Objectives Burnout and occupational stress are frequently experienced by healthcare professionals (HCPs). Mindfulness-based stress reduction (MBSR) has been found to improve the psychological health outcomes of HCPs. To date, systematic reviews and meta-analyses have primarily focused upon empirical investigations into the reduction of stress amongst HCPs using MBSR and are limited to empirical studies published before December 2019. This systematic review aimed to update the current evidence base and broaden our understanding of the effectiveness of MBSR on improving the psychological functioning of HCPs. Methods Three electronic databases (Medline, Psych Info and Web of Science) were searched without time frame restrictions. Quantitative studies included randomised controlled trials, clinical controlled trials, pre-post designs and studies with up to a 12-month follow-up period. All studies included in the review employed a MBSR programme, standardised measures of psychological functioning and qualified HCPs as participants. Results Using PRISMA guidelines thirty studies were included in the review. The reviewed literature suggested that MBSR was effective in reducing HCPs experiences of anxiety, depression and stress. MBSR was also found to be effective in increasing HCP levels of mindfulness and self-compassion. However, MBSR did not appear as effective in reducing burnout or improving resilience amongst HCPs. Abbreviated MBSR programmes were found to be as effective as the traditional 8-week MBSR programmes. Conclusions MBSR is an effective intervention which can help improve the psychological functioning of HCPs. Recommendations include improving the overall quality of the studies by employing more robust controlled designs with randomisation, increased sample sizes with heterogeneous samples, and making active comparisons between interventions used.
Purpose. Although forensic services are often regarded as highly stressful environments, there has been a surprising lack of research into the phenomena of occupational stress among forensic health care professionals (FHCP) in the United Kingdom. This study investigated stress, coping, and psychological well-being among FHCP employed within inpatient settings. Methods.One hundred and thirty-five FHCP were recruited from four Medium Secure Units in the United Kingdom. A postal research pack was used to collect background information and measures of psychological well-being, burnout, occupational stress, work satisfaction, and coping.Results. The study found that a substantial proportion of FHCP experienced elevated levels of occupational stress and psychological distress, while moderate levels of burnout were demonstrated in terms of emotional exhaustion, depersonalization, and reduced personal accomplishment. The findings confirmed that FHCP utilized a range of problemfocused (e.g., positive), emotion-focused (e.g., religious, negative, and supported), and palliative coping strategies (e.g., excessive smoking and drinking). Conclusions.The results appeared to support the commonly held assertion that forensic services are an inherently stressful and dangerous working environment, which can cause FHCP to experience marked levels of psychological distress, burnout, and occupational stress.
Objectives The epidemiology, clinical characteristics and outcomes of antimicrobial-associated anaphylaxis remain ill-defined. We sought to examine antimicrobial anaphylaxis with regard to: (i) the frequency of implicated antimicrobials; (ii) attributable mortality; and (iii) referral for definitive allergy assessment. Methods This was conducted through a national retrospective multicentre cohort study at five Australian tertiary hospitals (January 2010 to December 2015). Cases of antimicrobial anaphylaxis were identified from ICD-10 coding and adverse drug reaction committee databases. Results There were 293 participants meeting the case definition of antimicrobial anaphylaxis and 310 antimicrobial anaphylaxis episodes. Of 336 implicated antimicrobials, aminopenicillins (62/336, 18.5%) and aminocephalosporins (57/336, 17%) were implicated most frequently. ICU admission occurred in 43/310 (13.9%) episodes; however, attributable mortality was low (3/310, 1%). The rate of anaphylaxis to IV antibiotics was 3.5 (95% CI = 2.9–4.3) per 100 000 DDDs and the rate of hospital-acquired anaphylaxis was 1.9 (95% CI = 2.1–3.3) per 100 000 occupied bed-days. We observed overall low rates of hospital discharge documentation (222/310, 71.6%) and follow-up by specialist allergy services (73/310, 23.5%), which may compromise medication safety and antimicrobial prescribing in future. Conclusions This study demonstrated that a high proportion of severe immediate hypersensitivity reactions presenting or acquired in Australian hospitals are secondary to aminopenicillins and aminocephalosporins. Overall rates of hospital-acquired anaphylaxis, predominantly secondary to cephalosporins, are low, and also associated with low inpatient mortality.
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