burnout; moral distress

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Etiology

Epidemiology

Clinical manifestations

Complications

Management

  • lifestyle
    • obtain adequate sleep
    • ensure proper nutrition
    • participation in regular physical activity
    • schedule adequate vacation time
    • participate in outside interests
    • engage in spirituality
    • meditate &/or pray
    • use humor
    • recognize limitations
    • carry out positive inner dialogue
  • social support systems
    • foster open communication about professional stress with colleagues
    • seek emotional support & practical assistance from family
    • maintain network of friends
  • organizational
    • enhance cooperation among members of healthcare team
    • carify roles & responsibilities of team members
    • develop supportive work relationships
    • improve policies to allow flexibility of staff to provide care
    • reducing workloads[6]
    • enhancing teamwork & communication skills[6]
  • training in mindfulness, reflection, problem solving, work-life balance, & job satisfaction[3][6][7]
  • self-compassion & vulnerability[7]
  • organizational changes & individual training sessions are modestly effective[5]

More general terms

References

  1. Vachon MLS, Staff Stress and burnout: In: Berger AM, Portenoy RK, Weissman DE, eds, Principles & Practice of Palliative Care & Supportive Oncology, 2nd ed, Philadelphia, PA, Lipincott & Williams, 2003:831
  2. 2.0 2.1 2.2 2.3 Shanafelt TD et al. Burnout and satisfaction with work-life balance among US physicians relative to the general US population. Arch Intern Med 2012 Aug 20; <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/22911330 <Internet> http://archinte.jamanetwork.com/article.aspx?articleid=1351351
  3. 3.0 3.1 West CP et al. Intervention to promote physician well-being, job satisfaction, and professionalism: A randomized clinical trial. JAMA Intern Med 2014 Apr 1; 174:527. PMID: https://www.ncbi.nlm.nih.gov/pubmed/24515493
    Goitein L. Physician well-being: Addressing downstream effects, but looking upstream. JAMA Intern Med 2014 Apr 1; 174:533 PMID: https://www.ncbi.nlm.nih.gov/pubmed/24515255
  4. 4.0 4.1 Swift D Physician Burnout Climbs 10% in 3 Years, Hits 55% Medcscape. Dec 1, 2015 http://www.medscape.com/viewarticle/855233
  5. 5.0 5.1 West CP et al. Interventions to prevent and reduce physician burnout: A systematic review and meta-analysis. Lancet 2016 Sep 28; PMID: https://www.ncbi.nlm.nih.gov/pubmed/27692469
    Epstein RM, Privitera MR. Doing something about physician burnout. Lancet 2016 Sep 28 PMID: https://www.ncbi.nlm.nih.gov/pubmed/2769246
  6. 6.0 6.1 6.2 6.3 Panagioti M et al. Controlled interventions to reduce burnout in physicians: A systematic review and meta-analysis. JAMA Intern Med 2016 Dec 5. PMID: https://www.ncbi.nlm.nih.gov/pubmed/27918798
  7. 7.0 7.1 7.2 Thomas LR, Ripp JA, West CP. Charter on Physician Well-being. JAMA. Published online March 29, 2018 PMID: https://www.ncbi.nlm.nih.gov/pubmed/29596592 https://jamanetwork.com/journals/jama/fullarticle/2677478
    Mount Sinai Hospital/Mount Sinai School of Medicine Medical group offers steps to address physician burnout. EurekAlert. March 29, 2018 https://www.eurekalert.org/pub_releases/2018-03/tmsh-mgo032818.php
    Schwenk TL Physician Well-being and the Regenerative Power of Caring. PMID: https://www.ncbi.nlm.nih.gov/pubmed/29596590 JAMA. Published online March 29, 2018
  8. 8.0 8.1 Panagioti M, Geraghty K, Johnson J et al Association Between Physician Burnout and Patient Safety, Professionalism, and Patient Satisfaction. A Systematic Review and Meta-analysis. JAMA Intern Med. Published online September 4, 2018. PMID: https://www.ncbi.nlm.nih.gov/pubmed/30193239 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2698144
    Linzer M Clinician Burnout and the Quality of Care. JAMA Intern Med. Published online September 4, 2018. PMID: https://www.ncbi.nlm.nih.gov/pubmed/30193370 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2698140
  9. Rotenstein LS et al. Prevalence of burnout among physicians: A systematic review. JAMA 2018 Sep 18; 320:1131 PMID: https://www.ncbi.nlm.nih.gov/pubmed/30326495
    Dyrbye LN, Burke SE, Hardeman RR et al. Association of clinical specialty with symptoms of burnout and career choice regret among US resident physicians. JAMA 2018 Sep 18; 320:1114 PMID: https://www.ncbi.nlm.nih.gov/pubmed/30422299
  10. 10.0 10.1 Cervantes L, Richardson S, Raghavan R et al. Clinicians' perspectives on providing emergency-only hemodialysis to undocumented immigrants: A qualitative study. Ann Intern Med 2018 Jul 17; 169:78 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/29800062 <Internet> http://annals.org/aim/article-abstract/2682329/clinicians-perspectives-providing-emergency-only-hemodialysis-undocumented-immigrants-qualitative-study
  11. 11.0 11.1 Melnick ER et al The Association Between Perceived Electronic Health Record Usability and Professional Burnout Among US Physicians Mayo Clinic Proceedings Nov 2019 PMID: https://www.ncbi.nlm.nih.gov/pubmed/31735343 https://www.mayoclinicproceedings.org/article/S0025-6196(19)30836-5/fulltext
  12. 12.0 12.1 Kachadourian LK, Feder A, Murrough JW et al. Transdiagnostic psychiatric symptoms, burnout, and functioning in frontline health care workers responding to the COVID-19 pandemic: A symptomics analysis. J Clin Psychiatry 2021 Apr 27; 82:20m13766. PMID: https://www.ncbi.nlm.nih.gov/pubmed/34004095 https://www.psychiatrist.com/jcp/covid-19/transdiagnostic-psychiatric-symptoms-burnout-functioning-frontline-health-care-workers-responding-to-covid-19/
  13. 13.0 13.1 Geriatric Review Syllabus, 11th edition (GRS11) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2022
  14. 14.0 14.1 14.2 14.3 14.4 Shanafelt TD et al. Changes in burnout and satisfaction with work-life integration in physicians during the first 2 years of the COVID-19 pandemic. Mayo Clin Proc 2022 Sep 13; [e-pub]. https://www.mayoclinicproceedings.org/article/S0025-6196(22)00515-8/fulltext
    Hodkinson A et al. Associations of physician burnout with career engagement and quality of patient care: Systematic review and meta-analysis. BMJ 2022 Sep 14; 378:e070442. https://www.bmj.com/content/378/bmj-2022-070442