Physical activity has a positive effect on general health, but its influence on burnout remains unclear. The aim of this study was to determine the association between physical activity and the ...incidence of burnout in Slovenian family physicians (FPs) and family medicine trainees (FMTs) during the COVID-19 pandemic, which exacerbated the already-existing problem of burnout. We conducted a cross-sectional observational study among Slovenian family physicians and FMTs in which sociodemographic variables, the type and duration of physical activity, and an assessment of burnout were collected using the Maslach Burnout Inventory. Comparisons between groups were made using the independent-samples
-test, Fisher's exact test, and the Wilcoxon sign-rank test. A value of
< 0.05 determined the limit of statistical significance. Of 1230 FPs and FMTs invited to participate, 282 completed the survey (22.9% response rate); there were 243 (86.2%) FPs and 39 (13.8%) FMTs. The overall rating for burnout during the pandemic was high, at 48.6% of FPs and FMTs; 62.8% of respondents reported a high rating for emotional exhaustion and 40.1% for depersonalization. Compared to FMTs, emotional exhaustion and total burnout scores were higher for FPs (
< 0.001 and
= 0.010, respectively), but work status was not related to personal acomplishment, which 53.5% of all participants rated as low. Physical activity did not appear to be a statistically significant factor in the occurrence of burnout during the pandemic. Therefore, work status or occupational role (FP vs. FMT) should be thoroughly investigated in the future along with some other factors and a better response rate.
Since many health problems are associated with abuse and neglect at all ages, domestic violence victims may be considered as a group of primary care patients in need of special attention.
The aim of ...this multi-centre study was to assess the prevalence of domestic violence in primary care patients, and to identify those factors which influence the co-occurrence of psychological and physical violence exposure and their consequences (physical, sexual and reproductive and psychological) as obtained from medical records.A study was carried out in 28 family practices in Slovenia in 2009. Twenty-eight family physicians approached every fifth family practice attendee, regardless of gender, to be interviewed about their exposure to domestic violence and asked to specify the perpetrator and the frequency. Out of 840 patients asked, 829 individuals, 61.0% women (n = 506) and 39.0% men (n = 323) were assessed (98.7% response rate). They represented a randomised sample of general practice attendees, aged 18 years and above, who had visited their physician for health problems and who were given a physical examination. Visits for administrative purposes were excluded.Multivariate binary logistic regression analysis was used to determine the factors associated with exposure to both psychological and physical violence.
Of 829 patients, 15.3% reported some type of domestic violence experienced during the previous five years; 5.9% reported physical and 9.4% psychological violence; of these 19.2% of men and 80.8% of women had been exposed to psychological violence, while 22.4% of men and 77.6% of women had been exposed to physical violence. The domestic violence victims were mostly women (p < 0.001) aged up to 35 years (p = 0.001). Exposure to psychological violence was more prevalent than exposure to physical violence. Of the women, 20.0% were exposed to either type of violence, compared to 8.0% of male participants, who reported they were rarely exposed to physical violence, while women reported often or constant exposure to physical violence. Their partners were mostly the perpetrators of domestic violence towards women, while amongst men the perpetrators were mostly other family members.In univariate analysis female gender was shown to be a risk factor for domestic violence exposure. Regression modelling, explaining 40% of the variance, extracted two factors associated with psychological and physical violence exposure: the abuse of alcohol in the patient (OR 4.7; 95% CI 1.54-14.45) and their unemployment (OR 13.3; 95% CI 1.53-116.45).
As far as the study design permits, the identified factors associated with both psychological and physical violence exposure could serve as determinants to raise family physicians' awareness when exploring the prevalence of domestic violence. The results of previous research, showing at least 15% prevalence of exposure to domestic violence among primary care patients in Slovenia, and the female gender as a risk factor, were confirmed.
Despite depression being a major driver of morbidity and mortality, the majority of primary care patients remain undiagnosed, so this study aimed to assess the prevalence of depression and the ...association with demographic and clinical variables, genetic risk, and quality of life. The participants were presumably healthy model family medicine practice (MFMP) attendees between 30 and 65 years of age and recruited during a preventive check-up in 2019. Each of the 40 pre-selected MFMP pragmatically invited 30 attendees to voluntarily participate. They completed a questionnaire of demographic, clinical, and social determinants, as well as a three-generational family history. The results were analyzed using multivariable modelling to calculate the associations with signs of depression. A modified Scheuner method was used to calculate the level genetic risk level using family history. Of 968 participants, aged 42.8 ± 8.6 years, 627 (64.8%) were women. The prevalence of depression was 4.1%. Signs of depression were negatively associated with health-related quality of life score, in particular in the domains of self-care (p = 0.001) and anxiety/depression (p < 0.001). Depression was also associated with predicted high risk for comorbidities given the family history (p = 0.030). Primary care directed at improving patients’ quality of life should implement more widespread screening for mental health disorders. Family history for disease even beyond depression can be used by physicians as an important primary prevention tool.
Burnout is a psychological, work-related syndrome associated with long-term exposure to emotional and interpersonal stressors in the workplace. Burnout syndrome in nurses is often caused by an ...imbalance between work requirements and preparation and fitness for work, a lack of control, insufficient performance recognition and a prolonged exposure to stress.
The aims of this study were to explore the associations between levels of burnout syndrome, coping mechanisms and job satisfaction in critical care nurses in multivariate modelling process. A specific aim was also to explore whether coping and job satisfaction in critical care nurses are gender related.
A cross-sectional multicentre study was conducted in a convenience sample of 620 critical care nurses from five university hospitals in Croatia in 2017. The data were collected using the Maslach Burnout Inventory and the Ways of Coping and Job Satisfaction Scale together with the nurses' demographic profiles and were analysed using a multivariable model.
The results showed no significant association between gender, coping mechanisms and job satisfaction. However, significant negative associations between burnout and job satisfaction (OR = 0.01, 95%CI = 0.00-0.02,
< 0.001) and positive association between burnout and passive coping (OR = 9.93, 95%CI = 4.01-24.61,
< 0.001) were found.
The association between job satisfaction and burnout in nurses urges hospital management teams to consider actions focused on job satisfaction, probably modifications of the work environment. Given that passive coping may increase the incidence of burnout, it is recommendable for active coping to be implemented in nurses' training programmes as an essential element of capacity building aimed at reducing the incidence of burnout in nurses.
Burnout is usually defined as a prolonged response to chronic emotional and interpersonal stressors, characterrized by emotional exhaustion, depersonalization and lack of social accomplishment. ...Coping mechanisms and job satisfaction are associated with the incidence of burnout symptoms in a work context.
The aim of this paper was to make a systematic analysis of the literature related to nurses' stress and the incidence of burnout syndrome in intensive care nurses, and also to determine the research into associations between coping mechanisms and job satisfaction on one side, and burnout on the other side. Appropriate databases (Scopus, PubMed) were searched with the aim of finding relevant studies and articles published in the last 15 years. The keywords were burnout, coping mechanisms, job satisfaction, nurses, and intensive care. Two independent reviewers carried out a selection of the studies.
The literature review found 786 studies about burnout and its association with different variables. Twenty-nine original research papers were discovered in this review process. Open questions still remain concerning burnout and the associations between the considered variables. We also found that studies using a qualitative approach, which could provide better insight into the investigation of burnout, was insufficient in this area.
Burnout syndrome is serious problem for healthcare systems and affects almost all profiles of healthcare workers. Although burnout is an evidence-based public health problem, there is still no systematic approach to prevention. Prevention activities to reduce stress and the incidence of burnout should be provided for nurses, especially those in very demanding posts.
Purpose
Resilience has become an important concept in health research, addressing mental health outcomes. The purpose of this study was to translate, adapt, and evaluate psychometric properties of ...the Slovenian version of the 14-item Resilience Scale (RS-14), using a sample of general population and cancer survivors.
Methods
The original version of the RS-14 was first back-translated and pilot tested. The factor structure was assessed with an exploratory analysis and confirmed with a confirmatory analysis. To assess reliability, internal consistency (Cronbach’s alpha) and test–retest (ICC,
t
student test) were determined. Measurement validity was assessed with demographic (age and gender) and psychological characteristics (symptoms of anxiety and depression and health-related quality of life).
Results
An exploratory factor analysis revealed one-factor solution in both samples and the fit indexes showed an acceptable model fit. Internal consistency showed excellent values (0.91–0.96), and test–retest reliability was found to be acceptable (
ICC
= 0.89). Significant correlations were found between RS-14 and anxiety and depression HADS subscales in Sample 1 (
r
= − 0.62, − 0.72 for anxiety and depression) and Sample 2 (
r
= − 0.43,
r
= − 0.51 for anxiety and depression) and the majority of EQ-5D subscales (usual activities, pain, anxiety/depression).
Conclusion
The study showed that the Slovenian version of the RS-14 test scores is valid and stable.
Trial registration number:
0120–25/2019/6
Due to the expensive and time-consuming diagnostics, most general physicians do not use a standardized psychodiagnostic tool to detect depression and anxiety and often rely on their own judgment. ...This often leads to inaccuracy of identification of patients with mental disorders.
To systematically review the literature of the 14-item resilience scale (RS-14) and offer directions for future studies.
Fourteen studies that included a translated/validated RS-14 regardless of the sample were included through Medline and CINAHL databases and the following questions were addressed: (i) What are the factor structure, internal consistency and repeatability of the RS-14? (ii) Is RS-14 concordant with other scales for measuring resilience, and what is the concurrent validity of this instrument? (iii) What are the critiques, conclusions and limitations of previous studies?
Most factor analyses demonstrated a one-factor solution and confirmed 14-item scale. Cronbach's α for was high (M = 0.88); the test-retest reliability was satisfactory in three (0.70 < r > 0.83) out of four studies (r = 0.49). Results of concurrent validity showed positive correlation with some variables, including quality of life and a negative correlation with depression and anxiety. Among other limitations, the biggest drawback was a non-representative sample.
RS-14 was found to perform well in clinical and non-clinical sample. Due to its wide use of population, time efficiency and good results on concurrent validity, we suggest future studies to examine whether RS-14 has a potential to serve as a first distress and quality of life screening tool in the family medicine practices.
Introduction: Physician’s burnout has been recognized as an increasing and significant work-related syndrome, described by the combination of emotional exhaustion (EE) and depersonalization (D), ...together with low personal accomplishment (PA). It has many negative consequences on personal, organizational, and patient care levels. This systematic review aimed to analyze research articles where psychological interventions with elements of mindfulness (PIMs) were used to support physicians in order to reduce burnout and foster empathy and well-being. Methods: Systematic searches were conducted in May 2019, within six electronic databases PubMed, EBSCOhost MEDLINE, PsycArticles, Cochrane Library, JSTOR, and Slovenian national library information system. Different combinations of boolean operators were used—mindfulness, empathy, medicine/family medicine/general practice/primary care, burnout, doctors/physicians, intervention, and support group. Additional articles were manually searched from the reference list of the included articles. Studies with other healthcare professionals (not physicians and residents) and/or medical students, and those where PIMs were applied for educational or patient’s treatment purposes were excluded. Results: Of 1194 studies identified, 786 screened and 139 assessed for eligibility, there were 18 studies included in this review. Regardless of a specific type of PIMs applied, results, in general, demonstrate a positive impact on empathy, well-being, and reduction in burnout in participating physicians. Compared with other recent systematic reviews, this is unique due to a broader selection of psychological interventions and emphasis on a sustained effect measurement. Conclusions: Given the pandemic of COVID-19, it is of utmost importance that this review includes also interventions based on modern information technologies (mobile apps) and can be used as an awareness-raising material for physicians providing information about feasible and easily accessible interventions for effective burnout prevention and/or reduction. Future research should upgrade self-reported data with objective psychological measures and address the question of which intervention offers more benefits to physicians.
Cancer survivors may experience unmet needs beyond the end of their treatment. This paper aimed to explore the prevalence and most frequently found unmet needs and to identify factors associated with ...higher levels of total unmet needs and with each domain separately. Five databases were searched using the keywords neoplasms, survivors, needs assessment, health services’ needs and demands. The results were presented based on the strength of the evidence (strong, moderate and weak association) and the categorisation of the pooled prevalence of at least one unmet need (high, moderate, low). Twenty‐six studies were included in the review. A higher prevalence of at least one reported unmet need was observed in survivors with less time since treatment and in women with breast cancer. The most frequently reported unmet needs were fear of cancer recurrence and requesting up to date information. Strong evidence was found for an association between a higher number of unmet needs and younger age, higher anxiety and poorer quality of life. Future studies on unmet needs should report how unmet needs are associated with each domain separately. This might solve the inconclusive evidence found for the stage of the disease at diagnosis and depression.
Background Previous studies on dental anxiety have examined the psychophysiological responses evoked in dentally anxious subjects by dental-related stimuli, but not during a real-life dental ...examination, which was achieved in the present study. Methods The heart rate, skin conductance level, and heart rate variability of 25 subjects with dental anxiety and 25 healthy controls were examined. Anxiety was determined by the Modified Dental Anxiety Scale and the Dental Anxiety Scale-Revised. The psychophysiological reactions of the two groups were compared during exposure to dental-related pictures, dental-related sounds, and an actual examination in a dental surgery. Results All the dental-related stimuli provoked an increase in heart rate, i.e. visual stimuli (p<0.001; 95% CI 0.98-3.95 bpm), auditory stimuli (p<0.001; 95% CI 1.34-4.99 bpm), and a dental examination (p<0.001; 95% CI 1.26-5.39 bpm). Dental-related pictures provoked inferior skin conductance level changes compared to dental-related sounds and the dental examination (visual modality vs auditory p<0.001; 95% CI 0.039-0.152; visual modality vs examination p<0.001; 95% CI 0.083-0.275). Heart rate variability manifested in a complex pattern of responses to the dental examination. However, when exposed to all three dental-related stimuli presentation conditions, the heart rate (F = 0.352, p = 0.556), skin conductance level (F = 0.009, p = 0.926), and heart rate variability parameters of subjects with dental anxiety did not differ in comparison to the healthy controls. Conclusions This pilot study represents an evaluation of psychophysiological reactions during a real-life dental examination compared to single modality stimuli, and shows that a real-life dental examination provokes an increase in heart rate, heart rate variability and skin conductance level. Additionally, autonomic responses did not differ between the experimental and control groups. The key issue for future studies is the effect of real-life situations on the physiological and psychological state of the subjects, which should be considered when planning new research and studied in depth.
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