scholarly journals Modifiable risk factors related to burnout levels in the medical workplace in Taiwan: cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e032779 ◽  
Author(s):  
Yu-Li Lin ◽  
Cing-Hua Chen ◽  
Wei-Min Chu ◽  
Sung-Yuan Hu ◽  
Yi-Sheng Liou ◽  
...  

ObjectivesTo detect the combined effects of lifestyle factors on work-related burnout (WB) and to analyse the impact of the number of weekend catch-up sleep hours on burnout risk in a medical workplace.DesignCross-sectional study.SettingHospital-based survey in Taiwan.ParticipantsIn total, 2746 participants completed the hospital’s Overload Health Control System questionnaire for the period from the first day of January 2016 to the end of December 2016, with a response rate of 70.5%. The voluntary participants included 358 physicians, 1406 nurses, 367 medical technicians and 615 administrative staff.Primary and secondary outcome measuresAll factors that correlated significantly with WB were entered into a multinomial logistic regression after adjustment for other factors. The dose–response relationship of combined lifestyle factors and catch-up sleep hours associated with WB was explored by logistic regression.ResultsAbnormal meal time (adjusted OR 2.41, 95% CI 1.85 to 3.15), frequently eating out (adjusted OR 1.49, 95% CI 1.12 to 1.97), lack of sleep (adjusted OR 5.13, 95% CI 3.94 to 6.69), no exercise (adjusted OR 1.41, 95% CI 1.10 to 1.81) and >40 work hours (adjusted OR 2.72, 95% CI 2.08–3.57) were independently associated with WB (for high level compared with low level). As the number of risk factors increased (1–5), so did the proportion of high severity of WB (adjusted OR 1.39, 95% CI 0.45 to 4.27, to adjusted OR 32.98, 95% CI 10.78 to 100.87). For those with more than 7 hours’ sleep on workdays, weekend catch-up sleep (≤0/>0 and ≤2/>2 hours) was found to be related to an increase of burnout risk (adjusted OR 4.91, 95% CI 2.24 to 10.75/adjusted OR 4.94, 95% CI 2.54 to 9.63/adjusted OR 6.74, 95% CI 2.94 to 15.46).ConclusionWB in the medical workplace was affected by five unhealthy lifestyle factors, and combinations of these factors were associated with greater severity of WB. Weekend catch-up sleep was correlated with lower burnout risk in those with a short workday sleep duration (less than 7 hours). Clinicians should pay particular attention to medical staff with short sleep duration without weekend catch-up sleep.

2020 ◽  
Vol 17 (1) ◽  
pp. 82-93
Author(s):  
Mary-Joe Youssef ◽  
Antoine Aoun ◽  
Aline Issa ◽  
Lana El-Osta ◽  
Nada El-Osta ◽  
...  

Background: The prevalence of gastroesophageal reflux disease (GERD) is increasing worldwide and the related chronic symptoms can be associated with morbidity and poor quality of life. Objective: The objective of this study was to identify foods and beverages consumed by the Lebanese population, dietary habits, socio-demographic and lifestyle factors, health parameters and perceived stress, implicated in increasing GERD symptoms. Methods: This observational cross-sectional study was carried among Lebanese adults in 2016. A convenient sample of 264 participants was equally divided into a GERD group and a control group. Data on socio-demographic characteristics, lifestyle, health status and dietary habits including Lebanese traditional dishes were collected. The perceived stress scale (PSS) was also used to assess the participants’ perception of stress. Logistic regression analyses were conducted with GERD symptoms (presence or absence) being the dependent variable. Results: The GERD symptoms were significantly associated with age (-p-value=0.017), family history of GERD symptoms (-p-value<0.001), smoking (-p-value=0.003) and chronic medical conditions (-p-value<.001). Regarding the dietary factors, participants who ate three meals or less/day, between meals and outside homes were 2.5, 2.9 and 2.4 times at a higher risk of experiencing GERD symptoms than others, respectively. Moreover, the logistic regression model showed that the GERD symptoms were significantly associated with the consumption of coffee (-p-value=0.037), Lebanese sweets (-p-value=0.027), fried foods (-p-value=0.031), ‘Labneh’ with garlic (-p-value<0.001), pomegranate molasses (-p-value=0.011), and tomatoes (-p-value=0.007). Conclusion: Some specific lifestyle factors and components of the Lebanese Mediterranean diet could be associated with GERD symptoms.


BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e043814
Author(s):  
Mesfin Tadese ◽  
Andargachew Kassa ◽  
Abebaw Abeje Muluneh ◽  
Girma Altaye

ObjectivesThe study aimed to provide an association between dysmenorrhoea and academic performance among university students in Ethiopia. Further, the study attempts to determine the prevalence and associated risk factors of dysmenorrhoea.Design and methodInstitution-based cross-sectional study was conducted from 1 April to 28 April 2019. A semistructured and pretested self-administered questionnaire was used to collect data. Binary logistic regression analysis and one-way analysis of variance were performed to model dysmenorrhoea and academic performance, respectively.Setting and participantsEthiopia (2019: n=647 female university students).OutcomesThe primary outcome is dysmenorrhoea, which has been defined as painful menses that prevents normal activity and requires medication. The self-reported cumulative grade point average of students was used as a proxy measure of academic performance, which is the secondary outcome.ResultsThe prevalence of dysmenorrhoea was 317 (51.5%). The educational status of father (adjusted OR (AOR) (95% CI) 2.64 (1.04 to 6.66)), chocolate consumption (AOR (95% CI) 3.39 (95% 1.28 to 8.93)), daily breakfast intake (<5 days/week) (AOR (95% CI) 0.63 (0.42 to 0.95)), irregular menstrual cycle AOR (95% CI) 2.34 (1.55 to 3.54)) and positive family history of dysmenorrhoea AOR (95% CI) 3.29 (2.25 to 4.81)) had statistically significant association with dysmenorrhoea. There was no statistically significant difference in academic performance among students with and without dysmenorrhoea (F (3611)=1.276, p=0.28)).ConclusionsDysmenorrhoea was a common health problem among graduating University students. However, it has no statistically significant impact on academic performance. Reproductive health officers should educate and undermine the negative academic consequences of dysmenorrhoea to reduce the physical and psychological stress that happens to females and their families.


BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e050629
Author(s):  
Vanessa W Lim ◽  
Hwee Lin Wee ◽  
Phoebe Lee ◽  
Yijun Lin ◽  
Yi Roe Tan ◽  
...  

ObjectivesWHO recommends that low burden countries consider systematic screening and treatment of latent tuberculosis infection (LTBI) in migrants from high incidence countries. We aimed to determine LTBI prevalence and risk factors and evaluate cost-effectiveness of screening and treating LTBI in migrants to Singapore from a government payer perspective.DesignCross-sectional study and cost-effectiveness analysis.SettingMigrants in Singapore.Participants3618 migrants who were between 20 and 50 years old, have not worked in Singapore previously and stayed in Singapore for less than a year were recruited.Primary and secondary outcome measuresCosts, quality-adjusted life-years (QALYs), threshold length of stay, incremental cost-effectiveness ratios (ICERs), cost per active TB case averted.ResultsOf 3584 migrants surveyed, 20.4% had positive interferon-gamma release assay (IGRA) results, with the highest positivity in Filipinos (33.2%). Higher LTBI prevalence was significantly associated with age, marital status and past TB exposure. The cost-effectiveness model projected an ICER of S$57 116 per QALY and S$12 422 per active TB case averted for screening and treating LTBI with 3 months once weekly isoniazid and rifapentine combination regimen treatment compared with no screening over a 50-year time horizon. ICER was most sensitive to the cohort’s length of stay in Singapore, yearly disease progression rates from LTBI to active TB, followed by the cost of IGRA testing.ConclusionsFor LTBI screening and treatment of migrants to be cost-effective, migrants from high burden countries would have to stay in Singapore for ~50 years. Risk-stratified approaches based on projected length of stay and country of origin and/or age group can be considered.


BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e029638 ◽  
Author(s):  
Qi Liu ◽  
Xi Zeng ◽  
Wen Wang ◽  
Ruo-lin Huang ◽  
Yan-jin Huang ◽  
...  

ObjectivesThis study aimed to assess the knowledge of risk factors and warning symptoms and attitude towards gastric cancer screening among the general population in China.SettingHunan province, ChinaParticipantsIndividuals aged older than 18 years were recruited using a cluster sampling method.DesignA cross-sectional study, and a pretested structured questionnaire was used to assess participants’ awareness of gastric cancer.Primary and secondary outcome measuresKnowledge level of risk factors and warning symptoms of gastric cancer, gastric cancer screening attitude, sociodemographic factors associated with gastric cancer knowledge and screening behaviour.ResultsThis study comprised 1200 participants with a mean age of 40.31 (SD 16.73) years, of whom 622 (51.8%) were women. The mean score for gastric cancer knowledge was 8.85/22 (SD 6.48). There were 47.0% of the participants who had a low knowledge level about the risk factors and warning symptoms of gastric cancer. In total, 83.8% believed screening is helpful for early detection of gastric cancer, and 15.2% had undergone gastric cancer screening. The most common reason for not undergoing screening was having ‘no symptoms’ (63.0%), followed by ‘fear of undergoing gastroscopy’ (38.1%). Independent factors related to lower knowledge levels included male sex, living in rural areas, lower educational level, working as a farmer and without a family history of gastric cancer (p<0.05). Factors independently associated with screening behaviour included white-collar employment, higher income and having upper gastrointestinal tract diseases (p<0.05).ConclusionsIn China, people have poor knowledge about risk factors and warning symptoms of gastric cancer, but a majority have a positive attitude towards the benefits of gastric cancer screening. Being asymptomatic and having a fear of gastroscopy were the main self-reported reasons for not undergoing screening. These results highlight the urgent need for educational campaigns to improve gastric cancer awareness.


2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Huiwu Han ◽  
Fan Zheng ◽  
Weiwei Dai ◽  
Hua Peng ◽  
Shi Zhou ◽  
...  

Objectives. Metabolic syndrome (MetS) is now becoming a serious public health threat. Some behaviors risk factors were considered to be associated with MetS and interacted to adversely affect MetS. However, the clustering effects of behavior risk factors of MetS among Chinese population remain unclear. The aim of this study is to observe the behavior risk factors and their clustering effects of MetS in China. Methods. A cross-sectional study design was used. Subjects were recruited in the departments of Cardiology Clinic, Endocrine Clinic, and Health Management from March to December 2019. A demographic sheet was designed to collect the demographic and clinical characteristics of the subjects. International Physical Activity Questionnaire-Short was applied to evaluate the level of PA in this study. Other behavior risk factors were observed by the questionnaire. The stepwise logistic regression analysis was performed to identify the determinants of MetS. The multiple logistic regression analysis was used to analyze the clustering effects of behavior risk factors in MetS. Results. There are a total of 532 eligible subjects (56.6% females; mean age was 48.4±15.3 years), and approximately 33.3% were diagnosed as MetS. The subjects with a smoking habit (heavy and long-time history) had a 1.833-fold higher risk for MetS than their counterparts (none and light smoking), and the subjects that preferred salty taste had a 1.626-fold higher risk for MetS than the comparison cohort. Smoking and alcohol drinking had the highest clustering effect on MetS among the behavior risk factors. Conclusions. The main finding of this study was that smoking and salty taste preference were the independent determinants of MetS. Smoking and alcohol consumption had the highest clustering effect on southern Chinese MetS.


2019 ◽  
Vol 13 (03) ◽  
pp. 233-239
Author(s):  
Hamish Mohammed ◽  
Mary H Hayden ◽  
Elise Lee ◽  
Luis M Santiago ◽  
Rosina C Krecek ◽  
...  

Introduction: After a large outbreak of dengue virus (DENV) serotype-3 in Saint Kitts and Nevis (SKN) in 2008, we performed a cross-sectional study to determine the prevalence of anti-DENV immunoglobulin G (IgG) antibodies in expatriate and local persons affiliated with an American veterinary school there. Methodology: This campus community comprised mostly expatriate students and faculty and Kittitian administrative staff. In 2009, a stratified random sample of students, faculty and staff was invited to complete an electronic survey to assess risk factors for DENV and provide blood for testing for anti-DENV IgG antibodies by an enzyme-linked immunosorbent assay. IgG-positive specimens were also tested by a 90% plaque reduction neutralization test (PRNT90) to determine immunoreactivity to DENV (1-4) serotypes and West Nile virus. Risk factors for anti-DENV IgG seropositivity were determined using simple and adjusted logistic regression. Results: Of the 118 participants, the overall prevalence of DENV IgG antibodies was 44.1% (95% confidence interval [CI]: 35.1-53.0%), ranging from 30.1% in students, 100.0% in staff and 57.9% in faculty (p < 0.001). Duration of residence in St. Kitts was the only variable significantly associated with seropositivity on multiple logistic regression (adjusted odds ratio [95% CI]: 1.21 [1.07-1.37]). The serotype of DENV was determined in 11 persons: DENV-1 (n = 4), DENV-2 (n = 3), and DENV-3 (n = 4). Conclusions: Expatriate students and faculty moving to St. Kitts from non-endemic areas were at high risk of DENV infection. There is a need for increased emphasis on pre-travel mosquito-borne virus prevention education for persons moving to St. Kitts to study and work.


2020 ◽  
Author(s):  
Xiaohua Yang ◽  
Huijuan Chen ◽  
Wanling Yang ◽  
Bin Deng ◽  
Jialing Zheng ◽  
...  

Abstract Background: Stroke-associated pneumonia (SAP) is a major complication after stroke, oral microorganisms are important contributors to SAP. Here, we aimed to investigate whether the oral hygiene was associated with SAP and related risk factors of them in patients with acute ischemic stroke. Methods: We performed a cross-sectional study that recruited 331 patients with acute ischemic stroke from two medical centers. A series of assessments were performed to evaluate the neurological status and habits of oral hygiene. According to whether the oral hygiene was abnormal and SAP occurred, univariate analyses were performed in cohort 1 (normal / abnormal oral hygiene groups) and cohort 2 (SAP / non-SAP groups). Multiple logistic regression analyses were conducted to confirm risk factors of oral cleanliness and SAP in stroke patients. Results: A total of 12 and 8 independent variables were included in the model 1 and 2 analysis. After adjusting for confounders, multivariable logistic regression analysis showed that oral cleanliness was not only closely related to SAP (OR=2.219, P=0.026), dental caries (OR=1.292, P=0.005) and age (OR=1.030, P=0.006) in model 1, but also an independent risk factor for predicting SAP (OR=1.678, P=0.001) in model 2. Barthel index was a protective factor for oral cleanliness (OR=0.986, P=0.019) and SAP (OR=0.977, P=0.002) in ischemic stroke patients. Conclusions: Mutually primary risk roles of abnormal oral cleanliness and SAP exist in patients with acute ischemic stroke. Dental caries and aging are important risk factors for oral health disorders. Improving the activities of daily living would have protective effects on both oral hygiene and SAP prevention in stroke patients.


BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e035551
Author(s):  
Antonios Konstantinos Bertsias ◽  
Ioanna Tsiligianni ◽  
Sophia Papadakis ◽  
Ioannis Zaganas ◽  
George Duijker ◽  
...  

ObjectivesCognitive impairment is known to have a significant impact on the quality of life of individuals and their caregivers, yet it is often underdiagnosed. The objective of this study is to assess the extent of cognitive impairment among elders visiting primary healthcare (PHC) practice settings, to explore associated risk factors and discuss current care challenges for PHC providers.DesignA cross-sectional study was conducted between March 2013 and May 2014.SettingFourteen PHC units located in rural and urban areas of the Heraklion district in Crete, Greece.ParticipantsConsecutive visitors aged at least 60 years attending selected PHC practices.Primary and secondary outcome measuresThe Mini-Mental State Examination (MMSE) was used to indicate cognitive status. Associations of low MMSE scores (≤23/24, adjusted for education level) with 12 socio-demographic factors, comorbidities and lifestyle factors were assessed.ResultsA total of 3140 PHC patients met inclusion criteria (43.2% male; mean age 73.7±7.8 years). The average MMSE score was 26.0±3.8; 26.7±3.5 in male and 25.4±3.9 in female participants (p<0.0001). Low MMSE scores were detected in 20.2% of participants; 25.9% for females vs 12.8% for males; p<0.0001. Female gender (adjusted OR (AOR)=2.72; 95% CI 2.31 to 3.47), age (AOR=1.11; 95% CI 1.10 to 1.13), having received only primary or no formal education (AOR=2.87; 95% CI 2.26 to 3.65), alcohol intake (AOR=1.19; 95% CI 1.03 to 1.37), reporting one or more sleep complaints (AOR 1.63; 95% CI 1.14 to 2.32), dyslipidaemia (AOR=0.80; 95% CI 0.65 to 0.98) and history of depression (AOR=1.90; 95% CI 1.43 to 2.52) were associated with low MMSE scores.ConclusionsThis study identified a relatively high prevalence of low MMSE scores among persons attending PHC practices in a southern European community setting and associations with several known risk factors.


BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e031281 ◽  
Author(s):  
Manel Mata-Cases ◽  
Josep Franch-Nadal ◽  
Jordi Real ◽  
Marta Cedenilla ◽  
Didac Mauricio

ObjectivesTo evaluate the prevalence and coprevalence of several chronic conditions in patients with type 2 diabetes in a Mediterranean region.DesignA cross-sectional study.SettingTwo hundred and eighty-six primary care teams of the Catalonian Health Institute (Catalonia, Spain).ParticipantsWe included patients aged ≥18 years with a diagnosis of type 2 diabetes by 31 December, 2016, who were registered in the Information System for the Development of Research in primary care (SIDIAP) database. We excluded patients with a diagnosis of type 1 diabetes, gestational diabetes mellitus and any other type of diabetes.Primary and secondary outcome measuresWe collected data on diabetes-related comorbidities (ie, chronic complications, associated cardiovascular risk factors and treatment complications). Diagnoses were based on the International Classification of Diseases, 10thRevision codes recorded in the database or, for some entities, on the cut-off points for a particular test result or a specific treatment indicated for that entity. The presence and stage of chronic kidney disease (CKD) were based on the glomerular filtration rate, the CKD Epidemiology Collaboration creatinine equation and the urine albumin-to-creatinine ratio.ResultsA total of 373 185 patients were analysed. 82% of patients exhibited ≥2 comorbidities and 31% exhibited ≥4 comorbidities. The most frequent comorbidities were hypertension (72%), hyperlipidaemia (60%), obesity (45%), CKD (33%), chronic renal failure (CRF)(28%) and cardiovascular disease (23%). The most frequently coprevalent pairs of chronic conditions were the combination of hypertension with hyperlipidaemia (45%), obesity (35%), CKD (28%), CRF (25%) or cardiovascular disease (19%), as well as the combination of hyperlipidaemia with obesity (28%), CKD (21%), CRF (18%) or cardiovascular disease (15%); other common pairs of comorbidities were obesity/CKD, obesity/CRF, hypertension/retinopathy, hypertension/albuminuria, hypertension/urinary tract infection, CVD/CRF and CVD/CKD, which were each present in more than 10% of patients.ConclusionPatients with type 2 diabetes have a high frequency of coprevalence of metabolic risk factors, cardiovascular disease and CKD and thus require an integrated management approach.


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