Use of Death Cafes to Prevent Burnout in ICU Healthcare Employees

Overview

Burnout affects a significant number of healthcare employees and leads to worsened mental health, increased job turnover, and patient safety events. Those caring for critically ill patients may be especially susceptible due to high patient mortality, long hours, and regular encounters with traumatic and ethical issues. Preliminary studies suggest that debriefing opportunities may reduce burnout through reflection on distressing patient events, enhancement of social support, and interprofessional collaboration. Death Cafés are a specific form of debriefing that focus on discussing death, dying, loss, and illness. The purpose of this study is to evaluate whether biweekly Death Cafe group debriefing sessions can prevent burnout in ICU physicians and staff.

Full Title of Study: “Systematic Trial Of PrevenTing Healthcare Employee Burnout: Using Reflection & Nourishment”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Parallel Assignment
    • Primary Purpose: Prevention
    • Masking: None (Open Label)
  • Study Primary Completion Date: December 26, 2022

Interventions

  • Behavioral: Death Cafe
    • Death Cafés are a specific form of debriefing that focuses on discussing death, dying, loss, and illness. Nourishment in the form of cake is provided. These sessions may allow for reflection on distressing patient events while developing a sense of community and collaboration among hospital employees.

Arms, Groups and Cohorts

  • Experimental: Death Cafe Arm
    • Participants undergo biweekly Death Café sessions hosted by a trained psychotherapist for 3 months.
  • No Intervention: Control Arm
    • Participants do not undergo biweekly Death Café sessions hosted by a trained psychotherapist for 3 months.

Clinical Trial Outcome Measures

Primary Measures

  • Differences in Burnout as measured by the Maslach Burnout Inventory Score (MBI).
    • Time Frame: At the time of enrollment and at 1 month, 3 months, 6 months after enrollment
    • This is a validated 22-item, self-reported questionnaire that asks respondents to indicate on a 7 point Likert scale the frequency of certain feelings related to their job. Presence of burnout is defined by high values of depersonalization and emotional exhaustion with low values for personal accomplishment. Changes in mean scores between groups and within groups over time will be assessed.

Secondary Measures

  • Differences in Depression as measured by the Patient Health Questionnaire 8 (PHQ-8)
    • Time Frame: At the time of enrollment and at 1 month, 3 months, 6 months after enrollment
    • This is an 8 question validated questionnaire that asks respondents to indicate the frequency with which they have experienced certain symptoms consistent with depression. Higher scores mean higher frequency of depression symptoms, and a score of 10 or higher will be considered to indicate clinically significant depression. Changes in mean scores between groups and within groups over time will be assessed.
  • Differences in Anxiety as measured by the Generalized Anxiety Disorder 7 Scale (GAD-7)
    • Time Frame: At the time of enrollment and at 1 month, 3 months, 6 months after enrollment
    • This is a 7 question validated questionnaire that asks respondents to indicate the frequency with which they have experienced certain symptoms consistent with anxiety. Higher scores mean higher frequency of anxiety symptoms, and a score of 10 or higher will be considered to indicate clinically significant anxiety. Changes in mean scores between groups and within groups over time will be assessed.

Participating in This Clinical Trial

Inclusion Criteria

  • Physicians, nurses, pharmacists, or therapists working in the Intensive Care Unit and have worked for the full-time equivalent of at least 1 week in the preceding 4 weeks Exclusion Criteria:

  • Not physicians, nurses, pharmacists, or therapists – Have worked less than the full-time equivalent of at least 1 week in the preceding 4 weeks

Gender Eligibility: All

Minimum Age: N/A

Maximum Age: N/A

Are Healthy Volunteers Accepted: Accepts Healthy Volunteers

Investigator Details

  • Lead Sponsor
    • Tulane University School of Medicine
  • Collaborator
    • Spirit of Charity Foundation – University Medical Center
  • Provider of Information About this Clinical Study
    • Sponsor
  • Overall Official(s)
    • Marjorie E Bateman, MD, Principal Investigator, Tulane University School of Medicine
    • Joshua Denson, MD, Principal Investigator, Tulane University School of Medicine

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