Background
Burnout among nurses is a worldwide public health epidemic that adversely affects nurses’ quality of life as well as the patient’s outcomes. The aim of this study was to evaluate the influence of stress on nurses’ burnout and to identify the mediating effects of secondary traumatic stress and compassion satisfaction among clinical nurses in South Korea.
Methods
A quantitative, cross-sectional study evaluated the survey data from 10,305 female registered hospital nurses who participated in the Korea Nurses’ Health Study (KNHS) Module 5. The survey included a demographic questionnaire and the Professional Quality of Life version 5 (ProQOL 5). Bootstrap analyses (using the PROCESS macro) were employed to evaluate the mediating effect between variables.
Results
Stress was significantly associated with burnout and mediated by secondary traumatic stress and compassion satisfaction (βindirect 1 = 0.185, Bootstrap confidence interval (BS CI) [0.175, 0.194]; βindirect 2 = 0.226, BS CI [0.212, 0.241], respectively). In addition, the magnitude of the indirect effects of compassion satisfaction was significantly greater than the magnitude of the indirect effects of secondary traumatic stress (βindirect 1-βindirect 2 = − 0.042, BS CI [− 0.058, − 0.026]). The findings of this study indicate that the positive aspect (compassion satisfaction) of work experiences can offset the negative aspects (secondary traumatic stress), consequently reducing burnout level.
Conclusions
Our study findings suggest that a multidimensional approach to assessing nurse burnout and implementation of proper management will improve quality of life for nurses and help maintain positive attitudes and quality of patient care.
This literature review identifies factors that may place older adult patients at risk for developing delirium after spine surgery. We conducted a meta-analysis according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Using a variety of electronic databases, we identified five studies for inclusion that represent 645 patients who were 65 years or older. The pooled incidence rate of postoperative delirium was 13.0%. Factors associated with developing postoperative delirium included preoperative opioid use, cervical spine surgery versus lumbar or thoracic spine surgery, spine fusion versus simple spine surgery, hypertension, cerebrovascular disease, pulmonary disease, duration of surgery, and infused IV fluid volume. Nurses who provide perioperative care for older adult patients undergoing spine surgery should be aware of the potential risk factors of delirium to ensure patient safety. Additional research is required to clearly delineate the risk factors for postoperative delirium in older adults.
Summary
Postoperative nausea and vomiting is the most common side‐effect of opioid‐based intravenous patient‐controlled analgesia. Apfel's simplified risk score is popular but it has some limitations. We developed and validated a dynamic predictive model for nausea or vomiting up to 48 postoperative hours, available as an online web application. Fentanyl was used by 22,144 adult patients for analgesia after non‐cardiac surgery under general anaesthesia: we randomly divided them into development (80%) and validation (20%) cohorts, repeated 100 times. We used linear discriminant analysis to select variables for multivariate logistic regression. The incidences of postoperative nausea or vomiting were: 0–48 h, 5691/22,144 (26%); 0–6 h, 2749/22,144 (12%); 6–12 h, 2687/22,144 (12%); 12–18 h, 2624/22,144 (12%); 18–24 h, 1884/22,144 (9%); and 24–48 h, 1082/22,144 (5%). The median (95%CI) area under the receiver operating characteristic curve was 0.72 (0.71–0.73) up to 48 postoperative hours compared with 0.65 (0.64–0.66) for the Apfel model, p < 0.001. The equivalent areas for 0–6 h, 6–12 h, 12–18 h, 18–24 h and 24–48 h were: 0.70 (0.69–0.72); 0.71 (0.69–0.73); 0.69 (0.68–0.71); 0.70 (0.67–0.72); and 0.69 (0.66–0.71), respectively. Our web application allows clinicians to calculate incidences of nausea and vomiting in patients receiving intravenous fentanyl for patient‐controlled analgesia.
Background
The triglyceride glucose (TyG) index is a noninsulin-based marker for insulin resistance (IR) in general practice. Although smoking and heavy drinking have been regarded as major risk factors for various chronic diseases, there is limited evidence regarding the combined effects of smoking and alcohol consumption on IR. This study aimed to investigate the relationship between the TyG index and smoking and alcohol consumption using two Korean population-based datasets.
Methods
This study included 10,568 adults in the Korean National Health and Nutrition Examination Survey (KNHANES) and 9586 adults in the Korean Initiatives on Coronary Artery Calcification (KOICA) registry datasets. Multivariate logistic analysis was conducted to explore the relationship between smoking and alcohol consumption and the TyG index. To assess the predictive value of smoking and alcohol consumption on high TyG index, the area under the curve (AUC) were compared and net reclassification improvement (NRI) and integrated discrimination improvement (IDI) analyses were derived.
Results
The combined effect of smoking and alcohol consumption was an independent risk factor of a higher TyG index in the KNHANES (adjusted odds ratio: 4.33, P < .001) and KOICA (adjusted odds ratio: 1.94, P < .001) datasets. Adding smoking and alcohol consumption to the multivariate logistic models improved the model performance for the TyG index in the KNHANES (AUC: from 0.817 to 0.829, P < .001; NRI: 0.040, P < .001; IDI: 0.017, P < .001) and KOICA (AUC: from 0.822 to 0.826, P < .001; NRI: 0.025, P = .006; IDI: 0.005, P < .001) datasets.
Conclusions
Smoking and alcohol consumption were independently associated with the TyG index. Concurrent smokers and alcohol consumers were more likely to have a TyG index that was ≥8.8 and higher than the TyG indices of non-users and those who exclusively consumed alcohol or smoking tobacco.
Aims
To examine the predictive ability of the frailty index in estimating gender‐specific mortality in a population of Korean adults.
Design
A descriptive and prospective longitudinal design.
Methods
Data were used from the Korean Longitudinal Study of Aging conducted from 2006 through 2018. A total of 10,254 adults aged 45–98 years at baseline were included. A 41‐item deficit accumulation frailty index was measured, based on multi‐domain assessment such as self‐rating of health, physical condition, mental status, cognitive function, activities of daily living, instrumental activities of daily living and chronic conditions. We categorized the frailty index into robust (≤0.10), prefrail (0.10–0.25) and frail (≥0.25). Cox's proportional hazards regression analysis was employed to determine the association between the frailty index and all‐cause mortality.
Results
A total of 4705 individuals (45.9%) were categorized as robust, 4178 (40.7%) as prefrail and 1371 (13.4%) as frail. The frailty index increased with age, and females were found to have a higher frailty index than males. The survival probabilities were significantly lower in older adults (aged ≥65) compared with adults and significantly lower in males compared with females. Compared with the robust group, the risk of mortality in the prefrail and frail groups was 1.37 and 2.57 times higher, respectively. The association between frailty status and all‐cause mortality was similar in adults and older adults, while the hazard ratios were higher in frail group of males than that of females.
Conclusion
The frailty index had a predictive ability for all‐cause mortality with respect to age and sex.
Impact
Using a frailty index among community‐dwelling adults could be beneficial to support healthcare providers in early detection of individuals with frailty and facilitate the development of more effective interventions for reducing mortality.
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