Depression in nursing students during the COVID-19 pandemic: Systematic review and meta-analysis.

The pandemic meant a change in academic approach. This had an impact on the mental health of students, leading to, among other problems, depressive disorders. The aim of this study was to find out the prevalence and factors that favoured the development of depression in nursing students during the COVID-19 pandemic. A systematic review with meta-analysis of prevalence was conducted in October 2023, using Pubmed, CINAHL and Scopus as the data sources used for the search. This review followed the guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Search equation was: "(undergraduate nurses OR nursing students) AND depression AND (COVID-19 OR Sars-CoV-2)". The final set of articles was N = 12. Quantitative primary studies using anonymous scales and surveys to assess the prevalence of depression in nursing students in the last 3 years were included. Studies show a high prevalence of depression among young university students with figures above 50%. The total sample of students in the meta-analysis was n = 4,479 with a prevalence value of 32% (CI95% 22%-42%). Affected students are characterised by young, female students. Concerns included generalised academic uncertainty, social isolation, work overload, fear of contagion and concern about teaching delivery. Coping mechanisms were generally resilience, spiritual support, laughter therapy, seeking information about COVID-19 and eating food. In conclusion, students, especially female students, are at high risk of depression due to social isolation. In addition, coping techniques were inadequate and future strategies to prevent this situation should be considered.

A comparison of univariate and meta-analytic structural equation modeling approaches to reliability generalization applied to the Maslach Burnout Inventory.

Introduction: Reliability is a property of tests scores that varies from sample to sample. One way of generalizing reliability of a test is to perform a meta-analysis on some reliability estimator. In 2011, a reliability generalization meta-analysis on the Maslach Burnout Inventory (MBI) was conducted, concluding that average alpha values for the MBI dimensions ranged from 0.71 to 0.88. In the present study, we aimed to update the average reliability values of the MBI by conducting a literature search from 2010 until now and comparing to statistical procedures of meta-analysis: the Univariate approach, that were used in the previous study, and a novel meta-analytic approach based on structural equation modeling. Method: An estimation of average reliability was done based on 69 independent primary reliability coefficients for the Univariate approach. The average reliability was based on 9 independent studies in the case of the Meta-analytic Structural Equation Modeling (MASEM) approach. Given that MASEM has the additional capability of testing the internal structure of a test, we also fitted several models. Results: The data was well-suited to the bifactor model, revealing the dominance of the general factor over the domain-specific ones. Acceptable overall alpha and omega coefficients were achieved for the two of the MBI dimensions, having depersonalization reliability estimates below recommendations. Discussion: In general, the MBI can be viewed as a highly interconnected three-factor scale, being its appropriate for research purposes.

Analyzing Latent Burnout Profiles in a Sample of Spanish Nursing and Psychology Undergraduates.

There is abundant literature suggesting that university students in helping professions experience high levels of stress, leading to an increased risk of developing burnout. The objective of this study was to identify burnout profiles in a sample of 1162 Spanish nursing and psychology undergraduates using latent profile analysis, a person-oriented statistical method that can identify hidden homogenous subgroups within a heterogeneous population. We expected to replicate in university students the five-profile structure (burnout, overextended, disengaged, ineffective, and engagement) proposed by Leiter and Maslach using the burnout dimensions (emotional exhaustion, cynicism, and inefficacy) as indicators. The results showed that burnout, overextended, and engagement profiles were adequately replicated. Given that levels of inefficacy and cynicism were medium to low, the ineffective and disengaged profiles somewhat deviated from those identified by Leiter and Maslach. We found differences between the five latent profiles in several psychological variables, such as depression and anxiety. These results suggest that psychosocial factors (e.g., workload) are significant among students and may adversely impact their health, leading to psychosomatic and emotional disorders. Hence, designing effective interventions to prevent health problems associated with burnout seems advisable, considering the specific burnout profile that a student exhibits.

Job satisfaction and burnout syndrome among intensive-care unit nurses: A systematic review and meta-analysis.

INTRODUCTION: The severe conditions often experienced in an intensive care unit, combined with poor working conditions, increase stress and therefore decrease job satisfaction. Sustained stress in the workplace leads to the development of burnout, a syndrome characterised by three dimensions: emotional exhaustion, depersonalisation and perceived lack of personal fulfilment. OBJECTIVE: To analyse the relationship between burnout syndrome and job satisfaction among ICU personnel. DATA SOURCES: The PubMed, CINAHL and Scopus databases were used. STUDY DESIGN: A systematic review and meta-analysis. The study sample consisted of 18 quantitative primary studies conducted in the last five years. Validated questionnaires were used to assess burnout in ICU healthcare workers, the most commonly used being the Maslach Burnout Inventory. EXTRACTION METHODS: The search equation applied was: "job satisfaction AND nurs* AND burnout AND (ICU OR intensive care units)". The search was performed in October 2022. PRINCIPAL FINDINGS: The search returned 514 results. Only 73 articles met the eligibility criteria. After reading the title and abstract, 20 articles were selected. After reading the full texts, 12 articles remained and after the reverse search, 18 articles were finally selected. The studies reported a 50% prevalence of burnout, all three dimensions of which were heightened by the COVID-19 pandemic. Analysis of the study findings revealed an inverse association between burnout and job satisfaction. CONCLUSIONS: Job dissatisfaction of ICU nurses depends on lack of experience, working conditions or working environment among others. ICU nurses with lower job satisfaction have higher levels of burnout. IMPLICATIONS FOR CLINICAL PRACTICE: This meta-analysis shows the potential value of job satisfaction on improving health outcomes related to burnout syndrome for nursing professional in Intensive Care Units. Different factors that could increase job satisfaction and consequently protect them from suffering high levels of burnout, such as salary, permanence in the service, mental health care are the responsibility of the hospital supervisor and, finally, of the own Health System. Knowledge of a risk profile based on the factors influencing job dissatisfaction would enable the implementation of effective workplace interventions to reduce or prevent the risk of burnout. Health policies should focus on protecting the worker, so in addition to improving working conditions, it would be interesting to promote coping skills in order to improve the quality of care and patient safety.

Psychiatric profiles in suicidal attempters: Relationships with suicide behaviour features.

BACKGROUND: Suicide constitutes a major health concern worldwide, being a significant contributor of death, globally. The diagnosis of a mental disorder has been extensively linked to the varying forms of suicidal ideation and behaviour. The aim of our study was to identify the varying diagnostic profiles in a sample of suicide attempters. METHODS: A sample of 683 adults (71.3% females, 40.10±15.74 years) admitted at a hospital emergency department due to a suicide attempt was recruited. Latent class analysis was used to identify diagnostic profiles and logistic regression to study the relationship between comorbidity profile membership and sociodemographic and clinical variables. RESULTS: Two comorbidity profiles were identified (Class I: low comorbidity class, 71.3% of attempters; Class II: high comorbidity class, 28.7% of attempters). Class I members were featured by the diagnosis of depression and general anxiety disorder, and low comorbidity; by contrast, the high comorbidity profile was characterized by a higher probability of presenting two or more coexisting psychiatric disorders. Class II included more females, younger, with more depressive symptoms and with higher impulsivity levels. Moreover, Class II members showed more severe suicidal ideation, higher number of suicide behaviours and a greater number of previous suicide attempts (p<.01, for all the outcomes), compared to Class I members. CONCLUSIONS: Psychiatric profiles may be considered for treatment provision and personalized psychiatric treatment in suicidal attempters as well as tackle suicide risk.

The Fear of COVID-19 Scale: A meta-analytic structural equation modeling approach.

The widespread administration and multiple validations of the Fear of COVID-19 Scale (FCV-19S) in different languages have highlighted the controversy over its underlying structure and the resulting reliability index. In the present study, a meta-analysis based on structural equation modeling (MASEM) was conducted to assess the internal structure of the seven-item, 5-point Likert-type FCV-19S version, estimate an overall reliability index from the underlying model that best reflected the internal structure (one τ-equivalent factor, one congeneric factor, or two-factor models), and perform moderator analyses for the model-implied interitem correlations and estimated factor loadings. A Pearson interitem correlation matrix was obtained for 48 independent studies, from which a pooled matrix was calculated following a random-effects multivariate meta-analysis. The results from the one-stage MASEM analysis showed that the two-factor model properly fitted the pooled matrix, while the τ-equivalent and congeneric one-factor models did not. Even though, the use of a bifactor model exhibited the predominance of the general factor over the domain-specific ones. High omega coefficients were obtained for the entire scale (.91) and the psychological (.83) and physiological (.83) symptoms subscales. Moderator analyses evidenced an increase in the estimated factor loadings, as well as in the reliability of the FCV-19S, when the standard deviation of the total scores increased and when the FCV-19S was administered to specific (vs. general) populations. The FCV-19S can be therefore considered as a highly related two-factor scale whose reliability makes it suitable for applied and research purposes. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Correction: Albendín-García et al. Explanatory Models of Burnout Diagnosis Based on Personality Factors in Primary Care Nurses. Int. J. Environ. Res. Public Health 2022, 19, 9170.

The following corrections have been made to the paper [...].

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.

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.

Prevalence of Burnout Syndrome and Fear of COVID-19 among Adolescent University Students.

This study aimed to estimate the prevalence of burnout syndrome in adolescents entering university studies, to detect differences in burnout levels, personality factors and fear of coronavirus in a pandemic context due to COVID-19. A cross-sectional predictive study was performed with a sample that comprised 134 individuals in their first year of a Psychology degree at Spanish universities. The Maslach Burnout Inventory Student Survey, the NEO Five-Factor Inventory and the Fear of COVID-19 Scale were applied. The prevalence of burnout is estimated according to three methods: Maslach and Jackson's severity classification, Golembiewski's phase model and Maslach et al.'s profile model. The estimates show significant differences. The results indicated that between 9 and 21% of students were at risk of developing burnout. On the other hand, students who reported having suffered psychological consequences of the pandemic showed greater emotional exhaustion, neuroticism and fear of COVID-19, and a lower level of personal accomplishment than those who did not suffer such consequences. Neuroticism was the only significant predictor for all burnout dimensions, and fear of COVID-19 did not contribute to any of them.

Explanatory Models of Burnout Diagnosis Based on Personality Factors in Primary Care Nurses.

Burnout in the primary care service takes place when there is a high level of interaction between nurses and patients. Explanatory models based on psychological and personality related variables provide an approximation to level changes in the three dimensions of the burnout syndrome. A categorical-response ordinal logistic regression model, based on a quantitative, crosscutting, multicentre, descriptive study with 242 primary care nurses in the Andalusian Health Service in Granada (Spain) is performed for each dimension. The three models included all the variables related to personality. The risk factor friendliness was significant at population level for the three dimensions, whilst openness was never significant. Neuroticism was significant in the models related to emotional exhaustion and depersonalization, whilst responsibility was significant for the models referred to depersonalization and personal accomplishment dimensions. Finally, extraversion was also significant in the emotional exhaustion and personal accomplishment dimensions. The analysis performed provides useful information, making more readily the diagnosis and evolution of the burnout syndrome in this collective.

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.

Spanish Adaptation of the Self- and Other-Interest Inventory in Academic Settings.

In the study of human motivations, self-interest is often seen as a determining factor and opposed to other-interest. Recently a new conceptualization has been proposed in which both interests can occur at the same time. In order to measure these constructs, the Self-and Other-Interest Inventory (SOII; Gerbasi & Prentice, 2013) was created, which has one version for adults and one for students. Due to the absence of similar measurement instruments in Spain, the aim of this work is to adapt the SOII to Spanish university students. Several studies were conducted. First, the construct was analyzed through rational-analytical procedures. Second, the items were translated following an iterative forward-translation design. Finally, evidence of validity was obtained through analytical procedures. Specifically, two pilot studies were carried out in which two independent samples of Spanish students participated (N1 = 119; N2 = 165). In both studies descriptive analyzes of the items were performed, reliability was estimated and the factor structure of the SOII was explored from an exploratory factor analysis. The results showed adequate reliability and a two-factor solution consistent with the original.

The effect of mindfulness training on burnout syndrome in nursing: A systematic review and meta-analysis.

AIM: To analyse the effect of mindfulness training on levels of burnout among nurses. BACKGROUND: Burnout syndrome is a common occupational hazard for nursing staff. Mindfulness training has been proposed as a valid intervention for burnout. DESIGN: Systematic review and meta-analysis. DATA SOURCES: The CINAHL, LILACS, Medline, ProQuest, PsycINFO, Scielo and Scopus databases were consulted, using the search equation 'Nurs * AND burnout AND mindfulness'. There was no restriction on the year of publication. REVIEW METHODS: Papers were selected for analysis in accordance with the PRISMA guidelines. The meta-analysis was carried out using Review Manager 5.3 software. RESULTS: The sample was of 17 articles including 632 nurses. Mindfulness training reduces levels of burnout, producing lower scores for emotional exhaustion and depersonalization and higher for personal accomplishment. The differences in the means were 1.32 (95% CI: -9.41-6.78), 1.91 (95% CI: -4.50-0.68) and 2.12 (95% CI: -9.91-14.14), respectively, between the intervention and control groups. CONCLUSION: Mindfulness training reduces the emotional burden and hence levels of burnout, among nurses. However, further randomized clinical trials are required.

Psychometric Properties of the Spanish Adaptation of the Personality Assessment Inventory in Correctional Settings: An ESEM Study.

The Personality Assessment Inventory (PAI; Morey, 1991, 2007) is among the most important personality and psychopathology assessment tools. However, its psychometric properties in the Spanish-speaking prison population have not yet been studied. We aimed to explore the factor structure of the Spanish adaptation of the PAI (Ortiz-Tallo et al., 2011) in an Ecuadorian sample of 811 convicted men using exploratory structural equation modeling, with the further objective of confirming its internal consistency. Hoelzle and Meyer (2009) identified three dimensions that are highly congruent across samples: general distress, elevated mood and dominance, and substance abuse and psychopathy. Taking these findings and the internalizing and externalizing dimensions (Ruiz & Edens, 2008) as a theoretical basis, three- and two-factor models were tested for the 22 scales and 11 clinical scales, respectively. We also tested four- and three-factor models that grouped the scales related to substance abuse as an independent factor, leaving intact the distribution presented by the remaining scales in the previous models. Although the original models showed a good fit, the 4- and 3-factor models obtained significantly better fit indexes. With respect to reliability, the Cronbach's alpha coefficients ranged from .49 to .89. This version shows acceptable psychometric properties in correctional settings.

La investigación en el síndrome de burnout: reflexión crítica desde una perspectiva metodológica / Research in Burnout Syndrome: Critical reflection from a methodological perspective

La investigación en Psicología se caracteriza por hacer uso del método científico, sobre todo el hipotético-deductivo. Recientemente se han publicado varios trabajos que muestran las dificultades con las que los psicólogos se encuentran a la hora de investigar. Algunas de ellas son la diversidad de modelos teóricos, la ausencia de estudios de replicación, los errores en el diseño, la alta tasa de falsos positivos, las prácticas inadecuadas de análisis de datos y la lentitud e ineficacia de la transmisión del conocimiento científico. En este trabajo, mediante una revisión narrativa, se pretende reflexionar de manera crítica sobre la ocurrencia de estos problemas en el campo de la Psicología de la Salud Ocupacional, en concreto, el síndrome de burnout. Se aportan evidencias de que algunos problemas mencionados a nivel general coinciden con los de este campo. Finalmente se discuten estos resultados

Research in Psychology is characterised by using the scientific method, specifically the hypothetico-deductive model. Recently, several authors have shown some of the problems that psychologists face when conducting research. For instance, a wide variety of theoretical models, lack of replication studies, study design errors, high rate of false positive, inappropriate data analysis practices and ineffective and slow scientific knowledge transmission. Through a narrative review, this study aims to critically analyse the occurrence of these problems in the field of Occupational Health Psychology, particularly regarding the burnout syndrome. Evidence suggests that some problems mentioned at a general level coincide with those in this field. Finally, these results are discussed

Factores de riesgo y niveles de burnout en enfermeras de atención primaria: una revisión sistemática / Risk factors and burnout levels in Primary Care nurses: a systematic review

OBJETIVO: Conocer los factores de riesgo y los niveles de burnout en enfermeras de :atención primaria. METODOLOGÍA: Se realizó una revisión sistemática. Fuentes de datos. Se consultaron CINAHL, CUIDEN, LILACS, Pubmed, ProQuest, ScienceDirect y Scopus. Las ecuaciones de búsqueda fueron: «burnout AND community health nursing» y «burnout AND primary care nursing». La búsqueda se realizó en octubre del 2015. Selección de estudios. La muestra final fue de n=12. Se incluyeron estudios primarios cuantitativos que utilizasen el Maslach Burnout Inventory para evaluar el burnout en enfermeras de atención primaria, sin restricción por fecha de publicación. Extracción de datos. Las principales variables fueron la media y desviación típica de las 3 dimensiones del burnout, las prevalencias de niveles bajos, medios y altos de cada dimensión, y los factores sociodemográficos, laborales y psicológicos que potencialmente influyen en su desarrollo. RESULTADOS: Los estudios muestran prevalencias de cansancio emocional alto, por lo general, entre el 23 y el 31%. Las prevalencias de despersonalización alta y realización personal baja muestran heterogeneidad, variando entre el 8-32 y el 4-92% de la muestra respectivamente. Los estudios informan de que las enfermeras con mayor edad, mayor antigüedad laboral, ansiedad y depresión, entre otras variables, presentan mayores niveles de burnout, mientras que aquellas con mayor sueldo, satisfacción laboral alta, apoyo de la organización y buen autoconcepto lo padecen menos. CONCLUSIÓN: El cansancio emocional alto es la principal dimensión del burnout afectada en la enfermería de atención primaria. En despersonalización y realización personal existe heterogeneidad. Debe prevenirse el burnout en estos profesionales potenciando los factores protectores y vigilando su aparición en los que presenten factores de riesgo

OBJECTIVE: To determine the risk factors and levels of burnout in Primary Care nurses. METHODS: A systematic review was performed. Data sources. CINAHL, CUIDEN, LILACS, PubMed, ProQuest, ScienceDirect and Scopus databases were consulted. Search equations were 'burnout AND community health nursing' and 'burnout AND primary care nursing'. The search was performed in October 2015. Study selection. The final sample was n=12 studies. Quantitative primary studies that used Maslach Burnout Inventory for burnout assessment in Primary Care nurses were included without restriction by publication date. Data extraction. The main variables were the mean and standard deviation of the three burnout dimensions, high, medium and low prevalence rates of each dimension, and socio-demographic, occupational and psychological variables that potentially influence burnout level. RESULTS: Studies show high prevalence rates, generally between 23% and 31%, of emotional exhaustion. The prevalence rates of high depersonalisation and low personal accomplishment show heterogeneity, varying between 8%-32% and 4%-92% of the sample, respectively. Studies show that older nurses with more seniority, anxiety and depression, among other variables, have higher burnout levels, while nurses with higher salary, high job satisfaction, organisational support, and good self-concept have less burnout. CONCLUSION: High emotional exhaustion is the main affected dimension of burnout in Primary Care nursing. There is heterogeneity in depersonalisation and personal accomplishment. Burnout must be prevented in these professionals, by increasing protective factors and monitoring its appearance in those with risk factors

[Risk factors and burnout levels in Primary Care nurses: A systematic review]. / Factores de riesgo y niveles de burnout en enfermeras de atención primaria: una revisión sistemática.

OBJECTIVE: To determine the risk factors and levels of burnout in Primary Care nurses. METHODS: A systematic review was performed. DATA SOURCES: CINAHL, CUIDEN, LILACS, PubMed, ProQuest, ScienceDirect and Scopus databases were consulted. Search equations were 'burnout AND community health nursing' and 'burnout AND primary care nursing'. The search was performed in October 2015. STUDY SELECTION: The final sample was n=12 studies. Quantitative primary studies that used Maslach Burnout Inventory for burnout assessment in Primary Care nurses were included without restriction by publication date. DATA EXTRACTION: The main variables were the mean and standard deviation of the three burnout dimensions, high, medium and low prevalence rates of each dimension, and socio-demographic, occupational and psychological variables that potentially influence burnout level. RESULTS: Studies show high prevalence rates, generally between 23% and 31%, of emotional exhaustion. The prevalence rates of high depersonalisation and low personal accomplishment show heterogeneity, varying between 8%-32% and 4%-92% of the sample, respectively. Studies show that older nurses with more seniority, anxiety and depression, among other variables, have higher burnout levels, while nurses with higher salary, high job satisfaction, organisational support, and good self-concept have less burnout. CONCLUSION: High emotional exhaustion is the main affected dimension of burnout in Primary Care nursing. There is heterogeneity in depersonalisation and personal accomplishment. Burnout must be prevented in these professionals, by increasing protective factors and monitoring its appearance in those with risk factors.