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Nursing Open Mar 2023This study aimed to determine factors that influence the nursing workforce shortage and their impact on nurses. (Meta-Analysis)
Meta-Analysis Review
AIM
This study aimed to determine factors that influence the nursing workforce shortage and their impact on nurses.
DESIGN
This study applied a systematic review design.
METHODS
Using Cochrane library guidelines, five electronic databases were systematically searched (Research 4life-PubMed/Medline, Scopus, Embase, CINAHL) from 2010-2021. The remaining articles with pertinent information were presented in a data extraction sheet for further thematic analysis. A Reporting Items for Systematic Reviews and Meta-Analysis Flow Diagram was adopted and used. The studies published from 2010-2021 and in English language were examined and included in the systematic review.
RESULTS
Four themes were identified as factors influencing the nursing workforce shortage, including Policy and planning barriers, Barriers to training and enrolment, Factors causing nursing staff turnover and Nurses' stress and burnout. Nursing workforce shortage is a global challenge that roots in multiple causes such as individual, educational, organizational and managerial and policy-making factors.
Topics: Humans; Hospitals; Job Satisfaction; Nursing Staff, Hospital; Workforce
PubMed: 36303066
DOI: 10.1002/nop2.1434 -
Minerva Anestesiologica Aug 2019The underlying clinical condition and the Intensive Care Unit (ICU) environment make critical illness a stressful event. Although the usual management consists of... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
The underlying clinical condition and the Intensive Care Unit (ICU) environment make critical illness a stressful event. Although the usual management consists of sedation, non-pharmacological interventions such as music therapy have been suggested for their drug-sparing effect. Aim of the present review is to assess the current evidence on the effectiveness of music therapy in reducing stress and anxiety in critically ill, adult patients.
EVIDENCE ACQUISITION
A systematic review of publications was undertaken using MEDLINE, CINAHL, Cochrane Library, Scopus, Web of Science, Indice Italiano di Letteratura di Scienze Infermieristiche. We included studies of critically ill patients that assessed any effect of music therapy on stress and anxiety, which were variably assessed according to each study's definition.
EVIDENCE SYNTHESIS
Eleven studies were included (10 RCTs and one quasi-experimental design), for a total of 959 patients (range 17-373). The overall quality of the studies was satisfactory; several potential sources for bias were identified. Music therapy was generally provided as a single, 30'-intervention, ranging from 15 to 60'. Only in two studies was the intervention repeated more than once daily. The control groups were standard care, relaxation, headphones with no music or noise-cancelling headphones. Music therapy determined a significant reduction in the levels of anxiety and stress, as assessed by self-reported scales and physiologic parameters. Pooled analysis was not performed due to the heterogeneity of the interventions.
CONCLUSIONS
Despite significant heterogeneity in trial designs, timing and features of the intervention, music therapy is consistently associated with a reduction in anxiety and stress of critically ill patients.
Topics: Anxiety; Critical Illness; Humans; Music Therapy; Randomized Controlled Trials as Topic; Stress, Psychological
PubMed: 30947484
DOI: 10.23736/S0375-9393.19.13526-2 -
Medicine Jun 2020Numerous systematic reviews and meta-analyses on the interventions to reduce burnout of physicians and nurses have been published nowadays. This study aimed to summarize... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
Numerous systematic reviews and meta-analyses on the interventions to reduce burnout of physicians and nurses have been published nowadays. This study aimed to summarize the evidence and clarify a bundled strategy to reduce burnout of physicians and nurses.
METHODS
Researches have been conducted within Cochrane Library, PubMed, Ovid, Scopus, EBSCO, and CINAHL published from inception to 2019. In addition, a manual search for relevant articles was also conducted using Google Scholar and ancestral searches through the reference lists from articles included in the final review. Two reviewers independently selected and assessed, and any disagreements were resolved through a larger team discussion. A data extraction spreadsheet was developed and initially piloted in 3 randomly selected studies. Data from each study were extracted independently using a pre-standardized data abstraction form. The the Risk of Bias in Systematic reviews and assessment of multiple systematic reviews (AMSTAR) 2 tool were used to evaluate risk of bias and quality of included articles.
RESULTS
A total of 22 studies published from 2014 to 2019 were eligible for analysis. Previous studies have examined burnout among physicians (n = 9), nurses (n = 6) and healthcare providers (n = 7). The MBI was used by majority of studies to assess burnout. The included studies evaluated a wide range of interventions, individual-focused (emotion regulation, self-care workshop, yoga, massage, mindfulness, meditation, stress management skills and communication skills training), structural or organizational (workload or schedule-rotation, stress management training program, group face-to-face delivery, teamwork/transitions, Balint training, debriefing sessions and a focus group) and combine interventions (snoezelen, stress management and resiliency training, stress management workshop and improving interaction with colleagues through personal training). Based on the Risk of Bias in Systematic reviews and AMSTAR 2 criteria, the risk of bias and methodological quality included studies was from moderate to high.
CONCLUSIONS
Burnout is a complicated problem and should be dealt with by using bundled strategy. The existing overview clarified evidence to reduce burnout of physicians and nurses, which provided a basis for health policy makers or clinical managers to design simple and feasible strategies to reduce the burnout of physicians and nurses, and to ensure clinical safety.
Topics: Burnout, Professional; Humans; Nurses; Physicians; Workload
PubMed: 32590814
DOI: 10.1097/MD.0000000000020992 -
Patient Education and Counseling Mar 2021Global migration and linguistic diversity are at record highs, making healthcare language barriers more prevalent. Nurses, often the first contact with patients in the... (Review)
Review
OBJECTIVE
Global migration and linguistic diversity are at record highs, making healthcare language barriers more prevalent. Nurses, often the first contact with patients in the healthcare system, can improve outcomes including safety and satisfaction through how they manage language barriers. This review aimed to explore how research has examined the nursing workforce with respect to language barriers.
METHODS
A systematic scoping review of the literature was conducted using four databases. An iterative coding approach was used for data analysis. Study quality was appraised using the CASP checklists.
RESULTS
48 studies representing 16 countries were included. Diverse healthcare settings were represented, with the inpatient setting most commonly studied. The majority of studies were qualitative. Coding produced 4 themes: (1) Interpreter Use/Misuse, (2) Barriers to and Facilitators of Quality Care, (3) Cultural Competence, and (4) Interventions.
CONCLUSION
Generally, nurses noted like experiences and applied similar strategies regardless of setting, country, or language. Language barriers complicated care delivery while increasing stress and workload.
PRACTICE IMPLICATIONS
This review identified gaps which future research can investigate to better support nurses working through language barriers. Similarly, healthcare and government leaders have opportunities to enact policies which address bilingual proficiency, workload, and interpreter use.
Topics: Allied Health Personnel; Communication Barriers; Delivery of Health Care; Humans; Quality of Health Care; Workload
PubMed: 32994104
DOI: 10.1016/j.pec.2020.09.017 -
CA: a Cancer Journal For Clinicians May 2017Answer questions and earn CME/CNE Patients with breast cancer commonly use complementary and integrative therapies as supportive care during cancer treatment and to... (Review)
Review
Answer questions and earn CME/CNE Patients with breast cancer commonly use complementary and integrative therapies as supportive care during cancer treatment and to manage treatment-related side effects. However, evidence supporting the use of such therapies in the oncology setting is limited. This report provides updated clinical practice guidelines from the Society for Integrative Oncology on the use of integrative therapies for specific clinical indications during and after breast cancer treatment, including anxiety/stress, depression/mood disorders, fatigue, quality of life/physical functioning, chemotherapy-induced nausea and vomiting, lymphedema, chemotherapy-induced peripheral neuropathy, pain, and sleep disturbance. Clinical practice guidelines are based on a systematic literature review from 1990 through 2015. Music therapy, meditation, stress management, and yoga are recommended for anxiety/stress reduction. Meditation, relaxation, yoga, massage, and music therapy are recommended for depression/mood disorders. Meditation and yoga are recommended to improve quality of life. Acupressure and acupuncture are recommended for reducing chemotherapy-induced nausea and vomiting. Acetyl-L-carnitine is not recommended to prevent chemotherapy-induced peripheral neuropathy due to a possibility of harm. No strong evidence supports the use of ingested dietary supplements to manage breast cancer treatment-related side effects. In summary, there is a growing body of evidence supporting the use of integrative therapies, especially mind-body therapies, as effective supportive care strategies during breast cancer treatment. Many integrative practices, however, remain understudied, with insufficient evidence to be definitively recommended or avoided. CA Cancer J Clin 2017;67:194-232. © 2017 American Cancer Society.
Topics: Anxiety; Breast Neoplasms; Complementary Therapies; Depression; Fatigue; Female; Humans; Lymphedema; Mood Disorders; Nausea; Peripheral Nervous System Diseases; Quality of Life; Sleep Wake Disorders; Stress, Psychological; Vomiting
PubMed: 28436999
DOI: 10.3322/caac.21397 -
Journal of Vascular Surgery Jun 2019Chronic limb-threatening ischemia (CLTI) is associated with mortality, amputation, and impaired quality of life. These Global Vascular Guidelines (GVG) are focused on...
Chronic limb-threatening ischemia (CLTI) is associated with mortality, amputation, and impaired quality of life. These Global Vascular Guidelines (GVG) are focused on definition, evaluation, and management of CLTI with the goals of improving evidence-based care and highlighting critical research needs. The term CLTI is preferred over critical limb ischemia, as the latter implies threshold values of impaired perfusion rather than a continuum. CLTI is a clinical syndrome defined by the presence of peripheral artery disease (PAD) in combination with rest pain, gangrene, or a lower limb ulceration >2 weeks duration. Venous, traumatic, embolic, and nonatherosclerotic etiologies are excluded. All patients with suspected CLTI should be referred urgently to a vascular specialist. Accurately staging the severity of limb threat is fundamental, and the Society for Vascular Surgery Threatened Limb Classification system, based on grading of Wounds, Ischemia, and foot Infection (WIfI) is endorsed. Objective hemodynamic testing, including toe pressures as the preferred measure, is required to assess CLTI. Evidence-based revascularization (EBR) hinges on three independent axes: Patient risk, Limb severity, and ANatomic complexity (PLAN). Average-risk and high-risk patients are defined by estimated procedural and 2-year all-cause mortality. The GVG proposes a new Global Anatomic Staging System (GLASS), which involves defining a preferred target artery path (TAP) and then estimating limb-based patency (LBP), resulting in three stages of complexity for intervention. The optimal revascularization strategy is also influenced by the availability of autogenous vein for open bypass surgery. Recommendations for EBR are based on best available data, pending level 1 evidence from ongoing trials. Vein bypass may be preferred for average-risk patients with advanced limb threat and high complexity disease, while those with less complex anatomy, intermediate severity limb threat, or high patient risk may be favored for endovascular intervention. All patients with CLTI should be afforded best medical therapy including the use of antithrombotic, lipid-lowering, antihypertensive, and glycemic control agents, as well as counseling on smoking cessation, diet, exercise, and preventive foot care. Following EBR, long-term limb surveillance is advised. The effectiveness of nonrevascularization therapies (eg, spinal stimulation, pneumatic compression, prostanoids, and hyperbaric oxygen) has not been established. Regenerative medicine approaches (eg, cell, gene therapies) for CLTI should be restricted to rigorously conducted randomizsed clinical trials. The GVG promotes standardization of study designs and end points for clinical trials in CLTI. The importance of multidisciplinary teams and centers of excellence for amputation prevention is stressed as a key health system initiative.
Topics: Cardiac Imaging Techniques; Cardiology; Chronic Disease; Consensus; Evidence-Based Medicine; Heart Function Tests; Humans; Ischemia; Peripheral Arterial Disease; Predictive Value of Tests; Risk Factors; Terminology as Topic; Treatment Outcome
PubMed: 31159978
DOI: 10.1016/j.jvs.2019.02.016 -
Nutrients Jan 2021Although creatine has been mostly studied as an ergogenic aid for exercise, training, and sport, several health and potential therapeutic benefits have been reported....
Although creatine has been mostly studied as an ergogenic aid for exercise, training, and sport, several health and potential therapeutic benefits have been reported. This is because creatine plays a critical role in cellular metabolism, particularly during metabolically stressed states, and limitations in the ability to transport and/or store creatine can impair metabolism. Moreover, increasing availability of creatine in tissue may enhance cellular metabolism and thereby lessen the severity of injury and/or disease conditions, particularly when oxygen availability is compromised. This systematic review assesses the peer-reviewed scientific and medical evidence related to creatine's role in promoting general health as we age and how creatine supplementation has been used as a nutritional strategy to help individuals recover from injury and/or manage chronic disease. Additionally, it provides reasonable conclusions about the role of creatine on health and disease based on current scientific evidence. Based on this analysis, it can be concluded that creatine supplementation has several health and therapeutic benefits throughout the lifespan.
Topics: Aging; Biological Availability; Chronic Disease; Creatine; Dietary Supplements; Humans; Wounds and Injuries
PubMed: 33572884
DOI: 10.3390/nu13020447 -
BMJ Open Jun 2023There is a growing need for interventions to improve well-being in healthcare workers, particularly since the onset of COVID-19.
UNLABELLED
There is a growing need for interventions to improve well-being in healthcare workers, particularly since the onset of COVID-19.
OBJECTIVES
To synthesise evidence since 2015 on the impact of interventions designed to address well-being and burnout in physicians, nurses and allied healthcare professionals.
DESIGN
Systematic literature review.
DATA SOURCES
Medline, Embase, Emcare, CINAHL, PsycInfo and Google Scholar were searched in May-October 2022.
ELIGIBILITY CRITERIA FOR SELECTING STUDIES
Studies that primarily investigated burnout and/or well-being and reported quantifiable preintervention and postintervention outcomes using validated well-being measures were included.
DATA EXTRACTION AND SYNTHESIS
Full-text articles in English were independently screened and quality assessed by two researchers using the Medical Education Research Study Quality Instrument. Results were synthesised and presented in both quantitative and narrative formats. Meta-analysis was not possible due to variations in study designs and outcomes.
RESULTS
A total of 1663 articles were screened for eligibility, with 33 meeting inclusion criterium. Thirty studies used individually focused interventions, while three were organisationally focused. Thirty-one studies used secondary level interventions (managed stress in individuals) and two were primary level (eliminated stress causes). Mindfulness-based practices were adopted in 20 studies; the remainder used meditation, yoga and acupuncture. Other interventions promoted a positive mindset (gratitude journaling, choirs, coaching) while organisational interventions centred on workload reduction, job crafting and peer networks. Effective outcomes were reported in 29 studies, with significant improvements in well-being, work engagement, quality of life and resilience, and reductions in burnout, perceived stress, anxiety and depression.
CONCLUSION
The review found that interventions benefitted healthcare workers by increasing well-being, engagement and resilience, and reducing burnout. It is noted that the outcomes of numerous studies were impacted by design limitations that is, no control/waitlist control, and/or no post intervention follow-up. Suggestions are made for future research.
Topics: Humans; Quality of Life; COVID-19; Health Personnel; Physicians; Workplace; Burnout, Psychological; Delivery of Health Care; Nurses
PubMed: 37385740
DOI: 10.1136/bmjopen-2022-071203 -
PloS One 2021Does time management work? We conducted a meta-analysis to assess the impact of time management on performance and well-being. Results show that time management is... (Meta-Analysis)
Meta-Analysis
Does time management work? We conducted a meta-analysis to assess the impact of time management on performance and well-being. Results show that time management is moderately related to job performance, academic achievement, and wellbeing. Time management also shows a moderate, negative relationship with distress. Interestingly, individual differences and contextual factors have a much weaker association with time management, with the notable exception of conscientiousness. The extremely weak correlation with gender was unexpected: women seem to manage time better than men, but the difference is very slight. Further, we found that the link between time management and job performance seems to increase over the years: time management is more likely to get people a positive performance review at work today than in the early 1990s. The link between time management and gender, too, seems to intensify: women's time management scores have been on the rise for the past few decades. We also note that time management seems to enhance wellbeing-in particular, life satisfaction-to a greater extent than it does performance. This challenges the common perception that time management first and foremost enhances work performance, and that wellbeing is simply a byproduct.
Topics: Adult; Female; Humans; Job Satisfaction; Male; Stress, Psychological; Time Management
PubMed: 33428644
DOI: 10.1371/journal.pone.0245066 -
Industrial Health Nov 2018The aim of this systematic review was to explore studies regarding association between occupational stress and heart rate variability (HRV) during work. We searched...
The aim of this systematic review was to explore studies regarding association between occupational stress and heart rate variability (HRV) during work. We searched PubMed, Web of Science, Scopus, Cinahl and PsycINFO for peer-reviewed articles published in English between January 2005 and September 2017. A total of 10 articles met the inclusion criteria. The included articles were analyzed in terms of study design, study population, assessment of occupational stress and HRV, and the study limitations. Among the studies there were cross-sectional (n=9) studies and one longitudinal study design. Sample size varied from 19 to 653 participants and both females and males were included. The most common assessment methods of occupational stress were the Job Content Questionnaire (JCQ) and the Effort-Reward Imbalance (ERI) questionnaire. HRV was assessed using 24 h or longer Holter ECG or HR monitoring and analyzed mostly using standard time-domain and frequency-domain parameters. The main finding was that heightened occupational stress was found associated with lowered HRV, specifically with reduced parasympathetic activation. Reduced parasympathetic activation was seen as decreases in RMSSD and HF power, and increase in LF/HF ratio. The assessment and analysis methods of occupational stress and HRV were diverse.
Topics: Autonomic Nervous System; Electrocardiography; Heart Rate; Humans; Occupational Health; Occupational Stress; Surveys and Questionnaires; Workplace
PubMed: 29910218
DOI: 10.2486/indhealth.2017-0190