Burnout and psychological distress among nurses in a Nigerian tertiary health institution

Background

The role of nurses in the health care delivery system cannot be overemphasized. Nurses are needed at all levels of healthcare and the profession requires a lot of dedication, time and energy with regards to patient management and service delivery. This time investment and dedication to duty is likely to lead to burnout and psychological distress among the nurses.

Objective

This study assesses the prevalence of burnout and psychological distress among nurses working in Nigerian tertiary health institution.

Method

The Maslach Burnout Inventory (MBI) and the General Health Questionnaire (GHQ-12) were used to assess 210 nurses working in this health institution for symptoms of burnout and psychological distress.

Results

High levels of burnout were identified in 42.9% of the respondents in the area of emotional exhaustion, 47.6% in the area of depersonalization and 53.8% in the area of reduced personal accomplishment, while 44.1% scored positive in the GHQ-12 indicating presence of psychological distress.

Conclusion

Prevalence of burnout and psychological distress is high among nurses.     

Introducing a lecturer-practitioner: the management perspective

The West Midlands Regional Health Authority Department of Nursing funded a 1-year study to look at 'Implementation aspects of the lecturer-practitioner role (in nursing)'. A feasibility study was carried out from November 1992 to October 1993 to address the issue and highlight areas requiring more in-depth study. Twenty-nine subjects working as or with lecturer-practitioners were interviewed using a semi-structured questionnaire. The interview was divided into two discrete parts. The first section contained a mixture of open and closed questions and the second section adopted a modified repertory grid technique. This paper provides the main results from the first half of the interview. The study describes in practical terms how managers need to plan for the introduction of a lecturer-practitioner post; the key responsibilities of the role; and a person specification. The work identifies clear prerequisite criteria for job role and gives guidance on lecturer-practitioner management and function.     

d－生物素的立体专一性全合成研究

对ｃｏｎｆａｉｏｎｅ的ｄ－生物素（１）全合成进行了改进，从半胱氨酸计算，总收率３．７％。５与４－溴代三苯膦丁酸甲酯进行Ｗｉｔｔｉｇ－Ｓｃｈｌｏｓｓｅｒ缩合反应可立体专一性地转化成反式－烯（６）。以叠氮三甲基硅烷代替叠氮化锂亲核进攻９分子中Ｃ３－溴原子，可显著地提高顺式－叠氮内酰胺１０的收率。     

Evidence for posttranslational control of Hb C synthesis in an individual with Hb C trait and alpha-thalassemia

The level of Hb C in the erythrocytes of individuals with Hb C trait decreases significantly in the presence of coexisting alpha- thalassemia. This relationship may result from the higher affinity of beta A than beta C for limiting amounts of alpha-globin during hemoglobin assembly. This mechanism would predict that the beta A and beta C synthetic capacity in alpha-thalassemic individuals with Hb C trait should be balanced despite the low levels of Hb C in their circulating erythrocytes. To directly test this prediction, we have measured the beta A and beta C synthetic capacity of reticulocyte RNA isolated from two individuals with Hb C trait, one with a normal alpha- globin genotype and one with alpha-thalassemia. The balanced expression of beta A and beta C in both cases supports the proposed posttranslational control over Hb C expression.     

A prospective study of NAT2 acetylation genotype, cigarette smoking, and risk of breast cancer

Polymorphisms in the N-acetyltransferase 2 (NAT2) gene are determinants of the rate of metabolic activation of carcinogenic compounds such as aryl aromatic amines. Homozygosity for any combination of three variant alleles in Caucasians defines 'slow' acetylators; presence of one or two wild-type alleles characterizes 'rapid' acetylators. Although most previous studies have not observed an overall elevation in risk of breast cancer among slow acetylators, a recent study observed that cigarette smoking was associated with a large increase in risk of breast cancer among slow acetylators. We assessed the relation between NAT2 acetylation status and breast cancer risk, and its interaction with smoking, in a prospective study of mainly Caucasian US women. Four hundred and sixty-six incident cases who were diagnosed with breast cancer after giving a blood specimen in 1989-90 were matched to 466 controls in a nested case-control study. NAT2 genotype was determined using PCR-RFLP assays. The multivariate relative risk (RR) comparing slow with rapid acetylators was 0.9 (95% CI 0.7-1.2). Among slow acetylators, current smoking immediately prior to diagnosis was not associated with a significant elevation in risk compared with never smoking rapid acetylators (RR = 1.4, 95% CI 0.7-2.6). No significant association was seen between pack-years of smoking and risk of breast cancer among either slow or fast acetylators. A non-significant elevation in risk was observed among women who smoked for > or = 5 years prior to first pregnancy and were rapid acetylators, compared with never smoking rapid acetylators (RR = 1.5, 95% CI 0.9-2.6). In analyses limited to 706 post-menopausal women, the elevated risks for current smokers immediately prior to diagnosis who were slow acetylators compared with never smokers who were fast acetylators were slightly stronger but still not statistically significant. In summary, we observed little evidence of an association between NAT2 genotype and breast cancer. In this prospective study, cigarette smoking was not appreciably associated with breast cancer among either slow or fast NAT2 acetylators.      

Nephrolithiasis and risk of hypertension in women

Cross-sectional and prospective studies of men suggest a positive association between nephrolithiasis and hypertension. However, this association remains controversial in women. We conducted a prospective study of the relation between nephrolithiasis and the risk for hypertension in the Nurses' Health Study, a cohort of 89,376 women aged 34 to 59 years in 1980. Information on the history of nephrolithiasis, physician-diagnosed hypertension, and other relevant exposures was obtained by biennial mailed questionnaire. A history of nephrolithiasis before 1980 was reported by 2,558 women (2.9%), and a history of hypertension was reported by 11,883 women (13.3%). Among women without hypertension before 1980, 12,540 women reported a new diagnosis of hypertension between 1980 and 1992, during 711,039 person-years of follow-up. Compared with those without a history of nephrolithiasis, the age-adjusted relative risk (RR) for incident hypertension in women with such a history was 1.36 (95% confidence interval [CI], 1.20 to 1.43). After further adjustment for body mass index (BMI) and the intake of calcium, sodium, potassium, magnesium, caffeine, and alcohol, the RR was only slightly attenuated (RR=1.24; 95% CI, 1.13 to 1.37). In contrast, the occurrence of incident nephrolithiasis during follow-up was similar in women with hypertension at baseline compared with women without (adjusted odds ratio [OR]=1.01; 95% CI, 0.85 to 1.20). These data are consistent with the results obtained in men and support the hypothesis that a history of nephrolithiasis is associated with an increased risk for subsequent hypertension. Dietary factors, such as the intake of calcium, sodium, and potassium, do not explain this association. Unidentified pathogenic mechanisms common to nephrolithiasis and hypertension may be responsible for the development of both disorders.