Influence of occupational dysfunction on the psychological problem in healthcare workers: A study using structural equation modeling

Purpose: Belief conflict has been hypothesized to contribute to increased stress and burnout syndrome among healthcare workers. However, tests on this hypothesis have been limited. The aim of this study was to evaluate the effect of belief conflict on stress and burnout syndrome in healthcare workers using structural equation modeling (SEM). Method: A sample of 488 participants (4.3% physicians, 32.4% nurses, 16.2% occupational therapists, 10.7% physical therapists, 36.4% other) responded to a questionnaire based on the Assessment of Belief Conflict in Relationship-14 (ABCR-14), Stress Response Scale-18 (SRS-18), and Japanese Burnout Scale (JBS). These data were examined using descriptive statistics and a causal sequence model. Results : The hypothesized model exhibited an excellent model fit (RMSEA = 0.041, CFI = 0.937, TLI = 0.933). The results suggested that belief conflict has positive causal effects on stress and burnout syndrome: standardized total effect = 0.676 (S.E. = 0.041, Est . /S.E. = 16.334, p-value = 0.000, 95% CI = 0.411; 0.646), standardized total indirect effect = 0.221 (S.E. = 0.031, Est . /S.E. = 7.066, p-value = 0.000, 95% CI = 0.115; 0.231), standardized direct effect = 0.455 (S.E. = 0.048, Est . /S.E. = 9.497, p-value = 0.000, 95% CI = 0.257; 0.455). Conclusion: This study indicated that healthcare workers suffer stress and burnout related to belief conflict. Therefore, assessment of belief conflict in healthcare workers, followed by appropriate intervention where indicated, would be beneficial in preventing stress and burnout.

Purpose: The purpose of this study was to analyze the structural relationship among occupational dysfunction, stress coping, and occupational participation in healthcare workers.Method: This cross-sectional study included 601 subjects. Personal characteristics (such as age, gender, job category, opportunities for refreshment, time spent on leisure activities, and work relationships) were obtained. The Classification and Assessment of Occupational Dysfunction (CAOD), Coping Scale (CS), and Self-completed Occupational Performance Index (SOPI) were used for measurements. Descriptive statistics were analyzed, and item analysis, confirmatory factor analysis (CFA), correlation analysis, and path analysis using a structural equation modeling (SEM) were performed. CFA was performed to determine the factor structure for CAOD, CS, and SOPI. Correlation analysis was performed to determine the correlation among the factor scores of CAOD, CS, and SOPI. Path analysis was performed to examine the structural relationship among CS, SOPI, and CAOD. Results: CFA of CAOD, CS, and SOPI indicated a good fit to the predicted models. Correlation analysis of CAOD and SOPI showed a strong negative correlation and a moderate negative correlation. CAOD and emotion-focused coping showed a weak negative correlation. Path analysis suggested that SOPI (self-care, leisure, and productivity) and CS (emotion-focused coping) had a negative structural relationship with occupational dysfunction (RMSEA = 0.053, CFI = 0.958, and TLI = 0.954, χ2 = 1808.032, df = 677, p = 0.000). Conclusion: Occupational participation and stress coping can decrease occupational dysfunction. Occupational therapists can contribute to the reduction of occupational dysfunction in healthcare workers by instigating preventive occupational therapy.

Background: Occupational burnout and fatigue are critical issues affecting the health and performance of healthcare workers (HCWs) globally. These outcomes are often driven by complex and overlapping work-related stressors, which remain insufficiently understood in combination. Objective: To investigate the associations of multiple work-related stressors with occupational burnout and fatigue, and to identify distinct stress patterns and critical stressors among HCWs. Method: A cross-sectional survey was conducted using a self-administered electronic questionnaire among 2695 HCWs in Shanghai, China. Validated questionnaire scales were used to assess work-related stress (self-developed occupational stress scale for medical staff, CSSM), occupational burnout (Maslach Burnout Inventory-General Survey, MBI-GS), and fatigue (Fatigue Scale-14, FS-14). Latent profile analysis (LPA) was employed to identify distinct work-related stress patterns. Generalized linear models (GLMs) were used to explore the associations between individual stressors, stress patterns, and occupational burnout and fatigue. Additionally, weighted quantile sum (WQS) models were utilized to evaluate the combined effects of multiple stressors and identify the main contributors. Results: In this study, 77.0% and 71.2% of participants were classified as experiencing occupational burnout and fatigue, respectively. A strained doctor-patient relationship was the highest-rated work-related stressor. All work-related stressors, including career development, interpersonal relationships, work-life imbalance, physical environment, doctor-patient relationship, social environment, and workload, were significantly associated with burnout (β: 0.444~0.956, p < 0.001) and fatigue (β: 1.384~3.404, p < 0.001). WQS assigned higher weights to career development and workload for burnout, and to workload and work-life imbalance for fatigue. LPA identified two distinct occupational stress patterns. HCWs characterized by higher stress levels in physical environment, career development, workload, and interpersonal relationships exhibited significantly higher burnout scores (β = 0.325, 95% CI: 0.122, 0.528), particularly in the reduced personal accomplishment (PA) dimension (β = 1.003, 95% CI: 0.746, 1.259). Conclusions: This study highlighted the high prevalence of occupational burnout and fatigue among HCWs in Shanghai, China. Occupational stressors were associated with both burnout and fatigue, with higher workload, work-life imbalance, and poorer career development showing particularly significant contributions. These findings emphasized the urgent need for targeted interventions, including workload management, career development programs, and mental health support, to reduce occupational stress and mitigate its adverse effects on HCWs.

Background: There is evidence of a high psychological toll from the COVID-19 pandemic in healthcare workers. This paper was aimed at conducting a systematic review and meta-analysis of studies reporting levels of depression among healthcare workers during the COVID-19 and estimating the pooled prevalence of depression. Methods: We searched for cross-sectional studies listed on PubMed from 1 December 2019 to 15 September 2020 that reported prevalence of depression in healthcare workers, nurses, medical doctors, and COVID-19 frontline professionals. The pooled proportions of depression were calculated with random effects models. Results: We identified 57 studies from seventeen countries. The pooled prevalence of depression in healthcare workers was 24% (95% CI: 20–28%), 25% for nurses (95% CI: 18–33%), 24% for medical doctors (95% CI: 16–31%), and 43% for frontline professionals (95% CI: 28–59%). Conclusions: The proportion of depression in nurses and medical doctors during the COVID-19 pandemic was similar to that found in the general population as previously reported in other meta-analyses conducted with smaller numbers of studies. Importantly, almost half of the frontline healthcare workers showed increased levels of depression. There is need for a comprehensive, international response to prevent and treat common mental health problems in healthcare workers.

Workplace incivility is defined as low-intensity deviant behavior with ambiguous intent to harm the target. In this sense, it involves a violation of workplace norms that could damage the quality of working relationships. The aim of this study is to evaluate the factor structure of the adaptation of Straightforward Incivility Scale (SIS; Leiter 2013) in an Italian sample. A sample of 404 healthcare workers completed the SIS. Exploratory and confirmatory factor analyses were conducted. In the first step of analysis, exploratory factor analysis and parallel analysis with 202 participants revealed three factors: supervisor, coworker, and instigated incivility. In the second step, a confirmatory factor analysis with 202 participants supported the 15-item three-factor model in the cross-validation sample. Results provide confirmation of the cross-cultural stability of the facet, factor, and global scale structure of the SIS.

BackgroundHereditary hemorrhagic telangiectasia (HHT) disease is a rare genetic disorder with symptoms and complications that can significantly affect patients’ daily lives. To date, no scale has been validated to assess the specific symptoms of this disease on the quality of life (QOL) of HHT patients. This makes it difficult for clinicians to accurately measure the quality of life of patients with HHT. The present study aims to develop and validate a QOL measurement tool specific to HHT disease: the QOL questionnaire in HHT (QoL-HHT).MethodsA quantitative, non-interventional, multi-center study involving HHT patients in twenty French HHT expert centers was conducted. A calibration sample of 415 HHT patients and a validation sample of 228 HHT patients voluntarily participated in the study. Data were analyzed using exploratory factor analysis (EFA), confirmatory factor analysis (CFA), Exploratory Structural Equation Modeling (ESEM) analyses, reliability analyses, and correlational analyses.ResultsThe EFA, CFA and ESEM results allowed us to provide evidence of the factorial structure of a questionnaire composed of 24 items measuring 6 domains of QOL: Physical limitations, social relationships, concern about bleeding, relationship with the medical profession, experience of symptoms, and concern about the evolution of the disease. Cronbach’s alpha coefficients (> 0.70) demonstrated reliable internal consistency of all the QoL-HHT scores (dimensions). The results of the test–retest provided further evidence of the reliability of the QOL-HHT scores over time. Correlational analyses provided evidence for the convergent validity of the QoL-HHT scores.ConclusionsWe developed a simple and quick self-assessment tool to measure quality of life specific to HHT disease. This study demonstrated reliability and validity of our QoL-HHT scores. It is a very promising tool to evaluate the impact of HHT disease on all aspects of the quality of life of HHT patients in order to offer them individualized medico-psycho-social support.Trial registration: ClinicalTrials, NCT03695874. Registered 04 October 2018, https://www.clinicaltrials.gov/ct2/show/NCT03695874

Due to globalization and the accelerated growth of technology, ever more employees of companies are affected by burnout syndrome, the psychological nature of which requires a prolonged response to chronic interpersonal stressors in work environments. The present research aims to validate the operability of the Maslach Burnout Inventory-General Survey (MBI-GS) using a sample of 378 professionals belonging to middle and senior management working in companies within the IMMEX sector (comprising the industrial-manufacturing, maquiladora and export services) located in the state of Baja California, Mexico. Firstly, an exploratory factor analysis using the principal components method and Varimax rotation was performed and the results revealed the existence of three factors representing more than 67 percent of the total variance. Secondly, a confirmatory factorial analysis was carried out performing appropriate results for the indices Chi-square goodness-of-fit model, Root Mean Square Error of Approximation (RMSEA), Normed Fit Index (NFI), Comparative Fit Index (CFI), Relative Fit Index (RFI), Parsimony Ratio (PRATIO) and Parsimony Normed Fit Index (PNFI), which are highly recommended by literature in these types of studies. Additionally, construct validity was satisfactorily verified. The factorial solution coincided with the Maslach Burnout Inventory original proposal so that this instrument can be considered a valid and reliable option to analyze the burnout levels in people pertaining to middle and senior management in these types of industries.

Analysis of relationship of psychosocial factors with patient safety culture in a Brazilian hospital: Study with structural equation modeling analysis

Background Burnout is a state of emotional, mental, and physical exhaustion affecting a large number of health care workers. In Ethiopia, there is limited evidence about burnout syndrome and work-related determinant factors among health care workers. Therefore, this study aimed to determine the prevalence of burnout syndrome and identify the associated risk factors among public hospitals health care workers in Addis Ababa, Ethiopia, 2019. Methods Institution-based cross-sectional study design was employed from March 10 to May 13, 2019. Stratified random sampling with simple random sampling techniques was used to select participants. The standardized Maslach Burnout Inventory-Human service survey questionnaire was used to collect the data. Five-hundred twenty-five workers completed and valid questionnaire were entered into Epi Info version 7 and exported to SPSS version 20 for further analysis. Logistic regression analysis was used to identify factors associated with burnout syndrome. The significant level was obtained at p-value ≤ 0.05. Result The overall prevalence of burnout syndrome among health care workers in this study was found to be 31.6% (n = 166) (95%CI: 27.8, 36). Moreover, 42% (n = 218) of respondents were highly emotionally exhausted. In addition, 43% (n = 224) and 45% (n = 234) of respondents experienced depersonalization and low personal achievement, respectively. Age (AOR = 0.4, 95%CI: 0.2, 0.9), long night shift work (AOR = 3.36, 95%CI: 1.83, 6.2), job satisfaction (AOR = 2.08 95%CI: 1.3, 3.3), and educational level (AOR = 6.33, 95%CI: 2.3–17.5) were factors significantly associated with burnout syndrome. Conclusion This study shows that a high proportion of health care workers suffer from burnout syndrome. Low education level, long night- and day-shift work, and job dissatisfaction are significant determinant factors of burnout syndrome. Therefore, interventions focusing on shift work management, establishing stress management programs, and improving interpersonal relationships and working conditions to increase job satisfaction among health care workers are essential to reduce the problem.

EPA-0792 – Burnout syndrome and depression in czech medical doctors – national study

COVID-19 is a contagious disease and was declared a pandemic by WHO on March 11, 2020. In handling COVID-19 patients, health workers, especially nurses, have a high risk of contracting due to longer working hours than usual and the pressure felt that causes burnout syndrome in nurses while handling COVID-19 patients. The purpose of this study was to identify nurses' burnout syndrome during treatment in COVID-19 patients. This research was conducted in 2022 at St. Vincent A Paulo Catholic STIKES Surabaya with a population of 137 people. The method used is purposive sampling technique and uses Maslach Burnout Inventory (MBI) questionnaire of 31 questions using Likert scale model. The presentation of data from the results of the study includes the general characteristics of respondents and specific data. The results showed that 137 people had experienced mild burnout syndrome with a percentage of 83.9% in terms of personality factors and general characteristic factors which included high expectations and heavy burden on work. It is hoped that hospital/clinic management will be able to manage the conditions experienced by health workers by providing assistance to be able to refocus the expectations of health workers to be more realistic so that burnout syndrome conditions can be avoided and health workers can remain productive in their work even during a pandemic.

Studies on occupational burnout among health workers, especially in Nigeria have been at best isolated. No adequate inter-occupational comparative study on burnout among health workers, police personnel, and teachers has been conducted. This study, therefore, investigated the extent to which health workers were different from police personnel, and teachers in the manifestations of emotional exhaustion, depersonalization, reduced personal accomplishment, and overall occupational burnout. Participants were 455 employees (203 males; 252 females) sampled from 3 service occupations (police = 139; health = 159; teaching = 157), whose ages averaged 35.94 years (SD = 7.93). Health workers reported higher levels of emotional exhaustion, depersonalization, and overall occupational burnout than either police personnel or teachers. Although health workers reported a higher level of reduced personal accomplishment than police personnel, results indicated that teachers felt as underachieving as health workers. The findings were discussed in terms of the perceived imbalance in the job demands-rewards ratio in the job situations.

To investigate the association between empathy and the subdomains of affective and cognitive empathy and burnout syndrome in nurses from any health field. Empathy is an ability composed of affective and cognitive domains that have been widely studied in healthcare providers. Affective and cognitive empathy have subdomains, and the associations with burnout syndrome are under-investigated. Burnout syndrome is an occupational disease that often affects nurses. A meta-analysis was conducted guided by the PRISMA Statement checklist and was registered in the PROSPERO database (CRD42024600740). Twenty-nine studies met the eligibility criteria. A negative correlation was found between global empathy and burnout syndrome. When considering the subdomains of affective empathy, no statistically significant correlation was found with empathic concern, whereas a moderate positive correlation was found between personal distress and burnout syndrome. Considering the subdomains of cognitive empathy, a weak negative correlation was found between perspective taking and burnout syndrome, whereas a weak positive correlation with fantasy was found. The subdomains of empathy are distinctly related to burnout syndrome in nurses. Perspective taking served as a protective factor for the mental health of these health professionals. Global empathy was negatively associated with burnout syndrome, while its subdomains showed distinct and sometimes opposing associations. When considering the subdomains of affective and cognitive empathy, distinct interactions were identified. Personal distress and fantasy were positively correlated with burnout syndrome, whereas perspective taking was negatively correlated. Understanding the impact of empathy subdomains can assist in the planning of interventions aimed at optimizing empathic functioning while minimizing risks to nurses' mental health.

Background: During SARS-CoV2 pandemic, patients are becoming more aggressive against health care workers when seeking their demands. Violence against Health care workers is of multifactor, and a one that strongly has associated is their burnout syndrome. Objectives: The aim of this study was to draw a conclusion from the previous literatures about the association of violence against HCWs and their burnout syndrome. Also to find out other associated factors and solutions for this phenomenon. Results: HCWs are subjected to stressful situations and high pressure; of highly infectious diseases (SARS-CoV2), shortage of PPE, working for more than 24 hours’ duty, without payment or reward, difficulties in the workplace and a poor hospital administration; all’s can lead to burnout syndrome. On the other hand, patient’s demand for the high expectations of their needs and attendants' (co-patients) fearfulness, anxiousness about their patient fate. Also, patient or co-patients believes on a doctor to be the only savior, so any unexpected behavior or un sympathy from the burned-out HCWs can result in aggressiveness and violence. Conclusion: The high prevalence of burnout syndrome among HCWs has become a global issue. A real attempt should be made focusing on the radical solution of the problem of burnout syndrome, rather than to enact laws to punish the aggressors against HCWs.

Healthcare professionals deal with the greatest prevalence of burnout syndrome (BS). The object of this paper is to study the effect of psychological climate and working conditions on risks of burnout in a team of healthcare professionals. Working conditions of 136 healthcare workers from the Saratov region who underwent little training were examined according to Regulation 2.2006–05. The level of burnout was estimated in accordance with the method of V. V. Boyko, and the psychological climate in a team was analyzed using A. F. Fiedler’s questionnaire. The results were processed with the help of Microsoft Еxcel 10 for Windows. Based on the research results, the BS signs were recorded in 52.3% of healthcare workers. Physical and emotional symptoms were predominant BS signs. Factors predisposing to BS in healthcare workers have been determined. It is established that there is a dependence between a harmful factor of working conditions and probable BS. The dependence acquires significance at 3.2 level of working conditions. It is determined that the risk of BS was 74.3% in the most unfavorable psychological climate, and didn’t reach 21% if the climate was favorable.