NoFumo+: A Clinical Trial of an mHealth for Smoking Cessation with Hospitalized Patients.

Smartphone applications (apps) improve accessibility to smoking cessation treatments. The NoFumo+ app administers a cognitive behavioral therapy program for smoking cessation. This study evaluates the efficacy of NoFumo+ for quitting smoking or reducing cigarette consumption versus the usual information-based treatment. A clinical trial was conducted with 99 hospitalized smokers, 54 pseudo-randomly assigned to the app treatment and 45 to the usual treatment. The two groups had homogeneous baseline characteristics to ensure comparability. Abstinence was evaluated at post-treatment (two months) and at a six-month follow-up. The results obtained indicate that participants who receive the usual treatment are 5.40 times more likely to continue smoking than those who undergo the app treatment (95% CI = [1.35; 20.15]). Participants who do not succeed in quitting smoking with the app manage to decrease their habitual consumption. Users who successfully complete treatment with NoFumo+ access all its contents and use the chat, but without requesting professional support. There is not enough empirical evidence to attribute this success to any specific element of the app. NoFumo+ achieves better abstinence rates than the usual information-based treatments, and the goal of generalizing its use to the non-hospitalized smoking population may be achievable in the future.

Confirmatory factorial analysis of the Maslach Burnout Inventory - Human Services Survey in health professionals in emergency services.

OBJECTIVE: to confirm the factorial validity of the Maslach Burnout Inventory - Human Services Survey version in a sample of health professionals from the emergency services. METHOD: a quantitative, exploratory, descriptive and analytical study. Two hundred and eighty-two health professionals participated in the study. For data collection, a sociodemographic questionnaire and the Maslach Burnout Inventory were used. The psychometric sensitivity for the MBI-HSS items was estimated by measures of central tendency, variability and the distribution shape. Internal consistency was estimated using Cronbach's alpha coefficient and the adequacy of the sample was verified using the Kaiser-Meyer-Olkin (KMO) index. As indexes for assessing the quality of fit of the model, the chi-square ratio by the degrees of freedom (χ2/DoF), the comparative fit index (CFI), the goodness of fit index (GFI), the Tucker Lewis index (TLI) and the root mean square error of approximation (RMSEA) were considered. To test data fit, the maximum likelihood method was used. RESULTS: the three-factor structure of the Maslach Burnout Inventory was confirmed. Items 9, 12, 15 and 16 had a factorial weight below what was considered appropriate and were removed from the model. The second order hierarchical model with the aforementioned modifications presented an adequate adjustment to the data and can be considered the best and most parsimonious model tested according to the information theory indexes. The internal consistency of the instrument's factors was recalculated considering the exclusion of the items and the three factors were considered adequate. CONCLUSION: the results obtained show that the Maslach Burnout Inventory is a reliable and factorially valid instrument for measuring the burnout syndrome in emergency service professionals in Brazil.

Apps for smoking cessation through Cognitive Behavioural Therapy. A review. / Apps para dejar de fumar mediante Terapia Cognitivo Conductual. Una revisión sistemática.

Smoking is a health and economic problem that is difficult to eradicate. Nicotine addicts also often suffer from psychological problems such as depression and anxiety. The recommended treatment according to clinical practice guidelines (CPG) is Cognitive Behavioural therapy (CBT), alone or combined with medication. Currently, health-related apps (m Health) enable wider availability and access to this treatment. The objectives of this study are to carry out a review of the smoking cessation apps that apply CBT and to describe the techniques used by them. Following the PRISMA framework, the databases EBSCOhost, Cochrane, Web of Science and Scopus were searched for publications between 2010-2019. Four hundred fifteen studies were found and, after applying the inclusion and exclusion criteria, only five articles were eligible for systematic review. Only three apps were identified as using CBT, and the techniques most commonly used were the recording of smoking history, progress visualised through graphics, psycho-educational videos, motivation, social support through social media, and elements of gamification to reinforce adherence and abstinence behaviour. The results recommend the inclusion of smoking behaviour analysis in these types of apps, as not all of them do so, as well as an interface between the health professionals and the users to provide a personalised treatment.

El tabaquismo constituye un problema sanitario y económico de difícil erradicación. Las personas más dependientes a la nicotina suelen presentar, además, problemas psicopatológicos como depresión y ansiedad. Según las Guías de Práctica Clínica (GPC), el tratamiento recomendado para abandonar el hábito es la Terapia Cognitivo Conductual (TCC), sola o combinada con medicación. Actualmente, las aplicaciones móviles (App) en salud (mHealth) permiten un acceso masivo y económico a este tratamiento. El objetivo de este trabajo consiste en llevar a cabo una revisión bibliográfica de las Apps para dejar de fumar que apliquen TCC y describir las técnicas implementadas. En el marco del protocolo PRISMA, la búsqueda se ciñó al periodo 2010-19 y se realizó en las bases de datos: EBSCOhost, Cochrane, Web of Science y Scopus. Se hallaron un total de 415 trabajos, de los cuales, tras aplicar los criterios de inclusión/exclusión, solo 5 artículos fueron objeto de revisión. Únicamente se identificaron 3 Apps (en inglés) que incluyeran TCC y, las técnicas más utilizadas fueron: el registro de cigarrillos, la visualización del progreso mediante gráficas, videos psicoeducativos, la motivación, el apoyo social mediante redes sociales y elementos de gamificación para reforzar la adherencia y la conducta de abstinencia. Los resultados sugieren incluir en este tipo de Apps el análisis de la conducta de fumar, ya que no todas lo hacen, así como una interfaz que comunique el personal sanitario con el usuario y pueda proporcionar un tratamiento personalizado.

Intervening variables of Burnout in health professionals of emergency services / Variables de intervención del Burnout en los profesionales sanitarios de los servicios de emergencia / Variáveis interventoras do Burnout em profissionais de saúde dos serviços emergenciais

ABSTRACT Objective: to analyze the association between Burnout, stress, mental suffering and other personal and work factors associated with this syndrome. Method: cross-sectional, descriptive and correlational study with 282 health professionals from the emergency services of the city of Ribeirão Preto, Brazil, collected from October 2015 to March 2016. The instruments used were: sociodemographic questionnaire, Maslach Burnout Inventory, Childhood Trauma Questionnaire, Stress Symptom Inventory, Perceived Stress Scale, Psychiatric Screening Questionnaire, Fantastic Lifestyle Checklist, Hospital Anxiety and Depression Scale and Holmes-Rahe Social Readjustment Rating Scale. Descriptive writing of the data. Pearson's Chi-Square or Fisher's Exact Tests to check the association between variables and later regression analysis, in which ORs were calculated, with 95% CI and 5% significance level. Results: there was statistical evidence of an association between Burnout and education, early stress, stress, common mental disorders, lifestyle, anxiety and depression. The regression analysis shows that the variables that influence Burnout are: type of service (p=0.032; OR=0.187), education (p=0.029; OR=2.313), perception of stress (p=0.037; OR=1.67) and social readjustment (p=0.031; OR=1.279). Conclusion: this study points to a profile for the development of Burnout, consisting of health professionals with higher education, who suffered early stress, who have symptoms and perception of stress, who do not have a healthy lifestyle and show symptoms of mental suffering. Such results can assist in the development and implementation of strategies aimed at reducing both work stress and the prevalence of Burnout syndrome.

RESUMEN Objetivo: analizar la asociación entre Burnout, estrés, sufrimiento mental y otros factores personales y laborales asociados a este síndrome. Método: estudio transversal, descriptivo y correlacional entre 282 profesionales sanitarios de los servicios de emergencia de la ciudad de Ribeirão Preto, Brasil, recolectados de octubre de 2015 a marzo de 2016. Utilizados os instrumentos: Los instrumentos utilizados fueron: cuestionario sociodemográfico, Inventario de Burnout de Maslach, Cuestionario de Trauma Infantil, Inventario de Síntomas de Estrés, Escala de Estrés Percibido, Cuestionario de Exploración Psiquiátrica, Cuestionario de Estilo de Vida Fantástico, Escala de Ansiedad y Depresión Hospitalaria y Escala de Reajuste Social de Holmes-Rahe. Redacción descriptiva de los datos. Prueba Chi-Cuadrado de Pearson o Prueba exacta de Fisher para comprobar la asociación entre variables y posterior análisis de regresión, en el que se calcularon OR, con IC del 95% y nivel de significancia del 5%. Resultados: hubo evidencia estadística de asociación entre Burnout y educación, estrés temprano, estrés, trastornos mentales comunes, estilo de vida, ansiedad y depresión. El análisis de regresión muestra que las variables que influyen en el Burnout son: tipo de servicio (p=0.032; OR=0.187), educación (p=0.029; OR=2.313), percepción de estrés (p=0.037; OR=1.67) y reajuste social (p=0.031; OR=1.279). Conclusión: Este estudio apunta a un perfil para el desarrollo del Burnout, conformado por profesionales sanitarios con educación superior, que sufrieron estrés temprano, que presentan síntomas y percepción de estrés, que no tienen un estilo de vida saludable y presentan síntomas de sufrimiento mental. Dichos resultados pueden ayudar en el desarrollo e implementación de estrategias destinadas a reducir tanto el estrés laboral como la prevalencia del síndrome de Burnout.

RESUMO Objetivo: analisar a associação entre Burnout, estresse, sofrimento mental e demais fatores pessoais e laborais associados a esta síndrome. Método: estudo transversal, descritivo e correlacional entre 282 profissionais de saúde dos serviços de emergências da cidade de Ribeirão Preto, Brasil, coletado de outubro de 2015 a março de 2016. Utilizados os instrumentos: questionário sociodemográfico, Maslach Burnout Inventory, Childhood Trauma Questionnaire, Inventário de Sintomas de Stress, Escala de Estresse Percebido, Psychiatric Screeming Questionnaire, Questionário de Estilo de Vida Fantástico, Escala Hospitalar de Ansiedade e Depressão e Escala de Reajustamento Social de Homes-Rahe. Redação descritiva dos dados. Testes Qui-Quadrado de Pearson ou Exato de Fisher para verificar a associação entre as variáveis e posteriormente análise de regressão, na qual foram calculados OR, com IC de 95% e o nível de significância de 5%. Resultados: houve evidência estatística de associação entre Burnout e escolaridade, estresse precoce, estresse, transtornos mentais comuns, estilo de vida, ansiedade e depressão. A análise de regressão evidencia que as variáveis que influenciam no Burnout são: tipo de serviço (p=0,032; OR=0,187), escolaridade (p=0,029; OR=2,313), percepção de estresse (p=0,037; OR=1,67) e reajustamento social (p=0,031; OR=1,279). Conclusão: este estudo aponta um perfil para o desenvolvimento de Burnout, constituído por profissionais de saúde com maior escolaridade, que sofreram estresse precoce, que apresentam sintomas e percepção de estresse, que não possuem um estilo de vida saudável e apresentam sintomas de sofrimento mental. Tais resultados podem auxiliar no desenvolvimento e implementação de estratégias visando reduzir tanto o estresse laboral como a prevalência da síndrome de Burnout.

Confirmatory factorial analysis of the Maslach Burnout Inventory - Human Services Survey in health professionals in emergency services / Análise fatorial confirmatória do Maslach Burnout Inventory - Human Services Survey em profissionais de saúde dos serviços de emergência / Análisis factorial confirmatorio del Maslach Burnout Inventory - Human Services Survey en profesionales de la salud de los servicios de emergencia

Objective: to confirm the factorial validity of the Maslach Burnout Inventory - Human Services Survey version in a sample of health professionals from the emergency services. Method: a quantitative, exploratory, descriptive and analytical study. Two hundred and eighty-two health professionals participated in the study. For data collection, a sociodemographic questionnaire and the Maslach Burnout Inventory were used. The psychometric sensitivity for the MBI-HSS items was estimated by measures of central tendency, variability and the distribution shape. Internal consistency was estimated using Cronbach's alpha coefficient and the adequacy of the sample was verified using the Kaiser-Meyer-Olkin (KMO) index. As indexes for assessing the quality of fit of the model, the chi-square ratio by the degrees of freedom (χ2/DoF), the comparative fit index (CFI), the goodness of fit index (GFI), the Tucker Lewis index (TLI) and the root mean square error of approximation (RMSEA) were considered. To test data fit, the maximum likelihood method was used. Results: the three-factor structure of the Maslach Burnout Inventory was confirmed. Items 9, 12, 15 and 16 had a factorial weight below what was considered appropriate and were removed from the model. The second order hierarchical model with the aforementioned modifications presented an adequate adjustment to the data and can be considered the best and most parsimonious model tested according to the information theory indexes. The internal consistency of the instrument's factors was recalculated considering the exclusion of the items and the three factors were considered adequate. Conclusion: the results obtained show that the Maslach Burnout Inventory is a reliable and factorially valid instrument for measuring the burnout syndrome in emergency service professionals in Brazil.

Objetivo: confirmar a validade fatorial do Maslach Bunout Inventory - versão Human Services Survey numa amostra de profissionais da saúde dos serviços de emergência. Método: estudo de abordagem quantitativa, exploratório, descritivo e analítico. Participaram do estudo 282 profissionais de saúde. Utilizou-se para a coleta de dados, um questionário sociodemográfico e o Maslach Burnout Inventory. A sensibilidade psicométrica dos itens do Maslach Bunout Inventory - versão Human Services Survey foi estimada pelas medidas de tendência central, variabilidade e forma da distribuição. A consistência interna foi estimada por meio do Coeficiente alfa de Cronbach e a adequação da amostra verificada por meio do índice de Kaiser-Meyer-Olkin (KMO). Como índices para a avaliação da qualidade de ajustamento do modelo foram considerados a razão de qui-quadrado pelos graus de liberdade (χ2 /gl), comparative fit index (CFI), goodness of fit index (GFI), índice de Tucker Lewis (TLI) e root mean square error of aproximation (RMSEA). Para testar o ajustamento dos dados utilizou-se o método de máxima verossimilhança. Resultados: confirmou-se a estrutura trifatorial do Maslach Burnout Inventory. Os itens 9, 12, 15 e 16 apresentaram peso fatorial abaixo do considerado adequado e foram removidos do modelo. O modelo hierárquico de segunda ordem, com as modificações mencionadas, apresentou ajustamento adequado aos dados e pôde ser considerado o melhor e mais parcimonioso modelo testado de acordo com os índices da teoria da informação. A consistência interna dos fatores do instrumento foi recalculada considerando-se a exclusão dos itens e foi considerada adequada nos três os fatores. Conclusão: os resultados obtidos mostram que o Maslach Burnout Inventory é um instrumento confiável e fatorialmente válido para medir a síndrome de o burnout em profissionais dos serviços de emergência no Brasil.

Objetivo: confirmar la validez factorial del Maslach Bunout Inventory - versión Human Services Survey en una muestra de profesionales de la salud de los servicios de emergencia. Método: estudio cuantitativo, exploratorio, descriptivo y analítico. Participaron en el estudio 282 profesionales de la salud. Para la recopilación de datos, se utilizó un cuestionario sociodemográfico y el Maslach Burnout Inventory . La sensibilidad psicométrica de los ítems del Maslach Bunout Inventory - versión Human Services Survey se estimó mediante medidas de tendencia central, variabilidad y forma de distribución. La consistencia interna se estimó usando el Coeficiente alfa de Cronbach y la adecuación de la muestra se verificó usando el índice de Kaiser-Meyer-Olkin (KMO). Como índices para evaluar la calidad de ajuste del modelo fueron considerados la razón chi-cuadrado para los grados de libertad (χ 2 /gl), comparative fit index (CFI), goodness of fit index (GFI), índice de Tucker Lewis (TLI) y root mean square error of aproximation (RMSEA). Para probar el ajuste de los datos, se utilizó el método de máxima verosimilitud. Resultados: se confirmó la estructura de tres factores del Maslach Burnout Inventory . Los ítems 9, 12, 15 y 16 presentaron un peso factorial por debajo de lo que se consideraba adecuado y se eliminaron del modelo. El modelo jerárquico de segundo orden, con las modificaciones antes mencionadas, presentó un ajuste adecuado a los datos y puede considerarse el mejor y más parsimonioso modelo probado de acuerdo con los índices de teoría de la información. La consistencia interna de los factores del instrumento se recalculó ponderando la exclusión de los ítems y se consideró adecuada en los tres factores. Conclusión: los resultados obtenidos muestran que el Maslach Burnout Inventory es un instrumento confiable y factorialmente válido para medir el síndrome de burnout en los profesionales de los servicios de emergencia en Brasil.

Apps para dejar de fumar mediante Terapia Cognitivo Conductual. Una revisión sistemática / Apps for smoking cessation through Cognitive Behavioural Therapy. A review

El tabaquismo constituye un problema sanitario y económico de difícil erradicación. Las personas más dependientes a la nicotina suelen presentar, además, problemas psicopatológicos como depresión yansiedad. Según las Guías de Práctica Clínica (GPC), el tratamientorecomendado para abandonar el hábito es la Terapia Cognitivo Conductual (TCC), sola o combinada con medicación. Actualmente, lasaplicaciones móviles (App) en salud (mHealth) permiten un accesomasivo y económico a este tratamiento. El objetivo de este trabajo consiste en llevar a cabo una revisión bibliográfica de las Apps para dejarde fumar que apliquen TCC y describir las técnicas implementadas.En el marco del protocolo PRISMA, la búsqueda se ciñó al periodo2010-19 y se realizó en las bases de datos: EBSCOhost, Cochrane, Webof Science y Scopus. Se hallaron un total de 415 trabajos, de los cuales,tras aplicar los criterios de inclusión/exclusión, solo 5 artículos fueron objeto de revisión. Únicamente se identificaron 3 Apps (en inglés)que incluyeran TCC y, las técnicas más utilizadas fueron: el registrode cigarrillos, la visualización del progreso mediante gráficas, videospsicoeducativos, la motivación, el apoyo social mediante redes socialesy elementos de gamificación para reforzar la adherencia y la conductade abstinencia. Los resultados sugieren incluir en este tipo de Apps elanálisis de la conducta de fumar, ya que no todas lo hacen, así comouna interfaz que comunique el personal sanitario con el usuario ypueda proporcionar un tratamiento personalizado. (AU)

Smoking is a health and economic problem that is difficult to eradicate.Nicotine addicts also often suffer from psychological problems suchas depression and anxiety. The recommended treatment according toclinical practice guidelines (CPG) is Cognitive Behavioural therapy(CBT), alone or combined with medication. Currently, health-relatedapps (m Health) enable wider availability and access to this treatment.The objectives of this study are to carry out a review of the smokingcessation apps that apply CBT and to describe the techniques used bythem. Following the PRISMA framework, the databases EBSCOhost,Cochrane, Web of Science and Scopus were searched for publicationsbetween 2010-2019. Four hundred fifteen studies were found and,after applying the inclusion and exclusion criteria, only five articleswere eligible for systematic review. Only three apps were identifiedas using CBT, and the techniques most commonly used were therecording of smoking history, progress visualised through graphics,psycho-educational videos, motivation, social support through socialmedia, and elements of gamification to reinforce adherence and abstinence behaviour. The results recommend the inclusion of smokingbehaviour analysis in these types of apps, as not all of them do so, aswell as an interface between the health professionals and the users toprovide a personalised treatment. (AU)

The Role of Neuroticism in Predicting Psychological Harassment in Nursing: A Longitudinal Study.

Psychological harassment is a serious occupational risk for nurses, but little is known about its related factors and possible predictors. The objective of the present study was to investigate whether nursing students' neuroticism trait and coping styles can predict psychological harassment at work when they later become nurses. A non-experimental, longitudinal, three-wave prospective study with a time lag of 6 years was carried out, following nursing students from three Spanish universities until they joined the health labor market. The age range of the sample was 20⁻48 years, and the mean age was 26.99 ± 5.72; the majority of the sample were women (88.5%). Predictor variables were neuroticism and coping styles (emotional and behavioral coping). The criterion variable was psychological harassment. To examine the model fit between the predictor and criterion variables, we conducted structural equation modelling. Results confirmed a high correlation between neuroticism and psychological harassment. In addition, a direct effect of neuroticism on psychological harassment was found; however, emotional and behavioral coping styles did not show a good fit. Proactive interventions to improve emotional self-control are needed in order to prevent negative effects of psychological harassment at work on nurses.

Effects of Stress on Critical Care Nurses: A National Cross-Sectional Study.

BACKGROUND:: Health care is a demanding field, with a high level of responsibility and exposure to emotional and physical danger. High levels of stress may result in depression, anxiety, burnout syndrome, and in extreme cases, post-traumatic stress disorder. The aim of this study was to determine which personal, professional, and organizational variables are associated with greater perceived stress among critical care nurses for purposes of developing integrative solutions to decrease stress in the future. METHODS:: We conducted a correlation research survey using a cross-sectional design and an in-person survey method. The questionnaire consisted of 2 parts: (1) socioeconomic, professional, and institutional variables and (2) work stressors. Surveys were conducted between January 1, 2011, and December 1, 2015. Multistage cluster random sampling was utilized for data collection. Inclusion criteria were (1) age ≥18 years, (2) registered nurse, (3) works in the intensive care unit (ICU), and (4) willing and able to complete the survey. RESULTS:: We surveyed 21 767 ICU nurses in Iran and found that male sex, lower levels of peer collaboration, working with a supervisor in the unit, nurse-patient ratios, and working in a surgical ICU were positively associated with greater stress levels. Increasing age and married status were negatively associated with stress. Intensive care unit type (semi-closed vs open), ICU bed number, shift time, working on holidays, education level, and demographic factors including body mass index, and number of children were not significantly associated with stress levels. CONCLUSION:: As the largest study of its kind, these findings support those found in various European, North, and South American studies. Efforts to decrease workplace stress of ICU nurses by focusing on facilitating peer collaboration, improving resource availability, and staffing ratios are likely to show the greatest impact on stress levels.

Implicaciones del hostigamiento psicológico (mobbing) sobre los testigos: Un estudio observacional en enfermería / Implications of psychological harassment on witnesses: an observational study in nursing staff

El hostigamiento psicológico en el trabajo (mobbing) es un problema de considerable magnitud para el personal de enfermería a nivel mundial. Aunque el maltrato psicológico laboral esté basado en comportamientos subjetivos, el elevado número de personas que lo testifica plantea, como mínimo, una mayor reflexión sobre este tema. El objetivo de este estudio es analizar la problemática del mobbing desde el punto de vista exclusivo de los testigos y conocer las repercusiones psicológicas del fenómeno sobre los mismos. Se realizó un estudio descriptivo transversal, usando cuestionarios autoadministrados. La muestra está compuesta de 204 profesionales de enfermería, de los cuales el 28.4% reportaron haber testificado conductas hostiles hacia sus compañeros de trabajo. Las conductas más observadas fueron el desprestigio profesional, la humillación, el rechazo profesional, el ninguneo y el aislamiento profesional. Los resultados demostraron que los testigos de hostigamiento psicológico, aunque no se percibían víctimas de ello, presentaban significativamente más síntomas de estrés que los no testigos, así como un mayor deseo de abandonar la profesión y una mayor percepción de que la enfermería es una profesión poco valorada. Los resultados indican que el mobbing en enfermería es un comportamiento objetivable y que su impacto repercute negativamente en los observadores del mismo, convirtiéndolos en víctimas secundarias del fenómeno (AU)

Psychological harassment at work (mobbing) is considered a worldwide problem of great magnitude for nursing staff. Although hostility is described as a subjective behavior, the large number of witnesses suggests a reflection on the phenomenon. The aim of this study is to analyze the problem of psychological harassment from the point of view of the witnesses, and to find out the psychological impact of this phenomenon on them. We performed a cross-sectional study using self-administered questionnaires. The sample consisted of 204 nurses who were non-victims of mobbing. 28.4% (n = 58) of them reported to have observed hostile behavior toward coworkers. The most observed behaviors were professional discrediting, professional humiliation, rejection, scorn, and professional isolation. It was found that the witnesses of mobbing had significantly more symptoms of stress than non-witnesses, a greater desire to leave the profession, and a greater perception that nursing is an undervalued profession. The results indicate that mobbing in nursing is an objective behavior and its impact reaches observers thereof, who may be secondary victims of the phenomenon. The results indicate that mobbing in nursing is an objective behavior and its impact reaches observers thereof, which could be considered secondary victims of the phenomenon (AU)

Coping, stress, and personality in Spanish nursing students: A longitudinal study.

The purpose of this study was to examine the dominant stress coping style in nursing students, its relationships with stressful life events and personality traits, and the students' changes during their academic training. A non-experimental two-wave longitudinal design was carried out in 199 nursing students recruited from three Spanish nursing schools. The Stressful Life Events Scale, NEO-FFI, and COPE questionnaire were administered at the beginning (T1) and end (T2) of their nursing studies. Descriptive statistics, Anova(s), NPar tests, and Pearson correlations were carried out. Results show that nursing students' dominant coping style was emotion-focused coping, both at T1 and T2. Highly significant correlations between emotional coping and the neuroticism trait were found. Coping, stress, and personality changed positively during the training program. At T2, the use of problem-focused strategies increased, and participants became more extroverted, agreeable, and conscientious. Coping and personality changes experienced by nursing students throughout their degree program seem to mirror the professional competences needed by future licensed nurses.

The effect of progressive muscle relaxation on daily cortisol secretion.

Abbreviated progressive muscle relaxation (APMR) is a much used stress-management technique. Its efficacy relevant to placebo control is already established in the literature and the primary aim of the present study was to ascertain whether its proven impact on psychological stress measures is matched by a decrease in prevailing levels of the stress-associated hormone cortisol, using accurate and robust measurement based on multiple sampling of full diurnal cortisol secretion profiles. First-year university students can face significant stress in adjustment to academic demands and immersion in a novel social network and provided a convenient study population. One hundred and one first-year students completed APMR with prevailing stress levels assessed a week before and after intervention. Both cortisol and self-report measures were significantly reduced post-intervention by 8% and 10%, respectively. The efficacy of the intervention was independent of, and not modulated by neuroticism, gender, age and smoking status. We also demonstrated that cortisol reduction was unlikely to have been a consequence of adaptation to any initial cortisol elevation prompted by the challenge of the demanding saliva collection protocol. We conclude that the efficacy of APMR in this population extends to reduction in biologically expressed stress levels as well as levels based solely on self-report.

Estrés psicológico y problemática musculoesquelética. Revisión sistemática / Psychological stress and musculoskeletal problems. Systematic review

Objetivo. Analizar los diseños epidemiológicos más utilizados en el estudio de la relación entre estrés psicológico y problemática musculoesquelética. Metodología. Búsqueda bibliográfica con criterios de inclusión y exclusión específicos, en PubMed/Medline, EBSCOhost y revistas electrónicas de diversas disciplinas siguiendo las recomendaciones del estándar PRISMA. Se extrajeron 2782 artículos de los cuales fueron seleccionados 41 para la revisión. Resultados. Más del 80% de los estudios confirmaron la relación entre estrés psicológico y problemática musculoesquelética, determinando que los niveles de estrés mantenidos aumentan el riesgo de aparición de sintomatología, sobre todo en lumbares y cervicales. Del total de estudios, más del 50% fueron de diseño transversal y 77% sobre temática laboral. La población más vulnerable fue la femenina, especialmente funcionarios y trabajadores de oficina. Las “Demandas laborales” constituyeron el estresor psicosocial más descrito. Respecto a los instrumentos de medición más usados, destacan el “Stress Energy Questionnaire”, el “Job Content Questionnaire” y el “Standardized Nordic Musculoskeletal Questionnaire”. Conclusión: Los estudios sobre estrés psicológico y problemática musculoesquelética tienen diseños y resultados heterogéneos. Los hallazgos resaltaron múltiples estresores psicosociales y áreas corporales afectadas, siendo escasos los consensos en diagnósticos e instrumentos de medida. Aunque aparece una asociación entre estrés psicológico y problemas musculo esqueléticos, no se vislumbran relaciones causales claras. Dado el elevado coste de estos problemas, se considera necesario realizar más estudios con diseños y metodologías rigurosas (AU)

Objective: Analyze the epidemiological approach more used in the study of the relationship between psychological stress and musculoskeletal problems. Methodology: Bibliographic research with specific inclusion and exclusion criteria on PubMed / Medline, EBSCOhost and electronic journals from diverse disciplines following the recommendations of PRISMA standards. 2782 articles were extracted, of which 41 were selected for the revision. Results: More than 80% of the articles confirmed that maintained stress levels increase the risk of developing musculoskeletal symptoms, especially in the lower back and neck. Over 50% of the studies followed a transversal design, and 77% of them dealt with labour issues. The most vulnerable population were women working in civil service or white collars, and labour demands was the most described psychosocial stressor. Regarding measurement instruments, the most used were the Energy Stress Questionnaire, the Job Content Questionnaire, and the Standardized Nordic Musculoskeletal Questionnaire. Conclusion: Studies on psychological stress and musculoskeletal problems had heterogeneous results and designs. The findings highlight multiple psychosocial stressors and body areas affected and there was little consensus on diagnosis and measuring instruments. Although there was an association between psychological stress and musculoskeletal problems, their causal relationships are unclear. Given the higher cost of this problem, it is necessary to develop more studies with designs and rigorous methodologies (AU)

Stress and neuroticism in Spanish nursing students: a two-wave longitudinal study.

The aim of this study was to clarify the direction of the stress-neuroticism relationship in a sample of 200 nursing students from three Spanish universities before their entry into the work force using a two-wave longitudinal design. The Stressful Life Events Scale and NEO-FFI Neuroticism subscale were administered at the beginning (T1) and end (T2) of nursing studies. Female students reported higher scores in both perceived stress due to life events and neuroticism than males. Older students scored higher in life events stress than younger ones. High neuroticism was associated with a high level of stress. Finally, neuroticism scores rose in the group in which stress increased from T1 to T2. Our findings partially support the stress causation interactionist model of stress in which life events can modify personality traits.

[Socioprofessional variables involved in mobbing in nursing]. / Variables socioprofesionales implicadas en el hostigamiento psicológico en enfermería.

OBJECTIVE: To determine the type, frequency and cause of the most frequent hostile behaviors in a sample of nurses in the Balearic Islands and the socio-professional variables involved. METHOD: We performed a cross-sectional descriptive study. The sample was composed of 464 members of the association of nurses of the Balearic Islands (392 women and 49 men). Age ranged from 25 to 65 years (mean: 35.11; SD: 9.62); 368 worked in public institutions and 71 in private centers. The instrument used was the Psychological Mobbing Questionnaire. RESULTS: A total of 17.2% of the nurses believed they had experienced mobbing at work (men: 22.4%; women: 14.5%). Significant differences were found according to age, but not according to institution. The most frequent hostile behavior was related to distortion of information, criticism of the purported victim, and lack of professional consideration. The perpetrators of mobbing were mainly, and very significantly, the bosses. CONCLUSIONS: According to these results, one in five nurses in the Balearic Islands has experienced mobbing in the workplace. However, because of the low response rate, caution should be exercised when generalizing these results. Nevertheless, health institutions should bear these findings in mind to ensure standards of behavior that do not jeopardize workers' health and dignity.

Variables socioprofesionales implicadas en el hostigamiento psicológico en enfermería / Socioprofessional variables involved in mobbing in nursing

Objetivo. Determinar tipo, frecuencia y procedencia de conductas hostiles habituales en una muestra de enfermeras de Baleares y las variables socioprofesionales implicadas.Método. Estudio transversal y descriptivo. Muestra constituida por 464 enfermeras y enfermeros colegiadas en la Comunidad Autónoma de les Illes Balears: 392 mujeres y 49 varones. Edad situada entre 25 y 65 años (media: 35,11 y desviación típica = 9,62). Trabajaban en instituciones públicas 368 y en privadas 71. Instrumento utilizado: Cuestionario de Hostigamiento Psicológico-HPT.Resultados. El 17,2% de las enfermeras encuestadas se percibe hostigada psicológicamente en el trabajo (varones: 22,4%; mujeres: 14,5%). Aparecen diferencias muy significativas según la edad, pero no según la institución. Los comportamientos hostiles más frecuentes se refieren a distorsiones en la información, críticas hacia la supuesta víctima y falta de consideración profesional. Estas conductas proceden mayoritariamente y de forma muy significativa de los jefes.Conclusiones. Los resultados muestran que 1 de cada 5 enfermeras de Baleares se percibe hostigada. Sin embargo,la baja tasa de respuesta obliga a ser cautos en la generalización. Aun así, consideramos que son datos que hay que tener en cuenta por parte de las instituciones sanitarias para que los órganos de prevención aseguren uncomportamiento que proteja la salud y dignidad de los trabajadores

Objective. To determine the type, frequency and cause of the most frequent hostile behaviors in a sample of nurses in the Balearic Islands and the socio-professional variables involved. Method. We performed a cross-sectional descriptive study. The sample was composed of 464 members of the association of nurses of the Balearic Islands (392 women and 49 men). Age ranged from 25 to 65 years (mean: 35.11; SD: 9.62); 368 worked in public institutions and 71 in private centers. The instrument used was the Psychological Mobbing Questionnaire. Results. A total of 17.2% of the nurses believed they had experienced mobbing at work (men: 22.4%; women: 14.5%). Significant differences were found according to age, but not according to institution. The most frequent hostile behavior was related to distortion of information, criticism of the purported victim, and lack of professional consideration. The perpetrators of mobbing were mainly, and very significantly, the bosses. Conclusions. According to these results, one in five nurses in the Balearic Islands has experienced mobbing in the workplace. However, because of the low response rate, caution should be exercised when generalizing these results. Nevertheless, health institutions should bear these findings in mind to ensure standards of behavior that do not jeopardize workers’ health and dignity

[Mobbing in nursing. A pilot study]. / Hostigamiento psicológico (mobbing) en enfermería. Un estudio piloto.

While planning to help shed light on the phenomenon of mobbing in the work place and to develop an instrument by which to measure it, the authors carried out a pilot study in which 160 persons from varying professional classes and autonomous communities in Spain participated, 65 of whom were nurses whose ages lie between 20 and 48 years, with a medium age of 33.98. By means of a factorial analysis, the authors discovered that the most common mobbing practices are grouped in a set of eight factors; these eight factors cover 74.17% of all the various factors. The two most significant factors refer to behaviors which can be considered to be personal humiliation and professional discredit. The most common mobbing practice, according to the overall findings of this study group, consists in providing contradictory information to the victim (19.4% once or more times per week), while in nursing, this practice consists of exposing the victim to criticism by the group (50%).

Hostigamiento psicológico (mobbing) en enfermería. Un estudio piloto / Mobbing in nursing. A pilot study

Con el propósito de contribuir a poner luz al fenómeno del hostigamiento psicológico en el trabajo y depurar un instrumento para su medida, se realiza un estudio piloto en el que participan 160 personas de diferentes estamentos profesionales y comunidades autónomas de España, 65 de las cuales son enfermeros/as, con edades comprendidas entre los 20 y los 48 años (Med = 33,98; dt = 6,83). A través de un análisis factorial se identificó que las prácticas de hostigamiento más habituales se agrupaban en ocho factores que explican el 74,17 por ciento de la varianza. Los dos factores más representativos se refieren a comportamientos de humillación personal y desacreditación profesional. La práctica de hostigamiento más habitual para la totalidad del grupo consiste en proporcionar información contradictoria a la víctima (19,4 por ciento una o más veces a la semana), y en enfermería, la exposición a críticas por parte del grupo (50 por ciento) (AU)

Ansiedad-estrés en Enfermería / Anxiety and stress in Nursing

En este artículo, parte integrante de un trabajo más amplio, se presentan los resultados obtenidos del análisis efectuado para averiguar la relación entre algunas variables sociolaborales y el estrés en enfermería. Los datos evidencian que existen algunas variables, tales como los años de ejercicio profesional, el tiempo de permanencia en un servicio/unidad, la asignación y el tipo de acomodación a estas unidades, que pueden ser predictoras de ciertos niveles de estrés en el colectivo de enfermería (AU)