SACM - United Kingdom
Permanent URI for this collectionhttps://drepo.sdl.edu.sa/handle/20.500.14154/9667
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Item Restricted Stress and Burnout in Critical Care Nurses in Saudi Arabia: A Systematic Literature Review(Queen's University Belfast, 2025-03) Aljohani, Abdulelah; Rice, BilliejoanBackground: Burnout is a significant occupational health problem in critical care nurses, particularly working in intensive care units and emergency departments. The intensive work of critical care, involving long shifts, high patient acuity, and emotional stress, is a contributing factor to burnout, impacting job satisfaction, patient care quality, and nursing staff turnover. In Saudi Arabia, regional health disparities, nursing shortages, and reliance on expatriate nurses add to the issue, requiring closer examination. Aim: The aim of this systematic review seeks to synthesise current evidence on risk factors and the prevalence for stress and burnout among critical care nurses in the Kingdom of Saudi Arabia. Methods: Systematic literature search was conducted by utilising PUBMED, CINAHL, and EMBASE databases. Inclusion was rigorous, and studies regarding the prevalence, risk factors, and Saudi Arabian critical care nurses’ exposure to burnout: a total of ten articles were included in the review. Meta-analyses were not feasible; thus, the results were synthesised narratively and categorised into two major categories: Levels of burnout and factors contributing to burnout. Results: There are high to moderate levels of burnout present in Critical care nurses, and there is regional variation between Riyadh, Makkah, and Jazan. Intensive care units’ nurses exhibited more emotional exhaustion, and emergency department nurses exhibited physical exhaustion as a result of workload intensity. There was added stress due to expatriate nurses, including uncertainty in jobs, cultural challenges, and language. Organisational factors, including shortages in staff, shift working, and rigid hospital hierarchies, also contributed to burnout. Conclusion: Burnout among Saudi Arabian critical care nurses’ is a serious workforce issue with direct effects on patient safety, healthcare efficiency, and retention. Addressing burnout requires policy changes, mental health support, and workforce reforms to improve nurse well-being and patient care. Future research should focus on longitudinal studies and intervention-based strategies for sustainable solutions.9 0Item Restricted Intensive Care Nurses' Experiences of Burnout During the COVID-19 Pandemic in Saudi Arabia: A Constructivist Grounded Theory Study(King's College London, 2024) Alzailai, Nawal; Xyrichis, Andreas; Barriball, LouiseBackground: Burnout amongst healthcare staff, particularly amongst intensive care unit (ICU) nurses, is a critical issue that intensified during the COVID-19 pandemic. Previous research, especially within the Saudi context, has identified significant levels of burnout in ICU nurses. However, a notable gap exists in the use of qualitative methodologies to deepen our understanding of ICU nurses’ burnout in the Saudi context. Moreover, comprehending the experiences of nurses who suffered from burnout during the pandemic, focusing on the factors that contributed to their stress, has been essential for identifying developmental needs and for shaping interventions aimed at mitigating burnout amongst nurses. Despite this, the existing literature lacks a reliable theory or model that adequately captures the phenomenon of burnout within highly demanding environments like ICUs, particularly under the unpredictable and greatly challenging circumstances of disasters. Aim: To construct a theory grounded in burnout experiences of ICU nurses in Saudi Arabia during the COVID-19 pandemic, intended to act as a foundation for future research that explores burnout in high-stress environments for nurses or other healthcare staff working in similar contexts. Methods: Building from one scoping review and one systematic review, a constructivist grounded theory design was employed for this study, as proposed by Charmaz (2014a). Conducted in four distinct adult ICU departments of a tertiary hospital in Saudi Arabia, the research involved 22 ICU nurses experienced in caring for COVID-19 patients and 10 decision-makers, recruited through initial purposive sampling and subsequent theoretical sampling until theoretical saturation was reached. Data were collected through semi-structured, in-depth interviews. Field notes and a reflexive methodological journal were maintained throughout the research process. Interviews were transcribed verbatim and translated into English where necessary. The analysis followed “Charmazian” principles, which include initial, focused and theoretical coding; constant comparison; theoretical sampling and sensitivity; memo writing; and diagramming. Ethical approval was secured from King’s College London and from the relevant Institutional Review Board in Saudi Arabia. Results: The theory generated by this investigation suggests burnout is a process, resulting from multiple interrelated factors within and beyond an individual’s working environment. This process occurs in three dynamic stages affected by the coping and supportive resources that the nurse has used/received. The core category that emerged, ‘we fought and now we need to be healed’, encapsulates the essence of the nurses’ experiences with perceived burnout and their vital need for recovery and support. This finding led to the development of the BuRN-ICU19 model, a comprehensive framework representing the ICU nurses’ experiences with burnout during the COVID-19 pandemic and informed by results from two fundamental reviews: a scoping review and a systematic review. Conclusion: This thesis offers novel insights into the experiences of burnout among ICU nurses in Saudi Arabia during a disaster situation. It highlights the critical need for targeted interventions and policy reforms to alleviate burnout in, improve the well-being of and effectively support ICU nurses in demanding situations. The BuRN-ICU19 model presents a valuable framework for future research and practical application in ICU nursing, with potential implications extending beyond the Saudi context.47 0Item Restricted Burnout in mental health nurses in Saudi Arabia: A mixed method study.(Newcastle University, 2024-02-27) Faisal Al-Dhafeeri; McColl, Elaine; Chaddock, Anna; Ahmad, Balsam; Teare, DawnIntroduction: Workplace burnout is a social phenomenon that affects healthcare professionals and patient care. It is a response to workplace stressors and is characterised by high emotional exhaustion (EE), high depersonalisation (DP), and low personal accomplishment (PA). Aim: The aim of this research was to explore workplace burnout and associated factors among mental health nurses in Saudi Arabia and to identify potential solutions to minimise burnout and its impact. Method: A mixed methods design was employed, comprising an umbrella review of predictors of burnout in mental health nurses (MHNs), a survey of MHNs from three Saudi Arabian hospitals, using validated measures of burnout, workplace stressors and social support, and in-depth interviews and a focus group with a subset of respondents to this survey. Findings: The umbrella review identified a range of predictors of burnout which could be grouped as intrapersonal (e,g, age, gender), interpersonal (e,g. social support, aggression at work) and extrapersonal (e.g. lack of training, high workload). Cluster analysis showed that more than half of the sample (56%) were Engaged (high EE, high DP, high PA), with approximately 20% in each of Ineffective (PA only reduced) and Burnt-out (EE and DP reduced) profiles. Social support came most often from friends/family, least often from colleagues. Hospital base, number of years’ experience, time to travel to work, Workload, Client Related Difficulties and Organisational Structure and Process and Colleague Support were statistically significantly associated with profile type. Three themes were identified from qualitative data analysis: the experience of burnout among mental health nurses in Saudi Arabia; how nurses deal with the challenges of burnout; changes on the horizon in Saudi Arabia from the perspective of mental health nurses. Conclusions and recommendations: One in five nurses in my sample could be characterised as Burnt-out. Recommendations to reduce workplace stress and ameliorate burnout included: improved staff: patient ratios, more opportunities for training and development, and ensuring nurses feel valued.50 0Item Restricted The Impact of Burnout Prevention Programs on Reducing Burnout Among Paediatric Nurses: qualitative Systematic Review(Saudi Digital Library, 2023-11-09) Aloufi, Khlood; Ritchie, DawnBackground: Paediatric nursing plays a pivotal role in delivering healthcare services to children, and the well-being of paediatric nurses directly influence the standard of care given. This systematic review aimed to comprehensively investigate the When compared to paediatric nurses who don't receive any treatment, the installation of burnout prevention programs might reduce burnout among them. Inclusion Criteria: To conduct this review, an exhaustive reliable database, such as PubMed, Google Scholar, and Cochrane, were searched. Ten relevant studies, published between 2013 and 2023, were meticulously selected based on stringent inclusion criteria. These criteria were shaped by the integration of the PRISMA flowchart and the PICOT framework. The inclusion criteria emphasized studies that specifically targeted intervention programs designed to reduce burnout among pediatric nurses. To ensure the methodological rigor of the selected studies, the Cochrane Risk of Bias Tool (RoB 2) was applied as a guiding framework. Search Strategy: The literature search strategy was executed with utmost precision, employing carefully chosen keywords related to burnout, pediatric nursing, and intervention programs. Furthermore, the search prioritized studies conducted and published in the English language, thereby ensuring a comprehensive yet linguistically focused approach. Methodological Quality: Each of the ten selected studies underwent a rigorous evaluation for methodological quality. This process involved the extraction of a diverse set of study attributes, including participant demographics, details of the interventions employed, outcome measures, and significant findings. The methodological quality assessment was conducted with meticulous attention to detail, further confirming the accuracy and validity of the results. Results: Results of this comprehensive review provided compelling evidence supporting the implementation of burnout prevention programs among pediatric nurses. The selected studies consistently demonstrated that these programs had a substantial positive impact. They were associated with a notable reduction in burnout rates among pediatric nurses, resulting in tangible improvements in patient care outcomes (HK and Leiter, 2006). Additionally, the programs contributed to elevated job satisfaction and an overall enhancement of the well-being of healthcare professionals in the pediatric nursing field. Conclusion: The findings underscore the significance of prioritizing the well-being of healthcare professionals, as it directly translates into improved patient outcomes and increased overall efficiency within the healthcare system.10 0Item Restricted Occupational Stress and Burnout in Nurses Working Extended Shifts: A Systematic Review(Saudi Digital Library, 2023-11-09) Almajed, Hamedh; Kerr, ClaireBackground: Extended nursing work hours have become common internationally, due to inadequate staffing levels and increasing population demands. Extended work hours can have adverse effects on the psychological well-being of nurses, including the manifestation of occupational stress and burnout.Aim: This review aims to explore if and how nurses working extended duty hours experience occupational stress and/or burnout.Methodology: A systematic search was conducted on four electronic databases: CINAHL Plus, MEDLINE, PubMed, and PsycINFO. A methodical search strategy was developed in collaboration with an expert librarian. Medical subject headings, keywords, and synonyms were utilised. Reference lists of papers eligible for inclusion in the review were also hand searched. The quality of each study was evaluated using the Joanna Briggs Institute's quality appraisal tool for cross-sectional studies. Meta-analyses were not possible; thus, findings were synthesised narratively.Results: Five studies were included, all focusing on the impact of extended shifts. One study focused on the nurses’ experience of occupational stress mainly; one study focused on the nurses’ experience of burnout; and two studies focused on the contributing factors of stress and burnout. The methodological quality of these studies was deemed satisfactory. The prevalence of 12-hour shifts was high, and evident across various countries. Long working hours and other variables such as inadequate rests, break-times, and fatigue contributed to the nurses’ experience of occupational stress and burnout. Conclusions: Extended shifts in nursing are a widely observed practise internationally. This systematic review sheds light on the effects of extended shift patterns and the prevalence of occupational stress and burnout among nurses. A better understanding of these concepts may help in building organisational initiatives and strategies to support nurses who work long shifts.14 0Item Restricted Burnout and Associated Stigma Among Saudi Arabian Healthcare Workers(Saudi Digital Library, 2023-11-06) Algahtani, Lina; Collins, KirstineBurnout and its associated stigma are critical issues affecting healthcare workers worldwide. This study examines the prevalence of burnout and stigma among healthcare workers in Saudi Arabia. The data was gathered through an online survey with 75 healthcare workers participants to explore their experiences with burnout, stigma, coping strategies, and potential workplace interventions. The results revealed a high prevalence of burnout, with 76% of participants reporting experiencing it. Numerous psychological and physical symptoms were associated with burnout, including exhaustion, lack of motivation, and sleep problems. Many participants felt unsupported in their workplace, highlighting the need for more effective communication and resources. 56% reported experiencing stigma when speaking about burnout at work and expressing worries about appearing incompetent. Fear of judgment and toxic work environments contributed to this stigma. Participants provided valuable insights on improving work conditions through a healthy environment, reduced hours, raising awareness, prioritising wellbeing, and offering counselling. This study sheds light on the interconnecting challenges of burnout and the stigma Saudi healthcare professionals face. The findings emphasise the importance of multifaceted strategies to address this issue. This research contributes to the limited existing knowledge on burnout and stigma in the Saudi healthcare system.52 0Item Restricted Workplace Factors Associated with Psychological Effects in Paramedics, A systematic Review and Meta- Analysis(Saudi Digital Library, 2023-10-13) Zahran, Rahaf; Brad, MetcalfThis systematic review and meta-analysis study aims to assess the correlation between workplace factors and psychological effects on paramedics. A search of four databases found 1794 papers, from which 31 were deemed eligible from the years 2000 to 2023. Their methodological quality was assessed using the Critical Appraisal Skill Program (CASP, 2018) tool and the Strengthening the Reporting of Observational Studies in Epidemiology (STOBE) guidelines to help in assessing cross-sectional studies. The results give the overall effect size with an OR=1.65 and a P<0.001, indicating statistical significance for the first forest plot. Similarly, forest plot 2 demonstrates an overall effect size with a correlation r= 0.29 and a P<0.001, also indicating statistical significance. In summary, this review found a small and positive correlation in reported odds ratio studies. For Pearson correlation r reported studies, a moderate and positive correlation were found linking psychological effect to workplace factors in paramedics. The limitation of this study included research published in English and variation in reporting results in the studies. The findings will inform future research and help policymakers, healthcare organizations, and practitioners in developing strategies to support paramedics' mental health and enhance quality of care.24 0Item Restricted The impact of shift work on the mental health, burnout syndrome, and job satisfaction of female nurses in a general hospital: a comparison between rotating night shifts and day shifts(Saudi Digital Library, 2023-07-29) Alqani, Shahalil; Zolfaghari, ParjamNumerous industries, including transportation, healthcare and hospitality, rely on the availability of employees who work beyond the conventional hours of 7:00 am to 6:00 pm (1). Up to 40% of healthcare workers within the European Union are subjected to shift work (2). Shift work is regarded as essential in the healthcare system to guarantee and facilitate continuity of care in hospitals and residential institutions. Shift work requires nurses to follow rotating schedules that include night shifts. These schedules are necessary to provide 24-hour care for patients and imply that nurses may have to work extended hours to ensure the continuous availability of healthcare professionals to address patients’ needs (3, 4), which can potentially contribute to the onset of burnout. Burnout is a state that arises from prolonged exposure to difficult and demanding work circumstances. It is primarily triggered by a combination of physical and psychological risks associated with one’s occupation, especially when the work environment lacks factors that promote well-being and satisfaction (4). Burnout is defined by extreme exhaustion, a sense of cynicism or detachment, and difficulties in thinking clearly and managing emotions effectively. It is a condition where individuals experience significant fatigue, develop negative attitudes or scepticism towards their work, and struggle with cognitive and emotional functioning (4). Studies have revealed that between 25% and 37% of nurses in Europe and the United States experience burnout (5, 6). Burnout and weariness have serious consequences for both the affected individuals and the organisations that employ them. Individuals who are burned out are more likely to request sick time and declare their intention to leave their jobs. These outcomes will have a substantial impact not just on the efficiency and well- being of individuals, nevertheless on the general functioning and performance of the organisations to which they are associated with (7). Patient safety is also affected by nurse burnout since burnout is linked to a higher risk of medication errors and increases the likelihood of patients encountering infections, falls and adverse events (8).18 0Item Restricted Exploration of burnout among Healthcare Professionals in Gulf regions during the COVID-19 pandemic: A systematic review.(Saudi Digital Library, 2023-09-04) Alhussaini, Abdullah; Skivington, KathrynAim: The aim of this study was to identify and understand the key factors that influence the likelihood of professional burnout in healthcare workers (HCWs) in the Gulf Cooperation Council (GCC) during and after the COVID-19 pandemic. Understanding these factors will help policy makers and institutional management develop and implement strategies that will protect and support HCWs, and thus develop a more flexible and robust healthcare system. Method: HCWs’ views on, and experiences of, burnout, during and after the COVID-19 pandemic, were examined. This was achieved through a systematic review and narrative synthesis of relevant qualitative studies published between 2020 and 2023. The studies were identified through a comprehensive search of three major databases (Ovid MEDLINE, EMBASE, CINHAL), and were evaluated using the Critical Appraisal Skills Programme (CASP). Results: The results of the study suggested that the causes of burnout (stressors) can be categorised under four main themes: (a) workload and role expansion, (b) fear of infection, (c) lack of administrative support, and (d) inadequacy of personal protective equipment. These, either collectively or individually, led to psychological and emotional effects, resulting in burnout. The study also found that these stressors did not affect all HCWs equally: their impact depended on the personal and professional profile of individual HCWs. HCWs appeared to exhibit a sense of professionalism, and an ability to adapt and grow professionally, through a range of coping mechanisms. Discussion: The results of the review are examined in the light of the research questions, and the case is made for improving pandemic preparedness through the implementation of context-specific strategies which take account of the identified stressors, and which include coping mechanisms. Conclusion: While the COVID-19 pandemic resulted in increased stress among HCWs across the GCC regions, burnout appeared to be highly influenced by individual context, such as age, experience and role. The factors identified, and their context dependency, should be considered in developing context-specific strategies to support healthcare workers' wellbeing and resilience during crisis conditions.21 0Item Restricted Surgeon Burnout, Patient Safety and Quality of Care: Contributors, Consequences and Possible Solutions(Tmam Al-Ghunaim, 2023-05-21) Al-Ghuanim, Tmam; Johnson, Judith; O'Conner , Daryl; Biyani, ShekharAbstract Research has linked increased staff burnout to poorer patient safety in healthcare settings. Surgeons, in particular, are more inclined to suffer from burnout whereas surgeons often suffer silently when they are experiencing stress and burnout and do not ask for help which make the issue not clear. There needs to be more research on surgeon burnout, how it affects them and how to enhance their well-being. This thesis aimed to improve understanding of surgeon burnout and identify potential solutions. This thesis reports five studies. The first was a systematic review and meta-analysis which aimed to investigate the association between surgeon burnout and 1) patient safety and 2) surgical professionalism. The results of a systematic review provided important insights into the existing evidence base on surgeon’s burnout and identified gaps in knowledge, one of which is that there is not enough qualitative study to give a deep understanding of how surgeons experience and deal with burnout. Hence, the next two studies used semi-structured interviews to explore the main factors that lead to surgeon burnout and to examine how surgeons cope with burnout at work (Study 2) and to understand how burnout affects surgeons and the care they provide (Study 3). The systematic review also revealed that there is no evidence regarding the link between surgeon burnout and patient safety in the UK, to address this, the fourth study used questionnaire survey methods to investigate the association between surgeon burnout and patient safety outcomes. This study also tested whether surgeons' burnout levels varied over the first six months of the COVID-19 pandemic. The fifth study, ../ qualitative methods, investigated the effects of the COVID-19 pandemic on surgeons' mental health. Key findings This thesis found a significant link between surgeon burnout and patient care. The systematic review and meta-analysis (Study 1) results showed that burnout was associated with a 2.5-fold increased risk of medical error. Study 3 identified four themes about how burnout affects patient care: first, burnout weakens surgeon–patient relationships; second, burnout affects patient safety; third, burnout hurts staff relationships; and fourth, burnout makes surgeons less motivated to improve. Burnout was also associated with patient safety in the survey study (Study 4), and the longitudinal findings indicated a bi-directional connection between burnout and patient safety perceptions (Study 4). Regarding the main factors that can lead to burnout in surgeons, the thematic analysis identified several factors captured in the following themes: rising to the challenge of surgical work; interpersonal conflict at work; greater demands than resources; the challenge of work-life balance; and the devastating impact of errors and poor patient outcomes (Study 2). The analyses also revealed various strategies surgeons employed to cope with burnout: cognitive restructuring; seeking social support; stepping aside or down from the job; and prioritising personal health. Additionally, some surgeons also reported using maladaptive coping (Study 2). A second qualitative analysis also found three themes in surgeons' experiences of burnout: first, burnout is common but frequently not recognised nor understood; second, burnout is a personal crisis; and third, burnout creates vulnerability at work (Study 3). The impact of the COVID-19 pandemic on surgeons was also investigated in this thesis (Studies 4 and 5). Qualitative thematic analysis identified four major themes: a changing and challenging work environment due to the COVID-19 pandemic; professional development and life challenges; personal change and loss, and emotional and psychological repercussions (Study 5). Quantitative analyses found that burnout increased during the pandemic's first (June 2020) to second waves (January 2021) (Study 4). In conclusion, surgeons suffer from a high level of burnout, especially after the COVID-19 pandemic (Study 4). Without a defined retention plan, the problem affects not only surgeons through bad habits such as substance abuse, but also organisations through workforce loss due to surgeons leaving. It may also increase risks to patient safety.12 0