Impact of Extra Corporal Membrane Oxygenation Services on Burnout Development in Intensive Care Units.
Condition: Burnout, Caregiver; Extracorporeal Membrane Oxygenation Complication; Intensive Care Unit
MeSH terms: Burnout, Psychological; Caregiver Burden
Study type: Observational

Summary: 
      The burnout phenomenon first came to clinical science 50 years ago. It is exponentially
      rising worldwide which prompted its discoverers to develop the most popular tool for its
      assessment, known as the Maslach burnout inventory (MBI)1. Common symptoms of burnout include
      depression, irritability, and insomnia. The growing demand for extra-corporeal membrane
      oxygenation (ECMO) may have an effect on burnout as the newly introduced services is
      demanding in effort and put the practitioners on complex ethical and administrative
      situations.

      We conducted a cross-sectional descriptive study using a combined methodological quantitative
      and qualitative approach involving a convenience sample of 1000 healthcare practitioners
      within surgical and medical ICUs of Hamad Medical Corporation (HMC), Qatar. We will use used
      two main instruments to develop an online questionnaire: - The MBI-human service survey
      (MBI-HSS) and the Leadership scale Expectations: we expect that we will have a new insight
      about the impact of these complex interventions on practitioner's burnout.
    

Detailed description: 
      This study predominates at investigating the BOS in ECMO ICU and non-ECMO ICU, and whether
      the leadership attitude could have effect on the mentioned syndrome problem.

      Methodology Settings This study will in a tertiary hospital in the Middle East "Hamad Medical
      Corporation" as a main centre, the study will be disseminated an online survey among other
      centres who will agree to participate on. The participants will be screened for
      socio-demographic data such as age, gender, profession, marital state, education, native
      country, years of experience, weekly working hours and salary. The questionnaire was
      clarified to the potential respondents in order to clear any poor understanding. English used
      as the official language in the organization; translation of the used instruments to
      individual mother languages is not required.

      Design Cross-sectional descriptive survey with purposeful sampling. Mixed qualitative and
      quantitative methodology used in this dissertation. Invitations to participate through the
      mail, anonymous questionnaire survey will be presented to the staff members including
      physicians, nurses and respiratory therapists who work as full time.

      1. Study Population and Study Setting/ Location In this section describe the study population
      that is to be enrolled in the study, planned recruitment number and Inclusion and Exclusion
      Criteria to be listed here. Also list the Hospitals in which this study will be conducted (
      e.g. HGH, Rumailah etc) The study population would include physicians, nurses, and
      respiratory therapists working in ICUs. The inclusion criteria will include practitioners
      working in intensive care unit including physician, respiratory therapists and nurses who
      agree to participate in the survey. We will exclude practitioners who decline to participate
      and who will not complete the questionnaires. A flow diagram will be prepared for the
      enrollment.

      The participants will be approached through communication with one representative within the
      assigned ICUs within Qatar, in case of agreement we will ask for a list of mails from each
      department to be enrolled in the study.

      1. Study procedures

      The study will be conducted for 12 months from the time of ethical approval. Instrumentation

      The used instrumentation is questionnaire that is divided into the following sections:

      A) Condition of work effectiveness questionnaire (CWEQ): This scale consisted of 19 items
      developed by Kanter, (1977) measured by a 5-point Likert type response. (9) B) Maslach
      Burnout Inventory human services survey (MBI-HSS): The scale is a standardized instrument to
      measure burnout it utilize 9 items related to emotional exhaustion and it is most frequently
      used in health care researches, the nine items are calculated to get the whole score, scores
      of 27 and more signals severe burnout. (10) The percentage of high degree of burnout was used
      for advanced analysis. We will get permission to use this scale from (Mindgarden.com, USA) C)
      Leadership Behaviours scale (LS): The staff discernment of managers' leadership attitude will
      be measured using the 11 item Manager Action Scale. (11)

      The questionnaires will be submitted in English form; no need for translation, as health care
      practitioners in the organization, must practice English that is the official language at
      workplace. The results of the analysis will be presented using descriptive methods. The
      quantitative and qualitative data will be analysed statistically, the relations between the
      variables will be interpreted, the relation between burnout score and socio-demographic
      variables, occupational stress score, and empowerment scale will be assessed statistically
      using (t-test, analysis of variance, correlation efficient and regression).

      Ethical Considerations:

      Participant identity kept confidential, final report would not contain any identity.
      Comprehensive explanation for the participants about the questionnaires, the type, purpose of
      the study and outcome was done, early rejection, or late withdrawal was permissive. Ethical
      approval was obtained according to the corporate regulations. The ethical consent attached
      after being approval from the medical research centre.

      Health care practitioners working on ICU whether providing ECMO services or not will be
      eligible to participate in the study

      The primary objective will be to detect the prevalence of burnout among health care
      practitioner s working in ICU with ECMO services The secondary objectives will be to compare
      the burnout association in ECMO and non ECMO ICU, the effect of leadership attitude on
      burnout syndrome and to look at the burnout in special population within the groups like
      respiratory therapists
    

Intervention name(s): Observational
Intervention type(s): Other
Intervention description(s): Survey
Observational model: Other
Time perspective: Cross-Sectional
Sampling method: Non-Probability Sample
Study population: 
        - The study population would include physicians, nurses, and respiratory therapists working
        in ICUs.
      
Keywords: burnout; Extracorporeal Membrane Oxygenation; Intensive care unit