Primary care providers (PCPs) in the United States work in challenging environments and may be at risk for burnout. This article identifies the predictors and outcomes of burnout among PCPs in the United States. A comprehensive literature search of eight databases was conducted to identify studies investigating predictors or outcomes of PCP burnout. The Joanna Briggs Institute’s critical appraisal checklists for cross-sectional and cohort studies were used for quality appraisal. Overall, 21 studies met inclusion criteria, had sufficient quality, reported personal and/or organizational predictors of burnout, and described burnout outcomes at the patient, provider, or organizational level. Prevalence of PCP burnout ranged from 13.5% to 60%. The primary care practice environment was the most common predictor of PCP burnout. In conclusion, developing interventions to improve the practice environment may help reduce PCP burnout. Future studies using robust study designs and standardized instruments to consistently measure burnout are needed.

Poor practice environments contribute to burnout, but favorable environments containing support, resources, autonomy, and optimal relations with colleagues may prevent burnout. Compared with all nurse practitioners (NPs), 69% of these NPs provide primary care to patients, yet whether the practice environment is associated with NP burnout is unknown. A study to examine environmental factors related to NP burnout was conducted. Overall, 396 NPs completed the survey, and 25.3% were burnt-out. Higher scores on the professional visibility, NP-physician relations, NP-administration relations, independent practice, and support subscales were associated with 51%, 51%, 58%, and 56% lower risk of NP burnout, respectively.

Introduction: Depression is prevalent among adolescents with chronic illness. However, little is known about how depression affects chronic illness over time. This review aimed to synthesize longitudinal relationships between depression and disease control, self-management behaviors, illness-related morbidity, and quality of life. Method: Four databases were searched, including PubMed, Cumulative Index of Nursing and Allied Health Literature, PsycINFO, and EMBASE. Inclusion criteria were cohort studies examining depression among adolescents aged 10−21 years with a chronic illness and studies published in English. Study quality was appraised using the Newcastle-Ottawa scale and data was synthesized by the outcome. Results: Of the 3,463 articles identified, 11 were included in the review. For adolescents with diabetes, increased depressive symptoms predicted decreased metabolic control and monitoring, medication adherence, quality of life, and increased hospitalization. Studies on cystic fibrosis, congenital heart disease, sickle cell disease, and juvenile idiopathic arthritis were limited but demonstrated that depressive symptoms affected the quality of life, disability, pain, and hospitalization rates/costs. Discussion: Evidence supports the need for mental health care strategies suitable for adolescents with chronic illness. Future research is needed to examine the effects of depressive symptoms across diversified chronic illness populations.

Background Burnout threatens patient care and clinicians are experiencing challenges within the practice environment. Little is known about nurse practitioner (NP) perceptions of burnout and its relationship to care quality and practice environment. We investigate the relationship between primary care NP burnout on perceptions of care quality and if the practice environment moderates the relationship between burnout and care quality. Methods This is a secondary analysis of cross‐sectional survey data from 396 NPs. Burnout and care quality were measured using a single item, but the practice environment was measured using the Nurse Practitioner Primary Care Organizational Climate Questionnaire. Multi‐level proportional odds cumulative logit models were built to test for associations between burnout and care quality and for moderation. Results Total, 25.3% of NPs reported burnout. Odds of perceiving higher quality of care was 85% less for NPs experiencing burnout compared to those not experiencing burnout. Practice environment did not moderate the relationship between burnout and care quality, but with a one unit increase in the practice environment subscales, the odds of NPs perceiving higher care quality increased anywhere from 3.83 to 7.57 times. Conclusion Burnout is related to lower perceptions of care quality but favorable environments were related to higher perceptions of quality.

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