Neuropsychology of frontal lobe epilepsy in children and adults: Systematic review and meta-analysis.

Frontal lobe epilepsy (FLE) is associated with cognitive problems, especially in areas related to frontal lobe functioning as executive functions, attention, and motor skills, but with impact on memory and psychosocial adaptation. Deficits are similar in both adults and children with FLE, although no studies have compared adult and pediatric performance in the same study. The aim of this research was to analyze the existing evidence concerning the cognition in adults and children with FLE. A random effect meta-analysis was used using Cohen's d, and the confidence interval for each cognitive factor was calculated. The results in the meta-analysis show a general pattern of cognitive dysfunction in FLE, especially in functions related to the frontal lobe, with an influence of the duration and the age at onset of epilepsy, as well as the age of the sample used. In addition, researches in this type of epilepsy are heterogeneous, with too many different sampling and methodological characteristics, which is not a standard format for reporting clinical sample characterization, making it difficult to study FLE in depth.

The Revised Child Anxiety and Depression Scale: A systematic review and reliability generalization meta-analysis.

BACKGROUND: Anxiety and depression are among the most common mental disorders during childhood and adolescence. Among the instruments for the brief screening assessment of symptoms of anxiety and depression, the Revised Child Anxiety and Depression Scale (RCADS) is one of the more widely used. Previous studies have demonstrated the reliability of the RCADS for different assessment settings and different versions. The aims of this study were to examine the mean reliability of the RCADS and the influence of the moderators on the RCADS reliability. METHODS: We searched in EBSCO, PsycINFO, Google Scholar, Web of Science, and NCBI databases and other articles manually from lists of references of extracted articles. RESULTS: A total of 146 studies were included in our meta-analysis. The RCADS showed robust internal consistency reliability in different assessment settings, countries, and languages. We only found that reliability of the RCADS was significantly moderated by the version of RCADS. However, these differences in reliability between different versions of the RCADS were slight and can be due to the number of items. LIMITATIONS: We did not examine factor structure, factorial invariance across gender, age, or country, and test-retest reliability of the RCADS. CONCLUSIONS: The RCADS is a reliable instrument for cross-cultural use, with the advantage of providing more information with a low number of items in the assessment of both anxiety and depression symptoms in children and adolescents.

[Burnout in Nursing Professionals Performing Overtime Workdays in Emergency and Critical Care Departments. Spain]. / Síndrome de burnout en profesionales de enfermería que realizan jornada física complementaria en servicios de cuidados críticos y urgencias.

OBJECTIVE: Burnout syndrome is a disorder that seriously affects people who suffer it, the institutions in which they work and the quality of healthcare. It is of great interest to advance in burnout research for its possible prevention. The aim of this work was to study the levels of burnout syndrome in nurses of emergency department with overtime workdays and to know the relationship between burnout and personality characteristics. METHODS: Multicenter cross-sectional study with a sample of 1225 emergency nurses from the Andalusian Health Service. Demographic, social and occupational variables were recorded. Burnout was assessed with Maslach Burnout Inventory and personality factors with NEO-Five Factor Inventory. Descriptive analysis of the variables, independent means hypothesis contrast and bayesian analysis were done. RESULTS: 44.1% of nurses who perform overtime workdays have high burnout versus a 38% for those without such overload. These differences have been also found in burnout dimensions, especially in emotional exhaustion (15.3% versus 10.8%) and depersonalization (17.9% versus 11.8%). CONCLUSIONS: Overtime workdays performed by emergency nurses seems to have a negative on them and it could also influence the development of burnout syndrome.

OBJETIVO: El síndrome de burnout es un trastorno que afecta a las personas que lo padecen, a las instituciones en las que éstas prestan servicio y a la calidad de los cuidados a los pacientes. El objetivo fue estudiar los niveles de síndrome de burnout en los profesionales de enfermería de urgencias con jornada física complementaria y conocer su relación con características de personalidad y realización de jornada física complementaria y conocer su relación con características de personalidad de los profesionales de enfermería. METODOS: Estudio transversal multicéntrico con una muestra de 1.225 profesionales de enfermería de urgencias del Servicio Andaluz de Salud. Se recogieron variables sociodemográficas, psicológicas y laborales. El síndrome de burnout fue evaluado mediante el Maslach Burnout Inventory y los factores de personalidad a través del NEO-Five Factor Inventory. Se realizaron análisis descriptivos de las variables, contrastes de hipótesis de dos medias independientes y análisis bayesianos. RESULTADOS: El 44,1% de los profesionales de enfermería que realizaban jornada física complementaria presentaban síndrome de burnout alto frente a un 38% de los que no tenían dicha sobrecarga. Respecto a las dimensiones del burnout se mantenían estas diferencias, especialmente en las dimensiones cansancio emocional (15,3% frente a 10,8%) y despersonalización (17,9% frente a 11,8%). CONCLUSIONES: La realización de jornada física complementaria parece afectar negativamente a los profesionales de enfermería de urgencias y podría favorecer en ellos el desarrollo del síndrome de burnout.

Prevalencia bayesiana y niveles de burnout en enfermería de urgencias. Una revisión sistemática / Bayesian prevalence and burnout levels in emergency nurses. A systematic review

Este trabajo tiene como objetivos conocer los niveles de burnout, estimar la prevalencia del trastorno asi como analizar las relaciones entre algunos factores de riesgo y el síndrome en profesionales de enfermería que trabajan en servicios de urgencias. Se ha realizado una revisión sistemática de estudios primarios cuantitativos que midiesen el síndrome de burnout en enfermeros del servicio de urgencias. La búsqueda se realizó en octubre de 2014 en las siguientes bases: CINAHL, CUIDEN, IBECS, LILACS, Pubmed, Proquest, Psycinfo, Scielo, Scopus y la Biblioteca Cochrane. Siguiendo los criterios de inclusión y exclusión se obtuvo una muestra final de 27 estudios. Se han encontrado mayoritariamente niveles medios y altos en la dimensión cansancio emocional. En la dimensión despersonalización los valores han sido principalmente de nivel intermedio aunque también se han encontrado estudios que informan de niveles altos. En la dimensión realización personal no existe consenso en la literatura revisada sobre un nivel más prevalente. Variables como el género, el turno de trabajo y la carga horaria, entre otras, son factores de riesgo de burnout. Los trabajos revisados informan de niveles intermedios y altos en todas las dimensiones del burnout y concluyen que la prevalencia de burnout en enfermeros de servicios de urgencias es alta. Algunos factores de riesgo sociodemográficos, como edad y sexo, otros laborales como antigüedad en la profesión y servicio, y alguno psicológico, como ansiedad, juegan un papel importante por su relación con el burnout.

This research sought to explore the level of burnout, to estimate its prevalence, and to analyze the relationships among some risk factors and the syndrome in nurses working at emergency departments. A systematic review of primary quantitative studies that measure the burnout syndrome in emergency department nurses has been performed. The search was done in October 2014 in these databases: CINAHL, CUIDEN, IBECS, LILACS, Pubmed, Proquest, Psycinfo, SciELO, Scopus and Cochrane Library. A sample of 27 studies was obtained following the inclusion and exclusion criteria. Medium and high levels of emotional exhaustion dimension were mostly found. Depersonalization dimension values were mainly middle level, but also some studies found reported high levels. As for the personal accomplishment dimension, there was no consensus as to the most prevalent level in the literature reviewed. Variables such as gender, work shift and workload among others, can play a role as risk factors. The studies reviewed report medium and high level of each burnout dimension, and conclude that the prevalence of burnout in emergency nurses is high. Some sociodemographic risk factors such as age and sex, other occupational risk factors such as seniority in the profession and service, and some psychological risk factors such as anxiety, play an important role in the relationship with burnout.

Síndrome de Burnout en profesionales de enfermería que realizan jornada física complementaria en servicios de cuidados críticos y urgencias / Burnout in nursing professionals performing overtime workdays in emergency and critical care departments. Spain

Fundamentos: El síndrome de burnout es un trastorno que afecta a las personas que lo padecen, a las instituciones en las que éstas prestan servicio y a la calidad de los cuidados a los pacientes. El objetivo fue estudiar los niveles de síndrome de burnout en los profesionales de enfermería de urgencias con jornada física complementaria y conocer su relación con características de personalidad y realización de jornada física complementaria y conocer su relación con características de personalidad de los profesionales de enfermería. Métodos: Estudio transversal multicéntrico con una muestra de 1.225 profesionales de enfermería de urgencias del Servicio Andaluz de Salud. Se recogieron variables sociodemográficas, psicológicas y laborales. El síndrome de burnout fue evaluado mediante el Maslach Burnout Inventory y los factores de personalidad a través del NEO-Five Factor Inventory. Se realizaron análisis descriptivos de las variables, contrastes de hipótesis de dos medias independientes y análisis bayesianos. Resultados: El 44,1% de los profesionales de enfermería que realizaban jornada física complementaria presentaban síndrome de burnout alto frente a un 38% de los que no tenían dicha sobrecarga. Respecto a las dimensiones del burnout se mantenían estas diferencias, especialmente en las dimensiones cansancio emocional (15,3% frente a 10,8%) y despersonalización (17,9% frente a 11,8%). Conclusiones: La realización de jornada física complementaria parece afectar negativamente a los profesionales de enfermería de urgencias y podría favorecer en ellos el desarrollo del síndrome de burnout (AU)

Background: Burnout syndrome is a disorder that seriously affects people who suffer it, the institutions in which they work and the quality of healthcare. It is of great interest to advance in burnout research for its possible prevention. The aim of this work was to study the levels of burnout syndrome in nurses of emergency department with overtime workdays and to know the relationship between burnout and personality characteristics. Methods: Multicenter cross-sectional study with a sample of 1225 emergency nurses from the Andalusian Health Service. Demographic, social and occupational variables were recorded. Burnout was assessed with Maslach Burnout Inventory and personality factors with NEO-Five Factor Inventory. Descriptive analysis of the variables, independent means hypothesis contrast and bayesian analysis were done. Results: 44.1% of nurses who perform overtime workdays had high burnout versus a 38% for those without such overload. These differences have been also found in burnout dimensions, especially in emotional exhaustion (15.3% versus 10.8%) and depersonalization (17.9% versus 11.8%). Conclusions: Overtime workdays performed by emergency nurses seems to have a negative on them and it could also influence the development of burnout syndrome (AU)

Psychometric properties and scales of the Granada Burnout Questionnaire applied to nurses / Propiedades psicométricas y baremos del Cuestionario de Burnout Granada en profesionales de enfermería

Nurses are an occupational group with extremely high levels of burnout. The most accepted definition of the burnout syndrome was proposed by Maslach and Jackson, who characterized it in terms of three dimensions: (i) Emotional Exhaustion; (ii) Depersonalization; (iii) Personal Accomplishment. This definition was the basis for the Granada Burnout Questionnaire (GBQ). The objective of this research was to evaluate the psychometric properties of the GBQ and to elaborate an evaluation scale to measure burnout in nursing professionals in Spain. A total of 1,177 nurses participated in this study and successfully completed the GBQ. Evidence of construct validity was verified by cross-validation and convergent validity, and evidence of criteria validity was checked by concurrent validity. Cronbach's alpha was used to measure internal consistency. The results obtained in our study show satisfactory fit values in the confirmatory factor analysis and in the evidence of convergent and concurrent validity. All of the Cronbach alpha values were greater than .83. This signifies that the GBQ has good psychometric properties that are applicable to nurses. For this purpose a scale of T-scores and centiles was created that permitted the evaluation of burnout in Spanish nursing professionals (AU)

Los enfermeros son uno de los colectivos profesionales que presentan mayores niveles de burnout. La definición más aceptada de este trastorno fue propuesta por Maslach y Jackson, y se caracteriza por Cansancio Emocional, Despersonalización y Realización Personal. Esta definición operativa fue usada en la elaboración del Cuestionario de Burnout Granada (CBG). El objetivo de la presente investigación fue evaluar las propiedades psicométricas del CBG y elaborar un baremo para profesionales de enfermería españoles. El CBG era cumplimentado por 1177 enfermeros. Las evidencias de validez de constructo fueron examinadas usando estrategias de validez cruzada y validez convergente, y las evidencias de validez de criterio mediante la validez concurrente. El coeficiente alfa de Cronbach se utilizó para medir la consistencia interna. Los resultados indican índices de ajuste satisfactorio en el análisis factorial confirmatorio, y en las evidencias de validez convergente y concurrente. Todos los valores de alfa de Cronbach fueron superiores a 0,83. Los resultados muestran que el CBG tiene buenas propiedades psicométricas para ser usado en enfermeros. Se elaboró un baremo en puntuaciones T y centiles que permite evaluar burnout en enfermeros españoles (AU)

Psychometric properties and scales of the Granada Burnout Questionnaire applied to nurses.

Nurses are an occupational group with extremely high levels of burnout. The most accepted definition of the burnout syndrome was proposed by Maslach and Jackson, who characterized it in terms of three dimensions: (i) Emotional Exhaustion; (ii) Depersonalization; (iii) Personal Accomplishment. This definition was the basis for the Granada Burnout Questionnaire (GBQ). The objective of this research was to evaluate the psychometric properties of the GBQ and to elaborate an evaluation scale to measure burnout in nursing professionals in Spain. A total of 1,177 nurses participated in this study and successfully completed the GBQ. Evidence of construct validity was verified by cross-validation and convergent validity, and evidence of criteria validity was checked by concurrent validity. Cronbach's alpha was used to measure internal consistency. The results obtained in our study show satisfactory fit values in the confirmatory factor analysis and in the evidence of convergent and concurrent validity. All of the Cronbach alpha values were greater than .83. This signifies that the GBQ has good psychometric properties that are applicable to nurses. For this purpose a scale of T-scores and centiles was created that permitted the evaluation of burnout in Spanish nursing professionals.

Los enfermeros son uno de los colectivos profesionales que presentan mayores niveles de burnout. La definición más aceptada de este trastorno fue propuesta por Maslach y Jackson, y se caracteriza por Cansancio Emocional, Despersonalización y Realización Personal. Esta definición operativa fue usada en la elaboración del Cuestionario de Burnout Granada (CBG). El objetivo de la presente investigación fue evaluar las propiedades psicométricas del CBG y elaborar un baremo para profesionales de enfermería españoles. El CBG era cumplimentado por 1177 enfermeros. Las evidencias de validez de constructo fueron examinadas usando estrategias de validez cruzada y validez convergente, y las evidencias de validez de criterio mediante la validez concurrente. El coeficiente alfa de Cronbach se utilizó para medir la consistencia interna. Los resultados indican índices de ajuste satisfactorio en el análisis factorial confirmatorio, y en las evidencias de validez convergente y concurrente. Todos los valores de alfa de Cronbach fueron superiores a 0,83. Los resultados muestran que el CBG tiene buenas propiedades psicométricas para ser usado en enfermeros. Se elaboró un baremo en puntuaciones T y centiles que permite evaluar burnout en enfermeros españoles.

Risk factors and prevalence of burnout syndrome in the nursing profession.

BACKGROUND: The burnout syndrome is beginning to be regarded as an occupational illness of high prevalence among nursing in Spain. Individuals suffering from the syndrome manifest important health problems. More information about prevalence and risk factors for burnout is needed to prevent the syndrome and to determine the most appropriate clinical interventions when the disorder appears. OBJECTIVES: Burnout levels were evaluated in a group of nurses. The objectives of this study were to estimate the prevalence of burnout, to identify the variables related to burnout and to propose a risk profile for this syndrome among the nursing personnel. SETTING: The study was carried out in public health centers in Andalusia (Spain). METHODS: The sample consisted of 676 nursing professionals from public health centers. Dependent variables were the three Burnout dimensions: emotional exhaustion, depersonalization and personal accomplishment. Independent variables were socio-demographic, organizational, personality-related variables. RESULTS: The nurses manifested average to high burnout levels. There were statistically significant differences in burnout levels associated with the following variables: age, gender, marital status, having children, level of healthcare, type of work shift, healthcare service areas and conducting administrative tasks. Burnout was also associated with personality-related variables. CONCLUSIONS: The prevalence of burnout among nursing professionals is high. Gender, age, marital status, level of healthcare, work shift and healthcare service areas predicted at least one of the dimensions of the syndrome. Neuroticism, agreeability, extraversion and conscientiousness are personality traits that predict at least two of the dimensions of burnout syndrome in nurses. Therefore, personality factors should be considered in any theory of risk profiles for developing burnout syndrome in the nursing profession.

Evidencia de validez factorial del Maslach Burnout Inventory y estudio de los niveles de burnout en profesionales sanitarios / Evidence for factorial validity of Maslach Burnout Inventory and burnout levels among health workers

En el presente trabajo se quieren conocer los niveles de burnout y variables relacionadas con el síndrome en un grupo de profesionales sanitarios. Los objetivos de la investigación fueron la obtención de evidencias de validez factorial del Maslach Burnout Inventory, la estimación de la prevalencia y la identificación de factores de riesgo de burnout en un grupo de profesionales sanitarios. Se realizó un estudio transversal, cuantitativo y exploratorio. Los datos corresponden a una muestra de 435 profesionales que incluye auxiliares, enfermeros y médicos. Los resultados obtenidos indican un adecuado ajuste en la estructura trifactorial del Maslach Burnout Inventory; asimismo, se ha obtenido que la categoría profesional, edad y tipo de dedicación son factores de riesgo de padecimiento de burnout. Por otra parte, se obtiene que los enfermeros presentaban niveles de burnout más altos que el resto de grupos profesionales considerados. Lo anterior sugiere que los factores indicados deben ser tenidos en cuenta en la implantación de programas encaminados a la prevención del desarrollo del síndrome.

In this research we studied the levels and the associated variables with the burnout syndrome in health professionals. This research aimed to obtain evidences of factorial validity of the Maslach Burnout Inventory (MBI), to estimate the prevalence of burnout, and to identify the risk factors for this syndrome among health professionals. A cross-sectional, quantitative, and exploratory study was conducted for this purpose. The sample consisted of 435 professionals including assistants, nurses and doctors. The results indicated proper adjustment in the tri-factorial structure of the MBI. It was also found that professional category, age and type of dedication, are risk factors for suffering from burnout. On the other hand, the results showed that nurses had higher burnout levels than the rest of the professional groups studied. The foregoing suggests that the above risk factors should be taken into account when implementing programs to prevent development of the syndrome.

Procedimiento para la detección del FDI tanto en ítems politómicos como dicotómicos / A procedure for detecting DIF in polythomous and dichotomous items.

En el presente trabajo se expone una variación del procedimiento de detección del funcionamiento diferencial de los ítems (FDI), que dentro del marco de la TRI, y siguiendo la propuesta de Linn y Harnisch (1981) ha sido utilizado por Barbero, Sánchez Bruno, Prieto y San Luís (1995), Prieto y Barbero (1996), Prieto, Barbero y San Luis (1997), Barbero y Prieto (1997), entre otros. El objetivo de esta variación es el de solucionar el problema que se puede plantear con aquellos ítems que de entrada no presentan un buen ajuste en el grupo de referencia y sin embargo se aceptan como ítems que no presentan FDI en base a un buen ajuste con las respuestas de los sujetos en el grupo focal, cuando quizás la conclusión debería ser que si el ítem se ajusta correctamente a las respuestas de uno de los grupos pero no a las del otro, estamos en presencia de un ítem con FDI entre los grupos. Básicamente el procedimiento consiste en determinar el ajuste de las respuestas de los sujetos en el grupo focal, para luego comprobar el ajuste de los mismos datos pero con los parámetros previamente estimados en el grupo de referencia. La diferencia entre los dos índices de ajuste obtenidos se compara con un valor crítico obtenido mediante un procedimiento de simulación. En este estudio se ha aplicado el procedimiento a ítems de respuesta politómica, aunque es igualmente válido en ítems con respuesta dicotómica. Las condiciones manipuladas fueron tamaño y tipo del FDI, porcentaje de ítems con FDI y nivel de significación. Los resultados indican que el procedimiento propuesto es bastante eficaz en la detección del FDI, especialmente en el caso de FDI no uniforme y mixto, siendo la tasa de falsos positivos bastante baja, sobre todo cuando se compara con otros estudios de características similares (AU)

In the present paper a modification of a DIF detection procedure is presented. The DIF procedure was proposed by Linn and Harnisch (1981) and used in applied settings by Barbero, Sánchez Bruno, Prieto and San Luis (1995), Prieto and Barbero (1996), Prieto, Barbero and San Luis (1997), Barbero and Prieto (1997), among others. The purpose of this modification was to be able to detect adequately the DIF when some items from the test don’t fit to the data in the reference group. Basically, the procedure consists in several steps: first, to check the fit of the model to the subject responses in the focal group. Second, to estimate the item parameters in the reference group and to check the fit of these parameters in the focal group and, lastly, to calculate the difference between both fit indices in each item and to compare with a critical value obtained throught a simulation procedure. This procedure can be used with both polythomous and dichotomous items. In this stimulation study, the procedure was applied to polythomous items and four factors were manipulated: percent of DIF presented in each item, type of DIF, percent of the items with DIF and significance level. The results indicates that the proposed procedure is effective in the detection of DIF, mainly when the DIF is non-uniform and mixed. Likewise, the rates of false alarms was very low, specially if it is compared with the rates from other simulation studies with similar features (AU)