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Giovannini S, Iacovelli C, Loreti C, Frisullo G, Castelli L. In response to: Letter to the Editor regarding "The role of nutritional supplement on post-stroke fatigue: a pilot randomized controlled trial". J Nutr Health Aging 2024; 28:100301. [PMID: 38901114 DOI: 10.1016/j.jnha.2024.100301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Accepted: 06/13/2024] [Indexed: 06/22/2024]
Affiliation(s)
- Silvia Giovannini
- Department of Geriatrics and Orthopaedics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; UOS Riabilitazione Post-Acuzie, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy.
| | - Chiara Iacovelli
- Department of Emergency, Anaesthesiology and Intensive Care Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Claudia Loreti
- Department of Emergency, Anaesthesiology and Intensive Care Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giovanni Frisullo
- UOC Neurologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Letizia Castelli
- Department of Neurosciences, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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Baysal Y, Goy N, Hartnack S, Guseva Canu I. Moral distress measurement in animal care workers: a systematic review. BMJ Open 2024; 14:e082235. [PMID: 38643012 PMCID: PMC11033641 DOI: 10.1136/bmjopen-2023-082235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 04/09/2024] [Indexed: 04/22/2024] Open
Abstract
OBJECTIVES The mental health of veterinary and other animal health professionals is significantly impacted by the psychological stressors they encounter, such as euthanasia, witnessing animal suffering and moral distress. Moral distress, initially identified in nursing, arises when individuals are aware of the right action but are hindered by institutional constraints. We aimed to review existing research on moral distress scales among animal care workers by focusing on the identification and psychometric validity of its measurement. DESIGN Two-step systematic review. First, we identified all moral distress scales used in animal care research in the eligible original studies. Second, we evaluated their psychometric validity, emphasising content validity, which is a critical aspect of patient-reported outcome measures (PROMs). This evaluation adhered to the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN). The results were reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. DATA SOURCES PubMed, EMBASE and PsycINFO to search for eligible studies published between January 1984 and April 2023. ELIGIBILITY CRITERIA FOR SELECTING STUDIES We included original (primary) studies that (1) were conducted in animal care workers; (2) describing either the development of a moral distress scale, or validation of a moral distress scale in its original or modified version, to assess at least one of the psychometric properties mentioned in COSMIN guidelines. DATA EXTRACTION AND SYNTHESIS Two independent reviewers used standardised methods to search, screen and code included studies. We considered the following information relevant for extraction: study reference, name and reference of the moral distress scale used, psychometric properties assessed and methods and results of their assessments. The collected information was then summarised in a narrative synthesis. RESULTS The review identified only one PROM specifically adapted for veterinary contexts: the Measure of Moral Distress for Animal Professionals (MMD-AP), derived from the Measure of Moral Distress for Healthcare Professionals (MMD-HP). Both MMD-HP and MMD-AP were evaluated for the quality of development and content validity. The development quality of both measures was deemed doubtful. According to COSMIN, MMD-HP's content validity was rated as sufficient, whereas MMD-AP's was inconsistent. However, the evidence quality for both PROMs was rated low. CONCLUSION This is the first systematic review focused on moral distress measurement in animal care workers. It shows that moral distress is rarely measured using standardised and evidence-based methods and that such methods should be developed and validated in the context of animal care. PROSPERO REGISTRATION NUMBER CRD42023422259.
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Affiliation(s)
- Yigit Baysal
- Section of Epidemiology, University of Zurich Vetsuisse Faculty, Zurich, Switzerland
| | - Nastassja Goy
- Department of Occupational and Environmental Health, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Sonja Hartnack
- Section of Epidemiology, University of Zurich Vetsuisse Faculty, Zurich, Switzerland
| | - Irina Guseva Canu
- Department of Occupational and Environmental Health, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
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Shoman Y, Hostettler R, Canu IG. Psychometric validity of the Shirom-Melamed Burnout Measure and the Burnout Assessment Tool: a systematic review. Arh Hig Rada Toksikol 2023; 74:238-245. [PMID: 38146759 PMCID: PMC10750325 DOI: 10.2478/aiht-2023-74-3769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 10/01/2023] [Accepted: 11/01/2023] [Indexed: 12/27/2023] Open
Abstract
In the absence of internationally recognised standardised criteria, several patient-reported outcome measures (PROMs) have been developed to measure occupational burnout. The aim of this study was to extend our 2021 review of the psychometric validity of five PROMs to the Shirom-Melamed Burnout Measure (SMBM) and the Burnout Assessment Tool (BAT). To do that we ran a systematic literature search in the MEDLINE, PsycINFO, and Embase databases following our previous methodological framework and the COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN). We assessed the level of evidence using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) guideline. We identified 694 publications on SMBM and 421 on BAT, but the final review includes eight papers on SMBM and three on BAT. Of the seven psychometric properties assessed for SMBM, content, structural, and criterion validity were rated as insufficient, whereas the quality of evidence for construct and internal consistency was high and moderate, respectively. Of the nine psychometric properties assessed for BAT, content, structural, criterion, and construct validity was moderate and internal consistency was high. One limitation of this study is that we did not assess cross-cultural validity, because the number of studies reviewed is too small and content validity can only be assessed based on the original PROM version rather than translation. To conclude, BAT is superior to SMBM in terms of psychometric validity, but the quality of evidence for some properties is low or very low, suggesting a need for additional validation studies.
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Affiliation(s)
- Yara Shoman
- University of Lausanne Centre of Primary Care and Public Health (Unisanté), Lausanne, Switzerland
| | - Roy Hostettler
- University of Lausanne Centre of Primary Care and Public Health (Unisanté), Lausanne, Switzerland
| | - Irina Guseva Canu
- University of Lausanne Centre of Primary Care and Public Health (Unisanté), Lausanne, Switzerland
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Abdalla R, Pavlova M, Groot W. Prioritizing Outcome Measures for Value-Based Healthcare: Physicians' Perspectives in Saudi Arabia. Value Health Reg Issues 2023; 37:62-70. [PMID: 37327619 DOI: 10.1016/j.vhri.2023.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 03/31/2023] [Accepted: 05/05/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVES To inform the stepwise transformation to value-based healthcare in Saudi Arabia, we assess physicians' priorities for measuring general patient outcomes. This is done as an initial step toward the implementation of disease-specific outcome sets. METHODS A cross-sectional, electronic self-administered questionnaire-based study among physicians in 6 hospitals in Saudi Arabia was conducted between March 2022 and May 2022. Purposive sampling was used to select hospitals and physicians. The questionnaire included 30 health outcomes taken from about 60 disease-specific outcome sets. These were classified into 6 domains per the Outcome Measures Hierarchy Framework of Michael Porter. The physicians were asked to prioritize outcomes in each domain by their order of importance. The Relative Importance Index (RII) and multivariate binary logistic regression were used to analyze the priorities and to relate them to physicians' characteristics. RESULTS A total of 204 physicians completed the questionnaire accounting for 40% response rate. The top priority outcomes per domain were overall survival (RII 89.4%); quality of life (RII 92.4%); time to treatment (RII 90.8%); incidence of adverse effects (RII 72.9%); need for retreatment (RII 80.5%); and incidence of hospital-acquired infections (RII 89.3%). Regression analysis revealed that physician seniority is a characteristic associated with physicians' perceptions of the importance of measuring health outcomes (highest odds ratio 2.693; 95% CI 1.501-4.833; P = .001). CONCLUSION Establishing a general set of the most important outcomes that applies to all patients, including survival and mortality, quality of life, adverse events, and complications, need to be considered in the early stages of hospitals' transformation to value-based healthcare.
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Affiliation(s)
- Rawia Abdalla
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Center, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Limburg, The Netherlands.
| | - Milena Pavlova
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Center, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Limburg, The Netherlands
| | - Wim Groot
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Center, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Limburg, The Netherlands; Top Institute Evidence-Based Education Research (TIER), Maastricht University, Maastricht, Limburg, The Netherlands
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Mijakoski D, Cheptea D, Marca SC, Shoman Y, Caglayan C, Bugge MD, Gnesi M, Godderis L, Kiran S, McElvenny DM, Mediouni Z, Mesot O, Minov J, Nena E, Otelea M, Pranjic N, Mehlum IS, van der Molen HF, Canu IG. Determinants of Burnout among Teachers: A Systematic Review of Longitudinal Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095776. [PMID: 35565168 PMCID: PMC9104901 DOI: 10.3390/ijerph19095776] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 05/02/2022] [Accepted: 05/04/2022] [Indexed: 12/03/2022]
Abstract
We aimed to review the determinants of burnout onset in teachers. The study was conducted according to the PROSPERO protocol CRD42018105901, with a focus on teachers. We performed a literature search from 1990 to 2021 in three databases: MEDLINE, PsycINFO, and Embase. We included longitudinal studies assessing burnout as a dependent variable, with a sample of at least 50 teachers. We summarized studies by the types of determinant and used the MEVORECH tool for a risk of bias assessment (RBA). The quantitative synthesis focused on emotional exhaustion. We standardized the reported regression coefficients and their standard errors and plotted them using R software to distinguish between detrimental and protective determinants. A qualitative analysis of the included studies (n = 33) identified 61 burnout determinants. The RBA showed that most studies had external and internal validity issues. Most studies implemented two waves (W) of data collection with 6–12 months between W1 and W2. Four types of determinants were summarized quantitatively, namely support, conflict, organizational context, and individual characteristics, based on six studies. This systematic review identified detrimental determinants of teacher exhaustion, including job satisfaction, work climate or pressure, teacher self-efficacy, neuroticism, perceived collective exhaustion, and classroom disruption. We recommend that authors consider using harmonized methods and protocols such as those developed in OMEGA-NET and other research consortia.
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Affiliation(s)
- Dragan Mijakoski
- Institute of Occupational Health of RNM, WHO Collaborating Center, 1000 Skopje, North Macedonia;
- Faculty of Medicine, Ss. Cyril and Methodius, University in Skopje, 1000 Skopje, North Macedonia
- Correspondence:
| | - Dumitru Cheptea
- Faculty of Medicine and Pharmacy, Nicolae Testemitanu State University of Medicine and Pharmacy, 2004 Chisinau, Moldova;
| | - Sandy Carla Marca
- Center of Primary Care and Public Health (Unisanté), University of Lausanne, 1066 Epalinges-Lausanne, Switzerland; (S.C.M.); (Y.S.); (Z.M.); (O.M.); (I.G.C.)
| | - Yara Shoman
- Center of Primary Care and Public Health (Unisanté), University of Lausanne, 1066 Epalinges-Lausanne, Switzerland; (S.C.M.); (Y.S.); (Z.M.); (O.M.); (I.G.C.)
| | - Cigdem Caglayan
- Department of Public Health, Faculty of Medicine, Kocaeli University, İzmit 41001, Turkey;
| | - Merete Drevvatne Bugge
- National Institute of Occupational Health (STAMI), 0363 Oslo, Norway; (M.D.B.); (I.S.M.)
| | - Marco Gnesi
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy;
| | - Lode Godderis
- Department of Primary Care and Public Health, University of Leuven, 3000 Leuven, Belgium;
| | - Sibel Kiran
- Department of Occupational Health and Safety, Institute of Public Health, Hacettepe University, Ankara 06100, Turkey;
| | - Damien M. McElvenny
- Research Group, Institute of Occupational Medicine, Edinburgh EH14 4AP, UK;
- Centre for Occupational and Environmental Health, University of Manchester, Manchester M13 9PL, UK
| | - Zakia Mediouni
- Center of Primary Care and Public Health (Unisanté), University of Lausanne, 1066 Epalinges-Lausanne, Switzerland; (S.C.M.); (Y.S.); (Z.M.); (O.M.); (I.G.C.)
| | - Olivia Mesot
- Center of Primary Care and Public Health (Unisanté), University of Lausanne, 1066 Epalinges-Lausanne, Switzerland; (S.C.M.); (Y.S.); (Z.M.); (O.M.); (I.G.C.)
| | - Jordan Minov
- Institute of Occupational Health of RNM, WHO Collaborating Center, 1000 Skopje, North Macedonia;
- Faculty of Medicine, Ss. Cyril and Methodius, University in Skopje, 1000 Skopje, North Macedonia
| | - Evangelia Nena
- Medical School, Democritus University of Thrace, 68100 Alexandroupolis, Greece;
| | - Marina Otelea
- Clinical Department 5, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania;
| | - Nurka Pranjic
- Department of Occupational Medicine, School of Medicine, University of Tuzla, 75000 Tuzla, Bosnia and Herzegovina;
- Clinic of Occupational Pathology and Toxicology, University Institute of Primary Health, 75000 Tuzla, Bosnia and Herzegovina
| | - Ingrid Sivesind Mehlum
- National Institute of Occupational Health (STAMI), 0363 Oslo, Norway; (M.D.B.); (I.S.M.)
- Institute of Health and Society, University of Oslo, 0373 Oslo, Norway
| | - Henk F. van der Molen
- Amsterdam UMC Location University of Amsterdam, Public and Occupational Health, Netherlands Center for Occupational Diseases, Meibergdreef 9, 1100 DD Amsterdam, The Netherlands;
- Amsterdam Public Health Research Institute, Societal Participation & Health, 1105 BP Amsterdam, The Netherlands
| | - Irina Guseva Canu
- Center of Primary Care and Public Health (Unisanté), University of Lausanne, 1066 Epalinges-Lausanne, Switzerland; (S.C.M.); (Y.S.); (Z.M.); (O.M.); (I.G.C.)
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