Burnout of Physicians, Pharmacists and Nurses in the Course of the COVID-19 Pandemic: A Serbian Cross-Sectional Questionnaire Study

Occupational burnout and job satisfaction among community pharmacists

Introduction

Community pharmacists (CPs) are the most accessible healthcare professionals in primary care due to pharmacies' open-door policy and convenience, resulting in high patient and prescription volumes, and numerous free-of-charge consultations. Therefore, they are at high risk for burnout.

Objectives

The primary objective of this study was to assess the levels of burnout among community pharmacists in Greece, marking the first investigation of its kind within the country. Additionally, this study aimed to explore potential correlations between demographic variables and other health-related factors with burnout scores.

Methods

This study used a quantitative cross-sectional design involving two validated questionnaires(the Greek version of Maslach (MBI) questionnaire and the SF-36 questionnaire). Prior to data collection, all the relevant documentation was approved by the Metropolitan College Research Ethics Committee and was adopted under the auspices of the Panhellenic Pharmaceutical Association. Random sampling was used. Data collection period was July to August 2022.

Results

A total of 368 responses were included in the analysis, with the majority being pharmacy-owners (n = 292, 79.3%). Notably, a significant proportion of respondents were female practitioners working within community pharmacy settings (n = 230, 62.5%). Analysis revealed that the sample exhibited low levels of personal achievement (M = 30.99, SD = 6.41), high levels of emotional exhaustion (M = 41.73, SD = 6.94), and moderate levels of depersonalization (M = 23.38, SD = 3.78), indicative of substantial occupational burnout. Furthermore, gender had a discernible impact on depersonalization, with women scoring higher than men (t = -3.29, p < 0.01). Pharmacists who identified medicine shortages as their primary challenge in daily practice reported lower emotional burnout and depersonalization, albeit with a diminished sense of accomplishment (t = -2.62, p < 0.01).

Conclusions

This study sheds light on burnout levels and health-related quality of life among community pharmacists in Greece.

Burnout Among Saudi Radiographers

Introduction

Burnout research is limited in Saudi Arabia, particularly among radiographers. Burnout among Saudi radiographers may have a negative impact on the services offered.

Objective

This study aims to assess the burnout among radiographers in Medina hospitals.

Materials and Methods

This quantitative cross-sectional study included 104 radiographers from government and private Medina hospitals. The Maslach Burnout Inventory-Human Services Survey for Medical Personnel, which consists of 22 questions, was used to measure the burnout level. The data were evaluated descriptively using the Statistical Package for the Social Sciences (version 25), and independent t-tests and analysis of variance were applied to assess group differences and linear regression analysis to evaluate associations between the burnout level and sociodemographic variables (ie sex, age, experience, and department).

Results

The emotional exhaustion (EE) and depersonalization (DP) scores were moderate, while the personal accomplishment (PA) score was high, with total scores of 23.53 (9.32), 7.29 (5.95), and 29.70 (1.35), respectively. The DP score was influenced by the participants' experience. Specifically, an experience of 1-5 years yielded a substantially higher burnout score than did an experience of >10 years (p>0.05). Conversely, sex, age, and department did not affect the DP score (p<0.05). Similarly, the EE and PA scores were not influenced by sex, age, experience, or department (p<0.05).

Conclusion

Burnout is prevalent among radiographers in Medina hospitals in Saudi Arabia. The EE and DP scores are moderate, while the PA score is high, indicating a suitable work environment. Policymakers should take the required steps to identify the variables contributing to employee burnout and enhance the work environment.

Impact of the COVID-19 pandemic on pharmacists practicing in community pharmacies in the state of Nebraska

BACKGROUND

The rapid increase in COVID-19 combined with uncertainty surrounding transmission and treatment protocols resulted in unprecedented burnout amongst health care workers. As other health care workers scrambled to support patients, community pharmacists quickly responded to the pandemic by extending their services. This constantly changing environment amongst other factors created a high degree of psychological burden associated with COVID-19 for pharmacists. Although studies have examined the psychological impact of the pandemic on frontline health care workers, pharmacists are rarely included in these studies.

OBJECTIVE

To examine the impact of COVID-19 on work and personal well-being from the perspective of pharmacists practicing in community pharmacies in Nebraska.

METHODS

A cross-sectional online survey collected data from pharmacists with an active Nebraska Pharmacist license (N=2763) from November 2022 to January 2023. The survey was a hybrid of researcher-developed items and the validated abbreviated Maslach Burnout Inventory (aMBI). The aMBI is a 9-item Likert-scale scored instrument, which captures three domains of burnout: Personal Accomplishment; Emotional Exhaustion; and Depersonalization. Data was analyzed using IBM SPSS Statistics version 27.

RESULTS

The response rate to the survey was 12.3% (n=339). Mean age of the respondents was 44.8 years with an average of 18.7 years in practice. Most respondents (n = 113, 50.7%) practiced in a community pharmacy followed by hospital (n = 72, 32.3%). 55.8% of community pharmacists reported that they considered leaving their current employer. Chi-square analysis confirmed that community pharmacists are more burned out than noncommunity pharmacists.

CONCLUSIONS

Pharmacists realized they had not been recognized for their contributions as frontline health care workers, which motivated them to consider leaving their employer and even the profession of pharmacy. This study found community pharmacists are burned out more than non-community pharmacists. Within community pharmacies, it was found that pharmacists practicing at corporate-owned community pharmacies had increased burnout compared to those practicing in independent community pharmacies.

Stress and Burnout among Medical Specialists in Romania: A Comparative Study of Clinical and Surgical Physicians

This study, which focuses on 227 participants (196 females and 31 males) comprising 187 clinical specialists and 40 surgical physicians, examines the prevalence of burnout in medical specialists. We investigate the effects of the emotional exhaustion (EE), Depersonalization (D), and personal accomplishment (PA) dimensions on professional satisfaction and plans to change careers using the modified licensed Maslach Burnout Inventory-Human Services Survey (MBI-HSS (MP)). High emotional exhaustion is reported by 52.63% of men and 71.28% of women in the clinical medicine group (n = 188). In the surgical specialties (n = 39), scores are significantly higher, with 75% of men and 77.77% of women reporting EE. In our sample group, 71.36% express high levels of emotional exhaustion, with similar patterns across specialization and gender. Clinical medicine respondents report high degrees of depersonalization in 33.13% of females and 21.05% of males, while surgical specialty respondents report high levels in 33.33% of females and 50% of males. Across genders and specializations, 33.03% of all respondents show high levels of depersonalization. Clinical medicine participants report high levels of personal accomplishment (42.60% of females and 42.10% of males), whereas surgical specialties report 44.44% of females and 66.66% of male on the PA dimension. Of the total number of respondents, 44.05% report having a high level of personal accomplishment; differences exist depending on specialty and gender. In addition, questions regarding professional fulfilment and intention to change careers were presented to the participants. A total of 53.40% (16 male and 105 female) of the clinical medicine respondents said they intended to change careers, while 33 participants (9 male, 34 female) doubted if they would remain in the same specialization. Furthermore, 86 individuals (9 male and 77 female) in the surgical specialties said they would never choose to work in healthcare again. Regression analysis suggests that being male, higher in age, and working in surgical specialties with lower job satisfaction and a higher intention to change profession are associated with higher levels of EE. Age and work satisfaction are significant predictors of depersonalization, and higher career satisfaction is associated with increased levels of PA.

Burnout study during the COVID-19 pandemic in Thailand: psychometric evaluation of the Maslach Burnout Inventory-Human Services Survey for Medical Personnel

Objectives

This study aimed (1) to determine the psychometric properties of a Thai version of the Maslach Burnout Inventory-Human Services Survey for Medical Personnel (MBI-HSS [MP]) and (2) to examine the mean scores of burnout and associated factors during the COVID-19 pandemic.

Methods

Forward and back translations of the MBI-HSS (MP) questionnaire were performed. The Thai version was subsequently completed by 682 Thai physicians and nurses who worked during the COVID-19 pandemic. Exploratory factor analysis was performed on the first subsample (n = 341) by conducting Kaiser Mayer-Olkin sampling adequacy measurement and Bartlett's test of sphericity whereas confirmatory factor analysis (CFA) was performed on the second subsample (n = 341) using fit indices of the normed chi-square (χ2/df), the comparative fit index, the Tucker-Lewis index, and the root mean square error of approximation. This version's internal consistency was investigated using Cronbach's alpha coefficient. Demographic profiles were evaluated with descriptive and analytical statistics.

Results

The Thai version of the MBI-HSS (MP) displayed good psychometric characteristics, as the Cronbach's alpha values of the 3 burnout factors ranged from 0.843 to 0.945. The CFA also showed good fit indices (χ2/df = 4.473; P < 0.001; RMSEA = 0.075 (95%CI = 0.055-0.079); CFI = 0.946; and TLI = 0.936). The physicians' mean EE, DP, and PA scores were 25.28 ± 13.27, 7.15 ± 6.11, and 36.83 ± 8.13, respectively, whereas The nurses' mean EE, DP, and PA scores were 23.10 ± 14.14, 4.43 ± 5.06, and 35.67 ± 10.24, respectively. Healthcare professionals who were younger, single, had fewer years of practice, and had more working hours per week tended to express more burnout scores.

Conclusions

The Thai version of the MBI-HSS (MP) demonstrates good psychometric properties in assessing burnout among healthcare professionals. Several factors may be pivotal in intensifying burnout.

Nurse burnout before and during the COVID-19 pandemic: a systematic comparative review

Introduction

This review aimed to compare available evidence examining burnout using the Maslach Burnout Inventory (MBI) in nurses before and during the COVID-19 pandemic. The specific objective was to compare nurse burnout scores in terms of emotional exhaustion, depersonalization, and personal accomplishment.

Methods

A comprehensive search was conducted for studies on nurses' burnout using the MBI published between 1994 and 2022. In total, 19 studies conducted prior to the pandemic and 16 studies conducted during the pandemic were included and compared using the criteria from the Joanna Briggs Institute Critical Appraisal Tool.

Results

Surprisingly, the results indicated that nurses' burnout scores did not differ significantly before (N = 59,111) and during (N = 18,629) the pandemic. The difference observed was qualitative rather than quantitative.

Discussion

The outbreak of the COVID-19 pandemic exacerbated an already critical situation, and while COVID-19 may serve as an additional triggering factor for staff mental illness, it cannot solely explain the observed burnout levels. These findings underscore the need for long-term clinical and preventive psychological interventions, suggesting that psychological resources should not be limited to emergencies but extended to address the ongoing challenges faced by nurses.

Systematic review registration

https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=399628, identifier: CRD42023399628.

Behind the scenes of the healthcare COVID-19 pandemic crisis: potential affecting factors of healthcare work sustainability in Romania during 2020-2022

Aim

The COVID-19 pandemic represented a great disturbance for medical systems around the world, putting medical personnel on the front lines of the fight against the SARS-Cov2 virus. This fight was particularly impactful in countries with medical systems already facing various challenges, including Romania; where the pandemic unfolded in five waves that severely affected the psychological and physical well-being of medical professionals in terms of overload and continuous exposure to health threats. Against this background, our research aims to identify the mediating role of potential affecting factors of healthcare work sustainability during the change-related uncertainty conditions generated by the COVID 19 crisis. Dynamics and relations of nine carefully selected constructs were tracked along all five pandemic waves in Romania, which span from March 2020 to April 2022. The tested variables and constructs are perception of healthcare workers of their own state of health, their workplace safety, the work-family conflict, the satisfaction of basic needs, the work meaningfulness and work engagement, patient care, pandemic stress and burnout.

Methods

This cross-sectional study is based on an online snowball sampling of 738 health workers from 27 hospitals. Panel research is limited to a maximum of 61 respondents for two successive waves. The analytical part is built on means comparison of analysed variables between all five pandemic waves and an in-depth model to explain the relationships between the variables.

Results

The results indicate statistically significant correlations between the perception of health risks and all selected factors excluding patient care, which seems to be above the own health perception. The factors' dynamics was followed along all five pandemic waves. The developed model identified that one's health status satisfaction is a mediator of the family-work conflict and, together, of work engagement. In turn, work engagement plays a significant role in satisfying basic psychological needs and supporting work meaningfulness. Also, work meaningfulness influences the satisfaction of basic psychological needs.

Discussion

Health workers with higher levels of positive perceived health are better at managing pandemic stress, burnout effects and work-family imbalances. Adaptive behaviors and attitudes towards COVID-19 pandemic threats could be identified in later pandemic waves due to the progress in terms of medical protocols and procedures.

Pharmacists' Mental Health during the First Two Years of the Pandemic: A Socio-Ecological Scoping Review

Healthcare workers have been under a great deal of stress and have been experiencing burnout throughout the COVID-19 pandemic. Among these, healthcare workers are pharmacists who have been instrumental in the fight against the pandemic. This scoping review examined the impact of the pandemic on pharmacists' mental health and their antecedents using three databases (CINAHL, MEDLINE, and PsycINFO). Eligible studies included primary research articles that examined the mental health antecedents and outcomes among pharmacists during the first two years of the pandemic. We used the Social Ecological Model to categorize antecedents per outcome. The initial search yielded 4165 articles, and 23 met the criteria. The scoping review identified pharmacists experiencing poor mental health during the pandemic, including anxiety, burnout, depression, and job stress. In addition, several individual, interpersonal, organizational, community, and policy-level antecedents were identified. As this review revealed a general decline in pharmacists' mental health during the pandemic, further research is required to understand the long-term impacts of the pandemic on pharmacists. Furthermore, we recommend practical mitigation strategies to improve pharmacists' mental health, such as implementing crisis/pandemic preparedness protocols and leadership training to foster a better workplace culture.

Natural multi-hazard risk perception and educational insights among Geography and Tourism students and graduates amid the Covid-19 pandemic

Multi-hazard risk perception is an emerging research topic that has been gaining more and more interest since the beginning of the Covid-19 pandemic, due to the unprecedented interactions between the management practices of the pandemic and of other co-occurring natural hazards, and to the compounded impact of these multi-hazards. This paper aims to investigate the specialization and study level-dependent differences concerning multi-hazard risk perception and hazard-related education insights of future potential specialists in natural hazard-induced risk management and tourism reconstruction. These differences were explored by applying a multi-layer questionnaire on 547 Geography and Tourism students and graduates from two universities in Iași City (Romania) and Novi Sad (Serbia), and performing descriptive and differential statistical analyses. The statistically significant differences that emerged refer to estimations of the impact level of the Covid-19 pandemic and of other natural hazards at different spatial scales and on different socio-economic activities, on the training/career of the respondents, and to the hazard-related education improvements. Up to date, none of the papers in the existing literature integrate both the Covid-19 pandemic and the co-occurrent natural hazards as objects of students' perception, which makes the present study a starting point for such research endeavours.

Burnout, negative emotions, and wellbeing among social workers in China after community lockdowns during the COVID-19 pandemic: Mediating roles of trait mindfulness

Objective

This study aimed to investigate burnout situation of social workers (SWs) who experienced the COVID-19 pandemic-related community lockdown 1 year before, and to assess the protective value of trait mindfulness (TM) in states of burnout.

Method

We surveyed the burnout, trait mindfulness, negative emotions (NEs) and wellbeing (WB) of 182 social workers provided services to Wuhan lockdowns community by COVID-19 one year before. Burnout were measured using the Maslach Burnout Inventory-Human Services Survey; TM using the Mindful Attention Awareness Scale; NEs using the Depression Anxiety and Stress Scale-21; and WB using the General Wellbeing Schedule. We also performed correlation regression analysis and mediation test for burnout, TM, NEs, and WB.

Results

Among the 182 respondents, 75 (41.2%) still suffered from severe burnout. TM was negatively correlated with burnout (r = -0.623), negatively correlated with NEs (r = -0.560), and positively correlated with WB (r = 0.617). Burnout had a significantly positive correlation with NEs (r = 0.544) and a significantly negative correlation with WB (r = -0.666). Further, WB had significantly negative correlation with NEs (r = -0.758). After controlling for age, gender, marital status, educational level, and years of employment, burnout had a significantly positive predictive effect on NEs (β = 0.509), whereas TM had a significantly negative predictive effect on NEs (β = -0.334). TM played a partial mediating role in the effect of burnout on NEs, with a mediating effect and effect ratio of 0.088 and 39.7%, respectively. Burnout had a significantly negative predictive effect on WB (β = -0.598), whereas TM had a significantly positive predictive effect on WB (β = 0.299). TM played a partial mediating role in the effect of burnout on NEs, with a mediating effect and effect ratio of -0.164 and 30.3%, respectively. WB had a significantly negative predictive effect on NEs (β = -0.711), and it played a partial mediating role in the effect of burnout on NEs, with a mediating effect and effect ratio of 0.185 and 83.3%, respectively.

Conclusion

The current levels of burnout among local SWs remained high 1 year after the community lockdowns. TM played a mediating role in the relationship between burnout, NEs, and WB. Concomitantly, WB played a mediating role in the relationship between burnout and NEs. Therefore, in the context of burnout, TM is a protective factor for reducing emotional stress and risks of developing psychiatric disorders through the enhancement of WB.