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To investigate the association between healthcare workers' demographic and work-environment variables during the COVID-19 pandemic and their turnover intentions or actual turnover after two years.
Two-step longitudinal cohort study.
A nationwide longitudinal cohort study was conducted using a convenience sample of Belgian HCWs who participated in online surveys at two time points: November 24th, 2021, to March 15th, 2022 (Period 1), and November 16th, 2023, to December 12th, 2023 (Period 2).
Out of 2149 participants in the first survey, 700 responded in the second. During the pandemic, 31.3% intended to leave the profession. In Period 2, 52.3% of those reaffirmed their intention or had left (6.5%). Work autonomy, resilience, and perceived patient harm predicted turnover intention. Pandemic-related work pressure was the primary reason for leaving.
Promoting healthcare workers' autonomy and resilience is crucial for mitigating turnover. HCWs who experience patient harm during a pandemic will have a higher risk for turnover. Knowing this, healthcare managers and policymakers should develop strategies to prepare for future health crises.
Enhancing work autonomy and resilience among healthcare workers can improve retention and job satisfaction, ultimately leading to better patient care and a more stable healthcare workforce.
Problem Addressed: The study addresses the high turnover intentions among healthcare workers during and after the COVID-19 pandemic.
Main Findings: Work autonomy, resilience, and perceived patient harm due to workload are significant predictors of turnover intentions.
Impact: The research impacts healthcare managers and policymakers by providing insights into factors that can improve healthcare workers' retention and job satisfaction.
This study adhered to the STROBE guidelines for reporting observational studies.
No patient or public contribution.
Gestational weight gain (GWG) is an important indicator of maternal nutrition to be monitored during pregnancy. However, there is no evidence-based tool that can be used to monitor it across all geographic locations and pre-pregnancy body mass index (BMI) categories. The WHO is undertaking a project to develop GWG charts by pre-pregnancy BMI category, and to identify GWG ranges associated with the lowest risks of adverse maternal and infant outcomes. This protocol describes all the steps that will be used to accomplish the development of these GWG charts.
This project will involve the analysis of individual participant data (researcher-collected or administrative). To identify eligible datasets with GWG data, a literature review will be conducted and a global call for data will be launched by the WHO. Eligible individual datasets obtained from multiple sources will be harmonised into a pooled database. The database will undergo steps of cleaning, data quality assessment and application of individual-level inclusion criteria. Heterogeneity of maternal weight and GWG will be assessed to verify the possibility of combining datasets from multiple sources and regions into a single database. Generalized Additive Models for Location, Scale and Shape will be applied for the construction of the centile curves. Diagnostic measures, internal and external validation procedures will also be performed.
This project will include an analysis of existing study de-identified data. To be included in the pooled database, each included study should have received ethics approvals from relevant committees. Manuscripts will be submitted to open-access journals and a WHO document will be published, including the GWG charts and cut-offs for application in antenatal care.
Meeting the recommended guidelines for physical activity (PA), sedentary behaviour (SB) and sleep, collectively referred to as 24-hour movement behaviours (24h-MBs), is crucial for type 2 diabetes mellitus (T2DM) management and is associated with favourable health outcomes. However, it is suggested that adults with T2DM spend more time in SB and less time in PA compared with adults without diabetes.
This study aims to compare 24h-MBs between adults with and without T2DM (ie, controls with similar characteristics except for having T2DM), investigate how this is associated with cardiometabolic health, and assess changes in 24h-MBs after two years of follow-up (FU) in adults with T2DM.
Cross-sectional and longitudinal study.
Community-dwelling adults with T2DM and controls in Belgium.
This study took place between September 2021 and December 2023. The 24h-MBs were measured using accelerometers (Actigraph wGT3X+); cardiometabolic variables (adiposity, blood pressure and advanced glycation end-products) were collected in both groups. In adults with T2DM, fasting blood samples were collected at baseline and second FU. Compositional data analysis was used to explore group differences in 24h-MBs using multivariate analysis of variance, and regression models analysed associations with cardiometabolic health. Changes in 24h-MBs over time in adults with T2DM were assessed using a linear mixed model.
52 adults with T2DM (mean age 63.2 SD 10.6) and 74 controls (mean age 62.7 SD 9.4) were included in the cross-sectional analysis. The 24h-MBs of adults with T2DM differed significantly from the controls (p=0.026). Adults with T2DM spent significantly less time in light (–34.7 min/day) and moderate to vigorous PA (MVPA) (–24.1 min/day) compared with controls. In adults with T2DM, reallocating 30 min from any behaviour to MVPA was associated with a significant increase in high-density lipoprotein-cholesterol (sleep: 5.05 mg/dL (2.45; 7.80), standardised effect size (ES)=0.53; SB: 4.53 mg/dL (1.93; 7.27), ES=0.47; light PA: 5.29 mg/dL (2.07; 8.73), ES=0.55) whereas in the control group significant decreases in waist circumference were found when reallocating 30 min from SB to sleep (2.42 cm (0.86–3.97), ES=0.34). 37 (mean age 65.0 SD 9.5) and 22 (mean age 67.0 SD 7.7) adults with T2DM provided valid data after 1 year and 2 years of FU, respectively. No significant changes in 24h-MBs were found after 1-year (p=0.93) or 2-year (p=0.79) FU among adults with T2DM.
Adults with T2DM have a less favourable 24h-MB composition compared to adults without T2DM, indicating the need for additional effort to achieve and maintain the guidelines. Despite the limited associations found, time reallocations from other behaviours to MVPA theoretically suggest the biggest health benefits.
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