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Coping with Burnout in the Healthcare Field 在医疗保健领域应对职业倦怠
Pub Date : 2023-10-13 DOI: 10.21926/obm.icm.2304042
Ami Rokach, karishma Patel
The healthcare industry is the largest and fastest growing industry in the world; however, being a part of the healthcare system involves being at an increased risk of experiencing mental health problems, loneliness, stress, and increased susceptibility to experiencing compassion fatigue related to the emotional wear associated with providing patient-centered care. Healthcare workers include, but are not limited, to physicians, nurses, allied health professionals, and psychologists. Often, healthcare workers place the needs and wellbeing of patients before their own. This article aims to highlight the occupational hazards of working in the healthcare field, the physical and emotional isolation associated with clinical practice, managing distressing behaviors by patients, and reviewing the systemic barriers influencing the development and management of moral distress. We further aim to bring attention to the need for healthcare professionals to place self-care at the forefront of their therapeutic repertoire through various individualized strategies, through the importance of building moral resilience, and the shift towards improving workplace spirituality. Practicing self-care can address the consequences of neglecting one’s own wellbeing, positively impact the ability to provide better quality patient care, and benefits relationships with patients, loved ones, and of most importantly with oneself.
医疗保健行业是世界上规模最大、发展最快的行业;然而,作为医疗保健系统的一部分,经历心理健康问题、孤独、压力的风险增加,以及与提供以患者为中心的护理相关的情感消耗相关的同情疲劳的易感性增加。卫生保健工作者包括但不限于医生、护士、专职卫生专业人员和心理学家。通常,卫生保健工作者将患者的需求和福祉置于自己的需求和福祉之前。本文旨在强调在医疗保健领域工作的职业危害,与临床实践相关的身体和情感隔离,管理患者的痛苦行为,并回顾影响道德痛苦发展和管理的系统性障碍。我们的进一步目标是通过各种个性化策略、建立道德弹性的重要性以及向改善工作场所精神的转变,引起人们对医疗保健专业人员将自我保健置于其治疗曲目的最前沿的关注。实践自我护理可以解决忽视自己健康的后果,积极影响提供更好质量的患者护理的能力,并有利于与患者,亲人,最重要的是与自己的关系。
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引用次数: 0
‘It’s Nice for My Body but I Don’t Like It’ – Experiences of Soothing Rhythm Breathing in Clients with Depression “这对我的身体很好,但我不喜欢它”——抑郁症患者舒缓节奏呼吸的经验
Pub Date : 2023-10-11 DOI: 10.21926/obm.icm.2304041
Jasmine French, Richard Brown, Tobyn Bell
Soothing-rhythm breathing (SRB) is a core component of compassion focused therapy (CFT). While integral to CFT, research has yet to explore personal experiences of SRB. This study aimed to explore the experiences of individuals with depression who had practiced SRB in NHS primary care services. Interpretative phenomenological analysis (IPA) was used to analyse data from individual semi-structured interviews. Three experiential themes were identified: ‘mind-body connection and bodily needs’, ‘a new relationship with the mind’, and ‘slowing down: shifting to the new and challenging’. Results highlighted the benefits of connecting with the body and the challenges of practicing SRB. Clinical implications and suggestions for further research are discussed.
舒缓节奏呼吸(SRB)是同情集中疗法(CFT)的核心组成部分。虽然这是CFT不可或缺的一部分,但研究尚未探索SRB的个人经历。本研究旨在探讨在NHS初级保健服务中实施SRB的抑郁症患者的经历。解释现象学分析(IPA)用于分析来自个人半结构化访谈的数据。他们确定了三个体验主题:“身心联系和身体需求”、“与心灵的新关系”和“慢下来:转向新的挑战”。结果强调了与身体联系的好处和练习SRB的挑战。本文还讨论了临床意义和进一步研究的建议。
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引用次数: 0
Maximizing the Benefit of Respite for Dementia Caregivers: A Study Protocol Describing the Development & Evaluation of the Time for Living & Caring (TLC) Intervention 最大限度地提高痴呆护理人员的休息效益:一项描述发展的研究方案& &;对生活时间的评价关怀(TLC)干预
Pub Date : 2023-10-08 DOI: 10.21926/obm.icm.2304040
Rebecca L. Utz, Michael Caserta, Eli Iacob, Catharine Sparks, Louisa Stark, Alexandra Terrill, Amber Thompson, Bob Wong
Dementia caregivers are susceptible to adverse physical and mental health outcomes, given the often prolonged and challenging care and support they provide to family members with Alzheimer’s Disease and Related Dementias (ADRD). This report describes a community-engaged implementation of a novel behavioral intervention - an “app” (interactive website) called TLC (Time for Living and Caring) that coaches caregivers on how to maximize the benefits associated with respite time. The rationale and features of the TLC intervention and the full research protocol used to develop and then evaluate its feasibility, acceptability, and initial efficacy are described here.
痴呆症护理人员很容易受到不利的身心健康结果的影响,因为他们向患有阿尔茨海默病和相关痴呆症(ADRD)的家庭成员提供的护理和支持往往是长期的和具有挑战性的。本报告描述了一种社区参与的新型行为干预的实施——一个名为TLC(生活和护理时间)的“应用程序”(互动网站),它指导护理人员如何最大限度地利用喘息时间。本文描述了TLC干预的基本原理和特点,以及用于开发和评估其可行性、可接受性和初始疗效的完整研究方案。
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引用次数: 0
Nature and City Sounds Influence Physiological and Psychological Markers in College Students 自然和城市声音对大学生生理和心理指标的影响
Pub Date : 2023-09-28 DOI: 10.21926/obm.icm.2303039
Domenic John DiPietro, Maria Gabriela Bidart
Worldwide, human population growth has led to a higher demand for urbanization. While this development is in accordance with our gregarious lifestyles, our availability and contact with nature has consequentially been minimized. The goal of this study was to evaluate whether sounds from nature versus urban environments affect vital signs (i.e., heart rate and respiration rate) and mood states of female college students. Emotional states were assessed using the Positive and Negative Affect Schedule (PANAS) questionnaire. While nature sounds included a mixture of birdsongs and water sounds, urban sounds included traffic, construction, and sirens. Following a within-subject design, each participant listened to a 7-minute segment of nature sounds and a 7-minute segment of city sounds in a randomized order. Sounds were played through each participant’s own headphones and devices at a conversational volume of approximately 70 decibels. All dependent variables were recorded before and after listening to each type of sound. This study was performed throughout the COVID-19 pandemic (April-August 2020). To comply with health and safety guidelines, each participant met with the experimenter through a WebEx virtual conference, and variables were self-recorded by each of the participants. Exposure to 7-minutes of sounds from a natural environment resulted in statistically significant decreases in both respiration rate and negative affect schedule score when compared to the same time exposure to urban sounds. Furthermore, participants had a significantly higher preference for natural over urban environments according to a survey performed prior to listening to both types of sounds. Future research could help to better understand causes for variability in human responses to sound stimuli.
在世界范围内,人口增长导致对城市化的更高需求。虽然这种发展符合我们的社交生活方式,但我们与自然的接触和接触也因此减少了。本研究的目的是评估来自自然环境和城市环境的声音是否会影响女大学生的生命体征(即心率和呼吸频率)和情绪状态。采用积极和消极情绪量表(PANAS)评估情绪状态。自然的声音包括鸟鸣和水声,而城市的声音包括交通、建筑和警笛声。按照受试者内部设计,每个参与者按随机顺序听一段7分钟的自然声音和一段7分钟的城市声音。声音通过每个参与者自己的耳机和设备播放,音量约为70分贝。在听每种声音之前和之后记录所有因变量。这项研究是在2019冠状病毒病大流行期间(2020年4月至8月)进行的。为了遵守健康和安全准则,每个参与者通过WebEx虚拟会议与实验人员会面,并由每个参与者自行记录变量。与同样时间暴露在城市声音中相比,暴露在自然环境中7分钟的声音导致呼吸频率和负面影响时间表得分显著降低。此外,根据在听这两种声音之前进行的一项调查,参与者对自然环境的偏好明显高于城市环境。未来的研究可以帮助我们更好地理解人类对声音刺激反应差异的原因。
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引用次数: 0
Resilience and Burnout among Medical Students: The Role of Difficulties with Emotion Regulation as A Mediator 医学生心理弹性与倦怠:情绪调节困难的中介作用
Pub Date : 2023-09-19 DOI: 10.21926/obm.icm.2303038
Jordan Ensz, Changiz Mohiyeddini
Burnout is a chronic state of exhaustion caused by prolonged stress. Medical training has been shown to leave many medical students vulnerable to burnout, which can negatively impact their health and patient care. While resilience has been associated with lower burnout, the mechanisms through which resilience reduces burnout are not well established. Therefore, this study aimed to investigate whether difficulties with emotion regulation mediate the relationship between resilience and burnout among medical students. For this cross-sectional study, we conducted a power analysis to determine the necessary sample size and recruited 82 medical students (mean age = 25.2, 35.4% male) to complete a questionnaire that measured burnout (Oldenburg Burnout Inventory), difficulties with emotion regulation (Difficulties in Emotional Regulation Scale), and resilience (Brief Resilience Scale). Hierarchical regression analysis was conducted to examine the mediation model. Our results indicate that difficulties with emotion regulation mediate the relationship between resilience and burnout, with a significant indirect effect of resilience on burnout. The mediation model explained 16% of the variance in burnout. In conclusion, difficulties in emotion regulation may increase the risk of burnout among medical students. Our findings suggest that enhancing resilience and adaptive emotion regulation could help protect medical students against burnout.
倦怠是由长期压力引起的一种慢性疲劳状态。医学培训已被证明使许多医学生容易倦怠,这会对他们的健康和病人护理产生负面影响。虽然弹性与较低的职业倦怠有关,但弹性减少职业倦怠的机制尚未得到很好的确立。因此,本研究旨在探讨情绪调节困难是否在医学生心理弹性与职业倦怠之间起到中介作用。在横断面研究中,我们进行了功率分析以确定必要的样本量,并招募了82名医学生(平均年龄为25.2岁,其中35.4%为男性)完成了一份调查问卷,测量了倦怠(Oldenburg倦怠量表)、情绪调节困难(情绪调节困难量表)和心理弹性(简要心理弹性量表)。采用层次回归分析对中介模型进行检验。研究结果表明,情绪调节困难在心理弹性与倦怠之间起中介作用,心理弹性对倦怠具有显著的间接影响。中介模型解释了16%的倦怠方差。综上所述,情绪调节困难可能增加医学生倦怠的风险。我们的研究结果表明,增强弹性和适应性情绪调节有助于保护医学生免受倦怠。
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引用次数: 0
Bringing the Inside Out and the Outside in: The Therapeutic Relationship in Compassion Focused Therapy Chairwork 从内到外:以同情为中心的治疗椅子工作中的治疗关系
Pub Date : 2023-09-19 DOI: 10.21926/obm.icm.2303037
Tobyn Bell, Jane Montague, James Elander, Matthew Pugh, Paul Gilbert
Chairwork is a central component in Compassion Focused Therapy (CFT). Despite its importance, there has been no prior research on the relational factors underpinning the application of chairwork in CFT. There is also a general paucity of research on the role of the therapeutic relationship in chairwork across modalities. This paper analyses data from interviews with 21 clients following a CFT chairwork intervention to ascertain how relational factors influenced their experience of this method. An Interpretative Phenomenological Analysis (IPA) found three main themes: 1) direction and coaching during enactment; 2) externalisation: bringing the inside out and outside in; 3) regulation and trust: the relational requirements to ‘let go’. The implications of these findings, both for the delivery and training of chairwork, are then discussed in the context of CFT.
椅子工作是同情心疗法(CFT)的核心组成部分。尽管它很重要,但对支撑椅子在CFT中应用的相关因素的研究尚无先例。关于跨模式椅子工作中治疗关系的作用的研究也普遍缺乏。本文分析了21位客户的访谈数据,以确定关系因素如何影响他们对这种方法的体验。解释性现象学分析(IPA)发现了三个主要主题:1)制定过程中的指导和指导;2)外化:将内外向内;3)监管与信任:“放手”的关系要求。然后在CFT的背景下讨论这些发现对椅子工作的交付和培训的影响。
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引用次数: 1
Cultural Biases and Psychedelic Experiences: Western Scientific Perspectives about Amazonian Mestizo Therapeutic Traditions 文化偏见和迷幻体验:西方科学对亚马逊混血儿治疗传统的看法
Pub Date : 2023-09-07 DOI: 10.21926/obm.icm.2303035
Alberto Dubbini
This article aims to analyze how Western researchers can be influenced by their epistemic and ethical foundations, which are also expressed through a culturally shared idea of therapy, and how this influence can significantly hinder the understanding of a different cultural reality and its resources in terms of knowledge and practices. While examining a collection of research cases in the field of psychedelic therapy, the present paper focuses on the obstacles created by ethical and epistemic conflicts in the mind of researchers with Western scientific training and their consequent difficulty in exploring the situations induced by psychedelic substances in a context of articulation and integration between their therapeutic know-how and that of a spiritual hundreds-year-old psychedelic tradition like Amazonian mestizo vegetalismo. Such obstacles may offer a chance to increase awareness of the cultural bias and limitations of the scientific gaze and highlight the importance of therapeutic and research contexts in which declared independence, neutrality and effectiveness of human alert thinking as undebatable ethical and epistemic value are under discussion.
本文旨在分析西方研究人员如何受到其认知和伦理基础的影响,这些基础也通过文化上共享的治疗理念来表达,以及这种影响如何严重阻碍对不同文化现实及其知识和实践资源的理解。在检查迷幻疗法领域的一组研究案例时,摘要本文着重探讨了受过西方科学训练的研究人员在心理上的伦理和认识冲突所造成的障碍,以及他们在探索迷幻物质引发的情况时所遇到的困难素食主义者。这些障碍可能为提高人们对科学凝视的文化偏见和局限性的认识提供了机会,并突出了治疗和研究背景的重要性,在这些背景下,人类警觉思维的独立性、中立性和有效性作为不可否认的伦理和认识价值正在被讨论。
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引用次数: 0
Introducing a Novel Intervention, CoHealing, to Address Teacher Burnout and Indirect Trauma 引入一种新的干预措施,CoHealing,以解决教师倦怠和间接创伤
Pub Date : 2023-09-07 DOI: 10.21926/obm.icm.2303036
Jennifer King, Megan Holmes, Kylie Evans, Anna Bender, Dakota King-White
The COVID-19 pandemic exacerbated the long-standing issues of stress and burnout in the education sector, with teachers and education staff facing unprecedented challenges including significant adjustments to teaching methods and balancing the mental health and academic needs of their students. The resulting challenges have contributed to heightened levels of stress and burnout among teachers and education staff. The impact of the pandemic on teachers and education staff has highlighted the need for greater support and resources to help them cope with these challenges and address their stress and burnout. One such promising intervention, CoHealing, is aimed at promoting a more resilient, interdisciplinary network of trauma-informed helping professionals (e.g., teachers, medical providers, social workers) by reducing secondary traumatic stress, burnout, and isolation. CoHealing is a monthly group-intervention delivered over six months that aims to reduce secondary traumatic stress, burnout, and isolation. CoHealing provides self-regulation tools, relational connection as a coping resource, and psychoeducation on the causes and symptoms of indirect trauma. CoHealing was born out of the need to enhance the relational health of trauma-informed helping professionals and to address indirect trauma and job-related vicarious trauma, secondary traumatic stress, and compassion fatigue across disciplines. Reducing the damaging effects of indirect trauma is critical to maintaining a healthy and resilient workforce that will, in turn, continue to provide high-quality health and human services to individuals and communities experiencing trauma and adversity. This paper provides an intervention description with limited preliminary evidence. More research is needed to robustly evaluate the impacts quantitatively and/or qualitatively.
2019冠状病毒病大流行加剧了教育部门长期存在的压力和倦怠问题,教师和教育工作人员面临前所未有的挑战,包括对教学方法进行重大调整,平衡学生的心理健康和学业需求。由此带来的挑战加剧了教师和教育工作人员的压力和倦怠。大流行对教师和教育工作人员的影响突出表明,需要提供更多支持和资源,帮助他们应对这些挑战,缓解压力和倦怠。其中一个很有希望的干预措施是“共同治疗”,其目的是通过减少继发性创伤压力、倦怠和孤立,促进一个更有弹性、跨学科的创伤知情帮助专业人员(如教师、医疗提供者、社会工作者)网络。共同治疗是一项为期六个月、每月一次的团体干预,旨在减少继发性创伤压力、倦怠和孤立。共同治疗提供自我调节工具,关系连接作为应对资源,并对间接创伤的原因和症状进行心理教育。“共同治疗”的诞生是为了加强创伤知情帮助专业人员的关系健康,并解决间接创伤和与工作相关的间接创伤、继发性创伤压力和跨学科的同情疲劳。减少间接创伤的破坏性影响对于维持一支健康和有复原力的劳动力队伍至关重要,而这支队伍又将继续向遭受创伤和逆境的个人和社区提供高质量的保健和人力服务。本文提供了一个初步证据有限的干预描述。需要更多的研究来定量和/或定性地对这些影响进行有力的评价。
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引用次数: 0
Promoting College Student and Staff Well-being Through a Mindfulness-based Coping Program 通过以正念为基础的应对计划促进大学生和员工的健康
Pub Date : 2023-08-30 DOI: 10.21926/obm.icm.2303034
Robyn Long, Megan Kennedy, Katie Malloy Spink, L. Lengua
This study evaluated the impact on student and staff well-being of a mindfulness-based cognitive-behavioral coping program, Be REAL (Resilient Attitudes & Living), delivered by campus staff using a task-sharing approach. The program was adapted for online delivery during COVID19. Study participants included 325 undergraduate students and 100 staff members at a large tri-campus university in the U.S. Participants completed surveys with self-report measures assessing mindfulness, perceptions of stress, emotion regulation, executive control, coping, self-compassion, anxiety, depression, and indicators of well-being including resilience and flourishing. Students also completed measures of social connectedness and happiness, while staff completed measures of work-related burnout and self-efficacy. With students we employed an assessment only control group, and with staff, a waitlist control (WLC) design was used. Feasibility and acceptability measures were obtained. Compared to students in the assessment-only group, students participating in Be REAL showed significant improvements in mindfulness, self-compassion, flourishing, resilience, happiness, emotion regulation problems, executive control, active coping, social connection, depression and anxiety symptoms. These effects were maintained at follow-up. Compared to WLC, staff participating in Be REAL reported improved self-efficacy and reduced anxiety symptoms. This study demonstrated that a mindfulness-based cognitive-behavioral coping enhancement program, Be REAL, delivered online during the pandemic, can improve the well-being and mental health of college students and staff. It further demonstrated feasibility, acceptability, and effectiveness through a task-sharing model whereby staff supporting students facilitated the groups, which presents universities with a promising model of cultivating a campus culture of well-being.
这项研究评估了校园工作人员使用任务共享方法提供的基于正念的认知行为应对计划Be REAL(弹性态度和生活)对学生和教职员工幸福感的影响。该计划适用于新冠肺炎疫情期间的在线交付19。研究参与者包括美国一所大型三校区大学的325名本科生和100名工作人员。参与者完成了自我报告测量的调查,评估正念、压力感知、情绪调节、执行控制、应对、自我同情、焦虑、抑郁以及包括复原力和繁荣在内的幸福指标。学生们还完成了社会联系和幸福感的测量,而工作人员则完成了工作倦怠和自我效能感的测量。对于学生,我们采用了仅评估的对照组,而对于工作人员,则采用了等待名单对照(WLC)设计。获得了可行性和可接受性措施。与只参加评估组的学生相比,参加Be REAL的学生在正念、自我同情、繁荣、韧性、幸福感、情绪调节问题、执行控制、积极应对、社交联系、抑郁和焦虑症状方面表现出显著改善。这些影响在随访中得以维持。与WLC相比,参与Be REAL的员工报告说,他们的自我效能感有所提高,焦虑症状有所减轻。这项研究表明,在疫情期间在线提供的基于正念的认知行为应对增强计划Be REAL可以改善大学生和教职员工的幸福感和心理健康。它通过任务共享模式进一步证明了可行性、可接受性和有效性,支持学生的工作人员为小组提供了便利,这为大学培养幸福校园文化提供了一个很有前途的模式。
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引用次数: 0
Burnout Among Special Education Teachers and the Role of Individual, Interpersonal, and Organizational Risk and Protective Factors 特殊教育教师的倦怠与个人、人际和组织风险及保护因素的作用
Pub Date : 2023-08-10 DOI: 10.21926/obm.icm.2303033
V. Hofmann, Céline Pagnotta, Noémie Lacombe, Myriam Squillaci
Burnout is a syndrome commonly characterized by the three dimensions of Maslach and Leiter's model, namely emotional exhaustion, depersonalization, and lack of professional accomplishment. While burnout affects individuals in all professions, teachers are recognized as being at particular risk, a fact explained in the literature by the high level of relational demands inherent to the profession. During the pandemic and subsequently, these demands have even increased. Several studies have focused on the influence of individual, interpersonal, and organizational factors predicting teacher burnout risk. Yet, less is known about special education teachers working in inclusive and non-inclusive settings and how the pandemic has particularly affected their burnout risk. Thus, this study aimed to examine (1) whether burnout risk among special education teachers has increased since the pandemic and (2) whether burnout risk is related to individual, interpersonal, and organizational variables, including factors related to the pandemic. For this purpose, a cross-sectional study was conducted among a sample of special education teachers in Switzerland (n = 358) using the Maslach Burnout Inventory. Since there are three distinctive dimensions of burnout, which might also be differently associated with risk and protective factors, we conducted separate logistic regression analyses to predict risk status for emotional exhaustion, depersonalization, and personal accomplishment by individual, interpersonal, and organizational variables. Results indicate that for emotional exhaustion, individual teaching satisfaction and health problems are most important, whereas for depersonalization individual teaching satisfaction, good relationships with parents and working in an inclusive setting decrease burnout risk. An inclusive setting increases the risk, regarding lack of personal accomplishment, while all other effects are non-significant. Implications for practice are discussed.
倦怠是一种综合征,通常以马斯拉赫和雷特模型的三个维度为特征,即情绪衰竭、人格解体和缺乏职业素养。虽然倦怠影响着所有职业的个人,但教师被认为面临着特殊的风险,这一事实在文献中可以通过职业固有的高度关系需求来解释。在疫情期间以及随后的疫情期间,这些需求甚至有所增加。一些研究集中在个人、人际和组织因素对教师倦怠风险的预测作用上。然而,人们对在包容性和非包容性环境中工作的特殊教育教师以及疫情如何特别影响他们的倦怠风险知之甚少。因此,本研究旨在检验(1)自疫情以来,特殊教育教师的倦怠风险是否增加;(2)倦怠风险是否与个人、人际和组织变量有关,包括与疫情相关的因素。为此,使用Maslach倦怠量表对瑞士特殊教育教师样本(n=358)进行了一项横断面研究。由于倦怠有三个不同的维度,也可能与风险和保护因素有不同的关联,我们进行了单独的逻辑回归分析,通过个人、人际和组织变量预测情绪衰竭、人格解体和个人成就的风险状态。结果表明,对于情绪衰竭,个体教学满意度和健康问题最为重要,而对于人格解体,个体教学满意、与父母的良好关系以及在包容性环境中工作会降低倦怠风险。包容性的环境会增加缺乏个人成就的风险,而所有其他影响都不显著。讨论了对实践的启示。
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引用次数: 0
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OBM integrative and complimentary medicine
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