Feeling burned out? The contributors could be more related to depression than you think
April 29, 2020
Science Daily/Medical University of South Carolina
Researchers found that similar factors cause both medical intern burnout and depression. These findings can be used to identify and treat burnout as well as mitigate the risk of burnout by modifying workplace factors.
An article published in the Journal of General Internal Medicine looks at the relationship between burnout and depressive symptoms in medical interns.
The article is authored by Constance Guille, M.D., an associate professor in the Department of Psychiatry and Behavioral Sciences at the Medical University of South Carolina, and Lisa Rotenstein, M.D., an internal medicine resident at Harvard Medical School/Brigham and Women's Hospital, among others.
According to Rotenstein, these findings help correct a long-held misconception about burnout and depression.
"There is a long-standing thought that burnout is associated with workplace factors and that depressive symptoms are associated with workplace factors but also heavily influenced by personal factors," explained Rotenstein. "We found that the factors that drive burnout are much more closely related to the factors that drive depressive symptoms than previously realized."
In this study, Rotenstein and Guille uncover that there is substantial overlap between the factors that predict burnout and depressive symptoms. The study surveyed 1,552 medical interns entering residency programs at 68 different institutions about depressive symptoms, emotional exhaustion and depersonalization, as well as about potential contributing factors. Depressive symptoms were measured by a standard 9-item Patient Health Questionnaire, while emotional exhaustion and depersonalization were measured with a 9-item abbreviated Maslach Burnout Inventory. Workload and learning environment satisfaction were assessed with a standardized instrument. Personal factors assessed included age, gender, ethnicity, relationship status, sexual orientation, parenting status, specialty, self-reported history of depression, early life stress and neuroticism score.
The study found significant overlap between factors that contribute to depressive symptoms and those that contribute to burnout, with about two-thirds of variance in both depressive symptoms and burnout attributable to personal factors, and one-third of the variance in these measures attributable to workplace factors.
With more than 142 definitions circulating in the literature, the definition of burnout has historically been unclear. This lack of clear definition has led to highly variable rates of burnout being reported among medical interns, residents and attending physicians. In contrast, depressive symptoms are well-defined and have been clinically validated. The results of this study suggest that assessing for depressive symptoms may be a validated, standardized alternative to assessing for burnout among medical personnel. They also underscore that interventions that help address burnout may be effective in addressing depressive symptoms and vice versa. Examples of such interventions include leveraging resources such as scribes to address documentation burdens, time banking for physician service and resources such as childcare to take stress off those physicians with familial obligations.
For Guille, the takeaway message from this study is clear.
"Previous to this work, depression and burnout were conceptualized as separate entities with different factors contributing to these outcomes," explained Guille. "This work suggests there is substantial overlap between both workplace and personal factors that contribute to an increase in both depressive symptoms and burnout."
https://www.sciencedaily.com/releases/2020/04/200429105914.htm
Consensus report shows burnout prevalent in health care community
October 23, 2019
Science Daily/Vanderbilt University Medical Center
Clinician burnout is affecting between one-third and one-half of all of U.S. nurses and physicians, and 45 to 60% of medical students and residents, according to a National Academy of Medicine (NAM) report released today.
Vanderbilt University Medical Center is among 32 institutions and foundations that sponsored the 296-page report, "Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being," which investigates the causes of widespread clinician burnout and offers solutions to address the problem at its source.
"There's an all too direct connection between clinician burnout and health care safety and quality. While clinician burnout isn't a new problem, its worsening prevalence and impact are due to system factors inherent in the modern health care system," said Matthew Weinger, MD, professor of Anesthesiology and Norman Ty Smith Chair in Patient Safety and Medical Simulation at VUMC, and a member of the NAM authoring committee for the new report.
"The Committee came to realize that addressing clinician burnout will require a deliberate and substantive health care system redesign with a focus on those activities that deliver the most value to patients while enabling and empowering clinicians to deliver high-quality care," he said.
The report discusses key issues that need to be addressed:
· Clinician burnout needs to be tackled early in professional development and special stressors in the learning environment need to be recognized. Leaders in health care and health professions education have a responsibility to foster, monitor and continuously improve work and learning environments.
· While some health care technologies appear to contribute to clinician burnout (poorly designed electronic health record systems, for example), there is real potential for well-designed and implemented technologies to help reduce burnout.
· Federal and state governments, other payors and regulators and the health care industry itself have important roles to play in preventing clinician burnout. Increasing administrative burdens and distracting clinicians from the care of their patients can directly affect burnout.
· Medical societies, state licensing boards, specialty certification boards, medical education and health care organizations all need to take concrete steps to reduce the stigma for clinicians seeking help for psychological distress and make assistance more easily available.
The report concludes with goals and recommendations centered on creating more positive work and learning environments, reducing administrative burden, enabling technology solutions, providing more support to clinicians and learners, and investing in research to address clinician burnout.
The new report is the latest in a series that includes the landmark volumes, "To Err Is Human: Building a Safer Health System" (2000) and "Crossing the Quality Chasm: A New Health System for the 21st Century" (2001).
https://www.sciencedaily.com/releases/2019/10/191023172121.htm
The power of gratitude in the workplace
March 13, 2019
Science Daily/Portland State University
The study shows that being thanked more often at work predicted better sleep, fewer headaches and healthier eating, because it improved nurses' work satisfaction
If you knew that expressing gratitude to a colleague would improve their life and yours, would you do it more often?
A new study by Portland State University researchers -- business professor David Cadiz, psychology professor Cynthia Mohr, and Alicia Starkey, a recent Ph.D. graduate in psychology -- together with Clemson State University professor Robert Sinclair, exhibits a positive relationship between expressed workplace gratitude, physical health and mental health.
The study, "Gratitude reception and physical health: Examining the mediating role of satisfaction with patient care in a sample of acute care nurses," shows that being thanked more often at work predicted better sleep, fewer headaches and healthier eating, because it improved nurses' work satisfaction.
Improving Self-Care in a Stressful Work Environment
The study involved a group of Oregon nurses, a profession that has a particularly high rate of burnout. Cadiz discusses the findings and how applying the research can have a significant impact on quality of life and job retention by preventing stress-related illnesses and disease.
"Nurses tend to have a thankless job. It's very physical, and they're often being screamed at by patients who are at their lowest. When nurses receive gratitude, it boosts them," Cadiz explains.
"This type of study helps us understand how to keep nurses in the workforce in a healthy way. Nurses strongly align their profession with their identity and often look out for patients more than themselves. The gratitude matches up with their identity, gives them satisfaction in a job well done and ultimately increases self-care."
Many people inherently connect their identity to their job and feelings of appreciation within their roles. Employers who understand and react to this can create positive social and economic change.
Gratitude is Good Business
From an organizational, policy and leadership perspective, Cadiz says that employers should create formal or informal opportunities for people to express gratitude. Including gratitude in a business plan is an essential step that many business leaders miss, and that omission can have financial consequences.
"Employees that receive positive feedback are healthier, and that can impact the bottom line," adds Cadiz. "Preventing headaches and other stress-related symptoms means fewer sick days, and, in this case, cuts down the cost of replacement nurses and overtime pay."
These small changes can have a dramatic fiscal impact over time, which can result in more staff, better pay rates and increased benefits.
The big takeaway -- express gratitude when you see someone doing a good job. A positive feedback loop impacts you and those around you, and can ultimately shape a healthier and happier community.
https://www.sciencedaily.com/releases/2019/03/190313091929.htm