Prevalence of occupational burnout in Swiss workers: a systematic review and meta-analysis

Introduction: Occupational burnout (OB) has been associated with job dissatisfaction, lower productivity, intentions to leave the job, increased turnover and health-care costs, as well as other socioeconomic issues. Despite such negative consequences, the prevalence of burnout among Swiss workers remains unknown. Material and Methods: We interrogated international databases such as Medline (Pubmed), EMBASE, and PsycINFO, and 15 Swiss universities’ databases from 2010 up to July 6, 2021 to identify studies reporting the prevalence of OB and/or emotional exhaustion (EE) - the core OB dimension- in Swiss workers. Data were summarized descriptively and quantitatively using random effects meta-analysis. Results: We identified 23 studies that used different outcome assessment methods: hetero-assessment by physicians and self-reported, using a specific question or one burnout inventory scale (frequently used: Maslach Burnout Inventory (MBI) and Copenhagen Burnout Inventory (CBI)). We estimated the prevalence of clinical/severe burnout, overall burnout and emotional exhaustion (EE)] at 4%, 18% and 18%, respectively, with considerable heterogeneity (I-square >90%, p< 0.00). Conclusions: Despite between-study heterogeneity, our overall estimate of OB in Swiss workers is high enough to reinforce the current efforts to detect it better and earlier and reduce its negative consequences at individual and societal levels

A qualitative study among (para-)medical and non-medical professionals in Switzerland

Background: There is still a gap of knowledge in the detection and treatment of occupational burnout because it is not recognized as a disease and there are no standard criteria for its detection. We conducted a qualitative study to: (1) identify the different types of professionals who intervene in occupational burnout detection, treatment, prevention or administrative management; (2) describe their respective roles, intervention levels and professional interactions; (3) describe the types of interventions and modalities available; and (4) conceptualize the main models of care currently in use in Switzerland. Methods: We conducted in-depth semi-structural interviews with Swiss (para-)medical and non-medical professionals that deal with occupational burnout. Data were analyzed following the grounded theory principles. Results: A total of 42 professionals were interviewed from different professional fields (e.g., physicians, nurses, psychologists, human resources, professionals working in insurance, politics, or private consulting) and from all regions of Switzerland. Three main care models for occupational burnout (Support, Extractor, and Systemic) were proposed, based on the categorization of the most cited intervention modalities used by the interviewed professionals. Conclusions: Based on the preliminary findings of this study, the need for collaboration between medical and non-medical professionals appeared to be the most important requirement to ensure the treatment of and recovery from occupational burnout. Keywords: Burnout; care; diagnosis; intervention; professional

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Who deals with occupational burnout? ::A qualitative study among (para-)medical and non-medical professionals in Switzerland

Background: There is still a gap of knowledge in the detection and treatment of occupational burnout because it is not recognized as a disease and there are no standard criteria for its detection. We conducted a qualitative study to: (1) identify the different types of professionals who intervene in occupational burnout detection, treatment, prevention or administrative management; (2) describe their respective roles, intervention levels and professional interactions; (3) describe the types of interventions and modalities available; and (4) conceptualize the main models of care currently in use in Switzerland. Methods: We conducted in-depth semi-structural interviews with Swiss (para-)medical and non-medical professionals that deal with occupational burnout. Data were analyzed following the grounded theory principles. Results: A total of 42 professionals were interviewed from different professional fields (e.g., physicians, nurses, psychologists, human resources, professionals working in insurance, politics, or private consulting) and from all regions of Switzerland. Three main care models for occupational burnout (Support, Extractor, and Systemic) were proposed, based on the categorization of the most cited intervention modalities used by the interviewed professionals.Conclusions: Based on the preliminary findings of this study, the need for collaboration between medical and non-medical professionals appeared to be the most important requirement to ensure the treatment of and recovery from occupational burnout

Prise en charge des personnes en burnout en Suisse : Résultats de l’étude épidémiologique auprès des professionnels de la santé

Le burnout est associé à des souffrances des employés, à une diminution de productivité et à des dépenses considérables au niveau social et sanitaire. Cependant, bien que le burnout soit fréquent en Suisse et dans plusieurs pays développés, il n’existe pas de consensus sur les critères de son diagnostic, sur son traitement et sur sa prévention. Afin d’améliorer la compréhension de ce phénomène, nous avons mené le projet « Standardisation du repérage de burnout par les professionnels de santé vaudois (STOBS-VD) ». Plus de trois milles professionnels de la santé ont répondu à notre enquête en ligne durant les mois de mai et juin 2021. Cela nous a permis d’estimer la prévalence du burnout dans la patientèle des professionnels de santé interrogés. L’enquête a aussi permis de préciser les principaux symptômes du burnout, de décrire les pratiques de son diagnostic et de traitement, mais également d’identifier des pistes pour améliorer la situation actuelle en terme de prise en charge du burnout. Les résultats ont révélé un manque de clarté sur la définition du burnout et de sa prise en charge chez les professionnels de santé intérrogés, ainsi qu’un manque de collaboration entre les acteurs principaux dans le domaine. La fréquence de prescription des antidépresseurs et d’autres médicaments psychotropes et de l’arrêt de travail suggèrent que le burnout est généralement détecté à un stade avancé, avec une forme clinique sévère. Des différences importantes en terme de prévalence et de pratiques de prise en charge ont été également révélées au niveau cantonal et régional. Une harmonisation des pratiques de traitement, la mise en place de mesures permettant une détection précoce du burnout, la pluridisciplinarité de la prise en charge, ainsi qu’un renforcement des interactions interdisciplinaires et une collaboration entre les professionnels de la santé et les employeurs sont proposées pour améliorer la situation. Il est également important de mieux comprendre les différences entre les cantons en terme de prévalence du burnout et de pratiques de prise en charge afin de promouvoir les pratiques de soin et de prévention les plus efficaces

Perioperative risk of bleeding with antithrombotic agents in macular surgery: a national, prospective, multicentre study

International audiencePurpose To compare the risk of haemorrhagic complications in elective macular surgery between patients with no antithrombotic (AT) treatment (defined as patients with no history of AT therapy or who discontinued AT therapy) and patients who continued AT treatment during the surgery. Methods E-case report forms were prospectively recorded in a database before vitreoretinal surgery and 1 month after. Data on patient characteristics, surgical techniques, haemorrhagic complications and antithrombotic status were collected. Patients with retinal detachment, proliferative diabetic retinopathy and previous retinal haemorrhage were excluded. Results A total of 748 procedures (single procedure in one eye per patient) were performed between January and May 2019. Among them, 202 patients (27.0%) were treated with antithrombotic therapy at the time of surgery: 19.5% with antiplatelet agents (n = 146), 6.3% with anticoagulants (n = 47) including 3.2% (n = 24) patients treated with novel oral anticoagulants, 0.8% (n = 6) with anticoagulants and antiplatelet agents, and 0.4% (n = 3) with heparin. Overall, 92 patients (12.3%) developed one or more haemorrhagic complications, of which 63 (11.5%) and 29 (14.4%) were in the non-AT and AT group, respectively. The multivariate logistic regression model showed no difference between AT treatment groups regarding ocular bleeding complications (odds ratio [OR] 1.2, 95% confidence interval (CI) [0.7-2.2], p = 0.54). Conclusion No cases of uncontrolled or severe perioperative haemorrhage in patients continuing antithrombotic agents were reported in this selected population. For the majority of the patients taking antiplatelets or anticoagulants, these agents could be safely continued during macular surgery

Qui diagnostique et traite le burnout professionnel en Suisse et comment ? ::Premiers résultats du projet STOBS-VD

Trois études complémentaires réalisées dans le cadre du projet STOBS-VD ont permis d’objectiver le phénomène du burnout en Suisse et de décrire les acteurs impliqués dans sa détection, sa prise en charge et sa prévention. Les chiffres de prévalence du burnout estimés à partir de l’enquête quantitative et à l’aide d’une métaanalyse interpellent par leur ampleur. L’étude qualitative et l’enquête quantitative portant sur un grand effectif de professionnels présentent les données inédites sur la définition des stades de développement et de sévérité du burnout, son diagnostic différentiel et sa prise en charge médicale, psychologique et sociale. Les données montrent que bien que le burnout ne soit pas reconnu comme diagnostic médical en Suisse, plusieurs types de professionnels médicaux et non-médicaux ont développé une expertise sur cette problématique ainsi que de nombreux services pour y répondre. Plus d’interactions interdisciplinaires entre ces professionnels, notamment avec des ergonomes et des psychologues du travail, favoriseraient un environnement de travail sain et la prévention du burnout