Burnout syndrome in nursing professionals in the context of the COVID-19 pandemic

Objective: to investigate the prevalence of Burnout Syndrome in nursing workers during the COVID-19 pandemic. Methods: cross-sectional study using instruments to collect sociodemographic and professional data and the Maslach Burnout Inventory. The population was formed by 52 nursing workers from three institutions that attend patients with COVID-19. The sampling was by convenience, and workers were contacted via email or WhatsApp®. We compared the means of each domain using Student's t-test, considering the variables from the Maslach Burnout Inventory, namely, emotional exhaustion, depersonalization, and effectiveness at work. Results: the overall mean Burnout was 3.21. The differences between the means of emotional exhaustion and personal accomplishment domains were significant for the variables "would change jobs” (p<0.04) and “job satisfaction” (p<0.001). Conclusion: Workers had a high level of Burnout, being thus susceptible to mental suffering and psychic disease: Contributions to practice: the knowledge produced here can provoke reflections that will help develop and apply strategies to reduce the negative impact of the Burnout Syndrome in the health of the nursing professional

Fatores sociodemográficos moderam a associação da prática de atividade física dos pais e amigos com o nível de atividade física dos adolescentes?

O objetivo deste estudo foi analisar se os fatores sociodemográficos moderam a associação da prática de atividade física dos pais e dos amigos com o nível de atividade física dos adolescentes. Trata-se de um estudo epidemiológico transversal, realizado com 2.859 adolescentes (57,8% sexo feminino) de 14 a 19 anos de idade do município de João Pessoa (PB). O nível de atividade física dos adolescentes e a prática de atividade física dos pais e dos amigos foram mensurados por questionários. A prevalência de adolescentes fisicamente ativos foi de 50,2% (IC95%: 47,3-53,1), sendo mais elevada no sexo masculino (66,3%; IC95%: 63,7-69,0) comparada ao feminino (38,4%; IC95%: 36,1-40,8). Os resultados da análise multivariável demostraram que há associação entre a prática de atividade física dos pais e dos amigos e o nível de atividade física dos adolescentes. No entanto, essa associação é moderada por fatores sociodemográfi cos (sexo e classe econômica). A magnitude da medida de associação entre a prática de atividade física dos amigos e a dos adolescentes foi mais elevada nos adolescentes do sexo masculino e de classe econômica alta. A prática de atividade física da mãe se associou de forma significativa e positiva com o nível de atividade física nos adolescentes de classe econômica alta. Conclui-se que os fatores sociodemográficos moderam a associaçãoda prática de atividade física dos amigos e da mãe com o nível de atividade física dos adolescentes. A magnitude da associação entre essas variáveis variou com o sexo e a classe econômica dos adolescentes

Comportamento sedentário e marcadores cardiometabólicos em adolescentes: um estudo longitudinal

Sedentary behaviour has been negatively associated with different cardiometabolic markers in adults. However, in adolescents, most studies used a cross-sectional design, did not consider possible confounding variables for analyses, and did not analyze the moderating effect. In addition, the results are inconclusive, mainly when the sedentary behaviour was measured by accelerometer. This study aimed to analyze the possible associations between time spent on sedentary behaviour and cardiometabolic markers in adolescents. This is a longitudinal study which analyzed the data from 294 adolescent enrolled at public school in the city of João Pessoa, state of Paraiba, Brazil, baseline (2014) and the first follow-up (2015) from the “Longitudinal Study of Sedentary Behavior, Physical Activity, Eating Habits and Health of Adolescents – LONCAAFS Study”. Sedentary behaviour was measured by the triaxial accelerometer (Actigraph GT3X+) and the cutoff point used was =100 counts/minutes. The total time of sedentary behaviour was estimated by minutes/day and the adolescents were categorized as “high” and “low” sedentary behaviour in 2014 and 2015 according to the cutoff of eight hours/day exposure to this behaviour. The cardiometabolic markers measured were fasting glucose, total cholesterol, plasma triglycerides, high (HDL-C) and low-density lipoproteins (LDL-C), body mass index, abdominal circumference, systolic and diastolic blood pressure. The score of cardiometabolic marker was obtained by the sum of the z scores of individual markers. The potential confounding factors tested were sociodemographic variables, hours of sleep, food intake, body mass index, light and moderate-vigorous physical activity. The moderator variables tested were moderate-vigorous physical activity and nutritional status. In each year, 60% of adolescents spent seven and nine hours/day on sedentary behavior (65.0% in 2014 and 63.3% in 2015) and there was an increase of 30 minutes/day from 2014 (mean = 7.5; sd = 1.8 hours) to 2015 (mean = 8.0, sd = 1.7 hours, p < 0.001). It was found that 22.5% of adolescents remained and 27.9% increased to more than eight hours/day of sedentary behaviour from 2014 to 2015. The longitudinal analysis showed a significant inverse relationship between total time spent in sedentary behavior and total cholesterol (ß = –0.098; 95%CI: – 0.173; –0.022) and LDL-C (ß = –0.091; 95%CI: –0.157; –0.026). It was found which nutritional status moderated the relationship between sedentary behaviour and diastolic blood pressure, and it was positively associated in obese adolescents (ß = 0.047; 95%CI: 0.010; 0.085). However, this relationship was not moderated by moderate-vigorous physical activity. Also, no significant differences were identified in the mean values of the cardiometabolic markers considering the "high" and "low" groups of sedentary behavior, according to the classification of physical activity and nutritional status. It was concluded that adolescents spend an excessive amount of time on sedentary behaviour per day, with a tendency to increase during follow-up. The exposure to sedentary time was not associated with cardiometabolic markers, except for the higher values of diastolic blood pressure presented among obese adolescents.Sedentary behaviour has been negatively associated with different cardiometabolic markers in adults. However, in adolescents, most studies used a cross-sectional design, did not consider possible confounding variables for analyses, and did not analyze the moderating effect. In addition, the results are inconclusive, mainly when the sedentary behaviour was measured by accelerometer. This study aimed to analyze the possible associations between time spent on sedentary behaviour and cardiometabolic markers in adolescents. This is a longitudinal study which analyzed the data from 294 adolescent enrolled at public school in the city of João Pessoa, state of Paraiba, Brazil, baseline (2014) and the first follow-up (2015) from the “Longitudinal Study of Sedentary Behavior, Physical Activity, Eating Habits and Health of Adolescents – LONCAAFS Study”. Sedentary behaviour was measured by the triaxial accelerometer (Actigraph GT3X+) and the cutoff point used was =100 counts/minutes. The total time of sedentary behaviour was estimated by minutes/day and the adolescents were categorized as “high” and “low” sedentary behaviour in 2014 and 2015 according to the cutoff of eight hours/day exposure to this behaviour. The cardiometabolic markers measured were fasting glucose, total cholesterol, plasma triglycerides, high (HDL-C) and low-density lipoproteins (LDL-C), body mass index, abdominal circumference, systolic and diastolic blood pressure. The score of cardiometabolic marker was obtained by the sum of the z scores of individual markers. The potential confounding factors tested were sociodemographic variables, hours of sleep, food intake, body mass index, light and moderate-vigorous physical activity. The moderator variables tested were moderate-vigorous physical activity and nutritional status. In each year, 60% of adolescents spent seven and nine hours/day on sedentary behavior (65.0% in 2014 and 63.3% in 2015) and there was an increase of 30 minutes/day from 2014 (mean = 7.5; sd = 1.8 hours) to 2015 (mean = 8.0, sd = 1.7 hours, p < 0.001). It was found that 22.5% of adolescents remained and 27.9% increased to more than eight hours/day of sedentary behaviour from 2014 to 2015. The longitudinal analysis showed a significant inverse relationship between total time spent in sedentary behavior and total cholesterol (ß = –0.098; 95%CI: – 0.173; –0.022) and LDL-C (ß = –0.091; 95%CI: –0.157; –0.026). It was found which nutritional status moderated the relationship between sedentary behaviour and diastolic blood pressure, and it was positively associated in obese adolescents (ß = 0.047; 95%CI: 0.010; 0.085). However, this relationship was not moderated by moderate-vigorous physical activity. Also, no significant differences were identified in the mean values of the cardiometabolic markers considering the "high" and "low" groups of sedentary behavior, according to the classification of physical activity and nutritional status. It was concluded that adolescents spend an excessive amount of time on sedentary behaviour per day, with a tendency to increase during follow-up. The exposure to sedentary time was not associated with cardiometabolic markers, except for the higher values of diastolic blood pressure presented among obese adolescents.Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPqCoordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPESFundação de Apoio à Pesquisa do Estado da Paraíba - FAPESQO comportamento sedentário tem sido associado negativamente a diferentes marcadores cardiometabólicos em adultos. No entanto, em adolescentes, a maioria dos estudos foi realizada por delineamento transversal, não considerando possíveis variáveis de confusão e moderação em suas análises. Além disso, os resultados de tais estudos foram inconclusivos, principalmente quando a medida do comportamento sedentário foi realizada por acelerômetro. O objetivo do estudo foi, pois, analisar as possíveis associações entre tempo em comportamento sedentário e marcadores cardiometabólicos em adolescentes. Trata-se de um estudo longitudinal que analisou dados de 294 adolescentes de escolas públicas do município de João Pessoa, Paraíba, Brasil, da linha de base (2014) e do primeiro acompanhamento (2015) do Estudo Longitudinal sobre Comportamento Sedentário, Atividade Física, Hábitos Alimentares e Saúde de Adolescentes – Estudo LONCAAFS. O comportamento sedentário foi mensurado por acelerômetro triaxial (Actigraph GT3X+), e o ponto de corte usado para defini-lo foi =100 counts/minutos. Foi estimado o tempo total sedentário em minutos/dia, e os adolescentes foram categorizados em grupos de “alto” e “baixo” comportamento sedentário nos anos de 2014 e 2015, de acordo com o critério de oito horas/dia. Os marcadores cardiometabólicos mensurados foram glicose de jejum, colesterol total, triglicerídeos plasmáticos, lipoproteínas de alta (HDL-C) e de baixa (LDL-C) densidade, índice de massa corporal, circunferência abdominal, pressão arterial sistólica e diastólica. Também foi produzido o escore dos marcadores cardiometabólicos de acordo com a soma dos escores-Z dos marcadores individuais. Os potenciais fatores de confusão testados foram variáveis sociodemográficas, horas de sono, consumo alimentar, índice de massa corporal, atividades físicas leves e moderadas-vigorosas. As variáveis moderadoras testadas foram atividade física moderada-vigorosa e estado nutricional. Identificou-se, em cada ano, que cerca de 60% dos adolescentes despendiam de sete a nove horas/dia em comportamento sedentário (65,0% em 2014 e 63,3% em 2015) e houve um aumento médio de 30 minutos/dia no tempo sedentário de 2014 (média = 7,5; dp = 1,8h) para 2015 (média = 8,0; dp = 1,7h; p < 0,001). Observou-se que 22,5% dos adolescentes permaneceram e 27,9% aumentaram para mais de oito horas/dia seu comportamento sedentário de 2014 para 2015. Na análise longitudinal, houve uma relação significativa e inversa entre tempo total em comportamento sedentário e colesterol total (ß = -0,098; IC95%: -0,173; -0,022) e o LDL-C (ß = -0,091; IC95%: -0,157; -0,026). Foi identificado que o estado nutricional moderou a relação entre comportamento sedentário e pressão arterial diastólica, na qual a associação foi positivamente associada entre os obesos (ß = 0,047; IC95%: 0,010; 0,085). Entretanto, essa relação não foi moderada pela atividade física moderada-vigorosa. Também não foram identificadas diferenças significativas nos valores médios dos marcadores cardiometabólicos entre os grupos “alto” e “baixo” de comportamento sedentário, de acordo com a classificação da atividade física e estado nutricional. Conclui-se que os adolescentes despendiam tempo excessivo em comportamento sedentário, com tendência de aumento de exposição no período de acompanhamento. De forma geral, a exposição ao tempo sedentário não se associou aos marcadores cardiometabólicos, exceto para os maiores valores de pressão arterial diastólica apresentados apenas nos adolescentes obesos

Temporal trend in overweight among adolescents in northeastern Brazil

ABSTRACT Objective This study aimed to determine the prevalence and the temporal trend in overweight, as well as their relationship with sociodemographic factors in adolescents from northeastern Brazil. Subjects and methods We analyzed data from two similar school-based, cross-sectional epidemiological studies conducted in 2005 (n = 2,768) and 2009 (n = 2,776), with public and private high school students of both sexes, aged 14 to 18 years, in João Pessoa, state of Paraiba, Brazil. Sociodemographic information (sex, age and economic class), body weight (kg) and height (cm) were self-reported by the students. Body mass index was classified according to International Obesity Task Force criteria. Results There was a significant increase of three percentage points in overweight prevalence from 2005 (10.1%; CI95%: 8.9-11.3) to 2009 (13.1%; CI95%: 11.4-15.5), which was of greater magnitude in males (5.0%; p < 0.001) than in females (1.8%; p = 0.085). Adjusted analysis showed that the Odds Ratio for an adolescent to show overweight in 2009 compared with 2005 was 1.34 (CI95%: 1.13-1.60), which was also greater in males (OR = 1.45; CI95%: 1.15-1.83), in adolescents aged 16 years (females – OR = 3.01; CI95%: 1.62-5.55), and in those from the middle economic class (males: OR = 1.47; CI95%: 1.03-2.23; females: OR = 1.59; CI95%: 1.01-2.53). Conclusions Prevalence of overweight in adolescents was high, and showed an increasing trend, particularly in males who belonged to the middle economic class

Physical activity in adolescents: analysis of social influence of parents and friends

Objective: To analyze the association between physical activity and social support from parents and friends on the physical activity level among adolescents. Methods: Data from 2,361 adolescents (56.6% females; mean age 16.4; SD = 1.2), from public and private high schools were analyzed. The physical activity level of the adolescents, parents, and friends were measured through a questionnaire. Parents’ and friends’ support and self‐efficacy were measured using two previously tested scales. Data analysis was performed usingthe structural equation modeling in IBM® SPSS® AmosTM 20.0. Results: Physical activity of friends was directly associated with physical activity level of adolescents. Physical activity of the father was associated with their sons, and the physical activity of mother was associated with their daughters. An indirect association was identified between the physical activity of parents and friends with physical activity level of the adolescents, mediated by social support. Social support was directly associated with physical activity in adolescents of both genders and indirectly mediated by self‐efficacy. Conclusions: Parents and friends have a social influence on adolescents’ level of physical activity through the mechanism of behavior modeling or through social support, mediated by self‐efficacy

Physical activity in adolescents: analysis of the social influence of parents and friends

Objective: to analyze the association between physical activity and social support from parents and friends on the physical activity level among adolescents. Methods: data from 2,361 adolescents (56.6% females; mean age 16.4; SD = 1.2), from public and private high schools were analyzed. The physical activity level of the adolescents, parents, and friends were measured through a questionnaire. Parents’ and friends’ support and self-efficacy were measured using two previously tested scales. Data analysis was performed using the structural equation modeling in IBM® SPSS® Amos™ 20.0. Results: physical activity of friends was directly associated with physical activity level of adolescents. Physical activity of the father was associated with that of their sons, and the physical activity of mother was associated with that of their daughters. An indirect association was identified between the physical activity of parents and friends with physical activity level of the adolescents, mediated by social support. Social support was directly associated with physical activity in adolescents of both genders and indirectly mediated by self-efficacy. Conclusions: parents and friends have a social influence on adolescents’ level of physical activity through the mechanism of behavior modeling or through social support, mediated by self-efficacy. Resumo: Objetivo: analisar a associação da prática de atividade física e do apoio social dos pais e dos amigos com o nível de atividade física dos adolescentes. Métodos: foram analisados dados de 2,361 adolescentes (56,6% do sexo feminino, média de idade = 16,4; dp = 1,2) do ensino médio de escolas públicas e privadas. A atividade física dos adolescentes, dos pais e dos amigos foi mensurada por questionário. O apoio social dos pais e dos amigos e a autoeficácia foram mensurados por duas escalas previamente testadas. A modelagem por equações estruturais foi utilizada para análise dos dados, recorrendo-se ao programa AMOS 20.0. Resultados: a prática de atividade física dos amigos se associou diretamente ao nível de atividade física dos adolescentes, enquanto a prática do pai se associou diretamente com a do filho e a da mãe com a da filha. Também foi identificada uma relação indireta entre a prática de atividade física dos pais e dos amigos e o nível de atividade física dos adolescentes, sendo parcialmente mediada pelo apoio social desses dois grupos. O apoio social dos pais e dos amigos se associou diretamente à atividade física do adolescente, e foi mediado, indiretamente pela percepção de autoeficácia. Conclusões: pais e amigos exercem influência social sobre a prática de atividade física dos adolescentes por meio da modelação do comportamento e do fornecimento de apoio social. Keywords: Motor activity, Adolescents, Parents, Friends, Social support, Palavras-chave: Atividade motora, Adolescentes, Pais, Amigos, Apoio socia

Reproducibility and concurrent validity of the Physical Activity Questionnaire for Adolescents (QAFA) aged 10-14 years

The aim of the study was to evaluate the reproducibility and concurrent validity of the Physical Activity Questionnaire for Adolescents (QAFA). The reproducibility study (repeated evaluations with two-day interval between them) included 171 adolescents (average age 12.3 years, SD = 1.1), and the validity study (reference method: “Actgraph GT3X” accelerometer) included 341 adolescents (average age 11.9 years, SD = 1.0). All participants were students enrolled in public schools of Joao Pessoa (PB), Brazil. The QAFA reproducibility was measured using the intraclass correlation coefficient (ICC) and the Kappa PABAK Coefficient. Validity was evaluated by the Spearman correlation, Bland and Altman plot, sensitivity and specificity analysis. Reproducibility was satisfactory (ICC = 0.73; 95%CI: 0.63 - 0.79; Kappa PABAK = 0.58), and higher in physical activity frequency items (eight activities with ICC ≥ 0.70) than in duration items (seven activities with ICC ≥ 0.70). The correlation between QAFA and accelerometer was low (rho = 0.37; p < 0.001). Sensitivity was high (from 79.3% to 90.4%) and specificity was low (from 29.9% to 50.6%). The agreement between QAFA and accelerometer was satisfactory (Bland-Altman). QAFA showed satisfactory reproducibility and validity and can be used to evaluate physical activity in younger adolescents in face-to-face interviews

Prevalência de níveis suficientes de atividade física em adolescentes: comparação entre a medida obtida de um questionário simplificado e a de um detalhado

O estudo teve como objetivo comparar as prevalências de níveis suficientes de atividade física produzida pela medida de um questionário simplificado e a de outro detalhado, e analisar a concordâncias entre estas medidas, em adolescentes. Estudo transversal conduzido com 2.859 adolescentes do ensino médio com idade entre 14 e 19 anos (57,8% do sexo feminino), João Pessoa (PB), Nordeste do Brasil.. Dados sobre atividade física foram obtidos utilizando um questionário simplificado e outro detalhado. Foram classificados como suficientemente ativos adolescentes com prática de atividade física ≥300 minutos/semana. A concordância entre as medidas dos questionários foi avaliada pelo índice Kappa (k) e medidas de sensibilidade e especificidade, tendo como referência a medida do questionário detalhado. A prevalência de níveis suficientes de prática atividade física do questionário simplificado (20,1%, IC95%: 18,6-21,6) foi inferior a do questionário detalhado (50,2%, IC95%: 48,4-52,7). A concordância entre as medidas dos questionários foi leve (k variando de 0,21 a 0,34). A sensibilidade da medida de atividade física do questionário simplificado foi baixa (variou de 26,4%, IC95%: 22,9 30,0; a 40,9%, IC95%: 37,0-45,0) e a especificidade alta (variou de 92,3%, IC95%: 86,9 96,0; a 94,3%, IC95%: 92,0-96,1). Concluiu-se que as prevalências de níveis suficientes de prática de atividade física foram mais baixas na medida simplificada comparada a detalhada e a concordância entre elas foi leve. É preciso ter cautela na utilização de questionários simplificados e na comparação dos níveis de atividade física produzidas por essa medida e a de questionários detalhados

Reliability and validity of a physical activity social support assessment scale in adolescents - ASAFA Scale

Objective: To analyze the reliability and validity of a scale used to measure social support for physical activity in adolescents - ASAFA Scale. Methods: This study included 2,755 adolescents (57.6% girls, 16.5 ± 1.2 years of age), from Joao Pessoa, Paraiba, Brazil. Initially, the scale was consisted of 12 items (6 for social support from parents and 6 from friends). The reliability of the scale was estimated by Cronbach's alpha coefficient (α), by the Composite Reliability (CR), and by the model with two factors and factorial invariance by Confirmatory Factor Analysis (CFA) adequacy. Results: The CFA results confirmed that the social support scale contained two factors (factor 1: social support from parents; factor 2: social support from friends) with five items each (one item was excluded from each scale), all with high factor loadings (> 0.65) and acceptable adjustment indexes (RMR = 0.050; RMSEA = 0.063; 90%CI: 0.060 - 0.067); AGFI = 0.903; GFI = 0.940; CFI = 0.934, NNFI = 0.932). The internal consistency was satisfactory (parents: α ≥ 0.77 and CR ≥ 0.83; friends: α ≥ 0.87 and CR ≥ 0.91). The scale's factorial invariance was confirmed (p > 0.05; Δχ2 and ΔCFI ≤ 0.01) across all subgroups analyzed (gender, age, economic class). The construct validity was evidenced by the significant association (p < 0.05) between the adolescents physical activity level and the social support score of parents (rho = 0.29) and friends (rho = 0.39). Conclusions: The scale showed reliability, factorial invariance and satisfactory validity, so it can be used in studies with adolescents