Due to the inherent demands of their profession, doctors and nurses are at great risk of suffering from burnout caused by job stress. This study examined the prevalence of burnout among doctors and nurses in Mongolia and identified the factors influencing their burnout. A self-administered questionnaire of 180 doctors (45.9%) and 212 nurses (54.1%) resulted in a response rate of 87%. Burnout was measured by the Copenhagen Burnout Inventory (CBI) in three scales: personal burnout, work-related burnout, and client-related burnout. Job stress was measured by the effort-reward imbalance (ERI) model. Compared with the prior studies of hospital staffs in other countries, doctors and nurses in Mongolia had relatively higher burnout rates, with personal, work-related and client-related average scores of 45.39, 44.45, and 32.46, respectively. Multiple regression analysis revealed that ERI significantly influenced all dimensions of burnout but over-commitment significantly influenced only personal and work-related burnout. Both ERI and over-commitment were different among professions.

After a hospice patient dies, hospice providers can experience a variety of emotional responses. While work has been done on social workers' and nurses' reactions to patient death, home health aides (HHAs) have been overlooked. To address this gap, we conducted focus groups and individual qualitative interviews with 14 hospice HHAs. Questions covered HHAs' grief responses and how they coped with grief. We found a high burden of grief reactions; many HHAs often developed very close patient relationships. HHAs also noted that they often started working with new patients almost immediately after a death, leaving little time to process the loss. However, HHAs found support from other HHAs, their supervisors, as well as family, friends, and spiritual practices to be helpful in coping with their grief. Future work should enhance support to HHAs around patient loss; for example, grief support may be embedded into hospice team activities.

Objectives: A sizable minority of those who lose a loved one in hospice will experience symptoms of bereavement-related mental health disorders. Though hospices offer services to bereaved informal caregivers (family members or friends) of patients, little is known about services offered or interest in them. Therefore, we sought to assess services offered by hospice staff and interest expressed by bereaved informal caregivers with symptoms of depression, anxiety, or complicated grief (CG). Methods: De-identified electronic bereavement care charts of 3561 informal caregivers who lost someone in a large urban metropolitan hospice from October 1,2015, to June 30, 2016, were reviewed. Results: Of bereaved informal caregivers in the sample, 9.4% (n = 333) were positive for symptoms of depression, anxiety, or CG. The symptom-positive family members/friends were more likely than other family members/friends to be offered mailings, one-to-one counseling, telephone calls, and reference material. However, interest in most services by symptom-positive caregivers was low, with only 6% interested in one-to-one counseling and 7% interested in outside referral. Discussion: The findings suggest that hospices offer a range of services to family members or friends with symptoms of anxiety, depression, and CG, but that there can be a gap between what is offered and in the interest levels of the bereaved. Engagement with symptomatic family members and friends could be enhanced in future work.

Elder abuse (EA) is a significant global social problem that jeopardizes the health and wellbeing of older adults around the world. Health providers can play a pivotal role in detection of EA and accessing resources and interventions. In Mongolia, where elder abuse is not widely recognized, family physicians (FPs) are particularly critical, providing frequent contact and home visits free of charge to community-dwelling older adults. However, little is known about FP knowledge and engagement with potential victims of EA. We interviewed 12 FPs from Ulaanbaatar participated via Skype about their knowledge of and responses to EA, using Grounded Theory data collection and analysis. All respondents reported encountering at least one case of EA in practice, and described the creative strategies they used to engage older patients, detect abuse, and prevent further harm. We present significant implications for guidelines for identification and prevention of EA in primary health care.