Death Cafes for Prevention of Burnout in Intensive Care Unit Employees: Study Protocol for a Randomized Controlled Trial (STOPTHEBURN)

Abstract

Background: Burnout is an occupational syndrome that leads to mental health problems, job turnover, and patient safety events. Those caring for critically ill patients are especially susceptible due to high patient mortality, long hours, and regular encounters with trauma and ethical issues. Interventions to prevent burnout in this population are needed. Preliminary studies suggest debriefing sessions may reduce burnout. This study aims to assess whether participation in regular debriefing can prevent burnout in intensive care unit (ICU) clinicians.Methods: A randomized controlled trial will be conducted in two large academic medical centers. 200 ICU clinicians will be recruited with target enrollment of 100 physicians and 100 non-physicians (nurses, pharmacists, therapists). Participants must have worked in the ICU for the equivalent of at least 1 full time work week in the preceding 4 weeks. Enrolled subjects will be randomized to virtually attend biweekly debriefing sessions facilitated by a psychotherapist for 3 months or to a control arm without sessions. Our debriefs are modelled after Death Cafés, which are informal discussions focusing on death, dying, loss, grief and illness. These sessions allow for reflection on distressing events and offer community and collaboration among hospital employees outside of work. The primary outcome is clinician burnout as measured by the Maslach Burnout Inventory (MBI) Score. Secondary outcomes include depression and anxiety, as measured by the patient health questionnaire 8 (PHQ-8) and generalized anxiety disorder 7-item scale (GAD-7), respectively. Questionnaires will be administered prior to the intervention, at 1 month, at 3 months, and at 6 months after enrollment. These values will be compared between groups temporally. Qualitative feedback will also be collected and analyzed. This trial was registered prospectively with clinicaltrials.gov on April 15, 2020 (NCT04347811).Discussion: With ICU clinician burnout rates exceeding 50%, Death Café debriefing sessions may prove to be an effective tool to avert this debilitating syndrome. With COVID-19 limiting social interactions and overloading ICUs worldwide, the virtual administration of the Death Café for ICU clinicians provides an innovative strategy to potentially mitigate burnout in this vulnerable population.

Influence of empathy on work alienation among Chinese nurses during the COVID-19 pandemic: The mediating effect of ego depletion

“…Work alienation refers to the subjective psychological experience in which the material, spiritual and other important needs of individuals cannot be met at work, which leads to the separation of employees from work and negative coping at work (Amarat et al, 2019). The sense of work alienation can easily lead to a decline in nurses' work autonomy (Tummers and Den Dulk, 2013), participation in decision-making (Mudallal et al, 2017), and nursing quality (Jun et al, 2021) and an increase in the turnover rate and nursing safety (Bateman et al, 2020). Especially during the COVID-19 pandemic, the number of nurses had difficulty coping with large-scale infections, and the work pressure increased (Denning et al, 2021).…”

PERSonality, Ehical, and PROfessional quality of life in Pediatric/Adult Intensive Nurses study: PERSEPRO PAIN study

“…For BOS intervention, there are already reports that some psychological interventions are helpful in nurses. For example, a previous randomized controlled trial (RCT) reported that recording three good things each day significantly improved self-efficacy and job performance in BOS nurses [ 55 ] while an RCT called STOP THE BURN is ongoing to reveal the effect of “death cafés” for preventing BOS in ICU nurses [ 56 ]. The still-new death café concept is a debriefing method focusing on death now being studied for its ability to bring self-efficacy to applicable fields [ 57 ].…”

Possíveis estratégias de enfrentamento do Burnout entre profissionais de saúde durante a pandemia do coronavírus

“…However, during the pandemic, holding these meetings became more difficult, one possibility pointed out by the authors would be the online format. The authors argue that professionals are quite resistant to accepting the experience, but the professionals who participate report being able to better deal with the questions, insecurities, stress and feelings when they have contact with death 17 .…”