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

Harmonized definition of occupational burnout : A systematic review, semantic analysis, and Delphi consensus in 29 countries

Funding Information: This study was supported by the University of Lausanne and European Cooperation in Science and Technology, Action CA 16216 "Network on the Coordination and Harmonisation of European Occupational Cohorts” (OMEGA-NET). Publisher Copyright: © 2021, Nordic Association of Occupational Safety and Health. All rights reserved.Objective A consensual definition of occupational burnout is currently lacking. We aimed to harmonize the definition of occupational burnout as a health outcome in medical research and reach a consensus on this definition within the Network on the Coordination and Harmonisation of European Occupational Cohorts (OMEGA-NET). Methods First, we performed a systematic review in MEDLINE, PsycINFO and Embase (January 1990 to August 2018) and a semantic analysis of the available definitions. We used the definitions of burnout and burnout-related concepts from the Systematized Nomenclature of Medicine Clinical Terms (SNOMED-CT) to formulate a consistent harmonized definition of the concept. Second, we sought to obtain the Delphi consensus on the proposed definition. Results We identified 88 unique definitions of burnout and assigned each of them to 1 of the 11 original definitions. The semantic analysis yielded a first proposal, further reformulated according to SNOMED-CT and the panelists` comments as follows: "In a worker, occupational burnout or occupational physical AND emotional exhaustion state is an exhaustion due to prolonged exposure to work-related problems". A panel of 50 experts (researchers and healthcare professionals with an interest for occupational burnout) reached consensus on this proposal at the second round of the Delphi, with 82% of experts agreeing on it. Conclusion This study resulted in a harmonized definition of occupational burnout approved by experts from 29 countries within OMEGA-NET. Future research should address the reproducibility of the Delphi consensus in a larger panel of experts, representing more countries, and examine the practicability of the definition.Peer reviewe

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

Real‐World Effectiveness of Osteoporosis Medications in France: A Nationwide Cohort Study

ABSTRACT Although drugs for osteoporosis have been demonstrated to be effective in reducing fracture risk in placebo‐controlled clinical trials, data on effectiveness in real‐world practice is limited. Data from the French national health insurance claims database (SNDS) were used to follow five cohorts of women aged ≥55 years after initiating treatment for ≥6 months with either denosumab, zoledronic acid, oral bisphosphonates, raloxifene, or teriparatide in 2014–2016. Fracture incidence was compared within each cohort between the 3 months following initiation (baseline fracture risk) and the 12month, 18month, and 24 month postinitiation periods. Data are presented as incidence rate ratios (IRRs) with their 95% confidence intervals (CIs)s. Overall, 67,046 women were included in the denosumab cohort, 52,914 in the oral bisphosphonate cohort, 41,700 in the zoledronic acid cohort, 11,600 in the raloxifene cohort, and 7510 in the teriparatide cohort. The baseline vertebral fracture rate ranged from 1.74 per 1000 person years (‰PY) in the raloxifene cohort to 34.75‰PY in the teriparatide cohort, and the baseline hip fracture rate from 0.70‰PY in the raloxifene cohort to 10.52‰PY in the zoledronic acid cohort. Compared with the baseline fracture rate, vertebral fractures involving hospitalization were significantly reduced in the 3–24–month postinitiation period with denosumab (IRR 0.6; 95% CI, 0.5–0.7), zoledronic acid (IRR 0.4; 95% CI, 0.3–0.4), teriparatide (IRR 0.3; 95% CI, 0.2–0.5), and oral bisphosphonates (IRR 0.6; 95% CI, 0.4–0.8). Hip fracture incidence was reduced with denosumab (IRR 0.8; 95% CI, 0.6–0.9), but higher for oral bisphosphonates (IRR 1.7; 95% CI, 1.2–2.3); no significant change in hip fracture rate was observed for zoledronic acid, teriparatide, or raloxifene. A reduction in nonvertebral, non‐hip fracture incidence was observed only in the denosumab cohort (IRR 0.8; 95% CI, 0.7–0.9). These findings indicate that treatment with osteoporosis drugs is effective in the real‐world setting. © 2023 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research

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

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

Efficacy, tolerability, and safety of an innovative medical device for improving oral accessibility during oral examination in special-needs patients: A multicentric clinical trial.

BackgroundPeople with special needs have high unmet oral healthcare needs, partly because dentists find it difficult to access their oral cavity. The Oral Accessibility Spatula aims to improve oral accessibility. This prospective multicenter interventional open-label non-randomized patient-self-controlled trial assessed the ability of the spatula to improve the oral accessibility of special-needs patients during dental examinations.MethodsThe cohort was a convenience sample of minor and adult patients with special needs due to physical, intellectual, and/or behavioral disorders who underwent dental check-up/treatment in five French tertiary hospitals/private clinics in 2016-2018 and evinced some (Venham-Score = 2-4) but not complete (Venham-Score = 5) resistance to oral examination. After inclusion, patients underwent oral examination without the spatula and then immediately thereafter oral examination with the spatula. Primary outcome was Oral Accessibility Score (0-12 points; higher scores indicate visualization and probing of the tooth sectors). Secondary outcomes were patient toleration (change in Venham-Score relative to first examination), safety, and Examiner Satisfaction Score (0-10; low scores indicate unsatisfactory examination).ResultsThe 201 patients were mostly non-elderly adults (18-64 years, 65%) but also included children (21%), adolescents (11%), and aged patients (3%). One-quarter, half, and one-quarter had Venham-Score = 2, 3, and 4 at inclusion, respectively. The spatula significantly improved Oral Accessibility Score (4.8 to 10.8), Venham-Score (3.1 to 2.6), and Examiner Satisfaction Score (3.4 to 7.2) (all pConclusionThe spatula significantly improved oral access, was safe and well-tolerated by the patients, and markedly improved oral examination quality