This study aimed to discover the prevalence and risk factors of burnout among physicians and nurses working in intensive care units and emergency departments.

This systematic review followed the reporting guidance from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. A literature search was conducted using the following databases: PubMed, MEDLINE, CINAHL, and Embase. The search was conducted in November 2023. English-language studies reporting burnout prevalence and risk factors among intensive care units and emergency physicians and nurses, with primary outcomes, were identified. Quantitative studies with observational designs underwent review, with 2 independent reviewers screening titles, abstracts, and full texts for inclusion. Quality assessment used Joanna Briggs Institute critical appraisal tools. A meta-analysis was conducted if data were sufficient.

This review included 17 studies. The pooled prevalence rates for burnout, high emotional exhaustion, high depersonalization, and low personal accomplishment were 46%, 48%, 30%, and 47%, respectively. Factors such as age, sex, smoking/tobacco use, education level, years of experience, workload, and the impact of coronavirus disease 2019 were identified as significant determinants of burnout in this population.

The results assisted in determining preventive strategies and identified areas for future research.

Only one third of European countries use intermediate care units (IMCs). An IMC makes it possible to manage patients who do not require intensive care but who need a higher level of nursing care that cannot be provided on the general ward. In Belgium, there are no national criteria for ICU admission or discharge, and no policies regarding IMC care or for differentiating ICU intensity levels.

The aim of our study was to analyse the profile of ICU patients in Belgium on the basis of registered nursing activity in order to quantify the number of ICU days potentially transferable to an IMC.

The study was conducted on 310 ICU beds. Patients admitted to the study were recruited during two different one-month periods in 2018 and were included into a prospective database that evaluated nursing workload carried out in 15 hospitals in the French-speaking part of Belgium. The number of ICU days that could be supported on an IMC was defined according to the Nursing Activities Score (NAS) items.

A total of 3279 ICU patients for a total of 13 942 ICU days were included. 4987 days (35.8%) were considered as "transferable" to an IMC. The proportion of ICU days transferable to an IMC was highly variable among hospitals, ranging from 20.4% to 59.5% of all ICU days. On the day of ICU admission, 665/2142 (31.0%) of the patients were already identified as transferable to an IMC; this percentage significantly increased on day 2 (972/2066, 47.1%) and day 3 (650/1390, 46.7%).

In Belgian ICUs, 35.8% of ICU hospital days, as per recorded NAS, do not necessitate intensive monitoring. These 35.8% of days of ICU hospitalization could be supported on an IMC.

In this study, a significant number of days spent in the ICU could be supported on an IMC, this could alleviate the workload of nurses and reduce the occupancy rate of intensive care units.

To identify factors protecting and hindering the well-being of critical care nurses during the COVID-19 pandemic.

The unique work challenges of critical care nurses can undermine their professional and mental well-being; as evidenced by the prevailing literature on burnout, compassion fatigue, and moral distress. The COVID-19 pandemic has seen these professionals on the front lines and has raised many questions about professional well-being. Identifying the factors that protect and hinder the well-being of critical care nurses would help to develop the strategies necessary to reduce worrying phenomena associated with professional malaise.

A systematic review was conducted using electronic databases including PubMed, CINAHL, Scopus, Cochrane, PsycINFO, and Web on Science.

After full text analysis, 25 papers were included in the current systematic review. Factors influencing the well-being of critical care nurses have been grouped into "Protective" and "Hindering."

This review shows that critical care nurses' well-being is influenced by factors like personal resilience and supportive work environments, which enhance their experience. Challenges include sociodemographic issues and the COVID-19 pandemic's impact. Addressing these factors is crucial for their well-being and the effectiveness of healthcare systems.

The well-being of nurses is intricately linked to the quality and security of patient care, ultimately influencing clinical outcomes. This review delves deeply into the multifaceted factors that affect the professional well-being of critical care nurses during the COVID-19 pandemic. Recognizing these elements is critical for directing health policy toward the development of initiatives that bolster healthcare workers' welfare. Prioritizing the professional well-being of nurses is imperative, as it is fundamental in mitigating the increasing inclination towards job turnover, a challenge that is profoundly impacting the healthcare sector.

Burnout is a significant issue among healthcare professionals, particularly nurses, due to high workloads and emotional demands. However, limited research has explored burnout among primary healthcare nurses in Saudi Arabia, who play a vital role in healthcare delivery. This study aims to address this gap by investigating burnout levels and their association with anxiety, depression and self-efficacy among primary healthcare nurses. A cross-sectional survey design was employed, with 161 primary healthcare nurses from the Qassim region, Saudi Arabia. Data were collected using the Maslach Burnout Inventory, the Patient Health Questionnaire-4 and the General Self-Efficacy Scale. Pearson correlation and logistic regression were used to analyse the associations between study variables. A high prevalence of burnout risk (78.9%) was observed. Emotional exhaustion was detected in 35.4%, depersonalisation in 44.7% and low personal accomplishment in 57.8%. Anxiety (r = 0.707, p < 0.01) and depression (r = 0.564, p < 0.01) were positively correlated with emotional exhaustion, while self-efficacy was negatively correlated (r = -0.260, p < 0.05). Logistic regression analysis revealed that anxiety (OR = 5.784, 95% CI: 2.056-16.269) and low self-efficacy (OR = 6.625, 95% CI: 2.979-14.737) were significant predictors of burnout. Targeted interventions are essential to mitigate burnout among primary healthcare nurses. Specific measures could include mindfulness-based stress reduction programmes to address emotional exhaustion, peer support sessions to reduce depersonalisation and skill-building workshops to enhance self-efficacy. These interventions can improve nurse well-being and ensure sustainable healthcare delivery in primary care settings.

Highly cited papers in critical care nursing can offer valuable insights for all stakeholders engaged in the research process by highlighting key research trends, guiding resource allocation and shaping future research priorities.

To gain insights from the top-cited papers in the top critical care nursing journals.

This was a bibliometric analysis of the top-cited papers in the top critical care nursing journals as reported by the Journal Citation Report 2023-released in June 2024. Data were tabulated and visualized using Microsoft Excel and the VOSviewer software.

Forty papers from the top four critical care nursing journals (Intensive and Critical Care Nursing [ICCN], Nursing in Critical Care [NICC], Australian Critical Care [ACC] and American Journal of Critical Care [AJCC]) were analysed. Half of the analysed papers were related to the COVID-19 pandemic, and mental health was the most addressed theme (n = 11 papers). Papers from the ICCN featured contributions from 17 countries, the highest among the journals analysed, followed by NICC, with contributions from 11 countries. Articles received more citations than reviews (median [interquartile range]: 18 [9-23] vs. 8 [8-11.5]), and open-access papers were cited about twice those published under a subscription model (19 [16-31] vs. 9 [8-15]). In ICCN, 9 of the 10 analysed papers were published open access compared with 3 in NICC and ACC and 2 in AJCC.

The identified themes in this paper underscore the dynamic nature of the field of critical care nursing and the ongoing efforts to address key challenges in critical care nursing practice and health care delivery. Publishing open-access articles on trending topics and collaborating internationally seem to be effective approaches for gaining more citations.

Understanding these prevalent themes has significant implications for guiding research priorities, informing clinical practice, shaping policy and improving patient outcomes. Academic journals need to encourage increasing the representation of researchers from the Global South in both journals' editorial boards and submissions to the journals.

The objectives of this study were to determine the prevalence of burnout risk and intention-to-leave among intensive care unit (ICU) nurses and analyse the association of these with workload and work environment.

A cross-sectional survey of nurses working in ICUs was conducted in France between 15 January 2024 and 15 April 2024 alongside a longitudinal assessment of workload during the same period.

ICU nurse workload was assessed using the Nursing Activities Score (NAS). The risk of burnout was assessed using the Maslach Burnout Inventory scale and intention-to-leave the hospital was assessed with a binary question. A total of 1271 nurses working in 61 intensive care units completed the questionnaire and 14,134 NAS per patient and 1885 NAS per nurse were included in the study.

The median overall of burnout by hospital site was 64.7% [P25: 53.3-P75: 72.7] for the broad definition and a median of 20.7% [13.3-27.3] of ICU nurses reported an intent-to-leave their job. The median overall NAS score per nurse was 135.9% [121.4-156.9] and the prevalence of NAS scores exceeding 100% per nurse was 73.9% [62.8-80.3]. A significant association was found between nurses working in an ICU with a better work environment and all dimensions of burnout as well as the intention-to-leave the job. A prevalence in the hospital site of NAS scores exceeding 100% per nurse below the median was associated with a lower burnout (OR = 0.69, 95% CI: 0.50-0.88 for broad definition) and intention-to-leave the job (OR = 0.68, 95% CI: 0.50-0.92).

This study found significant associations between burnout and the intention to leave the job for nurses in ICUs, mainly due to a better work environment and, to a lesser extent, a lower workload for nurses.

In an era of nurse shortages and absenteeism, it is crucial for institutions to retain their nursing staff. Our results should encourage hospital managers to take action to improve the ICU work environment and keep ICU workloads manageable to decrease burnout and the intention-to-leave the job among ICU nurses.

This article follows the STROBE guidelines for the reporting of cross-sectional studies.

No patient or public contribution.

To use the job demands-resources model of occupational stress to quantify and explain the impact of working in critical care during the COVID-19 pandemic on nurses and their employing organisation.

Two-phase mixed methods: a cross-sectional survey (January 2021-March 2022), with comparator baseline data from April to October 2018 (critical care nurses only), and semistructured interviews.

Critical care nurses (n = 461) and nurses redeployed to critical care (n = 200) who worked in the United Kingdom National Health Service (primarily Scotland) between January 2021 and March 2022. The 2018 survey was completed by 557 critical care nurses (Scotland only). Survey response rate in Scotland was 32% but could not be determined outside Scotland. Forty-four nurses were interviewed (critical care = 28, redeployed = 16).

A survey measured job demands, job resources, health impairment, work engagement and organisational outcomes. Data were compared to 2018 data. Regression analyses identified predictors of health impairment, work engagement and organisational outcomes. Semistructured interviews were conducted remotely, audio-recorded and transcribed. Data were analysed deductively using framework analysis.

Three-quarters of nurses reached threshold for psychological distress, approximately 50% reached threshold for burnout emotional exhaustion and a third clinically concerning post-traumatic stress symptoms. Compared to 2018, critical care nurses were at elevated risk of probable psychological distress, odds ratio 6.03 (95% CI 4.75 to 7.95); burnout emotional exhaustion, odds ratio 4.02 (3.07 to 5.26); burnout depersonalisation, odds ratio 3.18 (1.99 to 5.07); burnout accomplishment, odds ratio 1.53 (1.18 to 1.97). There were no differences between critical care and redeployed nurses on health impairment outcomes, suggesting elevated risk would apply to redeployed nurses. Job demands increased and resources decreased during the pandemic. Higher job demands predicted greater psychological distress. Job resources reduced the negative impact of job demands on psychological distress, but this moderating effect was not observed at higher levels of demand. All organisational outcomes worsened. Lack of resources predicted worse organisational outcomes. In interviews, staff described the pace and amount, complexity, physical and emotional effort of their work as the most difficult job demands. The sustained high-demand environment impacted physical and psychological well-being, with most interviewees experiencing emotional and physical exhaustion, burnout, and symptoms of post-traumatic stress disorder. Camaraderie and support from colleagues and supervisors were core job resources. The combination of sustained demands and their impact on staff well-being incurred negative organisational consequences, with increasing numbers considering leaving their specialty or nursing altogether. Dissemination events with a range of stakeholders, including study participants, identified staffing issues and lack of learning and development opportunities as problematic. Critical care nurses are concerned about the future delivery of high-quality critical care services. Positive aspects were identified, for example, reduced bureaucratic systems, increased local autonomy and decision-making, recognition of the critical care nurse skill set.

The National Health Service needs to recognise the impact of COVID-19 on this staff group, prioritise the welfare of critical care nurses, implement workplace change/planning, and support them to recover from the pandemic. The National Health Service is struggling to retain critical care nurses and, unless staff welfare is improved, quality of care and patient safety will likely decline.

This synopsis presents independent research funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research as award number NIHR132068.

The purpose of this concept delineation was to differentiate similar concepts impacting nurse well-being during the COVID-19 pandemic, including: compassion fatigue, burnout, moral injury, secondary traumatic stress, and second victim.

A total of 63 articles were reviewed for concept delineation. Morse's (1995) approach to concept delineation was utilized to analyse the articles.

Concepts were described interchangeably but were found to present themselves in a sequence. A nurse may experience moral injury, leading to a second victim experience, synonymous with secondary traumatic stress, then compassion fatigue and/or burnout that can be acute or chronic in nature. An Occupational Trauma Conceptual Model was created to depict how these concepts interact based on concept delineation findings.

Nurses are experiencing long-lasting occupational trauma and future intervention research should centre on optimizing nurse well-being to ensure the sustainability of nursing profession.

There are increasing calls for the application of systems ergonomics methods in healthcare, although evidence for their utility and uptake is limited. In this study, 67 Australian healthcare workers participated in a six-month longitudinal study where they were trained to apply the AcciMap adverse event analysis and Net-HARMS risk assessment methods. Data were gathered in line with the RE-AIM (Reach, Efficacy, Adoption, Implementation, and Maintenance) evaluation framework, including rates of organisational uptake and method validity, perceived workload, usability, and barriers and facilitators to use in practice. Overall RE-AIM ratings for AcciMap were relatively high, and more moderate for Net-HARMS. Time constraints was the most frequently identified barrier to the use of both methods in practice, while there was more organisational resistance to Net-HARMS uptake. Facilitators for the use of both methods include providing quality training and mentorship, additional time and software resources, and dedicated job roles.

This study aimed to assess nursing workload in Cardiac Intensive Care Unit (CICU) after three cardiothoracic surgery procedures during first four postoperative days using Nursing Activities Score (NAS) and Nine Equivalents of Nursing Manpower Use Score (NEMS) systems, to compare their performance for that purpose and to investigate association between nursing workload and type of surgery.

A comparative study.

The research environment includes CICU of the University Hospital for Cardiovascular Diseases in Serbia. A total of 808 patients who underwent coronary, valvular, or combined surgery, resulting in 2282 filled NAS and NEMS pairs chart. Statistical analysis was performed using SPSS-19. The correlation between NAS and NEMS was tested by Spearman's correlation coefficient. Differences were considered statistically significant at p < 0.05.

The lowest median of cumulative NAS 176 (175-257) and NEMS 76 (64-91) had coronary surgery patients, the highest NAS 224.5 (178-334.5) and NEMS 83 (69-121) had those with combined surgery; this difference was statistically significant (p < 0.001). The median of both scores decreased after surgery, with the following values from the first to the fourth postoperative day: NAS from 104 (102-105) to 81 (74-85) and NEMS from 46 (42-46) to 30 (30-37). The difference in mean values of both scores between the first and the fourth postoperative day was statistically significant (p < 0.001). NAS and NEMS were in a positive, strong correlation (r = 0.913; p < 0.005).

Both scores can be used to measure nursing workload, identify the required number of nurses in CICU, and support task allocation. NAS may have an advantage because it better describes extensive postoperative monitoring and care needed for cardiac surgery patients. Nursing workload is associated with type of surgery, with the highest workload measured in patients who underwent combined surgery procedure and on the first postoperative day.

Within French intensive care units (ICUs), patients are treated with two levels of care (intensive or intermediate) with different nurse-to-patient ratios legally defined.

We aimed to compare the nursing workload associated with these two levels of care.

A nationwide prospective observational study was conducted in France between April and July 2023. Each ICU was allowed to choose its own two-week period of data collection during which the Nursing Activities Score was collected by nurses at patients' bedside, during each shift. The Nursing Activities Score ranges from 20 to 177% and a 100% score represents a nurse per shift. The number of patients per nurse was collected and the Nursing Activities Score per nurse was assessed.

One hundred and five ICUs participated. Overall, 21,665 measurements of Nursing Activities Score per patient and 9,885 Nursing Activities Score per nurse were collected. ICUs were composed by 2083 beds distributed into 1520 (73 %) intensive care beds and 563 (27 %) intermediate care beds. Among the participating units, 93 (89 %) of the teams worked in 2 shifts. Median [p25-p75] Nursing Activities Score per adult patient was 61 % [49-80] for intensive care patients and 47 % [38-61] for intermediate care patients (p < 0.001). Median Nursing Activities Score per nurse for adult population was 127 % [92-167], 143 % [92-198], and 164 % [126-213] for nurses only providing intensive care, only intermediate care or both levels of care, respectively (p < 0.001). A Nursing Activities Score per nurse value >100 % was observed in 71.4 %.

Nurses' workload was high in the ICU, especially when providing intermediate or mixed levels of care.

In order to reduce nurses' workload, a review of the nurse-to-patient ratios is expected. Physically separating the two levels of care may be a valuable option.

To investigate the unique and cumulative associations of different sleep problem subtypes with burnout among Chinese nurses.

A survey was conducted in Quanzhou, China, and a total of 744 nurses were included. Burnout was measured by Maslach Burnout Inventory-Human Services Survey across three dimensions: emotional exhaustion (EE), depersonalization (DP) and low personal accomplishment (PA). Pittsburgh Sleep Quality Index was used to measure 15 types of sleep problems. Binary logistic regression was employed to explore the association between sleep problems and burnout.

Prevalence of sleep problems, high EE, high DP and low PA were 43.3, 6.9, 23.4, and 63.2%, respectively. Experience of sleep problems significantly increased risk for EE (OR = 1.31, 95%CI: 1.185-1.436), DP (OR = 1.08, 95%CI: 1.023-1.142) and PA (OR = 1.09, 95%CI: 1.036-1.146). Of the 15 sleep problem subtypes, "feel too cold" and "have pain" were significant predictors of high EE (OR = 3.89, 95%CI: 1.629-9.302; OR = 3.00, 95%CI: 1.314-6.827, respectively), and "daytime dysfunction" significantly predicted low PA (OR = 1.68, 95%CI: 1.135-2.491). Around 40.9% of nurses had reported more than three subtypes of sleep problems. Experiencing more than three subtypes of sleep problems were significantly associated with an increased risk of DP and PA (ORs range from 2.07 to 2.71).

These findings suggested that sleep problems was associated with an increased risk of burnout in nurses, with both unique and cumulative risks. Interventions should focus on the prevention and management of the effects of sleep problems among nurses.

The prevalence of Occupational Burnout is high among healthcare professionals (HCP). Hence, it is crucial to have robust measures for ascertaining burnout in this population. The Shirom-Melamed Burnout Measure is a prevalent tool used in the diagnosis of burnout, and in the delivery planning of mental health services. The 14-item Shirom-Melamed Burnout Measure (SMBM) was developed after a methodological revision of the 22-item Shirom-Melamed Burnout Questionnaire (SMBQ). Studies on the psychometric properties of the SMBM and SMBQ exist, but there remains a need for thorough evaluation to assess the methodological quality of individual studies. To address this gap, this systematic review aimed to critically appraise the measurement properties of the different versions of the Shirom-Melamed Burnout Measure/Questionnaire (SMBM/Q) used among healthcare professionals.

Four databases (PubMed, CINAHL, PsychINFO, and Scopus) were searched for studies on the psychometric properties of all versions of the SMBM/Q among HCP. The methodological quality of the studies was evaluated using the COSMIN Risk of Bias checklist. Evidence supporting the measurement properties (EMP) of the SMBM was synthesized using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach.

Our final pool consisted of five research articles. One study on the 12-item SMBM was included to estimate content validity, two studies reported on the 14-item SMBM, while the other two employed the 22-item version. Interestingly, each study used the SMBM in a different language, namely English/Hebrew, Chinese, French, Serbian, and Swedish. Structural validity, internal consistency, and construct validity are the SMBM's most assessed measurement properties. The Hebrew and French versions demonstrated high levels of structural validity and internal consistency, and the remaining reports on validity demonstrated low levels due to methodological flaws.

Per COSMIN guidelines, the SMBM should not be utilized for clinical purposes due to insufficient content validity, but has promising potential with ongoing research. Engaging critical stakeholders for concept elicitation will ensure the relevance, comprehensiveness, and comprehensibility of the PRO items. Likewise, establishing an MIC will allow capturing change over time, which will benefit longitudinal experimental studies. Occupational burnout is a significant problem among healthcare professionals, and it is crucial to have a reliable tool to measure it. The Shirom-Melamed Burnout Measure (SMBM) is commonly used to diagnose burnout and plan mental health services. Studies on the psychometric properties of the SMBM exist, but there remains a need for thorough evaluation to assess the methodological quality of individual studies. To address this gap, this systematic review critically appraised the measurement properties of the different versions of the Shirom-Melamed Burnout Measure (SMBM) used among healthcare professionals. Our findings indicate that only a few studies have examined the SMBM, and they have used the tool in different languages. Structural validity, internal consistency, and construct validity are the SMBM's most assessed measurement properties. We recommend that more research is needed to assess the content validity of the SMBM. We also suggest that critical stakeholders should be involved in the development of the SMBM to ensure that it is relevant, comprehensive, and understandable.

To investigate the relationship between the psychological resilience and burnout of nurses caring for COVID-19 patients and to determine the factors that affect their psychological resilience and burnout.

In pandemic diseases such as COVID-19, nurses experience burnout due to long working hours, decreased quality of life and anxiety/fear about their own/families' health. Psychological resilience helps to control burnout in nurses and prevent the development of a global nurse shortage.

This was a descriptive, correlational study.

The sample of this study included 201 nurses in a Training and Research Hospital. The study used the Brief Resilience Scale and the Burnout Measure Short Version. Data were collected between 4 May and 1 June 2020. Statistical analysis was made with Pearson/Spearman, independent sample t test, one-way analysis of variance (ANOVA) test.

Nurses reported moderate burnout and psychological resilience, with a negative and highly significant correlation between psychological resilience and burnout levels.

In order to increase the quality of patient care/treatment, nurse managers need to reduce nurses' burnout and increase their psychological resilience. Nurses are recommended to adopt a healthy lifestyle, organize training programmes and implement psychological resilience interventions to prevent sleep disorders. Giving nurses the tools to understand what they need to manage within their locus of control will allow them to find a new sense of resilience, preventing potential burnout.

A previous study reported significant excess mortality among non-COVID-19 patients due to disrupted surgical care caused by resource prioritization for COVID-19 cases in France. The primary objective was to investigate if a similar impact occurred for medical conditions and determine the effect of hospital saturation on non-COVID-19 hospital mortality during the first year of the pandemic in France.

We conducted a nationwide population-based cohort study including all adult patients hospitalized for non-COVID-19 acute medical conditions in France between March 1, 2020 and 31 May, 2020 (1st wave) and September 1, 2020 and December 31, 2020 (2nd wave). Hospital saturation was categorized into four levels based on weekly bed occupancy for COVID-19: no saturation (< 5%), low saturation (> 5% and ≤ 15%), moderate saturation (> 15% and ≤ 30%), and high saturation (> 30%). Multivariate generalized linear model analyzed the association between hospital saturation and mortality with adjustment for age, sex, COVID-19 wave, Charlson Comorbidity Index, case-mix, source of hospital admission, ICU admission, category of hospital and region of residence.

A total of 2,264,871 adult patients were hospitalized for acute medical conditions. In the multivariate analysis, the hospital mortality was significantly higher in low saturated hospitals (adjusted Odds Ratio/aOR = 1.05, 95% CI [1.34-1.07], P < .001), moderate saturated hospitals (aOR = 1.12, 95% CI [1.09-1.14], P < .001), and highly saturated hospitals (aOR = 1.25, 95% CI [1.21-1.30], P < .001) compared to non-saturated hospitals. The proportion of deaths outside ICU was higher in highly saturated hospitals (87%) compared to non-, low- or moderate saturated hospitals (81-84%). The negative impact of hospital saturation on mortality was more pronounced in patients older than 65 years, those with fewer comorbidities (Charlson 1-2 and 3 vs. 0), patients with cancer, nervous and mental diseases, those admitted from home or through the emergency room (compared to transfers from other hospital wards), and those not admitted to the intensive care unit.

Our study reveals a noteworthy "dose-effect" relationship: as hospital saturation intensifies, the non-COVID-19 hospital mortality risk also increases. These results raise concerns regarding hospitals' resilience and patient safety, underscoring the importance of identifying targeted strategies to enhance resilience for the future, particularly for high-risk patients.

This is a qualitative phenomenological study that was designed to navigate through nurses' lived experiences, burdens, and coping strategies while working with COVID-19 patients. The sample included 20 nurses who had worked with COVID-19 patients for more than or equal to 6 months. The interviews were conducted between October 1, 2021, and April 15, 2022. At that time, the third COVID wave had elapsed, and we were peaking on a fourth pandemic wave, so included participants had lived through a minimum of 2 to 3 peaks. Six themes emerged, which were: nurses coping with COVID-19 crisis, professional relationship burden, personal burden, environmental burden, physical symptom burden, and emotional burden of the crisis. Nurses' lived experiences during the pandemic were deep, intense, and moderately to highly affecting their ways of thinking, feeling, and behaving. That experience opened nurses' eyes on countless number of challenges that require special attention, care, and preparation on many levels. The minimal preparatory levels are personal, departmental, organizational, and strategic.

The purpose of the study is to examine the psychological impact of COVID-19 on health workers' career satisfaction and intention to leave the health profession, with neurotic personality type as a moderator.

A total of 277 health workers in two public hospitals in Ghana were included in this study. Purposive and convenience sampling techniques were adopted for the study, focusing on eight departments that were involved in the management of COVID-19 cases. Validated instruments were used to measure burnout, intention to leave, neurotic personality and career satisfaction. Using AMOS and partial least squares structural equation modeling (PLS-SEM), various techniques were employed to analyze mediating and moderating mechanisms.

The departments had staff sizes ranging from 19 to 40, with 67% female and 33% male, with an average age of 31. Nurses accounted for the majority of responses (67.8%), followed by physicians (13.9%), sonographers (0.9%), lab technicians (0.9%) and other respondents (16.5%). The study found that health workers' level of burnout during COVID-19 had a positive effect on their intention to leave the health profession. Career satisfaction does not mediate this relationship; however, career satisfaction negatively influences the intention to leave the health profession. A neurotic personality does not moderate this relationship.

This study provides validation of burnout and intention to leave among health workers in Ghana during COVID-19 and supports the proposition that threats to resources (burnout) and having a resource (career satisfaction) have effects on the intention to leave one's profession.

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.

To analyse the relationship between burnout syndrome and job satisfaction among ICU personnel.

The PubMed, CINAHL and Scopus databases were used.

A systematic review and meta-analysis. The study sample consisted of 18 quantitative primary studies conducted in the last five years. Validated questionnaires were used to assess burnout in ICU healthcare workers, the most commonly used being the Maslach Burnout Inventory.

The search equation applied was: "job satisfaction AND nurs* AND burnout AND (ICU OR intensive care units)". The search was performed in October 2022.

The search returned 514 results. Only 73 articles met the eligibility criteria. After reading the title and abstract, 20 articles were selected. After reading the full texts, 12 articles remained and after the reverse search, 18 articles were finally selected. The studies reported a 50% prevalence of burnout, all three dimensions of which were heightened by the COVID-19 pandemic. Analysis of the study findings revealed an inverse association between burnout and job satisfaction.

Job dissatisfaction of ICU nurses depends on lack of experience, working conditions or working environment among others. ICU nurses with lower job satisfaction have higher levels of burnout.

This meta-analysis shows the potential value of job satisfaction on improving health outcomes related to burnout syndrome for nursing professional in Intensive Care Units. Different factors that could increase job satisfaction and consequently protect them from suffering high levels of burnout, such as salary, permanence in the service, mental health care are the responsibility of the hospital supervisor and, finally, of the own Health System. Knowledge of a risk profile based on the factors influencing job dissatisfaction would enable the implementation of effective workplace interventions to reduce or prevent the risk of burnout. Health policies should focus on protecting the worker, so in addition to improving working conditions, it would be interesting to promote coping skills in order to improve the quality of care and patient safety.

The phenomenon of burnout among healthcare workers during the COVID-19 pandemic is a widespread problem with several negative consequences for the healthcare system. The many stressors of the pandemic have led to an increased development of anxiety and depressive disorders in many healthcare workers. In addition, some manifested symptoms of the so-called postpandemic stress syndrome and the emergence of occupational burnout syndrome, commonly referred to as "COVID-19 burnout." The aim of this study was to assess the burnout and life satisfaction of healthcare workers during the COVID-19 pandemic.

The study was conducted in 2020-2022 among medical staff working in hospitals in Silesia, Poland. The instruments used to assess life satisfaction and burnout were the Satisfaction with Life Scale (SWLS) and the Maslach Burnout Inventory (MBI), which assesses three dimensions: emotional exhaustion (EE), depersonalisation (DEP), and sense of reduced professional accomplishment (SRPA).

The study group included 900 participants. There were 300 physicians (mean age 38 ± 7 years), 300 nurses (mean age 35 ± 6 years), and 300 paramedics (mean age 31 ± 5 years). Life satisfaction as measured by the SWLS was lowest among nurses and paramedics in 2021 and among doctors in 2022. Male respondents and those with fewer years of work had higher levels of life satisfaction. People with more years of work had higher scores in EE and DEP and lower scores in SRPA (p = 0.001). We found a negative correlation between life satisfaction and EE (p = 0.001), DEP (p = 0.001), and SRPA (p = 0.002).

The results highlight the need for further research into the causes of burnout among medical professionals and the need for effective interventions to promote well-being and prevent burnout in this group.

Mental health problems are critical and common in medical staff working in Intensive Care Units (ICU) even at the late stage of COVID-19, particularly for nurses. There is little research to explore the inner relationships between common syndromes, such as depression and burnout. Network analysis (NA) was a novel approach to quantified the correlations between mental variables from the perspective of mathematics. This study was to investigate the interactions between burnout and depression symptoms through NA among ICU nurses.

A cross-sectional study with a total of 616 Chinese nurses in ICU were carried out by convenience sampling from December 19, 2022 to January19, 2023 via online survey. Burnout symptoms were measured by Maslach Burnout Inventory-General Survey (MBI-GS) (Chinese version), and depressive symptoms were assessed by the 9-item Patient Health Questionnaire (PHQ-9). NA was applied to build interactions between burnout and depression symptoms. We identified central and bridge symptoms by R package qgraph in the network model. R package bootnet was used to examined the stability of network structure.

The prevalence of burnout and depressive symptoms were 48.2% and 64.1%, respectively. Within depression-burnout network, PHQ4(Fatigue)-MBI2(Used up) and PHQ4(Fatigue)-MBI5(Breakdown) showed stronger associations. MBI2(Used up) had the strongest expected influence central symptoms, followed by MBI4(Stressed) and MBI7 (Less enthusiastic). For bridge symptoms. PHQ4(Fatigue), MBI5(Breakdown) and MBI2(Used up) weighed highest. Both correlation stability coefficients of central and bridge symptoms in the network structure were 0.68, showing a high excellent level of stability.

The symptom of PHQ4(Fatigue) was the bridge to connect the emotion exhaustion and depression. Targeting this symptom will be effective to detect mental disorders and relieve mental syndromes of ICU nurses at the late stage of COVID-19 pandemic.

The COVID-19 pandemic has significantly increased the risk of burnout among frontline nurses. However, the prevalence of burnout and its associated factors in the post-pandemic era remain unclear. This research aims to investigate burnout prevalence among frontline nurses in the post-pandemic period and pinpoint associated determinants in China.

From April to July 2023, a cross-sectional study was carried out across multiple centers, focusing on frontline nurses who had been actively involved in the COVID-19 pandemic. The data collection was done via an online platform. The Maslach Burnout Inventory-Human Services Survey was utilized to evaluate symptoms of burnout. A multivariable logistic regression analysis was used to pinpoint factors associated with burnout.

Of the 2210 frontline nurses who participated, 75.38% scored over the cut-off for burnout. Multivariable logistic regression revealed that factors like being female [odds ratio (OR) = 0.41, 95%CI = 0.29-0.58] and exercising 1-2 times weekly[OR = 0.53, 95%CI = 0.42-0.67] were protective factors against burnout. Conversely, having 10 or more night shifts per month[OR = 1.99, 95%CI = 1.39-2.84], holding a master's degree or higher[OR = 2.86, 95% CI = 1.59-5.15], poor health status[OR = 2.43, 95% CI = 1.93-3.08] and [OR = 2.82, 95%CI = 1.80-4.43], under virus infection[OR = 7.12, 95%CI = 2.10-24.17], and elevated work-related stress[OR = 1.53, 95% CI = 1.17-2.00] were all associated with an elevated risk of burnout.

Our findings indicate that post-pandemic burnout among frontline nurses is influenced by several factors, including gender, monthly night shift frequency, academic qualifications, weekly exercise frequency, health condition, and viral infection history. These insights can inform interventions aimed at safeguarding the mental well-being of frontline nurses in the post-pandemic period.

To critically synthesis the qualitative literature to understand the experiences of critical care nurses during the COVID-19 pandemic.

A meta-aggregation systematic review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Relevant online databases were searched using a wide range of keywords and subject headings. All qualitative studies were included to understand the lived experiences of critical care nurses in the intensive care unit during the COVID-19 pandemic. All studies were screened using a pre-eligibility screening criteria by three reviewers. The Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Qualitative Research was used to provide methodological appraisal. The JBI method of meta-aggregation was used to extract, synthesize, and categorise the data.

17 publications met the inclusion criteria. 136 individual findings were extracted, which were synthesised into 18 categories and eight synthesised findings. The eight synthesised findings included,1) Working as a team to adapt to the challenges of the pandemic, 2) Striving to provide patient centred care, 3) Coping with frequent deaths in the intensive care unit, 4) Challenges of supporting patients family from a distance, 5) The psychological impact of caring for critically unwell patients with COVID-19, 6) Working through the challenges of the intensive care unit setting during the pandemic, 7) The challenges of wearing personal protective equipment while undertaking patient care, 8) The impact of working in the intensive care unit during the pandemic on life at home..

This qualitative systematic review has given new insight into the lived experiences of critical care nurses. There were significant psychological and physical impacts on critical care nurses working during the COVID-19 pandemic. Therefore, improving psychological support, maintaining adequate staffing levels/skill mix to ensure basic nursing care can be completed, and the attendance of leadership/management staff is essential to ensure the retention of critical care nurses and achieve optimal patient outcomes.

This review has highlighted implications for staff retention (counselling, skills development, contingency staffing), the need for improved management/leadership strategies and human resource policies to support critical care nurses when hospitals are in crisis. Additionally, the presence and needs of the family members of critically unwell patients' needs to be prioritised in the intensive care unit.

The aim of the study was to examine the impact of moral resilience on quiet quitting, job burnout, and turnover intention among nurses. A cross-sectional study was implemented in Greece in November 2023. The revised Rushton Moral Resilience Scale was used to measure moral resilience among nurses, the Quiet Quitting Scale to measure levels of quiet quitting, and the single-item burnout measure to measure job burnout. Moreover, a valid six-point Likert scale was used to measure turnover intention. All multivariable models were adjusted for the following confounders: gender, age, understaffed department, shift work, and work experience. The multivariable analysis identified a negative relationship between moral resilience and quiet quitting, job burnout, and turnover intention. In particular, we found that increased response to moral adversity and increased moral efficacy were associated with decreased detachment score, lack of initiative score, and lack of motivation score. Additionally, personal integrity was associated with reduced detachment score, while relational integrity was associated with reduced detachment score, and lack of initiative score. Moreover, response to moral adversity was associated with reduced job burnout. Also, increased levels of response to moral adversity were associated with lower probability of turnover intention. Moral resilience can be an essential protective factor against high levels of quiet quitting, job burnout, and turnover intention among nurses. This study was not registered.

In public health emergencies, nurses are vulnerable to adverse reactions, especially job burnout. It is critical to identify nurses at risk of burnout early and implement interventions as early as possible.

A cross-sectional survey of the hospitals in Xiangyang City was conducted in January, 2023 using stratified cluster sampling. Anonymized data were collected from 1584 working nurses. The Impact of Events Scale-Revised (IES-R) and the Chinese version of the Maslach Burnout Inventory-General Survey (MBI-GS) were used to evaluate the post-traumatic stress disorder (PTSD) and burnout of nurses in public health emergencies. Logistic regression analysis was established to screen for risk factors of burnout, and a nomogram was developed to predict the risk of burnout. A calibration curve and the area under the receiver operating characteristic (ROC) curve were used to validate the nomogram internally.

This study showed that only 3.7% of nurses were completely free of PTSD during a public health emergency. We found that PTSD varied by age, marital status, procreation status, length of service, employee status, and whether working in the ICU. The nurses aged 30 ~ 40 years old, single, married without children, non-regular employees, worked for less than three years or worked in the ICU had higher levels of PTSD. Regarding the prevalence of burnout, 27.4%, 48.5%, and 18.6% of nurses had a high level of emotional exhaustion (EE), depersonalization (DP), and diminished personal accomplishment (PA), respectively. There, 31.1% of nurses had more than two types of job burnout. The number of night shifts, the type of hospital, marital status, and the severity of PTSD were all associated with higher rates of exhaustion among nurses. As a graphical representation of the model, a nomogram was created and demonstrated excellent calibration and discrimination in both sets (AUC = 0.787).

This study confirmed the PTSD and burnout are common problems for in-service nurses during public health emergencies and screened out the high-risk groups of job burnout. It is necessary to pay more attention nurses who are single and working in general hospitals with many night shifts, especially nurses with severe PTSD. Hospitals can set up nurses' personal health records to give timely warnings to nurses with health problems, and carry out support interventions to relieve occupational stress.

The COVID-19 pandemic has triggered crises in the public health sector that have complex and multifaceted interrelationships with antimicrobial resistance. It is important to evaluate the impact of COVID-19 on microbiological profile, antibiotic and alcohol gel consumption in Intensive Care Units (ICU).

This is a retrospective study undertaken in an infectious disease hospital located in Bahia/Brazil during three periods: from March 2019 to February 2020; from March 2020 to February 2021; and from March 2021 to February 2022. It was evaluated the incidence density of Candida spp and of multidrug-resistant Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species (ESKAPE group) in blood, urine and tracheal secretion isolated 48 h after the patient's admission to the ICU, as well as the use of alcohol gel (in milliliters) and consumption of antibiotics in Defined Daily Dose (DDD) per 1,000 ICU patient-days in the previous year and in the first two years of COVID-19 pandemic.

There was an increase in Candida spp. (5.81, p < 0.001, IRR = 10.47, 95 % CI 2.57‒42.62) and in carbapenem-resistant A. baumannii in clinical cultures (4.71, p < 0.001, IRR = 8.46, 95 % CI 2.07‒34.60), the latter mainly in tracheal secretions (3.18, p= 0.02, IRR = 11.47, 95 % CI 1.58‒83.39). A rise in the consumption of ceftriaxone and piperacillin-tazobactam, along with an increase in the utilization of alcohol gel were observed.

The shifting microbiological profile can be attributed to both the unique characteristics of patients with COVID-19 and the adjustments made to healthcare facilities' structural and work routines. Understanding these changes is essential in addressing the accelerated impact of antimicrobial resistance during the pandemic. Therefore, conducting thorough reviews of institutional practices and routines becomes critical in mitigating the consequences of antimicrobial resistance and its implications for patient care.

The COVID-19 pandemic has had both a psychological and physiological effect on the human race. For those working in health care, particularly in critical care, the pandemic has put unprecedented strain on staff. Witnessing suffering during crisis in an organizational setting can be a traumatic experience and critical care nurses often risked, not only their own lives, but their psychological well-being, so that those infected with the virus might have a better chance at survival.

The aim of this study was to explore the challenges to mental health and psychological well-being experienced by Critical Care Nurses during the COVID-19 pandemic.

A longitudinal, qualitative study involving semi-structured interviews with 54 critical care nurses across 38 hospitals in the United Kingdom and Ireland. Interviews were transcribed verbatim and analysed using thematic analysis.

Four key themes were identified which represent the challenges faces by critical care nurses during the COVID-19 pandemic: Lack of control, Psychological trauma, Unexpected leadership, Public-political betrayal.

While public-political praise may lead to a short-term lift in morale for front line workers; where it is not accompanied by practical support in terms of appropriate equipment, leadership, emotional support and renumeration it is likely to be damaging in the longer term.

This study has provided a greater understanding of the factors which affected the well-being and mental health of critical care nurses during a global pandemic.

Background: Professional quality of life pertains to the balance between compassion fatigue and compassion satisfaction. In recent years, there was an increase in compassion fatigue among medical staff due to the pandemic, all over the world, while compassion satisfaction was reported at a moderate level.Objectives: The aim of this study was to identify the relationship between workplace humour and professional quality of life among medical staff, as well as the moderating role of compassion in this relationship.Method: The sample consisted of 189 participants (Mage = 41.01; SD = 9.58). Of the total sample, 57.1% are physicians, 32.3% are nurses and 6.9% are clinical psychologists. The participants completed scales measuring compassion, workplace humour, and professional quality of life.Results: The results showed that self-enhancing and affiliative humour were positively related, while self-defeating humour was negatively related to compassion satisfaction. Burnout and secondary traumatic stress were negatively related to self-enhancing humour and positively related to self-defeating humour. Compassion moderated the relationship between affiliative humour and secondary traumatic stress.Conclusions: Encouraging coping strategies based on adaptive humour (i.e. affiliative humour, self-enhancing) and raising awareness about negative humour strategies (i.e. self-defeating) could contribute to an increase of quality of life among healthcare providers. Another conclusion derived from the present study sustains that compassion is a valuable personal resource positively related to compassion satisfaction. Compassion also facilitates the relationship between affiliative humour and low secondary traumatic stress. Thus, encouraging compassionate skills could be beneficial for the optimal professional quality of life.

This study evaluated job burnout among primary healthcare workers (PHCWs) in China during the COVID-19 pandemic, explored its influencing factors, and examined PHCWs' preferences for reducing job burnout.

We conducted a multicenter cross-sectional study in Heilongjiang, Sichuan, Anhui, Gansu, and Shandong Provinces. An electronic questionnaire survey was conducted through convenience sampling in communities from May to July 2022. We collected sociodemographic characteristics, job burnout level, job satisfaction, and preferred ways to reduce job burnout among PHCWs.

The job burnout rate among PHCWs in China was 59.87% (937/1565). Scores for each dimension of job burnout were lower among PHCWs who had a better work environment (emotional exhaustion OR: 0.60; depersonalization OR: 0.73; personal accomplishment OR: 0.76) and higher professional pride (emotional exhaustion OR: 0.63; depersonalization OR: 0.70; personal accomplishment OR: 0.44). PHCWs with higher work intensity (emotional exhaustion OR: 2.37; depersonalization OR: 1.34; personal accomplishment OR: 1.19) had higher scores in all job burnout dimensions. Improving work environments and raising salaries were the preferred ways for PHCWs to reduce job burnout.

Strategies should be developed to improve job satisfaction among PHCWs, enhance their professional identity, and alleviate burnout to ensure the effective operation of the healthcare system, especially during periods of overwork.

Sleep disturbance and fatigue are prevalent in nurses. Little is known about the characteristics of shift work nurses' sleep-wake features and their subsequent impact on work performance. The study aimed to describe the characteristics of the sleep-wake index, reaction time, saliva cortisol level, and fatigue severity among female shift work nurses.

This is a cross-sectional exploratory study. A convenience sample of 152 female nurses (8-hour day-evening-night, n = 70; 12-hour day-night, n = 82) participated in this study from nine intensive care units (ICUs) from two teaching hospitals in Beijing, China. A consecutive 7-day actigraphy data were used to analyse sleep-wake indexes, including total sleep time (TST) and circadian activity rhythms (CAR). Before and after shifts, the following data were collected, psychomotor vigilance task for reaction time, saliva cortisol for the level of alertness, and self-reported fatigue severity with the Lee Fatigue Scale-Short Form.

All nurses reported clinically significant fatigue severity. Compared with the 8-hour shift nurses, the 12-hour shift nurses had significantly more TST (456 vs. 364 min), higher saliva cortisol levels before the day shift (0.54 vs. 0.31), but longer reaction time before the night shift (286 vs. 277 ms). In both shifts, those with better CAR had significantly longer TST.

Female nurses experienced fatigue and desynchronized CAR, especially nurses on a 12-hour shift. The CAR-friendly shift work schedule is needed to minimize the health and safety impacts of circadian misalignment for nurses.Key messagesThis is the first use of consecutive 7-day actigraphy data to explore the link between sleep disturbances as a stressor to CAR, salivary cortisol, and reaction time among clinical nurses.CAR may be a helpful indicator for overworked nurses, and it can serve as a modifiable target for interventions to enhance nurses' well-being.

To review and synthesize available evidence exploring the impact of pandemics on direct healthcare providers' workloads in the acute care setting.

Scoping review.

A review of English research articles published up to August 2022 that examined the impact of pandemics on healthcare providers' workloads was undertaken. Studies were identified by searching four electronic databases: Medline (EBSCO), CINAHL (EBSCO), Web of Science and PsychInfo (EBSCO). Fifty-five studies met the inclusion criteria.

The review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses Scoping Review checklist.

Healthcare workers experience an increase in workload pressures during a pandemic. This included patients requiring more care, undertaking non-normal work activities, increase in work content including changes to documentation, increase in demand and skills required, an increase in overtime and hours of work per week and higher patient-to-nurse ratios. The review also highlighted changes to the work environment and worsened work environments, including staffing shortages.

Focused efforts from health organizations to prioritize supportive conditions, policies focused on improved work environments, staffing adequacy and fair and reasonable workloads will enhance retention of the current workforce and future planning for pandemics.

Understanding workload challenges faced by frontline health professionals during the pandemic can improve planning, including policies and procedures, and resource allocation for future pandemic or emergency situations. In addition, extended periods of high workloads can impact staff retention. As many countries return to life after COVID-19, it is important that healthcare organizations examine staff pressures and identify ways to support staff moving forward. This will be vital for the future sustainability of the workforce.

No patient or public contribution.

The COVID-19 pandemic involved a rapid change to the working conditions of all healthcare workers (HCW), including those in primary care. Organizational responses to the pandemic, including a shift to virtual care, changes in staffing, and reassignments to testing-related work, may have shifted more burden to these HCWs, increasing their burnout and turnover intent, despite their engagement to their organization. Our objectives were (1) to examine changes in burnout and intent to leave rates in VA primary care from 2017-2020 (before and during the pandemic), and (2) to analyze how individual protective factors and organizational context affected burnout and turnover intent among VA primary care HCWs during the early months of the pandemic.

We analyzed individual- and healthcare system-level data from 19,894 primary care HCWs in 139 healthcare systems in 2020. We modeled potential relationships between individual-level burnout and turnover intent as outcomes, and individual-level employee engagement, perceptions of workload, leadership, and workgroups. At healthcare system-level, we assessed prior-year levels of burnout and turnover intent, COVID-19 burden (number of tests and deaths), and the extent of virtual care use as potential determinants. We conducted multivariable analyses using logistic regression with standard errors clustered by healthcare system controlled for individual-level demographics and healthcare system complexity.

In 2020, 37% of primary care HCWs reported burnout, and 31% reported turnover intent. Highly engaged employees were less burned out (OR = 0.57; 95% CI 0.52-0.63) and had lower turnover intent (OR = 0.62; 95% CI 0.57-0.68). Pre-pandemic healthcare system-level burnout was a major predictor of individual-level pandemic burnout (p = 0.014). Perceptions of reasonable workload, trustworthy leadership, and strong workgroups were also related to lower burnout and turnover intent (p < 0.05 for all). COVID-19 burden, virtual care use, and prior year turnover were not associated with either outcome.

Employee engagement was associated with a lower likelihood of primary care HCW burnout and turnover intent during the pandemic, suggesting it may have a protective effect during stressful times. COVID-19 burden and virtual care use were not related to either outcome. Future research should focus on understanding the relationship between engagement and burnout and improving well-being in primary care.

During the SARS-CoV-2 pandemic, as in past disasters and emergencies, nurses around the world play an important role. What is more, the unprecedented pressure exerted by the pandemic on healthcare systems in every country brings big challenges to nurses, which may affect their well-being, work efficacy and job satisfaction.

The main objective of the presented studies was to describe anxiety factors related to the work of nurses during the SARS-CoV-2 pandemic; to assess the intensity of coronavirus anxiety and job satisfaction experienced by nurses at that time; to assess predictors of job satisfaction of nurses during the COVID-19 pandemic; to assess the differences in the intensity of job satisfaction and coronavirus anxiety depending on the selected variables related to their experiences during the COVID-19 pandemic.

Anonymous questionnaire surveys were conducted online among the participants between 23 June 2020 and 23 March 2022 in Poland.

433 nurses from 15 Polish provinces were included in the studies (age range 22-68; M = 41.63). Nursing seniority M = 18.6.

The studies were based on: Satisfaction with Job Scale (SSP), Coronavirus Anxiety Scale (CAS), and a self-report structured questionnaire.

The most respondents indicated that they were afraid of becoming infected with SARS-CoV-2 (25.4 %), transmitting infection to the family (22.4 %), becoming sick with COVID-19 and experiencing health complications (6.7 %) and of excessive work responsibilities and physical fatigue (6.5 %). Based on the bivariate correlation, it can be concluded that job satisfaction of the respondents during the COVID-19 pandemic was on an average level (M = 19.9); coronavirus anxiety was on an average level (M = 4.9), and stress at work was on a high level (M = 7.1). Coronavirus anxiety did not constitute statistically significant predictors of job satisfaction of subjects studied during the pandemic (SE = 0,048; β = 0,05; p = 0.942).

Coronavirus anxiety wasn't associated with job satisfaction of nurses directly. Job satisfaction of nurses during the COVID-19 pandemic was likely to be shaped by a range of different factors.

In Polish nurses coronavirus anxiety was average and wasn't associated with their job satisfaction.

Intensive care unit (ICU) nurses faced an increased risk of compassion fatigue and ethical concerns during the COVID-19 pandemic.

To evaluate compassion fatigue of ICU nurses and their ethical attitudes in care during the COVID-19 pandemic and analyze contributing factors.

An exploratory cross-sectional research design was used.

A total of 103 ICU nurses participated. The nurses' compassion fatigue and ethical attitude scores were high. Compassion fatigue was explained by the following variables: considering resigning, receiving support for ethical decisions, willingness to work in the ICU, duration of providing activities of daily living in a shift, and number of patients per nurse.

Compassion fatigue was high in nurses working in the ICU during COVID-19. The high level of ethical attitudes shows commitment to professional ethics and reflects the development of the nurses' professional identity. Implementation of interventions that help improve compassion fatigue among nurses is needed.

During the COVID-19 pandemic, health workers' workload is increasing, with the risk of burnout. Several instruments for assessing burnout have been developed since the concept was coined in the 1970s. It is important to map and describe the application of burnout instruments for health workers in the current COVID-19 pandemic situation.

This article aimed to map and describe what instruments are used and variations of their application to research burnout in health workers during the COVID-19 pandemic.

This scoping review searched articles systematically through 7 databases (PubMed, Clinical Key, Scopus, EBSCOhost, APA PsycINFO, Science Direct, and Wiley Online Library). Articles were screened and analyzed following the Arksey and O'Malley framework.

From 507 results, 31 peer-reviewed articles were selected. These studies involved 33,879 participants from various health professions. Generally, the research instrument is still dominated by Maslach Burnout Inventory. Applications of burnout measurements vary widely because there is no consensus on the concept of burnout assessment.

Inconsistency in burnout-measuring tools can be seen as providing flexibility and alternatives, but at the same time, it is a gap that challenges researchers to develop more comprehensive instruments, especially for the burnout phenomenon in health workers during the COVID-19 pandemic.

During the COVID-19 pandemic, a shortage of intensive care unit beds was encountered across Europe. Opening a semi-intensive pulmonary ward freed up intensive care unit beds. This study aimed to determine the appropriate nurse staffing level for a semi-intensive pulmonology unit (SIPU) for patients with COVID-19 and to identify factors associated with an increase in nursing workload in this type of unit.

This was a retrospective study of the SIPU of the Erasme university clinics in Belgium. Nursing staff was determined with the Nursing Activities Score (NAS) during the second wave of COVID-19 in Belgium.

During the study period, 59 patients were admitted to the SIPU, and a total of 416 NAS scores were encoded. The mean (±SD) NAS was 70.3% (±16.6%). Total NAS varied significantly depending on the reason for admission: respiratory distress (mean [SD] NAS, 71.6% [±13.9%]) or critical illness-related weakness (65.1% ± 10.9%). The items encoded were significantly different depending on the reason for admission. In multivariate analysis, body mass index > 30 (odds ratio [OR], 1.77; 95% confidence interval [CI], 1.07-3.30) and higher Simplified Acute Physiology Score II score (OR, 1.05; 95 CI, 1.02-1.11) were associated with higher NAS. Patients admitted via the emergency department (OR, 2.45; 95% CI, 1.15-5.22) had higher NAS. Patients on noninvasive ventilation (OR, 13.65; 95% CI, 3.76-49.5) and oxygen therapy (OR, 4.29; 95% CI, 1.27-14.48) had higher NAS. High peripheral venous oxygen saturation (OR, 0.86; 95% CI, 0.78-0.94) was a predictor of lower workload.

A ratio of 2 nurses to 3 patients is necessary for SIPU care of patients with COVID-19. Factors associated with higher workload were high Simplified Acute Physiology Score II score, body mass index > 30, admission via emergency room, patients on oxygen, and noninvasive ventilation.

The COVID-19 (coronavirus disease) pandemic placed a great burden on all health-care resources, especially nurses. The prevalence and underlying risk factors of affective symptoms related to the COVID-19 pandemic have been studied primarily among nurses in intensive care units (ICU) and emergency departments. The aim of this study was to identify at-risk nursing areas by examining the psychological and physical stress values of nurses in different functional areas.

A questionnaire with standardized items was developed to assess psychological and physical stress values. At least 50 nurses with a minimum work experience of 3 years were recruited from the ward, outpatient clinic (OC), intermediate care (IMC) unit, and operating room (OR) of the University Hospital RWTH Aachen. The participants answered the questionnaire by referring to their perceptions before and during the COVID-19 pandemic. Absolute differences and relative trends in psychological and physical stress values were compared within and across functional areas.

The ward and OR nurses experienced significant increases in workload (p < 0.001 and p = 0.004, respectively) and time stressors (p < 0.001 and p = 0.043, respectively) during the COVID-19 pandemic. Regardless of functional area, the nurses showed strong tendencies toward increases in subclinical affective symptoms. After adjustments for age, sex, working in a shift system, the treatment of patients with COVID-19, and the impact of the COVID-19 pandemic on personal life, the values for working with pleasure decreased significantly among the ward (p = 0.001) and OR nurses (p = 0.009) compared with the OC nurses. In addition, the ward (p < 0.001) and OR nurses (p = 0.024) were significantly more likely to express intent to leave their profession than OC nurses.

The IMC nurses showed good adaptation to the exacerbated situation caused by the COVID-19 pandemic. The ward nurses, followed by the OR nurses, were the most vulnerable to mental and physical exhaustion, which threatened the nurses' resilience and retention in the wake of the COVID-19 pandemic. Therefore, intervention programs must specifically address the professional and emotional needs of ward and OR nurses to prepare the health-care system for future crises.

Sporadic evidence exists for burnout interventions in terms of types, dosage, duration, and assessment of burnout among clinical nurses. This study aimed to evaluate burnout interventions for clinical nurses. Seven English databases and two Korean databases were searched to retrieve intervention studies on burnout and its dimensions between 2011 and 2020.check Thirty articles were included in the systematic review, 24 of them for meta-analysis. Face-to-face mindfulness group intervention was the most common intervention approach. When burnout was measured as a single concept, interventions were found to alleviate burnout when measured by the ProQoL (n = 8, standardized mean difference [SMD] = - 0.654, confidence interval [CI] =  - 1.584, 0.277, p < 0.01, I2 = 94.8%) and the MBI (n = 5, SMD = - 0.707, CI = - 1.829, 0.414, p < 0.01, I2 = 87.5%). The meta-analysis of 11 articles that viewed burnout as three dimensions revealed that interventions could reduce emotional exhaustion (SMD = - 0.752, CI = - 1.044, - 0.460, p < 0.01, I2 = 68.3%) and depersonalization (SMD = - 0.822, CI = - 1.088, - 0.557, p < 0.01, I2 = 60.0%) but could not improve low personal accomplishment. Clinical nurses' burnout can be alleviated through interventions. Evidence supported reducing emotional exhaustion and depersonalization but did not support low personal accomplishment.

The potential psychological health impact of pandemics on nurses has been increasingly widely recognised, as have recommendations to establish support measures for nurses' well-being. Despite the availability of support measures significant number of nurses still experienced burnout and mental distress during Covid-19. Few efforts have been made in the wider literature to understand how nurses experience well-being support or how they perceive it affects their well-being during pandemics. In the Middle East, understanding and exploring well-being support measures during pandemics from nurses' perspectives has not received significant attention.

To investigate nurses' perspectives and experiences of well-being support measures during prior pandemics and the Covid-19 pandemic in the Middle East.

A systematic qualitative review was undertaken utilising the JBI model as a framework. Searches were carried out in databases comprised CINAHL, MEDLINE, NUsearch Library of Nottingham University and Google Scholar. Moreover, a manual search through reference lists for relevant studies were carried out.

Eleven studies were included in the review. The findings from the included qualitative studies were extracted using the JBI-QARI data extraction tool for qualitative research. The results were synthesised using a meta-synthesis in line with the JBI approach.

The included studies yielded an aggregate of 111 findings and were categorised into 14 categories, followed by four synthesised findings. These were: [1] nurses experienced challenges during MERS, yet different strategies were implemented by leaders and nurses to manage these challenges; [2] some well-being support measures were unfulfilled during Covid-19; [3] additional aspects compounded negatively on nurses' well- being; and [4] nurses showed maturity during Covid-19.

In comparison to prior health emergencies, well-being support measures during Covid-19 were not sufficiently adopted. Nurse policymakers and managers should consider these support measures to correspond with nurses' needs and explore the contextual factors that affect their implementation.

PROSPERO (CRD42022344005).

The study aim was to investigate the prevalence of behavioral symptoms and burnout in healthcare workers in an intensive neurological rehabilitation unit in Messina, Italy, during the first COVID-19 lockdown in Italy.

Forty-seven healthcare workers (including neurologists, physiatrists, nurses and rehabilitation therapists) were enrolled in this cross-sectional study from February 2020 to June 2020. Participants were administered the following psychometric tests to investigate burnout and related symptoms: the Maslach Burnout Inventory, which measures emotional exhaustion, depersonalization and reduced personal accomplishment; the Zung Self-Rating Depression Scale (SDS); the Pre-Sleep Arousal Scale (PSAS); the Dyadic Adjustment Scale; and the Buss-Perry Aggression Questionnaire (BPAQ).

We found several correlations between test scores and burnout subdimensions. Emotional exhaustion was correlated with SDS (r = 0.67), PSAS-Cognitive (r = 0.67) and PSAS-Somatic (r = 0.70) scores, and moderately correlated with all BPAQ dimensions (r = 0.42). Depersonalization was moderately correlated with SDS (r = 0.54), PSAS-Cognitive (r = 0.53) and PSAS-Somatic (r = 0.50) scores.

During the first COVID-19 lockdown in Italy, healthcare workers were more exposed to physical and mental exhaustion and burnout. Research evaluating organizational and system-level interventions to promote psychological well-being at work for healthcare workers are needed.

The term resilience is used to refer to multiple related phenomena, including: (i) characteristics that promote adaptation to stressful circumstances, (ii) withstanding stress, and (iii) bouncing back quickly. There is little evidence to understand how these components of resilience are related to one another. Skills-based adaptive characteristics that can respond to training (as opposed to personality traits) have been proposed to include living authentically, finding work that aligns with purpose and values, maintaining perspective in the face of adversity, managing stress, interacting cooperatively, staying healthy, and building supportive networks. While these characteristics can be measured at a single time-point, observing responses to stress (withstanding and bouncing back) require multiple, longitudinal observations. This study's aim is to determine the relationship between these three aspects of resilience in hospital workers during the prolonged, severe stress of the COVID-19 pandemic.

We conducted a longitudinal survey of a cohort of 538 hospital workers at seven time-points between the fall of 2020 and the spring of 2022. The survey included a baseline measurement of skills-based adaptive characteristics and repeated measures of adverse outcomes (burnout, psychological distress, and posttraumatic symptoms). Mixed effects linear regression assessed the relationship between baseline adaptive characteristics and the subsequent course of adverse outcomes.

The results showed significant main effects of adaptive characteristics and of time on each adverse outcome (all p < .001). The size of the effect of adaptive characteristics on outcomes was clinically significant. There was no significant relationship between adaptive characteristics and the rate of change of adverse outcomes over time (i.e., no contribution of these characteristics to bouncing back).

We conclude that training aimed at improving adaptive skills may help individuals to withstand prolonged, extreme occupational stress. However, the speed of recovery from the effects of stress depends on other factors, which may be organizational or environmental.

Many studies have investigated how organizational support systems, remote work adaptation, and control over scheduling reduced psychological burnout and occupational stress, thus improving employee wellbeing during the COVID-19 pandemic. This systematic literature review has analyzed significant published peer-reviewed evidence concerning how remote employees lacking constant organizational support during the COVID-19 outbreak experienced escalated job demands, professional strain, low satisfaction and performance, and increased burnout. Throughout February 2023, a quantitative literature review covering scholarly databases such as the Web of Science, Scopus, and ProQuest was performed, with the following search terms: "COVID-19" + "remote work burnout," "COVID-19" + "professional job stress," and "COVID-19" + "employee emotional exhaustion." By inspecting research published between 2020 and 2022, a total of 311 articles satisfied the eligibility criteria. Excluding sources in PRISMA terms, 44 empirical sources were finally selected. Methodological quality assessment tools such as Assessing the Methodological Quality of Systematic Reviews (AMSTAR), Appraisal tool for Cross-Sectional Studies (AXIS), Mixed Methods Appraisal Tool (MMAT), and Systematic Review Data Repository (SRDR) were employed. Data visualization tools (VOSviewer and Dimensions), integrating layout algorithms and bibliometric mapping, were harnessed. The scope of this study does not include how taking breaks and time management in a psychologically safe environment prevented remote work burnout and increased productivity during the COVID-19 pandemic. Subsequent analyses should be developed on how remote work time and stress management-by using burnout assessment tools-will result in coherent workplace behaviors and processes, meeting organizational expectations and reducing emotional stress and workplace pressure.

The burnout syndrome (BS) is defined as a response to chronic work stress. It appears as a subjective phenomenon and its main symptoms are the loss of enthusiasm towards work, a feeling of professional failure, feelings of guilt, emotional exhaustion and indifference to patients' problems.

To evaluate the prevalence of BS in health personnel who care for cancer patients in a tertiary hospital.

Descriptive cross-sectional study. The sample consisted of 41 health professionals dedicated to providing direct care to cancer patients, which were selected through an intentional non-probabilistic sampling. The Questionnaire for the Evaluation of the Burnout Syndrome was applied.

In the sample studied, BS presented a prevalence of 51.21% at the medium level, 9.75% at the high level and 2.43% at the critical level. Significant differences were found between groups by service and work seniority.

A high prevalence of symptoms of BS was found in the study participants, derived mainly from the excessive workload, the type of care provided, as well as experiences related to contact with people living with cancer, the hospital environment, and the type of interpersonal relationships that emerge there. The personnel most affected was that one belonging to Medical Oncology, Psychology, and Social Work.

The aim of this study was to explore the experiences of frontline nurses caring for patients during the first 6 months of the COVID-19 pandemic.

The JBI manual for evidence synthesis and the PRISMA guidelines for reporting.

CINAHL Complete, MEDLINE, PsycINFO (EBSCO) and Scopus (Elsevier).

The JBI Mixed Methods Data Extraction Tool following a Convergent Integrated Approach.

Nineteen studies were included in the review, comprising eight countries and 2525 frontline nurses. Six themes emerged encompassing frontline nurses' COVID-19 experiences including emotional experiences, physical symptoms, ethical and moral challenges, professional impact, risk factors for negative emotional experiences and protective factors for future pandemic events.

Frontline nurses have faced numerous challenges during the COVID-19 pandemic. Providing frontline nurses with the required resources and support to perform their roles in global healthcare crises allows for an empowered and resilient workforce ensuring nurses remain in their chosen profession.