Occupational stress and burnout in anaesthesia Nyssen, A.S.; Hansez, I.; Baele, P. ...
British journal of anaesthesia : BJA,
03/2003, Volume:
90, Issue:
3
Journal Article, Web Resource
Peer reviewed
Open access
Formal studies on stress in anaesthetists have usually measured stress through mental or physiological indicators. When using this approach, one must be careful not to confuse the effects of stress ...or outcome variables and the sources of stress or antecedent variables. To date, it seems from the literature that there is no clear evidence of a common pattern of physiological effects of stress for all the sources of stress. Furthermore, work characteristics such as job satisfaction, job control and job support may moderate the effects of stress.
We measured the effects of stress together with the sources of stress and job characteristics, using self-reported questionnaires rather than physiological indicators in order to better diagnose stress in anaesthetists.
The mean stress level in anaesthetists was 50.6 which is no higher than we found in other working populations. The three main sources of stress reported were a lack of control over time management, work planning and risks. Anaesthetists reported high empowerment, high work commitment, high job challenge and high satisfaction. However, 40.4% of the group were suffering from high emotional exhaustion (burnout); the highest rate was in young trainees under 30 years of age.
Remedial actions are discussed at the end of the paper.
Background
Chronic pain is considered to be a complex phenomenon, involving an interrelation of biological, psychosocial and sociocultural factors. Currently, no single treatment or therapy can ...address all aspects of this pathology. In our expert tertiary pain centre, we decide to assess the effectiveness of four treatments for chronic pain classically proposed in our daily clinical work: physiotherapy; psycho‐education; physiotherapy combined with psycho‐education; and self‐hypnosis/self‐care learning.
Methods
This study included 527 chronic pain patients, with a mean duration of pain of 10 years. Patients were allocated either to one of the four pre‐cited treatment groups or to the control group. Pain intensity, quality of life, pain interference, anxiety and depression were assessed before and after treatment.
Results
This study revealed a significant positive effect on pain interference and anxiety in patients included in the physiotherapy combined with psycho‐education group, after 20 sessions spread over 9 months of treatment. The most prominent results were obtained for patients allocated to the self‐hypnosis/self‐care group, although they received only six sessions over a 9‐month period. These patients showed significant benefits in the areas of pain intensity, pain interference, anxiety, depression and quality of life.
Conclusions
This clinical report demonstrates the relevance of biopsychosocial approaches in the improvement of pain and psychological factors in chronic pain patients. The study further reveals the larger impact of self‐hypnosis/self‐care learning treatment, in addition to a cost‐effectiveness benefit of this treatment comparative to other interventions.
Hypnosis is well documented in the literature in the management of acute and chronic pain. Virtual reality (VR) is currently gaining credibility in the same fields as hypnosis for medical ...applications. Lately, the combination of hypnosis and VR was considered. The aim of this scoping review is to understand the current studied contexts and effects of virtual reality hypnosis (VRH) for the management of pain. We searched on PubMed, Taylor & Francis Online, and ProQuest databases with the following terms: "virtual reality," "3D," "hypnosis," and "pain". We included 8 studies that combined hypnosis and VR. All articles are in English. Two included healthy volunteers and six are clinical studies. Short-term results indicated significant decreases in pain intensity, pain unpleasantness, time spent thinking about pain, anxiety, and levels of opioids. However, results are not consistent for all patients all the days. VR alone seems to reduce pain independently of the hypnotizability level. One study claimed that VR and hypnosis could alter each other's effects and another argued that VR did not inhibit the hypnotic process and may even facilitate it by employing visual imagery. We cannot affirm that VR added value to hypnosis when they are combined. These trials and case series gave us indications about the possible applications of VRH in different contexts. Additional randomized clinical trials on VRH in the future will have to test this technique in clinical practice and help define guidelines for VRH utilization in pain management. Keywords: hypnosis, virtual reality, 3D animation, virtual reality hypnosis, acute pain, chronic pain
Although error has been shown as the main cause of accidents in complex systems, little attention has been paid to error detection. However, reducing the consequences of error depends largely on ...error detection. The goal of this paper is to synthesize the existing scientific knowledge on error detection, mostly based on studies conducted in laboratory or self reporting and to further knowledge through the analysis of a corpus of cases collected in a complex system, anaesthesia. By doing this, this paper is better able to describe how this knowledge can be used to improve understanding of error detection modes. An anaesthesia accident reporting system developed and organized at two Belgian University Hospitals was used in order to collect information about the error detection patterns. Results show that detection of errors principally occurred through the standard check (routine monitoring of the environment). Significant relationships were found between the type of error and the error detection mode, and between the type of error and the training level of the anaesthetist who committed the error.
Purpose of the study: The aim of this study was to evaluate the impact of 3D and 2D vision on performance of novice subjects using da Vinci robotic system.
Methods: 224 nurses without any surgical ...experience were divided into two groups and executed a motor task with the robotic system in 2D for one group and with the robotic system in 3D for the other group. Time to perform the task was recorded.
Results: Our data showed significant better time performance in 3D view (24.67 ± 11.2) than in 2D view (40.26 ± 17.49, P < 0.001).
Conclusions: Our findings emphasized the advantage of 3D vision over 2D view in performing surgical task, encouraging the development of efficient and less expensive 3D systems in order to improve the accuracy of surgical gesture, the resident training and the operating time.
This study aimed to evaluate the impact of two-dimensional (2D) and three-dimensional (3D) images on time performance and time estimation during a surgical motor task. A total of 60 subjects without ...any surgical experience (nurses) and 20 expert surgeons performed a fine surgical task with a new laparoscopic technology (da Vinci robotic system). The 80 subjects were divided into two groups, one using 3D view option and the other using 2D view option. We measured time performance and asked subjects to verbally estimate their time performance. Our results showed faster performance in 3D than in 2D view for novice subjects while the performance in 2D and 3D was similar in the expert group. We obtained a significant interaction between time performance and time evaluation: in 2D condition, all subjects accurately estimated their time performance while they overestimated it in the 3D condition. Our results emphasise the role of 3D in improving performance and the contradictory feeling about time evaluation in 2D and 3D. This finding is discussed in regard with the retrospective paradigm and suggests that 2D and 3D images are differently processed and memorised.
Communication soignant-soigné Faymonville, M.-E.; Nyssen, A.-S.
Douleur et analgésie,
12/2014, Volume:
27, Issue:
4
Journal Article, Web Resource
Peer reviewed
Résumé
La communication fait partie intégrante de la relation de soin. Mais, quelle attention portons-nous aux mots que nous utilisons au quotidien dans nos interactions ? Dans cet article, nous ...n’avons pas la prétention de faire un exposé exhaustif sur la communication thérapeutique. Nous invitons le lecteur à observer un regard critique sur nos échanges verbaux et non verbaux. Nous montrons notamment comment les mots peuvent être porteurs de suggestions négatives et avoir un « effet nocebo » et comment l’apprentissage de compétences communicationnelles constitue un outil puissant permettant d’améliorer la qualité des soins et le bienêtre au travail.
RésuméL’objectif de cet article est d’étudier les impacts des changements ainsi que les processus d’adaptation lors de l’introduction d’une nouvelle technologie en chirurgie, par l’analyse des ...communications recueillies en situation réelle. Pour cela, nous avons comparé les communications recueillies lors de l’utilisation de deux techniques différentes (laparoscopie classique et système robotique, étude 1) ainsi que les communications échangées lorsque les équipes sont composées de chirurgiens experts ou novices avec la nouvelle technologie (étude 2). Nos résultats montrent non seulement que le temps opératoire augmente et que le nombre de communications est plus élevé lors de l’introduction de la nouvelle technologie, mais nous mettons également en évidence l’existence de deux types de communications qui se distinguent selon l’expertise des acteurs : d’un côté, les communications qui traitent de la manipulation et de l’orientation spatiale, qui disparaissent avec l’expertise et qui mettent en évidence une stratégie d’adaptation à court terme et de l’autre, les ordres et les confirmations qui restent présents dans la pratique experte et qui témoignent d’un changement radical de structure de la tâche, induisant un mode de contrôle symbolique basé sur l’adressage verbal et augmentant le coût cognitif dans les situations de téléopération.
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