Agnessa Kozak

Burnout intervention studies for inpatient elderly care nursing staff: Systematic literature review

BACKGROUND Staff providing inpatient elderly and geriatric long-term care are exposed to a large number of factors that can lead to the development of burnout syndrome. Burnout is associated with an increased risk of absence from work, low work satisfaction, and an increased intention to leave. Due to the fact that the number of geriatric nursing staff is already insufficient, research on interventions aimed at reducing work-related stress in inpatient elderly care is needed. OBJECTIVE The aim of this systematic review was to identify and analyse burnout intervention studies among nursing staff in the inpatient elderly and geriatric long-term care sector. METHODS A systematic search of burnout intervention studies was conducted in the databases Embase, Medline and PsycNet published from 2000 to January 2012. RESULTS We identified 16 intervention studies. Interventions were grouped into work-directed (n=2), person-directed (n=9) and combined approaches (work- and person-directed, n=5). Seven out of 16 studies observed a reduction in staff burnout. Among them are two studies with a work-directed, two with a person-directed and three with a combined approach. Person-directed interventions reduced burnout in the short term (up to 1 month), while work-directed interventions and those with a combined approach were able to reduce burnout over a longer term (from 1 month to more than 1 year). In addition to staff burnout, three studies observed positive effects relating to the client outcomes. Only three out of ten Randomised Control Trials (RCT) found that interventions had a positive effect on staff burnout. CONCLUSION Work-directed and combined interventions are able to achieve beneficial longer-term effects on staff burnout. Person-directed interventions achieve short-term results in reducing staff burnout. However, the evidence is limited.

Psychosocial work-related predictors and consequences of personal burnout among staff working with people with intellectual disabilities.

The purposes of this study were to investigate the potential predictors of personal burnout among staff working with people with intellectual disabilities and to investigate whether personal burnout is associated with health and work-related outcomes. A cross-sectional survey was carried out in 2011 in 30 residential facilities in northern Germany (N = 409, response rate 45%). The German standard version of the Copenhagen Psychosocial Questionnaire was used. In a multiple logistic regression analysis, we identified factors which were predictive of personal burnout, such as work-privacy conflict (OR = 1.04, 95% CI 1.03, 1.05), emotional demands (OR = 1.03, 95% CI 1.01, 1.05), role conflicts (OR = 1.02, 95% CI 1.02, 1.03), job insecurity (OR = 1.03, 95% CI 1.01, 1.05) and feedback (OR = 0.98, 95% CI 0.97, 0.99). These factors explained 49% of the total variance. Higher levels of personal burnout were significantly correlated with higher rates of intention to leave the job and cognitive stress symptoms (p<.01). Low values of personal burnout were associated with greater job satisfaction, good general health, and higher satisfaction with life (p<.01). The present study indicates that improving the psychosocial work environment at the organizational level may reduce personal burnout and may also diminish unfavorable outcomes, such as intention to leave or job dissatisfaction.

Self-Reported Musculoskeletal Disorders of the Distal Upper Extremities and the Neck in German Veterinarians: A Cross-Sectional Study

Background Veterinary work is a physically demanding profession and entails the risk of injuries and diseases of the musculoskeletal system, particularly in the upper body. The prevalence of musculoskeletal disorders (MSD), the consequences and work-related accidents in German veterinarians were investigated. Work-related and individual factors associated with MSD of upper extremities and the neck were analyzed. Methods In 2011, a self-reporting Standardized Nordic Questionnaire was mailed to registered veterinarians in seven federal medical associations in Germany. A total of 3174 (38.4%) veterinarians responded. Logistic regression analysis was used to determine the association between risk factors and MSD-related impairment of daily activities. Results MSD in the neck (66.6%) and shoulder (60.5%) were more prevalent than in the hand (34.5%) or elbow (24.5%). Normal activities were affected in 28.7% (neck), 29.5% (shoulder), 19.4% (hand) and 14% (elbow) of the respondents. MSD in the upper body occurred significantly more often in large animal practitioners. Accidents that resulted in MSD were most frequently reported in the hand/wrist (14.3%) or in the shoulder (10.8%). The majority of all accidents in the distal upper extremities were caused by animals than by other factors (19% vs. 9.2%). For each area of the body, a specific set of individual and work-related factors contributed significantly to severe MSD: Older age, gender, previous injuries, BMI, practice type, veterinary procedures such as dentistry, rectal procedures and obstetric procedures as well as high demands and personal burnout. Conclusion From the perspective of occupational health and safety, it seems to be necessary to improve accident prevention and to optimize the ergonomics of specific tasks. Our data suggest the need for target group-specific preventive measures that also focus on the psychological factors at work.

Hospital physicians' work stressors in different medical specialities: a statistical group comparison.

BackgroundSome studies on the occupational health of hospital physicians have found that working conditions have different effects on physician’s well-being and health in different medical specialities. There has been no comparative study of the effects of various work stressors in different specialities. This study aims to close this gap.MethodsGerman hospital physicians were asked about their working conditions and aspects of health. The short version of the Instrument for Stress-Related Job Analysis for Hospital Physicians was used to measure working conditions. Irritation and emotional exhaustion were used to assess health. Physicians were also asked for socio-demographic aspects, including their medical speciality.ResultsData from 763 hospital physicians were included in the analyses. Significant differences between medical specialities were demonstrated for time pressure, uncertainty, frustration about how work needs to be done and social stressors with patients. Physicians in internal medicine showed consistently high levels of stressors. Time pressure, frustration about how work needs to be done, and emotional dissonance were found to be significantly related to both aspects of health.ConclusionsThe results showed that some medical specialities are more affected by specific stressors. It is therefore discussed how improvements can be implemented. Furthermore, it is illustrated which stressors are especially relevant for health. These relationships to health should be investigated in further research and in longitudinal designs to allow hints of causal relationships.

Are female daycare workers at greater risk of cytomegalovirus infection? A secondary data analysis of CMV seroprevalence between 2010 and 2013 in Hamburg, Germany.

Background: Close contact with asymptomatic children younger than three years is a risk factor for a primary cytomegalovirus (CMV) infection. In pregnant women, such primary infection increases the risk of CMV-induced feto- or embryopathy. Daycare providers have therefore implemented working restrictions for pregnant daycare workers (DCWs) in accordance with legislation and guidelines for maternity protection. However, little is known about the infection risk for DCWs. We therefore compared the prevalence of CMV antibodies of pregnant DCWs to that of female blood donors (BDs). Method: In a secondary data analysis, the prevalence of anti-CMV IgG among pregnant DCWs (N=509) in daycare centers (DCCs) was compared to the prevalence of female first-time BDs (N=14,358) from the greater region of Hamburg, Germany. Data collection took place between 2010 and 2013. The influence of other risk factors such as age, pregnancies and place of residence was evaluated using logistic regression models. Results: The prevalence of CMV antibodies in pregnant DCWs was higher than in female BDs (54.6 vs 41.5%; OR 1.6; 95%CI 1.3–1.9). The subgroup of BDs who had given birth to at least one child and who lived in the city of Hamburg (N=2,591) had a prevalence of CMV antibodies similar to the prevalence in pregnant DCWs (53.9 vs 54.6%; OR 0.9; 95%CI 0.8–1.2). Age, pregnancy history and living in the center of Hamburg were risk factors for CMV infections. Conclusion: The comparison of pregnant DCWs to the best-matching subgroup of female first-time BDs with past pregnancies and living in the city of Hamburg does not indicate an elevated risk of CMV infection among DCWs. However, as two secondary data sets from convenience samples were used, a more detailed investigation of the risk factors other than place of residence, age and maternity was not possible. Therefore, the CMV infection risk in DCWs should be further studied by taking into consideration the potential preventive effect of hygiene measures.

Prevalence and Consequences of Aggression and Violence towards Nursing and Care Staff in Germany—A Survey

Acts of aggression by patients or clients are a part of the average working day for many Health care employees. The objective of the survey was to study the frequency and nature of violence and the handling of aggressive behavior by facility management. The cross-sectional study was conducted in 2017, 81 different healthcare facilities and 1984 employees participated. The questionnaire encompassed socio-demographic details, the frequency of physical violence and verbal abuse, consequences of violence and the stress of employees. In the previous twelve months, 94.1% of the employees in the survey had experienced verbal abuse and 69.8% had experienced physical aggression. Acts of aggression were most commonly encountered in hospitals and residential facilities for the disabled. One third of the employees felt under high levels of stress as a result of the incidents. If the workplace prepares effectively, however, this reduces the perceived stress odds ratio (OR) 0.6, 95% CI 0.4–0.8). Violence and aggression are very common. Healthcare facilities are increasingly dealing with this topic. Awareness raising is likely to lead to higher incident reporting rates. Good preparation and an open approach to the topic in the facilities have a positive effect on the feeling of stress and work ability.

Evaluation of a Training Program to Reduce Stressful Trunk Postures in the Nursing Professions: A Pilot Study

Objectives: The aim of this pilot study was to evaluate metrologically the effectiveness of a training program on the reduction of stressful trunk postures in geriatric nursing professions. Methods: A training program, consisting of instruction on body postures in nursing, practical ergonomic work methods at the bedside or in the bathroom, reorganization of work equipment, and physical exercises, was conducted in 12 wards of 6 nursing homes in Germany. The Computer‐Assisted Recording and Long‐Term Analysis of Musculoskeletal Loads (CUELA) measurement system was used to evaluate all movements and trunk postures adopted during work before and 6 months after the training program. In total, 23 shifts were measured. All measurements were supported by video recordings. A specific software program (WIDAAN 2.75) was used to synchronize the measurement data and video footage. Results: The median proportion of time spent in sagittal inclinations at an angle of >20° was significantly reduced (by 29%) 6 months after the intervention [from 35.4% interquartile range (27.6‐43.1) to 25.3% (20.7‐34.1); P < 0.001]. Very pronounced inclinations exceeding 60° [2.5% (1.1‐4.6) to 1.0% (0.8‐1.7); P = 0.002] and static inclinations of over 20° for >4 s [4.4% (3.0‐6.7) to 3.6% (2.5‐4.5); P < 0.001] were significantly reduced, by 60% and 22%, respectively. Video analysis showed that in 49% of care situations, ergonomic measures were implemented properly, either at the bedside or in the bathroom. Conclusions: Stressful trunk postures could be significantly reduced by raising awareness of the physical strains that frequently occur during a shift, by changes in work practices and by redesigning the work environment. Workplace interventions aimed at preventing or reducing low back pain in nursing personnel would probably benefit from sensitizing employees to their postures during work.