Browsing by Subject "Burnout"
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Item An Exploratory Pilot Study of the Experience of Vicarious Trauma and Burnout in the Workforce of Indiana Health Centers(2023-07) Harris, Lori Gail; Stone, Cynthia; Maxey, Hannah; Day, ChristopherStudy Question: Does the unique population and experiences (such as adverse social determinants of health and trauma) of the patients served contribute to the burnout of the workforce in Indiana health centers? Methods: A quantitative exploratory study conducted via a survey sent to 241 participants of an Indiana Department of Health quality collaborative cohort. The questionnaire used the Copenhagen Burnout Inventory (CBI) with questions (similar to) 5 &6 from the Secondary Traumatic Stress Scale (STSS). Two open ended questions were also included to gather potential interventions to reduce burnout. Results: Survey was available March to April 2023 with IRB approval 18567. A total of 146 surveys were completed (60.6%). Respondents represented a geographically diverse cross section of health center types and locations in Indiana. Many types of exhaustion were experienced, including: emotional exhaustion being reported by 59% of the respondents, and work-related emotional effect by 68% of the sample. Work related burnout was present in 64.7% of respondents. Collecting information from the patient’s about lack of housing, lack of adequate income, food insecurity, and other SDOH factors exposed 42.7% of respondents to patient trauma experiences. Participants reported worksite resources that could decrease stress such as more paid time off, team building activities during work time, and more time to document care activities. Plan for Change: The Kotter Change model was applied. Some actions would include forming a collaborative with Indiana State Department of Health, Indiana Primary Care Association, and others to implement the reported worksite changes that would benefit health center staff and decrease burnout. A co-production of healthcare model is suggested to provide insight from both health center workers and administration to create collaborative solutions in an attempt to reduce burnout with the long-term goal of reducing turnover. Any successful solutions to be shared with state and national health center leaders and a proposal for a scale up of the study project to gain new or additional potential solutions. Conclusion: Emotional and physical exhaustion in the health center workforce is evident with study results. Collecting and addressing social determinants of health factors (like food and housing insecurity and others) is an important part of caring for vulnerable patient populations. Exposure to patient trauma may be a partial contributor to the levels of burnout experienced for providers, and additional studies would be useful to determine the degree of influence or other contributing demographics (like age, gender, etc.) However, the gathering of SDOH is critical to understand patient trauma to assist staff in improving their quality of life. Additional support for the providers and support staff can decrease the impact of their exposure to vicarious trauma.Item Antecedents and outcomes of work-linked couple incivility(2014) Jones, Morgan Dakota; Sliter, Michael; Devine, Denis John; Williams, Jane R.Workplace incivility has been shown to have negative organizational and individual effects on people who experience this low-intensity deviant behavior. Research has recently begun to look at incivility as a form of modern discrimination that may be used to target out-groups within organizations, where out-groups are broadly defined. The first goal of the current study was to examine the impact of incivility on work-linked couples. Second, the present study sought to determine the effect that experiences of WLC incivility had on individual and organizational outcomes: burnout, job satisfaction, and turnover intentions. Finally, although the outcomes of incivility have been well-established, the antecedents of this phenomenon have been examined considerably less. Therefore, the present study sought to examine and explain the relationship between a climate for formality, gender, and WLC incivility. To accomplish these goals a snowball sampling method was used to recruit a total of 86 participants for an online survey. Hierarchal regression and bootstrapping mediation were used to analyze the data. Results showed that WLC incivility was predictive of burnout, job dissatisfaction, and turnover intentions. Furthermore, both burnout and job satisfaction were shown to mediate the relationship between WLC incivility and turnover intentions. The theoretical and practical implications of these results are discussed as well as potential areas for future research.Item Assessing Resident Well-Being After the ABSITE: A Bad Time to Ask?(Wolters Kluwer, 2022-09-28) Cheung, Elaine O.; Hu, Yue-Yung; Jones, Andrew; Ma, Meixi; Schlick, Cary Jo R.; Moskowitz, Judith T.; Agarwal, Gaurava; Bilimoria, Karl Y.; Surgery, School of MedicineObjectives: Assess the association of residents' exam performance and transient emotions with their reports of burnout, suicidality, and mistreatment. Background: An annual survey evaluating surgical resident well-being is administered following the American Board of Surgery In-Training Examination (ABSITE). One concern about administering a survey after the ABSITE is that stress from the exam may influence their responses. Methods: A survey was administered to all general surgery residents following the 2018 ABSITE assessing positive and negative emotions (scales range from 0 to 12), as well as burnout, suicidality over the past 12 months, and mistreatment (discrimination, sexual harassment verbal/emotional or physical abuse) in the past academic year. Multivariable hierarchical regressions assessed the associations of exam performance and emotions with burnout, suicidality, and mistreatment. Results: Residents from 262 programs provided complete responses (N = 6987, 93.6% response rate). Residents reported high mean positive emotion (M = 7.54, SD = 2.35) and low mean negative emotion (M = 5.33, SD = 2.43). While residents in the bottom ABSITE score quartile reported lower positive and higher negative emotion than residents in the top 2 and 3 quartiles, respectively (P < 0.005), exam performance was not associated with the reported likelihood of burnout, suicidality, or mistreatment. Conclusions: Residents' emotions after the ABSITE are largely positive. Although poor exam performance may be associated with lower positive and higher negative emotion, it does not seem to be associated with the likelihood of reporting burnout, suicidality, or mistreatment. After adjusting for exam performance and emotions, mistreatment remained independently associated with burnout and suicidality. These findings support existing evidence demonstrating that burnout and suicidality are stable constructs that are robust to transient stress and/or emotions.Item Association Between Empathy and Burnout Among Emergency Medicine Physicians(Elmer Press, 2019-07) Wolfshohl, Jon A.; Bradley, Keegan; Bell, Charles; Bell, Sarah; Hodges, Caleb; Knowles, Heidi; Chaudhari, Bharti R.; Kirby, Ryan; Kline, Jeffrey A.; Wang, Hao; Emergency Medicine, School of MedicineBackground: The association between physician self-reported empathy and burnout has been studied in the past with diverse findings. We aimed to determine the association between empathy and burnout among United States emergency medicine (EM) physicians using a novel combination of tools for validation. Methods: This was a prospective single-center observational study. Data were collected from EM physicians. From December 1, 2018 to January 31, 2019, we used the Jefferson scale of empathy (JSE) to assess physician empathy and the Copenhagen burnout inventory (CBI) to assess burnout. We divided EM physicians into different groups (residents in each year of training, junior/senior attendings). Empathy, burnout scores and their association were analyzed and compared among these groups. Results: A total of 33 attending physicians and 35 EM residents participated in this study. Median self-reported empathy scores were 113 (interquartile range (IQR): 105 - 117) in post-graduate year (PGY)-1, 112 (90 - 115) in PGY-2, 106 (93 - 118) in PGY-3 EM residents, 112 (105 - 116) in junior and 114 (101 - 125) in senior attending physicians. Overall burnout scores were 43 (33 - 50) in PGY-1, 51 (29 - 56) in PGY-2, 43 (42 - 53) in PGY-3 EM residents, 33 (24 - 47) in junior attending and 25 (22 - 53) in senior attending physicians separately. The Spearman correlation (ρ) was -0.11 and β-weight was -0.23 between empathy and patient-related burnout scores. Conclusion: Self-reported empathy declines over the course of EM residency training and improves after graduation. Overall high burnout occurs among EM residents and improves after graduation. Our analysis showed a weak negative correlation between self-reported empathy and patient-related burnout among EM physicians.Item Balancing Demands: Determinants of Burnout Reported by Fellows in Pulmonary and Critical Care Medicine(American Thoracic Society, 2021-01-29) O’Toole, Jacqueline; Zaeh, Sandra; Eakin, Michelle N.; Adelman, Mark H.; Ashton, Rendell W.; Daugherty Biddison, Lee; Bosslet, Gabriel T.; Burkart, Kristin M.; Doyle, Stephen T.; Khan, Malik M. Khurram S.; Lenz, Peter H.; McCallister, Jennifer W.; Rand, Cynthia S.; Riekert, Kristin A.; Soffler, Morgan I.; Winter, Gretchen R.; Sharp, Michelle; Medicine, School of MedicineBackground: Burnout is common among physicians who care for critically ill patients and is known to contribute to worse patient outcomes. Fellows training in pulmonary and critical care medicine (PCCM) have risk factors that make them susceptible to burnout; for example, clinical environments that require increased intellectual and emotional demands with long hours. The Accreditation Council for Graduate Medical Education has recognized the increasing importance of trainee burnout and encourages training programs to address burnout. Objective: To assess factors related to training and practice that posed a threat to the well-being among fellows training in PCCM and to obtain suggestions regarding how programs can improve fellow well-being. Methods: We conducted a qualitative content analysis of data collected from a prior cross-sectional electronic survey with free-response questions of fellows enrolled in pulmonary, PCCM, and critical care medicine training programs in the United States. Fellows were asked what factors posed a threat to their well-being and what changes their training program could implement. Responses were qualitatively coded and categorized into themes using thematic analysis. Results: A total of 427 fellows (44% of survey respondents) completed at least one free-response question. The majority of respondents (60%) identified as male and white/non-Hispanic (59%). The threats to well-being and burnout were grouped into five themes: clinical burden, individual factors, team culture, limited autonomy, and program resources. Clinical burden was the most common threat discussed by fellows. Fellows highlighted factors contributing to burnout that specifically pertained to trainees including challenging interpersonal relationships with attending physicians and limited protected educational time. Fellows proposed solutions addressing clinical care, changes at the program or institution level, and organizational culture changes to improve well-being. Conclusion: This study provides insight into factors fellows report as contributors to burnout and decreased well-being in addition to investigating fellow-driven solutions toward improving well-being. These solutions may help pulmonary, PCCM, and critical care medicine program directors better address fellow well-being in the future.Item Burnout and Mental Health Stigma among Juvenile Probation Officers: The Moderating Effect of Participatory Atmosphere(Springer, 2019-03) Dir, Allyson L.; Saldana, Lisa; Chapman, Jason E.; Aalsma, Matthew C.; Pediatrics, School of MedicineDespite high rates of mental health problems among juvenile justice-involved youth, mental health stigma among juvenile probation officers (JPOs) is under-studied. This cross-sectional study examined effects of job burnout and workplace participatory atmosphere on mental health stigma among JPOs across Indiana (n = 226). Participatory atmosphere moderated the relationship between JPO burnout-related cynicism and mental health stigma (interaction β = - 0.14, p = .04); burnout was related to greater mental health stigma at low levels of participatory atmosphere. Findings suggest participatory atmosphere mitigates effects of burnout on mental health stigma among JPOs. Organizational-level interventions might help to reduce mental health stigma and combat negative effects from burnout among JPOs.Item Burnout and Self-Reported Quality of Care in Community Mental Health(2014) Salyers, Michelle P.; Fukui, Sadaaki; Rollins, Angela L.; Firmin, Ruth; Gearhart, Timothy; Noll, James P.; Williams, Stacy; Davis, C.J.Item Burnout and self-reported quality of care in community mental health(Springer, 2015-01) Salyers, Michelle P.; Fukui, Sadaaki; Rollins, Angela L.; Firmin, Ruth; Gearhart, Timothy; Noll, James P.; Williams, Stacy; Davis, C.J.; Department of Psychology, School of ScienceStaff burnout is widely believed to be problematic in mental healthcare, but few studies have linked burnout directly with quality of care. The purpose of this study was to examine the relationship between burnout and a newly developed scale for quality of care in a sample of community mental health workers (N=113). The Self-Reported Quality of Care scale had three distinct factors (Client-Centered Care, General Work Conscientiousness, and Low Errors), with good internal consistency. Burnout, particularly personal accomplishment, and to a lesser extent depersonalization, were predictive of overall self-rated Quality of Care, over and above background variables.Item Burnout hurts doctors, and is bad for patients – so what’s to be done?(The Conversation US, Inc., 2015-04-03) Gunderman, Richard; Radiology and Imaging Sciences, School of MedicineItem Burnout, Drop Out, Suicide: Physician Loss in Emergency Medicine, Part I.(University of California, 2019-05) Stehman, Christine R.; Testo, Zachary; Gershaw, Rachel S.; Kellogg, Adam R.; Emergency Medicine, School of MedicineEach year more than 400 physicians take their lives, likely related to increasing depression and burnout. Burnout-a psychological syndrome featuring emotional exhaustion, depersonalization, and a reduced sense of personal accomplishment-is a disturbingly and increasingly prevalent phenomenon in healthcare, and emergency medicine (EM) in particular. As self-care based solutions have proven unsuccessful, more system-based causes, beyond the control of the individual physicians, have been identified. Such system-based causes include limitations of the electronic health record, long work hours and substantial educational debt, all in a culture of "no mistakes allowed." Blame and isolation in the face of medical errors and poor outcomes may lead to physician emotional injury, the so-called "second victim" syndrome, which is both a contributor to and consequence of burnout. In addition, emergency physicians (EP) are also particularly affected by the intensity of clinical practice, the higher risk of litigation, and the chronic fatigue of circadian rhythm disruption. Burnout has widespread consequences, including poor quality of care, increased medical errors, patient and provider dissatisfaction, and attrition from medical practice, exacerbating the shortage and maldistribution of EPs. Burned-out physicians are unlikely to seek professional treatment and may attempt to deal with substance abuse, depression and suicidal thoughts alone. This paper reviews the scope of burnout, contributors, and consequences both for medicine in general and for EM in particular.