Impact effects of COVID-19 pandemic on chronic disease patients: A longitudinal prospective study.

AIMS: To assess the effects of COVID-19 pandemic on clinical variables as part of the routine clinical monitoring of patients with chronic diseases in primary care. DESIGN: A prospective longitudinal study was conducted in primary care centres of the Andalusian Health Service. METHODS: Data were recorded before the pandemic (T1), during the declaration of the state of emergency (T2) and in the transition phase (T3). The Barthel index and the Short Portable Mental Status Questionnaire (SPMSQ) were used to analyse functional and cognitive changes at the three time points. HbA1c, systolic and diastolic blood pressure, heart rate, BMI and lipid levels were assessed as clinical variables. Descriptive statistics and non-parametric chi-square test were used for analysis. STROBE checklist was used for the preparation of this paper. RESULTS: A total fo148 patients with chronic conditions were included in the analysis. Data analysis revealed in T2 only significant reductions in BMI, total levels of cholesterol and HDL during the onset of the pandemic. Barthel Index, SPMSQ, blood pressure and triglycerides and LDL levels worsened in T2, and the negative effects were maintained in T3. Compared to pre-pandemic values, HbA1c levels improved in T3, but HDL levels worsened. CONCLUSIONS: COVID-19 has drastically disrupted several functional, cognitive and biological variables. These results may be useful in identifying clinical parameters that deserve closer attention in the case of a new health crisis. Further studies are needed to assess the potential impacts of each specific chronic condition. IMPACT: Cognitive and functional status, blood pressure and triglycerides and LDL levels worsen in short term, maintaining the negative effects in medium-term.

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.

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.

Systematic Review and Meta-Analyses of Aminopeptidases as Prognostic Biomarkers in Amyotrophic Lateral Sclerosis.

Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease characterized by the progressive loss of motor neurons in the spinal cord, brain stem, and cerebral cortex. Biomarkers for ALS are essential for disease detection and to provide information on potential therapeutic targets. Aminopeptidases catalyze the cleavage of amino acids from the amino terminus of protein or substrates such as neuropeptides. Since certain aminopeptidases are known to increase the risk of neurodegeneration, such mechanisms may reveal new targets to determine their association with ALS risk and their interest as a diagnostic biomarker. The authors performed a systematic review and meta-analyses of genome-wide association studies (GWASs) to identify reported aminopeptidases genetic loci associated with the risk of ALS. PubMed, Scopus, CINAHL, ISI Web of Science, ProQuest, LILACS, and Cochrane databases were searched to retrieve eligible studies in English or Spanish, published up to 27 January 2023. A total of 16 studies were included in this systematic review, where a series of aminopeptidases could be related to ALS and could be promising biomarkers (DPP1, DPP2, DPP4, LeuAP, pGluAP, and PSA/NPEPPS). The literature reported the association of single-nucleotide polymorphisms (SNPs: rs10260404 and rs17174381) with the risk of ALS. The genetic variation rs10260404 in the DPP6 gene was identified to be highly associated with ALS susceptibility, but meta-analyses of genotypes in five studies in a matched cohort of different ancestry (1873 cases and 1861 control subjects) showed no ALS risk association. Meta-analyses of eight studies for minor allele frequency (MAF) also found no ALS association for the "C" allele. The systematic review identified aminopeptidases as possible biomarkers. However, the meta-analyses for rs1060404 of DPP6 do not show a risk associated with ALS.

eHealth literacy, internet use and health-related behaviour among health sciences students: a cross sectional study.

BACKGROUND: Health sciences students should have the necessary skills required to find health information from online resources. OBJECTIVE: To assess the eHealth Literacy Scale (eHEALS) and its association with internet use for health-related purposes, self-perceived health and health-related behaviour. METHODS: A cross-sectional study was conducted in a sample of 528 health sciences students. Sociodemographic data, questions related to internet use for health-related purposes, self-perceived health and health-related behaviour, and the eHEALS tool were collected. RESULTS: The overall mean eHEALS score was 3.19 ± 0.78. Students who consider access to health resources on the internet to be very important had the highest eHEALS scores (p = 0.015). There were significant differences between the participants' perceptions of the usefulness of the internet with regard to making health decisions (p < 0.001), the accuracy of information on the internet (p = 0.001) and the eHEALS scores. CONCLUSIONS: Health sciences students have a moderate level of eHealth literacy. Positive attitude towards internet use and positive self-perception of health are the most relevant factors associated with eHealth literacy. IMPACT STATEMENT: As future healthcare providers, students need to develop eHealth literacy skills in order to find reliable health information. A positive attitude towards internet use and a positive self-perception of health are factors associated with eHealth literacy. Educators should promote training programmes that ensure students are acquiring suitable skills in eHealth literacy.

Nursing students' experience using an escape room for training clinical skills and competencies on emergency care: A qualitative observational study.

Game-based learning is increasing in nursing education. Also, the assessment of the utility of the escape room game is growing. To explore nursing students' opinion about the escape room as an evaluation game, a qualitative observational study with nursing students was carried out. An ad hoc questionnaire with open questions was sent after the game learning experience. The escape room included knowledge and techniques from different specialties. The escape room learning game was a positive experience for the students. The main highlighted characteristics were fun, dynamic, and motivating way to study and learn. Other interesting variables were: "Working as a team and under pressure" (It's a group activity in which everyone must work together. It is a good challenge to learn how to work in urgent situations) and "Different way to assess students´ learning" (In this type of game, I can show more things and not only theoretical knowledge). Game-based learning is increasing in nursing education, as well as the assessment of the utility of the escape room game. Using an escape room for assessing nursing students' knowledge is a positive experience. This learning experience can be also used with nurses in different specialties to promote teamwork and working under pressure.

Correlation between anthropometric measurements and blood pressure in a population of Palestinian adults.

Obesity can be a major problem due to its potential to cause a number of health issues, including high blood pressure and diabetes. Many reports have come out of Palestine on overweight and obesity and their direct link to non-communicable diseases, although there is only limited evidence available on the connection between obesity and hypertension in Palestinian adults. We aimed to look at the associations between anthropometric and body composition variables and blood pressure in a large population of Palestinian adults (1337 subjects) and determine which anthropometric indices most strongly correlate with high blood pressure. Anthropometric measurements including height, waist circumference (WC), hip circumference (HC), body mass index (BMI), and total body fat (TBF) were assessed. A body composition analyzer was used to measure body weight, fat mass and fat-free mass. Systolic (SBP) and diastolic (DBP) blood pressure were measured using a Dinamap vital signs monitor. In both males and females, all the anthropometric measurements showed significant strong positive correlations with mean SBP and mean DBP (p < 0.01). SBP correlated the most strongly with waist circumference in all subjects (r = 0.444 in females, r = 0.422 in males), while DBP correlated the most strongly with WC in males (r = 0.386), but with TBF in females (r = 0.256). By controlling fat percentage, WC, HC, and BMI, which are affected by extra weight and lack of exercise, blood pressure levels can be regulated.

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.

Standardizing nursing degree curriculum structure in Spain: A mixed-methods study.

BACKGROUND: Legislation regulating Spanish and European academic curricula prescribes a certain level of knowledge and skills any student must master. Spanish universities freely decide the number of credits assigned to each subject and in which year the subject will be taught. We hypothesize that this flexibility may give way to excessively heterogeneous training across universities in nursing degrees. Such curricula heterogeneity hinders inter-university transfers and weakens educational excellence. OBJECTIVES: 1) To review the existing differences in nursing degrees in Spanish universities; 2) to compare our results against current legislation; 3) to propose changes in the legislation, if necessary. DESIGN: Mixed-methods approach. SETTING: Spain. METHODS: We reviewed nursing degree curricula of all 60 Spanish universities. Inter-university differences were analyzed and checked against current legislation. A focus group proposed legislative changes accordingly. RESULTS: Several differences between public and private universities were statistically significant. During the first cycle, public universities´ course loads include more theoretical teachings, more credits in core subjects during the first year, and more compulsory subjects in second year. Private universities are more likely to offer external internships during the first cycle whereas the public ones are more likely to offer them during the second cycle. Public universities offer more credits under the following curricular blocks than private ones: "Nutrition/Dietetics," "Psychiatry," "Public and Community Health," and "Geriatrics." In turn, private universities offer more credits in the areas of "Theory/Methodology," "Ethics/Legislation," "English," and "Theology." Academic curricula meet most of the criteria established by the Spanish and European legislation. The proposed legislative changes aim at standardizing curricula by associating specific credits and their timeline to the teaching blocks. CONCLUSIONS: Nursing degree curricula among Spanish universities are highly heterogeneous. Legislative changes to homogenize teaching blocks would facilitate credit validations and student mobility across universities, in addition to increasing nursing degrees´ standardization and excellence.

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.

Nursing-Intense Health Education Intervention for Persons with Type 2 Diabetes: A Quasi-Experimental Study.

Type 2 diabetes mellitus (DM2) is a highly prevalent disease, the progression of which depends on high blood glucose levels, which are reflected in the level of glycosylated haemoglobin (HbA1c). Appropriate health education equips patients with the knowledge and skills to control their glucose and HbA1c levels to avoid long-term complications. This study was set up to compare the results of an intensive (360 min) educational intervention to improve HbA1c parameters in patients with DM2 with those of a usual 90 min intervention. For this purpose, healthcare personnel led a quasi-experimental study of 249 diabetics: 171 in the control group, and 78 in the intervention group. In the control group, the mean HbA1c value decreased from 6.97 to 6.75, while in intervention group it fell from 8.97 to 8.06. The before and after mean difference between both groups was compared with a Wilcoxon test, and the results statistically significant (W = 4530; p < 0.001), indicating a higher reduction of HbA1c in the intervention group. We concluded that the intensive health education provided by nurses during the consultation helped improve HBA1c levels in persons with DM2.

Design of the EBE-ST Questionnaire among Nursing Students: Multicenter Study from Eight Universities in Spain.

BACKGROUND: Twenty years after the degree in nursing was introduced in Spain, the subject of evidence-based nursing is still unstructured and unestablished in most faculties. Moreover, there are hardly any rigorous studies at a national level that evaluate the current state of this competence in our faculties. Understanding the starting point is essential for the curricular design to ensure that evidence-based practice is implemented among future professionals. AIM: To design and validate an evidence-based nursing competency questionnaire for fourth-year nursing students. METHODS: A specific questionnaire was developed and validated (EBE-ST). A cross-sectional survey design with psychometric validation of an instrument. Participants were 304 senior year nursing students from eight universities in Spain (2020). RESULTS: The EBE-ST questionnaire is composed of 33 items that determine eight factors. It presents adequate reliability and validity (alpha = 0.882), measuring knowledge, attitudes and the practical application of evidence-based practice. CONCLUSIONS: We have created an instrument with good psychometric properties to measure evidence-based practice competence among senior nursing students. The heterogeneity of knowledge regarding evidence-based nursing in our country suggests that further reflection is warranted on the incorporation of this topic during undergraduate training. We have designed and validated an evidence-based nursing competency questionnaire specific to nursing students.

Prevalence and Risk Factors of Respiratory Syncytial Virus in Children under 5 Years of Age in the WHO European Region: A Systematic Review and Meta-Analysis.

A respiratory syncytial virus (RSV) is the major cause of respiratory tract infection in children under 5 years. However, RSV infection in the European Region of the World Health Organization has not been systematically reviewed. The aim was to determine the prevalence and factors associated with RSV in children under 5 years of age in European regions. A systematic review and meta-analysis was performed. CINAHL, Medline, LILACS, ProQuest, SciELO, and Scopus databases were consulted for studies published in the last 5 years, following Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. The search equation was "respiratory syncytial virus AND (newborn OR infant OR child) AND (prevalence OR risk factors)". Studies reporting the prevalence of RSV were eligible for inclusion in the meta-analysis. A total of 20 articles were included. The meta-analytic prevalence estimation of RSV, with a sample of n = 16,115 children, was 46% (95% CI 34-59%). The main risk factors were age, male gender, winter season, and environmental factors such as cold temperatures, higher relative humidity, high concentrations of benzene, exposure to tobacco, and living in urban areas. Robust age-specific estimates of RSV infection in healthy children should be promoted in order to determine the optimal age for immunization. In addition, it is necessary to analyse in greater depth the potentially predictive factors of RSV infection, to be included in prevention strategies.

Risk Factors for Short-Term Lung Cancer Survival.

BACKGROUND: Lung cancer is typically diagnosed in an advanced phase of its natural history. Explanatory models based on epidemiological and clinical variables provide an approximation of patient survival less than one year using information extracted from the case history only, whereas models involving therapeutic variables must confirm that any treatment applied is worse than surgery in survival terms. Models for classifying less than one year survival for patients diagnosed with lung cancer which are able to identify risk factors and quantify their effect for prognosis are analyzed. METHOD: Two stepwise binary logistic regression models, based on a retrospective study of 521 cases of patients diagnosed with lung cancer in the Interventional Pneumology Unit at the Hospital "Virgen de las Nieves", Granada, Spain. RESULTS: The first model included variables age, history of pulmonary neoplasm, tumor location, dyspnea, dysphonia, and chest pain. The independent risk factors age greater than 70 years, a peripheral location, dyspnea and dysphonia were significant. For the second model, treatments were also significant. CONCLUSIONS: Age, history of pulmonary neoplasm, tumor location, dyspnea, dysphonia, and chest pain are predictors for survival in patients diagnosed with lung cancer at the time of diagnosis. The treatment applied is significant for classifying less than one year survival time which confirms that any treatment is markedly inferior to surgery in terms of survival. This allows to consider applications of more or less aggressive treatments, anticipation of palliative cares or comfort measures, inclusion in clinical trials, etc.

A Combination of Self-debriefing and Instructor-led Debriefing Improves Team Effectiveness in Health Science Students.

BACKGROUND: Debriefing is considered a critical component of simulation-based learning, but the differences between different debriefing methods remain unclear. PURPOSE: The purpose of the study was to investigate the effectiveness of the debriefing assessment, problem-solving process, and team effectiveness among students who received instructor-led debriefing, self-debriefing, and combined debriefing. METHODS: An experimental design was conducted with 250 students (nursing, physiotherapy, and occupational therapy). Differences in the Debriefing Experience Scale (DES), Problem Solving Inventory (PSI), and Communication and Teamwork Skills (CATS) assessment between the groups were measured. RESULTS: In nursing students, the combined debriefing group had the highest scores for the CATS assessment (P < .001) and for the coordination (P < .001), cooperation (P = .012), and communication (P = .002) categories. No significant differences were observed between debriefing groups for DES or PSI. CONCLUSIONS: Combined debriefing improves communication and team skills in students. Educators might promote combined debriefing after simulation sessions as it seems to improve team effectiveness.

Quality of Life After Coronary Artery Bypass Surgery: A Systematic Review and Meta-Analysis.

Coronary heart disease is a public health problem and is one of the leading causes of loss of quality of life, disability, and death worldwide. The main procedure these patients undergo is cardiac catheterisation, which helps improve their quality of life, symptoms of myocardial ischemia, and ventricular function, thus helping increase the survival rate of sufferers. It can also, however, lead to physical consequences, including kidney failure, acute myocardial infarction, and stroke. The objective of this study was to analyse how coronary artery bypass grafting (CABG) influences quality of life. A systematic review and meta-analysis were conducted using the CINAHL, PubMed, Scopus, and Cuiden databases in June 2020. A total of 7537 subjects were included, 16 in the systematic review and 3 in the meta-analysis. The studies analysing quality of life using the SF questionnaire showed improvements in the quality of physical and mental appearance, and those using the NHP questionnaire showed score improvements and, in some cases, differences in quality of life between women and men. This operation seems to be a good choice for improving the quality of life of people with coronary pathologies, once the possible existing risks have been assessed.

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.

[Prevalence and asociated factor for ideation and suicide attempt in adolescents: a systematic review.] / Prevalencia y factores asociados a la ideación e intento de suicidio en adolescentes: revisión sistemática.

BACKGROUND: Suicide ranks third among the teenager's death causes around the world. Recognizing the risk factors associated to suicide can serve as a base line to design timely and effective interventions. The objective of the study was to determine the prevalence and associated factors of ideation and suicide attempt in adolescents. METHODS: It was made Systematic review, through Search of bibliographic sources Cuiden, Lilacs, Pubmed/Medline, Scielo, Science direct, Scopus and Ebsco, of primary studies. The search was conducted in January between February 2019. The search terms were Suicide, Risk Factors, Adolescents and teenagers. The appraisal of the methodological quality was carried out using a specific guidance for observational epidemiological studies. A qualitative synthesis of the findings was made. Additionally, the vote counting and sign test technique was applied. RESULTS: 23 studies were selected. A variably prevalence of suicidal behavior in adolescents was found. Associated factors had to did with alcohol, tobacco and psychoactive substance that increased the risk in 30%, depression and anxiety, a family history of suicide 43%, poor relationships with parents 56%, physical and psychological abuse, hopelessness, poor school performance and previous thoughts of suicide. CONCLUSIONS: The prevalence of suicidal behavior was variable in the adolescent population, however, in several studies there was a percentage considered high for ideas and suicide attempts that were directly related to some risk factors.

OBJETIVO: El suicidio ocupa el tercer lugar entre las causas de muerte adolescente en el mundo. Reconocer los factores de riesgo asociados a este problema puede servir de base para el diseño de intervenciones oportunas y eficaces. El objetivo del estudio fue determinar la prevalencia y los factores asociados a la ideación e intento de suicidio en adolescentes. METODOS: Se elaboró una revisión sistemática, mediante la búsqueda de estudios primarios en las fuentes bibliográficas Cuiden, Lilacs, Pubmed/Medline, Scielo, Science Direct, Scopus y Ebsco. La búsqueda se realizó entre enero y febrero de 2019. Los términos de búsqueda fueron Suicidio, Factores de riesgo y Adolescentes. La evaluación de la calidad metodológica se realizó mediante una guía específica para estudios epidemiológicos observacionales. Se realizó una síntesis cualitativa de los hallazgos. Adicionalmente, se aplicó la técnica de conteo de votos y test del signo. RESULTADOS: Se seleccionaron 23 estudios. Hubo una prevalencia variable de la conducta suicida en adolescentes. Los factores asociados tuvieron que ver con el consumo de alcohol, tabaco y sustancias psicoactivas que aumentaban el riesgo en 30%, depresión y ansiedad, antecedentes familiares de suicidio en 43%, malas relaciones con los padres en 56%, maltrato físico y psicológico, desesperanza, bajo rendimiento escolar y las ideas previas de suicidio. CONCLUSIONES: La prevalencia de la conducta suicida fue variable en la población adolescente, sin embargo, en varios estudios hubo un porcentaje considerado elevado para las ideas y los intentos de suicidio que se relacionaron de manera directa con algunos factores de riesgo.

Burnout Syndrome in Paediatric Oncology Nurses: A Systematic Review and Meta-Analysis.

Purpose: To determine levels of burnout among paediatric oncology nurses, and the risk factors that may influence its development. Method: A literature review with meta-analysis was conducted, via a search in the PubMed, CINHAL, Scopus, ProQuest (Health and Medical Complete), Scielo and PsycINFO databases, using the search equation: "Nurs* AND burnout AND oncology AND pediatric". Results: The final sample of selected studies was of eight articles. All were quantitative studies of paediatric oncology nurses, using the Maslach Burnout Inventory, written in English or Spanish. No search restrictions were established on the year of publication. The eight studies reported moderate-high levels of burnout in each of its three dimensions. These dimensions were all related to the characteristics of the profession, in terms of complexity, shifts and workload, and to sociodemographic variables such as marital status, work experience, age and gender. The prevalence meta-analytical estimation for a sample of n = 361 nurses were 37% for high emotional exhaustion, 16% for high depersonalisation and 27% for low personal fulfilment. Conclusions: Most paediatric oncology nurses present moderate-high levels of burnout. Therefore, strategies and interventions should be identified and implemented to protect these workers from the syndrome.

Play Therapy as an Intervention in Hospitalized Children: A Systematic Review.

BACKGROUND: Hospitalization disrupts children's lives and can produce feelings such as anxiety, fear, or pain. Playing is an important part of children's lives. Thus, it is necessary to ensure holistic care during the process, including play therapy. The aim of this study was to analyze the effect of therapeutic play in hospitalized children. METHODS: A systematic review was performed. The search was conducted in CINAHL (Cumulative Index of Nursing and Allied Health Literature), CUIDEN, and PubMed (Medline). The search equation was "pediatric nurs* AND play therapy". The search was performed in March 2020. RESULTS: n = 14 studies were included in the review. The studies reveal that the application of therapeutic play in hospitalized children decreases postoperative pain, improves behavior and attitude, and reduces anxiety during the hospital stay. CONCLUSIONS: play therapy has a beneficial impact on the care of hospitalized children and should be implemented in pediatric units after assessing the resources and training needed for pediatric nurses.