Burnout in nurses during the COVID-19 pandemic in China: New challenges for public health.

During the COVID-19 pandemic, frontline nurses have faced extraordinary personal and professional challenges. These challenges have had mental health consequences, and concerning reports of burnout have emerged globally. We conducted a cross-sectional survey at a designated COVID-19 hospital in Shanghai at the peak of the pandemic, i.e. about 2 months after the onset of the outbreak from February to April 2020. Findings revealed burnout in 6.85% of nurses. Of 336 respondents, 87 (25.89%) had a high level of emotional exhaustion, 61 (18.15%) had a high level of depersonalization, and 100 (29.76%) had a low level of personal accomplishment. Burnout can be prevented by offering more support from families and supervisors, paying attention to health monitoring and personal protection, and creating a rational human resource allocation and shift management system. Specific training on infection control and self-protection, mental health guidance, and stress coping techniques must be implemented. As the current health crisis ultimately abates, moving the focus from mental health issues to public health issues, more attention and support at the national and organizational levels are needed to reduce occupational discrimination, nurse autonomy and status need to be promoted, and public health emergency teams need to be created. A positive and fair working environment is essential to effective healthcare delivery.

A Large-Scale Survey on Trauma, Burnout, and Posttraumatic Growth among Nurses during the COVID-19 Pandemic.

A large-scale survey study was conducted to assess trauma, burnout, posttraumatic growth, and associated factors for nurses in the COVID-19 pandemic. The Trauma Screening Questionnaire, Maslach Burnout Inventory, and Posttraumatic Growth Inventory-Short Form were utilized. Factors associated with trauma, burnout, and posttraumatic growth were analysed using logistic and multiple regressions. In total, 12 596 completed the survey, and 52.3% worked in COVID-19 designated hospitals. At the survey's conclusion in April, 13.3% reported trauma (Trauma ≥ 6), there were moderate degrees of emotional exhaustion, and 4,949 (39.3%) experienced posttraumatic growth. Traumatic response and emotional exhaustion were greater among (i) women (odds ratio [OR]: 1.48, 95% CI 1.12-1.97 P = 0.006; emotional exhaustion OR: 1.30, 95% CI 1.09-1.54, P = 0.003), (ii) critical care units (OR: 1.20, 95% CI 1.06-1.35, P = 0.004; emotional exhaustion OR: 1.23, 95% CI 1.12-1.33, P < 0.001) (iii) COVID-19 designated hospital (OR: 1.24, 95% CI 1.11-1.38; P < 0.001; emotional exhaustion OR: 1.26, 95% CI 1.17-1.36; P < 0.001) and (iv) COVID-19-related departments (OR: 1.16, 95% CI 1.04-1.29, P = 0.006, emotional exhaustion only). To date, this is the first large-scale study to report the rates of trauma and burnout for nurses during the COVID-19 pandemic. The study indicates that nurses who identified as women, working in ICUs, COVID-19 designated hospitals, and departments involved with treating COVID-19 patients had higher scores in mental health outcomes. Future research can focus on the factors the study has identified that could lead to more effective prevention and treatment strategies for adverse health outcomes and better use of resources to promote positive outcomes.

¿Es replicable la estructura factorial del Maslach Burnout Inventory Human Service Survey (MBI-HSS) en la profesión de enfermera del Perú?: un estudio nacional / Is the factorial structure of the Maslach Burnout Inventory Human Service Survey (MBI-HSS) replicable in the nursing profession in Peru? A national study

OBJETIVO: El Maslach Burnout Inventory (MBI) es un instrumento de uso habitual para la evaluación del síndrome de burnout. La versión del MBI-Human Service Survey (MBI-HSS) fue aplicado en enfermeros peruanos para explorar la prevalencia de este síndrome, sin considerar previamente posibles evidencias de validez para acreditar su uso. El propósito de la presente investigación es evaluar la estructura interna y la confiabilidad del MBI-HSS en enfermeros peruanos. MÉTODO: El estudio se elaboró mediante análisis secundario de datos a partir de la información recogida a 2.809 enfermeros del Perú obtenidos de la Encuesta Nacional de Satisfacción de Usuarios en Salud (ENSUSALUD) aplicado el año 2014. Se elaboró un análisis factorial exploratorio y confirmatorio; la confiabilidad fue estimada con el alfa de Cronbach y Omega. RESULTADOS: Los análisis indicaron la presencia de 3 factores, pero con una reducción de 7 ítems; la confiabilidad fue aceptable con el coeficiente Omega. CONCLUSIONES: Los resultados cuestionan la validez de la versión original del MBI-HSS para su aplicación en las enfermeras peruanas, por tanto, se requiere tomar con cautela su utilidad diagnóstica. Como alternativa, es recomendable priorizar la versión de 15 ítems y continuar con los estudios de validación

OBJECTIVE: The Maslach Burnout Inventory (MBI) is an instrument commonly used for the evaluation of burnout syndrome. The version of the MBI-Human Service Survey (MBI-HSS) was applied to Peruvian nurses to explore the prevalence of this syndrome without previously considering possible evidence of validity to accredit its use. The purpose of this research is to evaluate the internal structure and reliability of the MBI-HSS in Peruvian nurses. METHODS: The study was prepared through secondary data analysis based on the information collected from 2809 nurses in Peru obtained from the National Survey of Satisfaction of Health Users (ENSUSALUD) applied in 2014. An exploratory and confirmatory factor analysis was prepared; reliability was estimated with Cronbach alpha and omega. RESULTS: The analyses indicated the presence of three factors, but with a reduction of 7 items; reliability was acceptable with the omega coefficient. CONCLUSION: The results question the validity of the original version of the MBI-HSS for its application in Peruvian nurses, therefore, its diagnostic utility should be viewed with caution. As an alternative, it is advisable to prioritise the 15-item version and to continue with validation studies

Validación lingüística del Demand-Control-Support Questionnaire para profesionales de enfermería en España / Linguistic validation of the Demand-Control-Support Questionnaire for nursing professionals in Spain

FUNDAMENTO: Los profesionales de enfermería son uno de los grupos más afectados por el estrés laboral, lo que puede afectar la calidad de vida del profesional y comprometer la calidad de los cuidados de enfermería. A nivel internacional, el Demand-Control-Support Questionnaire (DCSQ) ha demostrado ser una herramienta breve, válida y fiable para evaluar el estrés laboral. El objetivo de este estudio fue obtener una versión adaptada al español del DCSQ para profesionales de enfermería. MÉTODO: La validación lingüística se realizó en dos fases: 1) traducción-retrotraducción y adaptación lingüística del instrumento y 2) validación de contenido del instrumento mediante un panel de siete expertos y evaluación de la aplicabilidad y comprensión de la versión adaptada en una muestra de veintiún profesionales de enfermería. RESULTADOS: Fase 1) En el proceso de traducción, un ítem precisó cambios semánticos, mientras que cinco ítems precisaron cambios sintácticos. Las retrotraducciones fueron similares. Las dudas más relevantes se encontraron en el ítem 5, identificado como un ítem problemático a lo largo de todo el proceso. Fase 2) El análisis de la validez de contenido mostró excelentes resultados (índice de validez de contenido ≥ 0,90 y valores de kappa ≥ 0,65); además, el estudio piloto confirmó la adecuada comprensibilidad y aplicabilidad del cuestionario. CONCLUSIONES: El empleo de una metodología sistemática y rigurosa ha permitido obtener una versión adaptada al español del DCSQ, conceptual y lingüísticamente equivalente al instrumento original, y adecuada para valorar de manera multidimensional el estrés psicosocial de profesionales de enfermería en el ámbito laboral

BACKGROUND: Nursing professionals are one of the groups most affected by work-related stress, which may affect the professional's quality of life and the quality of nursing care. At the international level, the Demand-Control-Support Questionnaire (DCSQ) has proved to be a brief, valid and reliable tool for assessing psychosocial stress at work. The objective of this study was to obtain a Spanish version of the DCSQ for nursing professionals. METHODS: The linguistic validation proceeded in two phases: 1) forward-translation, back-translation and linguistic adaptation of the instrument and 2) content validation of the instrument using a panel of seven experts, and evaluation of the applicability and comprehension of the adapted version in a sample of twenty-one nursing professionals. RESULTS: Phase 1) In the translation process, one item required semantic changes, while five items required syntactic changes. The back-translation versions were similar, and the most relevant doubts were found in item 5, identified as a problematic item throughout the entire process. Phase 2) The content validity analysis showed excellent values (content validity index ≥ 0.90 and Kappa index values ≥ 0.65); moreover, the pilot study confirmed the adequate comprehensibility and applicability of the questionnaire. CONCLUSIONS: The use of a systematic and rigorous methodology made it possible to obtain a Spanish version of the DCSQ that is conceptually and linguistically equivalent to the original instrument and suitable for assessing psychosocial stress of nursing professionals in the workplace in a multidimensional manner

Calidad de vida laboral y autocuidado en enfermeras asistenciales con alta demanda emocional / Quality of work life and self-care in nursing staff with high emotional demand

Objetivo: Explorar las variables relacionadas con la calidad de vida laboral y el autocuidado de profesionales de enfermería en situaciones estresantes y con alta demanda emocional. Método: Cualitativo, según el paradigma constructivista, combinando el método fenomenológico-hermenéutico/interpretativo mediante el uso de entrevistas semiestructuradas. La información fue analizada con Maxqda 11. Las entrevistas se realizaron a profesionales de centros sanitarios y servicios de Valencia con perfiles característicos de enfermería en unidades médico-quirúrgicas, urgencias, oncología, atención domiciliaria, y de ayuda humanitaria. Resultados: Los factores organizativos se expresaron como barrera para el autocuidado, afectando a la actividad asistencial. Como factor protector, se señala el trato con pacientes, basado en la satisfacción que genera la relación de ayuda en situaciones de gravedad, y sufrimiento. La valoración de la calidad de vida laboral manifestada no fue la deseada y resulta deficiente. Los factores que más afectan se refieren al tipo de jornada laboral y los horarios de trabajo (turnos rodados, noches, festivos, guardias...). Las dimensiones física, psíquica y social del autocuidado, pueden atenuar los efectos negativos de esta situación. Conclusiones: Es necesario profundizar en el constructo del autocuidado, para contrarrestar los problemas y situaciones emocionalmente estresantes, plantear estrategias de intervención, planes formativos y una mayor implicación de las instituciones sanitarias en la mejora de la calidad de vida laboral de enfermería

Objective: To explore the variables related to the quality of work life and the self-care of nursing professionals working with high emotional demand. Method: Qualitative, according to the constructivist paradigm. It combines the phenomenological-hermeneutic/interpretative method with the use of semi-structured interviews. Information was analyzed with Maxqda 11. Interviews included professionals from the Valencian healthcare system, with typical profiles of nurses working in surgical units, emergencies, oncology, home care, and cooperation. Results: Organizational factors were reported as a barrier to self-care, affecting healthcare activity. Working with patients was highlighted as a protective factor, based on the satisfaction derived from helping in situations of serious illness and suffering. The quality of work life manifested was assessed as not being what they would desire and deficient. The factors that affected the professionals most were the type of working day and work schedules (shifts, nights, holidays, on call...). The physical, mental and social dimensions of self-care can attenuate the negative effects of this situation. Conclusions: It is necessary to examine in depth the construct of self-care, to counteract emotionally stressful problems and situations, to propose intervention strategies, training plans and greater involvement of health institutions in the improvement of nurses' quality of work life

Resiliencia, compromiso laboral y agotamiento profesional en personal de Enfermería / Resilience, work engagement, and professional burnout among Nursing staff

Objetivo: valorar los niveles de resiliencia, compromiso laboral (engagement) y agotamiento profesional (burnout) en el personal de Enfermería y conocer la relación entre ellos. Métodos: estudio descriptivo transversal en el personal enfermero en activo que ejercía como enfermera/o o técnico en cuidados auxiliares de Enfermería (TCAE) en el Complejo Asistencial de Segovia, durante el periodo de marzo-abril de 2016. Se registraron variables sociodemográficas, laborales y profesionales. Se usaron distintas escalas para valorar la resiliencia (escala CD-RISC), el compromiso laboral o engagement (escala UWES) y el agotamiento profesional o burnout (escala MBI-GS). Se realizó un análisis descriptivo. Se comprobó la correlación entre resiliencia, engagement y burnout, y la asociación entre ellas. Se utilizó el programa estadístico SPSS versión 20.0. Resultados: participaron 42 sujetos. Prevalecieron niveles medios (45,2%) de engagement. Respecto al burnout, prevalecieron niveles medio-bajos (26,2%) en la dimensión de agotamiento emocional, en la dimensión de cinismo niveles medio-altos (31%), al igual que en la dimensión de eficacia (33,3%). Se registró un nivel alto de resilencia en el 16,7% de los participantes. La correlación de la resiliencia con el engagement y burnout fue de 0,661 y -0,561 respectivamente (ambas p< 0,001). La resiliencia estuvo asociada con los niveles de engagement (ß= 0,567, IC95%: 0,248-0,886, p= 0,001). En cambio, no hubo asociación entre resiliencia y niveles de burnout (ß= -0,096, IC95%= -0,433 a 0,240, p= 0,566). Conclusión: el personal de Enfermería del estudio presentó niveles medios de resiliencia, engagement y burnout, y parece existir una asociación entre la resiliencia y los niveles de engagement, pero no entre la resiliencia y los niveles de burnout

Objective: to assess the levels of resilience, work engagement and professional burnout among the Nursing staff, and to understand the relationship between them. Methods: a descriptive cross-sectional study with active nursing staff working as nurses or auxiliary nurse technicians at the Complejo Asistencial de Segovia, during March-April, 2016. Sociodemographical, occupational and professional variables were registered. Different scales were used to assess resilience (CD-RISC scale), work engagement (UWES scale), and professional burnout (MBI-GS scale). A descriptive analysis was conducted. The correlation between resilience, engagement and burnout was confirmed, as well as the association between them. The SPSS statistical program version 20.0 was used. Results: the study included 42 subjects; medium levels (45.2%) of engagement prevailed. Regarding burnout, there was a prevalence of medium-low levels (26.2%) in the emotional exhaustion dimension, and medium-high levels (31%) in the cynicism dimension, as well as in the efficacy dimension (33.3%). There was a high level of resilience in 16.7% of participants. The correlation of resilience with engagement and burnout was of 0.661 and -0.561 respectively (both p< 0.001). Resilience was associated with engagement levels (ß= 0.567, CI95%: 0.248-0.886, p= 0.001). On the other hand, there was no association between resilience and burnout levels (ß= -0.096, CI95%= -0.433 to 0.240, p= 0.566). Conclusion: the Nursing staff in the study presented medium levels of resilience, engagement and burnout, and there seemed to be an association between resilience and engagement levels, but not between resilience and burnout levels

Síndrome de burnout y satisfacción laboral en enfermeras españolas en tiempo de crisis económica / Burnout Syndrome and job satisfaction among Spanish nurses at a time of economic crisis

Objetivo: analizar el grado de burnout y de satisfacción laboral en enfermeras españolas en tiempos de crisis económica. Método: la población de estudio fueron enfermeras españolas que desarrollaban su actividad en España o en el extranjero. Se distribuyó una encuesta online a través de redes sociales desde octubre de 2017 hasta mayo de 2018 que contenía el cuestionario CUBO para valorar burnout y el de satisfacción laboral de Warr, Cook y Wall. El muestreo fue por conveniencia. Se llevó a cabo un análisis descriptivo y analítico con pruebas paramétricas y no paramétricas. Resultados: participaron 1.346 enfermeras. El 39,67% tenía síndrome de burnout, el 37,07% estaba en riesgo de padecerlo. La satisfacción laboral era de grado medio y se asociaba negativamente al grado de burnout. El 16,34% pensaba que se había equivocado de profesión, el 43,16% se había planteado comenzar otros estudios para orientar su vida profesional hacia otra área y el 59,29% pensaba que se había endurecido emocionalmente. Los profesionales de Enfermería estaban insatisfechos fundamentalmente con su salario, las relaciones sociales entre dirección y trabajadores, las oportunidades de promoción, la forma de dirección de la empresa, la atención que se presta a sus sugerencias y las horas de trabajo. Se encontró correlación negativa entre la satisfacción laboral y el síndrome de burnout. La mayoría consideraba que la crisis había afectado a sus condiciones laborales. Conclusiones: se ha detectado un elevado grado de burnout y de insatisfacción laboral en profesionales de Enfermería españoles. Se presenta asociación negativa entre el síndrome de burnout y la satisfacción laboral. Los profesionales de Enfermería consideran que la crisis económica ha repercutido negativamente en la profesión

Objectives: to analyze the level of burnout and job satisfaction among Spanish nurses at times of economic crisis. Methods: the study population consisted in Spanish nurses carrying out their activity in Spain or abroad. An online survey was distributed through the social networks from October, 2017 until May, 2018, including the CUBO questionnaire for burnout assessment, and the Warr, Cook, and Wall's Job Satisfaction Scale. Convenience sampling was used, and descriptive and analytical analysis was conducted with parametric and non-parametric tests. Results: the study included 1,346 nurses; 39.67% of them had Burnout Syndrome, and 37.07% were at risk of suffering it. Also, 16.34% of them thought that they had chosen the wrong profession, 43.16% had considered studying something different in order to orientate their professional life towards another area, and 59.29% of them thought that they had become emotionally tougher. Nursing professionals were essentially unsatisfied with their salary, the social relationships between management and workers, promotion opportunities, the way in which the company was managed, the attention paid to their suggestions, and their working hours. A negative correlation was found between job satisfaction and Burnout Syndrome. The majority considered that the crisis had had an impact on their working conditions. Conclusions: a high level of burnout and job dissatisfaction has been detected among the Spanish Nursing professionals. There is a negative association between Burnout Syndrome and job satisfaction. Nursing professionals consider that the economic crisis has had a negative impact on their profession

Impacto del Diplomado Prevención de Burnout en el autocuidado del personal de enfermería / Impact of Postgraduate Course Prevention of Burnout in the self-care of the personnel of infirmary

Introducción: El proceso de cuidar es el resultado de una construcción propia de cada situación, se origina con la identificación de los problemas de salud y las necesidades reales o potenciales de las personas, familia y comunidad que demandan cuidado. Objetivo: Evaluar el impacto del Diplomado Prevención del Síndrome de Burnout, en el autocuidado del personal de enfermería de la Atención Secundaria de Salud de la provincia Camagüey. Métodos: Se realizó un estudio descriptivo observacional, en el Hospital Amalia Simoni Argilagos de Camagüey, durante el Diplomado Prevención del Síndrome de Burnout dirigido al personal de enfermería de la Atención Secundaria de Salud. Para ello se aplicó una encuesta y el Test Psicológico de Maslach y Jackson al inicio y al final de la aplicación del Diplomado. Los datos aportados por estos instrumentos se complementaron con los provenientes de la aplicación de la técnica del PNI.Resultados: Predominó el sexo femenino. El total de los cursistas son licenciados en Enfermería. Con la ejecución del diplomado se constatan cambios importantes en cuanto a la autopreparación, el rendimiento, los hábitos de descanso, satisfacción personal y realización de ejercicios físicos. Discusión: La aplicación del diplomado logró transformar estilos de trabajo, afrontamientos al estrés, así como una mejor satisfacción personal y colectiva(AU)

Introduction: The process of taking care is the result of a proper construction of every situation, it originates with the identification of the problems of health and the real or potential needs of the persons, family and community that demand care. Objective: To evaluate the impact of Postgraduate Course Prevention of the Syndrome of Burnout, in the self-care of the personnel of infirmary of the Secondary Attention of Health of the Camagüey province. Methods: a descriptive, observational study was carried out in the Hospital Amalia Simoni Argilagos of Camagüey, during Postgraduate Course Prevention of the Syndrome of Burnout directed to the personnel of infirmary of the Secondary Attention of Health. For that reason, a survey and the Psychological Test of Maslach and Jackson was applied at the beginning and at the end of the application of the course. The information contributed by these instruments complemented itself with the originated ones from the application of the technique of the PNI. Results: The sex that predominated was the feminine one. All of the students are licensed in Infirmary. With the execution of the course important changes are stated as for the self-preparation, the yield, the habits of rest, personal satisfaction and achievement of physical exercises.Discussion: The application of the course managed to transform styles of work, confrontations to the stress, as well as a better personal and collective satisfaction(AU)

Why is change a challenge in acute mental health wards? A cross-sectional investigation of the relationships between burnout, occupational status and nurses' perceptions of barriers to change.

Changes in UK psychiatric wards have been difficult to implement. Specific areas of nursing staff resistance remain unclear. Previous healthcare research suggests that burnout is common and that managers' regard changes more positively than direct care staff. We will therefore examine whether burnout and workforce characteristics influence psychiatric nurses' perceptions of barriers to change. Psychiatric nurses (N = 125) completed perceptions measures of 'barriers to change' (VOCALISE: subscales included 'powerlessness, confidence and demotivation'); and 'burnout' (Maslach Burnout Inventory: subscales included 'emotional exhaustion, personal accomplishment and depersonalization '). Staff characteristics, such as length of employment, occupational status, education, ethnicity, gender and age, were also collected. Correlations between these measures informed random-effects regression models, which were conducted to predict the barriers to change score and to explore differential effects in the subscales of VOCALISE. Perceptions of barriers to change (VOCALISE) were correlated with burnout (r = 0.39), occupational status (r = -0.18) and age (r = 0.22). Burnout (Coef. ß: 10.52; P > 0.001) and occupational status (Coef. ß: -4.58; P = 0.05) predicted VOCALISE. Emotional exhaustion (Coef. ß: 0.18; P < 0.001) and low personal accomplishment (Coef. ß: 0.21; P = 0.001) predicted powerlessness. Emotional exhaustion predicted low motivation regarding changes (Coef. ß: 0.11; P = 0.005). Low confidence predicted high levels of depersonalization (Coef ß: 0.23; P = 0.01). Direct care staff expressed significantly more powerlessness (Coef. ß: -2.60; P = 0.02) and significantly less confidence (Coef. ß: -3.07; P = 0.002) than managers. For changes to be successful in psychiatric wards, burnout will need to be addressed. Future change strategies may consider involving direct care staff to improve perceptions of barriers to change.

Resilience and mental health nursing: An integrative review of international literature.

Mental health nurses work in challenging and potentially high stress settings. Stressors can occur in the context of consumer, family, and/or staff relationships, as well as the work environment and organization. The cumulative effects of stress and professional challenges can lead to harmful impacts for mental health nurses including burnout and poorer physical and mental health. Resilience involves a process of positive adaptation to stress and adversity. The aims of this integrative review were to examine understandings and perspectives on resilience, and explore and synthesize the state of knowledge on resilience in mental health nursing. Following systematic search processes, screening, and data extraction, 12 articles were included. Constant comparative analysis and synthesis of the data resulted in two key categories: Theoretical concepts of resilience and Knowledge on mental health nurses' resilience. In mental health nursing, resilience has been variously constructed as an individual ability, collective capacity, or as an interactive person-environment process. Resilience was most often reported as low-moderate, with positive correlations with hardiness, self-esteem, life and job satisfaction, and negative correlations with depression and burnout. A resilience programme improved mental health nurses' coping self-efficacy and capacity to regulate thoughts and emotions and developed their resilient practice. Use of contemporary resilience definitions will inform more consistent investigation and progressively scaffold knowledge of this emergent construct in mental health nursing. Future research on the implementation of resilience programmes and resilience-building strategies for mental health nurses at the individual, work unit, and organizational levels is needed.

Un estudio sobre la precariedad laboral en enfermería: consecuencias y relaciones en torno al síndrome de agotamiento y el abandono profesional / A study about precarious work in nursing: consequences and relationships around the syndrome of burnout and professional abandonment

Los profesionales de enfermería constituyen cuantitativamente la mayor fuerza de trabajo en los sistemas de salud de casi todos los países del mundo, sin embargo, el índice de abandono de la profesión es importante, un problema que merece encontrar soluciones. Muchos son los motivos que se han esgrimido para ello, pero entre los que menos han sido estudiados, estarían algunas relaciones contractuales precarias que se dan en España y que no parecen estar en sintonía con las recomendaciones internacionales sobre la calidad en el trabajo enfermero. Objetivo: la posible existencia de una relación entre este tipo de contratos con el agotamiento profesional y, en caso positivo, con una posible afectación de la vida cotidiana que redunde en la satisfacción laboral y en la posibilidad del abandono laboral constituye el objetivo principal de este estudio. Método: para ello, se ha llevado a cabo un estudio observacional, descriptivo y transversal sobre una muestra de 216 enfermeros con experiencia en contratos precarios denominados tipo "Pool"/"volante". Los cuestionarios utilizados fueron el Maslach Burnout Inventory, para evaluar el síndrome de agotamiento profesional, y un cuestionario de elaboración propia consistente en 8 preguntas sociodemográficas y sobre aspectos de su vida cotidiana que pudieran tener relación con el abandono laboral. Resultados: la muestra estudiada posee un nivel medio en la escala de agotamiento emocional con 23,3 puntos [desviación típica = 11,42], un nivel elevado en la escala de despersonalización con 10,70 puntos [6,33] y un nivel elevado de realización personal con 31,63 puntos [9,25]. Conclusiones: los resultados de este estudio concluyen que los profesionales con relaciones contractuales "Pool"/"volante" presentan un nivel medio-elevado de agotamiento profesional. A su vez se han podido observar asociaciones estadísticamente significativas entre puntuaciones elevadas en las diferentes esferas del síndrome y aspectos de la vida personal de los enfermeros estudiados, lo que estaría influyendo en los sentimientos de insatisfacción personal y aumentando las posibilidades de incidencia sobre el abandono profesional

Nursing professionals are quantitatively the largest workforce in the health systems of almost all countries in the world however, the rate of abandonment of the profession is important problem that deserves to find solutions. There are many reasons for this, but among those that have been least studied, there would be some precarious contractual relationships that occur in Spain and do not seem to be in line with international recommendations on quality in nursing work. Objective: the possible existence of a relationship between this type of contract with syndrome of burnout and, in a positive case, with a possible impact on daily life, that results in job satisfaction and the possibility of leaving the workplace, is the main objective of this study Method: to this end, an observational, descriptive and cross-sectional study was carried out on a sample of 216 nurses with experience in precarious contracts called "Pool" / "volante", type. The questionnaires used were the Maslach Burnout Inventory, to evaluate the syndrome of professional exhaustion, and a self-prepared questionnaire consisting of 8 sociodemographic questions and aspects of their daily life that may be related to the abandonment of work. Results: the sample studied has an middle level on the emotional exhaustion scale with 23.3 points [standard deviation = 11.42], a high level on the depersonalization scale with 10.70 points[6.33] and a high level of personal achievement with 31.63 points[9.25]. Conclusions: the results of this study conclude that professionals with contractual relations "Pool" / "volante", present a medium-high level of professional exhaustion. At the same time, statistically significant associations have been observed between high scores in the different spheres of the syndrome and aspects of the personal life of the nurses studied, which would be influencing the feelings of personal dissatisfaction and increasing the possibilities of incidence on professional abandonment

Factores asociados con los niveles de burnout en enfermeros de urgencias y cuidados críticos / Nurse burnout in critical care units and emergency departments: intensity and associated factors

Objetivos. Describir los niveles de síndrome de burnout y su relación con variables sociodemográficas, laborales y psicológicas en enfermeras de emergencias y cuidados críticos. Método. Se realizó un estudio tipo encuesta en una muestra de enfermeras de emergencias y cuidados críticos de Andalucía (España). Las variables recogidas fueron datos sociodemográficos, laborales, tipo de personalidad, ansiedad, depresión y el nivel de burnout. Resultados. Del total de 1.721, se encuestaron 337 (19,5%) enfermeras. Un 38,5% de los participantes se encontraba en una fase de burnout alto. Un 10,5% de la muestra presentó un nivel alto de agotamiento emocional, un 16,8% obtuvo niveles altos de despersonalización y un 63,3% puntuó bajo en realización personal, obteniéndose relaciones significativas entre los factores de personalidad y la depresión con un nivel alto de burnout. Conclusiones. Más de un tercio de las enfermeras de emergencias y cuidados críticos presentaron un nivel de burnout alto. Los factores de personalidad y los niveles altos de depresión se asociaron con la presencia de síndrome de burnout en estos profesionales

Objectives. The aim of this study was to describe the level of nurse burnout in critical care units and emergency departments and to analyze the relation between intensity of burnout and sociodemographic, workplace, and psychological factors. Methods. Survey of a sample of emergency and critical care nurses in Andalusia, Spain. Sociodemographic and work variables as well as personality type, anxiety, depression, and level of burnout. Results. Of a total of 1721 critical care and emergency nurses in Andalusia, 337 (19.5%) were surveyed. A high level of burnout was detected in 38.5%. Emotional exhaustion was present in 10.5% of the sample, depersonalization in 16.8%, and a low level of personal accomplishment in 63.3%. A high burnout score was significantly associated with personality factors and depression. Conclusions. More than a third of emergency and critical care nurses experience a high level of burnout. Personality factors and high levels of depression are associated with burnout in nurses

Estrés y bienestar en profesionales de enfermería intensiva dentro del ámbito de la donación y el trasplante de órganos: una propuesta desde la psicología de la salud ocupacional / Stress and well-being in nursing professionals of intensive care within the organ donation and transplantation field: a proposal from the occupational health psychology

Los profesionales de enfermería que trabajan en unidades de cuidados intensivos y que participan en las actividades relacionadas con la donación y trasplante de órganos están expuestos a un número importante de estresores en su trabajo, lo que favorece la aparición de determinados riesgos psicosociales como son el estrés laboral, el desgaste profesional, el trabajo emocional, el estrés traumático secundario, el estrés moral y el conflicto entre el trabajo y la familia. Además, los nuevos escenarios que se presentan y van consolidando en nuestro país en relación a la donación de órganos, como son la donación en asistolia controlada y no controlada, o los cuidados intensivos orientados a la donación, generan nuevas situaciones y estresores a estos profesionales que aumentan su exposición al riesgo psicosocial en su trabajo. Por todo ello, aquí llevamos a cabo una revisión y propuesta de las demandas específicas y las causas que podrían influir en el desarrollo de estos riesgos entre estos profesionales, así como sus posibles consecuencias. También se proponen una serie de recursos laborales y personales que podrían ser útiles para afrontar las demandas laborales y que satisfacen muchas de las necesidades apuntadas por organismos de referencia en éste ámbito para la prevención y promoción de la salud y bienestar dentro de este colectivo, así como para la mejora del proceso de donación y trasplante de órganos

Nursing professionals who work in intensive care units and participate in activities related to organ donation and transplantation are exposed to a significant number of stressors their work, which favors the appearance of certain psychosocial risks such as work stress, burnout, secondary traumatic stress, moral stress, and the conflict between work and family. In addition, the new scenarios in our country in relation to organ donation, such as uncontrolled and controlled donation after cardiac death, or the intensive cares oriented to organ donation, generate new situations and stressors among these professionals that increase their exposure to psychosocial risks. Therefore, this paper reviews and proposes the specific demands and causes that could influence the development of these risks these professionals, as well as their possible consequences. It also proposes a series of job and personal resources that could be useful to these workers to face these job demands. These proposals meet many of the needs pointed by reference institutions in this field to prevention and promotion of health and well-being in this group of professionals, as well as to improve the process of organ donation and transplantation

Percepción sobre la calidad de los cuidados, entorno laboral y características del sueño de las enfermeras que trabajan en el Sistema Nacional de Salud / Perception of the quality of care, work environment and sleep characteristics of nurses working in the National Health System

OBJETIVO: Describir la percepción de las enfermeras sobre la calidad de los cuidados que prestan y de su entorno laboral, así como analizar las características del sueño. Analizar si existe relación entre la unidad y el turno de trabajo con la percepción de las enfermeras de su entorno laboral y con la calidad de sueño y la somnolencia diurna. MÉTODO: Estudio multicéntrico, observacional, descriptivo realizado entre los años 2012 y 2014 en 7 hospitales españoles del Sistema Nacional de Salud que mostraron su interés por participar en este proyecto de seguimiento. Se ha medido el entorno laboral, la satisfacción laboral, la calidad del sueño y la calidad de los cuidados con herramientas validadas. RESULTADOS: Participaron en el estudio 635 enfermeras. Un 83,7% percibía la calidad de los cuidados como buena/excelente, y el 55,1% valoró el entorno laboral de su hospital como bueno/excelente. El PES-NWI clasificó al 39% de los hospitales como desfavorable y al 20% como favorable. El 15,4% de las enfermeras tenía alto nivel de burnout y el 58,3% bajo. La calidad del sueño fue de 6,38 para el turno de día, de 6,78 para el turno rotatorio y de 7,93 para el turno de noche. Se encontraron diferencias en la calidad subjetiva, en la duración, en las perturbaciones del sueño y en la disfunción durante el día. CONCLUSIONES: En la prestación de cuidados de calidad interactúan multitud de factores como el turno, la unidad, la satisfacción, la percepción de la seguridad y la calidad del sueño

OBJECTIVE: To describe nurses' perception in relation to the quality of care and their work environment, as well as to describe their quality of sleep. To analyze the relationship between ward and work shift with nurses' perception of their work environment, sleep quality and day time drowsiness. METHODS: A multicentre, observational and descriptive study carried out between 2012-2014 in seven hospitals of the Spanish National Health System. Work environment, work satisfaction, sleep quality and quality of patient care were evaluated through validated tools. RESULTS: 635 registered nurses participated in the study. Eighty-three point seven percent perceived the quality of cares as good/excellent, and 55.1% rated the work environment of their hospital as good/excellent. PES-NWI classified 39% of hospitals as unfavourable and 20% as favourable. Fifteen point four percent of the nurses had a high level of burnout and 58.3% had low burnout. Sleep quality was 6.38 for nurses working on day shifts, 6.78 for the rotational shifts and 7.93 for night shifts. Significant differences were found between subjective sleep quality score, sleep duration, sleep disturbances and daytime dysfunction. CONCLUSIONS: In the provision of quality care services, there is a multitude of related factors such as shift, ward, satisfaction, and nurses' perceptions of patient safety and sleep quality

Moral Distress (MD) and burnout in mental health nurses: a multicenter survey.

INTRODUCTION: Moral Distress (MD) is a common experience among nurses and if it is not recognised and treated, it may lead to serious consequences on nurses' health and quality of care. MD has been studied in several healthcare contexts. However, there are only few studies on MD in psychiatry and in Italy there are no data in this field.  Objective: To assess the presence of MD among mental health nurses in Italy and verify whether there is a relationship between MD and burnout. METHODS: We conducted a multicentre survey among nurses of Mental Health services of four hospitals in Milan. The MD Scale for Psychiatric NursesItalianrevised (MDS-PItarev) and the Maslach Burnout Inventory (MBI) were used for data collection. Factor analysis and calculation of content validity index (CVI) and Cronbach's alpha were performed on the Italian version of the MDS-PIta. Three items of the old version of the scale were removed, because judged not relevant in the Italian context. The revised scale maintained excellent CVI (0.89) and Cronbach's alpha (0.93). RESULTS: Of 285 questionnaires distributed, 228 (80%) were returned. The median of MD was 2 (scale range 0-6); MD is correlated with two burnout dimensions: emotional exhaustion (rho(ρ)=0.28, p<0,001) and depersonalization (ρ=0.20, p<0,001). CONCLUSIONS: This is the first study about MD among psychiatric nurses in Italy. We found a medium-low level of MD among nurses who participated in the survey. We also found a modest but significant correlation between MD and two dimensions of MBI. Further studies are needed to confirm these results.

Factores de estrés laboral en el personal de enfermería hospitalario del equipo volante según el modelo de demanda-control-apoyo / Factors of work-related stress in hospital nursing bureau according to the demand-control-support model

Objetivos: Analizar la presencia de estrés laboral en el equipo volante de enfermería de un Hospital General Universitario tomando como referencia el modelo demandas-control-apoyo de Karasek. Método: Estudio observacional de corte transversal. La muestra estuvo constituida por 38 profesionales de enfermería del equipo volante de un Hospital General Universitario. Instrumentos de evaluación: para conocer la percepción de los profesionales de enfermería sobre el contenido de su trabajo y determinar los estresores laborales, se empleó el cuestionario Job Content Questionnaire (JCQ) traducido y validado para enfermería hospitalaria. Resultados: La tasa de participación fue del 90,47% (N=38). Se registró una media para la dimensión de apoyo social de 2,59±0,47, para la dimensión de demandas psicológicas en el trabajo de 3,26±0,47, y para la dimensión de control sobre el trabajo se obtuvo una media de 2,87±0,40. El análisis de datos puso de manifiesto un nivel moderado de estresores, destacando un déficit de apoyo social por parte de los superiores, que resultó ser más acusado en el grupo de profesionales adscritos a la dirección de enfermería (2,89 vs 2,49; p<0,05). Ninguna de las tres dimensiones se mostró asociada a las variables socio-laborales de sexo, edad, turno, adscripción y tipo de vinculación al hospital. Conclusiones: Existe una percepción moderada de estresores laborales, resaltando el escaso apoyo social por parte de los superiores, siendo este aspecto una área de mejora sobre la que intervenir

Objectives: To analyse the presence of work-related stress in the nursing bureau of a University General Hospital taking as reference Karasek's demand-control-support model. Methods: Cross-sectional observational study. The sample included 38 nursing professionals from the nursing bureau of a University General Hospital. Assessment tools: the Job Content Questionnaire (JQC), translated and validated for hospital nursing, was used to know the perception of nursing professionals concernins their work, and to determine the presence of any work-related stressors. Results: The participation rate was 90.47% (N=38). The average for the social support dimension was 2.59±0.47, for the psychological demands of 3.26±0.47, and for control over their own work of 2.87±0.40. Data analysis pointed to a moderate level of stress, reflecting a deficit in the social support provided by superiors, particulary in the group of professionals assigned to nursery management (2.89 vs 2.49; p<0.05). None of the three dimensions showed a link of any kind with socio-occupational variables of gender, age, shift, assignment or type of connection to the hospital. Conclusion: Improvement is needed in this area on the part of human resources management in order to lessen the effect of work-related stress, psychological demands and lack of control over these

Los factores relacionados con el desarrollo de el estrés y el burnout entre los profesionales de enfermería que trabajan en el cuidado de las personas que viven con el VIH / sida / Fatores relacionados ao desenvolvimento de estresse e burnout entre profissionais de enfermagem que atuam na assistência a pessoas vivendo comHIV/aids / Factors related to the development of stress and burnout among nursing professionals who work in the care of people living with HIV/aids

Objetivo: identificar quais os fatores relacionados ao desenvolvimento de desgaste emocional, estresse e Burnout estão presentes na assistência de enfermagem às pessoas vivendo com HIV/AIDS. Método: Revisão integrativa de literatura, com busca eletrônica de publicações nas bases de dados MEDLINE e LILACS, utilizando-se os descritores: esgotamento profissional, enfermagem, infecções por HIV em português e/ou em suas variações na língua inglesa. Resultados: Somente 9 artigos foram incluídos na seleção por se enquadrarem nos critérios de inclusão e atender a questão norteadora. Ressalta-se que 100% destes artigos são originários de periódicos internacionais, assim como desenvolvidos no continente africano. Conclusão: Estressores como falta de recursos, dificuldades para atender às expectativas da clientela, sobrecarga de trabalho, necessidade de lidar com a morte dos clientes e medo de contaminação estão presentes no cotidiano desses profissionais, podendo culminar na ocorrência de estresse e Burnout, e comprometer a assistência prestada.

Objetivo: identificar factores relacionados con el desarrollo de agotamiento emocional, estrés y burnout presentes en los cuidados de enfermería a personas que viven con el VIH/SIDA. Método: revisión integrativa de literatura con búsqueda electrónica de publicaciones en las bases de datos MEDLINE y LILACS, utilizando los descriptores: burnout, enfermería, infecciones por VIH en portugués y/o variaciones en el idioma Inglés. Resultados: 9 artículos fueran incluídos en la selección porque se ajustan a los criterios de inclusión y responden a pregunta de guía. 100% de estos artículos se originan en revistas internacionales, así como desarrollado en África. Conclusión: Factores de estrés como falta de recursos, dificultades para cumplir con las expectativas del cliente, carga de trabajo, tener que lidiar con la muerte y temor a la contaminación están presentes en la vida diaria de estos profesionales y puede resultar en aparición de estrés, agotamiento y daño a la asistencia prestada.

Objective: to identify factors related to the development of emotional exhaustion, stress and burnout that are present in nursing care to people living with HIV/AIDS. Method: Integrative review of literature with electronic search of publications in the MEDLINE and LILACS databases, using the descriptors: burnout, nursing, HIV infections in Portuguese and/or variations in the English. Results: Only 9 articles were included into the selection because they fit the inclusion criteria and answer the guiding question. It is noteworthy that 100% of these items were originated from international journals, as well as developed in Africa. Conclusion: Stressors such as lack of resources, difficulties to meet the customer’s expectations, workload, need to deal with the death of customers and fear of contamination are present in the daily lives of these professionals and may result in the occurrence of stress and burnout, and compromise the assistance provided.

Serviços de saúde mental: percepção da enfermagem em relação à sobrecarga e condições de trabalho / Servicios de salud mental: percepción de las enfermeras frente a la sobrecarga y condiciones de trabajo / Mental health services: perception of nursing in relation to overload and working conditions

Objective: to identify the perception of nursing professionals about the work overload in hospital psychiatric services. Method: descriptive, analytical and exploratory study analyzed through Bardin referential. Data collection occurred from April to May 2013 with 70 nursing professionals who underwent Labor Impact Assessment Scale Mental Health Services. Once authorized by the Ethics Committee Unicesumar (CAEE n. 13676913.2.0000.5539). Results: thematic categories: The causes of work overload; Aspects that relieve the workload and changes proposed to reduce the workload. Conclusion: The main factor is that overload relates to the lack of human resources and relations between professionals. The management of the work process can be a strategy to reduce the burden of work.

Objetivo: conhecer a percepção dos profissionais de enfermagem em relação à sobrecarga e condições de trabalho em serviços psiquiátricos hospitalares. Método: Estudo descritivo, analítico e exploratório, desenvolvido a partir do referencial de Bardin. A coleta de dados ocorreu no período de abril a maio de 2013 com 70 profissionais de enfermagem, aplicando-se a Escala de Avaliação do Impacto do Trabalho em Serviços de Saúde Mental. Obteve-se o Certificado de Apresentação para Apreciação Ética sob nº 13676913.2.0000.5539. Resultados: Da análise de conteúdo emergiram três categorias: As causas da sobrecarga de trabalho; Aspectos que aliviam a sobrecarga; Mudanças propostas para diminuir a sobrecarga. Considerações finais: Falta de recursos humanos e relações interpessoais conflituosas incrementam a sobrecarga, ao passo que a infraestrutura física do ambiente influencia negativamente nas condições de trabalho.

Objetivo: identificar la percepción de los profesionales de enfermería acerca de la sobrecarga de trabajo em los servicios de psiquiatria del hospital. Método: estúdio descriptivo, analítico y exploratório analizada a través Bardin referencial. Los datos fueron recolectados entre abril y mayo de 2013, con 70 profesionales de enfermería que se sometieron Trabajo de Impacto Escala de Evaluación de Servicios de Salud Mental. Una vez autorizado por el Comité de Ética Unicesumar (CAEE n. 13676913.2.0000.5539). Resultados: categorías temáticas: Las causas de la sobrecarga de trabajo; Aspectos que alivian la carga de trabajo y los câmbios propuestos para reducir la carga de trabajo. Conclusión: El principal factor que la sobrecarga se relaciona com la falta de recursos humanos y las relaciones entre los profesionales. La gestión del proceso de trabajo puede ser una estrategia para reducir la carga de trabajo.