Burnout and health among critical care professionals

To analyse the mediational role of resilience in relationships between burnout and health in critical care professionals; to determine relationships among resilience level, three burnout dimensions, and physical/mental health | Intensive & Critical Care Nursing

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Participants/setting: A total of 52 critical care professionals, mainly nurses, were recruited from an intensive care unit of Madrid (Spain).

Conclusions: Resilience minimises and buffers the impact of negative outcomes of workplace stress on mental health of critical care professionals. As a result, resilience prevents the occurrence of burnout syndrome. Resilience improves not only their mental health, but also their ability to practice effectively. It is therefore imperative to develop resilience programs for critical care nurses in nursing schools, universities and health centres.

Full reference: Arrogante, O & Aparicio-Zaldivar, E. (2017) Burnout and health among critical care professionals: The mediational role of resilience. Intensive & Critical Care Nursing. DOI: http://dx.doi.org/10.1016/j.iccn.2017.04.010

Measuring Moral Distress Among Critical Care Clinicians

Lamiani, G. et al. Critical Care Medicine. Published online: December 7 2016

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Objectives: Moral distress is a common experience among critical care professionals, leading to frustration, withdrawal from patient care, and job abandonment. Most of the studies on moral distress have used the Moral Distress Scale or its revised version (Moral Distress Scale-Revised). However, these scales have never been validated through factor analysis. This article aims to explore the factorial structure of the Moral Distress Scale-Revised and develop a valid and reliable scale through factor analysis.

Conclusions: The Italian Moral Distress Scale-Revised is a valid and reliable instrument to assess moral distress among critical care clinicians and develop tailored interventions addressing its different components. Further research could test the generalizability of its factorial structure in other cultures.

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Perceived Nonbeneficial Treatment of Patients, Burnout, and Intention to Leave the Job Among ICU Nurses and Junior and Senior Physicians.

Schwarzkopf, D. et al. Critical Care Medicine. Published online: October 21 2016

businessman-150451_960_720Objectives: Perceiving nonbeneficial treatment is stressful for ICU staff and may be associated with burnout. We aimed to investigate predictors and consequences of perceived nonbeneficial treatment and to compare nurses and junior and senior physicians.

Design: Cross-sectional, multicenter paper-pencil survey on personal and work-related characteristics, perceived nonbeneficial treatment, burnout, and intention to leave the job.

Setting: Convenience sample of 23 German ICUs.

Subjects: ICU nurses and physicians.

Interventions: None.

Measurements and Main Results: A total of 847 questionnaires were returned (51% response); 778 had complete data for final multivariate analyses. Nonbeneficial treatment was in median perceived “sometimes.” Adjusted for covariates, it was perceived more often by nurses and junior physicians (both p <= 0.001 in comparison to senior physicians), while emotional exhaustion was highest in junior physicians (p <= 0.015 in comparison to senior physicians and nurses), who also had a higher intention to leave than nurses (p = 0.024). Nonbeneficial treatment was predicted by high workload and low quality collaboration with other departments (both p <= 0.001). Poor nurse-physician collaboration predicted perception of nonbeneficial treatment among junior physicians and nurses (both p <= 0.001) but not among senior physicians (p = 0.753). Nonbeneficial treatment was independently associated with the core burnout dimension emotional exhaustion (p <= 0.001), which significantly mediated the effect between nonbeneficial treatment and intention to leave (indirect effect: 0.11 [95% CI, 0.06-0.18]).

Conclusions: Perceiving nonbeneficial treatment is related to burnout and may increase intention to leave. Efforts to reduce perception of nonbeneficial treatment should improve the work environment and should be tailored to the different experiences of nurses and junior and senior physicians.

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Causes of Moral Distress in the ICU: A Qualitative Study

Henrich, N.J. et al. Journal of Critical Care. Published online: 12 May 2016

Purpose: To examine the causes of moral distress in diverse members of the ICU team in both community and tertiary ICUs.

Materials and Methods: We used focus groups and coding of transcripts into themes and sub-themes in 2 tertiary care intensive care units and 1 community intensive care unit.

Results: Based on input from 19 staff nurses (3 focus groups), 4 clinical nurse leaders (1 focus group), 13 physicians (3 focus groups), and 20 other health professionals (3 focus groups), the most commonly reported causes of moral distress were concerns about the care provided by other health care workers, the amount of care provided (especially too much care at end of life), poor communication, inconsistent care plans, and issues around end of life decision-making.

Conclusions: Causes of moral distress vary among ICU professional groups but all are amenable to improvement.

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