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Assessing the allostatic load of workers in the context of COVID -19 is of vital importance to elucidate the physiological responses to social and work stress. This is an integrative review of the literature including seven established steps: 1) identification of the topic and the guiding question; 2) definition of MeSH terms and search equations; 3) search in databases following defined criteria; 4) data collection according to inclusion criteria; 5) evaluation of the studies included in the integrative review; 6) discussion of results; and 7) presentation of the review/synthesis of knowledge. Seventeen studies were included, of which 15 were cross-sectional observational studies and two were longitudinal studies. Heterogeneity in the measurement of allostatic load was the common denominator of the studies. Allostatic load is mentioned in all of them as a parameter of measurement, but they measured it diferently; therefore, the relationship between burnout, work environment, and allostatic load, although positive in most studies, was highly variable. In conclusion, it is necessary to conduct studies that combine both biological markers and clinimetric tests, trying to standardize the batery of tests of allostatic load, so that the correlation with work stress is significant and reliable. Similarly, allostatic load requires a systemic and interdisciplinary approach, since this condition puts chronic stress on all organs and physiological compensation mechanisms. Therefore, the allostatic load invites to a comprehensive care of people, considering the work, social, psychological, and biological domains.
Valorar la carga alostática de los trabajadores en el contexto de la Covid-19 es de vital importancia para dilucidar las respuestas fisiológicas al estrés social y laboral. Esta es una revisión integrativa de la literatura, de siete pasos establecidos: 1) identificación del tema y de la pregunta orientadora; 2) definición de términos MeSH y ecuaciones de búsqueda; 3) búsqueda en bases de datos siguiendo criterios definidos; 4) recopilación de datos acorde a criterios de inclusión; 5) evaluación de los estudios incluidos en la revisión integradora; 6) discusión de resultados; 7) presentación de la revisión/síntesis de conocimientos. Se incluyeron 17 estudios, de los cuales 15 fueron estudios observacionales transversales y dos estudios longitudinales. La heterogeneidad en la medición de la carga alostática fue el común denominador de los estudios. En todos se menciona la carga alostática como parámetro de medición. Sin embargo, todos la midieron de formas diferentes, por lo que la relación entre desgaste ocupacional y carga alostática, aunque positiva en la mayoría de los estudios, fue muy variable. Se concluye que es necesario realizar estudios que combinen tanto los marcadores biológicos como las pruebas clinimétricas, tratando de estandarizar la batería de exámenes de la carga alostática, para que la correlación con estrés laboral sea significativa y confable. De igual forma, la carga alostática requiere un abordaje sistémico e interdisciplinario, dado que se ponen en tensión crónica todos los órganos y mecanismos de compensación fisiológicos. Por lo tanto, la carga alostática hace una invitación a un cuidado integral de las personas, desde los ámbitos laboral, social, psicológico y biológico.

BACKGROUND: Burnout is a chronic problem prevalent in radiology, with a significant burden on individuals and healthcare systems.
CONCLUSIONS: A substantial portion of the literature on managing burnout has focused on individual-based remedies. We posit that burnout is a systemic problem and present an overview of some system-based strategies that could be employed to mitigate burnout in radiology. These include managing workload, optimizing work shifts, maximizing autonomy, limiting work-life conflicts, creating opportunities for professional fulfillment, utilizing user-friendly electronic medical records (EMR), deploying efficient picture archiving and communication systems (PACS), building system redundancy, leadership transparency, and fostering a healthy work environment.  CONCLUSION: System-based strategies can help mitigate burnout.

UNASSIGNED: Before the COVID-19 pandemic began, medical staff and academic department workers reported increasing levels of stress and burnout because of strain on the health care system. The COVID-19 pandemic exacerbated this strain and introduced several novel stressors, which included transitioning to remote work. Safe and scalable strategies are needed to help health care workers cope with these stressors. Aromatherapy may help address this need.
UNASSIGNED: To assess the effect of 2 aromatherapy interventions (essential oil blends termed STILL and FOCUS) on perceived mental/psychological health parameters for academic department workers working from home during the COVID-19 pandemic.
UNASSIGNED: Participants were advised to use STILL for 5 days (Monday through Friday). After a 2-day washout period (Saturday and Sunday), participants were instructed to use FOCUS for 5 days (Monday through Friday). Participants completed a visual analog scale survey evaluating restlessness, fatigue, anxiety, stress, happiness, energy, relaxation, calmness, and well-being before and after each of the 2 intervention periods.
UNASSIGNED: Twenty academic department remote workers participated in the study. Mental/psychological health surveys were completed by 6 participants before and after using STILL and by 10 before and after using FOCUS. Five participants answered all survey questions before and after both interventions. Although mean (SD) perceived stress scores improved after both the STILL (4.3 [2.3] vs 1.8 [1.7], P = .03) and FOCUS (2.9 [2.3] vs 1.5 [1.4], P = .02) interventions, this improvement was not statistically significant after Bonferroni correction (adjusted α = .006). Most participants (73.3%) reported that participating in the study was worthwhile, and 81.3% indicated that they would recommend aromatherapy to others.
UNASSIGNED: The STILL and FOCUS aromatherapy interventions did not significantly improve mental/psychological health parameters for remote academic department workers, although perceived stress was marginally improved and participants reported a perceived benefit from using aromatherapy.

OBJECTIVE: To describe, through an integrative literature review, the factors contributing to the development of burnout and moral distress in nursing professionals working in intensive care units and to identify the assessment tools used most frequently to assess burnout and moral distress.
METHODS: An integrative literature review was carried out. PubMed, CINAHL, PsycINFO, SciELO, Dialnet, Web of Science, Scopus, and Cochrane databases were reviewed from January 2012 to February 2023. Additionally, snowball sampling was used. The results were analysed by using integrative synthesis, as proposed by Whittemore et al., the Critical Appraisal Skills Programme for literature reviews, the Strengthening the Reporting of Observational Studies in Epidemiology guidelines for quantitative observational studies, and the Joanna Briggs Institute checklist for qualitative research were used to evaluate evidence quality.
RESULTS: Forty-one articles were selected for review: 36 were cross-sectional descriptive articles, and five were literature reviews. The articles were grouped into five-factor categories: 1) personal factors, 2) organisational factors, 3) labour relations factors, 4) end-of-life care factors, and 5) factors related to coronavirus disease 2019 (COVID-19). The Maslach Burnout Inventory-Human Services Survey and the Moral Distress Survey-Revised instruments were the most commonly used to measure burnout and moral distress.
CONCLUSIONS: This review highlights the multiple personal, organisational, relational, situational, and end-of-life factors promoting burnout and moral distress among critical care nurses. Interventions in these areas are necessary to achieve nurses\' job satisfaction and retention while improving nurses\' quality of care.

OBJECTIVE: High rates of professional burnout and career choice regret among urology residents may increase professional dissatisfaction, shorten career longevity, and exacerbate urology workforce shortages. Understanding the prevalence of and risk factors for burnout may help develop interventions.
RESULTS: Up to 48% of contemporary U.S. urology residents experience burnout symptoms, including up to 70% of second-year residents. Among overlapping personal, professional, institutional, and lifestyle risk factors, barriers to accessing medical and mental health care are frequently cited as an important association in residents. Limited intervention studies suggest that providing basic needs, such as on-call meals, and facilitating physical wellness and social engagement among residents may result in sustained reductions in burnout. Urology residents continue to experience high rates of burnout and career choice regret among medical specialties. Evidence-based interventions and sustainable policies that address primary risk factors are urgently needed.

Description Burnout is a complex organizational phenomenon that diminishes employee well-being and overall organizational productivity. Researchers propose that leadership style contributes to employees\' well-being, which impacts employee productivity. Organizations and leaders must address the causes of burnout and promote techniques employees can use to mitigate burnout, such as employee participation in recovery experiences. Recovery experiences are non-work activities that create positive outlooks and restore the energy needed to focus on one\'s work. This literature review examines current research in employee recovery experiences, conservation of resource theory (COR), burnout, and transformational leadership theory. Studying burnout through the lens of COR shows how important resource gain and recovery activities are to healthy employees and their job performance within the organization. The research reviewed suggests that transformational and transactional leadership styles have higher probabilities of promoting employee participation in recovery experiences than passive avoidant leadership style. The literature consistently showed burnout as a significant organizational phenomenon negatively affecting productivity, employee well-being, and turnover rates. The literature revealed that mitigating burnout happens through participation in recovery experiences. The literature on leadership styles supports the assumption that leaders play a significant role in employee well-being, group identity, and organizational climate. Leaders who desire to mitigate employee burnout will benefit from research that links transformational leadership style behaviors and employee participation in recovery activities.

UNASSIGNED: The COVID-19 pandemic has impacted the residency experience for physicians across all specialties. There have been studies examining resident perspectives on changes in curriculum and clinical experiences due to the pandemic; however, little research has been conducted on how residents in different specialties interpreted their educational experience and rates of burnout during the pandemic.
UNASSIGNED: We extended surveys to 281 residents across 15 separate residency programs between November 17, 2020, and December 20, 2020. The questions pertained to burnout and the effects of the pandemic on their careers. Differences between general and specialty medicine resident responses were analyzed using descriptive statistics and the Mann-Whitney U test.
UNASSIGNED: The final analysis included 105 responses (40% response rate). We received 62 surveys (59%) from general medicine residents and 43 surveys (41%) from specialty medicine residents, with a higher response rate from junior level trainees in both groups. We found no significant differences between general and specialty residents on the level of burnout, impact on clinical experience, or future career due to COVID-19, though there was a significant difference between resident groups on the perceived impact of COVID-19 on learning.
UNASSIGNED: Specialty medicine residents reported a negative perception of the pandemic\'s impact on their learning during residency suggesting a greater impact on training than was perceived by the general medicine residents. Residents from general and specialty medicine programs reported similar levels of burnout and similar perceptions of the pandemic\'s impact on their clinical experience and future career prospects. Understanding the impacts of the COVID-19 pandemic on resident education and well-being should serve graduate medical education administrators well and prepare them for future interruptions in the traditional learning process.

UNASSIGNED: Well-being initiatives are essential components in fostering an engaged workforce and creating an effective health care ecosystem. Health care professional (HCP) burnout is widespread and has worsened since the COVID-19 pandemic. In 2014, with Health Resources and Services Administration funding support, the Andrew Weil Center for Integrative Medicine created an online course for HCP well-being. It was subsequently studied in medical residents and revised in 2020. In this study, we explore the impact of the course across larger systems, as well as the long-term impact on HCPs.
UNASSIGNED: The Health Care Professional Well-Being course is 4.5 hours of interactive online education that explores personal well-being, promoters and detractors of well-being, and systemic factors that influence the overall impact of well-being in health care systems. Participants were recruited through institutional members of the Academic Consortium for Integrative Medicine and Health and were randomized to either active or waitlist control groups. Assessments were taken pre-course, 1-month post-course, and 6-months post-course in the areas of burnout, compassion, resiliency, and lifestyle behaviors.
UNASSIGNED: Burnout measures of depersonalization and emotional exhaustion showed a significant improvement amongst active participants, sustained for 6 months after the course. However, no significant improvement in either the resiliency or the compassion measurements was noted for the active group. Initially, the active group showed improvement in personal accomplishment; however, both groups showed a decline overall. Most noteworthy, a large number of active participants demonstrated adoption of new health-promoting behavior; 95% incorporated at least 1 new lifestyle behavior learned from the course.
UNASSIGNED: This study of a brief, asynchronous, online well-being course with interprofessional HCPs, demonstrates that the course is associated with improvement in individual burnout measures and can educate HCPs about healthy behaviors and a framework for professional engagement.

UNASSIGNED: With long hours, significant responsibilities, and a heavy workload, residency can be an incredibly stressful experience. The aim of our study was to assess the impact of residency on mental health and wellness. A secondary aim was to determine if the post-graduate year (PGY) of the different residents impacted their mental health or ability to cope with the stressors of residency.
UNASSIGNED: Residents in anesthesiology, family medicine, internal medicine, and surgery were invited to complete a survey. The first portion of the survey had residents rank their mental health on a scale from 1 to 5. There was also a short-form answer portion, which collected suggestions on how to improve wellness. An analysis of variance was used to compare the means of 2 continuous outcome variables-Patient Health Questionnaire (PHQ) and burnout scores compared across specialties and post-graduate years. Burnout scores were measured using the Oldenburg Burnout Inventory. This survey was created and validated by psychology researchers to assess burnout based on the strongest indicators of burnout-emotional exhaustion and disengagement from work. The PHQ9 survey was chosen as it has a specificity of 91-94% and is a reliable method to screen for depression, a common companion to burnout.
UNASSIGNED: PHQ9 scores were highest among surgery residents (7.2 ± 7.07), followed by anesthesia (6.59 ± 6.64), emergency medicine (5.57 ± 4.09), and internal medicine (4.82 ± 3.68). Scoring was also higher among PGY4-6 residents. Burnout scores were highest among surgery (37.8 ± 8.69) and anesthesia (38.17 ± 7.09) residents and among PGY4-6 residents. PGY4-6 residents had a mean burnout score of 38.55 ± 7.67 compared to 36.17 ± 8.69 among first-year residents. Similarly, the P value noted no significant difference among burnout scores across either specialty or year: .5930 and .8061.
UNASSIGNED: There was no significant difference among specialties or years in training among their subjective ratings of depression.