Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
Urban Health Lab, University of Pennsylvania, Philadelphia, PA, USA.
Harm Reduct J. 2023 Mar 11;20(1):32. doi: 10.1186/s12954-023-00752-7.
The COVID-19 pandemic worsened the ongoing overdose crisis in the United States (US) and caused significant mental health strain and burnout among health care workers (HCW). Harm reduction, overdose prevention, and substance use disorder (SUD) workers may be especially impacted due to underfunding, resources shortages, and chaotic working environments. Existing research on HCW burnout primarily focuses on licensed HCWs in traditional environments and fails to account for the unique experiences of harm reduction workers, community organizers, and SUD treatment clinicians.
We conducted a qualitative secondary analysis descriptive study of 30 Philadelphia-based harm reduction workers, community organizers, and SUD treatment clinicians about their experiences working in their roles during the COVID-19 pandemic in July-August 2020. Our analysis was guided by Shanafelt and Noseworthy's model of key drivers of burnout and engagement. We aimed to assess the applicability of this model to the experiences of SUD and harm reduction workers in non-traditional settings.
We deductively coded our data in alignment with Shanafelt and Noseworthy's key drivers of burnout and engagement: (1) workload and job demands, (2) meaning in work, (3) control and flexibility, (4) work-life integration, (5) organizational culture and values, (6) efficiency and resources and (7) social support and community at work. While Shanafelt and Noseworthy's model broadly encompassed the experiences of our participants, it did not fully account for their concerns about safety at work, lack of control over the work environment, and experiences of task-shifting.
Burnout among healthcare providers is receiving increasing attention nationally. Much of this coverage and the existing research have focused on workers in traditional healthcare spaces and often do not consider the experiences of community-based SUD treatment, overdose prevention, and harm reduction providers. Our findings indicate a gap in existing frameworks for burnout and a need for models that encompass the full range of the harm reduction, overdose prevention, and SUD treatment workforce. As the US overdose crisis continues, it is vital that we address and mitigate experiences of burnout among harm reduction workers, community organizers, and SUD treatment clinicians to protect their wellbeing and to ensure the sustainability of their invaluable work.
COVID-19 大流行使美国（美国）持续的药物过量危机恶化，并导致医护人员（HCW）承受巨大的精神健康压力和职业倦怠。由于资金不足、资源短缺和混乱的工作环境，减少伤害、预防药物过量和物质使用障碍（SUD）工作者可能会受到特别影响。现有关于 HCW 倦怠的研究主要集中在传统环境中的持照 HCW 上，没有考虑到减少伤害工作者、社区组织者和 SUD 治疗临床医生的独特经历。
我们对 30 名费城的减少伤害工作者、社区组织者和 SUD 治疗临床医生进行了一项定性二次分析描述性研究，了解他们在 2020 年 7 月至 8 月期间在 COVID-19 大流行期间从事其角色的经历。我们的分析以 Shanafelt 和 Noseworthy 的倦怠和参与的关键驱动因素模型为指导。我们旨在评估该模型对非传统环境中 SUD 和减少伤害工作者的经验的适用性。
我们按照 Shanafelt 和 Noseworthy 的倦怠和参与的关键驱动因素进行了演绎编码：（1）工作量和工作要求，（2）工作意义，（3）控制和灵活性，（4）工作与生活的整合，（5）组织文化和价值观，（6）效率和资源以及（7）工作中的社会支持和社区。虽然 Shanafelt 和 Noseworthy 的模型广泛涵盖了我们参与者的经验，但它并没有完全考虑到他们对工作场所安全的担忧、对工作环境缺乏控制以及任务转移的经验。
全国范围内对医疗保健提供者的倦怠现象越来越关注。其中大部分报道和现有研究都集中在传统医疗保健领域的工作人员身上，而且通常不考虑社区为基础的 SUD 治疗、药物过量预防和减少伤害提供者的经验。我们的研究结果表明，现有倦怠框架存在差距，需要建立涵盖整个减少伤害、药物过量预防和 SUD 治疗劳动力的模型。随着美国药物过量危机的持续，解决和减轻减少伤害工作者、社区组织者和 SUD 治疗临床医生的倦怠感至关重要，以保护他们的福祉，并确保他们宝贵工作的可持续性。
