Occupational Burnout in the US Healthcare System Case Study

Chapter 1: Introduction - Strategies for Burnout Prevention

1.1 Rationale

Due to its pervasiveness and far-reaching effects within the healthcare industry, the topic of "Occupational Burnout in the US Healthcare System" requires in-depth investigation (Izdebski et al., 2023). The COVID-19 epidemic has exacerbated the already demanding and high-stress nature of hospital employment, emphasizing how urgent it is to combat burnout among healthcare professionals (Murthy, 2022). The purpose of this systematic review is to provide a thorough understanding of the numerous aspects of burnout, its effects on employee performance and health, and the efficacy of therapies and policies designed to lessen it.

Looking for top-notch assignment assistance? Get expert help with assignment from subject-specific writers who understand the intricacies of your course. Whether it's Nursing, Marketing, Java, or any other subject, our qualified professionals are here to ensure your assignments meet the highest standards.

This review states the difficulties faced by healthcare professionals while also providing valuable insights for healthcare organizations and policymakers to develop focused strategies for reducing burnout and improving the general standard of healthcare delivery in the United States. It is identified that a thorough global poll between February and April 2022 to get a better understanding of the widening gap between company initiatives and the rising difficulties in employees' mental health and wellbeing (McKinsey Health Institute, 2022). 15,000 employees and 1,000 HR decision-makers from 15 different countries participated in this poll (McKinsey Health Institute, 2022). The survey looked at several workplace factors, such as unhealthy workplace dynamics, environmentally friendly work practises, inclusivity and a sense of belonging, support for both professional and personal growth, the absence of stigma, organisational commitment, leadership accountability, and the accessibility of necessary resources (Zhenjing et al., 2022).

1.3 Potential for insightful outcomes

It can offer a thorough and fact-based narrative on the level of burnout among healthcare workers, stating the complex nature of this ubiquitous problem (Reith, 2018). The review can provide a comprehensive understanding of the variables causing burnout, its prevalence across healthcare professions, and the consequences for both healthcare professionals and the standard of patient care by synthesising a plethora of literature. Additionally, it can be an invaluable resource for healthcare organisations and policymakers by providing evidence-based suggestions for dealing with burnout (Dall’Ora et al., 2020).

1.4 Scope

Hospital employees are particularly susceptible to burnout because of the hard and frequently stressful nature of their jobs (Knudson, 2023). Hospitals are a major part of the US healthcare system, thus it's important to understand the causes, effects, and possible therapies for burnout in these settings. The review provides a comprehensive overview of this urgent issue by incorporating numerous important features, such as defining and evaluating burnout as well as examining its causes, influence on wellbeing and performance, and even its consequences for patient care (Søvold et al., 2021).

Additionally, it will explore the efficacy of interventions and strategies, giving healthcare organisations and policymakers concrete knowledge to better address and prevent burnout among hospital personnel in the US (Bailinson et al., 2020).

1.5 Aim and Objectives

Aim

This research aims to critically evaluate the causes and consequences of occupational burnout among hospital professionals in the United States.

Objectives

• To review how common occupational burnout is in the United States hospital professions
• To discuss how burnout among hospital professionals affects patient care's safety and quality, including the frequency of medical errors and the results for individual patients.
• To analyze long-term patterns in the incidence and kind of burnout, with a focus on how the COVID-19 epidemic has affected burnout among American healthcare workers.
• To provide evidence-based suggestions for best practices while assessing the efficacy of various interventions, programs, and policies targeted at preventing or alleviating burnout among healthcare professionals.

1.6 Theoretical overview

Job Demand-Control Model: Healthcare organizations can put several initiatives into place to manage job strain brought on by high demands and little control (Gameiro, Chambel and Carvalho, 2020). They can give healthcare personnel more control over their working procedures, enabling them to set priorities and make decisions.

Healthcare organisations should concentrate on recognising and rewarding the work of their staff to address perceived effort-reward discrepancies (Ge et al., 2021). Providing competitive wage packages, understanding the emotional needs of the job, and giving real rewards for exceptional performance are a few examples of how to do this.

The Effort-Reward Imbalance (ERI) Model (ERI) model is proposed by Johannes Siegrist, and centers on the psychological agreement established between employees and their respective organizations (Ren et al., 2019). This statement underscores the need to maintain a harmonious equilibrium between the exertion of employees in their professional endeavours and the corresponding remuneration they obtain (UNESCO, 2022). Within the healthcare industry, the presence of elevated demands and stress associated with work can result in an inequitable effort-reward dynamic, compromising the performance and overall well-being of employees (De Hert, 2020).

1.7 Integration of areas of MBA

• Leading and managing organizational resources: This topic focuses on strengthening organizational leadership abilities and efficient resource management. The leadership abilities learned here can be used in the context of entrepreneurship and international competition (Nguyen et al., 2021). To successfully navigate the challenges of global business and promote innovation, effective leadership is essential.
• Strategy and the Global Competitive Environment: Understanding the competitive landscape and creating strategies to attain organisational goals are the two main components of the strategy. The global competitive landscape requires that leaders adapt their leadership strategies accordingly (Northwest Executive Education, 2021). They must make strategic choices that consider global trends, competitive dynamics, and foreign markets.
• Corporate innovations and entrepreneurship: In this area, emphasis is placed on promoting an innovative culture and investigating business potential. One of the main forces behind competitiveness is innovation. The integration of innovation into leadership and strategic thinking is something that students can learn (Nguyen et al., 2021). Entrepreneurial abilities can also be used when entering new markets and expanding internationally.
• International and comparative human resource management: This subject focuses on comprehending international HR practises and managing a varied workforce across boundaries. Leaders need to be skilled at leading multicultural teams and knowledgeable about the subtle differences between regional HR practices (Center for Creative Leadership, 2022). Strategic choices relating to international expansion and mergers/acquisitions can be informed by knowledge of global HRM.

1.8 Method of Analysis

Any thorough analysis must include the literature research and data synthesis process, especially when using secondary qualitative data sources from an MBA programme. Gaining knowledge of the linked areas of the programme, such as Leading and Managing Organisational Resources, Strategy and the Global Competitive Environment, Corporate Innovations and Entrepreneurship, and International and Comparative Human Resource Management, is crucial at these stages (Center for Creative Leadership, 2022). Secondary qualitative study will be employed, and journals and articles will be taken from Google scholar, PubMed, and other authentic sites. Furthermore, journals and articles will be selected from 2018 to 2023 which help to get appropriate data.

1.9 Evidence

Criteria	Inclusion	Exclusion
Publication Type	Peer-reviewed journal articles	Non-peer-reviewed sources, e.g., books, conference abstracts
Publication Date	Within the last 10 years	Published more than 10 years ago
Research Methodology Qualitative studies	Quantitative studies Mixed-methods studies Systematic reviews Literature reviews Theoretical papers Opinion pieces
Scope and Relevance	Related to Leading and Managing Organizational Resources, Strategy and the Global Competitive Environment, Corporate Innovations and Entrepreneurship, or International and Comparative Human Resource Management within the context of MBA programs	Unrelated or tangentially related topics
Empirical studies	Conceptual or theoretical papers
Geographical Focus	Global studies or studies with relevance to the United States (Demeter, 2022)	Region-specific studies that are not applicable to MBA programs
Language	English	Non-English languages
Accessibility	Full-text sources	Sources with limited or no access

In this research process Peer-reviewed journal articles has been include within last 10 years framework. Different types of qualitative data has been used in this aspects related to the leading and managing organizational resources and human resources management process for MBA programs additionally the US and global prospectus (Sleeman, 2022). However, quantitative or mixed methods of research are not used In this study. Empirical research paper is used rather than conceptual and theoretical paper (Sivalingam, 2019).

Chapter 2: Literature Review and Method of Analysis

2.1. Introduction

The integration of Information Systems (IS) has emerged as a critical component of hospital administration and patient care in the quickly changing healthcare landscape. Although there are many advantages to this technological innovation are also special problems that especially in terms of employee wellness. An in-depth analysis of occupational burnout in the IS healthcare system is covered in this chapter with particular attention to how it affects hospital staff performance and well-being. Burnout is a condition of extreme physical and mental tiredness brought on by extended periods of stress and it is particularly common in high-stress settings like the medical field.

Journal matrix

Article Reference	Study Focus	Population Studied	Methodology	Key Findings
Chen et al. (2022a)	Transformational Leadership and Burnout	Hospital Employees	Quantitative Survey	Found that transformational leadership significantly reduces burnout by enhancing resilience and role clarity.
Kerlin et al. (2020)	Burnout and Joy in Critical Care Medicine	Critical Care Professionals	Review	Discussed the balance between burnout and finding joy in work, emphasizing the need for institutional changes.
Sangal et al. (2020)	Team Identification and Stress in Emergency Departments	Front-line Emergency Staff	Mixed-Methods	Identified strong team identification as a buffer against stress and burnout during the COVID-19 pandemic.
Venkatesh et al. (2020)	Agile Methods Reducing Work Exhaustion	IT Professionals	Qualitative Analysis	Suggested that agile methodologies in software development can reduce work exhaustion and burnout.
Garcia et al. (2019a)	Burnout's Influence on Patient Safety	Healthcare Professionals	Systematic Review and Meta-Analysis	Highlighted a significant correlation between healthcare professional burnout and decreased patient safety.
Page et al. (2021)	Delirium and Thiamine Levels in ICU	ICU Patients	Observational Study	Investigated the association between thiamine levels and delirium occurrence in ICU settings.
Hodkinson et al. (2022)	Burnout, Career Engagement, and Patient Care	Physicians	Systematic Review and Meta-analysis	Found that higher burnout levels are associated with decreased career engagement and potentially lower quality of patient care.
Jun et al. (2021)	Nurse Burnout and Organizational Outcomes	Nurses	Systematic Review	Explored how nurse burnout is linked to patient outcomes and organizational efficiency.
Patel et al. (2019)	Managing Physician Burnout	Physicians	Review	Reviewed strategies for managing physician burnout, including organizational and individual approaches.
Ge et al. (2021)	Job Factors on Health Among Healthcare Workers	Healthcare Workers	Cross-Sectional Study	Examined how effort-reward imbalance and job satisfaction affect self-rated health among healthcare workers.
Martínez-López et al. (2020a)	Burnout During COVID-19 in Spain	Health Professionals	Survey	Assessed the psychological impact and burnout incidence during the critical COVID-19 period in Spain.
Alruwaili et al. (2022)	Occupational Stressors in Emergency Nurses	Emergency Department Nurses	Mixed-Method Study	Explored the experiences and coping patterns of nurses facing occupational stressors in Saudi Arabian hospitals.
Salameh et al. (2023)	Secondary Traumatic Stress in Nurses	Emergency Nurses	Quantitative Study	Assessed the prevalence and consequences of secondary traumatic stress among emergency nurses in Palestine.

2.2 Demonstrated the key effectiveness of common occupational burnout in the context of the United States' hospital professions

Occupational burnout is a difficult issue in the US healthcare business that significantly affects hospital staff, especially those in information systems (IS) (Chen et al., 2022). This phenomenon can be attributed to the unique challenges this sector encounters, including as demanding schedules, high-stress environments, and the emotional toll of delivering patient care. This section discusses the prevalence and impacts of burnout emphasising how it impacts staff well-being and hospital performance.

Figure 2.1: Risk factors associated with burnout syndrome

It focuses on how effective commonly used strategies are at lowering burnout. These include changes to the organisation like improved work schedules mental health support and opportunities for career advancement. Moreover, the potential influence of technology and information systems (IS) on burnout is investigated considering the efficiency benefits as well as the heightened effort associated with these systems (Venkatesh et al., 2020). Burnout is a shockingly common occurrence among healthcare professionals in the US affecting almost half of physicians and one-third of nurses. This widespread issue not only negatively impacts the health of these personnel but also poses a significant risk to patient care and could contribute to the looming physician shortage. More than just the individual health worker is impacted by burnout. Numerous studies have shown how burnout among healthcare personnel negatively affects patient care (Garcia et al., 2019). For instance, there is a direct correlation between a surgeon's level of burnout and both the likelihood of being sued for medical malpractice and the frequency of major mistakes made in patient care. Higher rates of patient death and hospital infection transmission are linked to higher levels of burnout among nurses (Kabunga and Okalo, 2021). Medical student’s that experience burnout have concerning patterns such as unethical clinical practises, a diminished sense of altruism, and a tendency towards alcohol addiction. Furthermore, there is a correlation between higher rates of burnout among physicians and lower levels of patient satisfaction.

2.3 Evaluated the burnout effectiveness among hospital professional’s affects patient care's safety and quality

Research has repeatedly demonstrated that high levels of burnout among medical personnel such as physicians, nurses, and administrative staff have a negative impact on patient safety and the standard of care. For example, among healthcare personnel who are feeling burnout, there is a higher frequency of medical errors, which is a significant indicator of patient safety. Chronic stress and exhaustion have been linked to decreased cognitive performance, attentiveness, and decision-making ability (Koutsimani et al., 2021). Burnout is becoming more widely acknowledged as being a serious risk to patient safety, mainly because it can cause depersonalization and less encounters with patients. Burnout increases the likelihood that healthcare workers would believe that patient safety is being jeopardised in their organisations and will confess to mistakes or poor care. As a result, treating burnout has become a top priority for well-known organisations like the American Medical Association and the Mayo Clinic.

Figure 2.2: Physician burnout relation with the quality of patient care

The 2015 Annual Perspective places special emphasis on the relationship between physician burnout and patient safety, as well as methods for reducing burnout in this population (Garcia et al., 2019b). The majority of studies linking burnout to patient safety rely on the self-reported safety views of healthcare personnel, which is an important but rather imprecise measure. One noteworthy exception is a 2014 Swiss study that involved 54 intensive care units (ICUs) and found a unique correlation between burnout and both standardised mortality ratios and doctors' perceptions of safety (Page et al., 2021).

2.4 Assessing the efficacy of various interventions, programmes, and policies targeted at preventing or alleviating burnout among healthcare professionals

Burnout has a variety of negative repercussions on healthcare settings, including organisational and personal ones (Jun et al., 2021). They show up as a range of unfavourable consequences, such as poor patient care, patient discontent, a rise in medical errors, fewer hours worked, and an overall deterioration in the viability of healthcare systems. These consequences result in lower efforts, less dedication to work, and greater rates of employee turnover; they are especially noticeable in the case of nurses and doctors.

Enhancing mental health is essential for improving hospital service quality, and this requires recognising and preventing burnout (Patel et al., 2019). Interventions must be put into place at the organisational and individual levels to address this. The need to investigate and fund organisational methods is highlighted by the increasing awareness of workplace wellness and the elements that lead to occupational stress.

It is observed to apply workplace well-being interventions in two steps. Finding the existence of occupational stress and its most likely sources is the first step. Interventions can then be implemented at the elementary, secondary, or postsecondary levels. Primary therapies, which are primarily preventive in nature, try to eliminate or modify the stressors, including reducing workload. Secondary therapies use techniques such as relaxation training to assist employees in managing and reducing the consequences of occupational stress (Zhang et al., 2021). Workers, who have already experienced stress-related health problems, including anxiety or depression, are intended to be treated with tertiary interventions. In medical settings, occupational stress and burnout can be effectively and specifically managed with the help of this systematic method.

2.5. Examine long-term patterns in the incidence and kind of burnout affected by the COVID-19 epidemic among American healthcare workers

Healthcare professionals are under unprecedented stress as a result of the COVID-19 epidemic, which has had a serious negative influence on their physical and emotional health. 82% of these professionals said that throughout the previous three months, their level of emotional tiredness has increased (Martínez-López et al., 2020). They also experienced physical tiredness (68%), sleep difficulties (70%), and a feeling of dread about their jobs (63%). A majority of the participants reported experiencing alterations in their appetite (57%), bodily symptoms such headaches or stomachaches (56%), uncertainty over their professional choices (55%), compassion fatigue (52%), and heightened worry around viral exposure (52%).

Figure 2.3: Percentage of American workers experiencing burnout prior to COVID-19

When asked what their biggest work-related worries were, 61% said they didn't know when things would get back to normal, and 54% said they were burnt out. Additionally, nearly half (49%) said that a high or increasing workload constituted a major source of stress (Alruwaili et al., 2022). According to an American Medical Association poll, 43% of medical professionals said they were overworked, 49% said they were highly burned out, and 38% said they had symptoms of anxiety and sadness. The occupational therapists, social workers, and speech therapists allied health professionals reported the highest rates of burnout among them.

During the pandemic, burnout and Secondary Traumatic Stress (STS) have been particularly common in the pharmacy industry (Salameh, Abdalla Ghassen Daibes and Qaddumi, 2023). During the early phases of the pandemic, almost half of health-system chemists had burnout, half had STS, and three-quarters felt a sense of satisfaction from their work. According to a different poll, during the pandemic compared to pre-pandemic periods, chemists in hospital and community settings scored higher on emotional weariness and depersonalization (Search.proquest, 2023). Additionally, roughly half reported feeling more emotionally and physically exhausted at work, 40% reported feeling anxious, and 25% reported feeling more depressed or hopeless.

These results underline the tremendous strain and stress that the COVID-19 pandemic has placed on medical personnel, especially chemists, and the pressing need for efficient intervention and support plans. In addition to posing an urgent and serious threat to the healthcare system, the COVID-19 pandemic has had a long-lasting effect on the health of American healthcare professionals. To comprehend the long-term effects on these professionals' mental and emotional well-being, it is imperative to look at the long-term trends in the incidence and forms of burnout impacted by the pandemic (Martínez-López et al., 2020b).

A noteworthy trend that has surfaced is the ongoing rise in burnout rates among medical professionals. The impacts of the pandemic have been long-lasting, even if the initial months showed an increase in burnout as a result of the excessive demands (Manchikanti et al., n.d. 2022). Healthcare professionals, especially nurses, doctors, and chemists, have expressed continuous emotional weariness, depersonalization, and a diminished sense of personal success as the healthcare system continues to struggle with the aftermath of the pandemic.

Over time, the many forms of burnout have also changed. The first focus was on the emotional tiredness experienced by healthcare workers who were placed in the centre of a global health emergency (Chigwedere et al., 2021). But as the pandemic spread, other aspects of burnout like depersonalization and a decline in self-actualization became more noticeable. In addition to the physical rigours of patient care, healthcare professionals were also dealing with the psychological fallout from seeing so many cases of illness and death.

Furthermore, the epidemic has brought attention to how critical it is to treat Secondary Traumatic Stress (STS) in healthcare professionals (Moreno-Jiménez et al., 2021). STS has been linked to prolonged exposure to upsetting and traumatic experiences, such as patient deaths and the difficulties of giving care in an emergency. The burnout that affects healthcare workers is compounded by this secondary type of trauma.

There are significant ramifications for how COVID-19 affects healthcare workers' long-term burnout tendencies. Because of the ongoing psychological pressure, it has sparked worries about the longevity of the healthcare personnel and the possibility of a large exodus from the field. It is critical to put policies in place that take into account the long-term mental health and well-being of these vital professionals in addition to addressing immediate burnout as healthcare organisations and legislators deal with the pandemic's consequences. This entails fostering a climate of psychological safety in healthcare settings, offering continuous mental health assistance, and offering resilience training (Rangachari and L. Woods, 2020). Ultimately, developing successful therapies and guaranteeing the healthcare workforce's resilience in the face of upcoming difficulties depend on an awareness of the changing patterns of burnout.

2.6. Theoretical Overview

The relationship between job demands and job control is the main emphasis of Karasek's late 1970s Job Demand-Control Model (Balducci et al., 2020). Healthcare workers frequently deal with challenging work conditions in the industry, including lengthy workdays, challenging patients, and high emotional demands. They might also be constrained in their ability to control their work environment because of inflexible procedures and hierarchical organisations. Burnout and persistent stress can result from an unbalanced relationship between high expectations and poor control. According to this hypothesis, interventions could give healthcare personnel more autonomy and opportunity for decision-making, hence improving their job control (Spagnoli and Molinaro, 2020).

According to Siegrist's Effort-Reward Imbalance Model, burnout arises when there is an unbalance between the amount of effort put into one's job and the compensation one receives. In order to provide healthcare professionals more autonomy and authority, healthcare organisations may choose to restructure employment positions. This can entail giving employees more autonomy over decisions and providing flexible work hours. Rewarding healthcare professionals appropriately may boost their motivation and morale. A sense of value and gratitude can be fostered by acknowledging their hard work, which may increase overall job satisfaction and lower the risk of burnout. This strategy can lower stress levels, promote mental health, and improve job performance by assisting healthcare professionals in conserving their own resources. It can help promote a more encouraging and cooperative work environment (Bennett et al., 2020). The benefits, which could include cash payment, recognition, or professional growth, do not always match their hard work, though. Burnout may be caused in part by this perceived unfairness. This idea may be used to guide interventions that address reward systems, enhance recognition and support for healthcare staff, and improve working circumstances. Hobfoll's theory of conservation of resources centres on people's efforts to acquire, hold onto, and safeguard precious resources, including as material, social, and personal resources (He, An and Zhang, 2019). Healthcare professionals devote their mental and physical energies to providing for patients.

The COVID-19 pandemic's demands combined with work-related stress have caused resource depletion. Burnout can happen when resources are repeatedly depleted without being sufficiently replenished. Based on the COR hypothesis, interventions could include resource replenishment tactics including managing workloads, supporting mental health, and encouraging social support networks among medical workers (Yeh et al., 2020). To better understand burnout, the Demand-Resource Model integrates components of the Effort-Reward Imbalance Model with the Job Demand-Control Model. It suggests that limited job resources, like social support, combined with high job demands can cause burnout. The demand for patient care in the medical field can be extremely high, particularly in times of crisis like the current pandemic (Flett and Zangeneh, 2020). High demands, however, can be lessened by the availability of resources, such as enough staffing, training, and access to mental health care. To prevent burnout, interventions based on this idea might address demands as well as resources.

2.7. Literature Gap

A lot of research focuses on the short-term effects of burnout, especially in times of emergency like the COVID-19 epidemic (Sangal et al., 2020). Longitudinal studies that monitor burnout patterns over time are scarce, nevertheless. Studies that look at how burnout develops, endures, or shifts over time among medical professionals may offer important new perspectives on the long-term impacts of burnout and possible treatments. Research evaluating the long-term efficacy of these interventions at the organisational level is lacking, despite the rising corpus of literature on strategies to combat burnout among healthcare workers. The identification of interventions that result in long-term improvements in burnout rates and care quality can help healthcare organisations implement evidence-based practises (Pascoe et al., 2021). The experience of burnout varies throughout healthcare workers. Research on the intersectionality of burnout which takes into account variables including gender, colour, ethnicity, and socioeconomic status is desperately needed. By doing so, inequalities in burnout rates can be found and targeted treatments for underrepresented groups can be informed.

It is critical to address burnout among American healthcare personnel, particularly in the wake of the COVID-19 outbreak. The enduring consequences of burnout on healthcare personnel make it clear that thorough research is required to comprehend its changing patterns and the effectiveness of therapies. Studies that monitor patterns over time through longitudinal research can shed light on the persistence and consequences of burnout. Furthermore, maintaining gains in the wellbeing of healthcare workers depends on evaluating the long-term efficacy of organisational changes. Evidence-based practises can be guided by investigating resilience-building mechanisms, sustainable workforce tactics, and the intersectionality of burnout and its impact on patient outcomes.

Chapter 3: Method of Data Collection, Data Analysis and Findings

3.1 Research philosophy

Research philosophy is an essential component of the research paper in order to effectively analyse the data utilised for the study objective. Additionally, in order to effectively improve the research paper's overall quality, the research philosophy offers crucial information regarding the best way to use the data that has been gathered (Psarommatis et al., 2021). Positivism, pragmatism, realism, and interpretivism have been found as the four research philosophies that are employed to improve the overall quality of the research work. The present study employed interpretivism as a research philosophy to obtain fundamental insights into the aspects that contribute to the research paper's effectiveness (Loan Nguyen, 2019). Additionally, the “interpretivism research philosophy” enables researchers to critically examine the numerous contexts and cultural contexts of the research article in order to generate multiple interpretations of the context of the research study. Additionally, the interpretivism research philosophy will assist the researcher in recognising the various social elements associated with the next research paper and in offering pertinent viewpoints and ideas on the research setting (Amin et al., 2020).

The research philosophies have been essential in order to properly assess the study paper. Additionally, it has been considered that in order to perform the research article efficiently, the “interpretivism research philosophies” have been gained. Additionally, the interpretivism research philosophy allows for the speedy determination of all the variables and distribution (Ali et al., 2022). Therefore, one of the best study philosophies for examining the sociological components of situational contexts and determining the characteristics of human conduct and experience is interpretivism. Furthermore, it has been speculated that the research papers have been identified as the most successful in rectifying the interpretivism research philosophies (Mahesh and G, 2022). Additionally, it has been observed that it aids researchers in focusing on the various environmental components of research papers and in assessing the research objective of research pacers in societies.

3.2 Research approach

There are the two kinds of research methodologies have been employed to support the discovered research concepts with a suitable structure and to analyse the research concepts (Braun and Clarke, 2021). In order to effectively discover and analyse the various research topics included in the research paper, a deductive research approach has been employed for the subsequent research study. Moreover, a deductive research methodology will aid the researcher in more effectively developing the characteristics of the subsequent research paper, as this study also employed a secondary data collection method (Proudfoot, 2022). The utilisation of a deductive research approach enables researchers to apply several techniques for effectively identifying and analysing the various theories included in the research report. It has been shown that the deductive research strategy is more helpful for carrying out the research paper effectively. Furthermore, it has been proposed that the deductive research methodology in order to perform the research paper successfully (Pearse, 2019). Furthermore, it has been observed that the deductive research approach has been beneficial in generating statistical data related to research papers in societies as well as instigating many aspects related to research articles. Several issues that have surfaced in the domain of research articles in societies have been faced by the deductive research approach. The deductive research strategy has been used since it allows for the identification of variables in the data and the determination of their true values in the context of the research papers (Varela, Lopes and Rodrigues, 2021). Potential modifications to research papers have been made and the appropriate distinction between the implications of the papers' results for society has been made. However, as it comes to identifying the research papers' results and their implications for societies, the inductive research approach has proven instrumental.

3.3 Research design

The researcher has been including a suitable research design that gives the research a methodical structure to improve the overall quality of the research report (Carcary, 2020). A descriptive research design was employed for the next research article that greatly improved the paper's overall quality. Moreover, the descriptive research approach offers crucial data and information on the many aspects of the research context. As a result, a descriptive research design has been included in this research paper to conduct the research paper successfully. Furthermore, the descriptive research strategy used in the research article made it easier to identify the significant implications of the study's components. It also provides more room for academics to look into a number of variables that may point to different basic allocations. It also simulates an important role in creating the situation and assesses the significance of many external features that are present in the situation. Selecting a suitable research design is a useful technique for maintaining the research's contextual focus and ensuring its greater viability to achieve the intended results (Amin et al., 2020b). Additionally, it allows for a succinct examination of every situational context and appropriately considers every variable related to the circumstance. One of the methods that is frequently employed in secondary research to identify all the variables and provide appropriate consideration to all the situational contexts and various elements is the descriptive design.

Descriptive approaches also provide a more thorough conservation of research to demonstrate that a standardised assumption is unjust when describing situational factors and the distribution of "wide-ranged variables." Moreover, exploring a variety of interpretations and their ramifications benefits from a wider perspective. Descriptive research design is a widely used method for doing research and interpreting its findings (Remler and Ryzin, 2021). It also ensures that a range of changes are analysed and that datasets are more reliable. The research can clearly define each component and understand its location in relation to other references that might be utilised to reorganise the condition because of the descriptive design.

3.4 Data collection

Data collection is one of the main elements of the research paper that contributes to its overall quality improvement. Furthermore, primary and secondary data gathering methods are two distinct categories of data collection procedures. The primary data collection strategy also includes the information obtained via surveys and interviews for the study goal (Mwita, 2022). On the other hand, the secondary data collection strategy uses information from already existing secondary sources, such as papers and journals.

Secondary data-gathering approaches have been employed to obtain the necessary data for the research investigation. Hence, Pubmed, Google Scholar, papers, and journals have been employed as secondary sources of the data-gathering procedure for the research paper that follows. Furthermore, using secondary research is one of the most effective strategies to employ secondary sources for research purposes while also lowering the overall cost of the research paper (Khan et al., 2020). Furthermore, for the purpose of gathering data for the study article in question, a "keyword-based" search strategy has been employed to efficiently yield pertinent information. Additionally, gathering secondary data significantly cuts down on the total amount of time needed for the laborious research procedures.

3.5 Data analysis

The information gathered has been examined using a thematic data analysis procedure in preparation for the upcoming study report (Peel, 2020). Additionally, the method of thematic data analysis will assist the researcher in formulating themes based on the research paper's findings in order to effectively meet the paper's objectives. In order to develop the main findings pertaining to the study setting, the researcher will be assisted in identifying the thematic coding of the subsequent research paper by use of the thematic analysis procedure carried out for this research paper. Additionally, "thematic codes" assist researchers in identifying suitable study methodologies and research themes that other researchers have employed for the data analysis procedure. Furthermore, including key components of the research paper in the findings that also aids in the research's ability to effectively outline its objectives (Asma, 2023). Furthermore, the process of data analysis enables the investigator to recognise possible obstacles associated with the study's goal. Additionally, the descriptive research design is the main focus of the research paper that will be able to avoid any possible disputes during the analysis process and will also be better able to present graphical representations of the data they have collected thanks to the thematic data analysis process. On the contrary, journals and articles have been employed to both collect genuine data associated with the research findings and to effectively justify the findings (Vindrola-Padros and Johnson, 2020).

3.6 Ethical consideration

A proper ethical consideration eliminates many ethical framework-related issues and guarantees the validity of the research (Prisznyák, 2023). The research has been conducted in a way that complies with patent requirements and guarantees the validity of the findings. This has demonstrated that no data has been stolen or altered during the study process in order to arrive at the result. Additionally, the study complies with cyber security requirements and data protection laws. It facilitates the appropriate use of data required for the research's conduct and helps identify the study's intended conclusion. Cybersecurity laws have been followed to make sure that there is more protection available while using websites to access information (Taherdoost, 2022). In summary, it can be stated that all ethical frameworks that provide a solid ethical foundation for the research require the research.

3.7 Inclusion and exclusion criteria

Criteria Type	Description	Inclusion	Exclusion
Subject of Study	Focus on specific populations within research.	Healthcare workers in U.S. hospitals	Studies outside U.S. healthcare or not focused on healthcare workers
Aspect of Burnout	Types of burnout symptoms and conditions studied.	Emotional exhaustion, depersonalization, reduced personal accomplishment	General stress or fatigue not specified as occupational burnout
Outcomes Measured	The impact of burnout being measured.	Impact on professional performance, employee wellbeing, and patient care quality	Studies not measuring specific impacts of burnout or irrelevant outcomes
Study Design	The methodological approach of the study.	Quantitative, qualitative, or mixed-method research including surveys, case studies, and controlled trials	Opinion pieces, editorials, non-empirical articles, or studies with low methodological quality
Recentness	The publication date of the studies.	Published within the last 10 years	Outdated or irrelevant studies not reflecting current understanding
Language and Accessibility	Language and availability of the studies.	Published in English and available for review	Non-English articles or inaccessible texts

3.8 Systematic Review

Article Reference	Main Theme	Sub-Themes	Methodology	Key Findings
Salvado et al. (2021a)	Burnout in Healthcare Professionals	Mindfulness-Based Interventions	Systematic Review & Meta-Analysis	Mindfulness interventions were effective in reducing symptoms of burnout and stress among healthcare professionals.
Kasalak & Da?yar (2022)	Teacher Burnout	Demographic Variables, Teachers' Enthusiasm	Quantitative Survey	Higher burnout levels were associated with lower enthusiasm, particularly in teachers with larger class sizes and less experience.
Atroszko et al. (2020)	Work Addiction and Burnout	ICD-11 Implications	Literature Review	Work addiction was linked to higher rates of burnout, suggesting a need for workplace interventions and recognition in diagnostic criteria.
Vaismoradi et al. (2020)	Patient Safety	Nurses' Adherence	Systematic Review	Nurses' adherence to safety protocols significantly reduced patient safety incidents, with training and workplace culture being key factors.
Andersen-Hollekim et al. (2020)	Patient Participation	Narratives in Haemodialysis	Qualitative Study	Patient narratives revealed a need for more personalized care strategies to improve treatment adherence and satisfaction in haemodialysis.
Ewen et al. (2020)	Well-being in Healthcare Professionals	Stress and Burnout in Speech-Language Pathologists	Survey Analysis	Speech-language pathologists experience unique stressors related to job demands, leading to higher burnout rates compared to other professions.

According to the study, with perioperative physicians being especially susceptible. In addition to having serious negative effects on one's personal life, such as substance addiction, strained relationships, and even suicide, burnout has a major negative impact on one's career (Godini? and Obrenovic, 2020). Burnout is linked to less patient satisfaction, worse service quality, and a higher risk of medical errors. Furthermore, hospitals and carers may have to pay hefty legal fees due to the possibility of malpractice claims. It is difficult to determine the prevalence of burnout because there is no agreed-upon diagnosis and diagnostic criteria are subjective. However, reports indicate that up to 20% of working people may suffer from burnout.

The study also brought to light the intriguing discovery that, aside from minor gender-specific variations, burnout levels varied very little across all demographic groupings (Rendeiro et al., 2021). The study emphasised how hospital worker burnout has a significant impact on patient safety and the quality of care provided. Burnout can cause emotional tiredness, depersonalization, and a lessened sense of personal accomplishment, all of which can substantially impair the performance of healthcare professionals. This diminished efficacy may show itself as a deterioration in the standard of care given, a lack of focus on specifics, and a decreased ability to adapt to the demands of the patient. In addition to impairing a professional's sense of purpose and empathy, burnout can also cause problems with communication and interpersonal skills, which are essential for patient engagement. Moreover, the systemic character of burnout may result in a departure from safety procedures and evidence-based practises, endangering the safety of patients. The study stressed the value of interventions like mental health services, stress management programmes, and workload adjustments in reducing burnout and fostering an environment at work where providing excellent patient care is possible (Vajrala et al., 2023).

The study made clear that in order to fully comprehend the effects of COVID-19 on stress and mental health in healthcare workers, more research with sizable, diverse, multi-institutional samples is required. Despite the fact that physicians and nurses have garnered a lot of attention as "healthcare heroes," the study stressed the significance of taking into account the remaining 80% of the healthcare workforce, which includes respiratory therapists and nursing assistants, who work in the front lines and are more susceptible to getting the virus. The COVID-19 virus has been shown to make non-White patients and healthcare professionals more susceptible. However, there has not been a sizable national study looking at the impact of COVID-19-related stress, especially among healthcare workers from racial and ethnic minorities (CB Fiser, 2023). Specific demographic groups showed higher levels of stress, according to the research: women, Black and Latinx people, inpatient workers, and people in specific healthcare roles reported higher levels of stress. A significant number of allied health professionals, including social workers, occupational therapists, and speech therapists, experienced burnout.

Work overload, self-reported anxiety or despair, and fear of exposure or transmission were all linked to stress and burnout. Lower stress levels have been connected to feeling appreciated at work. The variance in burnout was mostly explained by these variables. The study highlighted organisational leaders' moral need to safeguard workers' health and welfare at work. For most individuals, work is essential to their life because it satisfies basic needs like achievement, motivation, and a sense of belonging. According to Maslach and Jackson, job burnout is a three-dimensional concept made up of depersonalization, emotional weariness, and personal achievement (A Pohaci, 2023). Because they frequently assist clients in vulnerable or crisis situations, human service providers invest a great degree of emotion into their work, which can result in depersonalization and emotional weariness. Developing empathetic relationships with clients is essential to their jobs, as dictated by moral standards that clearly call for empathetic comprehension. Human service personnel's well-being and the level of the services they deliver may suffer significantly from burnout.

Chapter 4: Discussion

• Discussion on Theme 1: Investigating the extent and frequency of burnout among various healthcare professionals in U.S. hospitals

Figure 4.1: Overview of the number of PubMed hits for the search term “burnout” between 1970 and 2019

Those employed in the healthcare industry, especially perioperative clinicians, are more susceptible to burnout. Along with serious personal repercussions like substance abuse, broken relationships, and even suicide, this also has serious professional repercussions like lower patient satisfaction, lower-quality care, and a higher risk of medical errors, which could result in malpractice lawsuits that could be very expensive for hospitals and carers. It is difficult to estimate the prevalence of burnout in the general population because there is no agreed-upon diagnosis, the condition has complex roots, and diagnostic criteria are subjective. Depending on the threshold values used to characterise severe burnout, some reports imply that up to 20% of working people may experience burnout (Salvado et al., 2021).

It is interesting to note that a Finnish study that looked at sociodemographic characteristics and burnout levels discovered very little variation across different population groupings. There were some gender-specific differences and an incidence of burnout that increased somewhat with age. For instance, burnout was linked to socioeconomic level and education in women, but it was related to marital status in men. Emotional tiredness, depersonalization, and a lowered sense of personal accomplishment are typical signs of burnout, which lowers one's effectiveness at work (KASALAK and DA?YAR, 2022). This syndrome has been recognised in various professional areas, but it is most frequently observed in professions involving considerable interpersonal interactions, such as medicine, nursing, social work, and teaching.

Occupational burnout is defined by the World Health Organisation (WHO) as a result of ongoing workplace stress (Atroszko, Demetrovics and Griffiths, 2020). It has three components: low energy, unpleasant work-related emotions, and psychological disengagement from work that lowers professional efficacy. The well-known theory put forth by Maslach et al. defines burnout as a psychological condition marked by depersonalization, emotional tiredness, and a diminished sense of accomplishment in one's daily work.

• Discussion on Theme 2: Determined the effectiveness of the hospital professionals that affect patients' safety and care quality

Hospital staff members' performance and general well-being are directly impacted by occupational burnout, a widespread problem in the medical field. The depersonalization, decreased sense of personal accomplishment, and emotional tiredness that come with burnout can seriously impair healthcare professionals' efficacy (Salvado et al., 2021b). This diminished efficacy could show up as a general deterioration in the standard of care given, as well as a diminished ability to pay attention to detail and respond to patient requirements. Hospital workers who experience burnout may lose their sense of purpose and empathy, which can impair their ability to communicate effectively and develop the interpersonal skills necessary for patient engagement. Moreover, the systemic character of burnout may lead to deviations from evidence-based practises and safety procedures, endangering patient safety (Vaismoradi et al., 2020). Prioritising the well-being of healthcare personnel is crucial in mitigating the impact of burnout on the quality of patient care. In order to reduce burnout and provide an environment at work where patients may receive quality care, interventions including stress management classes, mental health services, and workload modifications have been found crucial. Healthcare systems can foster a workforce of resilient and engaged professionals and ultimately improve patient safety and overall quality of treatment by recognising and managing occupational burnout.

As they directly care for patients, nurses play a vital role in guaranteeing patient safety. Even with a critically ill hospitalised patient, doctors may only visit them for 30 to 45 minutes a day, which limits their capacity to notice changes in the patient's state over time (Psnet, 2022). Despite this, doctors nevertheless make judgements about diagnosis and treatment. Nurses are essential to the prompt coordination and transmission of the patient's status to the team since they are a constant presence at the bedside and constantly engage with physicians, chemists, families, and all other members of the health care team. However, a nurse's responsibilities in terms of patient safety include keeping an eye out for signs of clinical deterioration in patients, spotting mistakes, and near-misses. It has also been comprehending care procedures and flaws in certain systems, recognising and informing patients of changes in their condition, and carrying out a myriad of other duties to guarantee patients receive outstanding treatment (Andersen?Hollekim et al., 2020).

The ratio of nurses to patients or residents in nursing homes with a lower number of registered nurses (RNs) is expressed as a fraction of an hour per resident day (hprd), usually expressed as a decimal. For instance, the national average in 2020 was 0.75 hprd, or 45 minutes, or ¾ of an hour, of RN time for every inhabitant in New Hampshire (Wadsworth, 2020). Numerous research with differing outcomes have examined the relationship between nurse staffing in NHs and quality and safety. However, a recent integrative review that there were fewer pressure ulcers and UTIs, a lower risk of hospitalisations, a lower death rate, and improved quality measures including falls and moderate to severe pain. Nurses' efforts to ensure patient safety are impacted by a variety of factors, including practice settings, staffing ratios, personal accountability, and transformational leadership. Nurses practising at their best within a transformational leadership framework (Asma, 2023) can achieve better patient outcomes. Hence, the managers will inspire them to think critically, develop their skills, and make the team feel more satisfied with their work.

Nurses may be less likely to experience a missed nursing care incident if they personally hold themselves accountable for upholding a culture of safety.

• Discussion on Theme 3: Analyse long-term trends in the prevalence and kind of burnout among US healthcare workers impacted by the COVID-19 pandemic

Comprehensive research employing large, diverse, multi-institutional samples is lacking, despite the fact that the impact of COVID-19 on stress and mental health has been examined within various medical specialisations and individual healthcare institutions in the United States. As "healthcare heroes," doctors and nurses have garnered a lot of publicity; but, the other 80% of the healthcare workforce—including respiratory therapists and nursing assistants—who work in the front lines and are at high risk of contracting the virus, have received less attention. Prior research has indicated a heightened vulnerability to COVID-19 in patients who are non-White and healthcare professionals.

There has not been a significant national study that describes the effects of COVID-19-related stress on US healthcare workers, especially those from racially and ethnically marginalised backgrounds, despite reports from the US Centres for Disease Control showing a higher prevalence of COVID-related mental health conditions among essential workers and Black and Hispanic populations.

Higher stress levels were found in women, Black and Latinx people, inpatient workers, and particular healthcare roles like social workers, medical assistants, and nursing assistants in a study with 20,947 US healthcare workers. Almost half of the participants said they had burned out, with social workers, occupational therapists, and speech therapists having the highest percentages among allied health professions (Ewen et al., 2020). Work overload, self-reported anxiety or despair, and fear of exposure or transmission were all linked to stress and burnout. On the other hand, reduced stress levels were linked to feeling appreciated at work. These variables accounted for 55% of the variance in burnout in a prediction model (Abdel Hadi, Bakker and Häusser, 2021).

Strong psychometric performance was also shown by a succinct four-item stress summary score. Interestingly, a sizable percentage of healthcare professionals who declined to disclose their racial or gender identity had exceptionally high burnout rates (61.8%), underscoring their susceptibility (K Cetrone, 2023). Future studies should employ study methods that are more inclusive of the perspectives of minority healthcare professionals and reassess the current instruments for assessing burnout. The aforementioned results highlight the significance of tackling stress and burnout among healthcare practitioners, particularly those from varied backgrounds, in order to guarantee the welfare of the healthcare labour force and the standard of patient care.

• Discussion on Theme 4: Impact of Job Burnout on the Health and Well-Being of Human Service Workers on hospital

Organisational researchers and administrators have focused a great deal of attention on the effects of job burnout on employees' well-being for two main reasons (Mihalache and Mihalache, 2021). First, organisational leaders have an ethical duty to protect their workers' health and welfare at work. For the majority of adults, work is an essential part of their life since it provides them with intrinsic needs like motivation, a sense of accomplishment, and belonging in addition to being a means of subsistence. Second, the performance of employees directly affects their well-being, and performance can impact the calibre of services provided and the results achieved for clients (Setyadi, Helmi and Hidayat, 2022).

Research in the human services field where overworked and emotionally spent employees were finding it difficult to stay motivated and engaged, gave rise to the idea of job burnout. Though there are many definitions of burnout, Maslach and Jackson's conceptual and operational definition from 1981 is the most commonly used (L Nadon, 2022). Three characteristics emotional exhaustion, depersonalization, and personal accomplishment are listed in this description of burnout. The primary dimension is emotional weariness, which is characterised by depletion from prolonged exposure to stress at work. Employees who experience emotional tiredness may grow cynical and alienated from their clientele. Regardless of effort put in, the third dimension personal accomplishment refers to emotions of ineffectiveness at work.

Job burnout is influenced by interpersonal relationships in the workplace and is not just an individual experience. Employees in the human services field frequently deal with clients who are weak or experiencing a crisis, which makes these interactions emotionally taxing for the professional. A key component of providing human services is building compassionate relationships with clients, which are guided by moral standards of behaviour (Qader et al., 2021). When interacting with clients, human service providers expend a lot of emotional energy, which can result in emotional weariness and depersonalization. Although this emotional commitment is essential to bringing about change, it can also lead to burnout.

use my discount

Summary

In summary, this chapter has focused on the burnout from a variety of angles among medical staff members working in American hospitals. It was discovered that burnout is a common problem with important ramifications for both personal and professional life. Medical errors as well as decreased patient satisfaction and care quality can result from burnout. The study also demonstrated how COVID-19 affects the stress levels of healthcare workers, with higher levels of stress and burnout observed in specific demographic groups. In order to prevent burnout and guarantee excellent patient care, interventions and support are essential. The study also underlined how ethically businesses should safeguard workers' health, particularly in the human services industry where depersonalization and emotional weariness are prevalent.

Linking with Objectives

• Linking with Objectives 1: The primary goal of this objective is to find out how common occupational burnout is among US hospital personnel. Recognising the prevalence of burnout in different healthcare occupations is the first step towards resolving the problem.
• Linking with Objectives 2: The second objective goal is closely related to evaluating how burnout affects the standard and safety of patient care. This goal looks at the frequency of medical errors and patient outcomes to find a direct correlation between the health of medical personnel and the standard of treatment they provide.
• Linking with Objectives 3: The third goal is to compile evidence-based recommendations for optimal methods for averting or reducing burnout in medical professionals. This objective, which aims to provide useful recommendations based on empirical facts, is directly related to the evaluation of interventions, programmes, and policies.
• Linking with Objectives 4: The fourth goal broadens the focus to look at long-term trends in the prevalence of burnout among medical practitioners. This includes a look at how burnout patterns have changed over time, with an emphasis on the effects of outside variables like the COVID-19 pandemic.

Recommendations

Implement Comprehensive Well-Being Programs

The development and integration of initiatives targeted at enhancing the mental, emotional, and physical health of healthcare professionals within the Information Systems (IS) healthcare system is necessary to implement complete well-being programmes in the context of tackling occupational burnout. In order to establish a resilient and encouraging work environment, these programmes must to be comprehensive, covering several facets of wellbeing. It is advisable to include mental health support mechanisms such as stress management courses, counselling services, and tools for managing work-related stress (Cahill et al., 2021). These programmes give medical staff members a private, encouraging way to deal with the psychological effects of their work. Programmes for stress management must to be put in place to give professionals useful tools for reducing and managing the stresses that come with their jobs. These could include time management skills catered to the particular requirements of the IS healthcare system, mindfulness exercises, and relaxation techniques.

Regular Training on Burnout Awareness and Prevention

One critical tactic for tackling occupational burnout in the Information Systems (IS) healthcare system is the frequent provision of training on burnout awareness and prevention within healthcare organisations (Chigwedere et al., 2021). The purpose of this training programme is to raise awareness and promote proactive prevention among healthcare workers by educating them about the warning signs, symptoms, and underlying causes of burnout. Emphasising the influence of burnout on both personal well-being and professional performance, training sessions should be created to offer thorough insights into the psychological, emotional, and physical elements of burnout.

Furthermore, the training programme must to furnish healthcare practitioners with applicable tactics for identifying stressors, overseeing workloads, and fostering resilience when confronted with obstacles specific to the IS healthcare system (Shirinda-Mthombeni, 2022). Topics like work-life balance, efficient time management, and the significance of asking for help when necessary should all be included in the curriculum. It ought to investigate the organisational variables that lead to burnout, such as an excessive workload, a lack of resources, and technological hurdles to promote a shared awareness of the systemic problems at hand. Interactive training programmes that promote candid conversations and give medical professionals a forum to exchange experiences and coping techniques are ideal (Shirinda-Mthombeni, 2022). Healthcare companies may provide their workers with the information and abilities necessary to proactively manage stress, preserve wellbeing, and contribute to a resilient and high-performing staff by regularly investing in training on burnout recognition and prevention. This effort promotes a culture of ongoing learning and support in the healthcare setting in addition to addressing the immediate burnout-related difficulties.

Encourage a Positive Work Culture

Fostering a spirit of cooperation and friendship is another aspect of creating a healthy work culture. Healthcare personnel can feel more united if they participate in team-building exercises, cooperative projects, and cross-disciplinary encounters. These kinds of initiatives can improve interpersonal connections. Professionals are more likely to work well together, share duties, and overcome obstacles as a team when they foster understanding and support one another, which eventually lower the risk of burnout. Leadership that recognises the knowledge and commitment of healthcare professionals should actively promote a culture of trust and respect. This entails appreciating the value of a work-life balance, offering flexibility when it is appropriate, and formulating rules that put the welfare of employees first. Organisations should also fund opportunities for professional development so that medical staff members can advance their careers and learn new skills within the IS healthcare system. Promoting a collaborative, communicative, and sense of purpose among healthcare professionals is a key component of developing a healthy work culture within the Information Systems (IS) healthcare system. The promotion of open channels of communication, a focus on transparency, and the provision of forums where team members can openly share ideas, concerns, and comments are at the heart of this effort (Hosseini et al., 2022). Setting the tone for the culture of the company and modelling excellent behaviour are critical roles played by leaders. Establishing a welcoming environment that appreciates each team member's effort and honours accomplishments of all sizes should be their top priority.

Research limitations

It is crucial to recognise the limitations of this study even if it offers insightful information about the incidence and effects of burnout among medical professionals working in American hospitals (MP Kaldas, 2022). The use of secondary data sources, mostly previously published research papers and books, is a major drawback. Because of this, the conclusions drawn from this study depend on the calibre, extent, and techniques of the research that were included. The synthesis of findings may contain biases and contradictions due to variations in research design, data collection techniques, and definitions of burnout amongst studies.

The chronological restriction imposed by the timeframe chosen for the literature review is another drawback (Rangachari and L. Woods, 2020b). Since the evaluation only included research that was published through 2019, it may not have included all recent advances about burnout, especially those made worse by the COVID-19 pandemic. The dynamics of burnout may have changed in response to the pandemic's added stressors and evolving healthcare contexts (Rangachari and L. Woods, 2020c). As a result, the evaluation might not accurately depict the level of burnout that exists among medical professionals at the moment.

Conclusion

In conclusion, this thorough systematic analysis has illuminated the important problem of burnout among medical staff in American hospitals. A large percentage of healthcare workers including doctors, nurses and allied health professionals struggle with burnout. It can have a major influence on patient care and safety and has far-reaching effects on both a personal and professional level. The review's most important result is the startlingly high rate of burnout among medical practitioners. According to the research, burnout rates are high with a significant percentage of doctors and nurses reporting burnout-related symptoms. This high raises concerns about patient treatment quality as well as the health of healthcare professionals.

The assessment also emphasised how burnout negatively impacts patient safety and care. Burnout increases the risk of medical errors, less attention to detail, and a lower capacity to meet patients' requirements for healthcare providers. These elements may lower the standard of care and perhaps have a negative impact on patient outcomes. Burnout and patient safety are related, which raises serious concerns and highlights the pressing need for treatments to alleviate burnout in the healthcare industry. The review also looked at how the COVID-19 epidemic affected healthcare personnel' burnout. Burnout has become more of a problem for healthcare workers as a result of the pandemic's unparalleled stress. During this difficult time, several demographic groups such as women and racial and ethnic minorities have been disproportionately impacted by rising levels of stress and burnout.

For healthcare organisations, addressing burnout is not adequately right but also strategically necessary. The standard of patient care is directly related to the health of healthcare personnel. Programmes and interventions designed to stop or lessen burnout are essential. These could include programmes on stress management, mental health services, adjustments to workloads, and efforts to establish a nurturing workplace culture. To effectively address burnout, organisational adjustments are required in addition to individual-level therapies. The implementation of policies and practises that mitigate stress and foster resilience among healthcare professionals is imperative for healthcare systems to prioritise the well-being of their personnel. This entails maintaining a culture of open communication and support, supporting work-life balance, and maintaining appropriate personnel levels.

In conclusion, burnout is a complex problem that affects healthcare workers in many ways and has a big impact on both people and patient care. This problem calls for all-encompassing, systemic fixes. In order to address burnout and establish a healthcare environment where healthcare workers may thrive and provide patients with high-quality care while protecting their own well-being, stakeholders, legislators, and healthcare organisations must collaborate. Ignoring burnout puts patients' safety and the standard of treatment they receive at risk in addition to the health and job happiness of healthcare professionals.

References

Chapter 1

Izdebski, Z., Kozakiewicz, A., Bia?orudzki, M., Dec-Pietrowska, J. and Mazur, J. (2023). (“IJERPH | Free Full-Text | Occupational Burnout in Healthcare ... - MDPI”) Occupational Burnout in Healthcare Workers, Stress and Other Symptoms of Work Overload during the COVID-19 Pandemic in Poland. International Journal of Environmental Research and Public Health, 20(3), p.2428. doi:https://doi.org/10.3390/ijerph20032428.

Murthy, V. (2022). Health Worker Burnout — Current Priorities of the U.S. Surgeon General. [online] www.hhs.gov. Available at: https://www.hhs.gov/surgeongeneral/priorities/health-worker-burnout/index.html.

Bailinson, P., Decherd, W., Ellsworth, D. and Guttman, M. (2020). How organizations can foster an inclusive workplace | McKinsey. [online] www.mckinsey.com. Available at: https://www.mckinsey.com/capabilities/people-and-organizational-performance/our-insights/understanding-organizational-barriers-to-a-more-inclusive-workplace.

McKinsey Health Institute (2022). Addressing Employee burnout: Are You Solving the Right problem? | McKinsey. [online] www.mckinsey.com. Available at: https://www.mckinsey.com/mhi/our-insights/addressing-employee-burnout-are-you-solving-the-right-problem [Accessed 24 Oct. 2023]

Zhenjing, G., Chupradit, S., Ku, K.Y., Nassani, A.A. and Haffar, M. (2022). Impact of Employees’ Workplace Environment on Employees’ Performance: A Multi-Mediation Model. Frontiers in Public Health, [online] 10(890400). Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9136218/.

Reith, T.P. (2018). Burnout in United States Healthcare Professionals: A Narrative Review. Cureus, [online] 10(12). doi:https://doi.org/10.7759/cureus.3681.

Dall’Ora, C., Ball, J., Reinius, M. and Griffiths, P. (2020). Burnout in nursing: a theoretical review. Human Resources for Health, [online] 18(1), pp.1–17. doi:https://doi.org/10.1186/s12960-020-00469-9.

Knudson, A. (2023). Most stressful jobs in the U.S.: Here are the top 25. [online] silive. Available at: https://www.silive.com/news/2023/01/most-stressful-jobs-in-the-us-here-are-the-top-25.html [Accessed 1 Nov. 2023].

Søvold, L.E., Naslund, J.A., Kousoulis, A.A., Saxena, S., Qoronfleh, M.W., Grobler, C. and Münter, L. (2021). Prioritizing the mental health and well-being of healthcare workers: An urgent global public health priority. Frontiers in Public Health, [online] 9(1), pp.1–12. doi:https://doi.org/10.3389/fpubh.2021.679397.

Gameiro, M., Chambel, M.J. and Carvalho, V.S. (2020). "A Person-Centered Approach to the Job Demands–Control Model: A Multifunctioning Test of Addictive and Buffer Hypotheses to Explain Burnout." (“EconPapers: A Person-Centered Approach to the Job Demands–Control Model ...”) International Journal of Environmental Research and Public Health, [online] 17(23), p.8871. doi:https://doi.org/10.3390/ijerph17238871.

UNESCO (2022). Reimagining our futures together. [online] Unesco.org. Available at: https://unesdoc.unesco.org/ark:/48223/pf0000379707.locale=en [Accessed 27 Oct. 2023].

De Hert, S. (2020). Burnout in healthcare workers: Prevalence, impact, and preventative strategies. Local and Regional Anesthesia, [online] 13, pp.171–183. doi:https://doi.org/10.2147/lra.s240564.

De Hert, S. (2020). Burnout in healthcare workers: Prevalence, impact and preventative strategies. Local and Regional Anesthesia, [online] 13(13), pp.171–183. doi:https://doi.org/10.2147/lra.s240564.

Loan Nguyen, T.T. (2019). Selection of Research Paradigms in English Language Teaching: Personal Reflections and Future Directions. KnE Social Sciences. doi:https://doi.org/10.18502/kss.v3i19.4826.

Northwest Executive Education (2021). "How to Change Your Leadership Style in a Changing Environment." (“Britt Burnett on LinkedIn: How to Change Your Leadership Style in a ...”) [online] Northwest Executive Education. Available at: https://northwest.education/insights/careers/how-to-change-your-leadership-style-in-a-changing-environment/ [Accessed 24 Oct. 2023].

Nguyen, P.V., Huynh, H.T.N., Lam, L.N.H., Le, T.B. and Nguyen, N.H.X. (2021). "The impact of entrepreneurial leadership on SMEs’ performance: the mediating effects of organizational factors." (“The impact of entrepreneurial leadership on SMEs' performance: the ...”) Heliyon, [online] 7(6), p.e07326. doi:https://doi.org/10.1016/j.heliyon.2021.e07326.

Center for Creative Leadership (2022). Leading a Multicultural Team | Building Your Cultural Intelligence | CCL. [online] Center for Creative Leadership. Available at: https://www.ccl.org/articles/leading-effectively-articles/leading-a-multicultural-team/ [Accessed 24 Oct. 2023].

References C2

Chen, J., Ghardallou, W., Comite, U., Ahmad, N., Ryu, H.B., Ariza-Montes, A. and Han, H. (2022a). Managing Hospital Employees’ Burnout through Transformational Leadership: The Role of Resilience, Role Clarity, and Intrinsic Motivation. International Journal of Environmental Research and Public Health, 19(17), p.10941. doi:https://doi.org/10.3390/ijerph191710941.

Kerlin, M.P., McPeake, J. and Mikkelsen, M.E. (2020). Burnout and Joy in the Profession of Critical Care Medicine. Critical Care, 24(1). doi:https://doi.org/10.1186/s13054-020-2784-z.

Sangal, R.B., Wrzesniewski, A., DiBenigno, J., Reid, E., Ulrich, A., Liebhardt, B., Bray, A., Yang, E., Eun, E., Venkatesh, A.K. and King, M. (2020). Work team identification associated with less stress and burnout among front-line emergency department staff amid the COVID-19 pandemic. BMJ Leader, p.leader-2020-000331. doi:https://doi.org/10.1136/leader-2020-000331.

Venkatesh, V., Thong, J.Y.L., Chan, F.K.Y., Hoehle, H. and Spohrer, K. (2020). How agile software development methods reduce work exhaustion: Insights on role perceptions and organizational skills. Information Systems Journal, 30(4), pp.733–761. doi:https://doi.org/10.1111/isj.12282.

Garcia, C., Abreu, L., Ramos, J., Castro, C., Smiderle, F., Santos, J. and Bezerra, I. (2019a). Influence of burnout on patient safety: Systematic review and meta-analysis. Medicina, [online] 55(9), p.553. doi:https://doi.org/10.3390/medicina55090553.

Garcia, C., Abreu, L., Ramos, J., Castro, C., Smiderle, F., Santos, J. and Bezerra, I. (2019b). Influence of burnout on patient safety: Systematic review and meta-analysis. Medicina, [online] 55(9), p.553. doi:https://doi.org/10.3390/medicina55090553.

Page, V., McKenzie, C., Mumin, M., Strain, D., Blackwood, B., Hopkins, P.A., Hadfield, D., Cunningham, E., Ostermann, M., Slooter, A., McAuley, D.F., Spronk, P.E., Page, V., McKenzie, C., Mumin, M., Strain, D., Blackwood, B., Hopkins, P.A., Hadfield, D. and Cunningham, E. (2021). Whole blood thiamine (WBT) and delirium occurrencein the Intensive Care Unit (ICU). [online] Intensive care medicine experimental. Available at: https://eprints.soton.ac.uk/478340/ [Accessed 17 Nov. 2023].

Hodkinson, Alex and Zhou, Anli and Johnson, Judith and Geraghty, Keith and Riley, Ruth and Zhou, Andrew & Panagopoulou, Efharis and Chew-Graham, Carolyn and Peters, David & Esmail, Aneez and Panagioti, Maria. (2022). Associations of Burnout with the Career Engagement of Physicians and the Quality of Patient Care: A Systematic Review and Meta-analysis. BMJ: British Medical Journal. 10.1136/bmj-2022-070442.

Jun, J., Ojemeni, M.M., Kalamani, R., Tong, J. and Crecelius, M.L. (2021). Relationship between nurse burnout, patient and organizational outcomes: Systematic review. International Journal of Nursing Studies, 119(103933). doi:https://doi.org/10.1016/j.ijnurstu.2021.103933.

Patel, R.S., Sekhri, S., Bhimanadham, N.N., Imran, S. and Hossain, S. (2019). A Review on Strategies to Manage Physician Burnout. Cureus, [online] 11(6). doi:https://doi.org/10.7759/cureus.4805.

Link to external site, this link will open in a new tab and Link to external site, this link will open in a new tab (2023). Pursuing Long-Term Business Performance: Investigating the Effects of Financial and Technological Factors on Digital Adoption to Leverage SME Performance and Business Sustainability—Evidence from Indonesian SMEs in the Traditional Market. ProQuest, [online] p.12668. doi:https://doi.org/10.3390/su151612668.

Ge, J., He, J., Liu, Y., Zhang, J., Pan, J., Zhang, X. and Liu, D. (2021). Effects of effort-reward imbalance, job satisfaction, and work engagement on self-rated health among healthcare workers. BMC Public Health, 21(1). doi:https://doi.org/10.1186/s12889-021-10233-w.

Martínez-López, J.Á., Lázaro-Pérez, C., Gómez-Galán, J. and Fernández-Martínez, M. del M. (2020a). Psychological Impact of COVID-19 Emergency on Health Professionals: Burnout Incidence at the Most Critical Period in Spain. Journal of Clinical Medicine, 9(9), p.3029. doi:https://doi.org/10.3390/jcm9093029.

Statista.com., (2021). Percentage of U.S. employees who had feelings of burnout pre-COVID Jan. 2020 vs Feb. 2021, by generation. Available from https://www.statista.com/statistics/1256283/burnout-among-us-employees-by-generation/. Accessed on 17.11.2023

Alruwaili, M.M., Abuadas, F.H., Maude, P. and Ross, A. (2022). Experiences, Perceptions, and Coping Patterns of Emergency Department Nurses with Occupational Stressors in Saudi Arabian Hospitals: Mixed-Method Study. Healthcare, 10(8), p.1504. doi:https://doi.org/10.3390/healthcare10081504.

Salameh, B., Abdalla Ghassen Daibes and Qaddumi, J. (2023). Assessing the Prevalence, Predictors, and Consequences of Secondary Traumatic Stress Among Emergency Nurses in Palestine During the COVID-19 Pandemic. SAGE open nursing, 9. doi:https://doi.org/10.1177/23779608231207224.

Martínez-López, J.Á., Lázaro-Pérez, C., Gómez-Galán, J. and Fernández-Martínez, M. del M. (2020b). Psychological Impact of COVID-19 Emergency on Health Professionals: Burnout Incidence at the Most Critical Period in Spain. Journal of Clinical Medicine, 9(9), p.3029. doi:https://doi.org/10.3390/jcm9093029.

Manchikanti, L., Pampati, V., Jha, S., Sanapati, M., Soin, A., Shah, S., Kaye, A. and Hirsch, J. (2022). The Impact of COVID-19 on Interventional Pain Management Practices is Significant and Long-Lasting: An Interventional Pain Management Physician Survey. [online] Available at: https://www.painphysicianjournal.com/current/pdf?article=NzQyMQ%3D%3D&journal=142.

Chigwedere, O.C., Sadath, A., Kabir, Z. and Arensman, E. (2021). The Impact of Epidemics and Pandemics on the Mental Health of Healthcare Workers: A Systematic Review. International Journal of Environmental Research and Public Health, 18(13), p.6695. doi:https://doi.org/10.3390/ijerph18136695.

Moreno-Jiménez, J.E., Blanco-Donoso, L.M., Demerouti, E., Belda Hofheinz, S., Chico-Fernández, M., Moreno-Jiménez, B. and Garrosa, E. (2021). The Role of Healthcare Professionals’ Passion in Predicting Secondary Traumatic Stress and Posttraumatic Growth in the Face of COVID-19: A Longitudinal Approach. International Journal of Environmental Research and Public Health, [online] 18(9), p.4453. doi:https://doi.org/10.3390/ijerph18094453.

Rangachari, P. and L. Woods, J. (2020a). Preserving Organizational Resilience, Patient Safety, and Staff Retention during COVID-19 Requires a Holistic Consideration of the Psychological Safety of Healthcare Workers. International Journal of Environmental Research and Public Health, [online] 17(12), p.4267. doi:https://doi.org/10.3390/ijerph17124267.

Balducci, C., Baillien, E., Broeck, A.V. den, Toderi, S. and Fraccaroli, F. (2020). Job Demand, Job Control, and Impaired Mental Health in the Experience of Workplace Bullying Behavior: A Two-Wave Study. International Journal of Environmental Research and Public Health, 17(4), p.1358. doi:https://doi.org/10.3390/ijerph17041358.

Spagnoli, P. and Molinaro, D. (2020). Negative (Workaholic) Emotions and Emotional Exhaustion: Might Job Autonomy Have Played a Strategic Role in Workers with Responsibility during the Covid-19 Crisis Lockdown? Behavioral Sciences, 10(12), p.192. doi:https://doi.org/10.3390/bs10120192.

Bennett, P., Noble, S., Johnston, S., Jones, D. and Hunter, R. (2020). COVID-19 confessions: a qualitative exploration of healthcare workers experiences of working with COVID-19. BMJ Open, 10(12), p.e043949. doi:https://doi.org/10.1136/bmjopen-2020-043949.

He, G., An, R. and Zhang, F. (2019). Cultural Intelligence and Work–Family Conflict: A Moderated Mediation Model Based on Conservation of Resources Theory. International Journal of Environmental Research and Public Health, [online] 16(13), p.2406. doi:https://doi.org/10.3390/ijerph16132406.

Yeh, T.-F., Chang, Y.-C., Feng, W.-H., sclerosis, M. and Yang, C.-C. (2020). Effect of Workplace Violence on Turnover Intention: The Mediating Roles of Job Control, Psychological Demands, and Social Support. INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 57, p.004695802096931. doi:https://doi.org/10.1177/0046958020969313.

Flett, G. and Zangeneh, M. (2020). Mattering as a Vital Support for People During the COVID-19 Pandemic: The Benefits of Feeling and Knowing That Someone Cares During Times of Crisis. Journal of Concurrent Disorders, 2(1), pp.106–123. doi:https://doi.org/10.54127/almc5515.

Pascoe, K.M., Petrescu-Prahova, M., Steinman, L., Bacci, J., Mahorter, S., Belza, B. and Weiner, B. (2021). Exploring the impact of workforce turnover on the sustainability of evidence-based programs: A scoping review. Implementation Research and Practice, 2, p.263348952110345. doi:https://doi.org/10.1177/26334895211034581.

References c3

Chapter 3

Psarommatis, F., Sousa, J., Mendonça, J.P. and Kiritsis, D. (2021). Zero-defect manufacturing the approach for higher manufacturing sustainability in the era of industry 4.0: a position paper. International Journal of Production Research, 60(1), pp.1–19. doi:https://doi.org/10.1080/00207543.2021.1987551.

Ali, M.A., Hussin, N., Haddad, H., Al-Ramahi, N.M., Almubaydeen, T.H. and Abed, I.A. (2022). The Impact of Intellectual Capital on Dynamic Innovation Performance: An Overview of Research Methodology. Journal of Risk and Financial Management, [online] 15(10), p.456. doi:https://doi.org/10.3390/jrfm15100456.

Mahesh, B. and G, D.K. (2022). Conception about the Data Visualization Techniques Including Data Stream Mining and Bioinformatics. TechnoareteTransactions on Intelligent Data Mining and Knowledge Discovery, 2(1). doi:https://doi.org/10.36647/ttidmkd/02.01.a004.

Braun, V. and Clarke, V. (2021). Can I use TA? Should I use TA? Should I not use TA? Comparing reflexive thematic analysis and other pattern?based qualitative analytic approaches. Counselling and Psychotherapy Research, 21(1), pp.37–47. doi:https://doi.org/10.1002/capr.12360.

Proudfoot, K. (2022). Inductive/Deductive Hybrid Thematic Analysis in Mixed Methods Research. Journal of Mixed Methods Research, [online] 17(3), p.155868982211268. doi:https://doi.org/10.1177/15586898221126816.

Pearse, N. (2019). An Illustration of a Deductive Pattern Matching Procedure in Qualitative Leadership Research. The Electronic Journal of Business Research Methods, [online] 17(3), pp.143–154. doi:https://doi.org/10.34190/JBRM.17.3.004.

Varela, M., Lopes, P. and Rodrigues, R. (2021). Rigour in the Management Case Study Method: A Study on Master’s Dissertations. Electronic Journal of Business Research Methods, 19(1), pp.pp1-13. doi:https://doi.org/10.34190/ejbrm.19.1.2072.

Carcary, M. (2020). The Research Audit Trail: Methodological Guidance for Application in Practice. Electronic Journal of Business Research Methods, 18(2). doi:https://doi.org/10.34190/jbrm.18.2.008.

Amin, M.E.K., Nørgaard, L.S., Cavaco, A.M., Witry, M.J., Hillman, L., Cernasev, A. and Desselle, S.P. (2020a). Establishing trustworthiness and authenticity in qualitative pharmacy research. Research in Social and Administrative Pharmacy, 16(10). doi:https://doi.org/10.1016/j.sapharm.2020.02.005.

Remler, D.K. and Ryzin, G.G.V. (2021). Research Methods in Practice: Strategies for Description and Causation. [online] Google Books. SAGE Publications. Available at: https://books.google.com/books?hl=en&lr=&id=2iI_EAAAQBAJ&oi=fnd&pg=PT28&dq=+Descriptive+research+design+is+a+widely+used+method+for+doing+research+and+interpreting+its+findings.+&ots=fvCQJk2vHQ&sig=QSae2nSO2hmod2chaW0VqZaq3nA [Accessed 17 Nov. 2023].

Mwita, K. (2022). Factors to consider when choosing data collection methods. International Journal of Research in Business and Social Science (2147- 4478), [online] 11(5), pp.532–538. doi:https://doi.org/10.20525/ijrbs.v11i5.1842.

Khan, S.A.R., Zhang, Y., Kumar, A., Zavadskas, E. and Streimikiene, D. (2020). Measuring the impact of renewable energy, public health expenditure, logistics, and environmental performance on sustainable economic growth. Sustainable Development, 28(4), pp.833–843.

Peel, K. (2020). A Beginner’s Guide to Applied Educational Research Using Thematic Analysis. Practical Assessment, Research, and Evaluation, 25(1). doi:https://doi.org/10.7275/ryr5-k983.

Asma, M. (2023). Exploring The Role of Studying Before Sleeping Using Audio-Visual Aids in Developing Students Memorization and Recall The Case of First Year EFL Students at Mohamed Kheider University of Biskr. archives.univ-biskra.dz, [online] 147(38). Available at: http://archives.univ-biskra.dz/handle/123456789/27075 [Accessed 17 Nov. 2023].

Vindrola-Padros, C. and Johnson, G.A. (2020). Rapid Techniques in Qualitative Research: A Critical Review of the Literature. Qualitative Health Research, 30(10), pp.1596–1604. doi:https://doi.org/10.1177/1049732320921835.

Prisznyák, A. (2023). Ethical AI: Proposal to bridge the gap in EU regulation on trustworthy AI and to support practical implementation of ethical perspectives. ECONOMY AND FINANCE: ENGLISH-LANGUAGE EDITION OF GAZDASÁG ÉS PÉNZÜGY, [online] 10(2), pp.163–188. Available at: http://real.mtak.hu/167726/ [Accessed 17 Nov. 2023].

Taherdoost, H. (2022). Understanding Cybersecurity Frameworks and Information Security Standards—A Review and Comprehensive Overview. Electronics, [online] 11(14), p.2181. doi:https://doi.org/10.3390/electronics11142181.

References c4

Salvado, M., Marques, D.L., Pires, I.M. and Silva, N.M. (2021a). Mindfulness-Based Interventions to Reduce Burnout in Primary Healthcare Professionals: A Systematic Review and Meta-Analysis. Healthcare, 9(10), p.1342. doi:https://doi.org/10.3390/healthcare9101342.

KASALAK, G. and DA?YAR, M. (2022). Teacher burnout and demographic variables as predictors of teachers’ enthusiasm. Participatory Educational Research, 9(2), pp.280–296. doi:https://doi.org/10.17275/per.22.40.9.2.

Atroszko, P.A., Demetrovics, Z. and Griffiths, M.D. (2020). Work Addiction, Obsessive-Compulsive Personality Disorder, Burn-Out, and Global Burden of Disease: Implications from the ICD-11. International Journal of Environmental Research and Public Health, 17(2), p.660. doi:https://doi.org/10.3390/ijerph17020660.

Salvado, M., Marques, D.L., Pires, I.M. and Silva, N.M. (2021b). Mindfulness-Based Interventions to Reduce Burnout in Primary Healthcare Professionals: A Systematic Review and Meta-Analysis. Healthcare, 9(10), p.1342. doi:https://doi.org/10.3390/healthcare9101342.

Vaismoradi, M., Tella, S., A. Logan, P., Khakurel, J. and Vizcaya-Moreno, F. (2020). Nurses’ Adherence to Patient Safety principles: a Systematic Review. International Journal of Environmental Research and Public Health, [online] 17(6), pp.1–15. doi:https://doi.org/10.3390/ijerph17062028.

Psnet (2022). Redirect Notice. [online] www.google.com. Available at: https://www.google.com/url?q=https://psnet.ahrq.gov/primer/nursing-and-patient-safety&sa=D&source=docs&ust=1700233660733885&usg=AOvVaw1T3WpNxaajG36dpTFp0Ibl [Accessed 17 Nov. 2023].

Andersen?Hollekim, T., Solbjør, M., Kvangarsnes, M., Hole, T. and Landstad, B.J. (2020). Narratives of patient participation in haemodialysis. Journal of Clinical Nursing, 29(13-14), pp.2293–2305. doi:https://doi.org/10.1111/jocn.15238.

Wadsworth, P.A. (2020). Regulation of signaling and function of the voltage-gated sodium channel complex by protein:protein interactions. utmb-ir.tdl.org. [online] Available at: https://utmb-ir.tdl.org/handle/2152.3/12076 [Accessed 17 Nov. 2023].

Ewen, C., Jenkins, H., Jackson, C., Jutley-Neilson, J. and Galvin, J. (2020). Well-being, job satisfaction, stress and burnout in speech-language pathologists: A review. International Journal of Speech-Language Pathology, 23(2), pp.1–11. doi:https://doi.org/10.1080/17549507.2020.1758210.

Abdel Hadi, S., Bakker, A.B. and Häusser, J.A. (2021). The role of leisure crafting for emotional exhaustion in telework during the COVID-19 pandemic. Anxiety, Stress, & Coping, 34(5), pp.1–15. doi:https://doi.org/10.1080/10615806.2021.1903447.

K Cetrone (2023). Exploring Physician Assistant Students’ Perceptions of Stress and Help Seeking Behavior - ProQuest. [online] www.proquest.com. Available at: https://search.proquest.com/openview/5bcebbd08058fd7ab0cf52257f033410/1?pq-origsite=gscholar&cbl=18750&diss=y [Accessed 17 Nov. 2023].

Mihalache, M. and Mihalache, O.R. (2021). How workplace support for the COVID ?19 pandemic and personality traits affect changes in employees’ affective commitment to the organization and job?related well?being. Human Resource Management, [online] 61(3). doi:https://doi.org/10.1002/hrm.22082.

Setyadi, B., Helmi, S. and Hidayat, A. (2022). The Influence Of Employee Performance On Customer Loyalty Is Mediated By Service Quality And Customer Satisfaction. Journal of Positive School Psychology, [online] 6(9), pp.5091–5102. Available at: https://journalppw.com/index.php/jpsp/article/view/13488.

L Nadon (2022). Redirecting... [online] heinonline.org. Available at: https://heinonline.org/hol-cgi-bin/get_pdf.cgi?handle=hein.journals/techssj34§ion=31 [Accessed 17 Nov. 2023].

Qader, K.S., Ismeal, B.A., Aziz, H.M., Hamza, P.A., Sorguli, S., Sabir, B.Y., Anwar, G. and Gardi, B. (2021). The Effect of Human Resources Management Skills on Accounting Information Quality in Kurdistan Public Sector. Journal of Humanities and Education Development, 3(3), pp.131–143. doi:https://doi.org/10.22161/jhed.3.3.14.

Godini?, D. and Obrenovic, B. (2020). Effects of Economic Uncertainty on Mental Health in the COVID-19 Pandemic Context: Social Identity Disturbance, Job Uncertainty and Psychological Well-Being Model. International Journal of Innovation and Economic Development, [online] 6(1), pp.61–74. Available at: https://philpapers.org/rec/GODEOE.

Rendeiro, A.F., Casano, J., Vorkas, C.K., Singh, H., Morales, A., DeSimone, R.A., Ellsworth, G.B., Soave, R., Kapadia, S.N., Saito, K., Brown, C.D., Hsu, J., Kyriakides, C., Chiu, S., Cappelli, L.V., Cacciapuoti, M.T., Tam, W., Galluzzi, L., Simonson, P.D. and Elemento, O. (2021). Profiling of immune dysfunction in COVID-19 patients allows early prediction of disease progression. Life Science Alliance, [online] 4(2), p.e202000955. doi:https://doi.org/10.26508/lsa.202000955.

Vajrala, B., Jyothi.K, S., R, P., Reddy.P.M, R., Mounika, Kumari, S. and C, K. (2023). Factors Mediating the Risk and Protective Psychological Health and Well-Being of Healthcare Workers: A Systematic Review. Journal for ReAttach Therapy and Developmental Diversities, [online] 6(9s(2)), pp.1135–1144. Available at: https://jrtdd.com/index.php/journal/article/view/1610 [Accessed 30 Oct. 2023].

CB Fiser (2023). APA PsycNet. [online] psycnet.apa.org. Available at: https://psycnet.apa.org/record/2022-50919-001 [Accessed 17 Nov. 2023].

A Pohaci (2023). Redirecting... [online] heinonline.org. Available at: https://heinonline.org/hol-cgi-bin/get_pdf.cgi?handle=hein.journals/techssj20§ion=58 [Accessed 17 Nov. 2023].

References

Chapter 5

Amin, M.E.K., Nørgaard, L.S., Cavaco, A.M., Witry, M.J., Hillman, L., Cernasev, A. and Desselle, S.P. (2020b). Establishing trustworthiness and authenticity in qualitative pharmacy research. Research in Social and Administrative Pharmacy, 16(10). doi:https://doi.org/10.1016/j.sapharm.2020.02.005.

Asif, M., Jameel, A., Hussain, A., Hwang, J. and Sahito, N. (2019). Linking Transformational Leadership with Nurse-Assessed Adverse Patient Outcomes and the Quality of Care: Assessing the Role of Job Satisfaction and Structural Empowerment. International Journal of Environmental Research and Public Health, [online] 16(13), p.2381. doi:https://doi.org/10.3390/ijerph16132381.

Cahill, J., Cullen, P., Anwer, S., Wilson, S. and Gaynor, K. (2021). Pilot Work Related Stress (WRS), Effects on Wellbeing and Mental Health, and Coping Methods. The International Journal of Aerospace Psychology, 31(2), pp.87–109. doi:https://doi.org/10.1080/24721840.2020.1858714.

Chen, J., Ghardallou, W., Comite, U., Ahmad, N., Ryu, H.B., Ariza-Montes, A. and Han, H. (2022b). Managing Hospital Employees’ Burnout through Transformational Leadership: The Role of Resilience, Role Clarity, and Intrinsic Motivation. International Journal of Environmental Research and Public Health, 19(17), p.10941. doi:https://doi.org/10.3390/ijerph191710941.

Hosseini, M., Senabre Hidalgo, E., Horbach, S.P.J.M., Güttinger, S. and Penders, B. (2022). Messing with Merton: The intersection between open science practices and Mertonian values. Accountability in Research, [online] pp.1–28. doi:https://doi.org/10.1080/08989621.2022.2141625.

Kabunga, A. and Okalo, P. (2021). Prevalence and predictors of burnout among nurses during COVID-19: a cross-sectional study in hospitals in central Uganda. BMJ Open, 11(9), p.e054284. doi:https://doi.org/10.1136/bmjopen-2021-054284.

Koutsimani, P., Montgomery, A., Masoura, E. and Panagopoulou, E. (2021). Burnout and Cognitive Performance. International Journal of Environmental Research and Public Health, [online] 18(4), p.2145. doi:https://doi.org/10.3390/ijerph18042145.

MP Kaldas (2022). APA PsycNet. [online] psycnet.apa.org. Available at: https://psycnet.apa.org/record/2020-91110-001.

Rangachari, P. and L. Woods, J. (2020b). Preserving Organizational Resilience, Patient Safety, and Staff Retention during COVID-19 Requires a Holistic Consideration of the Psychological Safety of Healthcare Workers. International Journal of Environmental Research and Public Health, [online] 17(12), p.4267. doi:https://doi.org/10.3390/ijerph17124267.

Ren, C., Li, X., Yao, X., Pi, Z. and Qi, S. (2019). Psychometric Properties of the Effort-Reward Imbalance Questionnaire for Teachers (Teacher ERIQ). Frontiers in Psychology, 10. doi:https://doi.org/10.3389/fpsyg.2019.02047.

fSearch.proquest (2023). Impact of COVID-19 on Pharmacists in Community Pharmacies in the State of Nebraska: A Mixed Methods Study - ProQuest. [online] www.proquest.com. Available at: https://search.proquest.com/openview/26a5566b4acb8bdbfe9884e134dede18/1?pq-origsite=gscholar&cbl=18750&diss=y [Accessed 17 Nov. 2023].

Shirinda-Mthombeni, K. (2022). Exploring the life stories of HIV/AIDS lay counsellors: from burnout to resilience. Unisa.ac.za. [online] doi:https://hdl.handle.net/10500/29098.

Vuong, Q.-H., Nguyen, M.-H. and La, V.-P. (2022). The mindsponge and BMF analytics for innovative thinking in social sciences and humanities. [online] Google Books. Walter de Gruyter GmbH. Available at: https://books.google.com/books?hl=en&lr=&id=EGeEEAAAQBAJ&oi=fnd&pg=PR3&dq=There+are+the+two+kinds+of+research+methodologies+have+been+employed+to+support+the+discovered+research+concepts+with+a+suitable+structure+and+to+analyse+the+research+concepts&ots=PYzXKH-1xm&sig=FM2ksliydUGj322o7_F67fz8Yqs [Accessed 17 Nov. 2023].

Zhang, M., Murphy, B., Cabanilla, A. and Yidi, C. (2021). Physical relaxation for occupational stress in healthcare workers: A systematic review and network meta?analysis of randomized controlled trials. Journal of Occupational Health, 63(1). doi:https://doi.org/10.1002/1348-9585.12243.