ObjectiveThe COVID-19 pandemic has had a significant impact on the burnout and mental health of medical staff. This meta-analysis aims to provide additional (and updated) evidence related to burnout and mental health problems among medical staff using a broader data pool.DesignSystematic review and meta-analysis.Data sourcesPubMed, Embase, Cochrane Library, CNKI, Wanfang data and three preprint databases (SSRN, bioRxiv and medRxiv) were searched from 1 January 2020 to 17 May 2021.Eligibility criteriaWe included observational studies investigating the prevalence of burnout and mental health problems among medical staff during the COVID-19 pandemic, including cross-sectional study, cohort study and case–control study.Data extraction and synthesisTwo independent reviewers used a self-designed form to extract the primary data. The Joanna Briggs Institute quality appraisal tool was used to assess the quality of selected studies. Heterogeneity among studies was assessed by I2statistic. A random-effects model was used to pool the prevalence. Subgroup analysis was performed to explore between-group differences.Results250 studies were included, with a sample of 292 230 participants from 46 countries. The pooled prevalence of burnout, anxiety, depression, insomnia, stress, post-traumatic stress disorder symptoms and somatic symptoms was 43.6% (95% CI 36.3% to 51.2%), 37.1% (95% CI 34.7% to 39.7%), 37.6% (95% CI 35.0% to 40.4%), 43.7% (95% CI 39.1% to 48.5%), 41.3% (95% CI 35.1% to 47.9%), 30.6% (95% CI 23.6% to 38.5%) and 25.0% (95% CI 16.7% to 35.6%), respectively. Subgroup analysis showed a higher prevalence of anxiety, depression and insomnia in frontline workers than in non-frontline workers, and a higher prevalence of anxiety in females than males. Mild cases accounted for the most significant proportion of the outcomes except for stress.ConclusionsThis study highlights that identifying the risks of burnout and mental health problems and adopting preventive interventions are priorities for policymakers and medical staff to avoid long-term occupational, health and social impacts.PROSPERO registration numberCRD42021254425.
Purpose: Perceived social support (PSS) is closely linked to health outcomes in dementia patients. However, its continuous benefits are unclear. This mixed-methods study examined the impact of social support perceptions and differentiation among patients and carers during disease progression. Patients and Methods: Persons with dementia (PWDs), family caregivers, and community family physicians were recruited from nine community health centers. Semi-structured interviews conducted with 12 PWDs (7 PWDs in mild dementia and 5 in moderate dementia), 12 family caregivers, and 6 community family physicians and conventional content analysis were used to explore social support perspectives at different dementia stages. A total of 470 PWDs were divided into mild (n=224), moderate (n=190), and severe (n=56) groups. Demographic, physical, and psychological factors related to PSS were examined by the group using multiple regression analysis. The group-based characteristics were entered into three prediction models. Results: In the qualitative study, three themes of social support were identified: two viewpoints refer to social support; different needs and preferences in each stage; non-personalized support services. Quantitatively, the mild group scored lowest in perceived social support, while the severe group scored highest (χ 2 =64.70, P<0.001). The mild group PSS was predicted by depression (β=−0.07, P=0.04), cognitive capacity (β=−0.18, P<0.001), and instrumental ability (β=−0.78, P<0.001), which differed from the moderate and severe groups. Conclusion: This study provided comprehensive insight into PSS from PWDs' perspective at different stages of the disease. Results indicated the need for a stratified care approach and direction for further research on intervention.
Aims and ObjectivesTo explore the perspectives of stroke survivors, caregivers and nurse coaches on a health coaching program during hospital‐to‐home transitional care.BackgroundStroke is a major public health problem that seriously affects the health and safety of people in China. Nurse‐led health coaching is a promising support option in enabling smooth hospital‐to‐home transition for stroke survivors and family caregivers. A qualitative study is valuable for gaining insight into their perspectives on using this program.DesignAn exploratory, descriptive qualitative process evaluation was conducted parallel with a former randomised controlled trial. Data were obtained from 26 stroke survivors, 33 caregivers and four nurse coaches with semi‐structured interviews. The inductive reflexive thematic analysis approach was used for data analysis. The COREQ checklist was followed in reporting this study.ResultsSeven themes were generated from the data: (1) the applicability of individualised health coaching sessions, (2) driving self‐efficacy to establish self‐care skills, (3) the key role of nurse coaches, (4) coordination among healthcare teams during the transition, (5) adequate community and social support, (6) insufficient rehabilitative services after discharge and (7) perceived extra workload for nurse coaches.ConclusionsThe study captured perspectives on a nurse‐led health coaching program towards hospital‐to‐home transition care from stroke survivors, caregivers and nurse coaches. Individualised health coaching sessions and driving self‐efficacy were perceived as facilitators for empowering the self‐care skills of stroke survivors and caregivers. The key role of nurse coaches in coordinating healthcare teams and adequate community and social support were detected as the power frame of the program's implementation. However, health system obstacles, such as insufficient rehabilitative services and the high workload of nurses, still need to be addressed to ensure the sustainability of health coaching intervention in transitional care.Relevance to Clinical PracticeThe study suggested the feasibility of implementing nurse‐led health coaching to smooth post‐stroke hospital‐to‐home transitional care. The findings also highlighted the importance of qualitative process evaluation when implementing evidence‐based interventions in health care.Trial RegistrationThe trial was registered with the Australia New Zealand Clinical Trials Registry (ID: ACTRN12619000321145).
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