Health Professional Wellbeing

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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A Dutch study by Zantinge et al. exploring the impact of burnout on the quality of health care delivered by GPs found that burnt-out GPs have, contrary to expectations, longer consolations with patients.

The study explored three facets of burnout - emotional exhaustion, depersonalisation and reduced accomplishments. It found that GPs with emotional exhaustion or depersonalisation additionally show more communication in their consultations (such as increased eye contact and greater explanation of diagnoses); while GPs with feelings of reduced accomplishment or competency have reduced communication and fewer patient-centred consultations.

The study offered two explanations for the results. The study first proposed that doctors who are suffering psychological problems may be more empathetic towards patients suffering from similar problems. The study also suggested that burnt-out GPs may take longer in their consultations because they are less efficient.

The study can be found at www.biomedcentral.com.

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A systematic review by Mukherjee et al. (2009) explored burnout in paediatric oncology staff. Of the 10 studies included in the analysis none directly measured the extent of burnout in the staff, and only one measured distress, reporting a lower level of distress then the general population.

The systematic review reported a number of factors associate with increased burnout and distress in the staff including coping style, duration of relationship of patients, and care settings.

Sources of stress in paediatric oncology staff included observing patient suffering, caring for a dying patient, death, supporting parents of patients, delivery of inadequate care, workload, lack of resources, insufficient managerial support and poor relationship with colleagues.

The study highlighted a number of major limitations including an extremely limited quantity of research, poor quality of research, and a large range of staff types within the area of research. The studies examined were also reported a number of limitations including  small sample sizes and limited research sites.

The study can be found at interscience.wiley.com.

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A study published in the MJA has found doctors who are involved in medico-legal matters are more likely to suffer from serious mental health problems including anxiety and depression.

The study of 2999 doctors also found that over 65% of doctors in Australia will be involved in medico-legal matters at some point of their career.

Dr Louise Nash, lead author of the study, emphasised that doctors need to look after themselves. “If they are feeling stressed, they should consider options for reducing their hours, and make sure they do not turn to any negative coping mechanisms, such as drinking,” she said.

Dr Nash noted that the study raised questions about the causality of the relationship between medico-legal processes and poor mental health.

From the Medical Observer.

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A Korean study by Cho et al. (2009) investigated the relationship between nurse staffing, the quality of care delivered by nurses, and nurse related job outcomes.

The survey of 1365 nurses working in intensive care units found half of the nurses were highly burned out, and a quarter were planning on leaving within a year. The survey also found perceived adequate staffing was significantly correlated with burnout in the nurses.

The study can be found at PubMed.

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In Australia, the Bettering Evaluation and Care of Health (BEACH) project was initiated 10 years ago to continuously collect information about the clinical activities in general practice in Australia. The programme is overseen by the Family Medicine Research Centre in collaboration with the Australian Institute of Health and Welfare. A sub-study from the BEACH project, supported by the Commonwealth Department of Veteran’s Affairs assessed the prevalence of stress and anxiety issues among patients of GPs. An analysis of 100 GP encounters with 3,684 patient encounters, found that 40% of respondents (i.e. 1, 470 patients) reported experiencing a period of anxiety or stress lasting 2 weeks or more in the previous 12 months. Of this group, 75% sought help from professionals and 58% from their GP. Similar results were found in a study of Australian patients by Cohen et al. (1983), clearly indicating that medical practitioners need to understand the aetiology and management of this widespread problem.

Dr Ramesh Manocha

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An Australian study by Rella et al. (2009) which explored the development of burnout in nursing students has found that 20% of nursing graduates suffer from serious maladaptive stress.

The survey of 431 Bachelor of Nursing students emphasised the need for additional support from nursing staff for nursing graduates in the form of mentoring and guidance, and provision of effective stress management.

The researchers emphasise that while nursing is an inherently stressful position, burnout in nurses occurs when there is a failure to consistent recovery from stress outside of work hours.

The full study can be found at www.ingentaconnect.com.

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An Australian study by Markwell and Wainer (2009) found 70% of junior doctors surveyed have experienced high levels of stress at work and 56% have been concerned about the wellbeing of their colleagues because of the work conditions.

The survey, published in the Medical Journal of Australia today also found over 70% of the junior doctors met the criteria for low job satisfaction, 69% met the criteria for burnout and 54% met the criteria for compassion fatigue.

The survey of 914 junior doctors recommended that stress management strategies be incorporated into continuing medical education.

From the Medical Journal of Australia.

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Research from the Australian Primary Health Care Research Institute (APHCRI) has found that 64% of GPs have faced violence ranging from verbal abuse to murder in the past year.

The findings have sparked an investigation by the Austrlain Goverment into the matter, including an online survey which will open in four weeks. The survey is expected to take around 10 minutes to complete, and will be organised by the APHCRI.

The APHCRI’s lead research Professor Rhian Parker says the issue must be more thoughroly investigated. “Often GPs, when they’re assaulted, don’t make a huge deal of it – but it’s significant and we need to find out how much it is going on,” she said.

From the Medical Observer.

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A systematic review of studies exploring stress in doctors and dentists by Rutter et al. (2002) found that teaching doctors and dentists experience less stress then their non-teaching counterparts. The review analysed seven studies and found evidence to suggest that a teaching role mitigated stress in doctors and dentists, with the authors suggesting several mechanism for the effect including lessend isolation, increased self-esteem and added interest in patients as a source of teaching opportunities. The authors emphasised that more research is neccesary to confirm and explain their findings.

The study can be found at Interscience.

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