Michelle T. Jesse

Determinants of Burnout Among Transplant Surgeons: A National Survey in the United States

Burnout is a response to chronic strain within the workplace characterized by feelings of inefficacy (reduced personal accomplishment), cynicism (depersonalization) and emotional exhaustion. The purpose of this study was to report prevalence and explore organizational and interpersonal contributors of burnout in transplant surgeons. We performed a national cross‐sectional survey of 218 transplant surgeons on sociodemographics, professional characteristics, frequency of difficult patient interactions and comfort in dealing with difficult patient interactions, decisional authority, psychological job demands, supervisor and coworker support, with burnout as the outcome. 40.1% reported high levels of emotional exhaustion, 17.1% reported high levels of depersonalization and 46.5% reported low personal accomplishment. Greater emotional exhaustion was predicted by lower decisional authority, higher psychological work demands, and lower coworker support. Greater discomfort with difficult patient interactions and lower coworker support predicted depersonalization. Lastly, lower decisional authority, lower coworker support, less frequent difficult patient interactions but greater discomfort with difficult patient interactions predicted lower personal accomplishment. The findings of this study show that unsupportive environments with little decisional control and high work‐related demands contribute to the development of burnout in transplant surgeons. Implications for interventions aimed at prevention of burnout in transplant surgeons are discussed.

Burnout in Transplant Nurses

Context— Burnout is a response to chronic strain within the workplace and is common across nursing professions. Little has been published about burnout in organ transplant nurses. Objective— To report the prevalence of the 3 main components of burnout (emotional exhaustion, depersonalization, and reduced personal accomplishment) in organ transplant nurses and to examine factors that contribute to the development of burnout in transplant nurses. Design— Cross-sectional survey of transplant nurses (recruited via listservs) on professional and personal demographics, decisional authority, psychological job demands, supervisor and coworker support, frequency and comfort with difficult patient interactions, and burnout. Participants— 369 transplant nurses. Results— About half reported high levels of emotional exhaustion, 15.7% reported high levels of depersonalization, and 51.8% reported low levels of personal accomplishment. Working more hours per week, lower decisional authority, greater psychological job demands, lower perceived supervisor support, and greater frequency and discomfort with difficult patient interactions were significant predictors of emotional exhaustion. Greater frequency and discomfort with difficult patient interactions were significant predictors of depersonalization. Younger age, lower decisional authority, and greater discomfort with difficult patient interactions were predictors of low personal accomplishment. Conclusions— The study provides strong evidence of the presence of burnout in transplant nurses and opportunities for focused and potentially very effective interventions aimed at reducing burnout.

Professional interpersonal dynamics and burnout in European transplant surgeons.

Burnout within the health professions has become an increasingly important topic. Evidence suggests there are differences in burnout across different countries. Research has yet to examine burnout in transplant surgeons throughout Europe.

Cost of Care for Subjective Tinnitus in Relation to Patient Satisfaction

Objective A consistent management algorithm for subjective tinnitus remains to be elucidated. Chronic tinnitus yields approximately US

Leadership Perspectives on Integrating Psychologists into Specialty Care Clinics: An Evolving Paradigm

2110 in annual health care costs per patient. However, it is unclear whether spending more in the management of tinnitus equates with greater patient satisfaction. Thus, the aim of this study is to correlate patient satisfaction with patient demographics, provider recommendations, and total health care–related expenditures. Study Design A retrospective chart review and a patient satisfaction questionnaire. Setting All data were collected from a large Midwestern hospital. Subjects and Methods Patients were included who presented to the tinnitus clinic during the year 2011 and were between the ages of 18 and 89 years. They were excluded with diagnoses of Ménière’s disease, pulsatile tinnitus, acoustic neuromas, or autoimmune inner ear diseases. The retrospective data and satisfaction surveys were entered by 3 of the authors. Responses were based on Likert scales. Results Of the 692 patients included, 230 completed and returned the satisfaction questionnaire (33.2% response rate), yielding an overall mean of

Report from the American Society of Transplantation Psychosocial Community of Practice Adherence Task Force: Real-world options for promoting adherence in adult recipients

662.60 charges. The frequency of intervention recommendations per patients ranged from 0 to 13, with a median of 4. Spearman’s correlations did not result in significant correlations between patient satisfaction and number of clinic visits (P = .499) or associated charges (P = .453). Conclusion Given that the variability among provider recommendations, the high overall mean of tinnitus-related charges, and patient satisfaction was not related to costs, further research is needed examining patient preference in the treatment of tinnitus.

Head and Neck Cancer Screenings in Suburban/Urban Populations in Michigan: Need for More Education

Integration of health psychologists into specialty care is a shift in the tertiary care construct that addresses all aspects of a patient’s presentation, including psychiatric/social history, psychological well-being, and behavioral contributions to the disease process, assuring both optimal health outcomes and cost-effectiveness in a financially challenging healthcare environment. In this paper, we discuss leadership perspectives (physician and psychologists) on the factors involved in integrating a health psychologist into a busy tertiary care environment. Ultimately, we hope that this information provides a primer on how to frame a proposal for an integrated health psychologist emphasizing the elements important to senior medical leadership and administration. First, we briefly discuss the current payer framework, providing support for integration emphasizing costs and other metrics. Second, we introduce organizational structure models and strategies for integration. Lastly, we will discuss the unique skillset psychologists possess, and additional skills necessary, to be effective in the changing landscape of healthcare. We think this information is important both for leaders attempting to integrate a health psychologist into specialty care and for the early career health psychologist embarking on his/her first senior staff position.

Head and neck cancer screenings and human papillomavirus knowledge across diverse suburban and urban populations

Starting in 2015, the American Society of Transplantation Psychosocial Community of Practice, with representatives of the Transplant Pharmacy Community of Practice, convened a taskforce to develop a white paper that focused on clinically practical, evidenced‐based interventions that transplant centers could implement to increase adherence to medication and behavioral recommendations in adult solid organ transplant recipients. The group focused on what centers could do in their daily routines to implement best practices to increase adherence in adult transplant recipients. We developed a list of strategies using available resources, clinically feasible methods of screening and tracking adherence, and activities that ultimately empower patients to improve their own self‐management. We limited the target population to adults because they predominate the research, and because adherence issues differ in pediatric patients, given the necessary involvement of parents/guardians. We also examined broader multilevel areas for intervention including provider and transplant program practices. Ultimately, the task force aims to foster greater recognition, discussion, and solutions required for implementing practical interventions targeted at improving adherence.

Transplant Surgeon Burnout and Marital Distress in the Sandwich Generation: The Call for Organizational Support in Family Life

Objectives: 1) Assess self-reported risk factors and knowledge gaps regarding head and neck cancer (HNC) risk factors in a multi-ethnic urban versus suburban population. 2) Improve education regarding behavioral risk factors for HNC, including regarding the transmission of human papillomavirus (HPV). Methods: The current sample includes a total of 118 individuals who presented for free HNC screenings across urban and suburban sites. Ninety-eight consented to complete behavioral risk questionnaires assessing for knowledge regarding HNC, ancestry, smoking/tobacco use, alcohol use, and sexual history. Results: Mean age was 56.63 years old (SD = 14.22, range 23 to 85), 60.2% female, predominantly African American (53.1%), Caucasian (42.7%), and other (4.1%). Those residing in an urban environment were more likely to be African American χ2(1, N = 98)=23.334, P < 0.001, have a history of treatment for some other cancer χ2(1, N=98)=6.063, P = 0.01, be a current smoker χ2(2, N=98)=5.885, P = 0.05, report more cumulative years consuming alcohol t(85)=2.050, P = 0.04, be willing to volunteer to promote awareness χ2(1, N=98)=4.866, P = 0.02, and feel the program increased their knowledge regarding HNC χ2(1, N=98)=4.726, P = 0.03, than those in a suburban environment. Conclusions: Free HNC screenings and related education are well received by a racially diverse urban population. HNC screenings should include evaluation of behavioral risk and specific knowledge associated with HNC.