Work stress and burnout

قَالَتۡ إِحۡدَىٰهُمَا يَٰٓأَبَتِ ٱسۡتَـٔۡجِرۡهُۖ إِنَّ خَيۡرَ مَنِ ٱسۡتَـٔۡجَرۡتَ ٱلۡقَوِيُّ ٱلۡأَمِينُ

One of the women said, ‘Father, hire him: a strong, trustworthy man is the best to hire.’

إِنَّمَا جَزَٰٓؤُاْ ٱلَّذِينَ يُحَارِبُونَ ٱللَّهَ وَرَسُولَهُۥ وَيَسۡعَوۡنَ فِي ٱلۡأَرۡضِ فَسَادًا أَن يُقَتَّلُوٓاْ أَوۡ يُصَلَّبُوٓاْ أَوۡ تُقَطَّعَ أَيۡدِيهِمۡ وَأَرۡجُلُهُم مِّنۡ خِلَٰفٍ أَوۡ يُنفَوۡاْ مِنَ ٱلۡأَرۡضِۚ ذَٰلِكَ لَهُمۡ خِزۡيࣱ فِي ٱلدُّنۡيَاۖ وَلَهُمۡ فِي ٱلۡأٓخِرَةِ عَذَابٌ عَظِيمٌ

Those who wage war against God and His Messenger and strive to spread corruption in the land should be punished by death, crucifixion, the amputation of an alternate hand and foot, or banishment from the land: a disgrace for them in this world, and then a terrible punishment in the Hereafter

أَمۡ كُنتُمۡ شُهَدَآءَ إِذۡ حَضَرَ يَعۡقُوبَ ٱلۡمَوۡتُ إِذۡ قَالَ لِبَنِيهِ مَا تَعۡبُدُونَ مِنۢ بَعۡدِيۖ قَالُواْ نَعۡبُدُ إِلَٰهَكَ وَإِلَٰهَ ءَابَآئِكَ إِبۡرَٰهِـۧمَ وَإِسۡمَٰعِيلَ وَإِسۡحَٰقَ إِلَٰهࣰ ا وَٰحِدࣰ ا وَنَحۡنُ لَهُۥ مُسۡلِمُونَ

Were you [Jews] there to see when death came upon Jacob? When he said to his sons, ‘What will you worship after I am gone?’ they replied, ‘We shall worship your God and the God of your fathers, Abraham, Ishmael, and Isaac, one single God: we devote ourselves to Him.’

يَٰٓأَيُّهَا ٱلَّذِينَ ءَامَنُواْ كُلُواْ مِن طَيِّبَٰتِ مَا رَزَقۡنَٰكُمۡ وَٱشۡكُرُواْ لِلَّهِ إِن كُنتُمۡ إِيَّاهُ تَعۡبُدُونَ

You who believe, eat the good things We have provided for you and be grateful to God, if it is Him that you worship

وَإِذۡ أَخَذۡنَا مِيثَٰقَ بَنِيٓ إِسۡرَٰٓءِيلَ لَا تَعۡبُدُونَ إِلَّا ٱللَّهَ وَبِٱلۡوَٰلِدَيۡنِ إِحۡسَانࣰ ا وَذِي ٱلۡقُرۡبَىٰ وَٱلۡيَتَٰمَىٰ وَٱلۡمَسَٰكِينِ وَقُولُواْ لِلنَّاسِ حُسۡنࣰ ا وَأَقِيمُواْ ٱلصَّلَوٰةَ وَءَاتُواْ ٱلزَّكَوٰةَ ثُمَّ تَوَلَّيۡتُمۡ إِلَّا قَلِيلࣰ ا مِّنكُمۡ وَأَنتُم مُّعۡرِضُونَ

Remember when We took a pledge from the Children of Israel: ‘Worship none but God; be good to your parents and kinsfolk, to orphans and the poor; speak good words to all people; keep up the prayer and pay the prescribed alms.’ Then all but a few of you turned away and paid no heed

قُلۡ أَتَعۡبُدُونَ مِن دُونِ ٱللَّهِ مَا لَا يَمۡلِكُ لَكُمۡ ضَرࣰّ ا وَلَا نَفۡعࣰ اۚ وَٱللَّهُ هُوَ ٱلسَّمِيعُ ٱلۡعَلِيمُ

Say, ‘How can you worship something other than God, that has no power to do you harm or good? God alone is the All Hearing and All Knowing.’

(The only reward of those who make war upon Allah and His messenger�) [5:33]. Abu Nasr Ahmad ibn �Ubayd Allah al-Makhladi informed us> Abu �Amr ibn Nujayd> Muslim> �Abd al-Rahman ibn Hammad> Sa�id ibn Abi �Arubah> Qatadah> Anas who related that a group of people from �Ukal and �Uraynah went to see the Messenger of Allah, Allah, bless him and give him peace. They said: �O Messenger of Allah, we were never people of agriculture, and before we settled around Medina we used to be people who looked after cattle�. The Messenger of Allah, Allah bless him and give him peace, ordered that they be given a flock of camels, a shepherd and commanded them to set off with them, with a dispensation to drink their milk and urine. When they reached the region of al-Harrah, they killed the shepherd of the Messenger of Allah, Allah bless him and give him peace, and took off with the camels. The Messenger of

(Or were ye present when death came to Jacob�) [2:133]. This was revealed about the Jews when they said: �Do you not know that when Jacob was about to die he advised his sons to follow Judaism?�

One of the two women the one that had been sent by her father either the elder or the younger said ‘O my father hire him employ him in return for a wage that he may tend our flock instead of us. Surely the best man you can hire is the strong the trustworthy man’ in other words hire him on account of his strength and trustworthiness. He Shu‘ayb asked her about him and she told him as mentioned above how he had lifted the rock off the well and that he had said to her ‘Walk behind me’ in addition to his lowering his head when he realised that she was coming towards him refusing to lift it until she left. He Shu‘ayb therefore was keen to have him marry one of his daughters.

The following was revealed when the ‘Arniyyūn came to Medina suffering from some illness and the Prophet s gave them permission to go and drink from the camels’ urine and milk. Once they felt well they slew the Prophet’s shepherd and stole the herd of camels Truly the only requital of those who fight against God and His Messenger by fighting against Muslims and hasten about the earth to do corruption there by waylaying is that they shall be slaughtered or crucified or have their hands and feet cut off on opposite sides that is their right hands and left feet or be banished from the land the aw ‘or’ is used to indicate the separate application of each of the cases listed; thus death is for those that have only killed; crucifixion is for those that have killed and stolen property; the cutting off of limbs on opposite sides is for those that have stolen property but have not killed; while b

Then there came to him one of them, walking shyly. She said: "Verily, my father calls you that he may reward you for having watered (our flocks) for us." So when he came to him and narrated the story, he said: "Fear you not. You have escaped from the people who are wrongdoers. (25)And said one of them (the two women): "O my father! Hire him! Verily, the best of men for you to hire is the strong, the trustworthy. (26)He said: "I intend to wed one of these two daughters of mine to you, on condition that you serve me for eight years; but if you complete ten years, it will be (a favor) from you. But I intend not to place you under a difficulty. If Allah wills, you will find me one of the righteous. (27)He (Musa) said: "That (is settled) between me and you: whichever of the two terms I fulfill, there will be no injustice to me, and Allah is Surety over what we say. (28) Musa, the Father of t

And mention when We made a covenant with the Children of Israel in the Torah where We said ‘You shall not worship a variant reading for lā ta‘budūna has third person plural lā ya‘budūn ‘they shall not worship’ any other than God lā ta‘budūna illā Llāha is a predicate denoting a prohibition; one may also read lā ta‘budū Worship you not; and to be good and righteous to parents and the near of kin here kinship is adjoined to parents; and to orphans and to the needy; and speak well good words to men commanding good and forbidding evil being truthful with regard to the status of Muhammad (s) and being kind to them sc. orphans and the needy a variant reading for hasanan has husnan the verbal noun used as a hyperbolic description; and observe prayer and pay the alms’ which you actually accepted but then you turned away refusing to fulfil these obligations here the second person address is used

حَدَّثَنَا يَحْيَى بْنُ بُكَيْرٍ، حَدَّثَنَا اللَّيْثُ، عَنْ عُقَيْلٍ، قَالَ ابْنُ شِهَابٍ فَأَخْبَرَنِي عُرْوَةُ بْنُ الزُّبَيْرِ، أَنَّ عَائِشَةَ ـ رضى الله عنها ـ زَوْجَ النَّبِيِّ صلى الله عليه وسلم قَالَتْ وَاسْتَأْجَرَ رَسُولُ اللَّهِ صلى الله عليه وسلم وَأَبُو بَكْرٍ رَجُلاً مِنْ بَنِي الدِّيلِ، هَادِيًا خِرِّيتًا وَهْوَ عَلَى دِينِ كُفَّارِ قُرَيْشٍ، فَدَفَعَا إِلَيْهِ رَاحِلَتَيْهِمَا، وَوَاعَدَاهُ غَارَ ثَوْرٍ بَعْدَ ثَلاَثِ لَيَالٍ بِرَاحِلَتَيْهِمَا صُبْحَ ثَلاَثٍ‏.‏

Narrated Aisha:(the wife of the Prophet) Allah's Messenger (ﷺ) and Abu Bakr hired a man from the tribe of Bani-Ad-Dil as an expert guide who was a pagan (follower of the religion of the pagans of Quraish). The Prophet (ﷺ) and Abu Bakr gave him their two riding camels and took a promise from him to bring their riding camels in the morning of the third day to the Cave of Thaur

حَدَّثَنَا يَعْقُوبُ بْنُ إِبْرَاهِيمَ، حَدَّثَنَا إِسْمَاعِيلُ ابْنُ عُلَيَّةَ، أَخْبَرَنَا ابْنُ جُرَيْجٍ، قَالَ أَخْبَرَنِي عَطَاءٌ، عَنْ صَفْوَانَ بْنِ يَعْلَى، عَنْ يَعْلَى بْنِ أُمَيَّةَ ـ رضى الله عنه ـ قَالَ غَزَوْتُ مَعَ النَّبِيِّ صلى الله عليه وسلم جَيْشَ الْعُسْرَةِ فَكَانَ مِنْ أَوْثَقِ أَعْمَالِي فِي نَفْسِي، فَكَانَ لِي أَجِيرٌ، فَقَاتَلَ إِنْسَانًا، فَعَضَّ أَحَدُهُمَا إِصْبَعَ صَاحِبِهِ، فَانْتَزَعَ إِصْبَعَهُ، فَأَنْدَرَ ثَنِيَّتَهُ فَسَقَطَتْ، فَانْطَلَقَ إِلَى النَّبِيِّ صلى الله عليه وسلم فَأَهْدَرَ ثَنِيَّتَهُ وَقَالَ ‏ "‏ أَفَيَدَعُ إِصْبَعَهُ فِي فِيكَ تَقْضَمُهَا ـ قَالَ أَحْسِبُهُ قَالَ ـ كَمَا يَقْضَمُ الْفَحْلُ ‏"‏‏.‏ قَالَ ابْنُ جُرَيْجٍ وَحَدَّثَنِي عَبْدُ اللَّهِ بْنُ أَبِي مُلَيْكَةَ، عَنْ جَدِّهِ، بِمِثْلِ هَذِهِ الصِّفَةِ أَنَّ رَجُلاً، عَضَّ يَدَ رَجُلٍ، فَأَنْدَرَ ثَنِيَّتَهُ، فَأَهْدَرَهَا أَبُو بَكْرٍ رضى الله عنه‏.‏

Narrated Ya`la bin Umaiya:I fought in Jaish-al-Usra (Ghazwa of Tabuk) along with the Prophet (ﷺ) and in my opinion that was the best of my deeds. Then I had an employee, who quarrel led with someone and one of the them bit and cut the other's finger and caused his own tooth to fall out. He then went to the Prophet (with a complaint) but the Prophet (ﷺ) canceled the suit and said to the complainant, "Did you expect him to let his finger in your mouth so that you might snap and cut it (as does a stallion camel)?" Narrated Ibn Juraij from `Abdullah bin Abu Mulaika from his grandfather a similar story: A man bit the hand of another man and caused his own tooth to fall out, but Abu Bakr judged that he had no right for compensation (for the broken tooth)

أَخْبَرَنَا أَحْمَدُ بْنُ سُلَيْمَانَ الرُّهَاوِيُّ، وَمُوسَى بْنُ عَبْدِ الرَّحْمَنِ، قَالاَ حَدَّثَنَا مُحَمَّدُ بْنُ بِشْرٍ، قَالَ حَدَّثَنَا سُفْيَانُ، عَنْ مُوسَى بْنِ عُقْبَةَ، عَنْ سَالِمِ بْنِ عَبْدِ اللَّهِ بْنِ عُمَرَ، عَنِ ابْنِ عُمَرَ، قَالَ كَانَتْ يَمِينٌ يَحْلِفُ عَلَيْهَا رَسُولُ اللَّهِ صلى الله عليه وسلم ‏ "‏ لاَ وَمُقَلِّبِ الْقُلُوبِ ‏"‏ ‏.‏

It was narrated that Ibn 'Umar said:"The oath by which the Messenger of Allah used to swear was: 'No, by the Controller of the hearts

أَخْبَرَنِي مُحَمَّدُ بْنُ يَحْيَى بْنِ عَبْدِ اللَّهِ، قَالَ حَدَّثَنَا مُحَمَّدُ بْنُ الصَّلْتِ أَبُو يَعْلَى، قَالَ حَدَّثَنَا عَبْدُ اللَّهِ بْنُ رَجَاءٍ، عَنْ عَبَّادِ بْنِ إِسْحَاقَ، عَنِ الزُّهْرِيِّ، عَنْ سَالِمٍ، عَنْ أَبِيهِ، قَالَ كَانَتْ يَمِينُ رَسُولِ اللَّهِ صلى الله عليه وسلم الَّتِي يَحْلِفُ بِهَا ‏ "‏ لاَ وَمُصَرِّفِ الْقُلُوبِ ‏"‏ ‏.‏

It was narrated from Salim that his father said:"The oath by which the Messenger of Allah used to swear was: 'No, by the Controller of the hearts

حَدَّثَنَا أَبُو بَكْرِ بْنُ أَبِي شَيْبَةَ، حَدَّثَنَا وَكِيعٌ، وَحُمَيْدُ بْنُ عَبْدِ الرَّحْمَنِ الرُّؤَاسِيُّ، عَنْ مُغِيرَةَ بْنِ زِيَادٍ، عَنْ عُبَادَةَ بْنِ نُسَىٍّ، عَنِ الأَسْوَدِ بْنِ ثَعْلَبَةَ، عَنْ عُبَادَةَ بْنِ الصَّامِتِ، قَالَ عَلَّمْتُ نَاسًا مِنْ أَهْلِ الصُّفَّةِ الْكِتَابَ وَالْقُرْآنَ فَأَهْدَى إِلَىَّ رَجُلٌ مِنْهُمْ قَوْسًا فَقُلْتُ لَيْسَتْ بِمَالٍ وَأَرْمِي عَنْهَا فِي سَبِيلِ اللَّهِ عَزَّ وَجَلَّ لآتِيَنَّ رَسُولَ اللَّهِ صلى الله عليه وسلم فَلأَسْأَلَنَّهُ فَأَتَيْتُهُ فَقُلْتُ يَا رَسُولَ اللَّهِ رَجُلٌ أَهْدَى إِلَىَّ قَوْسًا مِمَّنْ كُنْتُ أُعَلِّمُهُ الْكِتَابَ وَالْقُرْآنَ وَلَيْسَتْ بِمَالٍ وَأَرْمِي عَنْهَا فِي سَبِيلِ اللَّهِ ‏.‏ قَالَ ‏ "‏ إِنْ كُنْتَ تُحِبُّ أَنْ تُطَوَّقَ طَوْقًا مِنْ نَارٍ فَاقْبَلْهَا ‏"‏ ‏.‏

Narrated Ubaydah ibn as-Samit: I taught some persons of the people of Suffah writing and the Qur'an. A man of them presented to me a bow. I said: It cannot be reckoned property; may I shoot with it in Allah's path? I must come to the Apostle of of Allah (ﷺ) and ask him (about it). So I came to him and said : Messenger of Allah (ﷺ), one of those whom I have been teaching writing and the Qur'an has presented me a bow, and as it cannot be reckoned property, may I shoot with it in Allah's path? He said: If you want to have a necklace of fire on you, accept it

حَدَّثَنَا عَمْرُو بْنُ عُثْمَانَ، وَكَثِيرُ بْنُ عُبَيْدٍ، قَالاَ حَدَّثَنَا بَقِيَّةُ، حَدَّثَنِي بِشْرُ بْنُ عَبْدِ اللَّهِ بْنِ يَسَارٍ، قَالَ عَمْرٌو حَدَّثَنِي عُبَادَةُ بْنُ نُسَىٍّ، عَنْ جُنَادَةَ بْنِ أَبِي أُمَيَّةَ، عَنْ عُبَادَةَ بْنِ الصَّامِتِ، نَحْوَ هَذَا الْخَبَرِ - وَالأَوَّلُ أَتَمُّ - فَقُلْتُ مَا تَرَى فِيهَا يَا رَسُولَ اللَّهِ فَقَالَ ‏"‏ جَمْرَةٌ بَيْنَ كَتِفَيْكَ تَقَلَّدْتَهَا ‏"‏ ‏.‏ أَوْ ‏"‏ تَعَلَّقْتَهَا ‏"‏ ‏.‏

A similar tradition has also been transmitted by 'Ubadah b. al-Samit through a different chain of narrators, but the former tradition is more perfect. This version has:I said: What do you think about it, Messenger of Allah? He said: A live coal between your shoulders which you have put around your neck or hanged it

الخامس: المحترف: وهو محتاج إلى الكسب له أو لعياله، فليس له أن يستغرق الزمان في التعبد، بل يجتهد في الكسب مع دوام الذكر، فإذا حصل له ما يكفيه عاود الأوراد.

الثالثة الخوف من كثرة الحرج بسبب كثرة الأولاد والاحتراز من الحاجة إلى التعب في الكسب ودخول مداخل السوء وهذا أيضا غير منهي عنه فإن قلة الحرج معين على الدين نعم الكمال والفضل في التوكل والثقة بضمان الله حيث قال @QB@ وما من دابة في الأرض إلا على الله رزقها @QE@ ولا جرم فيه سقوط عن ذروة الكمال وترك الأفضل ولكن النظر إلى العواقب وحفظ المال وادخاره مع كونه مناقضا للتوكل لا نقول إنه منهي عنه

وخاصية التعبد الحب مع الخضوع والذل للمحبوب فمن أحب شيئا وخضع له فقد تعبد قلبه له بل التعبد آخر مراتب الحب ويقال له التتيم أيضا فان أول مراتبه العلاقة وسميت علاقة لتعلق الحب بالمحبوب قال الشاعر

قالوا لأنه أبعد الأشياء عن هواها وهو حقيقة التعبد

والأفضل في أيام عشر ذي الحجة الإكثار من التعبد لا سيما التكبير والتهليل والتحميد فهو أفضل من الجهاد غير المتعين

فعندهم أن العبادات شرعت أثمانا لما يناله العباد من الثواب والنعيم وأنها بمنزلة استيفاء أجرة الأجير

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Moral distress among acute mental health nurses: A systematic review.: Moral distress has been identified as an occupational hazard for clinicians caring for vulnerable populations. The aim of this systematic review was (i) to summarize the literature reporting on prevalence of, and factors related to, moral distress among nurses within acute mental health settings, and (ii) to examine the efficacy of interventions designed to address moral distress among nurses within this clinical setting. A comprehensive literature search was conducted in October 2022 utilizing

Can Schwartz Center Rounds support healthcare staff with emotional challenges at work, and how do they compare with other interventions aimed at providing similar support? A systematic review and scoping reviews.: Objectives: (i) To synthesise the evidence-base for Schwartz Center Rounds (Rounds) to assess any impact on healthcare staff and identify key features; (ii) to scope evidence for interventions with similar aims, and compare effectiveness and key features to Rounds. Design: Systematic review of Rounds literature; scoping reviews of comparator interventions (action learning sets; after action reviews; Balint groups; caregiver support programme; clinical supervision; critical incident stress debrie

Job satisfaction and burnout syndrome among intensive-care unit nurses: A systematic review and meta-analysis.: Introduction: The severe conditions often experienced in an intensive care unit, combined with poor working conditions, increase stress and therefore decrease job satisfaction. Sustained stress in the workplace leads to the development of burnout, a syndrome characterised by three dimensions: emotional exhaustion, depersonalisation and perceived lack of personal fulfilment. Objective: To analyse the relationship between burnout syndrome and job satisfaction among ICU personnel. Data sources: The

A small randomized pilot study of a workplace mindfulness-based intervention for surgical intensive care unit personnel: effects on salivary α-amylase levels.

Objective: To determine whether a workplace stress-reduction intervention decreases reactivity to stress among personnel exposed to a highly stressful occupational environment. Methods: Personnel from a surgical intensive care unit were randomized to a stress-reduction intervention or a waitlist control group. The 8-week group mindfulness-based intervention included mindfulness, gentle yoga, and music. Psychological and biological markers of stress were measured 1 week before and 1 week after the intervention. Results: Levels of salivary α-amylase, an index of sympathetic activation, were significantly decreased between the first and second assessments in the intervention group with no changes in the control group. There was a positive correlation between salivary α-amylase levels and burnout scores. Conclusions: These data suggest that this type of intervention could decrease not only r…

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Reflecting peer-support groups in the prevention of stress and burnout: randomized controlled trial.

Aim: This paper is a report of a study to test the effect of participating in a reflecting peer-support group on self-reported health, burnout and on perceived changes in work conditions. Background: Stress-related conditions are one of the most common causes for long-term sick-leave. There is limited evidence for the effectiveness of person-directed interventions aimed at reducing stress levels in healthcare workers. Prior research in the relationship between support and burnout show somewhat inconsistent results. Method: A randomized controlled trial with peer-support groups as the intervention was conducted with 660 healthcare workers scoring above the 75th percentile on the exhaustion dimension of the Oldenburg Burnout Inventory. One hundred and fifty-one (22.9%) agreed to participate. The intervention started in 2002 with 51 participants (96.1% were women), 80 of whom constituted th…

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The copenhagen psychosocial questionnaire II (COPSOQ II) in Spain--a tool for psychosocial risk assessment at the workplace.

Aims: To describe the second version of the Spanish Copenhagen Psychosocial Questionnaire and to present evidence of its validity and reliability. Methods: The original Danish long COPSOQ II questionnaire was adapted to the labor market, cultural, and linguistic setting of Spain and included in the 2010 Spanish Psychosocial Risks Survey. Analysis involved the assessment of psychometric characteristics and associations among psychosocial scales and health scales. Medium and short versions were derived from the long one. Results: The long questionnaire was configured with 24 dimensions (92 items); medium-length questionnaire with 20 dimensions (69 items); and short questionnaire with 14 dimensions (28 items). All scales showed acceptable reliability and concordance between versions. Most associations among psychosocial scales and Mental Health, Stress, and Burnout scales were in the expect…

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Comparing Effectiveness of HRV-Biofeedback and Mindfulness for Workplace Stress Reduction: A Randomized Controlled Trial.

Psychophysiological disorders due to work-related stress continue to be highly costly for health systems and approaches for cost-effective and easily accessible interventions are much needed. Both heart rate variability-biofeedback (HRV-Bfb) and mindfulness-based interventions (MBI) have been empirically shown to reduce stress. This study compares these two interventions in the work context to a wait-list-control-group (WLC). In this three-armed randomized controlled trial (RCT), 69 healthy adults employed in the same organization were randomized to participate in HRV-Bfb, MBI or the WLC. Participants were assessed for psychophysiological parameters of stress (stress perception, coping, HRV parameters and cortisol) and stress related symptoms (depressive symptoms, psychological wellbeing, mindfulness and self-compassion). Participants trained using either HRV-Bfb or MBI for 6 weeks on a …

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Moral injury and mental health outcomes in nurses: A systematic review.

Introduction: Moral injury involves the adverse psychological, biological, spiritual, behavioural, and social consequences of actions that violate moral values. It can lead to anxiety, depression, burnout, and post-traumatic stress disorder. Nurses, who often face ethical dilemmas, are particularly vulnerable. Despite its significance, the relationship between moral injury and mental health outcomes in nurses remains underexplored. Aim: This systematic review aimed to describe the associations among moral injury, anxiety, depression, and quality of life in nurses. Methods: The review was registered in PROSPERO (CRD42023438731) and was conducted following the PRISMA guidelines. A literature search was performed in December 2023 across PubMed, CINAHL, Scopus, and Web of Science. Peer-reviewed primary research involving nurses, published in English or Italian, without time restrictions, was…

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Moral injury and mental health among health-care workers during the COVID-19 pandemic: meta-analysis.

Background: During the COVID-19 pandemic, health-care workers (HCWs) may have been confronted with situations that may culminate in moral injury (MI). MI is the psychological distress that may result from perpetrating or witnessing actions that violate one's moral codes. Literature suggests that MI can be associated with mental health problems. Objective: We aimed to meta-analytically review the literature to investigate whether MI is associated with symptoms of posttraumatic stress disorder (PTSD), anxiety, depression, burnout, and suicidal ideation among active HCWs during the COVID-19 pandemic. Method: We searched eight databases for studies conducted after the onset of the COVID-19 pandemic up to 18 July 2023, and performed random-effects meta-analyses to examine the relationship between MI and various mental health outcomes. Results: We retrieved 33 studies from 13 countries, repres…

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Gender and intention to leave healthcare during the COVID-19 pandemic among U.S. healthcare workers: A cross sectional analysis of the HERO registry.

Importance: The COVID-19 pandemic stressed the healthcare field, resulting in a worker exodus at the onset and throughout the pandemic and straining healthcare systems. Female healthcare workers face unique challenges that may impact job satisfaction and retention. It is important to understand factors related to healthcare workers' intent to leave their current field. Objective: To test the hypothesis that female healthcare workers were more likely than male counterparts to report intention to leave. Design: Observational study of healthcare workers enrolled in the Healthcare Worker Exposure Response and Outcomes (HERO) registry. After baseline enrollment, two HERO 'hot topic' survey waves, in May 2021 and December 2021, ascertained intent to leave. Unique participants were included if they responded to at least one of these survey waves. Setting: HERO registry, a large national registr…

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Can mindfulness mitigate the energy-depleting process and increase job resources to prevent burnout? A study on the mindfulness trait in the school context.

Background: Past studies in the teaching context provided evidence of the role of mindfulness-based intervention in improving occupational wellbeing. This study aims to increase the extant knowledge by testing the mechanism that links teachers' mindfulness at work to occupational wellbeing. Rooted in the job demand-resource model, the mindfulness trait is conceptualized as a personal resource that has the ability to impact and interact with job demands and resources, specifically workload stress appraisal and perceived meaningfulness of work, in affecting teachers' burnout. Methods: A sample of primary, middle, and secondary school teachers (N = 605) completed a questionnaire that aimed to assess teachers' mindfulness trait and the measures of the quality of occupational life in the school context. Confirmatory factor analysis (CFA) was conducted to test the model fit indices; further an…

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Job stress and job satisfaction of physicians, radiographers, nurses and physicists working in radiotherapy: a multicenter analysis by the DEGRO Quality of Life Work Group.

Background: Ongoing changes in cancer care cause an increase in the complexity of cases which is characterized by modern treatment techniques and a higher demand for patient information about the underlying disease and therapeutic options. At the same time, the restructuring of health services and reduced funding have led to the downsizing of hospital care services. These trends strongly influence the workplace environment and are a potential source of stress and burnout among professionals working in radiotherapy. Methods and patients: A postal survey was sent to members of the workgroup "Quality of Life" which is part of DEGRO (German Society for Radiooncology). Thus far, 11 departments have answered the survey. 406 (76.1%) out of 534 cancer care workers (23% physicians, 35% radiographers, 31% nurses, 11% physicists) from 8 university hospitals and 3 general hospitals completed the FBA…

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Stress, burnout and depression: A systematic review on DNA methylation mechanisms.

Despite that burnout presents a serious burden for modern society, there are no diagnostic criteria. Additional difficulty is the differential diagnosis with depression. Consequently, there is a need to dispose of a burnout biomarker. Epigenetic studies suggest that DNA methylation is a possible mediator linking individual response to stress and psychopathology and could be considered as a potential biomarker of stress-related mental disorders. Thus, the aim of this review is to provide an overview of DNA methylation mechanisms in stress, burnout and depression. In addition to state-of-the-art overview, the goal of this review is to provide a scientific base for burnout biomarker research. We performed a systematic literature search and identified 25 pertinent articles. Among these, 15 focused on depression, 7 on chronic stress and only 3 on work stress/burnout. Three epigenome-wide stud…

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How does burnout affect physician productivity? A systematic literature review.

Background: Interest in the well-being of physicians has increased because of their contributions to the healthcare system quality. There is growing recognition that physicians are exposed to workplace factors that increase the risk of work stress. Long-term exposure to high work stress can result in burnout. Reports from around the world suggest that about one-third to one-half of physicians experience burnout. Understanding the outcomes associated with burnout is critical to understanding its affects on the healthcare system. Productivity outcomes are among those that could have the most immediate effects on the healthcare system. This systematic literature review is one of the first to explore the evidence for the types of physician productivity outcomes associated with physician burnout. It answers the question, "How does burnout affect physician productivity?" Methods: A systematic …

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Reflections on the Emotional Hazards of Pediatric Oncology Nursing: Four Decades of Perspectives and Potential.

Theoretical principles: Pediatric oncology nurses are particularly vulnerable to emotional distress. Responsible for the oversight of a child's care, these nurses sustain close interactions with multiple patients and families over time, many of whom are coping with life-limiting diagnoses. The world of pediatric oncology nurses is one where tragedy is routinely witnessed thus demanding self-care and healing across a continuum. Phenomenon addressed: The aim of this article is to outline and review the emotional sequelae of pediatric oncology nurses' work and to suggest interventions to support well-being in light of prolonged caregiving. Three major categories that are addressed include the aspects of clinical practice that influence caregiving, the risks of burnout, compassion fatigue, moral distress and grief, and interventions to counteract these phenomena. Research linkages: Future-nu…

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Stress of working abroad: a systematic review.

Purpose: Many companies target international markets to expand their business. Companies need to manage international teams with a wide variety of skills, knowledge and values to run their business effectively; however, there are many issues of acculturation stress. Not only business travellers and expatriates, but also immigrant workers have issues adjusting to foreign culture. The aim of the present study is to identify the stress factors affecting foreign-born workers via a systematic review. Methods: The systematic review was conducted using PubMed, PsycINFO, Embase and Cochrane Library databases. Articles on the subject of workers living abroad, such as immigrants, expatriates and business travellers, were included. The risk of bias in the included articles was assessed using the Cochrane Collaboration's tool for assessing risk of bias for randomised controlled trials (RCTs), RoBANS…

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Impact of social support in preventing burnout syndrome in nurses: A systematic review.

Aim: Burnout is a reality in the nursing profession. It is composed of three dimensions: emotional exhaustion, depersonalization and reduced personal accomplishment, and results from being subjected to chronic stress in the healthcare context. Social support (SS), that is, the assistance and protection given by others, is a predictive and protective factor against burnout syndrome. The aim of this study is to analyze the relationship between SS, in its different forms, and burnout syndrome in nurses, and to identify the risk factors for burnout. Methods: A systematic literature review was carried out, following the PRISMA recommendations. The databases CINAHL, PsycINFO, Proquest Platform (Proquest Health & Medical Complete), Pubmed and Scopus were consulted, using the descriptors: "burnout, professional AND social support AND nursing". To minimize potential publication bias, the search h…

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Mindfulness on-the-go: Effects of a mindfulness meditation app on work stress and well-being.

We investigated whether a mindfulness meditation program delivered via a smartphone application could improve psychological well-being, reduce job strain, and reduce ambulatory blood pressure during the workday. Participants were 238 healthy employees from two large United Kingdom companies that were randomized to a mindfulness meditation practice app or a wait-list control condition. The app offered 45 prerecorded 10- to 20-min guided audio meditations. Participants were asked to complete one meditation per day. Psychosocial measures and blood pressure throughout one working day were measured at baseline and eight weeks later; a follow-up survey was also emailed to participants 16 weeks after the intervention start. Usage data showed that during the 8-week intervention period, participants randomized to the intervention completed an average of 17 meditation sessions (range 0-45 sessions…

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Mindfulness-Based Stress Reduction for Residents: A Randomized Controlled Trial.

Background: Burnout is highly prevalent in residents. No randomized controlled trials have been conducted measuring the effects of Mindfulness-Based Stress Reduction (MBSR) on burnout in residents. Objective: To determine the effectiveness of MBSR in reducing burnout in residents. Design: A randomized controlled trial comparing MBSR with a waitlist control group. Participants: Residents from all medical, surgical and primary care disciplines were eligible to participate. Participants were self-referred. Intervention: The MBSR consisted of eight weekly 2.5-h sessions and one 6-h silent day. Main measures: The primary outcome was the emotional exhaustion subscale of the Dutch version of the Maslach Burnout Inventory-Human Service Survey. Secondary outcomes included the depersonalization and reduced personal accomplishment subscales of burnout, worry, work-home interference, mindfulness ski…

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Workplace interventions to improve well-being and reduce burnout for nurses, physicians and allied healthcare professionals: a systematic review.

There is a growing need for interventions to improve well-being in healthcare workers, particularly since the onset of COVID-19. Objectives: To synthesise evidence since 2015 on the impact of interventions designed to address well-being and burnout in physicians, nurses and allied healthcare professionals. Design: Systematic literature review. Data sources: Medline, Embase, Emcare, CINAHL, PsycInfo and Google Scholar were searched in May-October 2022. Eligibility criteria for selecting studies: Studies that primarily investigated burnout and/or well-being and reported quantifiable preintervention and postintervention outcomes using validated well-being measures were included. Data extraction and synthesis: Full-text articles in English were independently screened and quality assessed by two researchers using the Medical Education Research Study Quality Instrument. Results were synthesise…

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Autonomic nervous system activity and workplace stressors--a systematic review.

Aim: This systematic review evaluates and summarizes the evidence of the association between psychosocial work environment as indicated by several work-stress models such as Job-Demand-Control (JDC), Effort-Reward-Imbalance (ERI), or Organizational Justice (OJ) and autonomic nervous system (ANS) function as indexed by heart rate variability (HRV). Method: We conducted a systematic literature search following the PRISMA-Statement in eleven databases including Medline, Web of Science and PsycINFO to address medical as well as psychological aspects of the relation between psychosocial work-stress models and HRV. Results: We identified 19 publications with a total of 8382 employees from ten countries reporting data from the years 1976-2008. Overall, nine of all studies report a negative and significant association between vagally-mediated HRV and measures of stress at work, while eight of al…

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Is Grit Associated with Burnout and Well-being in Orthopaedic Resident and Faculty Physicians? A Multi-institution Longitudinal Study Across Training Levels.

Background: Grit has been defined as "perseverance and passion for long-term goals" and is characterized by maintaining focus and motivation toward a challenging ambition despite setbacks. There are limited data on the impact of grit on burnout and psychologic well-being in orthopaedic surgery, as well as on which factors may be associated with these variables. Questions/purposes: (1) Is grit inversely correlated with burnout in orthopaedic resident and faculty physicians? (2) Is grit positively correlated with psychologic well-being in orthopaedic resident and faculty physicians? (3) Which demographic characteristics are associated with grit in orthopaedic resident and faculty physicians? (4) Which demographic characteristics are associated with burnout and psychologic well-being in orthopaedic resident and faculty physicians? Methods: This study was an institutional review board-approv…

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The effect of Emotional Freedom Techniques on nurses' stress, anxiety, and burnout levels during the COVID-19 pandemic: A randomized controlled trial.

Background and objective: Infectious disease outbreaks pose psychological challenges to the general population, and especially to healthcare workers. Nurses who work with COVID-19 patients are particularly vulnerable to emotions such as fear and anxiety, due to fatigue, discomfort, and helplessness related to their high intensity work. This study aims to investigate the efficacy of a brief online form of Emotional Freedom Techniques (EFT) in the prevention of stress, anxiety, and burnout in nurses involved in the treatment of COVID patients. Methods: The study is a randomized controlled trial. It complies with the guidelines prescribed by the Consolidated Standards of Reporting Trials (CONSORT) checklist. It was conducted in a COVID-19 department at a university hospital in Turkey. We recruited nurses who care for patients infected with COVID-19 and randomly allocated them into an interv…

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SARS/MERS/SARS-CoV-2 Outbreaks and Burnout Syndrome among Healthcare Workers. An Umbrella Systematic Review.

The coronavirus-19 (COVID-19) pandemic is putting a severe strain on all healthcare systems. Several occupational risk factors are challenging healthcare workers (HCWs) who are at high risk of mental health outcomes, including Burnout Syndrome (BOS). BOS is a psychological syndrome characterized by emotional exhaustion, depersonalization, and low personal accomplishment. An umbrella review of systematic reviews and meta-analyses concerning BOS and coronavirus (SARS/MERS/SARS-CoV-2) outbreaks was carried out on PubMed Central/Medline, Cochrane Library, PROSPERO, and Epistemonikos databases. Data relating to COVID-19 is insufficient, but in previous SARS and MERS outbreaks about one-third of HCWs manifested BOS. This prevalence rate is similar to the figure recorded in some categories of HCWs exposed to chronic occupational stress and poor work organization during non-epidemic periods. Ina…

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The effectiveness of mindfulness based programs in reducing stress experienced by nurses in adult hospital settings: a systematic review of quantitative evidence protocol.

Review question/objective: The objective of this review is to identify the effectiveness of mindfulness based programs in reducing stress experienced by nurses in adult hospitalized patient care settings. Background: Nursing professionals face extraordinary stressors in the medical environment. Many of these stressors have always been inherent to the profession: long work hours, dealing with pain, loss and emotional suffering, caring for dying patients and providing support to families. Recently nurses have been experiencing increased stress related to other factors such as staffing shortages, increasingly complex patients, corporate financial constraints and the increased need for knowledge of ever-changing technology. Stress affects high-level cognitive functions, specifically attention and memory, and this increases the already high stakes for nurses. Nurses are required to cope with …

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The psychological impact of COVID-19 on Chinese healthcare workers: a systematic review and meta-analysis.

Purpose: This study aimed at investigating five dimensions of the psychological impact (post-traumatic stress symptoms (PTSS), anxiety, depression, sleep disturbance or profession-related burnout) of COVID-19 on healthcare workers (HCW) in China. Methods: Studies that evaluated at least one of the five target dimensions of the psychological impact of COVID-19 on HCW in China were included. Studies with no data of our interest were excluded. Relevant Databases were searched from inception up to June 10, 2020. Preprint articles were also included. The methodological quality was assessed using the checklist recommended by AHRQ. Both the rate of prevalence and the severity of symptoms were pooled. The protocol was registered in PROSPERO (CRD42020197126) on July 09, 2020. Results: We included 44 studies with a total of 65,706 HCW participants. Pooled prevalence rates of moderate to severe PTS…

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Development and validation of the Short Professional Quality of Life Scale based on versions IV and V of the Professional Quality of Life Scale.

Background: This research presents a short version of the Professional Quality of Life (ProQOL) scale, one of the most frequently used questionnaires in the arena of applied healthcare investigation. It measures burnout (BO), compassion fatigue (CF), and compassion satisfaction (CS). Methods: A 9-item version of the ProQOL was developed. In Study 1, this short version, which used items from version IV of the ProQOL, was administered to 817 palliative care professionals from Spain, Argentina, and Brazil. In Study 2, the same nine items, but this time from version V of the ProQOL, were administered to 296 Spanish palliative care professionals. Results: Study 1: The Short ProQOL showed an adequate internal structure, and invariance across the countries studied (χ2(106) = 185.620 (p < 0.001), CFI = .929, RMSEA = 0.058 [0.044, 0.072], SRMR = 0.081). Argentinians showed higher levels of BO (me…

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Turnover intention among primary health workers in China: a systematic review and meta-analysis.

Objectives: To analyse the prevalence and determinants of turnover intention (TI) among primary health workers (PHWs) in China to provide evidence for improving retention measures. Design: Systemic review and meta-analysis. Data sources: Four English-language databases (PubMed, EMBASE, Cochrane Library, PsycINFO) and three Chinese databases (CNKI, CSPD, CBM) were searched up to October 2019. Eligibility criteria: Eligible studies were observational or descriptive studies conducted in mainland China. The prevalence of TI among health workers and related factors had to be explicitly reported in each included study. Data extraction and synthesis: Data were extracted by one author and reviewed independently by two other authors. For each factor analysed by a meta-analysis, the factor was required to be the same across different studies, and at least three studies had to include it. The quali…

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