-
ORIGINAL ARTICLE
Association between hair cortisol concentration and acute stress symptoms in family members of critically ill patients: a cross-sectional study
- Cláudia Severgnini Eugênio
, - Thiago Wendt Viola ,
- Francisco Sindermann Lumertz ,
- Adriana Valéria Hoffmeister Daltrozo ,
- Maria Eduarda Ramos Saraiva , [ ... ],
- Márcio Manozzo Boniatti
10-01-2024
Abstract
ORIGINAL ARTICLEAssociation between hair cortisol concentration and acute stress symptoms in family members of critically ill patients: a cross-sectional study
Critical Care Science. 2024;36:e20240043en
10-01-2024DOI 10.62675/2965-2774.20240043-en
- Cláudia Severgnini Eugênio ,
- Thiago Wendt Viola ,
- Francisco Sindermann Lumertz ,
- Adriana Valéria Hoffmeister Daltrozo ,
- Maria Eduarda Ramos Saraiva ,
- Júlia Borges Casagrande ,
- Rafael Fernandes Zanin ,
- Márcio Manozzo Boniatti
Views55ABSTRACT
Objective:
The aim of this study was to investigate whether there is an association between hair cortisol concentrations and acute stress symptoms in family members of critically ill patients.
Methods:
A cross-sectional study was conducted in an adult intensive care unit of a tertiary hospital in Porto Alegre, Brazil, from August 2021 to February 2022. Family members of intensive care unit patients admitted for more than 10 days were approached for enrollment. We collected sociodemographic data and assessed resilience, religiosity, and symptoms of acute stress among family members. Samples of family members’ hair were collected shortly after the interview to measure the hair cortisol concentration.
Results:
A total of 110 family members were included in this study. Eighty-eight (80.0%) family members presented with symptoms of acute stress. The median hair cortisol concentration was 2.37pg/mg (1.16 - 5.06pg/mg). There was no significant difference in hair cortisol concentration between family members with and without acute stress symptoms (p = 0.419). According to the multivariate analysis, only the fact that the patient was alert at the time of the family member's interview was significantly associated with the prevalence of acute stress symptoms in the family member.
Conclusion:
We did not find an association between the hair cortisol concentration of family members in hair segments in the months prior to admission to the intensive care unit and the occurrence of acute stress symptoms.
Keywords:critical illnessFamilyHairHydrocortisoneintensive care unitsprevalenceResilience, psychologicalSee moreViews55
Abstract
ORIGINAL ARTICLEAssociation between hair cortisol concentration and acute stress symptoms in family members of critically ill patients: a cross-sectional study
Critical Care Science. 2024;36:e20240043en
10-01-2024DOI 10.62675/2965-2774.20240043-en
- Cláudia Severgnini Eugênio ,
- Thiago Wendt Viola ,
- Francisco Sindermann Lumertz ,
- Adriana Valéria Hoffmeister Daltrozo ,
- Maria Eduarda Ramos Saraiva ,
- Júlia Borges Casagrande ,
- Rafael Fernandes Zanin ,
- Márcio Manozzo Boniatti
Views55ABSTRACT
Objective:
The aim of this study was to investigate whether there is an association between hair cortisol concentrations and acute stress symptoms in family members of critically ill patients.
Methods:
A cross-sectional study was conducted in an adult intensive care unit of a tertiary hospital in Porto Alegre, Brazil, from August 2021 to February 2022. Family members of intensive care unit patients admitted for more than 10 days were approached for enrollment. We collected sociodemographic data and assessed resilience, religiosity, and symptoms of acute stress among family members. Samples of family members’ hair were collected shortly after the interview to measure the hair cortisol concentration.
Results:
A total of 110 family members were included in this study. Eighty-eight (80.0%) family members presented with symptoms of acute stress. The median hair cortisol concentration was 2.37pg/mg (1.16 - 5.06pg/mg). There was no significant difference in hair cortisol concentration between family members with and without acute stress symptoms (p = 0.419). According to the multivariate analysis, only the fact that the patient was alert at the time of the family member's interview was significantly associated with the prevalence of acute stress symptoms in the family member.
Conclusion:
We did not find an association between the hair cortisol concentration of family members in hair segments in the months prior to admission to the intensive care unit and the occurrence of acute stress symptoms.
Keywords:critical illnessFamilyHairHydrocortisoneintensive care unitsprevalenceResilience, psychologicalSee more
- Cláudia Severgnini Eugênio
-
CLINICAL REPORT
Adherence to low tidal volume in the transition to spontaneous ventilation in patients with acute respiratory failure in intensive care units in Latin America (SPIRAL): a study protocol
- Fabia Diniz-Silva ,
- Bruno Valle Pinheiro ,
- Luis Felipe Reyes ,
- Alexandre Biasi Cavalcanti ,
- Belinda Figueredo , [ ... ],
07-24-2024
Abstract
CLINICAL REPORTAdherence to low tidal volume in the transition to spontaneous ventilation in patients with acute respiratory failure in intensive care units in Latin America (SPIRAL): a study protocol
Critical Care Science. 2024;36:e20240044en
07-24-2024DOI 10.62675/2965-2774.20240044-en
- Fabia Diniz-Silva ,
- Bruno Valle Pinheiro ,
- Luis Felipe Reyes ,
- Alexandre Biasi Cavalcanti ,
- Belinda Figueredo ,
- Fernando Rios ,
- Flávia Ribeiro Machado ,
- Gabriel Preda ,
- Guillermo Bugedo ,
- Israel Silva Maia ,
- Leda Tomiko Yamada da Silveira ,
- Luis Herrera ,
- Manuel Jibaja ,
- Miguel Ibarra-Estrada ,
- Mino Cestari ,
- Nicolás Nin ,
- Rollin Roldan ,
- Tiago Mendonça dos Santos ,
- Viviane Cordeiro Veiga ,
- Alejandro Bruhn ,
- Juliana Carvalho Ferreira ,
Views97ABSTRACT
Objective:
Patients with acute respiratory failure often require mechanical ventilation to reduce the work of breathing and improve gas exchange; however, this may exacerbate lung injury. Protective ventilation strategies, characterized by low tidal volumes (≤ 8mL/kg of predicted body weight) and limited plateau pressure below 30cmH2O, have shown improved outcomes in patients with acute respiratory distress syndrome. However, in the transition to spontaneous ventilation, it can be challenging to maintain tidal volume within protective levels, and it is unclear whether low tidal volumes during spontaneous ventilation impact patient outcomes. We developed a study protocol to estimate the prevalence of low tidal volume ventilation in the first 24 hours of spontaneous ventilation in patients with hypoxemic acute respiratory failure and its association with ventilator-free days and survival.
Methods:
We designed a multicenter, multinational, cohort study with a 28-day follow-up that will include patients with acute respiratory failure, defined as a partial oxygen pressure/fraction of inspired oxygen ratio < 300mmHg, in transition to spontaneous ventilation in intensive care units in Latin America.
Results:
We plan to include 422 patients in ten countries. The primary outcomes are the prevalence of low tidal volume in the first 24 hours of spontaneous ventilation and ventilator-free days on day 28. The secondary outcomes are intensive care unit and hospital mortality, incidence of asynchrony and return to controlled ventilation and sedation.
Conclusion:
In this study, we will assess the prevalence of low tidal volume during spontaneous ventilation and its association with clinical outcomes, which can inform clinical practice and future clinical trials.
Keywords:Hospital mortalityIncidenceintensive care unitsOxygenprevalenceRespiration, artificialRespiratory insufficiencyTidal VolumeSee moreViews97Abstract
CLINICAL REPORTAdherence to low tidal volume in the transition to spontaneous ventilation in patients with acute respiratory failure in intensive care units in Latin America (SPIRAL): a study protocol
Critical Care Science. 2024;36:e20240044en
07-24-2024DOI 10.62675/2965-2774.20240044-en
- Fabia Diniz-Silva ,
- Bruno Valle Pinheiro ,
- Luis Felipe Reyes ,
- Alexandre Biasi Cavalcanti ,
- Belinda Figueredo ,
- Fernando Rios ,
- Flávia Ribeiro Machado ,
- Gabriel Preda ,
- Guillermo Bugedo ,
- Israel Silva Maia ,
- Leda Tomiko Yamada da Silveira ,
- Luis Herrera ,
- Manuel Jibaja ,
- Miguel Ibarra-Estrada ,
- Mino Cestari ,
- Nicolás Nin ,
- Rollin Roldan ,
- Tiago Mendonça dos Santos ,
- Viviane Cordeiro Veiga ,
- Alejandro Bruhn ,
- Juliana Carvalho Ferreira ,
Views97ABSTRACT
Objective:
Patients with acute respiratory failure often require mechanical ventilation to reduce the work of breathing and improve gas exchange; however, this may exacerbate lung injury. Protective ventilation strategies, characterized by low tidal volumes (≤ 8mL/kg of predicted body weight) and limited plateau pressure below 30cmH2O, have shown improved outcomes in patients with acute respiratory distress syndrome. However, in the transition to spontaneous ventilation, it can be challenging to maintain tidal volume within protective levels, and it is unclear whether low tidal volumes during spontaneous ventilation impact patient outcomes. We developed a study protocol to estimate the prevalence of low tidal volume ventilation in the first 24 hours of spontaneous ventilation in patients with hypoxemic acute respiratory failure and its association with ventilator-free days and survival.
Methods:
We designed a multicenter, multinational, cohort study with a 28-day follow-up that will include patients with acute respiratory failure, defined as a partial oxygen pressure/fraction of inspired oxygen ratio < 300mmHg, in transition to spontaneous ventilation in intensive care units in Latin America.
Results:
We plan to include 422 patients in ten countries. The primary outcomes are the prevalence of low tidal volume in the first 24 hours of spontaneous ventilation and ventilator-free days on day 28. The secondary outcomes are intensive care unit and hospital mortality, incidence of asynchrony and return to controlled ventilation and sedation.
Conclusion:
In this study, we will assess the prevalence of low tidal volume during spontaneous ventilation and its association with clinical outcomes, which can inform clinical practice and future clinical trials.
Keywords:Hospital mortalityIncidenceintensive care unitsOxygenprevalenceRespiration, artificialRespiratory insufficiencyTidal VolumeSee more
- Fabia Diniz-Silva
-
ORIGINAL ARTICLE
Prevalence and factors associated with symptoms of depression in family members of people hospitalized in the intensive care unit
- Luciana Maciel de Souza ,
- Kátia Santana Freitas ,
- Aloísio Machado da Silva Filho ,
- Jules Ramon Brito Teixeira ,
- Geysimara Santos Silveira Souza , [ ... ],
- Pollyana Pereira Portela
03-03-2022
Abstract
ORIGINAL ARTICLEPrevalence and factors associated with symptoms of depression in family members of people hospitalized in the intensive care unit
Revista Brasileira de Terapia Intensiva. 2022;34(4):499-506
03-03-2022DOI 10.5935/0103-507X.20220080-en
- Luciana Maciel de Souza ,
- Kátia Santana Freitas ,
- Aloísio Machado da Silva Filho ,
- Jules Ramon Brito Teixeira ,
- Geysimara Santos Silveira Souza ,
- Elaine Guedes Fontoura ,
- Alyne Henri Motta Coifman ,
- Pollyana Pereira Portela
Views34ABSTRACT
Objective:
To evaluate the prevalence and factors associated with depression in family members of people hospitalized in intensive care units.
Methods:
A cross-sectional study was conducted with 980 family members of patients admitted to the intensive care units of a large public hospital in the interior of Bahia. Depression was measured using the Patient Health Questionnaire-8. The multivariate model consisted of the following variables: sex and age of the patient, sex and age of the family member, education level, religion, living with the family member, previous mental illness and anxiety.
Results:
Depression had a prevalence of 43.5%. In the multivariate analysis, the model with the best representativeness indicated that factors associated with a higher prevalence of depression were being female (39%), age younger than 40 years (26%) and previous mental illness (38%). A higher education level was associated with a 19% lower prevalence of depression in family members.
Conclusion:
The increase in the prevalence of depression was associated with female sex, age younger than 40 years and previous psychological problems. Such elements should be valued in actions aimed at family members of people hospitalized in intensive care.
Keywords:DepressionFamilyHospital careHospitalizationintensive care unitsMental disordersMental healthprevalenceSee moreViews34Abstract
ORIGINAL ARTICLEPrevalence and factors associated with symptoms of depression in family members of people hospitalized in the intensive care unit
Revista Brasileira de Terapia Intensiva. 2022;34(4):499-506
03-03-2022DOI 10.5935/0103-507X.20220080-en
- Luciana Maciel de Souza ,
- Kátia Santana Freitas ,
- Aloísio Machado da Silva Filho ,
- Jules Ramon Brito Teixeira ,
- Geysimara Santos Silveira Souza ,
- Elaine Guedes Fontoura ,
- Alyne Henri Motta Coifman ,
- Pollyana Pereira Portela
Views34ABSTRACT
Objective:
To evaluate the prevalence and factors associated with depression in family members of people hospitalized in intensive care units.
Methods:
A cross-sectional study was conducted with 980 family members of patients admitted to the intensive care units of a large public hospital in the interior of Bahia. Depression was measured using the Patient Health Questionnaire-8. The multivariate model consisted of the following variables: sex and age of the patient, sex and age of the family member, education level, religion, living with the family member, previous mental illness and anxiety.
Results:
Depression had a prevalence of 43.5%. In the multivariate analysis, the model with the best representativeness indicated that factors associated with a higher prevalence of depression were being female (39%), age younger than 40 years (26%) and previous mental illness (38%). A higher education level was associated with a 19% lower prevalence of depression in family members.
Conclusion:
The increase in the prevalence of depression was associated with female sex, age younger than 40 years and previous psychological problems. Such elements should be valued in actions aimed at family members of people hospitalized in intensive care.
Keywords:DepressionFamilyHospital careHospitalizationintensive care unitsMental disordersMental healthprevalenceSee more
- Luciana Maciel de Souza
-
ORIGINAL ARTICLE
Prevalence and outcomes of sepsis in children admitted to public and private hospitals in Latin America: a multicenter observational study
- Daniela Carla Souza ,
- Eliane Roseli Barreira,
- Huei Hsin Shieh,
- Andrea Maria Cordeiro Ventura,
- Albert Bousso, [ ... ],
- Eduardo Juan Troster
07-05-2021
Abstract
ORIGINAL ARTICLEPrevalence and outcomes of sepsis in children admitted to public and private hospitals in Latin America: a multicenter observational study
Revista Brasileira de Terapia Intensiva. 2021;33(2):231-242
07-05-2021DOI 10.5935/0103-507X.20210030
- Daniela Carla Souza ,
- Eliane Roseli Barreira,
- Huei Hsin Shieh,
- Andrea Maria Cordeiro Ventura,
- Albert Bousso,
- Eduardo Juan Troster
Views65ABSTRACT
Objective:
To report the prevalence and outcomes of sepsis in children admitted to public and private hospitals.
Methods:
Post hoc analysis of the Latin American Pediatric Sepsis Study (LAPSES) data, a cohort study that analyzed the prevalence and outcomes of sepsis in critically ill children with sepsis on admission at 21 pediatric intensive care units in five Latin American countries.
Results:
Of the 464 sepsis patients, 369 (79.5%) were admitted to public hospitals and 95 (20.5%) to private hospitals. Compared to those admitted to private hospitals, sepsis patients admitted to public hospitals did not differ in age, sex, immunization status, hospital length of stay or type of admission but had higher rates of septic shock, higher Pediatric Risk of Mortality (PRISM), Pediatric Index of Mortality 2 (PIM 2), and Pediatric Logistic Organ Dysfunction (PELOD) scores, and higher rates of underlying diseases and maternal illiteracy. The proportion of patients admitted from pediatric wards and sepsis-related mortality were higher in public hospitals. Multivariate analysis did not show any correlation between mortality and the type of hospital, but mortality was associated with greater severity on pediatric intensive care unit admission in patients from public hospitals.
Conclusion:
In this sample of critically ill children from five countries in Latin America, the prevalence of septic shock within the first 24 hours at admission and sepsis-related mortality were higher in public hospitals than in private hospitals. Higher sepsis-related mortality in children admitted to public pediatric intensive care units was associated with greater severity on pediatric intensive care unit admission but not with the type of hospital. New studies will be necessary to elucidate the causes of the higher prevalence and mortality of pediatric sepsis in public hospitals.
Keywords:childcritical illnessHospital, privateHospital, publicintensive care unitsIntensive care units, pediatricLatin Americamortalityprevalencesepsisseptic shockSee moreViews65Abstract
ORIGINAL ARTICLEPrevalence and outcomes of sepsis in children admitted to public and private hospitals in Latin America: a multicenter observational study
Revista Brasileira de Terapia Intensiva. 2021;33(2):231-242
07-05-2021DOI 10.5935/0103-507X.20210030
- Daniela Carla Souza ,
- Eliane Roseli Barreira,
- Huei Hsin Shieh,
- Andrea Maria Cordeiro Ventura,
- Albert Bousso,
- Eduardo Juan Troster
Views65ABSTRACT
Objective:
To report the prevalence and outcomes of sepsis in children admitted to public and private hospitals.
Methods:
Post hoc analysis of the Latin American Pediatric Sepsis Study (LAPSES) data, a cohort study that analyzed the prevalence and outcomes of sepsis in critically ill children with sepsis on admission at 21 pediatric intensive care units in five Latin American countries.
Results:
Of the 464 sepsis patients, 369 (79.5%) were admitted to public hospitals and 95 (20.5%) to private hospitals. Compared to those admitted to private hospitals, sepsis patients admitted to public hospitals did not differ in age, sex, immunization status, hospital length of stay or type of admission but had higher rates of septic shock, higher Pediatric Risk of Mortality (PRISM), Pediatric Index of Mortality 2 (PIM 2), and Pediatric Logistic Organ Dysfunction (PELOD) scores, and higher rates of underlying diseases and maternal illiteracy. The proportion of patients admitted from pediatric wards and sepsis-related mortality were higher in public hospitals. Multivariate analysis did not show any correlation between mortality and the type of hospital, but mortality was associated with greater severity on pediatric intensive care unit admission in patients from public hospitals.
Conclusion:
In this sample of critically ill children from five countries in Latin America, the prevalence of septic shock within the first 24 hours at admission and sepsis-related mortality were higher in public hospitals than in private hospitals. Higher sepsis-related mortality in children admitted to public pediatric intensive care units was associated with greater severity on pediatric intensive care unit admission but not with the type of hospital. New studies will be necessary to elucidate the causes of the higher prevalence and mortality of pediatric sepsis in public hospitals.
Keywords:childcritical illnessHospital, privateHospital, publicintensive care unitsIntensive care units, pediatricLatin Americamortalityprevalencesepsisseptic shockSee more
- Daniela Carla Souza
-
ORIGINAL ARTICLE
Is the p-value properly interpreted by critical care professionals? Online survey
- Mauro Federico Andreu ,
- Ladislao Pablo Diaz Ballve,
- Daniel Héctor Verdecchia,
- Agustina Maria Monzón,
- Tatiana Dias de Carvalho
04-19-2021
Abstract
ORIGINAL ARTICLEIs the p-value properly interpreted by critical care professionals? Online survey
Revista Brasileira de Terapia Intensiva. 2021;33(1):88-95
04-19-2021DOI 10.5935/0103-507X.20210009
- Mauro Federico Andreu ,
- Ladislao Pablo Diaz Ballve,
- Daniel Héctor Verdecchia,
- Agustina Maria Monzón,
- Tatiana Dias de Carvalho
Views30ABSTRACT
Objective:
To determine the prevalence of and risk factors for insufficient knowledge related to p-values among critical care physicians and respiratory therapists in Argentina.
Methods:
This cross-sectional online survey contained 25 questions about respondents’ characteristics, self-perception and p-value knowledge (theory and practice). Descriptive and multivariable logistic regression analyses were conducted.
Results:
Three hundred seventy-six respondents were analyzed. Two hundred thirty-seven respondents (63.1%) did not know about p-values. According to the multivariable logistic regression analysis, a lack of training on scientific research methodology (adjusted OR 2.50; 95%CI 1.37 - 4.53; p = 0.003) and the amount of reading (< 6 scientific articles per year; adjusted OR 3.27; 95%CI 1.67 - 6.40; p = 0.001) were found to be independently associated with the respondents’ lack of p-value knowledge.
Conclusion:
The prevalence of insufficient knowledge regarding p-values among critical care physicians and respiratory therapists in Argentina was 63%. A lack of training on scientific research methodology and the amount of reading (< 6 scientific articles per year) were found to be independently associated with the respondents’ lack of p-value knowledge.
Keywords:Biomedical research/statistics & numerical dataBiostatisticsData interpretation, statisticalEvidence-based medicineHypothesis testingprevalenceSee moreViews30Abstract
ORIGINAL ARTICLEIs the p-value properly interpreted by critical care professionals? Online survey
Revista Brasileira de Terapia Intensiva. 2021;33(1):88-95
04-19-2021DOI 10.5935/0103-507X.20210009
- Mauro Federico Andreu ,
- Ladislao Pablo Diaz Ballve,
- Daniel Héctor Verdecchia,
- Agustina Maria Monzón,
- Tatiana Dias de Carvalho
Views30ABSTRACT
Objective:
To determine the prevalence of and risk factors for insufficient knowledge related to p-values among critical care physicians and respiratory therapists in Argentina.
Methods:
This cross-sectional online survey contained 25 questions about respondents’ characteristics, self-perception and p-value knowledge (theory and practice). Descriptive and multivariable logistic regression analyses were conducted.
Results:
Three hundred seventy-six respondents were analyzed. Two hundred thirty-seven respondents (63.1%) did not know about p-values. According to the multivariable logistic regression analysis, a lack of training on scientific research methodology (adjusted OR 2.50; 95%CI 1.37 - 4.53; p = 0.003) and the amount of reading (< 6 scientific articles per year; adjusted OR 3.27; 95%CI 1.67 - 6.40; p = 0.001) were found to be independently associated with the respondents’ lack of p-value knowledge.
Conclusion:
The prevalence of insufficient knowledge regarding p-values among critical care physicians and respiratory therapists in Argentina was 63%. A lack of training on scientific research methodology and the amount of reading (< 6 scientific articles per year) were found to be independently associated with the respondents’ lack of p-value knowledge.
Keywords:Biomedical research/statistics & numerical dataBiostatisticsData interpretation, statisticalEvidence-based medicineHypothesis testingprevalenceSee more
- Mauro Federico Andreu
-
Review Article
Prevalence of burnout among intensive care physicians: a systematic review
- Filippo Sanfilippo,
- Gaetano Joseph Palumbo ,
- Alberto Noto,
- Salvatore Pennisi,
- Mirko Mineri, [ ... ],
- Marinella Astuto
10-12-2020
Abstract
Review ArticlePrevalence of burnout among intensive care physicians: a systematic review
Revista Brasileira de Terapia Intensiva. 2020;32(3):458-467
10-12-2020DOI 10.5935/0103-507X.20200076
- Filippo Sanfilippo,
- Gaetano Joseph Palumbo ,
- Alberto Noto,
- Salvatore Pennisi,
- Mirko Mineri,
- Francesco Vasile,
- Veronica Dezio,
- Diana Busalacchi,
- Paolo Murabito,
- Marinella Astuto
Views77Abstract
Objective:
We performed a systematic review to summarize the knowledge regarding the prevalence of burnout among intensive care unit physicians.
Methods:
We conducted a systematic review of the MEDLINE and PubMed® databases (last update 04.02.2019) with the goal of summarizing the evidence on burnout among intensive care unit physicians. We included all studies reporting burnout in intensive care unit personnel according to the Maslach Burnout Inventory questionnaire and then screened studies for data on burnout among intensive care unit physician specifically.
Results:
We found 31 studies describing burnout in intensive care unit staff and including different healthcare profiles. Among these, 5 studies focused on physicians only, and 12 others investigated burnout in mixed intensive care unit personnel but provided separate data on physicians. The prevalence of burnout varied greatly across studies (range 18% - 49%), but several methodological discrepancies, among them cut-off criteria for defining burnout and variability in the Likert scale, precluded a meaningful pooled analysis.
Conclusion:
The prevalence of burnout syndrome among intensive care unit physicians is relatively high, but significant methodological heterogeneities warrant caution being used in interpreting our results. The lower reported levels of burnout seem higher than those found in studies investigating mixed intensive care unit personnel. There is an urgent need for consensus recommending a consistent use of the Maslach Burnout Inventory test to screen burnout, in order to provide precise figures on burnout in intensive care unit physicians.
Keywords:Burnout, professional/epidemiologyDepressionintensive care unitsOccupational diseases/epidemiologyPhysicians/psychologyprevalenceWorking conditionsSee moreViews77Abstract
Review ArticlePrevalence of burnout among intensive care physicians: a systematic review
Revista Brasileira de Terapia Intensiva. 2020;32(3):458-467
10-12-2020DOI 10.5935/0103-507X.20200076
- Filippo Sanfilippo,
- Gaetano Joseph Palumbo ,
- Alberto Noto,
- Salvatore Pennisi,
- Mirko Mineri,
- Francesco Vasile,
- Veronica Dezio,
- Diana Busalacchi,
- Paolo Murabito,
- Marinella Astuto
Views77Abstract
Objective:
We performed a systematic review to summarize the knowledge regarding the prevalence of burnout among intensive care unit physicians.
Methods:
We conducted a systematic review of the MEDLINE and PubMed® databases (last update 04.02.2019) with the goal of summarizing the evidence on burnout among intensive care unit physicians. We included all studies reporting burnout in intensive care unit personnel according to the Maslach Burnout Inventory questionnaire and then screened studies for data on burnout among intensive care unit physician specifically.
Results:
We found 31 studies describing burnout in intensive care unit staff and including different healthcare profiles. Among these, 5 studies focused on physicians only, and 12 others investigated burnout in mixed intensive care unit personnel but provided separate data on physicians. The prevalence of burnout varied greatly across studies (range 18% - 49%), but several methodological discrepancies, among them cut-off criteria for defining burnout and variability in the Likert scale, precluded a meaningful pooled analysis.
Conclusion:
The prevalence of burnout syndrome among intensive care unit physicians is relatively high, but significant methodological heterogeneities warrant caution being used in interpreting our results. The lower reported levels of burnout seem higher than those found in studies investigating mixed intensive care unit personnel. There is an urgent need for consensus recommending a consistent use of the Maslach Burnout Inventory test to screen burnout, in order to provide precise figures on burnout in intensive care unit physicians.
Keywords:Burnout, professional/epidemiologyDepressionintensive care unitsOccupational diseases/epidemiologyPhysicians/psychologyprevalenceWorking conditionsSee more
-
Original Articles
Prevalence of burnout syndrome in intensivist doctors in five Brazilian capitals
Revista Brasileira de Terapia Intensiva. 2016;28(3):270-277
01-01-2016
Abstract
Original ArticlesPrevalence of burnout syndrome in intensivist doctors in five Brazilian capitals
Revista Brasileira de Terapia Intensiva. 2016;28(3):270-277
01-01-2016DOI 10.5935/0103-507X.20160053
Views54ABSTRACT
Objective:
To estimate the prevalence of burnout in intensivist doctors working in adult, pediatric and neonatal intensive care units in five Brazilian capitals.
Methods:
Descriptive epidemiological study with a random sample stratified by conglomerate with 180 intensivist doctors from five capitals representing the Brazilian geographic regions: Porto Alegre (RS), Sao Paulo (SP), Salvador (BA), Goiania (GO) and Belem (PA). A self-administered questionnaire examining sociodemographic data and the level of burnout was evaluated through the Maslach Burnout Inventory.
Results:
A total of 180 doctors were evaluated, of which 54.4% were female. The average age was 39 ± 8.1 years, 63.4% had specialization as the highest degree, 55.7% had up to 10 years of work experience in an intensive care unit, and 46.1% had the title intensive care specialist. Most (50.3%) had weekly workloads between 49 and 72 hours, and the most frequent employee type was salaried. High levels of emotional exhaustion, depersonalization and inefficacy were found (50.6%, 26.1% and 15.0%, respectively). The prevalence of burnout was 61.7% when considering a high level in at least one dimension and 5% with a high level in three dimensions simultaneously.
Conclusion:
A high prevalence of burnout syndrome among intensivist doctors was observed. Strategies for the promotion and protection of health in these workers must be discussed and implemented in hospitals.
Keywords:Burnout, professional/epidemiologyintensive care unitsIntensive care units, pediatricIntensive care, neonatalOccupational diseases/epidemiologyPhysicians/psychologyprevalenceWorking conditionsSee moreViews54Abstract
Original ArticlesPrevalence of burnout syndrome in intensivist doctors in five Brazilian capitals
Revista Brasileira de Terapia Intensiva. 2016;28(3):270-277
01-01-2016DOI 10.5935/0103-507X.20160053
Views54ABSTRACT
Objective:
To estimate the prevalence of burnout in intensivist doctors working in adult, pediatric and neonatal intensive care units in five Brazilian capitals.
Methods:
Descriptive epidemiological study with a random sample stratified by conglomerate with 180 intensivist doctors from five capitals representing the Brazilian geographic regions: Porto Alegre (RS), Sao Paulo (SP), Salvador (BA), Goiania (GO) and Belem (PA). A self-administered questionnaire examining sociodemographic data and the level of burnout was evaluated through the Maslach Burnout Inventory.
Results:
A total of 180 doctors were evaluated, of which 54.4% were female. The average age was 39 ± 8.1 years, 63.4% had specialization as the highest degree, 55.7% had up to 10 years of work experience in an intensive care unit, and 46.1% had the title intensive care specialist. Most (50.3%) had weekly workloads between 49 and 72 hours, and the most frequent employee type was salaried. High levels of emotional exhaustion, depersonalization and inefficacy were found (50.6%, 26.1% and 15.0%, respectively). The prevalence of burnout was 61.7% when considering a high level in at least one dimension and 5% with a high level in three dimensions simultaneously.
Conclusion:
A high prevalence of burnout syndrome among intensivist doctors was observed. Strategies for the promotion and protection of health in these workers must be discussed and implemented in hospitals.
Keywords:Burnout, professional/epidemiologyintensive care unitsIntensive care units, pediatricIntensive care, neonatalOccupational diseases/epidemiologyPhysicians/psychologyprevalenceWorking conditionsSee more -
Original Articles - Clinical Research
Prevalence and outcomes of infections in Brazilian ICUs: a subanalysis of EPIC II study
Revista Brasileira de Terapia Intensiva. 2012;24(2):143-150
08-01-2012
Abstract
Original Articles - Clinical ResearchPrevalence and outcomes of infections in Brazilian ICUs: a subanalysis of EPIC II study
Revista Brasileira de Terapia Intensiva. 2012;24(2):143-150
08-01-2012DOI 10.1590/S0103-507X2012000200008
Views16See moreOBJECTIVE: To determine the prevalence of infections in Brazilian intensive care units and the associated mortality by analyzing the data obtained in the Extended Prevalence of Infection in Intensive Care (EPIC II) study. METHODS: EPIC II was a multicenter, international, cross-sectional prospective study of infection prevalence. It described the demographic, physiological, bacteriological, and therapeutic characteristics, outcome up to the 60th day, prevalence of infection, and mortality of all the patients admitted to the participating ICUs between zero hour and midnight on May 8, 2007. A total of 14,414 patients were included in the original study. Of these 14,414 patients, 1,235 were Brazilian and were hospitalized in 90 Brazilian ICUs. They represent the focus of this study. RESULTS: Among these 1,235 Brazilian patients, 61,6% had an infection on the day of the trial, and the lungs were the main site of infection (71.2%). Half of the patients had positive cultures, predominantly gram-negative bacilli (72%). On the day of the study, the median SOFA score was 5 (3-8) and the median SAPS II score was 36 (26-47). The infected patients had SOFA scores significantly higher than those of the non-infected patients 6 (4-9) and 3 (2-6), respectively). The overall ICU mortality rate was 28.4%: 37.6% in the infected patients, and 13.2% in the non-infected patients (p<0.001). Similarly, the in-hospital mortality rate was 34.2%, with a higher rate in the infected than in the non-infected patients (44.2% vs. 17.7%) (p<0.001). In the multivariate analysis, the main factors associated with infection incidence were emergency surgery (OR 2.89, 95%CI [1.72-4.86], p<0.001), mechanical ventilation (OR 2.06, 95% CI [1.5-2.82], p<0.001), and the SAPS II score (OR 1.04, 95% CI [1.03-1.06], p<0.001). The main factors related to mortality were ICC functional class III/ IV (OR 3.0, 95% CI [1.51-5.98], p<0.01), diabetes mellitus (OR 0.48, 95% CI [0.25-0.95], p<0.03), cirrhosis (OR 4.62, 95% CI [1.47-14,5], p<0.01), male gender (OR 0.68, 95% CI [0.46-1.0], p<0.05), mechanical ventilation (OR 1.87, 95% CI [1.19-2.95], p<0.01), hemodialysis (OR 1.98, 95% CI [1.05-3.75], p<0.03), and the SAPS II score (OR 1.08, 95% CI [1.06-1.10], p<0.001). CONCLUSION: The present study revealed a higher prevalence of infections in Brazilian ICUs than has been previously reported. There was a clear association between infection and mortality.
Views16Abstract
Original Articles - Clinical ResearchPrevalence and outcomes of infections in Brazilian ICUs: a subanalysis of EPIC II study
Revista Brasileira de Terapia Intensiva. 2012;24(2):143-150
08-01-2012DOI 10.1590/S0103-507X2012000200008
Views16See moreOBJECTIVE: To determine the prevalence of infections in Brazilian intensive care units and the associated mortality by analyzing the data obtained in the Extended Prevalence of Infection in Intensive Care (EPIC II) study. METHODS: EPIC II was a multicenter, international, cross-sectional prospective study of infection prevalence. It described the demographic, physiological, bacteriological, and therapeutic characteristics, outcome up to the 60th day, prevalence of infection, and mortality of all the patients admitted to the participating ICUs between zero hour and midnight on May 8, 2007. A total of 14,414 patients were included in the original study. Of these 14,414 patients, 1,235 were Brazilian and were hospitalized in 90 Brazilian ICUs. They represent the focus of this study. RESULTS: Among these 1,235 Brazilian patients, 61,6% had an infection on the day of the trial, and the lungs were the main site of infection (71.2%). Half of the patients had positive cultures, predominantly gram-negative bacilli (72%). On the day of the study, the median SOFA score was 5 (3-8) and the median SAPS II score was 36 (26-47). The infected patients had SOFA scores significantly higher than those of the non-infected patients 6 (4-9) and 3 (2-6), respectively). The overall ICU mortality rate was 28.4%: 37.6% in the infected patients, and 13.2% in the non-infected patients (p<0.001). Similarly, the in-hospital mortality rate was 34.2%, with a higher rate in the infected than in the non-infected patients (44.2% vs. 17.7%) (p<0.001). In the multivariate analysis, the main factors associated with infection incidence were emergency surgery (OR 2.89, 95%CI [1.72-4.86], p<0.001), mechanical ventilation (OR 2.06, 95% CI [1.5-2.82], p<0.001), and the SAPS II score (OR 1.04, 95% CI [1.03-1.06], p<0.001). The main factors related to mortality were ICC functional class III/ IV (OR 3.0, 95% CI [1.51-5.98], p<0.01), diabetes mellitus (OR 0.48, 95% CI [0.25-0.95], p<0.03), cirrhosis (OR 4.62, 95% CI [1.47-14,5], p<0.01), male gender (OR 0.68, 95% CI [0.46-1.0], p<0.05), mechanical ventilation (OR 1.87, 95% CI [1.19-2.95], p<0.01), hemodialysis (OR 1.98, 95% CI [1.05-3.75], p<0.03), and the SAPS II score (OR 1.08, 95% CI [1.06-1.10], p<0.001). CONCLUSION: The present study revealed a higher prevalence of infections in Brazilian ICUs than has been previously reported. There was a clear association between infection and mortality.
prevalence Archives - Critical Care Science (CCS)
