Burnout syndrome and work engagement in nursing staff: a systematic review and meta-analysis

The Supplementary Material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fmed.2023.1125133/full#supplementary-materialBackground: A difficult and demanding work environment, such as that often experienced in healthcare, can provoke fatigue, anxiety, distress, and discomfort. This study considers factors that may influence levels of burnout and work engagement among nurses and seeks to determine the relationship between these conditions.Method: A systematic scoping review was performed, in accordance with the PRISMA Extension for Scoping Reviews, based on data obtained from a search of the PubMed/MEDLINE and Scopus databases carried out in 2022 using the search equation: "work engagement AND nurs* AND burnout." This search identified nine quantitative primary studies suitable for inclusion in our analysis.Results: Work overload, type of shift worked, and/or area of hospital service, among other elements, are all relevant to the development of burnout. This syndrome can be countered by social support and appropriate personal resources and values, which are all positively associated with work engagement. Our analysis revealed a significant correlation between work engagement and the different domains of burnout. The correlation effect size between burnout and work engagement was -0.46 (95% CI -0.58, -0.31), with p < 0.001.Conclusion: Well-targeted interventions in the healthcare work environment can reduce burnout levels, strengthen work engagement, and enhance the quality of healthcare.FEDER/Consejeria de Universidad, Investigacion e Innovacion de la Junta de Andalucia P20-0062

Prevalence and Risk Factors of Respiratory Syncytial Virus in Children under 5 Years of Age in the WHO European Region: A Systematic Review and Meta-Analysis

A respiratory syncytial virus (RSV) is the major cause of respiratory tract infection in children under 5 years. However, RSV infection in the European Region of the World Health Organization has not been systematically reviewed. The aim was to determine the prevalence and factors associated with RSV in children under 5 years of age in European regions. A systematic review and meta-analysis was performed. CINAHL, Medline, LILACS, ProQuest, SciELO, and Scopus databases were consulted for studies published in the last 5 years, following Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. The search equation was “respiratory syncytial virus AND (newborn OR infant OR child) AND (prevalence OR risk factors)”. Studies reporting the prevalence of RSV were eligible for inclusion in the meta-analysis. A total of 20 articles were included. The meta-analytic prevalence estimation of RSV, with a sample of n = 16,115 children, was 46% (95% CI 34–59%). The main risk factors were age, male gender, winter season, and environmental factors such as cold temperatures, higher relative humidity, high concentrations of benzene, exposure to tobacco, and living in urban areas. Robust age-specific estimates of RSV infection in healthy children should be promoted in order to determine the optimal age for immunization. In addition, it is necessary to analyse in greater depth the potentially predictive factors of RSV infection, to be included in prevention strategies

Efficacy and Safety of New B Cell-Targeted Biologic Agent for the Treatment of Systemic Lupus Erythematosus: A Systematic Review and Meta-Analysis

Background: B cells are central to the pathogenesis of systemic lupus erythematosus (SLE). We aimed to analyze the efficacy and safety of new B cell-targeted drug therapies for SLE. Methods: A systematic review of randomized controlled trials (RCTs) and reference lists of relevant articles published from inception to 2022 were selected from PubMed, Scopus andWeb of Science databases. Random effects meta-analyses were performed to estimate an overall effect size for the risk of adverse events (AEs) and serious adverse events (SAEs) with belimumab and tabalumab treatment. Heterogeneity was assessed using the I2 statistic and meta-regression. Funnel asymmetry was evaluated using Egger’s test. Results: This study included 13 RCTs, of which three showed high risk of bias. Egger’s test showed no asymmetry. The risk of SAEs and AEs was lower in the treatment group with belimumab treatment. The risk of AEs for tabalumab treatment was lower in the treatment group and lower for SAEs. Conclusion: Belimumab and tabalumab therapies are effective and safe in the treatment of SLE, although tabalumab does not show sufficient statistical power. Advances in understanding the underlying mechanisms of SLE will be directed towards correlating clinical manifestations with specific pathogenic pathways and the development of precision medicine

Meta-estudo qualitativo sobre as experiências e gestão diárias em idosos com doenças crônicas

Objetivo: Describir la experiencia cultural, interpersonal y personal de los adultos mayores con enfermedades crónicas e identificar las estrategias y redes de apoyo que utilizan en su entorno cotidiano para gestionar la enfermedad. Método: Se desarrolló un metaestudio tipo metaanálisis cualitativo. La estrategia metodológica constó de cuatro etapas: Búsqueda bibliográfica, Categorización de los estudios, Evaluación de la calidad metodológica y Análisis de resultados. Resultados: Se obtuvo una muestra bibliográfica de 22 estudios de naturaleza cualitativa. Los hallazgos se organizaron en 4 categorías: Compresión del padecimiento, Autogestión en el cotidiano, Percepción de los Servicios de Salud y Cotidiano del cuidador. Conclusiones: El esfuerzo de los adultos mayores por alcanzar un nuevo equilibrio social y personal se articula en las estrategias de autogestión que utilizan en su día a día para afrontar sus padecimientos. Las interrelaciones con los servicios de salud, familia y redes de apoyo son fundamentales para gestionar la cronicidad.Aims: To describe the cultural, interpersonal and personal experience of older adults with chronic diseases and to identify the strategies and support networks used by them in their daily environment for managing the disease. Methods: A qualitative meta-analitic study was developed in four stages: literature search, studies categorization, methodological quality assessment and results analysis. Results: A sample of 22 qualitative studies was obtained. The findings were organized into 4 categories: Compression of the condition, daily self-management, perception of health services and the caregiver´s daily life. Conclusions: The effort of older adults to achieve a new social and personal balance is articulated in self-management strategies that they use to face their sufferings. Interrelationships with health services, family and support networks are essential for chronicity management.Objetivo: Descreva a experiência cultural, interpessoal e pessoal dos idosos com doenças crônicas e identificar estratégias e redes de apoio que eles usam em seu ambiente todos os dias para controlar a doença. Método: Um tipo qualitativo meta-meta foi desenvolvido. A estratégia metodológica consistiuem quatro etapas: pesquisa bibliográfica, categorização dos estudos, avaliação da qualidade metodológica e análise dos resultados. Resultados: Uma amostra bibliográfica de 22 estudos qualitativos foi obtido. Os resultados foram organizados em quatro categorias: condição de compressão, a auto-gestão no cotidiano, Percepção dos Serviços de Saúde e cuidador Daily. Conclusões: O esforço de adultos mais velhos para alcançar um novo equilíbrio social e pessoal é dividido em estratégias de auto-gestão que eles usam no seu dia a cumprir as suas condições. Inter-relações com os serviços de saúde, redes de apoio à família são essenciais para a gestão crônica

Analyzing Latent Burnout Profiles in a Sample of Spanish Nursing and Psychology Undergraduates

There is abundant literature suggesting that university students in helping professions experience high levels of stress, leading to an increased risk of developing burnout. The objective of this study was to identify burnout profiles in a sample of 1162 Spanish nursing and psychology undergraduates using latent profile analysis, a person-oriented statistical method that can identify hidden homogenous subgroups within a heterogeneous population. We expected to replicate in university students the five-profile structure (burnout, overextended, disengaged, ineffective, and engagement) proposed by Leiter and Maslach using the burnout dimensions (emotional exhaustion, cynicism, and inefficacy) as indicators. The results showed that burnout, overextended, and engagement profiles were adequately replicated. Given that levels of inefficacy and cynicism were medium to low, the ineffective and disengaged profiles somewhat deviated from those identified by Leiter and Maslach. We found differences between the five latent profiles in several psychological variables, such as depression and anxiety. These results suggest that psychosocial factors (e.g., workload) are significant among students and may adversely impact their health, leading to psychosomatic and emotional disorders. Hence, designing effective interventions to prevent health problems associated with burnout seems advisable, considering the specific burnout profile that a student exhibits

Quality of Life After Coronary Artery Bypass Surgery: A Systematic Review and Meta-Analysis

Coronary heart disease is a public health problem and is one of the leading causes of loss of quality of life, disability, and death worldwide. The main procedure these patients undergo is cardiac catheterisation, which helps improve their quality of life, symptoms of myocardial ischemia, and ventricular function, thus helping increase the survival rate of su erers. It can also, however, lead to physical consequences, including kidney failure, acute myocardial infarction, and stroke. The objective of this study was to analyse how coronary artery bypass grafting (CABG) influences quality of life. A systematic review and meta-analysis were conducted using the CINAHL, PubMed, Scopus, and Cuiden databases in June 2020. A total of 7537 subjects were included, 16 in the systematic review and 3 in the meta-analysis. The studies analysing quality of life using the SF questionnaire showed improvements in the quality of physical and mental appearance, and those using the NHP questionnaire showed score improvements and, in some cases, di erences in quality of life between women and men. This operation seems to be a good choice for improving the quality of life of people with coronary pathologies, once the possible existing risks have been assessed.Clinical Medicine and Health Public Programme of University of Granada, Spain B 12.56.

Effects of Supervised Cardiac Rehabilitation Programmes on Quality of Life among Myocardial Infarction Patients: A Systematic Review and Meta-Analysis

Coronary heart disease is the leading cause of death and disability worldwide. Traditionally, cardiac rehabilitation programmes are offered after cardiac events to aid recovery, improve quality of life, and reduce adverse events. The objective of this review was to assess the health-related quality of life, after a supervised cardiac rehabilitation programme, of patients who suffered a myocardial infarction. A systematic review was carried out in the CINAHL, Cochrane, LILACS, Medline, Scopus, and SciELO databases, according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. Randomised controlled trials were selected. Meta-analyses were performed for the Short Form Health Survey SF-36, Myocardial Infarction Dimensional Assessment Scale (MIDAS), MacNew Heart Disease-Health-Related Quality of Life (HRQL) questionnaire, and European Quality of Life-Visual Analogue Scale (EuroQol-VAS) with the software Cochrane RevMan Web. Ten articles were found covering a total of 3577 patients. In the meta-analysis, the effect size of the cardiac rehabilitation programme was statistically significant in the intervention group for physical activity, emotional reaction, and dependency dimensions of the MIDAS questionnaire. For the control group, the score improved for SF-36 physical functioning, and body pain dimensions. The mean difference between the control and intervention group was not significant for the remaining dimensions, and neither for the MacNew Heart Disease-HRQL and EuroQol-VAS questionnaires. Supervised cardiac rehabilitation programmes were effective in improving health-related quality of life, however, there was a potential variability in the interventions; therefore, the results should be interpreted with caution. This study supports the importance of providing care and evaluating interventions via the supervision of trained health professionals, and further randomised clinical trials are needed to analyse the positive changes in mental and physical health outcomes

Impact effects of COVID-19 pandemic on chronic disease patients: A longitudinal prospective study

Aims: To assess the effects of COVID-19 pandemic on clinical variables as part of the routine clinical monitoring of patients with chronic diseases in primary care. Design: A prospective longitudinal study was conducted in primary care centres of the Andalusian Health Service. Methods: Data were recorded before the pandemic (T1), during the declaration of the state of emergency (T2) and in the transition phase (T3). The Barthel index and the Short Portable Mental Status Questionnaire (SPMSQ) were used to analyse functional and cognitive changes at the three time points. HbA1c, systolic and diastolic blood pressure, heart rate, BMI and lipid levels were assessed as clinical variables. Descriptive statistics and non-parametric chi-square test were used for analysis. STROBE checklist was used for the preparation of this paper. Results: A total fo148 patients with chronic conditions were included in the analysis. Data analysis revealed in T2 only significant reductions in BMI, total levels of cholesterol and HDL during the onset of the pandemic. Barthel Index, SPMSQ, blood pressure and triglycerides and LDL levels worsened in T2, and the negative effects were maintained in T3. Compared to pre-pandemic values, HbA1c levels improved in T3, but HDL levels worsened. Conclusions: COVID-19 has drastically disrupted several functional, cognitive and biological variables. These results may be useful in identifying clinical parameters that deserve closer attention in the case of a new health crisis. Further studies are needed to assess the potential impacts of each specific chronic condition. Impact: Cognitive and functional status, blood pressure and triglycerides and LDL levels worsen in short term, maintaining the negative effects in medium-term

Gamification for the Improvement of Diet, Nutritional Habits, and Body Composition in Children and Adolescents: A Systematic Review and Meta-Analysis

Currently, one of the main public health problems among children and adolescents is poor adherence to healthy habits, leading to increasingly high rates of obesity and the comorbidities that accompany obesity. Early interventions are necessary, and among them, the use of gamification can be an effective method. The objective was to analyse the effect of game-based interventions (gamification) for improving nutritional habits, knowledge, and changes in body composition. A systematic review and meta-analysis were performed in CINAHL, EMBASE, LILACS, MEDLINE, SciELO, and Scopus databases, following the PRISMA recommendations. There was no restriction by year of publication or language. Only randomized controlled trials were included. Twenty-three articles were found. After the intervention, the consumption of fruit and vegetables increased, as well as the knowledge on healthy food groups. The means difference showed a higher nutritional knowledge score in the intervention group 95% CI 0.88 (0.05–1.75). No significant effect of gamification was found for body mass index z-score. Gamification could be an effective method to improve nutritional knowledge about healthier nutritional habits. Promoting the development of effective educational tools to support learning related to nutrition is necessary in order to avoid and prevent chronic diseases

Prevalence, Risk Factors and Burnout Levels in Intensive Care Unit Nurses: A Systematic Review and Meta-Analysis

Nursing is considered to be an at-risk profession of burnout due to daily exposure to difficult situations such as death and pain care. In addition, some units such as the intensive care unit (ICU), can be stressful due to high levels of morbidity and mortality and ethical dilemmas. Burnout causes a deterioration in quality of care, increasing the risk of mortality in patients due to poor performance and errors in the healthcare environment. The aim of this study was to analyse the levels, prevalence and related factors of burnout in ICU nurses. A systematic review and metaanalysis were carried out in the Medline, Scopus and CINAHL databases. Fifteen articles were found for the systematic review and four for the meta-analysis. With a sample of n = 1986 nurses, the meta-analytic estimate prevalence for high emotional exhaustion was 31% (95% CI, 8–59%), for high depersonalization was 18% (95% CI, 8–30%), and for low personal accomplishment was 46% (95% CI, 20–74%). Within the dimensions of burnout, emotional exhaustion had a significant relationship with depression and personality factors. Both sociodemographic factors (being younger, single marital status, and having less professional experience in ICU) and working conditions (workload and working longer hours) influence the risk of burnout syndrome