINDINGS: Many parents and young people reported that they had overheard healthcare professionals discussing care, including information about named patients, test results, personal disclosures and various comments or opinions. In many cases these breaches of confidentiality affected patients' overall experience of hospital and led some to withhold important information.CONCLUSION: This study demonstrates the challenges of preserving confidentiality in children's wards. Situations in which confidentiality breaches were reported appear to have been affected by the physical environment, such as ward design, as well as staff behaviour and attitudes. Therefore, nurses and other healthcare professionals need to enhance their understanding of issues related to confidentiality and pay attention to how and where information about patients is shared.

ProblemCompassion Fatigue (CF) in healthcare professionals has been explored in multiple studies, but few focused on hospital-based pediatric nurses. The purpose of this integrative review is to synthesize the evidence about CF prevalence in nurses caring for pediatric patients, and to describe its effects on retention and job satisfaction.Eligibility criteriaIncluded studies were in English from any date describing research or quality improvement studies about CF in pediatric nurses.SampleAn integrative review of nine electronic databases yielded 13 articles about 1921 nurses. Data were synthesized from four qualitative and nine quantitative studies separately before integrating results. A risk of bias analysis was included for evidence level and quality.ResultsOverall CF prevalence was low, but 14% of nurses were at high risk of burnout and 10% were at high risk for secondary traumatic stress. Studies examining the effects of CF on retention found no significant relationship. Most studies were about critical care or oncology nurses.ConclusionsA subset of pediatric nurses is highly vulnerable to CF, but more high-quality evidence is needed to fully address this topic. Leaders should study CF prevalence, protective and exacerbating factors, relationships between CF and retention, and targeted strategies to resolve CF in high-risk nurses.

Background: Mental health literacy reduces stigma and the risk of developing mental disorders along with increasing help-seeking behavior. The aim of this study was to translate and study both the psychometric properties of the Thai Mental Health Literacy Scale (TMHLS) and the mental health literacy in sixth-year Thai medical students of the Faculty of Medicine Siriraj Hospital, Bangkok. Methods: Two-hundred and fifty participants were enrolled using the convenience sampling method. Descriptive statistics were used to analyze demographic data and mental health experiences. Inferential statistics were applied to compare sources of mental health experiences. The content validity and reliability by internal consistency of the TMHLS was analyzed by Index of item objective congruence (IOC) obtained from the examination of three experts in mental health field and Cronbach’s Alpha, respectively. Results: The TMHLS had good content validity (IOC=.67-1.0) and good reliability (Cronbach’s alpha=.85). The participants’ mean (+S.D.) mental health literacy score was 123.09 (+11.55). Individuals who had a mental health professional as an intimate contact and individuals who had a history of seeking help from mental health professional(s) in person showed significantly higher mental health literacy than those who did not.Conclusions: The TMHLS has good psychometric properties. Dynamic knowledge transfer and exchange with a close mental health professional should be applied to promote mental health literacy in medical students.

Refereed/Peer-reviewed Introduction: Different cultures and societal structures influence the ethical experiences of physiotherapists. Objective: The study aimed to discover and describe contextual shades of ethical situations experienced by physiotherapists in their global practice. Methods: This paper reports the qualitative analysis of responses to an optional open question in an internationally distributed online survey (ESPI study) with 1,212 participants from 94 countries. All responses were coded to five categories describing the data’s relationship to the survey list of ethical situations. Data that described new ethical situations were analyzed thematically. Results: Three hundred and fifty four individual responses to the optional survey question reported400 ethical issues. Three hundred and seventy-eight of these issues were associated with the original survey questions. Twenty-two responses raised four new themes of ethical issues: lack of regulatory and/or accreditation policy and infrastructure, lack of recognition of the role and position of physiotherapists in healthcare, economic factors driving the conduct of practice, and political threats. Discussion: Local contexts and pressures of workplaces and societies in which physiotherapists practice make it almost impossible for some practitioners to comply with codes of ethics. Physiotherapists need support and preparation to respond to local affordances and the complexity, ambiguity, and sometimes messiness of ethical situations encountered in their practice. Conclusion: The findings highlight the relevance of cross-cultural research in the field of physiotherapy, and the necessity of investigating and bridging the gap between professional ethics theory and practice in diverse settings.

A multicenter cross-sectional survey study involving four Italian University Hospitals was performed to test the hypothesis that negative affect and positive affect (affective dimensions) mediate the association between risk perception (perceived risk of infection and death; cognitive dimensions) and the feeling of work exhaustion (WE) among obstetrics healthcare providers (HCPs) during the Coronavirus Disease 2019 (COVID-19) pandemic. Totally, 570 obstetrics HCPs were invited to complete the 104-item IPSICO survey in May 2020. A theoretical model built on the tested hypothesis was investigated by structural equation modelling. The model explained 32.2% of the WE variance. Only negative affect mediated the association between cognitive dimensions and WE and also the association between WE and psychological well-being before the pandemic, experiences of stressful events, female gender, and dysfunctional coping. Non-mediated associations with WE were observed for work perceived as a duty, experience of stressful events, support received by colleagues, and the shift strategy. Only previous psychological well-being, support by colleagues, and shift strategies were inversely associated with WE. Based on study results, monitoring negative than positive affect appears superior in predicting WE, with practical implications for planning psychological interventions in HCPs at the individual, interpersonal, and organizational levels.

Aim: The investigation of the level of burnout and optimism as well as the effect of socio-demographic and other factors on the above two variables among health workers during the period of covid-19. Methods: The following two psychometric tools were used to collect the research data: the Maslach Burnout Inventory to assess burnout and the Revised Life Orientation Test (LOT-R) to assess the level of optimism. Results: In the present study 10 men (24.4%) and 31 women (75.6%) participated. The majority of them were between 36-45 years (36.6%), married and unmarried (48.8% and 48.8% respectively), holding bachelor degree (61.0%) and with 11-25 years of work experience (53.7%). Very high levels of exhaustion and especially emotional exhaustion and depersonalization were observed with also a high degree of personal achievement. The levels of optimism were high. There were statistically significant differences between the two genders in terms of burnout (only the dimension of emotional exhaustion) with women showing higher rates. Employees aged 25-35 years and those who had 1-10 years of work seemed to have higher levels of emotional exhaustion (all differences were considered statistically significant for p, South Eastern European Journal of Public Health (SEEJPH), Special Volume No. 1, 2022: The Population's Health: Could South Eastern Europe Do Better?

The Australian and New Zealand Academy for Eating Disorders (ANZAED) launched a Credentialing scheme for Australian Eating Disorder (ED) clinicians in 2022. Credentialing programs establish a minimum standard of skills and expertise for professionals across various disciplines. Supervision is usually offered to support these professionals in meeting the criteria and becoming Credentialed. Although the effects of clinical supervision have been empirically established, supervision of mental health practitioners as part of Credentialing schemes remains relatively understudied.

This poster is the result of a collaboration between the Library Services and a Digital Marketing lecturer in mentoring students for a final year professional project.

The article describes the mechanisms of development of students' professional competence in engineering activities in higher education institutions on the example of the development and application of information maps in the form of a systematic list of textual and graphic information on specific topics of the science "Engineering and computer graphics".

O ramo farmacêutico é dos mais antigos existentes, sempre se teve a necessidade da busca por insumos a fim de melhorar alguma enfermidade. Com o passar dos anos, a profissão tem sido bastante valorizada e seus profissionais sempre buscam maneiras de se aperfeiçoar para melhorar sua atuação. A busca pela beleza é algo presente na vida do ser humano, que é movido pela necessidade de se encaixar dentro de padrões estéticos, seja fazendo o uso de cosméticos ou realizando procedimentos estéticos. Devido a isso, área da saúde estética é crescente e promissora, despertando assim o interesse de diversos profissionais a atuarem na área. O bacharel em farmácia adquiriu muitos conhecimentos devidos as disciplinas estudadas durante a graduação, logo surgindo o interesse do profissional farmacêutico para atuar na área da saúde estética. Em 2013, o Conselho Federal de Farmácia emitiu a primeira resolução que regulamenta a presença e atuação do farmacêutico na saúde estética, dispondo das atribuições, responsabilidade técnica e procedimentos que ele poderia realizar. Gerando assim, mais uma área de atuação e o título de farmacêutico esteta. Após essa resolução, foram publicadas mais duas resoluções que discutem sobre o farmacêutico na área estética.

ObjectivesFew surveys have focused on physician moral distress, burnout, and professional fulfilment. We assessed physician wellness and coping during the COVID-19 pandemic.DesignCross-sectional survey using four validated instruments.SettingSixty-two sites in Canada and the United States.SubjectsAttending physicians (adult, pediatric; intensivist, nonintensivist) who worked in North American ICUs.InterventionNone.Measurements and main resultsWe analysed 431 questionnaires (43.3% response rate) from 25 states and eight provinces. Respondents were predominantly male (229 [55.6%]) and in practice for 11.8 ± 9.8 years. Compared with prepandemic, respondents reported significant intrapandemic increases in days worked/mo, ICU bed occupancy, and self-reported moral distress (240 [56.9%]) and burnout (259 [63.8%]). Of the 10 top-ranked items that incited moral distress, most pertained to regulatory/organizational ( n = 6) or local/institutional ( n = 2) issues or both ( n = 2). Average moral distress (95.6 ± 66.9), professional fulfilment (6.5 ± 2.1), and burnout scores (3.6 ± 2.0) were moderate with 227 physicians (54.6%) meeting burnout criteria. A significant dose-response existed between COVID-19 patient volume and moral distress scores. Physicians who worked more days/mo and more scheduled in-house nightshifts, especially combined with more unscheduled in-house nightshifts, experienced significantly more moral distress. One in five physicians used at least one maladaptive coping strategy. We identified four coping profiles (active/social, avoidant, mixed/ambivalent, infrequent) that were associated with significant differences across all wellness measures.ConclusionsDespite moderate intrapandemic moral distress and burnout, physicians experienced moderate professional fulfilment. However, one in five physicians used at least one maladaptive coping strategy. We highlight potentially modifiable factors at individual, institutional, and regulatory levels to enhance physician wellness.

Although person-centred care represents the gold standard of nursing practice, there are still instances of care that fail to recognise patients as individuals. Person-centred care depends on the nurse's knowledge of the whole person, including their values, beliefs and aspirations. This article describes a quality improvement project that sought to develop patient profiles based on the concept of 'five things about me', thereby contributing to person-centred care for older people on a medical ward. The effect on staff, older people and their families was assessed through questionnaires, and group and individual discussions. During the project period, 37 person-centred profiles were completed from 52 eligible patients. Ward staff reported increased confidence when delivering person-centred care and older people and their family members confirmed improvements in care delivery and strengthened relationships with staff.

Objective Since nursing is a performance-based profession, clinical learning environments play an important role in the acquisition of professional abilities and train nursing students to enter the nursing profession and become a registered nurse. The study aimed to investigate the relations among professional identity, wellness, and future hope in nurse interns. Methods A cross-sectional, analytic, descriptive, correlational study design was used to test these relations in the study where 210 nurse interns’ students were selected using a convenience sampling from Zagazig University hospitals and Suez Canal University hospitals in Egypt. The questionnaires consisted of 4 parts, namely demographic characteristics, Professional Identity Scale for Nursing Students (PISNS), Holistic Health and Wellness Survey, and Hope scale. Results Less than half of the study sample had chosen nursing specialty by own will (43.8%), while slightly more than half of them had a “very good” graduation level, and had no nursing role model. The lowest mean professional identity score was for independence in career choice while the highest was for social modeling. The reported physical wellness mean-score was the least, while social wellness was the highest. Professional identity, wellness, and future hope scores differed significantly based on nurse interns’ personal characteristics. There were statistically significant, positive, weak-to-moderate correlations among the scores of professional identity, wellness, and future hope; however, the “choice of nursing study by own will” was a statistically significant independent positive predictor of the scores of professional identity, wellness, and future hope. Conclusions Nurse interns’ professional identity, wellness, and future hope were positively inter-correlated. However, nurse interns’ wellness was the lowest, and it should be fostered as it was the main predictor for future hope. The internship programs should be modulated to improve nurse interns’ professional identity, particularly regarding independence, and should foster their well-being in the clinical environment.

Endofibrosis is a rare disease that predominantly affects athletes and is caused by a gradual occlusion of the (usually iliac) artery due to a thickening of the intima. From our experience, we report in this article two cases with the entity of endofibrosis in females around 30 years old. The first case presented with acute limb ischemia, and the second one was with pain in the leg during exercise. In addition, both cases are professional cyclists. They were eventually diagnosed with endofibrosis and underwent surgical procedures. They are now pursuing their professional career successfully. Last but not least, endofibrosis might be classified as an occupational disease, particularly, in the case of professional athletes or cyclists.

Objective. To assess the six domains of worklife areas (Community, Control, Fairness, Reward, Workload Values) in pharmacy academicians that have been associated with burnout and poor job satisfaction. Methods. We aimed to assess the Areas of Worklife Survey (AWS) among a sample of pharmacy academicians attending a national meeting to evaluate personal, environmental, or workplace factors that may influence worklife environment. Data were analyzed using SPSS; descriptive statistics and Kruskal-Wallis and Pearson correlations were performed. Results. Participant response rate was 40.4% (n=49/121 attendees). Eighty-eight percent of participants reported working more than 40 hours per week. Mean AWS scores ranged from 2.7 to 3.9 with 1 representing a strong mismatch between person and work environment and 5 representing a strong match. Workload and Fairness domains were the lowest scores reported compared to Control being the highest. Higher mean scores were reported for Control and Reward in those with a mentor, and for Fairness in those reporting a hobby. Conclusion. Workload and Fairness were the lowest rated areas of worklife by participants. Developing targeted interventions such mentorship, hobbies, transparency in the work setting related in particular to workload and fairness may be an important step to prevent burnout in pharmacy academicians. Further studies in a larger population may further help to determine factors associated with low rated areas of worklife.

Children with neurodevelopmental disorders often have social-emotional and behavioural difficulties. The present study explored these difficulties in children (n = 50, aged 6–10 years) with autism spectrum disorder, attention-deficit/hyperactivity disorder and developmental language disorder. Parents, teachers and therapists evaluated children’s social-emotional and behavioural difficulties through a self-devised questionnaire and the Strengths and Difficulties Questionnaire. Additionally, the children, along with their typically developing age peers (n = 106), completed six emotion discrimination tasks. Analysis revealed some impaired emotion discrimination skills that were predictive for behavioural challenges in daily life and associated with the parent-reported existence of friends. Timely intervention in these children is needed, and it should also include emotion perception training.

Centar za socijalnu skrb ključna je institucija sustava socijalne skrbi, a stručni pomagači koji su u njemu zaposleni svakodnevno su izloženi profesionalnom stresu. Iako je početkom 1990-ih započela istraživačka praksa bavljenja problematikom profesionalnog stresa i mentalnog zdravlja pomagača, nedostaje kvalitativnih istraživanja o toj tematici. Stoga je provedeno kvalitativno istraživanje s ciljem opisivanja izvora profesionalnog stresa te potreba u zaštiti od profesionalnog stresa stručnih radnika Centra za socijalnu skrb Zagreb. Provedeno je 11 fokusnih grupa pri čemu u svakoj podružnici centra po jedna, a ukupno je sudjelovalo 85 stručnih radnika Centra za socijalnu skrb Zagreb. Rezultatima je identificirano pet područja izvora profesionalnog stresa: obilježja rada s korisnicima, obilježja uvjeta rada, obilježja organizacije rada, obilježja međuodjelne suradnje i suradnje s drugim podružnicama te obilježja suradnje s drugim institucijama. Također, identificirana su i tri područja potrebe stručnih radnika u zaštiti od profesionalnog stresa: potreba za poboljšanjem materijalnih i tehničkih uvjeta rada, potreba za unaprjeđenjem materijalnog i sigurnosnog položaja te potreba za podrškom. Istraživanje je donijelo novosti u identifikaciji izvora profesionalnog stresa te ukazalo na najslabije karike u funkcioniranju centara za socijalnu skrb na primjeru najvećeg hrvatskog centra. Stoga je preporuka, u svrhu boljeg razumijevanja stresnosti posla i potreba u radu stručnih radnika centara za socijalnu skrb, u budućnosti provoditi veći broj kvalitativnih istraživanja te poticati korištenje rezultata za pozitivne promjene u praksi., Social Welfare Centre is a key institution in the social welfare system and professional helpers employed in it are daily exposed to professional stress. Although research practice dealing with professional stress and mental health of helpers started in the beginning of the 1990s, there is still a lack of qualitative research in this area. Therefore, a qualitative research study was conducted with the aim of describing the sources of professional stress and the needs in protection from professional stress of Social Welfare Centre Zagreb professionals. 11 focus groups were conducted, one for each branch of the Centre, and the total of 85 professionals employed by the Social Welfare Centre Zagreb participated in them. The results identified five sources of professional stress: characteristics of work with clients, working conditions, work organization, interdepartmental co-operation and co-operation with other branches, and co-operation with other institutions. Additionally, three areas of needs in protection from professional stress were identified: the need to improve material and technical working conditions, the need to improve material and safety position and the need for support. The research contributed to the identification of the sources of professional stress and pointed to the weakest links in the operation of social welfare centres on the example of the largest Croatian centre. Therefore, in order to better understand the stressful nature of the job and the needs of professionals employed in social welfare centres, the recommendation is to conduct more qualitative research studies in the future and to encourage usage of the results for positive changes in the practice.

Exploring teachers’ identities while teaching in the Fourth Industrial Revolution (4IR) is essential. Such assists teachers to reflect, improving their teaching through various networks. Identities are conscious thoughts interrogating subconscious thoughts that drive teachers to understand their personal needs. Eleven teachers, registered for a Master of Education degree at a university in South Africa, were purposively selected for this study. The objective of this study was to understand teachers’ identities while teaching mathematics in the 4IR. Focus-group discussions, reflective activities, and one-on-one semi-structured interviews, framed by a pragmatic case study, were used for data collection. The teachers’ identities revealed that the Three Tree Rings Theory with Currere was useful when applied as the teaching framework. Such application of the theories generated three categories of teaching identities within the 4IR. Categories were societal, professional, and personal identities. The university at which these participants were registered prescribed Moodle. However, the students mostly used social media sites such as Facebook and WhatsApp. As a result, students used digital technologies even during face-to-face classes. The study concluded that, although there were elements of both personal and professional identities, the societal identity was that which drove teaching. Consequently, this study recommends that teachers should learn to reflect on, in, and for their actions, in order to address the ‘what’, ‘how’, ‘who’, and ‘why’ questions of education, natural identity, and the 4IR/5IR.

We provide aggregate data about income, demographics, and life experiences of women and men practicing clinical-forensic psychology primarily in the United States (N = 376). We examine how these variables relate to one another, as well as how gender demographics of the field have changed over time. On this page, we share portions of the data that we could share (we could not share it all due to concerns about privacy), materials, other relevant files, the summary of results shared with participants in summer 2021, and a preprint version of the paper.

Policymakers and business leaders often use peer comparison information—showing people how their behavior compares to that of their peers—to motivate a range of behaviors. Despite their widespread use, the potential impact of peer comparison interventions on recipients’ well-being is largely unknown. We conducted a 5-mo field experiment involving 199 primary care physicians and 46,631 patients to examine the impact of a peer comparison intervention on physicians’ job performance, job satisfaction, and burnout. We varied whether physicians received information about their preventive care performance compared to that of other physicians in the same health system. Our analyses reveal that our implementation of peer comparison did not significantly improve physicians’ preventive care performance, but it did significantly decrease job satisfaction and increase burnout, with the effect on job satisfaction persisting for at least 4 mo after the intervention had been discontinued. Quantitative and qualitative evidence on the mechanisms underlying these unanticipated negative effects suggest that the intervention inadvertently signaled a lack of support from leadership. Consistent with this account, providing leaders with training on how to support physicians mitigated the negative effects on well-being. Our research uncovers a critical potential downside of peer comparison interventions, highlights the importance of evaluating the psychological costs of behavioral interventions, and points to how a complementary intervention—leadership support training—can mitigate these costs.

Background: Burnout affects >50% of physicians, especially women. This study aimed to examine how negative workplace interactions can predict burnout, and whether positive social interactions can mitigate risk. Materials and Methods: In a study of 1627 physician mothers who responded to a survey by the Physician Moms Group, an online Facebook group, we first examined the association between workplace sexual harassment and burnout. In an embedded experiment, we then measured the causal impact of priming perceived social support and connectedness on the three dimensions of employee burnout. Results: Two-thirds of respondents reported having experienced sexual harassment in the past year. Sexual harassment by patients was associated with 0.27 points higher emotional exhaustion, one dimension of burnout (95% confidence interval [CI] 0.12-0.41), equivalent to the predicted impact of an additional 22 weekly work hours on emotional exhaustion. Sexual harassment by patients was also associated with 0.40 points higher patient depersonalization, another dimension of burnout (95% CI 0.27-0.53). Sexual harassment by colleagues was associated with 0.16 points higher emotional exhaustion (95% CI 0.02-0.30), but not other dimensions of burnout. We found no significant relationship between experiences of sexual harassment and levels of personal accomplishment (the third dimension of burnout) among this sample. Priming physician mothers to reflect on their connectedness with other physician mothers significantly increased their sense of personal accomplishment. The priming intervention did not yield a significant effect on emotional exhaustion or depersonalization. Conclusions: Negative and positive social interactions each affect different dimensions of burnout. Sexual harassment-a pervasive type of negative social interaction-strongly predicts emotional exhaustion and depersonalization. Reflecting on social connectedness-a type of positive social interaction-can improve one's sense of personal accomplishment with an effect similar in magnitude to more intensive in-person interventions, suggesting that social connectedness through online groups merits further consideration as a tool to mitigate burnout.

Background: Plantar fasciopathy is a common orthopaedic condition that affects athletes and limits their performance. Purpose: To conduct a scoping review of the literature to summarize the evidence provided so far for the management of plantar fasciopathy in elite athletes and identify potential gaps in the current knowledge. Study Design: Scoping review; Level of evidence, 5. Methods: This scoping review followed the 6-stage methodological framework of Arksey and O’Malley and was registered in the Open Science Framework. PubMed, Scopus, and Web of Science were used to identify eligible articles. After charting of data, studies were pooled into 3 categories: epidemiological/diagnostic studies, outcome research focused on plantar fasciitis or partial tears, and studies on the rupture of the plantar fascia. The modified Coleman Methodology Score was used to assess the quality of included articles. Results: Of 742 initial studies, 10 were selected (109 patients): 8 level 4 articles and 2 level 5 articles. In 4 studies (91 athletes), potential risk factors were discussed but not investigated (ie, preexistent thickening of the fascia, spike shoes, varus hindfoot/knee alignment). In 3 studies (6 athletes) focusing on plantar fasciitis, the nonsurgical treatment led to a satisfactory but poorly documented outcome. In 3 studies (12 athletes), the rupture of the fascia was treated nonoperatively with contrasting results, while surgery was performed only in 2 cases. The mean modified Coleman Methodology Score was 19 (range, 3-42), demonstrating overall poor methodology. Conclusion: The limited number of studies and their poor quality do not allow to define the gold standard treatment of plantar fasciopathy in elite athletes. Until high-quality studies are provided, clinicians have to rely on the available literature regarding the nonprofessional or nonathletic population to make the best evidence-based decision.

The article analyzes organizational and content features of social rehabilitation students’ professional training at higher education institutions in the United States. The two-year college programs for obtaining Associate’s degree, four-year Bachelor’s and interdisciplinary Master’s degree university programs for professional training in social rehabilitation have been characterized. The peculiar features of these programs for each academic degree have been determined. It has been identified that professional training is carried out on an interdisciplinary basis by integrating general scientific, professional and subject-specific knowledge, introducing wide range of elective courses. Three models for training social rehabilitation students have been defined: traditional didactic, problem-solving and facilitated. Preference is given to the facilitated model, the conceptual idea of which is the idea of an integral professional and personal development of a social rehabilitation student as a subject of educational process throughout the study period and further professional activities. According to these models, the key teaching technologies have been divided into three groups: traditional didactic (demonstration, asking and answering questions), problem-solving (discussions, problem-based situations, conversations) and facilitated (interactive technologies such as round-table discussions, brainstorming activities, case study etc.). It has been found out that American college and university teachers prefer interactive (group learning, gaming, reflective, combined, integrated, project-based, information and communication) technologies, the essential features of which are the problem-based nature of co-operative learning, partnership and dialogue. Effective use of interactive technologies helps to involve students in the process of cognition, develops students’ critical thinking, encourages them to participate in learning activities, become independent, develop their professional outlook, reflect upon their own educational and cognitive activities by promptly defining their learning outcomes, modeling real life situations, creating the atmosphere of community and co-operation. It has been found out that the system of professional training provides conditions for professional self-determination, self-development and self-improvement., У статті проаналізовано організаційні та змістові особливості професійної підготовки фахівців із соціальної реабілітації у закладах вищої освіти США. Схарактеризовано дворічні програми для здобуття освітнього ступеня «Асоціат» у коледжах США, чотирирічні бакалаврські та міждисциплінарні магістерські університетські програми професійної підготовки фахівців із соціальної реабілітації. Визначено спільні ознаки цих програм для кожного з освітніх ступенів. Встановлено, що професійна підготовка здійснюється на міждисциплінарній основі шляхом інтеграції загальнонаукових, професійних і спеціалізованих знань, широкого запровадження елективних курсів. Визначено три моделі навчання фахівців із соціальної реабілітації: традиційно-дидактичну, проблемно-пошукову і фасилітовану. З’ясовано, що система професійної підготовки забезпечує умови для професійного самовизначення, саморозвитку і самовдосконалення.

The healthcare providers caring for children with life-threatening illnesses experience considerable compassion fatigue. The purpose of this study was to describe the feelings and emotions of professionals working in an interdisciplinary pediatric palliative home care team. A qualitative case study was conducted, comprising 18 participants. A purposeful sampling technique approach was used including the home-based interdisciplinary pediatric palliative team. Data were collected via semi-structured interviews and researchers’ field notes. A thematic analysis was performed. Two themes emerged: (a) changing life for the better, which described how professionals value life more and helping children and families provides compassion satisfaction, which is comforting and explains their dedication to care; (b) adverse effects of work highlighted the emotional burden of caring for children with life-limiting or life-threatening illnesses, which can affect their job satisfaction and may lead to burnout, showing how experiencing in-hospital child deaths with suffering leads professionals to develop an interest in specializing in pediatric palliative care. Our study provides information on possible causes of emotional distress in professionals caring for children with life-threatening illnesses and highlights strategies that can help them to reduce their distress. Sin financiación 2.835 Q2 JCR 2021 0.504 Q2 SJR 2022 No data IDR 2021 UEM

Background: Millennials, born between 1982­ and 2000, became the largest share of the American workforce in 2015. As of 2014, 23.9% of American occupational therapists were under the age of 30. Positive traits ascribed to millennials include: highly educated, ambitious, confident, and optimistic. However, indicators of challenges for managing millennials emerge from media and anecdotal evidence, including stereotypes of disloyalty, entitlement, dependency, and casualness. Relevant for supporting professional development is a call to understand and enhance professional communication. Method: This study analyzed how emerging millennial occupational therapists self-describe their professional communication profile and needs, compared to the perspective of managers, while aiming to describe the accuracy of communication stereotypes. Occupational therapy managers and emerging occupational therapists of the millennial generation completed an online researcher-created survey. Results: Comparison of means revealed statistically significant differences, with the most significance noted on items reflecting professional communication skills of millennial occupational therapists. Conclusion: Analysis of results suggested support for some stereotypes and inaccuracy of others, painting a unique picture of the professional communication profile of millennial occupational therapists. Results from this small-population survey study may inform professional development opportunities for academic and fieldwork educators and occupational therapy managers related to the communication profile and needs of emerging occupational therapists through the lens of generational theory.

In the paper, we will deal with literary knowledge and reading competencies of a student which are necessary for a coherent literary and methodically based interpretation and evaluation of the genre in contemporary literature teaching on the example of three dramas by Dušan Kovačević: Claustrophobic Comedy, Professional and Hilarious Tragedy. The purpose of the paper is to show how complex and significant the reading of a dramatic text can be, and perhaps unfairly neglected in teaching practice, given how important it is to research and define the literary knowledge and competencies that are necessary for the student to acquire by reading and studying the genre and reach the level of creative reaction to it. The purpose of the paper is to point out the linguistic and stylistic characteristics and theoretical basis of the drama from the corpus of research, which would methodically justified give the possibility of their incorporation into the high school curriculum.

Background Informatics tools within electronic health records (EHRs)—for example, data rosters and clinical reminders—can help disseminate care guidelines into clinical practice. Such tools' adoption varies widely, however, possibly because many primary care providers receive minimal training in even basic EHR functions. Objectives This mixed-methods evaluation of a pilot training program sought to identify factors to consider when providing EHR use optimization training in community health centers (CHCs) as a step toward supporting CHC providers' adoption of EHR tools. Methods In spring 2018, we offered 10 CHCs a 2-day, 16-hour training in EHR use optimization, provided by clinician trainers, and customized to each CHC's needs. We surveyed trainees pre- and immediately post-training and again 3 months later. We conducted post-training interviews with selected clinic staff, and conducted a focus group with the trainers, to assess satisfaction with the training, and perceptions of how it impacted subsequent EHR use. Results Six CHCs accepted and received the training; 122 clinic staff members registered to attend, and most who completed the post-training survey reported high satisfaction. Three months post-training, 80% of survey respondents said the training had changed their daily EHR use somewhat or significantly. Conclusion Factors to consider when planning EHR use optimization training in CHCs include: CHCs may face barriers to taking part in such training; it may be necessary to customize training to a given clinic's needs and to different trainees' clinic roles; identifying trainees' skill level a priori would help but is challenging; in-person training may be preferable; and inclusion of a practice coach may be helpful. Additional research is needed to identify how to provide such training most effectively.

Background Studies on football and the coronavirus disease 2019 (COVID-19) have mainly focused on the lockdown consequences for player fitness, the resumption of football training, and how to safely restart the league play, but injury data are scarce. Objective To describe the injury incidence and injury burden in men’s professional football teams during the pandemic year of 2020. Methods Nineteen teams in 12 countries prospectively registered data on player-exposure and time-loss injuries throughout 2020. All major football leagues were paused as a direct response to the pandemic in March 2020 and were thereafter completely cancelled or restarted after a lockdown interval of at least two months. Historical data from 43 teams in the same cohort during the five preceding years (2015–2019) were used as reference. Between-season and within-season comparisons were made for injury incidence (number of injuries per 1000 h) and injury burden (number of absence days per 1000 h) with 95% confidence intervals and interquartile ranges. Results There was no increased match injury incidence or injury burden following the restart in 2020 compared with other time periods of 2020 and the corresponding periods 2015–2019. There was an increased training injury incidence and injury burden immediately during the lockdown in 2020, and they remained elevated also following the restart, being higher in 2020 compared with 2015–2019, respectively. The injury characteristics during the first months of the new 2020/21 season (August/September–December) were similar between the five teams that cancelled their 2019/20 season in March 2020 and the 14 teams that restarted their season in May/June 2020. Conclusions There was no increased match injury incidence or injury burden following the COVID-19 lockdown and restart of the football season in 2020, but training injury incidence and injury burden were elevated and higher than in 2015–2019.

While much attention has been given to organisational culture, there has been less focus on workplace culture. Yet workplace culture strongly influences the way care is delivered, received and experienced. An effective workplace culture is crucial for the well-being of individual staff members and teams as well as for patients’ experiences and outcomes of care. This article describes the ‘Guiding Lights for effective workplace cultures’ which were developed by the authors and provide a framework to assist in understanding and promoting effective workplace cultures and creating environments where staff and patients feel safe and valued. There are four Guiding Lights: ‘collective leadership’, ‘living shared values’, ‘safe, critical, creative learning environments’ and ‘change for good that makes a difference’. Each one articulates what good workplace cultures are through descriptors and intermediate outcomes and together produce a set of ultimate outcomes. The Guiding Lights provide nurses working in older people’s care settings with an opportunity to learn from, and celebrate, what is going well in their workplaces and to consider areas that require further development.

Background: Shared decision-making (SDM) is particularly important in oncology as many treatments involve serious side effects, and treatment decisions involve a trade-off between benefits and risks. However, the implementation of SDM in oncology care is challenging, and clinicians state that it is difficult to apply SDM in their actual workplace. Training clinicians is known to be an effective means of improving SDM but is considered time consuming. Objective: This study aims to address the effectiveness of an individual SDM training program using the concept of deliberate practice. Methods: This multicenter, single-blinded randomized clinical trial will be performed at 12 Dutch hospitals. Clinicians involved in decisions with oncology patients will be invited to participate in the study and allocated to the control or intervention group. All clinicians will record 3 decision-making processes with 3 different oncology patients. Clinicians in the intervention group will receive the following SDM intervention: completing e-learning, reflecting on feedback reports, performing a self-assessment and defining 1 to 3 personal learning questions, and participating in face-to-face coaching. Clinicians in the control group will not receive the SDM intervention until the end of the study. The primary outcome will be the extent to which clinicians involve their patients in the decision-making process, as scored using the Observing Patient Involvement-5 instrument. As secondary outcomes, patients will rate their perceived involvement in decision-making, and the duration of the consultations will be registered. All participating clinicians and their patients will receive information about the study and complete an informed consent form beforehand. Results: This trial was retrospectively registered on August 03, 2021. Approval for the study was obtained from the ethical review board (medical research ethics committee Delft and Leiden, the Netherlands [N20.170]). Recruitment and data collection procedures are ongoing and are expected to be completed by July 2022; we plan to complete data analyses by December 2022. As of February 2022, a total of 12 hospitals have been recruited to participate in the study, and 30 clinicians have started the SDM training program. Conclusions: This theory-based and blended approach will increase our knowledge of effective and feasible training methods for clinicians in the field of SDM. The intervention will be tailored to the context of individual clinicians and will target the knowledge, attitude, and skills of clinicians. The patients will also be involved in the design and implementation of the study.

Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/ by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Waitzberg and colleagues identified strategies that managers and physicians in hospitals apply to reconcile dilemmas between clinical and economic considerations. Contributions that actually acknowledge the institutional complexity of hospitals and describe how to deal with it are rare. This comment explains the reason behind the institutional complexity in healthcare organizations and argues that institutional complexity is a good foundation for a wellfunctioning and sustainable healthcare, as long as we are able to deal with this complexity. This point underscores the importance of their contribution. However, even if the identified strategies on how to reconcile and balance different, competing demands are important, they are not easy to apply in practice. First, the strategies require frequent and high-quality interaction between different actors adhering to different institutional logics. Second, even when the strategies are applied successfully, it is difficult to make them sustainable since they rest on a fragile balance between competing logics. However, these are important avenues for future research for researchers who want to follow the route of Waitzberg and colleagues.

Background: High-speed running is commonly implicated in the genesis of hamstring injury. The success of hamstring injury management is typically quantified by the duration of time loss or reinjury rate. These metrics do not consider any loss in performance after returning to play from hamstring injury. It is not known to what extent high-speed running is altered on return to play after such injury. Hypothesis: Match high-speed running distance will change after returning from hamstring injury. Study Design: Non-randomized cohort. Level of Evidence: Level 3. Methods: Match high-speed running distance in highest level professional football (soccer, Rugby League, Rugby Union, and Australian Rules) were examined for a minimum of 5 games prior and subsequent to hamstring strain injury for individual differences using a linear regression models approach. A total of 22 injuries in 15 players were available for analysis. Results: Preinjury cumulative high-speed running distances were strongly correlated for each individual ( r2 = 0.92-1.0; P < 0.0001). Pre- and postinjury high-speed running data were available for a median of 15 matches (range, 6-15). Variance from the preinjury high-speed running distance was significantly less ( P = 0.0005) than the post injury values suggesting a suppression of high-speed running distance after returning from injury. On return to play, 7 of the 15 players showed a sustained absolute reduction in preinjury high-speed running distance, 7 showed no change, and 1 player (only) showed an increase. Analysis of subsequent (second and third injury) return to play showed no differences to return from the index injury. Conclusion: Return to play was not associated with return to high-speed running performance for nearly half of the players examined, although the same number showed no difference. Persisting deficits in match high-speed running may exist for many players after hamstring strain injury. Clinical Relevance: Returning to play does not mean returning to (high-speed running) performance for nearly half of the high-level professional football players examined in this study. This suggests that successful return to play metrics should be expanded from simple time taken and recurrence to include performance.

Introduction: Mental imagery is one of the psychological skills that sports psychologists recommend athletes to focus on. Aim: This study aimed to investigate the effects of PETTLEP and traditional mental imagery on handball triple shooting in novice and professional adolescent handball players. Method: A semi-experimental study was conducted on all novice and professional adolescent handball players in Maragheh, East Azerbaijan Province, Iran, in 2018-2019. By using the revised Movement Imagery Questionnaire (MIQ-R) (Hall and Martin, 1997), 60 people from the statistical population were purposively selected as the sample. The participants were randomly assigned to 5 groups of 12: two groups of traditional mental imagery at the novice and professional levels, two groups of PETTLEP imagery at the novice and professional levels, and a control group. After the 9-meter line test as the pretest, 3 sessions of group training for 7 weeks and then the posttest were performed. The data were statistically analyzed by using the repeated measures ANOVA and the Tukey's test in SPSS-23. Results: The results showed that professional participants in the PETTLEP imagery group significantly outperformed their peers in the traditional imagery group in handball triple shooting (P=0.001). By contrast, such a significant difference was not observed between the two groups of novice handball players (P>0.05). The results also indicated that the highest increase in mean score from pretest to posttest was observed among professional handball players in the PETTLEP imagery group. Conclusion: Mental imagery can effectively improve the performance of athletes. Therefore, it is recommended to be used in combination with physical exercises.

Conducting palliative care research can be personally and professionally challenging. Although limitations in funding and training opportunities are well described, a less recognized barrier to successful palliative care research is creating a sustainable and resilient team. In this special report, we describe the experience and lessons learned in a single palliative care research laboratory. In the first few years of the program, 75% of staff quit, citing burnout and the emotional tolls of their work. To address our sustainability, we translated resilience theory to practice. First, we identified and operationalized shared mission and values. Next, we conducted a resilience resource needs assessment for both individual team members and the larger team as a whole and created a workshop-based curriculum to address unmet personal and professional support needs. Finally, we changed our leadership approach to foster psychological safety and shared mission. Since then, no team member has left, and the program has thrived. As the demand for rigorous palliative care research grows, we hope this report will provide perspective and ideas to other established and emerging palliative care research programs.

Objectives: This survey aimed to review aspects of clinical decision support (CDS) that contribute to burnout and identify key themes for improving the acceptability of CDS to clinicians, with the goal of decreasing said burnout.Methods: We performed a survey of relevant articles from 2018-2019 addressing CDS and aspects of clinician burnout from PubMed and Web of Science™. Themes were manually extracted from publications that met inclusion criteria.Results: Eighty-nine articles met inclusion criteria, including 12 review articles. Review articles were either prescriptive, describing how CDS should work, or analytic, describing how current CDS tools are deployed. The non-review articles largely demonstrated poor relevance and acceptability of current tools, and few studies showed benefits in terms of efficiency or patient outcomes from implemented CDS. Encouragingly, multiple studies highlighted steps that succeeded in improving both acceptability and relevance of CDS.Conclusions: CDS can contribute to clinician frustration and burnout. Using the techniques of improving relevance, soliciting feedback, customization, measurement of outcomes and metrics, and iteration, the effects of CDS on burnout can be ameliorated.

Objective To determine the effects of ESRT (an iteratively adapted and tailored MBI) on perceived stress, executive cognitive function, psychosocial well-being (ie, burnout, mindfulness), and pro-inflammatory gene expression in surgical (ESRT-1) and mixed specialty (ESRT-2) PGY-1 volunteers. Summary of background and data Tailored MBIs have proven beneficial in multiple high-stress and high-performance populations. In surgeons, tailored MBIs have been shown to be feasible and potentially beneficial, but whether mindfulness-based cognitive training can improve perceived stress, executive function, well-being or physiological distress in surgical and nonsurgical trainees is unknown. Methods In 2 small single-institution randomized clinical trials, ESRT, a tailored mindfulness-based cognitive training program, was administered and iteratively adapted for first-year surgical (ESRT-1, 8 weekly, 2-hour classes, n = 44) and mixed specialty (ESRT-2, 6 weekly, 90-minute classes, n = 45) resident trainees. Primary and secondary outcomes were, respectively, perceived stress and executive function. Other prespecified outcomes were burnout (assessed via Maslach Burnout Inventory), mindfulness (assessed via Cognitive Affective Mindfulness Scale - Revised), and pro-inflammatory gene expression (assessed through the leukocyte transcriptome profile "conserved transcriptional response to adversity"). Results Neither version of ESRT appeared to affect perceived stress. Higher executive function and mindfulness scores were seen in ESRT-1, and lower emotional exhaustion and depersonalization scores in ESRT-2, at pre-/postintervention and/or 50-week follow-up (ESRT-1) or at 32-week follow-up (ESRT-2), compared to controls. Pooled analysis of both trials found ESRT-treated participants had reduced pro-inflammatory RNA expression compared to controls. Conclusions This pilot work suggests ESRT can variably benefit executive function, burnout, and physiologic distress in PGY-1 trainees, with potential for tailoring to optimize effects.

Amaç: Bu araştırma bir üniversite hastanesinde çalışan hemşirelerde tükenmişlik düzeyinibelirlemek ve tükenmişliğin sosyo-demografik değişkenlerle ilişkisini incelemek amacıylayapılmıştır.Gereç ve Yöntem: Çalışma, araştırmaya katılmayı kabul eden 192 hemşire ile yapılmıştır. Veriler31 sorudan oluşan sosyodemografik veri formu ve 22 sorudan oluşan Maslach Tükenmişlik Ölçeği(MTÖ) ile toplanmıştır.Bulgular: Hemşirelerin MTÖ duygusal tükenme alt boyutu puan ortalamaları 20.3±7.0,duyarsızlaşma alt boyutu puan ortalamaları 6.0±3.2 ve kişisel başarı alt boyutu puan ortalamaları19.3±4.1 olarak belirlenmiştir. Hemşirelerde cinsiyet, algılanan gelir düzeyi, kronik hastalıkvarlığı, psikiyatrik yardım alma öyküsü, klinikteki toplam hizmet süresi, yıllık izin alırken problemyaşama durumu, mesleki uygunluk, mesleğe bağlılık, mesleğini sevme ve kurumun meslekigelişim imkanı sağlamasının tükenmişliği etkilediği saptanmıştır (p

Received 26 October 2019. Accepted 21 June 2020. Published online 9 July 2020. Many professional associations of nurses in Russia and other countries struggle to increase their membership. Even though there are obvious advantages of membership in a professional organization, many people decide against it, which makes the study of factors that affect their decision-making a pertinent task. The aim of our research is to study the factors of membership or nonmembership of nurses in professional organizations in Russia. We conducted semi-structured interviews among nurses in different Russian regions (N = 16). Their responses were analyzed by qualitative content analysis. We identified the main factors that determine nurses’ membership or non-membership in professional associations and distinguished between objective and subjective reasons as well as active or passive attitudes demonstrated by our respondents in this regard. The conclusion is made that nurses often adopt a “formal” approach to membership in professional associations, seeing it primarily as a certification requirement. This means that their interests may not coincide with the goals and mission declared by these associations in their charters. Some respondents, however, demonstrated a more active attitude, pointing out such reasons for membership as professional growth, opportunities for advanced training, socialization, exchange of ideas and so on. This research was supported by the Russian Fund of Federal Property, project No. 18-013-01154А.

The aim of this paper is to highlight the organizational factors that might influence perceived discomfort in police officers. The studies included in the thematic review referred to specific factors, not the general terms “organizational stressors” or “workplace stressors”. It is important to emphasize this distinction because most studies use the general term “organizational stressor” (referring to context) to distinguish from “operational stressor” (referring to content, such as exposure to danger, threat, and trauma). For our purposes, we selected the studies that examined specific organizational factors. The results indicate that organizational social support, organizational culture, leadership, and bureaucracy are the organizational factors associated with police officers’ perceived discomfort. These organizational factors could have negative impacts on individuals, perceptions of stigma when contacting support services, anxiety and depressive symptoms, burnout, PTSD, and suicidal thoughts, among others.

BackgroundPsychological safety-the belief that it is safe to speak up-is vital amid uncertainty, but its relationship to feeling heard is not well understood.PurposeThe aims of this study were (a) to measure feeling heard and (b) to assess how psychological safety and feeling heard relate to one another as well as to burnout, worsening burnout, and adaptation during uncertainty.MethodologyWe conducted a cross-sectional survey of emergency department staff and clinicians (response rate = 52%; analytic N = 241) in July 2020. The survey measured psychological safety, feeling heard, overall burnout, worsening burnout, and perceived process adaptation during the COVID-19 crisis. We assessed descriptive statistics and construct measurement properties, and we assessed relationships among the variables using generalized structural equation modeling.ResultsPsychological safety and feeling heard demonstrated acceptable measurement properties and were correlated at r = .54. Levels of feeling heard were lower on average than psychological safety. Psychological safety and feeling heard were both statistically significantly associated with lower burnout and greater process adaptation. Only psychological safety exhibited a statistically significant relationship with less worsening burnout during crisis. We found evidence that feeling heard mediates psychological safety's relationship to burnout and process adaptation.ConclusionPsychological safety is important but not sufficient for feeling heard. Feeling heard may help mitigate burnout and enable adaptation during uncertainty.Practice implicationsFor health care leaders, expanding beyond psychological safety to also establish a feeling of being heard may further reduce burnout and improve care processes.

Delegation of malnutrition care to dietitian assistants can positively influence patient, healthcare, and workforce outcomes. However, nutrition care for hospital inpatients with or at risk of malnutrition remains primarily individually delivered by dietitians—an approach that is not considered sustainable. This study aimed to identify barriers and enablers to delegating malnutrition care activities to dietitian assistants. This qualitative descriptive study was nested within a broader quality assurance activity to scale and spread systematised and interdisciplinary malnutrition models of care. Twenty-three individual semi-structured interviews were completed with nutrition and dietetic team members across seven hospitals. Inductive thematic analysis was undertaken, and barriers and enablers to delegation of malnutrition care to dietitian assistants were grouped into four themes: working with the human factors; balancing value and risk of delegation; creating competence, capability, and capacity; and recognizing contextual factors. This study highlights novel insights into barriers and enablers to delegating malnutrition care to dietitian assistants. Successful delegation to dietitian assistants requires the unique perspectives of humans as individuals and in their collective healthcare roles, moving from words to actions that value delegation; engaging in processes to improve competency, capability, and capacity of all; and being responsive to climate and contextual factors.

How violent extremism is interpreted among adolescents and young adults who experience a form of psychopathology can have far-reaching consequences for these youth and for society. A fundamental consideration here is the role that ideology and psychopathology play in radicalization and possibly related extremist violence. Risk management is challenged at various levels. This article seeks to contribute to academic and policy discussions on psychopathology and extremism by combining relevant insights from practices in the Netherlands. In this perspective article our aim is to stimulate awareness and research, on the basis of operational knowledge of the Dutch case, that helps professionals across the various domains of risk management with more expertise and the ability to better integrate and interact the concepts of psychopathology and ideology. We end with formulating hypotheses for further research.

PURPOSE: Graduate medical and research training has drastically changed during the COVID-19 pandemic, with widespread implementation of virtual learning, redeployment from core rotations to the care of patients with COVID-19, and significant emotional and physical stressors. The specific experience of hematology-oncology (HO) fellows during the COVID-19 pandemic is not known. METHODS: We conducted a mixed-methods study using a survey of Likert-style and open-ended questions to assess the training experience and well-being of HO fellows, including both clinical and postdoctoral trainee members of the American Society of Hematology and ASCO. RESULTS: A total of 2,306 surveys were distributed by e-mail; 548 (23.8%) fellows completed the survey. Nearly 40% of fellows felt that they had not received adequate mental health support during the pandemic, and 22% reported new symptoms of burnout. Pre-existing burnout before the pandemic, COVID-19–related clinical work, and working in a primary research or nonclinical setting were associated with increased burnout on multivariable logistic regression. Qualitative thematic analysis of open-ended responses revealed significant concerns about employment after training completion, perceived variable quality of virtual education and board preparation, loss of clinical opportunities to prepare for independent clinical practice, inadequate grant funding opportunities in part because of shifting research priorities, variable productivity, and mental health or stress during the pandemic. CONCLUSION: HO fellows have been profoundly affected by the pandemic, and our data illustrate multiple avenues for fellowship programs and national organizations to support both clinical and postdoctoral trainees.

PURPOSE: The COVID-19 pandemic has dramatically affected all areas of health care. Primary care practices are on the front lines for patients seeking health care during this period. Understanding clinical and administrative staff members’ strategies for managing the broad-ranging changes to primary care service delivery is important for the support of workforce well-being, burnout, and commitment to primary care. METHODS: Thirty-three staff members from 8 practices within a single health care system completed short, semistructured interviews from May 11, 2020 to July 20, 2020. Interviews were coded using a combination of conventional and directed content analysis. RESULTS: Themes emerged from the data that mapped onto the Job Demands-Control-Social Support model. Participants reported that every aspect of primary care service delivery needed to be adapted for COVID-19, which increased their job demands significantly. Several also described pride in their development of new skills, and in most interviews, they expressed that the experience brought staff together. Staff engaged in active cognitive reframing of events during the interviews as they coped with increased workplace stress. However, as the pandemic changed from an acute stress event to a chronic stressor, staff were more likely to indicate signs of burnout. CONCLUSIONS: Primary care teams absorbed tremendous burdens during COVID-19 but also found that some stress was offset by increased support from management and colleagues, belief in their own necessity, and new development opportunities. Considering high prepandemic strain levels, the ability of primary care teams to persist under these conditions might erode as the crisis becomes an enduring challenge.

Nurse, Midwives and Allied Health Professionals (AHPs), along with other health and social care colleagues are the backbone of healthcare services. They have played a key role in responding to the increased demands on healthcare during the COVID-19 pandemic. This paper compares cross-sectional data on quality of working life, wellbeing, coping and burnout of nurses, midwives and AHPs in the United Kingdom (UK) at two time points during the COVID-19 pandemic. An anonymous online repeated cross-sectional survey was conducted at two timepoints, Phase 1 (7th May 2020-3rd July 2020); Phase 2 (17th November 2020-1st February 2021). The survey consisted of the Short Warwick-Edinburgh Mental Wellbeing Scale, the Work-Related Quality of Life Scale, and the Copenhagen Burnout Inventory (Phase 2 only) to measure wellbeing, quality of working life and burnout. The Brief COPE scale and Strategies for Coping with Work and Family Stressors scale assessed coping strategies. Descriptive statistics and multiple linear regressions examined the effects of coping strategies and demographic and work-related variables on wellbeing and quality of working life. A total of 1839 nurses, midwives and AHPs responded to the first or second survey, with a final sample of 1410 respondents -586 from Phase 1; 824 from Phase 2, (422 nurses, 192 midwives and 796 AHPs). Wellbeing and quality of working life scores were significantly lower in the Phase 2 sample compared to respondents in Phase 1 (p

O gerente de enfermagem realiza suas funções num ambiente cujas condições de trabalho podem ser demasiadamente estressantes. A pandemia de Covid-19 aumentou ainda mais os estressores aos quais a equipe de enfermagem e consequente o gerente estão expostos. O presente capítulo, cujo objetivo foi discutir a síndrome de esgotamento profissional (burnout) em gerentes de enfermagem, foi elaborado através da leitura, análise e interpretação de estudos encontrados na Biblioteca Virtual em Saúde e no Google Acadêmico. Estudos apontam que gerentes de enfermagem apresentam altos níveis de exaustão emocional e de despersonalização. Idade, sexo, estado civil, ter filhos, e ocorrência de mobbing estão relacionados com a síndrome de esgotamento profissional. O adoecimento do gerente de enfermagem prejudica toda a equipe e consequentemente interfere negativamente na assistência. Apoio da equipe de enfermagem e da direção da instituição de saúde irá contribuir para a prevenção da síndrome de esgotamento profissional em gerentes de enfermagem. The nurse manager performs duties in an environment whose working conditions can be too stressful. The Covid-19 pandemic further increased the stressors to which the nursing team and consequently the manager are exposed. This chapter, whose objective was to discuss the burnout syndrome in nurse managers, was elaborated through the reading, analysis and interpretation of studies found in the Virtual Health Library and in Google Academic. Studies determined that nurse managers have high levels of emotional exhaustion and depersonalization. Age, sex, marital status, having children, and the occurrence of mobbing are related to the burnout syndrome. The nurse manager’s illness affects the entire team and consequently interferes negatively with care. Support from the nursing team and the health institution’s administration will contribute to the prevention of burnout syndrome in nurse managers.