In Belgium, the first peak of the COVID-19 epidemic took place in April 2020 with between 400 and 500 new hospitalisations per day. During this peak, frontline nurses were exposed to higher levels of stressful and traumatic events that could increase the risk of burnout. The objectives of this study were (1) to estimate the prevalence of burnout risk among nurses in Belgium during the peak of the COVID-19 epidemic and (2) to identify risk groups. We collected data on 4,552 nurses between April 21 and May 04 using an online survey. The risk of burnout was assessed using the validated Maslach Burnout Inventory (MBI) scale. Our results allow us to estimate that 71% of nurses were at risk of burnout. Compared to nurses working in a medical or surgical ward in hospital, nurses working in nursing homes (OR = 1.37, p <0.01), in COVID-19 ward in hospital (OR = 1.32, p < 0.01), in emergency department (OR = 1.29, p < 0.01), and in intensive care unit (OR = 1.25, p < 0.01) were at higher risk of burnout. Finally, the results of this study highlighted the impact of covid-19 on their working conditions and risk of burnout. A perceived increase in workload during the epidemic (OR = 1.81, p <0.01), the lack of adequate protective equipment (OR = 1.51, p < 0.01) and the number of COVID-19 patients in the ward (OT = 1.13, p <0.01) were significant risk factors for burnout. This study highlights the importance of managing the risk of nurses' burnout during the COVID-19 pandemic with interventions (screening, debriefing, etc.) and preventive measures on individual (rest time, family and professional support, etc.) and organisational factors (communication and training, workload, etc.)
The effect of school tobacco policies on the adoption of adolescent smoking: A school-level longitudinal study in 38 schools
In the last decades, school tobacco policies (STPs) have been implemented to limit smoking at school. Yet, the embeddedness of the policy highly varies from one school to another, affecting its effectiveness. A school with a stronger STP conveys a rather antismoking normative frame, which may influence the perceived peer approval of smoking among adolescents, and therefore the popularity of smoking. Extensive research has shown that adolescents tend to adopt smoking behaviours similar to their friends’. These peer effects may however be highly dependent on contextual features, such as the STP. This paper aims to examine how STPs influence the popularity of smoking. We hypothesized that the perception of stronger STPs may lessen the adoption among peers of smoking on school premises and of smoking in general, making them less popular. A whole-network study was carried out in 2013 and 2016 in 38 schools from six European cities. Adolescents from 3rd and 4th grades (n = 18,805) were requested to complete a questionnaire describing their friendship ties, their smoking behaviour, and other information about their health, family, and school environment. Recent researchers have suggested the use of diffusion centrality to capture individuals’ centrality in terms of their “ability to diffuse a given property”, such as smoking. Contrarily to standard peer effect measures that spot central leaders, the diffusion centrality rather identifies the most diffusive ones. We therefore adapted this measure to spot adolescents who were more likely to diffuse smoking on school premises and smoking in general. Indeed, popular adolescents who smoke are more likely to diffuse smoking to their peers than adolescents who smoke but are more peripheral in the network. Likewise, these adolescents would be more likely to diffuse smoking than adolescents who are more central in the network but do not smoke. Preliminary results showed that the diffusion centrality of smoking on school premises lowered with stronger perceived STPs in place. This association was not true for the diffusion centrality of smoking. Further analyses may suggest the use of various health interventions, depending on the social structure of smoking in schools.