Prevalencia de burnout en enfermeras de nefrología tras un año de pandemia por COVID-19

Introducción: La prevalencia de Enfermedad Renal Cróni ca, así como la complejidad de su manejo terapéutico, hace que las enfermeras de nefrología sean susceptibles a sufrir el síndrome de burnout. En este escenario, ha aparecido la pandemia por COVID-19. Esta nueva situación puede po tenciar la aparición de burnout entre las enfermeras nefro lógicas. Objetivo: Describir la prevalencia del síndrome de burnout entre las enfermeras de un servicio de nefrología de un hos pital terciario. Material y Método: Estudio observacional, descriptivo, transversal y unicéntrico. La recogida de datos se efectuó en mayo de 2021 mediante un cuestionario ad-hoc con preguntas sociodemográficas y laborales. Se administró el cuestionario validado “Maslach Burnout Inventory Human Services Survey”, compuesto de preguntas sobre sentimien tos y actitudes de profesionales hacia pacientes y compañe ros de trabajo. Resultados: Se incluyó a 28 enfermeras, correspondiendo al 71,8% de la población a estudio, con una media de 18±12,2 años de experiencia;11 (39,3%) tuvieron COVID-19;24 (85,7%) estaban vacunadas;18 (64,3%) no recibieron forma ción específica sobre el SARS-CoV-2;13 (46,4%) enferme ras tenían miedo de transmitir la COVID-19 a su entorno;5 (17,9%) tenían miedo a contagiarse y 19 (67,9%) se sentían mal anímicamente. Los resultados del “Maslach Burnout Inventory Human Servi ces Survey”, destacaron a 15 enfermeras (58,6%) con al me nos dos de las tres esferas afectadas. Conclusiones: Las enfermeras presentan un riesgo real de burnout en el contexto descrito y la implementación de pro gramas de prevención y tratamiento sería lo apropiado según la literatura de referencia. La esfera con mayor afectación reportada es la de la realización personal.Alternate : Introduction: The high prevalence of chronic kidney disease and the complexity of therapeutic management make nephrology nurses susceptible to burnout syndrome. In this scenario, the COVID-19 pandemic has appeared. This new situation may increase the appearance of burnout among nephrology nurses. Objective: To describe the prevalence of burnout syndrome among nurses in a nephrology department of a tertiary hospital. Method: Observational, descriptive, cross-sectional, single-centre study. Data collection was carried out in May 2021 using an ad-hoc questionnaire with socio-demographic and occupational questions. The validated questionnaire “Maslach Burnout Inventory Human Services Survey” was administered, consisting of questions on feelings and attitudes of professionals towards patients and co-workers. Results: 28 nurses were included, being 71.8% of the study population, with a mean of 18±12.2 years of experience;11 (39.3%) had COVID-19;24 (85.7%) were vaccinated;18 (64.3%) did not receive specific training on SARS-CoV-2;13 (46.4%) nurses were afraid of transmitting COVID-19 to their environment;5 (17.9%) were afraid of becoming infected and 19 (67.9%) felt bad mood. The results of the “Maslach Burnout Inventory Human Services Survey” showed that 15 nurses (58.6%) had at least two of the three spheres affected. Conclusions: Nurses present a real risk of burnout in the context described. The implementation of prevention and treatment programs is essential. The area with the greatest reported impact is that of self-fulfillment.

[Impact of the COVID-19 pandemic on Spanish Nephrology Services]. / Impacto de la pandemia COVID-19 en los servicios de Nefrología españoles.

The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, has required a rapid and drastic transformation of hospitals, and consequently also of Spanish Nephrology Units, to respond to the critical situation. The Spanish Society of Nephrology conducted a survey directed to the Heads of Nephrology Departments in Spain that addressed the reorganisation of Nephrology departments and activity during the peak of COVID-19 pandemic. The survey has been focused on the integration of nephrologists in COVID-19 teams, nephrology inpatient care activities (elective admissions, kidney biopsies), the performance of elective surgeries such as vascular accesses or implantation of peritoneal catheters, the suspension of kidney transplantation programmes and the transformation of nephrology outpatient clinics. This work details the adaptation and transformation of nephrology services during the COVID-19 pandemic in Spain. During this period, elective admissions to Nephrology Services, elective surgeries and biopsies were suspended, and the kidney transplant programme was scaled back by more than 75%. It is worth noting that outpatient nephrology consultations were carried out largely by telephone. In conclusion, the pandemic has clearly impacted clinical activity in Spanish Nephrology departments, reducing elective activity and kidney transplants, and modifying activity in outpatient clinics. A restructuring and implementation plan in Nephrology focused on telemedicine and/or virtual medicine would seem to be both necessary and very useful in the near future.

[Protection of nephrology health professionals during the COVID-19 pandemic]. / Protección de los profesionales sanitarios en nefrología ante la pandemia por COVID-19.

The COVID-19 epidemic represents a special risk for kidney patients due to their comorbidities and advanced age, and the need for hemodialysis treatment in group rooms. It also represents a risk for professionals responsible for their attention. This manuscript contains a proposal for action to prevent infection of professionals in the Nephrology Services, one of the most valuable assets at the present time.

[SARS-CoV-2 infection in patients on renal replacement therapy. Report of the COVID-19 Registry of the Spanish Society of Nephrology (SEN)]. / Situación de la infección por SARS-CoV-2 en pacientes en tratamiento renal sustitutivo. Informe del Registro COVID-19 de la Sociedad Española de Nefrología (SEN).

INTRODUCTION: The recent appearance of the SARS-CoV-2 coronavirus pandemic has had a significant impact on the general population. Patients on renal replacement therapy (RRT) have not been unaware of this situation and due to their characteristics they are especially vulnerable. We present the results of the analysis of the COVID-19 Registry of the Spanish Society of Nephrology. MATERIAL AND METHODS: The Registry began operating on March 18th, 2020. It collects epidemiological variables, contagion and diagnosis data, signs and symptoms, treatments and outcomes. It is an online registry. Patients were diagnosed with SARS-CoV-2 infection based on the results of the PCR of the virus, carried out both in patients who had manifested compatible symptoms or had suspicious signs, as well as in those who had undergone screening after some contact acquainted with another patient. RESULTS: As of April 11, the Registry had data on 868 patients, from all the Autonomous Communities. The most represented form of RRT is in-center hemodialysis (ICH) followed by transplant patients. Symptoms are similar to the general population. A very high percentage (85%) required hospital admission, 8% in intensive care units. The most used treatments were hydroxychloroquine, lopinavir-ritonavir, and steroids. Mortality is high and reaches 23%; deceased patients were more frequently on ICH, developed pneumonia more frequently, and received less frequently lopinavir-ritonavir and steroids. Age and pneumonia were independently associated with the risk of death. CONCLUSIONS: SARS-CoV-2 infection already affects a significant number of Spanish patients on RRT, mainly those on ICH, hospitalization rates are very high and mortality is high; age and the development of pneumonia are factors associated with mortality.