Differential effects of healthcare worker burnout on psychotropic medication use and misuse by occupational level

Hoopsick, Rachel A.; Las, Sylvia; Sun, Ruoyu

doi:10.1007/s00127-023-02496-y

Cited by 4 publications

(1 citation statement)

References 64 publications

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“…We asked participants to report their type of occupation in the healthcare sector. To capture the potential differences between the high-earning high-autonomy positions from other roles, we first grouped together healthcare administrators and prescribers (e.g., physicians, nurse practitioners, physician assistants) and then grouped other healthcare professionals together (e.g., registered nurses, nursing assistants, dietary aides, administrative support staff), resulting in a dichotomous occupational level variable (healthcare administrator/prescriber vs. other healthcare worker), consistent with prior work (Hoopsick et al, 2023).…”

Section: Occupational Levelmentioning

confidence: 97%

Moral injury and substance use among United States healthcare workers

Campbell,

Knipp,

Anwar

et al. 2023

Stress and Health

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Moral injury (i.e., perpetrating, witnessing, failing to prevent, or being a victim of acts that transgress one's moral beliefs, values, or ethics) has largely been studied in military‐connected populations and is associated with a range of adverse psychological sequelae. Emerging literature suggests that healthcare workers also experience moral injury, particularly in the context of the ongoing COVID‐19 pandemic. However, it is not known if moral injury contributes to substance use among healthcare workers or whether these effects might differ by gender, race/ethnicity, or occupational level. In March 2022, we collected self‐reported pilot data from a diverse sample of US healthcare workers (N = 200) We examined the cross‐sectional relationships between moral injury and several measures of substance use (i.e., current non‐medical use of prescription drugs [NMUPD], current cannabis use, current use of other illicit drugs, and hazardous drinking) using separate logistic regression models. Next, we used separate interaction models to examine if any of these relations differed by gender, race/ethnicity, or occupational level. In main effects models, healthcare workers reporting greater moral injury had greater odds of current NMUPD (adjusted odds ratio (aOR) = 1.07; p < 0.001), current use of other illicit drugs (aOR = 1.09; p < 0.01), and hazardous drinking (aOR = 1.07; p < 0.01). These relations did not differ by race/ethnicity or occupational level (ps > 0.05); however, men were more likely to report current NMUPD and hazardous drinking (ps < 0.05) in the presence of high moral injury than women healthcare workers. Our findings suggest that healthcare workers experience substantial distress related to morally injurious events, which may affect their likelihood of NMUPD, cannabis use, use of other illicit drugs, and hazardous drinking, and that men in healthcare may be particularly at risk. Healthcare organizations should address systemic issues driving moral injury (e.g., resource shortages, lack of psychosocial support) to prevent substance‐related harms among healthcare workers.

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Section: Occupational Levelmentioning

confidence: 97%

Moral injury and substance use among United States healthcare workers

Campbell,

Knipp,

Anwar

et al. 2023

Stress and Health

View full text Add to dashboard Cite

show abstract

Effects of compassion satisfaction, burnout, and secondary traumatic stress on current drug use among healthcare workers: Differences by occupational level

Okon,

Khan,

Duffy

et al. 2024

Preprint

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Work-related stress has been well-examined among physicians, but little is known about how it might affect drug use or healthcare workers in lower-wage occupations characterized by high job demands and low occupational autonomy (e.g., medical assistants, nursing assistants). In March 2022, we collected data from a diverse sample of healthcare workers (N = 200). We separately examined the cross-sectional relationships between several work-related experiences (i.e., compassion satisfaction, burnout, and secondary traumatic stress) and measures of current drug use (i.e., non-medical use of prescription drugs [NMUPD], cannabis use, and illicit drug use). We then examined for differences occupational level (i.e., prescriber/administrator vs. other healthcare worker). In main effects models, greater burnout and secondary traumatic stress were both associated with higher odds of NMUPD, cannabis use, and illicit drug use (ps < 0.01). Greater compassion satisfaction was associated with lower odds of illicit drug use (p < 0.05), but not with NMUPD or cannabis use (ps > 0.05). There was a significant interaction between secondary traumatic stress and occupational level on NMUPD (p < 0.05) such that there was no relationship between secondary traumatic stress and NMUPD among prescribers/administrators, but the likelihood of NMUPD among other healthcare workers increased with greater secondary traumatic stress. Similar trend-level interactions were observed between secondary traumatic stress and occupational level on cannabis use (p < 0.10) and between burnout and occupational level on NMUPD. Burnout and secondary traumatic stress are systemic issues, and results suggest they may contribute to drug use. Healthcare workers in positions characterized by high demands and low autonomy may be especially vulnerable.

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Relationship Between Heart Rate and Perceived Stress in Intensive Care Unit Residents: Exploratory Analysis Using Fitbit Data

Wang,

Rezaeian,

Asan

et al. 2024

JMIR Form Res

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Background Intensive care unit (ICU) residents are exposed to high stress levels due to the intense nature of their work, which can impact their mental health and job performance. Heart rate measured through wearable devices has the potential to provide insights into residents’ self-reported stress and aid in developing targeted interventions. Objective This exploratory study aims to analyze continuous heart rate data and self-reported stress levels and stressors in ICU residents to examine correlations between physiological responses, stress levels, and daily stressors reported. Methods A secondary data analysis was conducted on heart rate measurements and stress assessments collected from 57 ICU residents over a 3-week period using Fitbit Charge 3 devices. These devices captured continuous physiological data alongside daily surveys that assessed stress levels and identified stressors. The study used Spearman rank correlation, point-biserial correlation analysis, 2-tailed paired t tests, and mixed-effect models to analyze the relationship between heart rate features and stress indicators. Results The findings reveal complex interactions between stress levels and heart rate patterns. The correlation analysis between stress levels and median heart rate values across different percentile ranges showed that lower percentile heart rates (bottom 5%, 10%, 25%, and 50%) had modest correlations with stress, whereas higher percentiles (top 50%, 25%, 10%, and 5%) did not correlate significantly (all P>.05). The 2-tailed paired t test indicated significant differences in stress levels reported in midday versus end-of-day surveys (P<.001), although these changes in stress levels were not consistently reflected in heart rate patterns. Additionally, we explored and found that stressors related to “other health” issues had the highest positive correlation with stress level changes from midday to end-of-day surveys. However, the weak effect of these stressors on peak heart rate suggests that their impact on physiological measures like heart rate is not yet clear. According to our mixed-effects model, stress levels significantly influenced heart rate variations when hierarchical data were taken into account (P=.03), meaning that as the stress level increased, there was a significant increase in mean heart rate. Conclusions This study highlights the complexity of using heart rate as an indicator of stress, particularly in high-stress environments like the ICU. Our findings suggest that while heart rate is found to correlate with self-reported stress in the mixed-effect model, its impact is modest, and it should be combined with other physiological and psychological measures to obtain a more accurate and comprehensive assessment of residents’ stress levels.

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Differential effects of healthcare worker burnout on psychotropic medication use and misuse by occupational level

Cited by 4 publications

References 64 publications

Moral injury and substance use among United States healthcare workers

Moral injury and substance use among United States healthcare workers

Effects of compassion satisfaction, burnout, and secondary traumatic stress on current drug use among healthcare workers: Differences by occupational level

Relationship Between Heart Rate and Perceived Stress in Intensive Care Unit Residents: Exploratory Analysis Using Fitbit Data

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