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Chronobiology International Jul 2024Shift work is a recognized work pattern for nurses worldwide. The disruption of shift workers' biological clocks usually leads to sleep disorders and affects their... (Review)
Review
Shift work is a recognized work pattern for nurses worldwide. The disruption of shift workers' biological clocks usually leads to sleep disorders and affects their awareness at work. Eveningness and occupational stress might be effective in causing burnout syndrome. Therefore, this study aimed to evaluate the chronotype, job burnout and perceived stress among Chinese tertiary hospital nurses, and understand the predictors of circadian rhythm in this group. Between July and September 2020, 23 hospitals were randomly selected from 113 tertiary hospitals in Hunan Province. Twenty-five percent of the nurses working in each hospital were targeted for selection. 28.1% and 17.6% of nurses reported eveningness type and morningness type, respectively. The scores for emotional exhaustion, depersonalization, and perceived stress of eveningness nurses were higher than those of morningness counterparts. Eveningness nurses also reported a lower sense of personal accomplishment. Risk factors of eveningness included being under 30 years old, never exercising, having the stressors of late-night shifts and career development, higher levels of emotional exhaustion, sleep latency, sleep duration, and hypnotic use. Shifts may be unavoidable for nurses, nevertheless, understanding the predictors and related factors of chronotype for nurses is necessary for nursing educators and managers to develop a reasonable shift system and appropriate measures to assist nurses in adjusting their work.
PubMed: 38953516
DOI: 10.1080/07420528.2024.2373224 -
Vaccines Jun 2024During the coronavirus disease (COVID-19) pandemic healthcare workers (HCWs) acquired immunity by vaccination or exposure to multiple variants of severe acute...
During the coronavirus disease (COVID-19) pandemic healthcare workers (HCWs) acquired immunity by vaccination or exposure to multiple variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Our study is a comparative analysis between subgroups of HCWs constructed based on the number of SARS-CoV-2 infections, vaccination, and the dominant variant of SARS-CoV-2 in the population. We collected and analyzed data using the χ test and density incidence of reinfections in Microsoft Excel for Mac, Version 16.84, and MedCalc, 22.026. Of the 829 HCWs, 70.1% (581) had only one SARS-CoV-2 infection and 29.9% (248) had two infections. Of the subjects with two infections, 77.4% (192) worked in high-risk departments and 93.2% (231) of the second infections were registered during Omicron dominance. The density incidence of reinfections was higher in HCWs vaccinated with the primary schedule than those vaccinated with the first booster, and the incidence ratio was 2.8 (95% CI: 1.2; 6.7). The probability of reinfection was five times lower (95% CI: 2.9; 9.2) in HCWs vaccinated with the primary schedule if the first infection was acquired during Omicron dominance. The subjects vaccinated with the first booster had a density incidence of reinfection three times lower (95% CI: 1.9; 5.8) if the first infection was during Omicron. The incidence ratio in subgroups constructed based on characteristics such as gender, age group, job category, and department also registered significant differences in density incidence. The history of SARS-CoV-2 infection by variant is important when interpreting and understanding public health data and the results of studies related to vaccine efficacy for hybrid immunity subgroup populations.
PubMed: 38932411
DOI: 10.3390/vaccines12060682 -
International Journal of Environmental... Jun 2024Knee pain, specifically patellofemoral pain (PFP), may lead to limitations in physical activity and social participation. Identifying knee pain that is attributed to PFP...
Validity and Reliability of an Arabic Version of the Survey Instrument for Natural History, Aetiology and Prevalence of Patellofemoral Pain Studies: A Cross-Sectional Study.
BACKGROUND AND OBJECTIVES
Knee pain, specifically patellofemoral pain (PFP), may lead to limitations in physical activity and social participation. Identifying knee pain that is attributed to PFP is not an easy job for healthcare professionals. To overcome this issue, The Survey Instrument for Natural History, Aetiology and Prevalence of Patellofemoral Pain (SNAPPS), which is a self-reporting questionnaire instrument, was designed to identify PFP in many languages. However, the Arabic version of the SNAPPS is not validated yet. This study was performed to assess the validity and reliability of the Arabic version of the SNAPPS (A-SNAPPS).
MATERIALS AND METHODS
A cross-sectional study was conducted to achieve the study goals. To assess reliability, 38 participants were asked to complete the A-SNAPPS two times on the same day with a 30 min break in between. Convergent validity of the A-SNAPPS was assessed by exploring the correlations of the SNAPPS total score with the visual analogue scale (VAS) scores, including VAS for usual pain, VAS for worst pain, and VAS for pain during activities such as jumping, running, ascending and descending stairs, and squatting.
RESULTS
The validity test findings suggested that SNAPPS has a strong correlation with the VAS during ascending and descending stairs (r = 0.71) and moderate correlations during jumping (r = 0.54) and squatting (r = 0.57). The test-retest reliability ICC was 0.92, indicating a very strong test-retest reliability of the A-SNAPPS.
CONCLUSIONS
The A-SNAPPS was cross-culturally adapted and validated, demonstrating very strong reliability.
Topics: Humans; Cross-Sectional Studies; Adult; Female; Male; Reproducibility of Results; Patellofemoral Pain Syndrome; Prevalence; Surveys and Questionnaires; Young Adult; Middle Aged; Pain Measurement
PubMed: 38928978
DOI: 10.3390/ijerph21060732 -
The New England Journal of Medicine Jun 2024-related schwannomatosis (-SWN, formerly called neurofibromatosis type 2) is a tumor predisposition syndrome that is manifested by multiple vestibular schwannomas,...
BACKGROUND
-related schwannomatosis (-SWN, formerly called neurofibromatosis type 2) is a tumor predisposition syndrome that is manifested by multiple vestibular schwannomas, nonvestibular schwannomas, meningiomas, and ependymomas. The condition is relentlessly progressive with no approved therapies. On the basis of preclinical activity of brigatinib (an inhibitor of multiple tyrosine kinases) in -driven nonvestibular schwannoma and meningioma, data were needed on the use of brigatinib in patients with multiple types of progressive -SWN tumors.
METHODS
In this phase 2 platform trial with a basket design, patients who were 12 years of age or older with -SWN and progressive tumors were treated with oral brigatinib at a dose of 180 mg daily. A central review committee evaluated one target tumor and up to five nontarget tumors in each patient. The primary outcome was radiographic response in target tumors. Key secondary outcomes were safety, response rate in all tumors, hearing response, and patient-reported outcomes.
RESULTS
A total of 40 patients (median age, 26 years) with progressive target tumors (10 vestibular schwannomas, 8 nonvestibular schwannomas, 20 meningiomas, and 2 ependymomas) received treatment with brigatinib. After a median follow-up of 10.4 months, the percentage of tumors with a radiographic response was 10% (95% confidence interval [CI], 3 to 24) for target tumors and 23% (95% CI, 16 to 30) for all tumors; meningiomas and nonvestibular schwannomas had the greatest benefit. Annualized growth rates decreased for all tumor types during treatment. Hearing improvement occurred in 35% (95% CI, 20 to 53) of eligible ears. Exploratory analyses suggested a decrease in self-reported pain severity during treatment (-0.013 units per month; 95% CI, -0.002 to -0.029) on a scale from 0 (no pain) to 3 (severe pain). No grade 4 or 5 treatment-related adverse events were reported.
CONCLUSIONS
Brigatinib treatment resulted in radiographic responses in multiple tumor types and clinical benefit in a heavily pretreated cohort of patients with -SWN. (Funded by the Children's Tumor Foundation and others; INTUITT-NF2 ClinicalTrials.gov number, NCT04374305.).
Topics: Humans; Male; Adult; Female; Pyrimidines; Neurilemmoma; Adolescent; Organophosphorus Compounds; Young Adult; Middle Aged; Skin Neoplasms; Child; Neurofibromatoses; Neurofibromatosis 2; Antineoplastic Agents; Protein Kinase Inhibitors
PubMed: 38904277
DOI: 10.1056/NEJMoa2400985 -
Journal of the Turkish German... Jun 2024Premenstrual syndrome (PMS) is a common condition among women during their menstrual cycle. PMS can negatively affect a woman's daily life and function. Nurses, as an...
OBJECTIVE
Premenstrual syndrome (PMS) is a common condition among women during their menstrual cycle. PMS can negatively affect a woman's daily life and function. Nurses, as an important and substantial segment of healthcare staff, are affected by the demanding environment of work place. Since PMS, as a prevalent counterproductive condition, has not been studied in this population in Iran, we assessed the prevalence of PMS and its associated factors among nurses aged 23 to 49 in teaching hospitals of the Tehran province of Iran.
MATERIAL AND METHODS
In this cross-sectional study from April 2021 to January 2022, 280 participants from teaching hospitals were enrolled. Simple random sampling was used to determine the sample size of the study. Two validated questionnaires and a data gathering sheet were used to collect information. The premenstrual symptoms screening tool was used to determine PMS severity and the Copenhagen Psychosocial Questionnaire to evaluate the associated job demands. Demographic data and work-related data included: night shift, shift type, monthly COVID-19 care and gynecologic and past medical history were gathered. Then data were analyzed using logistic regression analysis, chi-square and t-test.
RESULTS
The severity of PMS was: mild (42.5%); moderate (30%); and severe (27.5%). Regular menstruation and dysmenorrhea were reported by 84.6% and 72.3%, respectively. Moderate to severe PMS was associated with: monthly COVID shift (p=0.02); emotional (p<0.01) and quantitative (p<0.01) demands; regular caffeine intake (p=0.01); education level (p=0.005); regular exercise (p=0.003); regular fiber intake (p=0.08); and irregular menstrual cycles (p=0.007). In logistic regression only quantitative (p=0.003) and emotional (p=0.018) job demands were significant.
CONCLUSION
Results showed that the prevalence of PMS was high among Iranian nurses and was associated with quantitative and emotional job demands. We suggest further studies focusing on preventative and effective interventions to diminish the consequences of PMS in this population. We also suggest investigating the practical application of the findings of this study for healthcare professionals and policymakers.
PubMed: 38867710
DOI: 10.4274/jtgga.galenos.2024.2023-3-1 -
CJC Open May 2024The COVID-19 pandemic effects among patients with a history of spontaneous coronary artery dissection (SCAD), a cause of acute coronary syndrome associated with...
BACKGROUND
The COVID-19 pandemic effects among patients with a history of spontaneous coronary artery dissection (SCAD), a cause of acute coronary syndrome associated with emotional and physical stress, are unknown.
METHODS
For this cross-sectional cohort study, participants of the Mayo Clinic "Virtual" Multicenter SCAD Registry were surveyed about the COVID-19 pandemic.
RESULTS
Among 1352 participants, 727 (53.8%) completed surveys between June 2, 2021 and September 29, 2021. The majority of respondents (96.7%) were female, with a mean age of 54.9 ± 9.4 years. At the time of completing the survey, which was early in the pandemic, 91 respondents (12.6%) reported having prior COVID-19 symptoms, with < 1% experiencing hospitalization (n = 4) or cardiac complications (n = 6). A total of 14% had ≥ moderate anxiety symptoms, per the General Anxiety Disorder-7 item survey, and 11.8% had ≥ moderate depressive symptoms, per the Patient Health Questionnaire-9 item. Higher stress scores on the Likert scale were correlated with pandemic-related reduction in work hours and/or pay and/or unemployment ( = 0.013), remote work and/or change of job ( < 0.001), and loss of insurance and/or medical coverage ( = 0.025). A higher anxiety level, as measured on the Likert scale, was correlated with pandemic-related remote work and/or change of job ( = 0.007) and loss of insurance and/or medical coverage ( = 0.008). Since the start of the pandemic, 54% of respondents reported having at least monthly chest pain. Chest pain and COVID symptoms were each associated with higher scores on the General Anxiety Disorder-7 item survey and the Patient Health Questionnaire-9 item.
CONCLUSIONS
Early in the pandemic, COVID-19 symptoms, hospitalization, and cardiac complications were uncommon among SCAD patients. The burden of anxiety and depressive symptoms was minimal to mild, similar to that in prior reports. Likert-scale measures of stress and anxiety were higher among persons with work and/or pay reduction and/or unemployment, remote work and/or change of job, and loss of insurance and/or medical coverage. Over half of respondents reported experiencing chest pain, which was correlated with depressive and anxiety symptoms, highlighting an overarching clinical need.
PubMed: 38846446
DOI: 10.1016/j.cjco.2024.01.006 -
The Journal of Orthopaedic and Sports... Jun 2024To (i) investigate the goals and expectations of participants enrolled in a clinical trial of physiotherapist-led treatment for femoroacetabular impingement (FAI)...
To (i) investigate the goals and expectations of participants enrolled in a clinical trial of physiotherapist-led treatment for femoroacetabular impingement (FAI) syndrome and (ii) explore associations between their expectations and self-reported hip burden and kinesiophobia. Data from 150 participants with FAI syndrome who participated in a clinical trial were analysed. Participants described their most important treatment goal and the expectation of achieving this goal throughout physiotherapy treatment. The International Hip Outcome Tool (iHOT-33) subscales were used to assess self-reported hip burden. The Tampa Scale for Kinesiophobia was used to assess kinesiophobia. Participants goals were qualitatively analysed using content analysis. Linear regression was used to explore associations between patient expectations and iHOT and Tampa Scale for Kinesiophobia scores. Participants with FAI syndrome reported goals relating to exercise (52%), improving activities of daily living quality (23%), improving physical function (15%), and reducing pain (10%). Negative expectations regarding physiotherapist-led treatment were reported by 68% of participants. Those with negative expectations reported worse scores for the iHOT-Total score (mean difference = 12 points, 95%CI = [4 to 19]), and iHOT-Symptoms (14 points, [7 to 21]) and iHOT-Social (11 points, [2 to 21]) subscales compared to those with positive expectations. Treatment expectations were not associated with iHOT-Sport, iHOT-Job, and Tampa Scale for Kinesiophobia scores (p > 0.05). Patients with FAI syndrome had a generally negative expectation of physiotherapist-led treatment. There was a mismatch between patients' goals and current treatment approaches. Participants with FAI syndrome and negative expectations reported worse quality of life, symptoms, and social concerns than those with positive expectations.
PubMed: 38840574
DOI: 10.2519/jospt.2024.12473 -
The American Surgeon Jun 2024Provider burnout is a work-related syndrome that is under-recognized, under-reported, and has negative repercussions on the individual, system, and patients. This study...
BACKGROUND
Provider burnout is a work-related syndrome that is under-recognized, under-reported, and has negative repercussions on the individual, system, and patients. This study investigated burnout incidence and its association with wellness characteristics such as resilience, psychological safety, and perceptions of the workplace to inform future work in improving well-being.
METHODS
Electronic surveys were sent to 153 physicians and advanced practice providers (APPs) in the department of surgery at a single institution. Survey topics included demographics, intention to stay, engagement, and items from validated measures for workplace perceptions including work pace/stress (Mini Z), burnout, psychological safety, and resilience. Descriptive statistics, bivariate associations, and logistic regression were used to evaluate responses.
RESULTS
Overall response rate was 47%. The majority of providers reported feeling burned out (56%), and 48% indicated they would probably leave the organization within three years. Additionally, 61% reported being satisfied with their job and 55% felt that they contributed professionally in the ways they value most (meaningful work/engagement). Significant predictors for burnout included negative work environment perceptions (work pace/stress), low resilience, low meaningful work, and professional role (physician vs APP).
DISCUSSION
Maintaining a healthy workforce requires investigation into the factors that support workplace well-being. The strongest predictors of burnout were work pace/stress. Protective factors against burnout were psychological safety and resilience. An organizational culture that promotes psychological safety, as well as workplace improvements to enhance providers' sense of meaning in work, and decreasing work pace and stress may contribute to the prevention of burnout and the retention.
PubMed: 38825791
DOI: 10.1177/00031348241244636 -
BMC Pregnancy and Childbirth May 2024Since 2018, WHO recommends oral fluid and food intake for low-risk women during labor to enhance positive childbirth experience and respect for women's preferences. This...
"We restrict certain things": a cross-sectional study of health provider adherence to WHO's recommendation for intrapartum oral intake of fluid and food in Greater Accra, Ghana.
BACKGROUND
Since 2018, WHO recommends oral fluid and food intake for low-risk women during labor to enhance positive childbirth experience and respect for women's preferences. This study investigated the current practices related to intrapartum oral intake among maternity care providers and women in public health facilities in Greater Accra, Ghana, and explored barriers and opportunities for adherence to the WHO guidance.
METHODS
We used a mixed-method design at five public health facilities in Greater Accra, Ghana, which included structured interviews with 11 facility-level quality improvement staff and 12 maternity care providers; a knowledge, attitudes, and practices survey with the same providers; and a client survey with 56 inpatient postpartum women. We conducted descriptive and inferential statistics, including z-tests to assess independent and dependent variables, and inductive thematic analyses.
RESULTS
Provider adherence to the WHO recommendation varied, with many imposing restrictions on oral intake during labor. Concerns included potential complications like Mendelson's syndrome, consequently framing oral intake decisions as clinical and leading providers to limit women's involvement in their care decisions. Within our sample, 54% and 43% women reported their provider counseled them on oral fluid and food intake respectively, while 41% and 34% reported their provider asked them their preference for drinking and eating respectively. Ultimately, 73% drank fluids and 19% ate food during their labor. Counseling significantly correlated with women's intake practices (p < 0.01) and providers' inquiry to women's preferences for drinking and eating (p < 0.001) during labor.
CONCLUSION
Adherence to evidence-based practices for intrapartum oral intake among low-risk women was inconsistence. Maternity care providers play a vital role in involving women in their care decisions and respecting women's preferences. Strengthening national-level labor care guidelines and provider quality improvement approaches like in-service training, supportive supervision, and job aides to include the WHO recommendation will help providers adhere to the guidance and contribute to promoting a positive childbirth experience for women.
Topics: Humans; Female; Ghana; Cross-Sectional Studies; World Health Organization; Pregnancy; Adult; Guideline Adherence; Labor, Obstetric; Drinking; Health Knowledge, Attitudes, Practice; Health Personnel; Young Adult; Practice Guidelines as Topic; Eating
PubMed: 38816819
DOI: 10.1186/s12884-024-06581-1 -
AANA Journal Oct 2023Imposter phenomenon (IP) is an evolving, multidimensional construct defined as self-perceived intellectual phoniness and professional ineptitude frequently experienced...
Imposter phenomenon (IP) is an evolving, multidimensional construct defined as self-perceived intellectual phoniness and professional ineptitude frequently experienced by individuals working in high-performance or competitive environments. IP consequences include psychological distress, role underoptimization, and career dissatisfaction. As high-achieving advanced practice nurses in a profession often evaluated by peers, certified registered nurse anesthetists (CRNAs) are at risk for IP. Identifying impostorism early in the CRNA's career and adopting healthy management strategies can optimize the nurse anesthesiologist's healthcare role, lead to a more fulfilling career, and support personal wellness.
Topics: Humans; Nurse Anesthetists; Job Satisfaction; Self Concept; Burnout, Professional; Female; Anxiety Disorders
PubMed: 38809211
DOI: No ID Found