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

Self-Compassion Explains Less Burnout Among Healthcare Professionals.

Objectives: Healthcare professionals are prone to experience burnout-a psychological syndrome resulting from chronic stressors at work. Some individual differences, like self-compassion-the non-judgmental observation of one's own pain and failure, while understanding that these are part of being human-can protect against burnout. Methods: We administered the Maslach Burnout Inventory, the Self-Compassion Scale, and the Stressful Life Events Scale to a sample of healthcare professionals (medical residents, nurses, and physicians) in Lebanon (N = 93). Results: The sample demonstrated a high degree of Emotional Exhaustion (M = 27, SD = 11.79), average levels of Depersonalization (M = 9.46, SD = 6.35), and Personal Accomplishment (M = 34.95, SD = 6.58), and moderate levels of Self-compassion (M = 3.25). All burnout components were significantly and inversely associated with self-compassion, …

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Factors Associated with Burnout Among Physicians: An Evaluation During a Period of COVID-19 Pandemic.

Purpose: The aim of the study is to evaluate the prevalence and extent of burnout among physicians and investigate the factors related with burnout and the influence of the fight against coronavirus (COVID-19) on the burnout syndrome. Methods: A cross-sectional survey design was adopted and conducted on 200 actively working physicians in Izmir/Turkey. Personal Information Form and Maslach Burnout Inventory were used in the survey. Results: The findings showed that the emotional exhaustion level of the physicians was medium, the levels of depersonalization and personal accomplishment were low, and the level of total burnout was low. It was observed that the burnout levels of males and females, and married and single physicians were similar. The emotional exhaustion level of 18-23-year-old physicians was lower than the rest of the physicians. Physicians' level of satisfaction with their in…

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Provider Burnout and Fatigue During the COVID-19 Pandemic: Lessons Learned From a High-Volume Intensive Care Unit

The novel coronavirus disease 2019 (COVID-19) pandemic has resulted in an overall surge in new cases of depression and anxiety and an exacerbation of existing mental health issues, with a particular emotional and physical toll on health care workers.1 Limited resources, longer shifts, disruptions to sleep and to work-life balance, and occupational hazards associated with exposure to COVID-19 have contributed to physical and mental fatigue, stress and anxiety, and burnout.2 Similar to most hospitals in the COVID-19–affected areas, the Houston Methodist Hospital (HMH) system has experienced an overwhelming impact of this pandemic on personnel. For example, we have observed an unprecedented number of staff requesting Americans with Disabilities Act exemptions. Physicians and nurses are worried about their families, and some hesitate to go home in fear of exposing family members to infection…

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Burnout and Resilience among Frontline Nurses during COVID-19 Pandemic: A Cross-sectional Study in the Emergency Department of a Tertiary Care Center, North India.

Background: The COVID-19 pandemic had a massive impact on healthcare systems, increasing the risks of psychological distress in health professionals. Burnout is a prolonged response to chronic emotional and interpersonal stressors on the job and is defined by the three dimensions of emotional exhaustion, cynicism, and personal inefficacy. Methodology: A cross-sectional descriptive design was used to assess the burnout and resilience among frontline nurses in the emergency department of a tertiary care center in North India during COVID-19 pandemic. The sample consisted of 120 frontline nurses working in the emergency department, selected by a simple random sampling method. Data were collected using the Maslach burnout inventory-general survey and the Connor-Davidson Resilience Scale. Results: The nurses in the emergency during pandemic experienced a moderate-to-severe level of burnout in…

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Effect of a Professional Coaching Intervention on the Well-being and Distress of Physicians: A Pilot Randomized Clinical Trial.

Importance: Burnout symptoms among physicians are common and have potentially serious ramifications for physicians and their patients. Randomized studies testing interventions to address burnout have been uncommon. Objective: To explore the effect of individualized coaching on the well-being of physicians. Design, setting, and participants: A pilot randomized clinical trial involving 88 practicing physicians in the departments of medicine, family medicine, and pediatrics who volunteered for coaching was conducted between October 9, 2017, and March 27, 2018, at Mayo Clinic sites in Arizona, Florida, Minnesota, and Wisconsin. Statistical analysis was conducted from August 24, 2018, to March 25, 2019. Interventions: A total of 6 coaching sessions facilitated by a professional coach. Main outcomes and measures: Burnout, quality of life, resilience, job satisfaction, engagement, and meaning a…

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Clinicians' Perspectives on Providing Emergency-Only Hemodialysis to Undocumented Immigrants: A Qualitative Study.

Background: In the United States, nearly half of undocumented immigrants with end-stage kidney disease receive hemodialysis only when they are evaluated in an emergency department and are found to have life-threatening renal failure ("emergency-only hemodialysis" [EOHD]). These patients experience psychosocial distress and much higher mortality than patients receiving regularly scheduled hemodialysis, but little is known about how providing EOHD affects the clinicians involved. Objective: To understand clinicians' experiences providing EOHD. Design: Qualitative study using semistructured interviews. Setting: A safety-net hospital in Denver, Colorado, and a safety-net system in Houston, Texas. Participants: Fifty interdisciplinary clinicians experienced in providing EOHD. Measurements: Interviews were analyzed using thematic analysis. Outcomes included themes and subthemes. Results: Four …

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A Brief Mindfulness-Based Intervention for Primary Care Physicians: A Pilot Randomized Controlled Trial.

Primary care physicians experience high rates of burnout, which results in diminished quality of life, poorer quality of care, and workforce attrition. In this randomized controlled trial, our primary aim was to examine the impact of a brief mindfulness-based intervention (MBI) on burnout, stress, mindfulness, compassion, and resilience among physicians. A total of 33 physicians completed the baseline assessment and were randomized to the Mindful Medicine Curriculum (MMC; n = 17) or waitlist control group (n = 16). Participants completed self-report measures at baseline, post-MBI, and 3-month follow-up. We also analyzed satisfaction with doctor communication (DCC) and overall doctor rating (ODR) data from patients of the physicians in our sample. Participants in the MMC group reported significant improvements in stress (P < .001), mindfulness (P = .05), emotional exhaustion (P = .004), a…

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Expanding the Conversation on Burnout Through Conceptions of Role Strain and Role Conflict

The program director (PD) for internal medicine at a large tertiary care hospital has been following the research on resident burnout and wants to proactively identify and address this problem in her program. Through informal conversations, the PD has confirmed that burnout is affecting the residents in this program. The discussion also reveals that burnout has many sources and contributing factors—both personal (eg, marital strain and ailing children) and professional (eg, academic performance anxiety and interprofessional conflicts). Many residents struggled to articulate how these stressors combine to lay the foundation for burnout, explaining: “It's not that I can't manage each problem. I can be a supportive spouse. I'm pretty good with my patients. But, everything, all together, it's too much. I just can't be everything for everyone all the time.” The PD knows that addressing the bu…

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Effect of heartfulness meditation on burnout, emotional wellness, and telomere length in health care professionals.

Background: Burnout poses significant challenges during training years in residency and later in the career. Meditation is a tool to treat stress-related conditions and promote wellness. Telomere length may be affected by burnout and stress. However, the benefits of meditation have not been fully demonstrated in health care professionals. Objective: We assessed the effects of a 12-week 'Heartfulness Meditation' program on burnout, emotional wellness, and telomere length in residents, faculty members, and nurses at a large community teaching hospital during the 2015-16 academic year. Methods: All subjects completed a baseline Maslach Burnout Inventory (MBI) and Emotional Wellness Assessment (EWA) at the beginning of the study. Meditators received instructions in Heartfulness Meditation. At week 12, subjects completed a follow up MBI and EWA scores. Salivary telomere length was measured at…

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Teachers' Relationship Closeness with Students as a Resource for Teacher Wellbeing: A Response Surface Analytical Approach.

Teachers' relationship quality with students has been argued to be an important source of teacher wellbeing. Thus, the current study aimed to investigate to what extent teachers' relationship closeness toward students, combined with attachment security is a resource protecting against teacher burnout. Eighty-three elementary school teachers reported on their most and least attached student's relationship closeness, their attachment security and levels of burnout, as measured by emotional exhaustion, depersonalization and personal accomplishment. Response surface analysis (RSA), enabling researchers to investigate the effect of congruence/incongruence of two predictors on an outcome, revealed that teachers' depersonalization and emotional exhaustion were lowest when they developed homogenous close relationships toward the students within their classroom and when teachers in general made c…

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Mindfulness, perceived stress, and subjective well-being: a correlational study in primary care health professionals

BACKGROUND: Primary health care professionals (PHPs) usually report high levels of distress and burnout symptoms related to job strain. Mindfulness, defined as non-judgmental-present-moment awareness, seems to be a moderator in the causal association between life stressors and well-being. This study aimed to verify correlations among self-reported mindfulness, perceived stress (PS), and subjective well-being (SW) in Brazilian PHPs. METHODS: We performed a correlational cross-sectional study in a purposive sample of Brazilian PHPs (physicians, nurses, nursing assistants, and community health workers), working in community-oriented primary care programs (known locally as "Family Health Programs"). We used validated self-reporting instruments: the Mindful Attention Awareness Scale (MAAS), the Perceived Stress Scale (PSS), and the Subjective Well-being Scale (SWS). We performed a multivariat…

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Development and preliminary evaluation of communication skills training program for oncologists based on patient preferences for communicating bad news.

Objective: The purposes of this study were to develop a communication skills training (CST) workshop program based on patient preferences, and to evaluate preliminary feasibility of the CST program on the objective performances of physicians and the subjective ratings of their confidence about the communication with patients at the pre- and post-CST. Methods: The CST program was developed, based on the previous surveys on patient preferences (setting up the supporting environment of the interview, making consideration for how to deliver bad news, discussing about additional information, and provision of reassurance and emotional support) and addressing the patient's emotion with empathic responses, and stressing the oncologists' emotional support. The program was participants' centered approach, consisted a didactic lecture, role plays with simulated patients, discussions and an ice-brea…

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A social neuroscience perspective on clinical empathy

Clinical empathy is an important element of quality health care. Empathic communication is associated with improved patient satisfaction, increased adherence to treatment, and fewer malpractice complaints 1. Patients' perceptions of their physicians' empathy are positively related to more favorable health outcomes 2-4. In addition to improving patient outcomes, clinical empathy is associated with increased overall well-being for the physician 5. High levels of practitioner empathy have been associated with decreased burnout, personal distress, depression and anxiety, along with increased life satisfaction and psychological well-being 6, 7. Despite increasing appreciation of the value of empathy, medical educators continue to struggle with how best to educate students and residents on empathy maintenance. There have been several promising creative approaches that have shown demonstrable s…

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Feasibility of a personal health technology-based psychological intervention for men with stress and mood problems: randomized controlled pilot trial.

Background: Work-related stress is a significant problem for both people and organizations. It may lead to mental illnesses such as anxiety and depression, resulting in increased work absences and disabilities. Scalable interventions to prevent and manage harmful stress can be delivered with the help of technology tools to support self-observations and skills training. Objective: The aim of this study was to assess the feasibility of the P4Well intervention in treatment of stress-related psychological problems. P4Well is a novel intervention which combines modern psychotherapy (the cognitive behavioral therapy and the acceptance and commitment therapy) with personal health technologies to deliver the intervention via multiple channels, includinggroup meetings, Internet/Web portal, mobile phone applications, and personal monitoring devices. Methods: This pilot study design was a small-sca…

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Suffering among carers working in critical care can be reduced by an intensive communication strategy on end-of-life practices.

Purpose: Burnout syndrome (BOS) has frequently been reported in healthcare workers, and precipitating factors include communication problems in the workplace and stress related to end-of-life situations. We evaluated the effect of an intensive communication strategy on BOS among caregivers working in intensive care (ICU). Methods: Longitudinal, monocentric, before-and-after, interventional study. BOS was evaluated using the Maslach Burnout Inventory (MBI) and depression using the Centre for Epidemiologic Studies Depression Scale (CES-D) in 2007 (period 1) and 2009 (period 2). Between periods, an intensive communication strategy on end-of-life practices was implemented, based on improved organisation, better communication, and regular staff meetings. Results: Among 62 caregivers in the ICU, 53 (85%) responded to both questionnaires in period 1 and 49 (79%) in period 2. We observed a signi…

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A Mindfulness Course Decreases Burnout and Improves Well-Being among Healthcare Providers

OBJECTIVE: Healthcare providers are under increasing stress and work-related burnout has become common. Mindfulness-based interventions have a potential role in decreasing stress and burnout. The purpose of this study was to determine if a continuing education course based on mindfulness-based stress reduction could decrease burnout and improve mental well-being among healthcare providers, from different professions. DESIGN: This was a pre-post observational study conducted in a university medical center. A total of 93 healthcare providers, including physicians from multiple specialties, nurses, psychologists, and social workers who practiced in both university and community settings, participated. The intervention was a continuing education course based on mindfulness-based stress reduction that met 2.5 hours a week for 8 weeks plus a 7-hour retreat. The classes included training in fou…

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Not all coping strategies are created equal: a mixed methods study exploring physicians' self reported coping strategies.

Background: Physicians experience workplace stress and draw on different coping strategies. The primary goal of this paper is to use interview data to explore physicians' self reported coping strategies. In addition, questionnaire data is utilized to explore the degree to which the coping strategies are used and are associated with feelings of emotional exhaustion, a key symptom of burnout. Methods: This mixed methods study explores factors related to physician wellness within a large health region in Western Canada. This paper focuses on the coping strategies that physicians use in response to work-related stress. The qualitative component explores physicians' self reported coping strategies through open ended interviews of 42 physicians representing diverse medical specialties and settings (91% response rate). The major themes extracted from the qualitative interviews were used to cons…

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Psychosocial stress at work doubles the risk of type 2 diabetes in middle-aged women: evidence from the Whitehall II study.

Objective: To investigate the effect of psychosocial stress at work on risk of type 2 diabetes, adjusting for conventional risk factors, among a sample of British, white-collar, middle-aged men and women. Research design and methods: This was a prospective analysis (1991-2004) from the Whitehall II cohort study. The current sample consists of 5,895 Caucasian middle-aged civil servants free from diabetes at baseline. Type 2 diabetes was ascertained by an oral glucose tolerance test supplemented by self-reports at baseline and four consecutive waves of data collection including two screening phases. The job strain and iso-strain models were used to assess psychosocial work stress. Results: Iso-strain in the workplace was associated with a twofold higher risk of type 2 diabetes in age-adjusted analysis in women but not in men (hazard ratio 1.94 [95% CI 1.17-3.21). This effect remained robus…

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The impact of work environment on mood disorders and suicide: Evidence and implications.

The purpose of this paper is to review the evidence estimating an impact of occupational factors on mood disorders and suicide, and the efficacy of interventions. This review is based on literature searches using Medline and Psych INFO from 1966 to 2007 (keywords: work stress, job insecurity, job strain, shift work, violence, occupational health, mood disorders, depression, and suicide). To establish the relationship between occupational variables and mood disorders, we focused on clinically significant disorders rather than depressive symptoms. During the last decade, prospective epidemiological studies have suggested a predictive association between the work environment and mood disorders. Recently, increasing numbers of clinical trials have shown favorable effect size of intervention and suggested preferable return-on-investment results. However, low awareness and social stigma still …

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Unpacking Profiles of School Burnout in High-Achieving Students in Türkiye: A MSEM Analysis.

Although high-achieving students are often perceived as well-adjusted, there is limited understanding of the varied ways they experience school burnout. Prior research tends to treat burnout as a uniform phenomenon, overlooking subgroups that may differ in psychological risk and academic outcomes. This study addresses this gap by identifying distinct profiles of school burnout and examining their psychological and academic correlates in high-achieving adolescents, defined by their mean grade of 85 or above out of 100 and placement in the top 2%, which earned them admission to science high schools based on their performance on Türkiye's High School Entrance Exam (LGS). Participants included 443 students (225 females, 50.8%) aged 14 to 19 years (M = 15.9, SD = 1.11). Given the broad age range spanning early to late adolescence, developmental variability in academic expectations and emotion…

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Modeling the relationships between growth language mindset, L2 grit, and foreign language learning burnout.

While the existing literature acknowledges the existence of foreign language learning burnout (FLLB) and its deleterious effect on English as a foreign language (EFL) learners, the protective factors that may alleviate FLLB in EFL contexts remain largely unexplored. The current study addresses this gap by examining the impact of learners' growth language mindset (GLM) on FLLB by employing the structural equation modeling (SEM). Furthermore, the mediating role of L2 grit in the relationship between GLM and FLLB was scrutinized. To achieve these objectives, 840 Chinese EFL learners were recruited to complete questionnaires encompassing scales assessing GLM, L2 grit, and FLLB. The results unveiled that learners' GLM and L2 grit were significantly and negatively associated with FLLB. The SEM analysis indicated that GLM exerted a negative predictive effect on EFL learners' FLLB. Additionally,…

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The Healing Healthcare Initiative: Guiding leaders to heal a traumatized workforce.

The COVID-19 pandemic amplified burnout and moral distress among healthcare professionals and accentuated the systemic gaps and limitations of current approaches to workforce well-being. The Schwartz Center for Compassionate Healthcare launched the Healing Healthcare Initiative (HHI) in response to these compounded challenges. Aligned with national recommendations, the HHI framework comprises six key principles and eight implementation domains that foster compassionate and trauma-informed organizational cultures. C-suite level executive teams from six diverse healthcare organizations were selected to participate in the year-long pilot. Organizational and executive team surveys identified siloed well-being efforts and gaps in knowledge and awareness that undermine meaningful progress. The HHI pilot offers executive teams a space for reflection and open conversations, fostering trust withi…

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mHealth Gratitude Exercise Mindfulness App for Resiliency Among Neonatal Intensive Care Unit Staff: Three-Arm Pretest-Posttest Interventional Study.

Background: Health care is highly complex and can be both emotionally and physically challenging. This can lead health care workers to develop compassion fatigue and burnout (BO), which can negatively affect their well-being and patient care. Higher levels of resilience can potentially prevent compassion fatigue and BO. Strategies that enhance resilience include gratitude, exercise, and mindfulness. Objective: The purpose of this study was to determine if a 3-week daily resiliency practice, prompted via a gratitude, exercise, and mindfulness smartphone app, impacted the professional quality of life, physical activity, and happiness level of health care workers in a newborn intensive care unit setting. Methods: In total, 65 participants from a level III newborn intensive care unit at a regional hospital in the western United States completed this study. The Professional Quality of Life Sc…

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Prevalence of Moral Injury, Burnout, Anxiety, and Depression in Healthcare Workers 2 Years in to the COVID-19 Pandemic.

COVID-19 has led to marked increases in healthcare worker distress. Studies of these phenomena are often limited to a particular element of distress or a specific subset of healthcare workers. We administered the Moral Injury Symptom Scale for Healthcare Professionals, Copenhagen Burnout Inventory, Patient Health Questionnaire-9, and Generalized Anxiety Disorder-7 via online survey to 17,000 employees of a large academic medical center between December 2021 and February 2022. A total of 1945 participants completed the survey. Across all roles, the prevalence of moral injury, burnout, depression, and anxiety were 40.9%, 35.3%-60.6%, 25.4%, and 24.8%, respectively. Furthermore, 8.1% had been bothered by thoughts that they would be better off dead or of hurting themselves for "several days" or more frequently. Healthcare workers across all roles and practice settings are experiencing unsust…

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Gender Differences in Physician Burnout: Driving Factors and Potential Solutions.

Introduction Burnout among physicians has reached an epidemic level, with substantially higher rates among women. In this brief report, the authors evaluate recent literature to identify major factors leading to gender differences in physician burnout. Methods The authors review data on gender within each of the key drivers of burnout, including workload and job demands, efficiency and resources, control and flexibility, organizational culture and values, social support and community at work, work-life integration, and meaning at work. Results Women physicians face a higher workload, spending more time in electronic health records, and more time per patient. Women physicians also receive fewer resources and report less control over their workload and schedules. Organizational culture factors, such as a lack of women in leadership roles, compensation disparities, lower rates of career adv…

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