Burnout profiles among young researchers:A latent profile analysis

INTRODUCTION: Burnout is a growing problem among young researchers, affecting individuals, organizations and society. Our study aims to identify burnout profiles and highlight the corresponding job demands and resources, resulting in recommendations to reduce burnout risk in the academic context. METHODS: This cross-sectional study collected data from young researchers (n = 1,123) at five Flemish universities through an online survey measuring burnout risk, work engagement, sleeping behavior, and the most prominent job demands (e.g., publication pressure) and resources (e.g., social support). We conducted Latent Profile Analysis (LPA) to identify burnout profiles in young researchers and subsequently compared these groups on job demands and resources patterns. RESULTS: Five burnout profiles were identified: (1) High Burnout Risk (9.3%), (2) Cynical (30.1%), (3) Overextended (2.3%), (4) Low Burnout Risk (34.8%), and (5) No Burnout Risk (23.6%). Each burnout profile was associated with a different pattern of job demands and resources. For instance, high levels of meaningfulness (OR = −1.96) decreased the odds to being classified in the Cynical profile. CONCLUSION: Our findings show that the Cynical profile corresponds to a relatively high number of young researchers, which may imply that they are particularly vulnerable to the cynicism dimension of burnout. Additionally, work-life interference and perceived publication pressure seemed the most significant predictors of burnout risk, while meaningfulness, social support from supervisor and learning opportunities played an important protective role

Screening for the risk on long-term sickness absence

Background: Long-term sickness absence is a growing concern in Belgium and other European countries. Since 2017, Belgian physicians of the sickness funding organisations are required to assess the re-integration possibilities within the first two months of sickness absence. Given the shortage of physicians in the assessment of work disability and the growing number of people in sickness absence, there is a need for a triage tool, allowing to assign return-to work support to patients having a high-risk profile not to resume work. Methods/design: The current study comprises a comprehensive validation process of a screening tool that supports Belgian physicians in guiding people back to work. The study consists of a theoretical construct validation (face validity and content validity), and an empirical construct validation (concurrence validity, factorial validity, predictive validity, hypothesis testing validity and known- group validity). Expected impact of the study for Public Health: The screening instrument assessing the risk for long-term sickness absence is a tool developed to support physicians who work for sickness funds and for occupational health and safety organisations. Both professionals play an important role in the return to work process and the prevention of long-term sickness absence. The screening tool aims at making a distinction between people who will resume their work independently and people who will need support to do so. Generation of this prediction model will help physicians to focus effort and resources in the high-risk group. Results may also help understand the relationship between the biopsychosocial model and long-term sick-leave

How Accurate Are Electronic Monitoring Devices? A Laboratory Study Testing Two Devices to Measure Medication Adherence

In a prospective descriptive laboratory study, 25 Helping Hand™ (HH) (10 without and 15 with reminder system) and 50 Medication Event Monitoring Systems (MEMS) (25 with 18-month and 25 with 2-year battery life) were manipulated twice daily following a predefined protocol during 3 consecutive weeks. Accuracy was determined using the fixed manipulation scheme as the reference. Perfect functioning (i.e., total absence of missing registrations and/or overregistrations) was observed in 70% of the HH without, 87% of the HH with reminder, 20% MEMS with 18 months, and 100% with 2-year battery life respectively

1666a Overview on sentinel and alert systems in occupational medicine

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Keeping an eye on glaucoma patients: Patient Reported Outcomes, adherence to eye drop treatment and eye drop administration skills

Glaucoma is a chronic disease in ophthalmology, affecting 3% of the Belgian population. The most important risk-factor of glaucoma is an elevated intraocular pressure. Objective outcomes such as visual field and optic nerve defects only give limited information about the real impact of glaucoma and its treatment on a patients daily life. Therefore the patients perspective or so-called patient reported outcomes (PRO s) are essential for evaluating treatment efficacy, clinical outcomes, and disease impact. Due to the treatment complexity, its lifelong character and the presumable effect of nonadherence on disease outcomes, nonadherence should be considered as a very important PRO for patients with glaucoma. Yet, the PRO and adherence literature in glaucoma is characterized by content-and methodology related shortcomings. To fill these gaps, we first performed a systematic review on glaucoma specific PRO s and rated them on their quality (chapter 2). Second, a prospective study was conducted to explore the dynamics of eye drop nonadherence and its theory based predictors (chapter 3). Third, we investigated selected system factors in relation to nonadherence in a multi-center study (chapter 4). Fourth, we developed and validated instruments to assess two important theoretical drivers of nonadherence, i.e. barriers (chapter 5) and eye drop administration skills (chapter 6). Patient reported outcomes (PRO s) in glaucomaOf the 25 PRO-tools retrieved from literature, most were quality of life measures, with most being poorly developed and not validated according to the current methodological standards. A conceptual definition/framework and patient input were often lacking, which is mandatory for the guidance of the item generation process and further psychometric testing. Second, the selection of items in the final instrument and dimensionality was seldom tested using appropriate statistical techniques, while this is needed to derive subsequent valid (sub) scale scores. Third, the widely applied one size fits all rating scale is outdated, meaning that rating scales should be statistically justified with ranges that might vary across items and within 1 instrument. Finally, researchers should first provide strong evidence with respect to the instrument s content validity, before starting further validation based on predefined hypotheses. Unfortunately, most tools did not meet these requirements, indicating a need for well developed and validated PRO instruments for use in glaucoma populations. Future directions in PRO-research should be: 1) improving existing instruments using Rasch-analysis, 2) developing and validating new PRO s using modern validation techniques and 3) creating glaucoma specific item banks per patient reported outcome content (e.g. quality of life, side effects, adherence) integrating calibrated scales adapted to the patients ability.Nonadherence to eye drop treatmentIn our prospective study the prevalence of eye drop nonadherence was 52% at baseline and 68.4% after follow-up. Repeated measurements allowed us to detect 4 medication behavior dynamics, i.e. stable adherence, persistent nonadherence, increasing and decreasing adherence, learning us that 25% of the patients altered their behavior over time. Most of the patients reported more problems with timing- (i.e. about 40-47%) compared to taking nonadherence (or instilling eye drops) (i.e. about 30%)). Future studies hence should prospectively monitor adherence over time. Due to possible effects of timing deviations on the effectiveness of eye drops, attention should not only be given to instilling eye drops (i.e. taking adherence), but also to keeping regular intervals between doses (i.e. timing adherence). At patient-level, the number of reported barriers was the single significant predictor of eye drop nonadherence. Other factors such as knowledge, eye drop administration skills, and intention do not seem to play a major role in predicting medication adherence based on the Integrated Model of Behavioral Prediction we used to operationalize our risk factors of interest. Hence, assessing barriers and subsequently developing adherence-enhancing interventions are necessary to prevent adherence. Unfortunately, the glaucoma literature did not provide a well developed and validated tool to assess these barriers. We therefore developed a 13-item instrument focusing on barriers to eye drop adherence. The median number of reported barriers by glaucoma patients was 2 barriers (range 2-10), with the most frequently reported barriers being I had difficulties with getting an eye drop into my eye , something interfered with my daily routine (e.g. vacation) and I forgot to administer my eye drops . Given that barriers are highly individually determined, tailored interventions are mandatory. Besides risk-factors at the patient level, policy guidelines recommend that factors at the healthcare provider and healthcare system are worthwhile to be looked at. In our cross-sectional, multicenter study, using multilevel analyses, we found that, on top of known determinants at the patient level, patients with a lower frequency of follow-up (< every 3 months) are at higher risk for nonadherence, compared to patients visiting their ophthalmologist less frequently. This study also revealed that ophthalmologists cannot accurately detect nonadherence, given that the sensitivity of their adherence-assessment against self-report was only 3%. This indicates the need for training of ophthalmologists in adherence measurement. Not only is the high prevalence of eye drop nonadherence a concern, yet patients also seemed to possess poor eye drop administration skills. These findings were congruent with previous results, yet our study was the first to assess these skills using a standardized observation tool (EYEDO) we developed based on the state of the art eye drop administration technique based on the Fraunfelder method and American Academy of Ophthalmology guidelines. By using an objective observation scale, problems inherent to self-report (i.e. social desirability) are eliminated. When usingthe EyeDO in a sample of 133 patients with glaucoma, the most problematic skills were: 1) forming a conjunctival pocket (20.5%), 2) directing the bottle properly above the eye (60.6%) and 3) compressing the lachrymal duct for 1 to 3 minutes (85.6%). ConclusionGlaucoma demands many self management tasks of patients, which should be supported by the health care team. Based on our results, patients are preferably seen at least every 3 months during their life-long follow-up. Moreover, there is a need to educate and train both patients and professionals in adherence and eye drop administration skills. An advanced practice nurse can play a crucial role in bridging the gap between research and clinical practice. Not only can she support the team by giving evidence based education and training, but can also strengthen patients self management skills. More specifically, an advanced practice nurse can assess adherence and barriers to adherence regularly throughout long-term follow-up and offer patient-tailored interventions to overcome these barriers. Yet, these interventions have to be tested on their efficacy and effectiveness in future studies.status: publishe

Contextual factors moderating the relationship between qualitative job Insecurity and burnout:A plea for a multilevel approach

The aim of this chapter was to tap into the buffering role of contextual variables in the stressor-strain relationship, as predicted in the basic model of work psychology of Hans De Witte. Previous studies have examined these relationships primarily from an individual perspective, making it impossible to properly investigate variables as contextual factors. In response, this chapter specifically addressed and tested the buffering roles of organisational communication and procedural justice—both modelled at the individual- and organisational-level—in the relationship between qualitative job insecurity and burnout. Multilevel path analysis was conducted on a sample of 35,558 Belgian employees clustered within 83 organisations from various sectors. In line with previous findings, it was found that organisational communication and procedural justice modelled at the individual level attenuated the positive relationship between qualitative job insecurity and burnout. There was one exception: organisational communication did not moderate the relationship between qualitative job insecurity and the burnout dimension of emotional exhaustion. Besides this, collective organisational communication and procedural justice, modelled at the organisational level, buffered the qualitative job insecurity-burnout relationship (i.e., cross-level interactions). Despite the small effect sizes for the interaction effects, the multilevel approach allows inferences to be made at both the individual and the organisational level

Research review on rehabilitation and return to work

The European workforce is ageing. Older workers are particularly at risk of early disability retirement and long-term sickness absence, the costs of which are substantial. The objective of the review is to provide an up-to-date summary of knowledge regarding vocational rehabilitation and return to work systems, programmes and interventions and their different components. It analyses the current evidence for the effectiveness of interventions and explores the factors that underlie successful and sustainable rehabilitation and re-integration.status: publishe