Implementation context and burnout among Department of Veterans Affairs psychotherapists prior to and during the COVID-19 pandemic.

Autor: Rosen CS; National Center for Posttraumatic Stress Disorder Dissemination & Training Division, VA Palo Alto Health Care System, Menlo Park, CA, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA. Electronic address: craig.rosen@va.gov., Kaplan AN; Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN, USA; Department of Medicine, University of Minnesota, Minneapolis, MN, USA., Nelson DB; Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN, USA; Department of Medicine, University of Minnesota, Minneapolis, MN, USA., La Bash H; National Center for Posttraumatic Stress Disorder Dissemination & Training Division, VA Palo Alto Health Care System, Menlo Park, CA, USA., Chard KM; Cincinnati VA Medical Center, Cincinnati, OH, USA; University of Cincinnati College of Medicine, Cincinnati, OH, USA., Eftekhari A; National Center for Posttraumatic Stress Disorder Dissemination & Training Division, VA Palo Alto Health Care System, Menlo Park, CA, USA., Kehle-Forbes S; Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN, USA; National Center for PTSD Women's Health Sciences Division, Boston MA, USA., Wiltsey Stirman S; National Center for Posttraumatic Stress Disorder Dissemination & Training Division, VA Palo Alto Health Care System, Menlo Park, CA, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA., Sayer NA; Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN, USA; Department of Medicine, University of Minnesota, Minneapolis, MN, USA; Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA.
Jazyk: angličtina
Zdroj: Journal of affective disorders [J Affect Disord] 2023 Jan 01; Vol. 320, pp. 517-524. Date of Electronic Publication: 2022 Sep 30.
DOI: 10.1016/j.jad.2022.09.141
Abstrakt: Background: The first goal of this study was to assess longitudinal changes in burnout among psychotherapists prior to (T1) and during the COVID-19 pandemic (T2). The second objective was to assess the effects of job demands, job resources (including organizational support for evidence-based psychotherapies, or EBPs) and pandemic-related stress (T2 only) on burnout.
Method: Psychotherapists providing EBPs for posttraumatic stress disorder in U.S. Department of Veterans Affairs (VA) facilities completed surveys assessing burnout, job resources, and job demands prior to (T1; n = 346) and during (T2; n = 193) the COVID-19 pandemic.
Results: Burnout prevalence increased from 40 % at T1 to 56 % at T2 (p < .001). At T1, stronger implementation climate and implementation leadership (p < .001) and provision of only cognitive processing therapy (rather than use of prolonged exposure therapy or both treatments; p < .05) reduced burnout risk. Risk factors for burnout at T2 included T1 burnout, pandemic-related stress, less control over when and how to deliver EBPs, being female, and being a psychologist rather than social worker (p < .02). Implementation leadership did not reduce risk of burnout at T2.
Limitations: This study involved staff not directly involved in treating COVID-19, in a healthcare system poised to transition to telehealth delivery.
Conclusion: Organizational support for using EBPs reduced burnout risk prior to but not during the pandemic. Pandemic related stress rather than increased work demands contributed to elevated burnout during the pandemic. A comprehensive approach to reducing burnout must address the effects of both work demands and personal stressors.
Competing Interests: Conflict of interest Dr. Rosen reported receiving grants from the U.S. Department of Defense and the U.S. Department of Veterans Affairs. Dr. Kaplan reported no conflicts of interest at the time of publication. Dr. Nelson reported receiving grants from the U.S. Department of Veterans Affairs. Dr. La Bash reported no conflicts of interest at the time of publication. Dr. Chard reported receiving grants from the U.S. Department of Defense, U.S. Department of Veterans Affairs and the Chris Sullivan Foundation. Dr. Eftekhari reported no conflicts of interest at the time of publication. Dr. Kehle-Forbes reported receiving grants from the U.S. Department of Veterans Affairs and the Patient-Centered Outcomes Research Institute. Dr. Wiltsey Stirman reported receiving grants from the U.S. National Institute of Mental Health and the Canadian Institutes of Health Research. Dr. Sayer is the PI of the U.S. Department of Veterans Affairs Health Services Research and Development grant that supported this work.
(Published by Elsevier B.V.)
Databáze: MEDLINE
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