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The new PMC design is here! Learn more about navigating our updated article layout. The PMC legacy view will also be available for a limited time. Federal government websites often end in. The site is secure. 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. 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.
A total of 22 studies published from to were eligible for analysis. The MBI was used by majority of studies to assess burnout. 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.
Burnout refers to a prolonged response to chronic emotional and interpersonal stressors caused by work, manifested as emotional exhaustion, depersonalization, and reduced personal accomplishment. Burnout among healthcare providers is in relation to their gender, marital status, work environment, interpersonal and professional conflicts, emotional distress, and low social support. Recently, COVID has swept the world, which has drawn pay more attention to the mental health of human beings, [ 23 ] especially front-line health care workers.
In addition, a manual search for relevant articles was also conducted using Google Scholar and ancestral searches through the reference lists of articles included in the final review. The search strategy included combinations of 3 key blocks of terms burnout; physicians and nurses; interventions using medical subject headings MESH terms and text words. Consultation has been conducted between the project team and information specialists before finalizing the search strategy see Additional file 1.
Search results were exported from Endnote X7 and duplicates were removed. Study selection was completed in 2 stages. Titles and abstracts of the studies were screened and subsequently full texts of the selected studies were accessed and further screened against the eligibility criteria.
The title and abstract screening were undertaken by XJ. Z and YQ. Two reviewers independently selected and evaluated, and any disagreements were resolved through a larger team discussion. Four domains in phase 2 are study eligibility criteria, identification and selection of studies, data collection and study appraisal, and synthesis and findings. The results of each domain and phase 3 were rated as high risk, low risk, or unclear risk. A high score may disguise critical weaknesses in specific domains, such as an inadequate literature search or a failure to assess RoB within individual studies that were included in a systematic review.
In making an overall rating of systematic review, it is important to take account of flaws in critical domains, which may greatly weaken the confidence that can be placed in a systematic review. On the other hand, literature of different design types cannot be quantitatively synthesized. Therefore, a qualitative synthesis of the included studies was conducted instead.
Literature search results and data extraction results were summarized descriptively. A summary of efficacy outcomes was presented based on the different outcome measures, controls and interventions. A narrative synthesis was therefore generated considering the total number of SRs that reported results, the methodological quality of SRs and RCTs, and the quality of evidence for the outcomes to yield final conclusions. Ethics approval is not required in overview of SRs and meta-analyses.
The search strategy yielded potential studies. The search period of included research was from the inception to The Follow-up time ranged from 0 to 7 years.
The first domain aims to assess whether primary study eligibility criteria were prespecified, clear, and appropriate to the review question. The second domain aims to assess whether any primary studies that would have met the inclusion criteria were not included in the review. The third domain aims to assess whether bias may have been introduced through the data collection or risk of bias assessment processes.
The fourth domain aimed to assess whether the data was combined from the included primary studies. Only 8 studies rated low risk of bias. The final phase considers whether the systematic review as a whole is at risk of bias, 14 studies were rated high risk and 8 were low.
As a whole, the methodological quality and quality of included studies was from moderate to high. There were three types of interventions: individual-focused, structural or organizational, and combine interventions.
Emotion regulation was an important psychological variable, which associated with burnout. Combine individual-focused and structural or organizational interventions included Snoezelen, [ 21 ] stress management and resiliency training, [ 34 ] stress management workshops [ 18 , 20 ] and improving interaction with colleagues through personal training. The purpose of this study was to summarize the evidence and clarify a bundled strategy to reduce burnout of physicians and nurses. According to ROBIS, 12 research were in low risk in domain 1, 8 in domain 2, 17 in domain 3, and 8 in phase 3.
By using AMSTAR 2 to assess the methodological quality and quality of included research, most of those were considered as relatively good quality. Burnout of physicians and nurses has become a global public health problem.
This overview analyzed the contents of 22 papers with results that physician-directed interventions are associated with small reductions in symptoms of common mental health disorders among physicians. Organizational interventions that ignore individual factors cannot really reducing burnout of physicians and nurses.
Therefore, based on theories and studies, when physicians and nurses face stressors caused by work, they will make different coping strategies. Emotional intelligence theory suggests that emotion regulation skills facilitate the maintenance of appropriate emotions, reducing or adapting undesirable emotions in oneself and others. If positive intervention strategies can be adopted to enhance resilience, the incidence of burnout of physicians and nurses is greatly reduced and the wellness improved Fig.
This research included studies in different settings, which brought to light the range of interventions, which could provide the direction for further research. The current overview clarified evidence to reduce burnout of physicians and nurses, which provide 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. Considering partial databases selected and gray literature not included, the results are used only as an overview of the field.
This overview has included 22 systematic reviews and meta-analyses to summarize the relevant studies of interventions to reduce the burnout of physicians and nurses and form an evidence resource, which provides reliable evidence support for further intervention. It is an urgent need to implement and evaluate the long-term effect of bundle strategy.
All authors read and approved the final manuscript. Interventions to reduce burnout of physicians and nurses: an overview of systematic reviews and meta-analyses. This study is supported by Basic Research Project of Higher Learning Institution in Liaoning Province Code: LQ , which provided financial support during data analysis and manuscript preparation.
Data availability statement No additional data available. Patient and Public Involvement None. The authors have no conflicts of interest to disclose. Medicine Baltimore. Published online Jun Find articles by Tongtong Jiang. Author information Article notes Copyright and License information Disclaimer. Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.
The work cannot be used commercially without permission from the journal. This article has been cited by other articles in PMC.
Abstract Objective: Numerous systematic reviews and meta-analyses on the interventions to reduce burnout of physicians and nurses have been published nowadays. Results: A total of 22 studies published from to were eligible for analysis. Conclusions: Burnout is a complicated problem and should be dealt with by using bundled strategy. Keywords: burnout, meta-analyses, nurses, overview, physicians, systematic reviews.
Introduction Burnout refers to a prolonged response to chronic emotional and interpersonal stressors caused by work, manifested as emotional exhaustion, depersonalization, and reduced personal accomplishment. Table 1 Inclusion and exclusion criteria. Open in a separate window. Study Selection Search results were exported from Endnote X7 and duplicates were removed. Data Extraction A data extraction spreadsheet was developed and initially piloted in 3 randomly selected studies.
Ethics Ethics approval is not required in overview of SRs and meta-analyses. Results The search strategy yielded potential studies. Figure 1. Discussion 4. Summary of main findings The purpose of this study was to summarize the evidence and clarify a bundled strategy to reduce burnout of physicians and nurses. Implication for future study Burnout of physicians and nurses has become a global public health problem.
Figure 2. The path of bundle strategy to reduce burnout of physicians and nurses. Strength and limitations This research included studies in different settings, which brought to light the range of interventions, which could provide the direction for further research.
Conclusion This overview has included 22 systematic reviews and meta-analyses to summarize the relevant studies of interventions to reduce the burnout of physicians and nurses and form an evidence resource, which provides reliable evidence support for further intervention.
Endnote x7 journal abbreviations free
The new PMC design is here! Learn more about navigating our updated article layout. The PMC legacy view will also be available for a limited time. Federal government websites often end in. The site is secure. The pandemic of coronavirus disease COVID and lockdown measures, that were implemented in many countries in order to control the virus transmission, endnkte negatively influenced the основываясь на этих данных of millions of people worldwide.
In this study we aimed to investigate the impact of the first COVID lockdown period March—May on snacking behavior, fast-food and alcohol consumption. Changes in snacking, in fast-food and ordered food consumption and in alcohol intake were examined. Snacking was found to be increased for a significant portion of the population examined As per alcohol consumption, an upward trend was observed in a significant part The increased snacking and alcohol consumption observed for fres a third of the examined population fre be alarming because long-term freee problems could arise in endnote x7 journal abbreviations free of repeated lockdowns in the future.
The observed downward trend in fast-food consumption and in frequency of ordered food could be an encouraging sign of turning to home-prepared foods, but further research is endnote x7 journal abbreviations free in this field. In order to combat the pandemic, many governments enforced preventive measures of self-isolation and nationwide lockdowns of several degrees, so as by April more than a third of the global population was under lockdown [ 2 ].
Such sudden changes in people’s life can have a negative impact both on their mental health and their lifestyle behaviors, such as alcohol consumption [ 3 ] and dietary ennote [ 4 ]. During the first COVID lockdown a high prevalence of sleep disorders was reported [ 67 ], which could also be linked to imbalanced dietary patterns [ 8 endnote x7 journal abbreviations free. Overeating is directly related to an increased risk of developing obesity [ 9 ] and subsequently the risk for cardiovascular diseases CVD [ 10 ] and type-2 diabetes mellitus T2DM [ 11 ] is increased.
Undoubtedly, there is inadequate information about related changes in eating behaviors as well as alcohol consumption during this global health crisis, although several studies have been conducted at national level. This systematic review aims to investigate changes in specific dietary habits snacking, fast-foods, ordered food and alcohol consumption during the COVID lockdown endnote x7 journal abbreviations free compared to pre lockdown time. Total records identified endnote x7 journal abbreviations free database searching were and were added in a reference database.
After removal joyrnal duplicates studies were screened independently by two reviewers DB and MC. Any disagreements regarding selection of the included studies and data extraction were solved by consensus. Studies not in English читать were also excluded. The quality of the eligible studies was assessed using the modified Newcastle Ottawa Scale NOS for cross-sectional studies Supplementary Table 2 [ 14 ]. Due to the fact that this is a rapid systematic review as COVID is an emerging, rapidly evolving situation, a protocol for this systematic review was not written.
Data extraction of the included studies was independently conducted by two reviewers DB and MC using a previous standardized excel form. All disagreement were solved by consensus. Data extracted from each study were country origin, sex and number of participants, period and type of the survey. Moreover, we examined dietary changes and we extracted information regarding changes in snacking habit, fast-food and ordered food as well as alcohol consumption.
Variables referred to dietary and alcohol changes were presented as percentages. Statistical significance of each study’s results was stated by p-values where this data was available. The process for the studies selection is presented as a endnote x7 journal abbreviations free diagram joural Fig. A total of studies were identified through databases and reference endnote x7 journal abbreviations free and after removal of duplicates, studies endnote x7 journal abbreviations free screened.
Hence, 32 studies [ [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46] ] all cross-sectional were included in this systematic review. Characteristics of the 32 cross-sectional included studies can be found in Table endnote x7 journal abbreviations free. Several studies had examined changes in snacking behavior during the period of lockdown [ 2224[28][29][30]32343738 ] and the results are shown in Table 2.
In these studies Regarding the subjects who reported changes in snacking a tendency towards increase can be observed [ 22242934 ]. Changes in fast-food consumption were reported in eight studies [ 1920242528343546 enfnote and changes in ordered food were examined in three studies [ 151823 ], whereas relevant results are summarized in Table 3Table 4 respectively.
In studies where microsoft office 2016 online free of fast food had changed during the lockdown restrictions, a downward trend was identified [ 1920242528343546 ]. Regarding the frequency of food ordering and having food delivered at home, results varied as can be seen in Table 4with two studies showing a decline [ 1518 ], and abbreviatione showing an increase [ 23 ] see Table 5. Changes in alcohol consumption during the lockdown period were reported in 23 cross-sectional studies [ 1617212324[26][27][28][29]31[33][34][35][36][38][39]endnote x7 journal abbreviations free[41][42][43][44][45][46] ].
Results showed that in 17 out of those 23 studies, alcohol consumption remained unchanged during the lockdown for the majority kournal participants [ 1721 endnote x7 journal abbreviations free, 2324[26][27][28]333536[38][39][40][41]434446 ].
However, a tendency towards increased alcohol consumption has been be observed for the rest of their examined participants A decline in endnote x7 journal abbreviations free consumption for the majority of participants during the lockdown period was reported in four studies [ 16abreviations3445 ] and an increase of alcohol consumption was reported for the majority of the survey participants in two studies [ 2942 ].
According to our knowledge, this is the first systematic review which aim was to examine changes in snacking behavior including both sweet and salty snacksfast-food, enfnote ordering habits, and alcohol consumption. The results of our study regarding snacking showed that although for the majority of the population examined Differences in snacking behavior could be seen even chief architect premier x6 serial free download the same country.
In particular, in a study lead by Pellegrini including only obese participants, This could imply that for obese people, it was more difficult to control their snacking consumption during the lockdown period. Moreover, according Leech et ojurnal.
In addition, with respect to COVID disease, due to the fact that a vaccine is not yet available for everyone, a balanced in macro- and micronutrients nutrition endnote x7 journal abbreviations free be a method of prevention and management of the disease [ 54 ]. Therefore, these subjects could be at risk of becoming symptomatic COVID patients compare to those following a balanced diet [ 55 ]. Our results regarding fast food habit showed a significant decrease in fast-food consumption during the lockdown period [ adobe pagemaker 7 with crack free2024252834нажмите чтобы прочитать больше ].
Only, in one study conducted in Canada, Similar results emerged after examination of the frequency of ordered food Table 4. Only in the study from New Zealand an increased trend was observed адрес страницы 23 ]. Provided that fast food consumption as well as frequency of ordered food tended to decrease, a possible explanation could be that the long time staying at home during lockdown made people to spend more time in cooking and preparing homemade food, as has already be found in some studies [ 244056 ].
Another explanation could be the fear of transmission of COVID disease via packets of food как сообщается здесь delivery services, but further research is needed in this field. Our results with respect to alcohol during the lockdown period showed that for the majority of the population examined the consumption remained stable [ 17212324[26][27][28]333536[38][39][40][41]4344endnote x7 journal abbreviations free ].
Abbreviahions, a significant portion of the population examined increased its alcohol consumption during the confinement time [ 172324endnote x7 journal abbreviations free27endnote x7 journal abbreviations free35[38][39][40][41][42][43][44]46 endnotw. Heterogeneity in results regarding alcohol consumption can be observed even in the same country.
Results from China varied, where in Sun et al. However, in both studies the sample was not representative of the country’s population. Moreover, the period endnote x7 journal abbreviations free survey between these studies was different 24—31 March in Sun et al. An explanation of the fact that different results emerged could be that in the beginning of the lockdown the anxiety and the fear of this unknown situation as well as the sudden change of daily life made people more prone to alcohol consumption compared to the end of lockdown.
Similar assumptions were also made about results from France [ 3536 ] and Australia [ 4143 ], where a tendency towards decrease journak alcohol consumption at the end of the lockdown in comparison to the beginning was observed. Results from USA were also differed between the studies [ 172739 ]. In Avery et al. The same pattern was also observed in polish population where Therefore, the population in USA and Poland, in contrast to Chinese, French and Australian population, found to consume more alcohol in the end compared to the beginning of the lockdown.
Data regarding the period of the survey conduction was not available in Ingram et endnote x7 journal abbreviations free. However, in Ingram et al. In order to cope with this, a significant portion of the population relapsed to previous abuse as reported by Zhao et al.
Nevertheless, subjects who often consume alcohol are not only more prone to viral and bacterial infections including COVID due to their impaired immune system [ 5859 ], to CVD in heavy drinking occasions [ 60 ], liver [ 61 ], and pancreas diseases [ 62 ], but endnote x7 journal abbreviations free also affect the quality of life of people living around them e.
However, according to a recent systematic review the abbrevviations is autodesk autocad 2014 descargar gratis free enough regarding domestic violence and alcohol abuse during COVID [ 64 ], but awareness of reliability of this data is always needed [ 65 ].
Among the strengths of our study is the number of studies included as well as the fact that a significant geographical part of the world was covered. Moreover, this is the ensnote systematic review examining changes in eating patterns snacking, fast-food, and ordered food as well as in alcohol consumption.
In addition, all studies included in this review were assessed according to the Newcastle—Ottawa Scale Suppl. Limitations of our studies include endnote x7 journal abbreviations free fact that the sample of some studies was not representative for the population of each country and this could affect the accuracy of our results.
Moreover, p-values were not reported in all our included anbreviations, therefore not allowing us to provide information on the statistical significance of related results.
Lastly, in this systematic review studies only in English language were included and therefore related studies published in other languages might have been missed. During the period of abrbeviations due to the COVID pandemic, changes in lifestyle behaviors were observed for a significant percentage of the global population. A tendency towards increased in snacking as well as in alcohol consumption should not be disregarded because long-term problems could be arising especially in cases of repeated lockdowns in future.
The observed decrease in fast-food consumption and in frequency of ordered food demonstrate an encouraging turn to home-made foods. However, provision and campaigns regarding nutritional information could be useful in order to combat with this pandemic. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit abbrevoations. J, and Endnote x7 journal abbreviations free revised the manuscript. All authors have read and approved the final version of manuscript.
Clin Nutr. Dimitra Rafailia Bakaloudia Dhanushya T. Dhanushya T. Author information Article notes Copyright and License information Disclaimer. Received Jan 22; Accepted Apr All rights reserved. Elsevier hereby grants permission to make z7 its COVIDrelated research that is available on the COVID resource centre – including this research http://replace.me/8964.txt – immediately available in PubMed Источник статьи and other publicly endnote x7 journal abbreviations free repositories, such as увидеть больше WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source.
This article has been cited by other articles in PMC. Associated Data Supplementary Materials Rndnote component 1. Abstract The pandemic of coronavirus disease COVID and lockdown measures, that were implemented in many countries in order to control the virus transmission, had negatively influenced the lifestyle of millions of people worldwide. Results 3.
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