Health Professional Wellbeing

A study of Icelandic nurses by Gunnarsdottir Et al. concluded that improved relations between nurses and nurse manages will likely improve the nurses’ job satisfaction and increase employee retention, and may improve patient quality of care.

The survey of 695 nurses measured a number of factors including burnout, job satisfaction, and nurse rated quality of care, and found that increased perception of support from unit level nurse managers significantly improved job satisfaction, emotional exhaustion and quality of care in the nurses.

The study also provided additional evidence for the theory that low staffing capacity and heavy work demands are the key causes of burnout in nurses.

The study can be found at scientificcommons.org.

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A study by Pedrini Et al. of mental health professionals employed in non-hospital psychiatric residential facilities in Italy found that low feedback about job performance, poor support from coordinators, and young age were predictors for burnout in the mental health employees.

The survey of 202 mental health employees, including nurses and nursing assistants, also found that 17% of participants reported high levels of emotional exhaustion, 26% reported high levels of depersonalisation and 26% reported reduced personal accomplishment on the Maslach Burnout Inventory.
The study concluded that the sample were of a high risk of developing burnout, and suggested that an emphasis be placed on developing workplace relationships, enhancing job resources and increasing support for the professionals.
The article can be found at psychiatryonline.org.

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The most recent U.K Health and Safety Executive (HSE) data (2008) indicates that the prevalence of musculoskeletal disorders from 1990 to 2007 had reduced significantly, as in fact the prevalence of all work related illnesses when taken as a single group. Yet, the prevalence of work related stress and related (mainly heart) conditions had increased significantly by a factor of approximately 2 In fact, work related stress, depression or anxiety in 2007 appears to be as prevalent as work related back pain and is significantly more prevalent than work-related lung or hearing problems.

The HSE report can be found here.

Dr Ramesh Manocha

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An American study by Robins Et al. of health care professionals in a children’s hospital found that 39% of staff were of a moderate to extreme risk of compassion fatigue, and 21% were of a moderate to high risk of burnout.

The study of 314 health care professionals additionally found that doctors reported higher levels of burn out than other professions and, more years spent working in child care was associated with higher burnout. The study also found an association between the time spent working in child care and compassion fatigue.

The study suggests decreased patient interaction may be the mechanism through which the physicians develop greater levels of burnout than other professions, and concluded that paediatric healthcare professionals are at greater risk of burnout, and similar risk of compassion fatigue, than trauma workers.

The study can be found at elsevier.com.

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Pirrotta (2000) conducted a survey of Australian GPs and  found that almost 80% of respondents had recommended meditation to patients at some time during the course of their practice, even though less than 35% had any formal training or education in the field. This reflects, on the one hand, the growing legitimacy of what was once regarded as a fringe concept and on the other, the paucity of quality education in the field. More recent surveys about the status of meditation in the perception of general practitioners have produced revealing results. For instance, a survey of GPs reported by Cohen et al. in 2005 found that:

• 82% regarded meditation as moderately or highly effective with low risk for harm, whereas only 3% regarded it as occasionally or frequently harmful,
• 23% were either self taught or had only attended an introductory workshop on meditation, while a mere 3% had formal training such as part of a certificate, diploma or degree,
• 51% said they would like to receive some form of training or had already done so over the previous 12 months for personal use,
• 40% affirmed that they had either used it over the previous 12 months or would consider using it in their practice
• 65% said they would actively encourage any patient who raised the topic to practice meditation,
• 9% had suggested the use of meditation at least once per week or more, while 56% had suggested it at least once per month.

While there is no hard data, it seems reasonable to assume that endorsement of meditation practice by a good proportion of physicians is likely to be seen as tacit approval by consumers.

Dr Ramesh Manocha

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A German survey of medical staff working in radiology by Sehlen Et al. (2009) found that the nurses reported the highest level of job stress followed closely by physicians. The survey of 82 physicians and 113 nurses found that the greatest stressor for physicians was reported to be excessive paperwork. Physicians and nurses both reported “structural conditions”, including underpayment and telephone ringing, also had a major impact on their job stress. Physicians also reported having the highest level of job satisfaction.

The authors comment that the results emphasise the importance of nurses and physicians developing a work/life balance and strategies for promoting personal wellness.

The study can be found at the Radiation Oncology journal.

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In order to develop an understanding of the potential efficacy of meditation as an stress management intervention (SMI) directed at stress and especially work stress, I reviewed the evidence in the peer-reviewed literature. Computer databases, including MEDLINE, PsycINFO, CINAHL, EMBASE, Current Contents and Biological Reports were consulted. I also searched the Internet, hardcopy reports and other sources of “grey literature”. Search terms included “stress”, “work”, “occupational”, “job”, “strain”, “meditation”, “stress management”, “psychotherapy”, “behaviour therapy”, “relaxation” and combinations of these terms. Of the 12 controlled studies found, 8 were described as RCTs and 4 as NRTs. The NRTs all compared meditation to either a waiting list or non-intervention control group, so it is not surprising that they all reported substantial positive effects of meditation. Such a design cannot however exclude the impact of non-specific effects such as placebo and spontaneous improvement and so were excluded from my review.

Of the 8 studies describing themselves as RCTs, those of Winzelberg and Peters clearly reported using a strategy that cannot be described as acceptable random allocation. Moreover, Peters used self-report questionnaires that had not been validated. They were re-classified as NRTs and excluded from this review.

The remaining 6 RCTs involved comparison with a number of different controls. Two used more than one control, simultaneously giving rise to 8 comparisons. The authors universally concluded that meditation was effective as an SMI.

Dr Ramesh Manocha

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A survey by Watson Et al. (2007) of  nursing students in Hong Kong explained the rise of burnout in some nursing students with the personality trait of neuroticism. The study examined the change in burnout in 147 nursing students between 7 months from finishing their degree and the last class prior to completion of their degree.

The study also explained the increase in stress in some nursing students with the increased emotion-oriented coping in the students. The authors recommended staff teaching nursing students be advised of the high-risk students.

The study can be found at elsevier.com.

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A study of ophthalmologists in Quebec by Viviers Et al. found that over 35% of the 133 ophthalmologists reported high levels of burnout. over 45% of the ophthalmologists reported having problems reconciling work and personal life.

The study, which was published in the Canadian journal of Ophthalmology, found that the three main occupational stressors were the rise in demand for services, the shortage of ophthalmologists and a high work load.

The study concedes a range of limitations including its cross-sectional nature. The study recommends ophthalmologists work to gain greater control over their participation in the workplace.

The full study can be found at pubs.nrc-cnrc.gc.ca.

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Work stress is a growing health problem relevant to organisations, health professionals and society in general. It is recognised world-wide as a major challenge to workers’ health and the healthiness of organisations. Workers who are stressed are likely to be less healthy, motivated, productive and safe at work. The organisations for which they work are less likely to be competitive or successful. (Leka et al., 2006)

Dr Ramesh Manocha

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