Relation and effect of resilience on burnout in nurses: A literature review and meta-analysis.

AIM: To study the relation between burnout and resilience and to identify the profile of nurses presenting this quality. BACKGROUND AND INTRODUCTION: Healthcare professionals are subject to high rates of burnout. Resilience could be an important factor in preventing or alleviating this condition. METHODS: The PubMed, ProQuest, Scopus and ScienceDirect databases were consulted in February 2022 using the equation 'burnout AND resilience AND nurs*'. The inclusion criteria applied were that the texts should describe quantitative studies, be published in English or Spanish, in any year, and be directly related to the question considered. The meta-analysis was performed using StatsDirect statistical software. RESULTS: Analysis of the 29 studies shows that among the dimensions of burnout, nurses are especially prone to emotional exhaustion, and are less affected by depersonalisation and low personal accomplishment. Those who score highly for resilience tend to have longer service experience, acceptable salaries and less work overload. Meta-analysis reveals an inverse correlation between resilience and burnout (r = -0.41; n = 2750), exhaustion (r = -0.27; n = 6966) and depersonalisation (r = -0.23; n = 6115). CONCLUSION: Many nurses present low levels of resilience and suffer from burnout syndrome. The application of programmes to enhance their resilience would help prevent burnout and optimise the potential to provide quality health care. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Resilience is inversely correlated with burnout, depersonalisation and emotional exhaustion. Accordingly, healthcare organisations should develop and implement evidence-based programmes to foster nurses' resilience and thus reduce their susceptibility to burnout.

Burnout syndrome and work engagement in nursing staff: a systematic review and meta-analysis.

Background: A difficult and demanding work environment, such as that often experienced in healthcare, can provoke fatigue, anxiety, distress, and discomfort. This study considers factors that may influence levels of burnout and work engagement among nurses and seeks to determine the relationship between these conditions. Method: A systematic scoping review was performed, in accordance with the PRISMA Extension for Scoping Reviews, based on data obtained from a search of the PubMed/MEDLINE and Scopus databases carried out in 2022 using the search equation: "work engagement AND nurs* AND burnout." This search identified nine quantitative primary studies suitable for inclusion in our analysis. Results: Work overload, type of shift worked, and/or area of hospital service, among other elements, are all relevant to the development of burnout. This syndrome can be countered by social support and appropriate personal resources and values, which are all positively associated with work engagement. Our analysis revealed a significant correlation between work engagement and the different domains of burnout. The correlation effect size between burnout and work engagement was -0.46 (95% CI -0.58, -0.31), with p < 0.001. Conclusion: Well-targeted interventions in the healthcare work environment can reduce burnout levels, strengthen work engagement, and enhance the quality of healthcare.

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.

Burnout and Professional Engagement during the COVID-19 Pandemic among Nursing Students without Clinical Experience: A Cross-Sectional Study.

Burnout affects many healthcare professionals, especially nurses, causing serious health problems and disrupting the work environment. Academic burnout may also be experienced, leading students to feel unable to cope with their education. As a result, they may lose interest and even consider abandoning their studies. Hence, burnout syndrome can affect both the mental health and the professional future of those affected. To evaluate academic burnout in nursing students who had no clinical experience before starting their practical training, a cross-sectional study involving 212 third-year nursing students at the University of Granada was conducted. Data were collected using the Granada Burnout Questionnaire, the Utrecht Work Engagement Scale, the NEO Five-Factor Inventory, the Hospital Anxiety and Depression Scale, and the Fear of CoronaVirus-19 Scale. High levels of burnout were present in 37.8% of the students. Moreover, 21.5% and 8.7% had borderline cases of anxiety or depression, respectively. Another 30.8% and 9.2%, respectively, were considered likely to present these conditions. According to the predictive models of burnout dimensions obtained, neuroticism is a predictor of all three burnout dimensions. Furthermore, anxiety, depression, extraversion, responsibility and engagement are predictors of some dimensions of the syndrome. Many nursing students present high levels of burnout, which is related to certain personality variables and to the presence of anxiety and/or depression. The level of professional engagement is inversely associated with the impact of burnout. The participants in this study have normalised their return to the pre-pandemic study routine (in-person classes), and fear of COVID-19 was not a significant predictor of any dimension of burnout.

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.

Evolution and Treatment of Academic Burnout in Nursing Students: A Systematic Review.

AIM: To analyse the scientific literature related to the evolution of burnout syndrome during nursing studies and the interventions for the treatment or prevention of this syndrome in nursing students. METHODS: A systematic review of the PubMed, Scopus, and CINAHL databases was performed in August 2022 using the search phrase "burnout AND nursing students" to extract experimental and longitudinal studies. RESULTS: Eleven relevant studies were obtained for analysis. Four were experimental, and seven were cohort studies. According to these studies, the interventions reduced burnout overall, but on occasion, the burnout scores for some aspects increased, as did the prevalence. Psychological and work environment-related variables were the most important factors predicting burnout. CONCLUSION: Burnout (i.e., emotional exhaustion and depersonalisation) tends to increase during nursing studies. Related factors include personality, coping strategies, life satisfaction, and the work environment. Interventions such as progressive muscle relaxation, behavioural therapy, and recreational music may alleviate burnout.

Personality Factors as Predictors in Burnout Level Changes for Surgical Area Nurses.

Surgical area nurses provide comprehensive care to patients throughout the surgical process. Increases in life expectancy lead to the appearance and development of diseases, translating into an increase in the number of necessary interventions. Increases in the workload can be another risk factor for the development of burnout in professionals in this area. Knowledge of psychological and personality-related variables provides relevant information of level changes in the dimensions of burnout syndrome. Three logistic regression models, based on a cross-sectional study with 214 nurses working in the surgical area in the Andalusian Health Service, Spain, were built for each dimension. These models included different variables related to depression and personality, with some being significant at the population level and consequently true risk or protection factors. Friendliness, responsibility and extraversion are protection factors for the personal accomplishment dimension, whilst neuroticism is a risk factor for this dimension. Friendliness is also a protection factor for depersonalization, whilst depression is a risk factor. Finally, neuroticism, responsibility and depression are risk factors for the emotional exhaustion dimension of burnout. These findings provide relevant information that makes anticipation of this syndrome in this group easier.

Impact of Non-Face-to-Face Teaching with Passive Training on Personal Protective Equipment Use in Health Science Students: A Randomized Controlled Trial.

BACKGROUND: In the COVID-19 era, there was a call for the transformation of higher education. Universities had to combine non-face-to-face teaching with traditional procedures. This study analyzed the effectiveness and perceived satisfaction in a cohort of health sciences students of non-face-to-face teaching with passive training versus face-to-face teaching with active training in the proper donning and doffing of personal protective equipment (PPE) in a clinical simulation scenario. METHODS: A total of 142 participants were randomized into two groups: (a) non-face-to-face teaching with passive training; (b) face-to-face teaching with active training. The proper protocol for donning and doffing PPE was assessed. Students evaluated their skills before and after training and satisfaction with training received. RESULTS: Significant differences were observed for the statements "I felt more confident in donning after receiving this training" (p = 0.029) and "I felt more confident in doffing after receiving this training" (p = 0.042) in the face-to-face teaching with active training group compared to the non-face-to-face teaching with passive training group, whose number of tasks violated was significantly higher (p = 0.020). Satisfaction was significantly higher in the face-to-face and active training group (p = 0.004). CONCLUSIONS: Face-to-face teaching with active training improves effectiveness and satisfaction more than non-face-to-face teaching with passive training for acquiring skills in donning and doffing PPE properly.

Anxiety, Distress and Stress among Patients with Diabetes during COVID-19 Pandemic: A Systematic Review and Meta-Analysis.

The prevalence of mental health disorders has increased during the COVID-19 pandemic. Patients with chronic diseases, such as diabetes, are a particularly vulnerable risk group. This study aims to assess the levels and prevalence of anxiety, distress, and stress in patients with diabetes during the COVID-19 pandemic. A systematic review was conducted in CINAHL, Cochrane, LILACS, Medline, SciELO, and Scopus in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Thirty-seven articles with a total of 13,932 diabetic patients were included. Five meta-analyses were performed. The prevalence of anxiety was 23% (95% CI = 19-28) in T1DM and 20% (95% CI = 6-40) in T2DM patients. For diabetes distress it was 41% (95% CI = 24-60) for T1DM and 36% in T2DM patients (95% CI = 2-84). For stress, the prevalence was 79% (95% CI = 49-98) in T1DM patients. People with diabetes have significant psychiatric comorbidity as well as psychological factors that negatively affect disease management, increasing their vulnerability in an emergency situation. To establish comprehensive care in diabetic patients addressing mental health is essential, as well as including specific policy interventions to reduce the potential psychological harm of the COVID-19 pandemic.

Relation between Burnout and Sleep Problems in Nurses: A Systematic Review with Meta-Analysis.

Burnout can affect nurses' sleep quality. The aim of this study was to analyze the relationship between burnout syndrome and sleep problems in nurses. A systematic review with meta-analysis was performed. PubMed, CINAHL and Scopus databases were used. Some of the inclusion criteria were quantitative studies, in which the levels of burnout and sleep disorders were investigated in a sample of nurses using validated scales. A total of 12 studies were included. Sociodemographic variables did not influence the relation between burnout and sleep problems, except for being female. The environment and workplace violence, together with psychological traits and shifts, affect the probability of developing burnout and insomnia. The meta-analysis sample was n = 1127 nurses. The effect size of the correlation between burnout and sleep disorders was r = 0.39 (95% CI 0.29−0.48) with p < 0.001, indicating that the higher the level of burnout in nurses, the greater the presence of sleep disorders. The positive correlation between burnout and sleep disorders is a problem that must be addressed to improve the health of nurses. Developing turnicity strategies, using warmer lights in hospital units during night shifts and eliminating the fixed night shift could improve nurses' working conditions.

Prevalence, levels and related factors of burnout in nurse managers: A multi-centre cross-sectional study.

AIMS: The aims of this study are to analyse the prevalence and levels of burnout syndrome in nurse managers and to evaluate the relationship between burnout and related sociodemographic, occupational and psychological factors. BACKGROUND: Burnout syndrome, defined as an emotional response to chronic stress, is a major problem among nurse managers. METHODS: The study was conducted using a cross-sectional survey design and data collected by the Maslach Burnout Inventory, the revised NEO Five Factor Inventory and the Educational-Clinical Questionnaire for Anxiety and Depression. The sample population consisted of 86 nurse managers from different hospitals from the Public Health Service of Andalusia, Spain. RESULTS: A total of 22.4% of the participants presented high levels of emotional exhaustion, 21% experienced depersonalisation and 57.6% had little sense of personal accomplishment. Working long shifts was related to burnout. Emotional exhaustion and depersonalization were predicted by depression, while personal accomplishment was predicted by conscientiousness, agreeableness and openness. CONCLUSIONS: A total of 34.1% of the participants presented high levels of burnout, manifested by feelings of low personal accomplishment. Psychological and occupational factors play an important role in the development of this syndrome. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers should seek to detect burnout among staff and colleagues matching the risk profile for this condition and promote interventions to prevent it.

Levels of Burnout and Engagement after COVID-19 among Psychology and Nursing Students in Spain: A Cohort Study.

The COVID pandemic has 0drastically changed the functioning of universities in Spain and may have altered individuals' behaviours and emotions, the way they engage in the learning process and their psychological well-being. Burnout syndrome is a psychological problem that arises from persistent confrontation with emotional and interpersonal stressors. COVID-related burnout among Spanish students has received little research attention. For this study, a pre-post cohort study design was used. Data were collected using the Maslach Burnout Inventory-Student Survey, the Granada Burnout Questionnaire for university students, the Utrecht Work Engagement Scale and the Fear of CoronaVirus-19 scale. The population was composed of two samples of 190 and 226 students from Spanish universities. According to the results obtained, significant differences were observed between the pre- and post-test samples. Levels of burnout were higher after the COVID-19 pandemic and students' levels of engagement have dropped significantly following their experiences of the COVID pandemic. This study shows the impact that the covid pandemic has had on Spanish university students, impacts which may have had important consequences for their mental and physical health. It is necessary to implement intervention programs to enable students to recover, at least, the levels of burnout and engagement prevailing before the outbreak of the pandemic.

Machine learning methods applied to triage in emergency services: A systematic review.

BACKGROUND: In emergency services is important to accurately assess and classify symptoms, which may be improved with the help of technology. One mechanism that could help and improve predictions from health records or patient flow is machine learning (ML). AIM: To analyse the effectiveness of ML systems in triage for making predictions at the emergency department in comparison with other triage scales/scores. METHODS: Following the PRISMA recommendations, a systematic review was conducted using CINAHL, Cochrane, Cuiden, Medline and Scopus databases with the search equation "Machine learning AND triage AND emergency". RESULTS: Eleven studies were identified. The studies show that the use of ML methods consistently predict important outcomes like mortality, critical care outcomes and admission, and the need for hospitalization in comparison with scales like Emergency Severity Index or others. Among the ML models considered, XGBoost and Deep Neural Networks obtained the highest levels of prediction accuracy, while Logistic Regression performed obtained the worst values. CONCLUSIONS: Machine learning methods can be a good instrument for helping triage process with the prediction of important emergency variables like mortality or the need for critical care or hospitalization.

Burnout Syndrome in Paediatric Nurses: A Multi-Centre Study.

BACKGROUND: Burnout syndrome is an increasingly prevalent problem, characterised by emotional exhaustion (EE), depersonalization (D), and low personal accomplishment (PA), feelings that appear with prolonged exposure to stress-inducing situations. The syndrome alters physical well-being and endangers the quality of services provided. Among nurses working in the paediatric area, the association between burnout and the corresponding risk profile has received little research attention, despite the highly stressful nature of this work. MATERIALS AND METHODS: The study population was composed of 95 nurses working in four hospitals in the province of Granada. Data were collected using the Maslach Burnout Inventory, the NEO Personality Inventory, and the Educational-Clinical Questionnaire: Anxiety and Depression. RESULTS: According to the results obtained, 22.0% of the nurses working in the paediatric area present high levels of EE, 18.5% present high levels of D, and 39.6% had feelings of low PA. These burnout levels do not depend on sociodemographic or labour variables, but the three domains of the syndrome are related to the psychological factors analysed. CONCLUSIONS: Among the nurses who participated in this study, 38.6% presented high levels of burnout, especially regarding feelings of low personal accomplishment. Personality factors play an important role in the development of this syndrome. This study shows the impact of burnout in paediatric nurses as well as the risk factors, providing information for the development of strategies to prevent it.

Predictors of burnout of health professionals in the departments of maternity and gynaecology, and its association with personality factors: A multicentre study.

AIMS AND OBJECTIVES: To analyse the prevalence, levels and phases of burnout syndrome in midwives and obstetrics and gynaecology nurses, and to evaluate the relationship between burnout and sociodemographic, occupational and psychological factors. BACKGROUND: Burnout syndrome is a major problem in occupational health, characterised by feelings of exhaustion, depersonalisation and a low sense of personal achievement that appears after long-term occupational stress. Recent research has found that burnout harms the physical and mental well-being of workers, and jeopardises the quality of care provided. The association between burnout and a risk profile in maternity wards has not previously been investigated but it deserves special attention since it is a highly stressful area to work in. DESIGN: A cross-sectional survey design was selected. METHODS: A total of 150 nurses and midwives at 18 hospitals participated in this study. The data were collected using the Maslach Burnout Inventory, NEO Personality Inventory and the Educational-Clinical Questionnaire: Anxiety and Depression. This study adhered to the STROBE guideline. RESULTS: 17% of participants presented high levels of emotional exhaustion, 16.6% high depersonalisation and 55.1% a sense of low personal accomplishment. The sociodemographic and occupational variables related to burnout were gender, marital status and work shift. The three dimensions of the syndrome, emotional exhaustion, depersonalisation and personal accomplishment were predicted by depression, neuroticism, agreeableness and openness. CONCLUSIONS: One third of the sample presented high levels of burnout, which was most strongly experienced as feelings of low personal accomplishment. Furthermore, personality factors play an important role in the development of burnout syndrome. RELEVANCE TO CLINICAL PRACTICE: Managers and policy makers should promote strategies to reduce burnout. To prevent the syndrome, personality factors should be taken into account, for the early identification of a profile of professionals most at risk of developing burnout.

Nurses Training and Capacitation for Palliative Care in Emergency Units: A Systematic Review.

Palliative care (PC) prevents and alleviates patients´ suffering to improve their quality of life in their last days. In recent years, there has been an increase in visits to the emergency services (ES) by patients who may need this type of care. The aims were to describe the training and capacitation of nurses from ES in PC. Accordingly, a systematic review was performed. Medline, Scopus, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases were used. The search equation was "Palliative care and nursing care and emergency room". A total of 12 studies were selected. The studies agree on the need for training professionals in PC to provide a higher quality care, better identification of patient needs and to avoid unnecessary invasive processes. Similarly, the implementation of a collaborative model between ES and PC, the existence of a PC specialized team in the ES or proper palliative care at home correspond to a decrease in emergency visits, a lower number of hospitalizations or days admitted, and a decrease in hospital deaths. The development of PC in the different areas of patient care is necessary. Better palliative care leads to a lower frequency of ES by terminal patients, which has a positive impact on their quality of life. Access to PC from the emergency unit should be one of the priority health objectives due to increment in the aged population susceptible to this type of care.

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.

Analysis of the Anti-Vaccine Movement in Social Networks: A Systematic Review.

The aim of this study was to analyze social networks' information about the anti-vaccine movement. A systematic review was performed in PubMed, Scopus, CINAHL and CUIDEN databases. The search equations were: "vaccine AND social network" and "vaccine AND (Facebook[title] OR Twitter[title] OR Instagram[title] OR YouTube[title])". The final sample was n = 12, including only articles published in the last 10 years, in English or Spanish. Social networks are used by the anti-vaccine groups to disseminate their information. To do this, these groups use different methods, including bots and trolls that generate anti-vaccination messages and spread quickly. In addition, the arguments that they use focus on possible harmful effects and the distrust of pharmaceuticals, promoting the use of social networks as a resource for finding health-related information. The anti-vaccine groups are able to use social networks and their resources to increase their number and do so through controversial arguments, such as the economic benefit of pharmaceuticals or personal stories of children to move the population without using reliable or evidence-based content.

Prevalence of Depression in Coronary Artery Bypass Surgery: A Systematic Review and Meta-Analysis.

Coronary artery bypass graft surgery (CABG) might adversely affect the health status of the patients, producing cognitive deterioration, with depression being the most common symptom. The aim of this study is to analyse the prevalence of depression in patients before and after coronary artery bypass surgery. A systematic review and meta-analysis was carried out, involving a study of the past 10 years of the following databases: CINAHL, LILACS, MEDLINE, PsycINFO, SciELO, Scopus, and Web of Science. The total sample comprised n = 16,501 patients. The total number of items was n = 65, with n = 29 included in the meta-analysis. Based on the different measurement tools used, the prevalence of depression pre-CABG ranges from 19-37%, and post-CABG from 15-33%. There is a considerable presence of depression in this type of patient, but this varies according to the measurement tool used and the quality of the study. Systematically detecting depression prior to cardiac surgery could identify patients at potential risk.

Smartphones and Apps to Control Glycosylated Hemoglobin (HbA1c) Level in Diabetes: A Systematic Review and Meta-Analysis.

INTRODUCTION: Diabetes mellitus is a chronic endocrine-metabolic disease, the evolution of which is closely related to people´s self-control of glycemic levels through nutrition, exercise, and medicines. AIM: To determine whether smartphone apps can help persons with diabetes to improve their % levels of glycosylated hemoglobin. METHOD: A systematic review and meta-analysis were done. ProQuest, Pubmed/Medline, and Scopus databases were used. The search equation used was "(Prevention and Control) AND Diabetes Mellitus AND Smartphones". The inclusion criteria applied were clinical trials, conducted in 2014-2019. RESULTS: n = 18 studies were included in the review. The studies tried different applications to monitor glycemia and support patients to improve glycosylated hemoglobin (HbA1c) levels. More than half of the studies found statistically significant differences in HbA1c in the intervention group compared with the control group. Eleven studies were included in the meta-analysis and the study sample was n = 545 for the experimental group and n = 454 for the control group. The meta-analytic estimation of the HbA1c % level means differences between intervention and control group was statistically significant in favour of the intervention group with a mean difference of -0.37 (-0.58, -0.15. 95% confidence interval). CONCLUSION: Smartphone apps can help people with diabetes to improve their level of HbA1c, but the clinical impact is low.