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The aim of this study was to explore physicians' experiences of the process leading up to their sick leave due to exhaustion disorder (ED).
A qualitative study with a narrative approach was conducted.
The study was conducted in Sweden. Interviews with physicians were conducted face-to-face during the Spring and Autumn of 2022. Each interview lasted between 35 and 60 min.
Purposive sampling was employed to recruit physicians on long-term sick leave for ED. We used an interview guide with open-ended questions.
12 physicians shared their experiences of the process leading to their ED-related sick leave. Four themes related to different phases of the process: Theme 1. Strongly motivated to become a physician, Theme 2. Demands delivering best practice, Theme 3. Symptoms of ill health and Theme 4. Managing symptoms of ED. The narrative analyses showed a holistic understanding of the personal consequences for the physicians and their families as well as the consequences in working life.
Politicians and leaders at different healthcare levels must take responsibility for strengthening the working environment, which is important for creating long-term and sustainable healthcare services.
To explore interprofessional team members’ experiences of teamwork at an intensive care unit.
Qualitative content analysis of focus group interviews with members from the intensive care teams.
University hospital in Sweden.
In total, 31 participants were interviewed. Enrolled nurses (n=7), critical care registered nurses (n=16), and intensive care physicians (n=8) employed at an intensive care unit were divided into nine focus groups organised according to the profession.
The overall theme, Balancing behaviour and knowledge in teamwork, emerged from the two categories of creating a safe atmosphere when working in an unknown environment and counteracting and mitigating destructive team dynamics. The theme captures how well-functioning teamwork must take into account members not acting as team players while also building a secure environment when working in new surroundings outside the intensive care unit. The categories describe how mutual respect, effective teamwork and a safe atmosphere were fostered through support without taking over tasks and countering power structures.
Navigating teamwork during critical situations is inherently complex, making it essential to understand team interactions and factors influencing individual behaviour. To ensure patient safety, the interprofessional team must recognise, understand and manage diverse behaviours and knowledge in dynamic settings. This research contributes to existing knowledge on teamwork in the intensive care context by providing insights into how knowledge and behaviour in teamwork can be optimised to enhance patient safety.
This study aimed to explore the predictive value of severe burnout complaints, symptom dimension of burnout and depressive symptoms for subsequent all-cause medically certified sickness absence (ACMCSA) during the pandemic among physicians in Sweden.
A 1 year follow-up panel cohort observational study—the Longitudinal Occupational Health Survey for HealthCare in Sweden. At baseline (February–May 2021), a representative sample of 6699 physicians was drawn from the Swedish occupational register and invited to participate in the study. At follow-up (March–May 2022), the full sample (excluding those who died, retired, stopped working as a physician or migrated, n=94) was invited to answer the survey.
Swedish primary and specialist healthcare.
At baseline, the response rate was 41.3% (n=2761) of which 1575 also answered at follow-up.
ACMCSA data came from the Swedish Social Insurance Agency. The Burnout Assessment Tool (BAT-23) was used to measure burnout, including a burnout total score and scores for the four symptom dimensions of exhaustion, mental distance, emotional impairment and cognitive impairment. Depressive symptoms were assessed using the Symptom Checklist-core depression (SCL-CD6). Associations between baseline burnout and depressive symptoms and subsequent ACMCSA were estimated with logistic regression analyses.
ACMCSA was found in 9% of the participating physicians. In the sample, 4.7% had severe burnout complaints, and 3.7% had depressive symptoms. Burnout (OR=2.57; 95% CI=1.27 to 5.23) and the burnout symptom dimensions emotional impairment (OR=1.80; 95% CI=1.03 to 3.15) and cognitive impairment (OR=2.52; 95% CI=1.12 to 5.50) were associated with a higher likelihood of subsequent ACMCSA. Depressive symptoms were not associated with ACMCSA when adjusted for severe burnout complaints and other covariates.
This study demonstrates the distinction between burnout and depressive symptoms, particularly in predicting future ACMCSA. Early intervention targeting exhaustion and burnout may mitigate symptom development and reduce the risk of ACMCSA.
Having more registered nurses (RNs) leave their workplace, with a shortage of RNs in healthcare as a consequence, might pose a risk to patient safety. According to the Job Demands Resource model, social support is a resource that can enhance work motivation, and if RNs are motivated at work, their willingness to remain in the workplace may increase.
The aims were to explore (1) differences in RNs' experiences of social support from their immediate manager and co-workers between different healthcare settings, (2) associations between RNs' experiences of social support and aspects of work motivation, and (3) if these associations differed in strength between healthcare settings.
A cross-sectional study design.
A stratified population of Swedish RNs, n = 2290, working in either hospitals, primary care, or home healthcare, responded to a survey in 2022. Chi-squared tests and linear and logistic regression analyses were used to analyze the data. Interaction was measured by adding an interaction term to the fully adjusted regression models. The findings' generalizability was strengthened by including calibrating weights in all analyses.
RNs in primary care reported higher social support from their immediate manager than RNs in hospitals and home healthcare. RNs in home healthcare reported lower social support from co-workers than RNs in hospitals and primary care. There were statistically significant associations between higher levels of social support from the immediate manager and co-workers, respectively, and higher ratings in all aspects of work motivation: work engagement (manager: beta coefficient [b] = 0.08, confidence interval [CI] 95% = 0.05; 0.10; co-workers: b = 0.12, CI 95% = 0.08; 0.16), job satisfaction (manager: b = 0.24, CI 95% = 0.21; 0.27; co-workers: b = 0.22, CI 95% = 0.16; 0.28), opportunities to provide high-quality care (manager: b = 0.15, CI 95% = 0.11; 0.18; co-workers: b = 0.19, CI 95% = 0.13; 0.24), satisfaction with the employer (manager: b = 0.46, CI 95% = 0.42; 0.50; co-workers: not statistically significant) and intention to remain at the workplace (manager: odds ratio = 1.89, CI 95% = 1.69; 2.13; co-workers: odds ratio = 1.42, CI 95% = 1.17; 1.72). The associations differed in strength between hospitals, primary care, and home healthcare.
Strengthening social support from the immediate manager and co-workers appears to be a way to increase RNs' work motivation, including their intention to remain at the workplace. This may be important, particularly in primary care and home healthcare.
To strengthen RNs' work motivation and willingness to stay in the workplace, it appears important for healthcare organizations to provide RN social support.
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