2020, Number 5
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Salud Mental 2020; 43 (5)
Pilot study of a brief psychological intervention for reducing emotional exhaustion and secondary traumatic stress among physicians of intensive care units in Mexico
Moreno-Jiménez JE, Yeo-Ayala MC, Palomera A, Blanco-Donoso LM, Rodríguez-Carvajal R, Garrosa E, Moreno-Jiménez B
Language: English
References: 41
Page: 219-226
PDF size: 179.98 Kb.
ABSTRACT
Introduction. Physicians of Intensive Care Units (ICU) have a potential risk to develop negative outcomes
such as emotional exhaustion and secondary traumatic stress (STS). Specifically, job demands in these units
(i.e., work stressors and emotional effort) may positively predict these outcomes, whereas personal resources
such as harmonious passion and self-compassion may diminish them.
Objetive. To design a specific intervention
for physicians in ICU and provide preliminary evidence of its effectiveness.
Method. A brief intervention of
five weekly sessions (two hour-sessions) was carried out with four physicians in ICU in a hospital in Mexico.
Other four physicians were selected as a control group. The intervention was aimed at reducing emotional
exhaustion and STS by increasing harmonious passion and self-compassion, and diminishing the emotional
effort.
Results. The intervention group showed a significant reduction in: a) work stressors (2/4 physicians;
RCI = .21); emotional effort (1/4 physicians; (
RCI = .60); emotional exhaustion (2/4 physicians;
RCI = .34);
and STS (3/4 physicians;
RCI = .26). One physician experienced a significant increase in harmonious passion
(
RCI = 1.00), but the intervention seems to maintain high levels of this and self-compassion in comparison with
the control group. The control group showed a worse result in its outcomes.
Discussion and conclusion.
Despite the limitations, this study provides preliminary evidence for effectively reducing emotional exhaustion
and STS. Our findings highlight the individual analysis of the effective tools per physician and address interventions
focused on harmonious passion and self-compassion. This study calls for future research concerning
intervention proposals in ICU with follow-up measures to diminish the negative consequences in the long-term.
REFERENCES
Bakker, A. B., & Demerouti, E. (2013). La teoría de las demandas y los recursos laborales. Revista de Psicología del Trabajo y de las Organizaciones, 29(3), 107-115. doi: 10.5093/tr2013a16
Bakker, A. B., & Demerouti, E. (2017). Job demands–resources theory: Taking stock and looking forward. Journal of Occupational Health Psychology, 22(3), 273- 285. doi: 10.1037/ocp0000056
Bakker, A. B., & Sanz-Vergel, A. I. (2013). Weekly work engagement and flourishing: The role of hindrance and challenge job demands. Journal of Vocational Behavior, 83(3), 397-409. doi: 10.1016/j.jvb.2013.06.008
Bakker, A. B., Demerouti, E., & Verbeke, W. (2004). Using the job demands-resources model to predict burnout and performance. Human Resource Management, 43(1), 83-104. doi: 10.1002/hrm.20004
Beaumont, E., Durkin, M., Hollins Martin, C. J. H., & Carson, J. (2016). Compassion for others, self-compassion, quality of life and mental well-being measures and their association with compassion fatigue and burnout in student midwives: A quantitative survey. Midwifery, 34, 239-244. doi: 10.1016/j.midw.2015.11.002
Blanco-Donoso, L. M., García Rubio, C., Moreno Jiménez, B., de la Pinta, M. L. R., Moraleda Aldea, S., & Garrosa, E. (2017). Intervención breve basada en ACT y mindfulness: Estudio piloto con profesionales de enfermería en UCI y Urgencias. International Journal of Psychology and Psychological Therapy, 17(1), 57-63.
Chuang, C., Tseng, P., Lin, C., Lin, K., & Chen, Y. (2016). Burnout in the intensive care unit professionals. A systematic review. Medicine, 95(50), e5629. doi: 10.1097/MD.0000000000005629
Dominguez-Gomez, E., & Rutledge, D. N. (2009). Prevalence of Secondary Traumatic Stress Among Emergency Nurses. Journal of Emergency Nursing, 35(3), 199-204. doi: 10.1016/j.jen.2008.05.003 Moreno-Jiménez et al. 226 Salud Mental, Vol. 43, Issue 5, September-October 2020
Donahue, E. G., Forest, J., Vallerand, R. J., Lemyre, P. N., Crevier-Braud, L., & Bergeron, É. (2012). Passion for work and emotional exhaustion: The mediating role of rumination and recovery. Applied Psychology: Health and Well-Being, 4(3), 341-368. doi: 10.1111/j.1758-0854.2012.01078.x
Dubreuil, P., Forest, J., & Courcy, F. (2014). From strengths use to work performance: The role of harmonious passion, subjective vitality, and concentration. Journal of Positive Psychology, 9(4), 335-349. doi: 10.1080/17439760.2014.898318
Flaxman, P. E., & Bond, F. W. (2010). A randomised worksite comparison of acceptance and commitment therapy and stress inoculation training. Behaviour Research and Therapy, 48(8), 816-820. doi: 10.1016/j.brat.2010.05.004
Forest, J., Mageau, G. A., Crevier-Braud, L., Bergeron, É., Dubreuil, P., & Lavigne, G. L. (2012). Harmonious passion as an explanation of the relation between signature strengths’ use and well-being at work: Test of an intervention program. Human Relations, 65(9), 1233-1252. doi: 10.1177/0018726711433134
Gallego-Alberto, L., Márquez-González, M., Romero-Moreno, R., Cabrera, I., & Losada, A. (2019). Pilot study of a psychotherapeutic intervention for reducing guilt feelings in highly distressed dementia family caregivers (Innovative practice). Dementia. doi: 10.1177/1471301219886761
García-Campayo, J., & Demarzo, M. (2015). Mindfulness y compasión: la nueva revolución. Barcelona: Siglantana.
Gracia Gozalo, R., Ferrer Tarrés, J., Ayora Ayora, A., Alonso Herrero, M., Amutio Kareaga, A., & Ferrer Roca, R. (2019). Application of a mindfulness program among healthcare professionals in an intensive care unit: Effect on burnout, empathy and self-compassion. Medicina Intensiva (English Edition), 43(4), 207-216. doi: 10.1016/j.medine.2019.03.006
Gómez-Salgado, J., Navarro-Abal, Y., López-López, M. J., Romero-Martín, M., & Climent-Rodríguez, J. A. (2019). Engagement, passion and meaning of work as modulating variables in nursing: A theoretical analysis. International Journal of Environmental Research and Public Health, 16(1), 108. doi: 10.3390/ ijerph16010108
Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (1999). Acceptance and Commitment Therapy: An experiential approach to behavior change. New York: Guilford Press.
Jacobson, N. S., & Truax, P. (1991). Clinical significance: a statistical approach to defining meaningful change in psychotherapy research. Journal of consulting and clinical psychology, 59(1), 12–19. https://doi.org/10.1037//0022- 006x.59.1.12
Kelly, L. (2020). Burnout, Compassion fatigue, and secondary trauma in nurses: Recognizing the occupational phenomenon and personal consequences of caregiving. Critical Care Nursing Quarterly, 43(1), 73-80. doi: 10.1097/ CNQ.0000000000000293
Kinker, B., Arfken, C., & Morreale, M. (2018). Secondary traumatic stress in medical students. Academic Psychiatry, 42(1), 181-182. doi: 10.1007/s40596-017-0767- 4
Kravits, K., McAllister-Black, R., Grant, M., & Kirk, C. (2010). Self-care strategies for nurses: A psycho-educational intervention for stress reduction and the prevention of burnout. Applied Nursing Research, 23(3), 130-138. doi: 10.1016/j.apnr.2008.08.002
Lavigne, G. L., Forest, J., Fernet, C., & Crevier-Braud, L. (2014). Passion at work and workers’ evaluations of job demands and resources: a longitudinal study. Journal of Applied Social Psychology, 44(4), 255-265. doi: 10.1111/jasp.12209
Martínez-Iñigo, D., Totterdell, P., Alcover, C. M., & Holman, D. (2007). Emotional labour and emotional exhaustion: Interpersonal and intrapersonal mechanisms. Work & Stress, 21(1), 30-47. doi: 10.1080/02678370701234274
Meda, R., Moreno-Jiménez, B., Palomera, A., Arias, E., & Vargas, R. (2012). La Evaluación del Estrés Traumático Secundario. Estudio Comparado en Bomberos y Paramédicos de los Servicios de Emergencia de Guadalajara, México. Terapia Psicológica, 30(2), 31-41. doi: 10.4067/S0718-48082012000200003
Moreno-Jiménez, B., Garrosa Hernández, E. & González Gutiérrez, J. L. (2000). El Desgaste profesional de enfermería. Desarrollo y validación factorial del CDPE. Archivos de Prevención de Riesgos Laborales, 3(1), 18-28.
Moreno-Jiménez, J. E., Rodríguez-Carvajal, R., Chico-Fernández, M., Lecuona, Ó., Martínez, M., Moreno-Jiménez, B., … Garrosa, E. (2019). Risk and protective factors of secondary traumatic stress in Intensive Care Units: An exploratory study in a hospital in Madrid (Spain). Medicina Intensiva (English Edition), (xx), 1-8. doi: 10.1016/j.medine.2019.06.013
Myhren, H., Ekeberg, Ø., & Stokland, O. (2013). Job satisfaction and burnout among intensive care unit nurses and physicians. Critical Care Research and Practice, 1-6. doi: 10.1155/2013/786176
Panagioti, M., Panagopoulou, E., Bower, P., Lewith, G., Kontopantelis, E., Chew- Graham, C., … Esmail, A. (2017). Controlled interventions to reduce burnout in physicians: A systematic review and meta-analysis. JAMA Internal Medicine, 177(2), 195-205. doi: 10.1001/jamainternmed.2016.7674
Pollack, J. M., Ho, V. T., O’Boyle, E. H., & Kirkman, B. L. (2020). Passion at work: A meta-analysis of individual work outcomes. Journal of Organizational Behavior, 41(4), 311-331. doi: 10.1002/job.2434
Quiñones-García, C., Rodríguez-Carvajal, R., Clarke, N., & Moreno-Jiménez, B. (2013). Development and cross-national validation of the Emotional Effort Scale (EEF). Psicothema, 25(3), 363-369. doi: 10.7334/psicothema2012.289
Raab, K. (2014). Mindfulness, self-compassion, and empathy among health care professionals: A review of the literature. Journal of Health Care Chaplaincy, 20(3), 95-108. doi: 10.1080/08854726.2014.913876
Rodríguez-Carvajal, R., García-Rubio, C., Paniagua, D., García-Diex, G., & de Rivas, S. (2016). Mindfulness Integrative Model (MIM): Cultivating positive states of mind towards oneself and the others through mindfulness and self-compassion. Anales de Psicología, 32(3), 749-760. doi: 10.6018/analesps.32.3.261681
Rodríguez-Carvajal, R., Moreno-Jiménez, B., de Rivas Hermosilla, S., & Herrero Lázaro, M. (2011). Recursos personales positivos en la relación con el paciente: las Estrategias de regulación emocional. Norte de Salud Mental, 38-48. Retrieved from https://pdfs.semanticscholar.org/81ba/54e810f0ad2af0e0a8244 cb1d7db21b3232b.pdf
Romani, M., & Ashkar, K. (2014). Burnout among physicians. Libyan Journal of Medicine, 9(1), 23556. doi: 10.3402/ljm.v9.23556
Saadat, H., & Kain, Z. N. (2018). Wellness interventions for anesthesiologists. Current Opinion in Anaesthesiology, 31(3), 375-381. doi: 10.1097/ ACO.0000000000000598
Serrano-Fernández, M. J., Boada-Grau, J., Gil-Ripoll, C., & Vigil-Colet, A. (2017). Spanish adaptation of the Passion Toward Work Scale (PTWS). Anales de Psicología, 33(2), 403–410. doi: 10.6018/analesps.33.2.240521
Vallerand, R. J. (2008). On the psychology of passion: In search of what makes people’s lives most worth living. Canadian Psychology/Psychologie Canadienne, 49(1), 1-13. doi: 10.1037/0708-5591.49.1.1
Vallerand, R. J., Blanchard, C., Mageau, G. A., Koestner, R., Ratelle, C., Léonard, M., … Marsolais, J. (2003). Les passions de l’âme: On obsessive and harmonious passion. Journal of Personality and Social Psychology, 85(4), 756-767. doi: 10.1037/0022-3514.85.4.756
Vallerand, R. J., Paquet, Y., Philippe, F. L., & Charest, J. (2010). On the role of passion for work in burnout: A process model. Journal of Personality, 78(1), 289-312. doi: 10.1111/j.1467-6494.2009.00616.x
van Mol, M. M. C., Kompanje, E. J. O., Benoit, D. D., Bakker, J., & Nijkamp, M. D. (2015). The prevalence of compassion fatigue and burnout among healthcare professionals in intensive care units: A systematic review. PLoS ONE, 10(8), e0136955. doi: 10.1371/journal.pone.0136955
Weintraub, A. S., Sarosi, A., Goldberg, E., & Waldman, E. D. (2020). A cross-sectional analysis of compassion fatigue, burnout, and compassion satisfaction in pediatric hematology-oncology physicians in the United States. Journal of Pediatric Hematology/Oncology, 42(1), e50-e55. doi: 10.1097/MPH.0000000000001548