Stress and burnout among critical care fellows: preliminary evaluation of an educational intervention

Kianoush Kashani, Perliveh Carrera, Alice Gallo De Moraes, Amit Sood, James A Onigkeit, Kannan Ramar, Kianoush Kashani, Perliveh Carrera, Alice Gallo De Moraes, Amit Sood, James A Onigkeit, Kannan Ramar

Abstract

Background: Despite a demanding work environment, information on stress and burnout of critical care fellows is limited.

Objectives: To assess 1) levels of burnout, perceived stress, and quality of life in critical care fellows, and 2) the impact of a brief stress management training on these outcomes.

Methods: In a tertiary care academic medical center, 58 critical care fellows of varying subspecialties and training levels were surveyed to assess baseline levels of stress and burnout. Twenty-one of the 58 critical care fellows who were in the first year of training at the time of this initial survey participated in a pre-test and 1-year post-test to determine the effects of a brief, 90-min stress management intervention.

Results: Based on responses (n=58) to the abbreviated Maslach Burnout Inventory, reported burnout was significantly lower in Asian fellows (p=0.04) and substantially higher among graduating fellows (versus new and transitioning fellows) (p=0.02). Among the intervention cohort, burnout did not significantly improve--though two-thirds of fellows reported using the interventional techniques to deal with stressful situations. Fellows who participated in the intervention rated the effectiveness of the course as 4 (IQR=3.75-5) using the 5-point Likert scale.

Conclusions: In comparison with the new and transitioning trainees, burnout was highest among graduating critical care fellows. Although no significant improvements were found in first-year fellows' burnout scores following the single, 90-min training intervention, participants felt the training did provide them with tools to apply during stressful situations.

Keywords: burnout; critical care; medical education; mental health; program evaluation; survey research.

References

    1. Collier VU, McCue JD, Markus A, Smith L. Stress in medical residency: status quo after a decade of reform? Ann Intern Med. 2002;136:384–90.
    1. Thomas NK. Resident burnout. JAMA. 2004;292:2880–9.
    1. Shanafelt TD, Sloan JA, Habermann TM. The well-being of physicians. Am J Med. 2003;114:513–9.
    1. Shanafelt TD, Bradley KA, Wipf JE, Back AL. Burnout and self-reported patient care in an internal medicine residency program. Ann Int Med. 2002;136:358–67.
    1. Dyrbye LN, West CP, Satele D, Boone S, Tan L, Sloan J, et al. Burnout among U.S. medical students, residents, and early career physicians relative to the general U.S. population. Acad Med. 2014;89:443–51.
    1. Maslach C, Schaufeli WB, Leiter MP. Job burnout. Ann Rev Psychol. 2001;52:397–422.
    1. Embriaco N, Azoulay E, Barrau K, Kentish N, Pochard F, Loundou A, et al. High level of burnout in intensivists: prevalence and associated factors. Am J Respir Crit Care Med. 2007;175:686–92.
    1. Firth-Cozens J, Greenhalgh J. Doctors’ perceptions of the links between stress and lowered clinical care. Soc Sci Med. 1997;44:1017–22.
    1. Fahrenkopf AM, Sectish TC, Barger LK, Sharek PJ, Lewin D, Chiang VW, et al. Rates of medication errors among depressed and burnt out residents: prospective cohort study. BMJ. 2008;336:488–91.
    1. West CP, Tan AD, Habermann TM, Sloan JA, Shanafelt TD, et al. Association of resident fatigue and distress with perceived medical errors. JAMA. 2009;302:1294–300.
    1. Haas JS, Cook EF, Puopolo AL, Burstin HR, Cleary PD, Brennan TA. Is the professional satisfaction of general internists associated with patient satisfaction? J Gen Int Med. 2000;15:122–8.
    1. Prins JT, van der Heijden FMMA, Hoekstra-Weebers JEHM, Bakker AB, van de Wiel HBM, Jacobs B, et al. Burnout, engagement and resident physicians’ self-reported errors. Psychol Health Med. 2009;14:654–66.
    1. Schiraldi GR, Jackson TK, Brown SL, Jordan JB. Resilience training for functioning adults: program description and preliminary findings from a pilot investigation. Int J Emerg Ment Health. 2010;12:117–29.
    1. Burton NW, Pakenham KI, Brown WJ. Feasibility and effectiveness of psychosocial resilience training: a pilot study of the READY program. Psychol Health Med. 2010;15:266–77.
    1. Prins JT, Gazendam-Donofrio SM, Tubben BJ, Van Der Heijden FMMA, Van De Wiel HBM, Hoekstra-Weebers JEHM, et al. Burnout in medical residents: a review. Med Educ. 2007;41:788–800.
    1. Mougalian SS, Lessen DS, Levine RL, Panagopoulos G, Von Roenn JH, Arnold RM, et al. Palliative care training and associations with burnout in oncology fellows. J Support Oncol. 2013;11:95–102.
    1. Prins JT, Hoekstra-Weebers JEHM, Gazendam-Donofrio SM, Dillingh GS, Bakker AB, Huisman M, et al. Burnout and engagement among resident doctors in the Netherlands: a national study. Med Educ. 2010;44:236–47.
    1. Sood A, Prasad K, Schroeder D, Varkey P. Stress management and resilience training among Department of Medicine Faculty: a pilot randomized clinical trial. J Gen Int Med. 2011;26:858–61.
    1. Loprinzi CE, Prasad K, Schroeder DR, Sood A. Stress Management and Resilience Training (SMART) Program to decrease stress and enhance resilience among breast cancer survivors: a pilot randomized clinical trial. Clin Breast Cancer. 2011;11:364–8.
    1. Sood A, Sharma V, Schroeder DR, Gorman B. Stress Management and Resiliency Training (SMART) Program among Department of Radiology Faculty: a pilot randomized clinical trial. EXPLORE: J Sci Heal. 2014;10:358–63.
    1. McCullough ME, Emmons RA, Tsang JA. The grateful disposition: a conceptual and empirical topography. J Pers Soc Psychol. 2002;82:112–27.
    1. Diener E, Emmons RA, Larsen RJ, Griffin S. The Satisfaction with Life Scale. J Pers Asses. 1985;49:71–5.
    1. Lyubomirsky S, Lepper H. A measure of subjective happiness: preliminary reliability and construct validation. Soc Indic Res. 1999;46:137–55.
    1. Maslach C, Jackson SE. The measurement of experienced burnout. J Org Behav. 1981;2:99–113.
    1. Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983;24:385–96.
    1. West CP, Dyrbye LN, Satele DV, Sloan JA, Shanafelt TD. Concurrent validity of single-item measures of emotional exhaustion and depersonalization in burnout assessment. J Gen Int Med. 2012;27:1445–52.
    1. Dyrbye L, Sotile W, Boone S, West C, Tan L, Satele D, et al. A survey of U.S. physicians and their partners regarding the impact of work–home conflict. J Gen Int Med. 2013;29:155–61.
    1. Andreou E, Alexopoulos EC, Lionis C, Varvogli L, Gnardellis C, Chrousos GP, et al. Perceived stress scale: reliability and validity study in Greece. Int J of Environ Res Public Health. 2011;8:3287–98.
    1. Guntupalli KK, Fromm RE., Jr Burnout in the internist-intensivist. Intensive Care Med. 1996;22:625–30.

Source: PubMed

Sponsors et collaborateurs

Les conditions médicales

Interventions en matière de drogue

3
S'abonner