RESUMEN

Background: The pandemic exacerbated burnout experienced by healthcare personnel, whose mental health had long been a public health concern before COVID-19. This study used the Copenhagen burnout inventory (CBI) tool to assess burnout and identify predictors among Indian healthcare workers managing COVID-19. Methods: A cross-sectional study was conducted from June to December 2022, after the third pandemic wave. A web-based, fillable Google form was used to recruit COVID-19 management professionals from multiple Jaipur district hospitals. Healthcare professionals provided socio-demographic, work-related, and CBI scores. Multiple linear regression was used to control for model covariant independent variables. Results: We evaluated the responses of a total of 578 participants with a mean age of 36.59 ± 9.1 years. Based on the CBI cut-off score of 50, 68.1% reported burnout. A total of 67.5%, 56.4%, and 48.6% of healthcare workers reported work-related, personal, and patient-related burnout, respectively. High burnout scores were significantly associated with the nursing profession (ß = 7.89, 95% CI; 3.66, 12.11, p < 0.0001). The p-value indicates the probability of observing the data if the null hypothesis is true, and the confidence interval shows the range within which we can be 95% confident that the true effect lies. An independent relationship exists between male gender and higher personal-related burnout scores (ß = 4.45, 95% CI 1.9-6.9). Conclusion: This study identified key indicators that need further emphasis and the need for organizational and individual-level burnout monitoring in healthcare delivery sectors. Health workers continue to experience burnout due to a combination of personal, professional, and patient-related factors. This underscores the need for targeted organizational and individual interventions. The findings also suggest that the CBI tool could identify healthcare worker burnout risk groups.

Asunto(s)

Agotamiento Profesional , COVID-19 , Personal de Salud , SARS-CoV-2 , Humanos , COVID-19/psicología , COVID-19/epidemiología , India/epidemiología , Estudios Transversales , Masculino , Agotamiento Profesional/epidemiología , Agotamiento Profesional/psicología , Femenino , Adulto , Personal de Salud/psicología , Persona de Mediana Edad , Pandemias , Encuestas y Cuestionarios

RESUMEN

OBJECTIVE: Cerebrovascular accidents are the second leading cause of death and the third leading cause of disability worldwide. We hypothesized that cerebellar transcranial direct current stimulation (ctDCS) of the dentate nuclei and the lower-limb representations in the cerebellum can improve functional reach during standing balance in chronic (>6 months' post-stroke) stroke survivors. MATERIALS AND METHODS: Magnetic resonance imaging (MRI) based subject-specific electric field was computed across a convenience sample of 10 male chronic (>6 months) stroke survivors and one healthy MRI template to find an optimal bipolar bilateral ctDCS montage to target dentate nuclei and lower-limb representations (lobules VII-IX). Then, in a repeated-measure crossover study on a subset of 5 stroke survivors, we compared 15minutes of 2mA ctDCS based on the effects on successful functional reach (%) during standing balance task. Three-way ANOVA investigated the factors of interest- brain regions, montages, stroke participants, and their interactions. RESULTS: "One-size-fits-all" bipolar ctDCS montage for the clinical study was found to be PO9h-PO10h for dentate nuclei and Exx7-Exx8 for lobules VII-IX with the contralesional anode. PO9h-PO10h ctDCS performed significantly (alpha = 0.05) better in facilitating successful functional reach (%) when compared to Exx7-Exx8 ctDCS. Furthermore, a linear relationship between successful functional reach (%) and electric field strength was found where PO9h-PO10h montage resulted in a significantly (alpha = 0.05) higher electric field strength when compared to Exx7-Exx8 montage for the same 2mA current. CONCLUSION: We presented a rational neuroimaging based approach to optimize deep ctDCS of the dentate nuclei and lower limb representations in the cerebellum for post-stroke balance rehabilitation. However, this promising pilot study was limited by "one-size-fits-all" bipolar ctDCS montage as well as a small sample size.