Prevalence of Burnout among General Practitioners: A Systematic Review and Meta-Analysis

Background Burnout is a work-related syndrome documented to have negative consequences for general practitioners (GPs) and their patients. Our objective was to conduct a systematic review and meta-analysis of the literature to provide an estimate of how widespread this phenomenon is. Aim: To review the existing literature concerning studies published up to December, 2020, on the prevalence of burnout amongst GPs in general practice, to determine GP burnout estimates worldwide. Design and setting: Systematic literature search and meta-analysis. Method: Searches of CINAHL Plus, Embase, MEDLINE, PsycINFO, and Scopus were conducted to identify published peer-reviewed quantitative empirical studies in English up to December, 2020, that have used the Maslach Burnout Inventory-Human Services Survey to establish the prevalence of burnout in practising GPs (i.e., excluding GPs in training). A random-effects model was employed. Results: Wide-ranging prevalence estimates (6% to 32%) for 22,177 GPs across 29 countries were reported for 60 studies included in this review. Mean burnout estimates were as follows: 16.43 (EE); 6.74 (DEP); and 29.28 (PA). Subgroup and meta-analyses documented that country-specific factors may be important determinants of the variation in GP burnout estimates. Moderate overall burnout cut-offs were found to be determinants of the variation in moderate overall burnout estimates. Conclusion: Moderate to high GP burnout exist worldwide. However, substantial variations in how burnout is characterised and operationalised resulted in considerable heterogeneity in GP burnout prevalence estimates. This highlights the challenge of developing a uniform approach, and the importance of considering the GP’s work context, to better characterise burnout.

Download Full-text

Standardisation of lymphatic filariasis microfilaraemia prevalence estimates based on different diagnostic methods: a systematic review and meta-analysis

Parasites & Vectors ◽

10.1186/s13071-020-04144-9 ◽

2020 ◽

Vol 13 (1) ◽

Author(s):

Natalie V. S. Vinkeles Melchers ◽

Luc E. Coffeng ◽

Sake J. de Vlas ◽

Wilma A. Stolk

Keyword(s):

Systematic Review ◽

Lymphatic Filariasis ◽

Membrane Filtration ◽

Meta Analysis ◽

Diagnostic Technique ◽

Diagnostic Techniques ◽

Diagnostic Methods ◽

Prevalence Estimates ◽

Study Population ◽

Meta Analyses

Abstract Background Lymphatic filariasis (LF) infection is generally diagnosed through parasitological identification of microfilariae (mf) in the blood. Although historically the most commonly used technique for counting mf is the thick blood smear based on 20 µl blood (TBS20), various other techniques and blood volumes have been applied. It is therefore a challenge to compare mf prevalence estimates from different LF-survey data. Our objective was to standardise microfilaraemia (mf) prevalence estimates to TBS20 as the reference diagnostic technique. Methods We first performed a systematic review to identify studies reporting on comparative mf prevalence data as measured by more than one diagnostic test, including TBS20, on the same study population. Associations between mf prevalences based on different diagnostic techniques were quantified in terms of odds ratios (OR, with TBS20 blood as reference), using a meta-regression model. Results We identified 606 articles matching our search strategy and included 14 in our analyses. The OR of the mf prevalences as measured by the more sensitive counting chamber technique (≥ 50 µl blood) was 2.90 (95% confidence interval (CI): 1.60–5.28). For membrane filtration (1 ml blood) the OR was 2.39 (95% CI: 1.62–3.53), Knott’s technique it was 1.54 (95% CI: 0.72–3.29), and for TBS in ≥ 40 µl blood it was 1.37 (95% CI: 0.81–2.30). Conclusions We provided transformation factors to standardise mf prevalence estimates as detected by different diagnostic techniques to mf prevalence estimates as measured by TBS20. This will facilitate the use and comparison of more datasets in meta-analyses and geographic mapping initiatives across countries and over time.

Download Full-text

What work-related exposures are associated with post-traumatic stress disorder? A systematic review with meta-analysis

BMJ Open ◽

10.1136/bmjopen-2021-049651 ◽

2021 ◽

Vol 11 (8) ◽

pp. e049651

Author(s):

Pieter Coenen ◽

Henk F van der Molen

Keyword(s):

Systematic Review ◽

Post Traumatic Stress Disorder ◽

Traumatic Stress ◽

Stress Disorder ◽

Meta Analysis ◽

Post Traumatic Stress ◽

Work Related ◽

Evidence Quality ◽

Post Traumatic ◽

Meta Analyses

ObjectivesAlthough there is evidence that work-related exposures cause post-traumatic stress disorder (PTSD), there are few quantitative studies assessing the degree to which these factors contribute to PTSD. This systematic review with meta-analysis identified work-related exposures associated with PTSD, and quantified their contribution to this disorder.MethodsWe searched Medline, PsycINFO, Embase, PILOTS and Web of Science (2005–10 September 2019) for longitudinal studies on work-related exposures and PTSD. We described included articles, and conducted meta-analyses for exposures with sufficient homogeneous information. We performed subgroup analyses for risk of bias, study design and PTSD ascertainment. We assessed evidence quality using Grades of Recommendations, Assessment, Development and Evaluation, and estimated population attributable fractions.ResultsAfter screening 8590 records, we selected 33 studies (n=5 719 236). From what was moderate quality evidence at best, we identified various work-related exposures that were associated with PTSD, mainly involving individuals in the military and first responder (eg, police or fire brigade) occupations. These exposures included the number of army deployments (OR: 1.15 (95% CI 1.14 to 1.16)), combat exposure (OR 1.89 (95% CI 1.46 to 2.45)), army deployment (OR 1.79 (95% CI 1.45 to 2.21)) and confrontation with death (OR 1.63 (95% CI 1.41 to 1.90)). Effects were robust across subgroups and exposures attributed modestly (7%–34%) to PTSD. We identified additional exposures in other occupations, including life threats, being present during an attack, and hearing about a colleague’s trauma.ConclusionsWe identified various work-related exposures associated with PTSD and quantified their contribution. While exposure assessment, PTSD ascertainment and inconsistency may have biased our findings, our data are of importance for development of preventive interventions and occupational health guidelines.

Download Full-text

The Effects of Gamification on Computerized Cognitive Training: Systematic Review and Meta-Analysis

JMIR Serious Games ◽

10.2196/18644 ◽

2020 ◽

Vol 8 (3) ◽

pp. e18644 ◽

Cited By ~ 2

Author(s):

Julie F Vermeir ◽

Melanie J White ◽

Daniel Johnson ◽

Geert Crombez ◽

Dimitri M L Van Ryckeghem

Keyword(s):

Systematic Review ◽

Cognitive Training ◽

Meta Analysis ◽

Empirical Studies ◽

Age Groups ◽

Future Research ◽

Computerized Cognitive Training ◽

Meta Analyses ◽

Game Elements ◽

The Impact

Background There has been a growing interest in the application of gamification (ie, the use of game elements) to computerized cognitive training. The introduction of targeted gamification features to such tasks may increase motivation and engagement as well as improve intervention effects. However, it is possible that game elements can also have adverse effects on cognitive training (eg, be a distraction), which can outweigh their potential motivational benefits. So far, little is known about the effectiveness of such applications. Objective This study aims to conduct a systematic review and meta-analysis to investigate the effect of gamification on process outcomes (eg, motivation) and on changes in the training domain (eg, cognition), as well as to explore the role of potential moderators. Methods We searched PsycINFO, Cumulative Index to Nursing and Allied Health Literature, ProQuest Psychology, Web of Science, Scopus, PubMed, Science Direct, Excerpta Medica dataBASE, Institute of Electrical and Electronics Engineers Xplore, Association for Computing Machinery, and a range of gray-area literature databases. The searches included papers published between 2008 and 2018. Meta-analyses were performed using a random-effects model. Results The systematic review identified 49 studies, of which 9 randomized controlled trials were included in the meta-analysis. The results of the review indicated that research in this context is still developing and lacks well-controlled empirical studies. Gamification in cognitive training is applied to a large range of age groups and audiences and is mostly delivered at a research site through computers. Rewards and feedback continue to dominate the gamification landscape, whereas social-oriented features (eg, competition) are underused. The meta-analyses showed that gamified training tasks were more motivating/engaging (Hedges g=0.72) and more demanding/difficult (Hedges g=–0.52) than non- or less-gamified tasks, whereas no effects on the training domain were found. Furthermore, no variables moderated the impact of gamified training tasks. However, meta-analytic findings were limited due to a small number of studies. Conclusions Overall, this review provides an overview of the existing research in the domain and provides evidence for the effectiveness of gamification in improving motivation/engagement in the context of cognitive training. We discuss the shortcomings in the current literature and provide recommendations for future research.

Download Full-text

Taking Stock: A Meta-Analysis of Work Engagement in the Hospitality and Tourism Context

Journal of Hospitality & Tourism Research ◽

10.1177/10963480211066958 ◽

2021 ◽

pp. 109634802110669

Author(s):

Pattamol Kanjanakan ◽

Dan Zhu ◽

Tin Doan ◽

Peter B. Kim

Keyword(s):

Systematic Review ◽

Work Engagement ◽

Meta Analysis ◽

Empirical Studies ◽

Effect Sizes ◽

Hospitality And Tourism ◽

Meta Analyses ◽

Practical Implications ◽

Current Stage

Although a number of empirical studies on work engagement have been conducted in the context of hospitality and tourism, few efforts have been made to consolidate previous findings in this area. Hence, this article explores the current stage of work engagement studies and meta-analyses the relations of work engagement with its antecedents and outcomes in the hospitality and tourism context. Through a systematic review, 134 empirical studies (N = 43,043) published from 2008 to September 2020 were identified. Given that the findings include the trends within work engagement studies and the effect sizes and variabilities of associated relationships, this study contributes to the hospitality and tourism literature by providing a useful reference for future researchers. The findings are discussed in light of their theoretical and practical implications.

Download Full-text

Auditory and visual hallucination prevalence in Parkinson's disease and dementia with Lewy bodies: a systematic review and meta-analysis

Psychological Medicine ◽

10.1017/s0033291718003161 ◽

2018 ◽

Vol 49 (14) ◽

pp. 2342-2353 ◽

Cited By ~ 4

Author(s):

Charlotte Louise Eversfield ◽

Llwyd David Orton

Keyword(s):

Systematic Review ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Dementia With Lewy Bodies ◽

Meta Analysis ◽

Lewy Bodies ◽

Eligibility Criteria ◽

Pooled Prevalence ◽

Prevalence Estimates ◽

Meta Analyses

AbstractBackgroundNon-motor features of Parkinson's disease (PD) and dementia with Lewy bodies (DLB), such as auditory hallucinations (AH), contribute to disease burden but are not well understood.MethodsSystematic review and random-effects meta-analyses of studies reporting AH associated with PD or DLB. Prevalence of visual hallucinations (VH) in identified studies meeting eligibility criteria were included in meta-analyses, facilitating comparison with AH. Synthesis of qualitative descriptions of AH was performed. PubMed, Web of Science and Scopus databases were searched for primary journal articles, written in English, published from 1970 to 2017. Studies reporting AH prevalence in PD or DLB were screened using PRISMA methods.ResultsSearches identified 4542 unique studies for consideration, of which, 26 met inclusion criteria. AH pooled prevalence in PD was estimated to be 8.9% [95% confidence interval (CI) 5.3–14.5], while in DLB was estimated to be 30.8% (±23.4 to 39.3). Verbal hallucinations, perceived as originating outside the head, were the most common form of AH. Non-verbal AH were also common while musical AH were rare. VH were more prevalent, with an estimated pooled prevalence in PD of 28.2% (±19.1 to 39.5), while in DLB they were estimated to be 61.8% (±49.1 to 73.0). Meta-regression determined that the use of validated methodologies to identify hallucinations produced higher prevalence estimates.ConclusionsAH and VH present in a substantial proportion of PD and DLB cases, with VH reported more frequently in both conditions. Both AH and VH are more prevalent in DLB than PD. There is a need for standardised use of validated methods to detect and monitor hallucinations.

Download Full-text

The Effects of Gamification on Computerized Cognitive Training: Systematic Review and Meta-Analysis (Preprint)

10.2196/preprints.18644 ◽

2020 ◽

Author(s):

Julie F Vermeir ◽

Melanie J White ◽

Daniel Johnson ◽

Geert Crombez ◽

Dimitri M L Van Ryckeghem

Keyword(s):

Systematic Review ◽

Cognitive Training ◽

Meta Analysis ◽

Empirical Studies ◽

Age Groups ◽

Future Research ◽

Computerized Cognitive Training ◽

Meta Analyses ◽

Game Elements ◽

The Impact

BACKGROUND There has been a growing interest in the application of gamification (ie, the use of game elements) to computerized cognitive training. The introduction of targeted gamification features to such tasks may increase motivation and engagement as well as improve intervention effects. However, it is possible that game elements can also have adverse effects on cognitive training (eg, be a distraction), which can outweigh their potential motivational benefits. So far, little is known about the effectiveness of such applications. OBJECTIVE This study aims to conduct a systematic review and meta-analysis to investigate the effect of gamification on process outcomes (eg, motivation) and on changes in the training domain (eg, cognition), as well as to explore the role of potential moderators. METHODS We searched PsycINFO, Cumulative Index to Nursing and Allied Health Literature, ProQuest Psychology, Web of Science, Scopus, PubMed, Science Direct, Excerpta Medica dataBASE, Institute of Electrical and Electronics Engineers Xplore, Association for Computing Machinery, and a range of gray-area literature databases. The searches included papers published between 2008 and 2018. Meta-analyses were performed using a random-effects model. RESULTS The systematic review identified 49 studies, of which 9 randomized controlled trials were included in the meta-analysis. The results of the review indicated that research in this context is still developing and lacks well-controlled empirical studies. Gamification in cognitive training is applied to a large range of age groups and audiences and is mostly delivered at a research site through computers. Rewards and feedback continue to dominate the gamification landscape, whereas social-oriented features (eg, competition) are underused. The meta-analyses showed that gamified training tasks were more motivating/engaging (Hedges g=0.72) and more demanding/difficult (Hedges g=–0.52) than non- or less-gamified tasks, whereas no effects on the training domain were found. Furthermore, no variables moderated the impact of gamified training tasks. However, meta-analytic findings were limited due to a small number of studies. CONCLUSIONS Overall, this review provides an overview of the existing research in the domain and provides evidence for the effectiveness of gamification in improving motivation/engagement in the context of cognitive training. We discuss the shortcomings in the current literature and provide recommendations for future research.

Download Full-text

Psychosocial factors at work and inflammatory markers: protocol for a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2018-022612 ◽

2018 ◽

Vol 8 (8) ◽

pp. e022612 ◽

Cited By ~ 1

Author(s):

Hisashi Eguchi ◽

Kazuhiro Watanabe ◽

Norito Kawakami ◽

Emiko Ando ◽

Hideaki Arima ◽

...

Keyword(s):

Systematic Review ◽

Psychosocial Factors ◽

Neurodegenerative Disorders ◽

Inflammatory Markers ◽

Metabolic Diseases ◽

Assessment Tool ◽

Data Extraction ◽

Meta Analysis ◽

Work Related ◽

Meta Analyses

IntroductionChronic inflammation may be a mediator for the development of cardiovascular disease (CVD), metabolic diseases and psychotic and neurodegenerative disorders. Meta-analytic associations between work-related psychosocial factors and inflammatory markers have shown that work-related psychosocial factors could affect the flexibility and balance of the immune system. However, few systematic reviews or meta-analyses have investigated the association between work-related psychosocial factors and inflammatory markers. Based on prospective studies, the present investigation will conduct a comprehensive systematic review and meta-analysis of the association between work-related psychosocial factors and inflammatory markers.Methods and analysisThe systematic review and meta-analysis will include published studies identified from electronic databases (PubMed, EMBASE, PsycINFO, PsycARTICLES, Web of Science and Japan Medical Abstracts Society) according to recommendations of the Meta-analysis of Observational Studies in Epidemiology guideline. Inclusion criteria are studies that: examined associations between work-related psychosocial factors and increased inflammatory markers; used longitudinal or prospective cohort designs; were conducted among workers; provided sufficient data for calculating ORs or relative risk with 95% CIs; were published as original articles in English or Japanese; and were published up to the end of 2017. Study selection, data extraction, quality assessment and statistical syntheses will be conducted by 14 investigators. Any inconsistencies or disagreements will be resolved through discussion. The quality of studies will be evaluated using the Risk of Bias Assessment Tool for Non-randomized Studies.Ethics and disseminationThe investigation study will be based on published studies, so ethics approval is not required. The results of this study will be submitted for publication in a scientific peer-reviewed journal. The findings may be useful for assessing risk factors for increased inflammatory markers in the workplace and determining future approaches for preventing CVD, metabolic diseases and psychotic and neurodegenerative disorders.PROSPERO registration numberCRD42018081553.

Download Full-text

Prevalence of schistosomiasis and its association with anemia among pregnant women: a systematic review and meta-analysis

Parasites & Vectors ◽

10.1186/s13071-021-04642-4 ◽

2021 ◽

Vol 14 (1) ◽

Author(s):

Ishag Adam ◽

Nadiah A. ALhabardi ◽

Osama Al-Wutayd ◽

Ammar H. Khamis

Keyword(s):

Systematic Review ◽

Pregnant Women ◽

Meta Analysis ◽

Perinatal Outcomes ◽

Prevalence Estimate ◽

Pooled Prevalence ◽

Significant Difference ◽

Prevalence Estimates ◽

Newcastle Ottawa Scale ◽

Meta Analyses

Abstract Background Schistosomiasis is a highly prevalent parasitic disease that can lead to adverse maternal and perinatal outcomes. To our knowledge, there has been no systematic review and meta-analysis of schistosomiasis during pregnancy. Methods We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Relevant published studies were searched in international databases (PubMed, Science Direct, Scopus, Web of Science, and Google Scholar), from their inception until May 31, 2020. The retrieved studies were assessed for quality using the Modified Newcastle-Ottawa Scale. OpenMeta Analyst software was used for the statistical analysis. Results Thirty-two studies enrolling 21024 pregnant women were included in this meta-analysis. All 32 of these studies were conducted in Africa. Of these studies, 19, 11, and 2 investigated S. mansoni, S. haematobium, and combined S. mansoni and S. haematobium infections, respectively. The pooled prevalence estimate of schistosomiasis during pregnancy was 13.2% (95 CI 11.0–15.4). A random model was used because of high heterogeneity (Q = 99.14; P < 0.001). In subgroup analyses, the pooled prevalence estimate of S. haematobium was significantly higher than the pooled prevalence estimates of S. mansoni [22.5% (95% CI 1.6–43.5) vs 8.7% (95% CI 6.0–11.3, P = 0.016), respectively]. The results of meta-regression analyses showed a non-significant difference in the prevalence of schistosomiasis during pregnancy according to the study sample sizes and year of publication. Only six studies evaluated the association between schistosomiasis during pregnancy and anemia. Schistosomiasis was associated with anemia in these six studies (OR = 3.02, 95% = 1.25‒7.28, P = 0.014). Conclusion The present meta-analysis suggests that schistosomiasis during pregnancy is an existing health problem. This meta-analysis also highlights the lack of data on the determinants and outcomes of schistosomiasis during pregnancy. Preventive measures are needed and could be part of antenatal care in areas endemic with schistosomiasis.

Download Full-text

Comparing Burnout in Sport-Specializing Versus Sport-Sampling Adolescent Athletes: A Systematic Review and Meta-analysis

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120907579 ◽

2020 ◽

Vol 8 (3) ◽

pp. 232596712090757 ◽

Cited By ~ 3

Author(s):

Nicolas E. Giusti ◽

Seth L. Carder ◽

Lisa Vopat ◽

Jordan Baker ◽

Armin Tarakemeh ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Youth Sports ◽

Athletic Participation ◽

Negative Consequences ◽

Adolescent Athletes ◽

Level Of Evidence ◽

Athlete Burnout ◽

Individual Participant ◽

Meta Analyses

Background: The prevalence of adolescent athletes who specialize in sports has increased in recent years. Substantial literature on youth sports has linked early sport specialization to negative consequences, such as burnout and injury. However, empirical evidence directly comparing burnout rates in sport specialization versus sport sampling is very limited. Purpose: To conduct a systematic review and meta-analysis to evaluate psychological burnout in adolescent athletes who sport specialize compared with adolescent athletes who sport sample. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review was performed through use of the PubMed, SportDiscus, PsychInfo, and CINAHL databases (between inception and May 2019) according to PRISMA-IPD (Preferred Reporting Items for Systematic Reviews and Meta-Analyses of individual participant data) guidelines. Results from the 3 measures of the Athlete Burnout Questionnaire and athlete specialization status were recorded and analyzed. An athlete was determined to be a “sport specializer” if he or she met the following 3 criteria: (1) athletic participation limited to 1 sport, (2) which is competed in > 8 months in 1 year, and (3) to the exclusion of all other sports. Results: Of 3578 studies, 8 met criteria for final meta-analysis, which included 1429 athletes (mean age, 15.59 years; range, 12.5-17.2 years). Of these, 1371 (95.9%) were sport specializers, whereas 58 (4.1%) were sport samplers. A total of 1422 (99.5%) athletes completed the Athlete Burnout Questionnaire. Athletes who specialized reported higher levels of burnout than athletes who did not specialize. Specializers had a greater sense of reduced accomplishment (difference of means [△], 0.87; 95% CI, 0.67-1.08; P < .01). Specializers also reported greater exhaustion (△, 0.46; 95% CI, 0.24-0.68; P < .01) and sport devaluation (△, 0.41; 95% CI, 0.22-0.60; P < .01) than athletes who were samplers. Conclusion: Adolescent sport specialization was associated with greater levels of burnout in all 3 aspects (reduced sense of accomplishment, sport devaluation, and exhaustion) compared with sport sampling.

Download Full-text

Effects of Equine-Assisted Therapies or Horse-Riding Simulators on Chronic Pain: A Systematic Review and Meta-Analysis

Medicina ◽

10.3390/medicina56090444 ◽

2020 ◽

Vol 56 (9) ◽

pp. 444 ◽

Cited By ~ 1

Author(s):

Daniel Collado-Mateo ◽

Ana Myriam Lavín-Pérez ◽

Juan Pedro Fuentes García ◽

Miguel Ángel García-Gordillo ◽

Santos Villafaina

Keyword(s):

Systematic Review ◽

Chronic Pain ◽

Meta Analysis ◽

Public Health Problem ◽

P Value ◽

Global Public Health ◽

Work Related ◽

Horse Riding ◽

Meta Analyses ◽

Equine Assisted

Background and objectives: Chronic pain is a complex global public health problem that affects the health status, quality of life, activities of daily living, and different work-related variables. Riding a horse may lead to some benefits in chronic pain patients through the improvement of postural control and other biopsychosocial processes. Therefore, this systematic review and meta-analysis aimed to evaluate the effects of horse riding (with real or simulated horses) on chronic pain. Materials and methods: A systematic literature search was carried out in accordance with PRISMA guidelines in Web of Science (WOS) and PubMed (Medline) electronic databases. Eleven articles (seven randomized controlled trials) were selected to be included in the review. Due to some risk of bias concerns, two meta-analyses (using postintervention or change-from-baseline measures) were conducted utilizing Review Manager Software (RevMan 5.3). Results: Horse-riding simulators significantly reduced the pain levels of patients with low back pain (p = 0.03, with a SMD of −1.14 and a 95% CI from −2.16 to −0.11) using change-from-baseline measures. However, the p-value in the meta-analysis with the postintervention measures was 0.06. Regarding interventions with real horses, it was not possible to conduct a meta-analysis due to the low number of studies. Conclusion: Horse riding could be a useful exercise to reduce pain, but more studies are needed to make evidence-based recommendations and to compare the effects of horse-riding with real and simulated horses.

Download Full-text