Prevalence and levels of burnout in nursing students: A systematic review with meta-analysis.

AIM: The aim of this study was to analyze burnout levels and prevalence in nursing students and to estimate prevalence levels with meta-analyses. BACKGROUND: Nurses are one of the healthcare professionals most affect by burnout, but nursing students, during their studies, can also suffer burnout. DESIGN: a systematic review with meta-analysis was performed. METHODS: The search equation used in Pubmed, CINAHL and Scopus databases was "burnout AND nursing students". Quantitative primary studies including information about burnout, emotional exhaustion, depersonalization, or personal accomplishment in nursing students were included. Four meta-analysis were performed. RESULTS: the sample was of n = 34 studies, with n = 15 studies being included in the meta-analysis with n = 2744 nursing students. Burnout prevalence was 19% (95% CI 11-28%). Regarding burnout dimensions, the most affected was high emotional exhaustion with a prevalence of 41%(95% CI 23-61%; n = 2222) followed by 27% low personal accomplishment(95% CI 9-49%; n = 2096), 25% high depersonalization (95% CI 15-36%; n = 2096). CONCLUSIONS: Prevalence of burnout and its dimensions vary from 19% to 41%, being emotional exhaustion the main problem in nursing students. This problem may affect their future as nursing professionals, and it would be of important to prevent and to treat burnout at university levels.

Factors related to the appearance and development of burnout in nursing students: a systematic review and meta-analysis.

Introduction: Burnout may be suffered not only by experienced nurses, but also by those in training. The university environment can be highly stressful for student nurses, who are exposed to various stress-producing situations. Aim: The aim of this study is to identify and analyse the main risk factors for burnout among nursing students. Methods: A systematic review with meta-analysis was performed. The search equation used was "Burnout AND Nursing students". Quantitative primary studies on burnout in nursing students, and related risk factors published in English or Spanish and with no restriction by year of publication were included. Results: A sample of n = 33 studies were included. Three variables are identified can influence burnout in nursing students: academic, interpersonal, environmental and/or social factors. The meta-analyses, with the higher sample of n = 418 nursing students, show that some personality factors, empathy, and resilience are correlated with emotional exhaustion, depersonalization and personal accomplishment. Conclusion: The personality factors that can influence the development of burnout in nursing students, such as resilience and empathy, among others, must be taken into account when preventing the appearance and treating burnout. Professors should teach nursing students to prevent and recognize the most frequent symptoms of burnout syndrome.

Does Self-Directed Learning with Simulation Improve Critical Thinking and Motivation of Nursing Students? A Pre-Post Intervention Study with the MAES© Methodology.

Motivation and critical thinking are fundamental for the development of adequate learning. The purpose of the present study was to assess the motivation for learning and critical thinking among nursing students before and after self-directed simulation-based training using the MAES© methodology. A cross-sectional and descriptive quantitative study was conducted with a sample of third-year nursing students. The instruments utilized were the Spanish-adapted version of the Motivated Strategies for Learning Questionnaire (MSLQ-44), and the Critical Thinking for Nursing Professionals Questionnaire (CuPCPE). The students improved their levels both of motivation components, (such as self-efficacy, strategy use, self-regulation) and critical thinking components (such as personal characteristics, intellectual and cognitive abilities, interpersonal abilities and self-management, and technical abilities). These improvements could be a result of the intrinsic characteristics of the MAES© methodology (as a team-based, self-directed, collaborative and peer-to-peer learning method).

Systematic Review of the Relationship between Couple Dyadic Adjustment and Family Health.

The importance of family functioning in the development of child and adult psychopathology has been widely studied. However, the relationship between partners' adjustment and family health is less studied. This paper aims to describe and summarize research that analyzes the relationship between partners' adjustment and family health. A systematic review was conducted in the PubMed, PsycINFO, Scopus, Lilacs, Psicodoc, Cinahl, and Jstor databases. Inclusion criteria were as follows: articles published from 2012 to 2019 in English, Spanish, or Portuguese. Data were extracted and organized according to the family health model: family climate, integrity, functioning, and coping. Initially, 835 references were identified, and 24 articles were assessed for quality appraisal. Finally, 20 publications were selected. Results showed that couple adjustment was an important factor that triggered the emotional climate of the family, was positively intercorrelated to parenting alliance or coparenting, and contributed to family efficacy and help when facing stressful life events. Findings revealed a consensus about the relationship between couple dyadic adjustment and family health. The results could orientate interventions to promote well-being and to increase quality of life and family strength. Health professionals should thoroughly study couple relationships to identify risk factors, assess family skills, and promote family health.

The Relationship between Mindfulness and Emotional Intelligence as a Protective Factor for Healthcare Professionals: Systematic Review.

Emotional intelligence is an essential trait and skill for healthcare professionals. Mindfulness meditation has proved to be effective in increasing the wellbeing of those who practice it, leading to better mental health, self-care and job satisfaction. This paper aims to identify the recent evidence on the relationship between mindfulness and emotional intelligence among healthcare professionals and students. A systematic review was conducted including the databases PubMed, Cinhal, PsycINFO and Web of Science. The main variables were emotional intelligence skills and mindfulness practice. Data were extracted according to the following outcomes: authors, year of publication, country, study design, participants, mindfulness training intervention, tools used in data collection and main results. The following inclusion criteria were applied: peer-reviewed articles; published in English or Spanish; published between 2010 and 2020; quantitative methodology; a study population of healthcare professionals or students; the relationship with the aim of the study. The Joanna Briggs Institute criteria were followed for assessing the methodological quality of the selected studies. Three researchers were involved in the review. After the selection process, 10 studies were selected out of the 197 references initially identified. These studies revealed a positive relationship between mindfulness and emotional intelligence, particularly the capacity to regulate emotions. Furthermore, mindfulness is negatively related to emotional exhaustion. Training interventions based on mindfulness have proved to be useful in promoting emotional balance, emotional awareness, emotional acceptance, emotion recognition, expressive suppression and a reduction in emotional exhaustion. This study could serve as a basis for further research on the benefits of emotional intelligence and practicing mindfulness for the bio-psycho-social welfare of healthcare professionals.

Efectividad del uso de los probióticos en la prevención y el tratamiento de las mastitis durante la lactancia materna. Revisión integrativa / Effectiveness of the use of probiotics in the prevention and treatment of mastitis during breastfeeding. Integrative review

Objetivo: Determinar la efectividad del tratamiento probiótico en la prevención y el tratamiento de la mastitis, y comprobar si existe relación entre el uso de antibióticos pre/intra/posparto por causa extrínseca y la posterior aparición de mastitis. Metodología: Se realiza una revisión por pares en las bases de datos MEDLINE, CINAHL, CUIDENplus, Scopus, WoS y Cochrane Library. La estrategia de búsqueda se ha llevado a cabo a partir de los descriptores MeSH: «probióticos/probiotics», «mastitis/mastitis», «lactancia materna/ breast feeding», «prevención/prevention», «tratamiento/treatment» y «terapéutica/therapeutics». Resultados: Se obtuvo un total de 34 artículos potencialmente útiles. Tras la aplicación de los criterios de inclusión/exclusión, se han seleccionado 8 investigaciones a nivel nacional e internacional de los últimos 5 años. La toma de probióticos muestra una disminución en la carga de estafilococos, el dolor asociado y la incidencia global de mastitis; los probióticos más usados eran Lactobacillus salivarius PS2 y Lactobacillus fermentum CECT5716. La relación existente entre la ingesta de antibióticos pre/intra/posparto y la aparición de mastitis en el periodo puerperal parece confirmarse. Conclusiones: A pesar de que los probióticos muestran eficacia en la prevención y el tratamiento de la mastitis puerperal, son necesarias más investigaciones para verificar su instauración de forma reglada. Parece que el uso de antibióticos podría afectar a la posterior aparición de mastitis, aunque no se conoce el momento de la administración. (AU)

Objetive: To determine the effectiveness of probiotic treatment in the prevention and treatment of mastitis, as well as know if there is a link between the use of pre, intra- and postpartum antibiotics, for extrinsic cause and the subsequent onset of mastitis. Methodology: A peer review was carried out of the MEDLINE, CINAHL, CUIDENplus, Scopus, WoS and Cochrane Library databases. The search was narrowed on the basis of the MeSH descriptors: “probióticos/probiotics”, “mastitis/mastitis”, “lactancia materna/breast feeding”, “prevención/prevention”, “tratamiento/treatment” and “terapéutica/therapeutics”. Results: With a total of 34 potentially useful articles. Following the application of the inclusion/exclusion criteria, 8 national and international investigations have been considered over the past 5 years. Taking probiotics shows a decrease in staph load, associated pain and overall incidence of mastitis; being the most commonly used probiotics Lactobacillus salivarius PS2 and Lactobacillus fermentum CECT5716. The relationship between pre, intra- and postpartum antibiotic intake and the onset of mastitis in the postpartum period appears to be related. Conclusions: Although probiotics have been shown to be efficacious in the prevention and treatment of puerperal mastitis, further research is needed to verify whether their use should be implemented in a regulated manner. It seems that the use of antibiotics may affect subsequent occurrences of mastitis, although the timing of administration remains unknown. (AU)

Prevalence, Related Factors, and Levels of Burnout Among Midwives: A Systematic Review.

INTRODUCTION: Burnout refers to a constellation of feelings of exhaustion, depersonalization, and low sense of personal accomplishment that develops secondary to long-term occupational stress. Several studies have identified that health care professionals are a high-risk occupational group for burnout, but knowledge about this syndrome among midwives has not been fully explored. The purpose of this study was to perform a systematic review of the prevalence and levels of burnout among midwives and analyze the related factors. METHODS: The following databases were searched: CINAHL, LILACS, MEDLINE, ProQuest, PsycINFO, SciELO, and Scopus. Any date of publication was acceptable. Literature from different countries was included. Studies were appraised for quality following the recommendations of the Oxford Centre for Evidence-Based Medicine. RESULTS: The literature review identified 27 studies with a total of N = 5612 midwives. The main factors related to burnout were working conditions such as work overload, lack of autonomy, and professional recognition. Midwives who had less than 10 years of experience were more vulnerable to burnout than those who had more than 10 years' experience. With regard to the subcategories of burnout (emotional exhaustion, depersonalization and perceived personal achievement), midwives who did not live with a partner were more vulnerable low levels of personal accomplishment when compared with midwives who were living with a partner. The most significant protective factors against burnout were good leadership and the use of continuity models of care. DISCUSSION: Midwives had moderate levels of emotional exhaustion and low levels of personal accomplishment. Working conditions were identified as the main modifiable factors related to burnout syndrome. Intervention programs for midwives should be aimed at reducing emotional exhaustion and enhancing personal accomplishment.

Assessment of the Anxiety Level of Andalusian Podiatrists during the COVID-19 Pandemic: The Increase Phase.

Coronavirus disease (COVID-19) is caused by SARS-CoV-2 and represents the causative agent of a potentially fatal disease that is of great global public health concern. COVID-19 is a respiratory disease produced by the coronavirus family. The World Health Organization declared the disease a pandemic on 11 March 2020. Podiatrists are in a peculiar situation regarding the COVID-19 pandemic: that of a health professional aspect and the singularity that most of them practise as self-employed workers. The aim of the study is to evaluate in a group of podiatrists, working at a national level, their knowledge, perception and degree of anxiety related to the COVID-19 pandemic via the use of a questionnaire specifically developed to this end in the initial phase of the pandemic. We employed a transversal descriptive study with 302 participants, with a purposive sampling technique. The degree of perception and knowledge of the podiatrists about COVID-19 was analysed as well as the cognitive impact of the situation of confinement. The results showed that the podiatrists perceive this situation as serious at the economic and health level, that they have a thorough knowledge of the disease and that they are in a moderate to severe percentile of anxiety. Additionally, 76.2% cancelled their usual work. The COVID-19 pandemic is negatively perceived by this group of podiatrists at the personal, professional, health and economic level, with even a state of anxiety being produced.

Burnout in Palliative Care Nurses, Prevalence and Risk Factors: A Systematic Review with Meta-Analysis.

Palliative care nurses are exposed to hard situations, death, and duel feelings in their daily practice. These, and other work stressors, can favor burnout development. Thus, it is important to analyze the prevalence and risk factors of burnout in palliative care nurses and estimate its prevalence. A systematic review and meta-analysis was done with quantitative primary studies. n = 15 studies were included with n = 6 studies including information for the meta-analysis. The meta-analytic prevalence estimation of emotional exhaustion was 24% (95% CI 16-34%), for depersonalization was 30% (95% CI 18-44%) and for low personal accomplishment was 28% with a sample of n = 693 palliative care nurses. The main variables related with burnout are occupational variables followed by psychological variables. Some interventions to improve working conditions of palliative care nurses should be implemented to reduce burnout.

Probiotics as a Coadjuvant Factor in Active or Quiescent Inflammatory Bowel Disease of Adults-A Meta-Analytical Study.

(1) Background: Inflammatory bowel diseases are pathologies of unknown etiology and auto-immune pathogenia. The use of probiotics is studied in order to increase the arsenal of treatments. The aim was to assess the efficacy of the probiotics in these diseases in the active or quiescent phases; (2) Methods: A systematic review with meta-analysis was performed by an exhaustive bibliographic search in Medline, Cinahl, Embase, Scopus, Web of Science, and Cochrane Library. The inclusion criteria were studies of more than 10 years, English/Spanish, clinical trials, and involving human beings. Relative risk was used to compare efficacy, which was meta-analyzed using a fixed effects model. Heterogeneity was evaluated with the Higgins I2 test; (3) Results: Nineteen studies were included in the systematic review and 17 in the meta-analysis, with a total of 1537 patients (nexperimental group = 762; nplacebo group = 775). There are significant remission differences in ulcerative colitis (relative risk (RR) = 0.81; 95% CI = 0.72-0.91; I2 = 32%; p = 0.16). However, no significant differences were found in the use of probiotics for the prevention of ulcerative colitis, and for the remission of Crohn's disease; (4) Conclusions: There are data showing an additional beneficial effect of probiotics on active ulcerative colitis. More and better studies are needed which assess its possible therapeutic efficacy for quiescent ulcerative colitis and for Crohn's disease.

Prevalence of Depression in Retirees: A Meta-Analysis.

Background: Retirement is a final life stage characterized by the ceasing of work and the loss of a routine, social relations, role, status, accomplishments, and aspirations, etc. Many times it is accompanied by negative feelings and can provoke different psychoemotional reactions such as depression, among others. The aim of this study is to analyze the prevalence of depression, as well as its psychoeducational approach in retirees. Methods: A paired systematic review with meta-analysis was conducted in different databases-Medline, Scopus, CUIDEN, CINAHL, LILACS and PsycINFO. Original studies were included in English, Spanish and French that were published in the last 10 years, and which approached depression in retirees. Results: A total of 11 articles were selected after applying inclusion and exclusion criteria. The mean value of the prevalence levels of depression in retirees obtained in the meta-analysis was 28%. Depression is more frequent in retirees, with mandatory retirement, retirement due to illness, and anticipated retirement presenting higher levels of this disease. The health role in the psychoeducational approach is highlighted in 41.6% (n = 5). Conclusions: With almost one-third of retirees suffering from depression, it is necessary to implement prevention and early detection measures to approach a public health problem.

Prevalence and Predictors of Burnout in Midwives: A Systematic Review and Meta-Analysis.

The prevalence of burnout in midwives has been briefly studied. Given the negative effects of burnout syndrome in the physical and mental health, and also related to the quality of care provided, rates of absenteeism and sick leave; identifying related factors for the syndrome are needed. The aim was to determine the prevalence, levels, and factors related to the burnout syndrome, measured with the Copenhagen Burnout Inventory in midwives. A systematic review and meta-analysis were selected from CINAHL, LILACS, ProQuest, PsycINFO, PubMed, SciELO, and Scopus databases, with the search equation "burnout AND (midwife OR midwives OR nurses midwives)". Fourteen articles were found with a total of 8959 midwives. Most of the studies showed moderate levels of personal burnout. The prevalence obtained was 50% (95% CI = 38-63) for personal burnout; 40% (95% CI = 32-49) for work-related burnout; and 10% (95% CI = 7-13) for client-related burnout. Midwives' age, less experience, and living alone constitute the main related factors, as well as, the scarcity of resources, work environment, and the care model used. Most midwives present personal and work-related burnout, which indicates a high risk of developing burnout. Personal factors and working conditions should be taken into account when assessing burnout risk profiles of midwives.

Impact of social support in preventing burnout syndrome in nurses: A systematic review.

AIM: Burnout is a reality in the nursing profession. It is composed of three dimensions: emotional exhaustion, depersonalization and reduced personal accomplishment, and results from being subjected to chronic stress in the healthcare context. Social support (SS), that is, the assistance and protection given by others, is a predictive and protective factor against burnout syndrome. The aim of this study is to analyze the relationship between SS, in its different forms, and burnout syndrome in nurses, and to identify the risk factors for burnout. METHODS: A systematic literature review was carried out, following the PRISMA recommendations. The databases CINAHL, PsycINFO, Proquest Platform (Proquest Health & Medical Complete), Pubmed and Scopus were consulted, using the descriptors: "burnout, professional AND social support AND nursing". To minimize potential publication bias, the search had no time or sample size limitation. RESULTS: Burnout was reported, to a greater or lesser extent, in all the articles analyzed, and the SS received by nurses in the workplace from supervisors and coworkers was found to play a fundamental role in preventing the syndrome. However, to date the bibliography on this issue is scant, and there is little consensus as to the degree of SS received. CONCLUSIONS: Burnout prevention plans, with particular attention to SS, should be developed to improve nurses' quality of life and to enhance the care they provide.

Influence of Personality Traits and Its Interaction with the Phenomenon of Bullying: Multi-Centre Descriptive Study.

Bullying affects thousands of teenagers worldwide and has devastating consequences. Various studies suggest that the personality of teenagers is a risk profile for bullying. The aim of this study was to analyse the relationship between the personality of teenagers aged 14 to 16 years from three education centres located in the province of Seville (Spain) and bullying in any of its victim or aggressor roles. A multi-centre cross-sectional observational descriptive study was conducted in three education centres in the province of Seville (Spain). The sample consisted of 93 students. In order to measure the two main variables, the Bull-S test was used for bullying, and the EPQ-J questionnaire was used for personality traits. A descriptive and correlation analysis was performed between variables. The results showed that 14% (n = 13) of the sample were detected as victims and another 14% (n = 13) were detected as aggressors. Statistically significant differences were found between neuroticism (p = 0.044; Phi = 0.615), sincerity (p = 0.016; V de Cramer = 0.474), and anti-social behaviour (p = 0.007; Phi = 0.620) with the variables victim/aggressor. Bullies are typically males who score high on neuroticism and anti-social behaviour, with a tendency towards social dissimulation.

A Risk Profile of Sociodemographic Factors in the Onset of Academic Burnout Syndrome in a Sample of University Students.

Studying for a university degree can be very demanding, as students must cope with a variety of academic, social and personal challenges. If these demands persist, and if there are insufficient resources with which to address them, they will eventually provoke stress. When stress is present for long periods of time, it can lead to academic burnout syndrome, the signs of which are emotional exhaustion, depersonalisation and inadequate personal accomplishment. This paper considers certain sociodemographic factors (age, sex, children, marital status, employment status, degree subject, faculty, academic year) in the identification of a risk profile of developing burnout syndrome. This study is cross-sectional, associative and ex post facto. The Maslach Burnout Inventory-Student Survey was administered to 445 students in the University of Granada. According to the risk profile obtained, first-year male students in Primary Education and Social Education courses are at risk of developing burnout syndrome.

An Explanatory Model of Potential Changes in Burnout Diagnosis According to Personality Factors in Oncology Nurses.

Burnout in a hospital oncology service takes place when there is a high level of interaction between nurses and patients. The aim of the present study is to identify models that will enable us to accurately classify a person at a given level within each of the three dimensions of burnout, according to the values presented for personality related explanatory variables, for a sample of 96 oncology nurses working in the regional health service of Andalusia (Spain). A quantitative, crosscutting, multicentre, descriptive study was designed, and for this purpose data on sociodemographic and personality variables and on the three dimensions of burnout were compiled. Three categorical-response logit ordinal models were used and the prognostic ratios for each level were obtained, with respect to every other level, according to possible changes in the explanatory variables considered. Certain personality factors are associated with one or more dimensions of burnout syndrome. Thus, nurses are more likely to develop high levels of burnout if they present high levels of neuroticism and low levels of friendliness and responsibility. Further research in this field is needed to confirm and extend these findings.

A Multicentre Study of Burnout Prevalence and Related Psychological Variables in Medical Area Hospital Nurses.

BACKGROUND: Nursing burnout is an important problem that affects nurses' wellness, the quality of care and the health institutions. Study aims were to estimate levels of burnout; to determine the phase of burnout experienced by nurses in the medical area; to analyse the relationship between burnout and personality and psychological factors. METHODS: Quantitative, cross-sectional, multicentre study. Hospitals from eight cities were included. The study sample was n = 301 nurses, working in the medical area of hospitals in the Andalusian Health Service during the second semester of 2017. Sociodemographic, occupational and personality variables were studied using the Revised NEO Personality Inventory together with the Educational-Clinical Questionnaire: Anxiety and Depression, and burnout was measured by the Maslach Burnout Inventory. RESULTS: Almost 40% of the nurses presented high levels of burnout. The three burnouts (emotional exhaustion, depersonalisation and personal accomplishment) presented statistically significant correlations with the personality factors of neuroticism, extraversion, openness, agreeableness and conscientiousness, and also with the scores recorded for anxiety and depression. Multiple linear regression models showed agreeableness and depression to be statistically significant predictors of all dimensions of the syndrome. CONCLUSION: Hospital nurses working in the medical area in Andalusia experience high levels of burnout.

Levels of Burnout and Risk Factors in Medical Area Nurses: A Meta-Analytic Study.

Research findings concerning burnout prevalence rate among nurses from the medical area are contradictory. The aim of this study was to analyse associated factors, to determine nurse burnout levels and to meta-analyse the prevalence rate of each burnout dimension. A systematic review, with meta-analysis, was conducted in February 2018, consulting the next scientific databases: PubMed, CUIDEN, CINAHL, Scopus, LILACS, PsycINFO and ProQuest Health & Medical Complete. In total, 38 articles were extracted, using a double-blinded procedure. The studies were classified by the level of evidence and degrees of recommendation. The 63.15% (n = 24) of the studies used the MBI. High emotional exhaustion was found in the 31% of the nurses, 24% of high depersonalisation and low personal accomplishment was found in the 38%. Factors related to burnout included professional experience, psychological factors and marital status. High emotional exhaustion prevalence rates, high depersonalisation and inadequate personal accomplishment are present among medical area nurses. The risk profile could be a single nurse, with multiple employments, who suffers work overload and with relatively little experience in this field. The problem addressed in this study influence the quality of care provided, on patients' well-being and on the occupational health of nurses.

Gender, Marital Status, and Children as Risk Factors for Burnout in Nurses: A Meta-Analytic Study.

The correlation between the burnout syndrome and sociodemographic variables in nursing professionals has been widely studied though research results are contradictory. The aim of this study was to assess the impact of gender, marital status, and children on the dimensions of the burnout syndrome (emotional exhaustion, depersonalization, and personal accomplishment) in nursing professionals, as measured with the Maslach Burnout Inventory. The search was performed in May 2018 in the next databases: CINAHL, CUIDEN, Dialnet, Psicodoc, ProQuest Platform, OVID Platform, and Scopus with the search equation ("Maslach Burnout Inventory" OR "MBI") AND "nurs*", without using any search restriction. The sample was n = 78 studies: 57 studies for gender; 32 for marital status; 13 for having children. A statistically significant relation between depersonalization and gender (r = 0.078), marital status (r = 0.047), and children (r = 0.053) was found. A significant relation was also found between emotional exhaustion and children (r = 0.048). The results showed that being male, being single or divorced, and not having children were related to the highest levels of burnout in nurses. Moreover, these relations could be accentuated by the influence of moderator variables (age, seniority, job satisfaction, etc.), which, in combination with the previously mentioned significant relations, should be evaluated in the design burnout risk profiles for nursing professionals.