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Martins P, Luzia RWS, Filho JAP, Welsh KS, Fuzikawa C, Nicolato R, Alemão MM, Gonçalves MA, Cavalheiro JC, Ávila ID, Veiga RT. Prevalence and factors associated with burnout among health professionals of a public hospital network during the COVID-19 pandemic. PLoS One 2024; 19:e0298187. [PMID: 38648225 PMCID: PMC11034648 DOI: 10.1371/journal.pone.0298187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 01/20/2024] [Indexed: 04/25/2024] Open
Abstract
Burnout is most commonly defined as a syndrome characterized by emotional exhaustion, cynicism, and ineffectiveness, which occurs in response to chronic stressors at work. It can adversely affect health workers' physical and mental health, and the quality of care provided. The COVID-19 pandemic increased stressors and could impact burnout prevalence in this group. There is a lack of information regarding the prevalence of burnout among hospital health workers in Brazil. A newer definition of burnout has been proposed that considers three different clinical profiles: the frenetic, underchallenged and worn-out subtypes. This differentiation could lead to interventions tailored for each subtype. The present study aimed to estimate the prevalence of burnout, its subtypes, and associated factors in workers of a public hospital network in Brazil, during the pandemic. A total of 143 randomly selected participants answered an online form that included sociodemographic and occupational items, and the Burnout Clinical Subtypes Questionnaire, a summarized version. This questionnaire evaluates three burnout dimensions (overload, lack of development, neglect) that can be used to discriminate the three burnout subtypes (frenetic, underchallenged, worn-out, respectively); higher scores indicate higher burnout levels. The prevalence of burnout was high (53.85%), similar to other studies during the pandemic. The most common subtypes were 'frenetic' (34.97%), characterized by increased efforts to meet work demands, to the point of neglecting personal needs, and 'lack of development' (23.78%), characterized by a sense that work is uninteresting and does not contribute to personal development, and a perfunctory behavior towards tasks. Age was associated with burnout: workers with less than 51 years presented higher levels of burnout. These findings indicate the need for effective interventions to prevent and/or treat burnout. The assessment of burnout subtypes can allow managers to better understand the processes affecting employees, and inform actions to improve workforce health.
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Affiliation(s)
- Patricia Martins
- Department of Mental Health, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Richardson Warley Siqueira Luzia
- Statistics and Workforce Management Center at Hospital Foundation of the State of Minas Gerais (FHEMIG), Belo Horizonte, Minas Gerais, Brazil
| | - Jair Alves Pereira Filho
- Statistics and Workforce Management Center at Hospital Foundation of the State of Minas Gerais (FHEMIG), Belo Horizonte, Minas Gerais, Brazil
| | - Kelly Silva Welsh
- Ezequiel Dias Foundation (FUNED), Belo Horizonte, Minas Gerais, Brazil
| | - Cíntia Fuzikawa
- Department of Mental Health, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Rodrigo Nicolato
- Department of Mental Health, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Márcia Mascarenhas Alemão
- Department of Health Management, School of Nursing, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Márcio Augusto Gonçalves
- Department of Administrative Sciences, Faculty of Economic Sciences, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - José Carlos Cavalheiro
- Department of Letters, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Ianny Dumont Ávila
- Academic at the Faculty of Medical Sciences of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Ricardo Teixeira Veiga
- Department of Administrative Sciences, Faculty of Economic Sciences, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
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Voltmer E, Köslich-Strumann S, Goetz K. The impact of the COVID-19 pandemic on professional life and well-being in German physicians: A cross-sectional study. Arch Environ Occup Health 2023; 78:321-328. [PMID: 37830498 DOI: 10.1080/19338244.2023.2268506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 10/03/2023] [Indexed: 10/14/2023]
Abstract
This study assessed perceptions of German physicians' regarding the impact of the COVID-19 pandemic on work-related issues as well as mental and physical health. Almost three quarters of the physicians felt stressed by the increased quantity (69%) and quality (73%) of the work and felt physically (68%) or mentally exhausted (71%). Also about three-quarters of physicians reported the pandemic having a strong impact on family life. A higher proportion feared to infect their family more than being infected themselves (66% vs 50%). Mental health scores were significantly lower in physicians compared to the general population. In female physicians, these findings were even more pronounced. Stressful work conditions and feelings of isolation were the most important predictors for mental health scores (R2 = 0.37), and also for motivation to work (R2 = 0.20). Preventive measures to strengthen resilience and optimize work organization are warranted to alleviate the toll of the pandemic on physicians.
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Affiliation(s)
- Edgar Voltmer
- Institute for Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany
| | | | - Katja Goetz
- Institute of Family Medicine, University Medical Centre Schleswig-Holstein, Lübeck, Germany
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Monti L, Marconi E, Bocci MG, Kotzalidis GD, Mazza M, Galliani C, Tranquilli S, Vento G, Conti G, Sani G, Antonelli M, Chieffo DPR. COVID-19 pandemic in the intensive care unit: Psychological implications and interventions, a systematic review. World J Psychiatry 2023; 13:191-217. [PMID: 37123099 PMCID: PMC10130962 DOI: 10.5498/wjp.v13.i4.191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 02/06/2023] [Accepted: 03/27/2023] [Indexed: 04/18/2023] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic produced changes in intensive care units (ICUs) in patient care and health organizations. The pandemic event increased patients’ risk of developing psychological symptoms during and after hospitalisation. These consequences also affected those family members who could not access the hospital. In addition, the initial lack of knowledge about the virus and its management, the climate of fear and uncertainty, the increased workload and the risk of becoming infected and being contagious, had a strong impact on healthcare staff and organizations. This highlighted the importance of interventions aimed at providing psychological support to ICUs, involving patients, their relatives, and the staff; this might involve the reorganisation of the daily routine and rearrangement of ICU staff duties.
AIM To conduct a systematic review of psychological issues in ICUs during the COVID-19 pandemic involving patients, their relatives, and ICU staff.
METHODS We investigated the PubMed and the ClinicalTrials.gov databases and found 65 eligible articles, upon which we commented.
RESULTS Our results point to increased perceived stress and psychological distress in staff, patients and their relatives and increased worry for being infected with severe acute respiratory syndrome coronavirus-2 in patients and relatives. Furthermore, promising results were obtained for some psychological programmes aiming at improving psychological measures in all ICU categories.
CONCLUSION As the pandemic limited direct inter-individual interactions, the role of interventions using digital tools and virtual reality is becoming increasingly important. All considered, our results indicate an essential role for psychologists in ICUs.
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Affiliation(s)
- Laura Monti
- UOS Psicologia Clinica, Governo Clinico, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy
| | - Elisa Marconi
- UOS Psicologia Clinica, Governo Clinico, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy
| | - Maria Grazia Bocci
- UOC Anestesia, Rianimazione, Terapia Intensiva e Tossicologia Clinica, Dipartimento di Scienze Dell’Emergenza, Anestesiologiche e Della Rianimazione, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy
| | - Georgios Demetrios Kotzalidis
- UOC Psichiatria Clinica e d’Urgenza, Dipartimento di Scienze Dell’Invecchiamento, Neurologiche, Ortopediche e Della Testa-collo, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy
- NESMOS Department, Facoltà di Medicina e Psicologia, Sant’Andrea University Hospital, Rome 00189, Italy
| | - Marianna Mazza
- UOC Psichiatria Clinica e d’Urgenza, Dipartimento di Scienze Dell’Invecchiamento, Neurologiche, Ortopediche e Della Testa-collo, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy
- Department of Psychiatry, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Carolina Galliani
- Department of Psychology, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Sara Tranquilli
- Department of Psychology, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Giovanni Vento
- UOC Neonatologia, Dipartimento di Scienze Della Salute Della Donna, Del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy
- UOC Neonatologia, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Giorgio Conti
- UOC Terapia Intensiva Pediatrica e Trauma Center Pediatrico, Dipartimento di Scienze Dell’Emergenza, Anestesiologiche e Della Rianimazione, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy
- UOC Terapia Intensiva Pediatrica e Trauma Center Pediatrico, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Gabriele Sani
- UOC Psichiatria Clinica e d’Urgenza, Dipartimento di Scienze Dell’Invecchiamento, Neurologiche, Ortopediche e Della Testa-collo, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy
- Department of Psychiatry, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Massimo Antonelli
- UOC Anestesia, Rianimazione, Terapia Intensiva e Tossicologia Clinica, Dipartimento di Scienze Dell’Emergenza, Anestesiologiche e Della Rianimazione, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy
- Department of Anesthesiology and Intensive Care Medicine, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Daniela Pia Rosaria Chieffo
- UOS Psicologia Clinica, Governo Clinico, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy
- Department of Psychology, Università Cattolica del Sacro Cuore, Rome 00168, Italy
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Abstract
PURPOSE OF REVIEW We aim to describe the extent of psychological trauma and moral distress in healthcare workers (HCW) working in the intensive care unit (ICU) during the coronavirus disease 2019 (COVID-19) pandemic. Specifically, we review reports on prevalence of mental health symptoms, highlight vulnerable populations and summarize modifiable risk factors associated with mental health symptoms in ICU HCW. RECENT FINDINGS The pandemic has resulted in a multitude of closely intertwined professional and personal challenges for ICU HCW. High rates of posttraumatic stress disorder (14-47%), burnout (45-85%), anxiety (31-60%), and depression (16-65%) have been reported, and these mental health symptoms are often interrelated. Most studies suggest that nurses and female HCW are at highest risk for developing mental health symptoms. The main personal concerns associated with reporting mental health symptoms among ICU HCW were worries about transmitting COVID-19 to their families, worries about their own health, witnessing colleagues contract the disease, and experiencing stigma from their communities. Major modifiable work-related risk factors were experiencing poor communication from supervisors, perceived lack of support from administrative leadership, and concerns about insufficient access to personal protective equipment, inability to rest, witnessing hasty end-of-life decisions, and restriction of family visitation policies. SUMMARY The COVID-19 pandemic has severely impacted ICU HCW worldwide. The psychological trauma, manifesting as posttraumatic stress disorder, burnout, anxiety, and depression, is substantial and concerning. Urgent action by lawmakers and healthcare administrators is required to protect ICU HCW and sustain a healthy workforce.
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Gilavand A. The effect of shift work on burnout and occupational fatigue among clinical faculty members during the COVID-19 pandemic. Front Public Health 2022; 10:973690. [PMID: 36324454 PMCID: PMC9621389 DOI: 10.3389/fpubh.2022.973690] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 09/09/2022] [Indexed: 01/21/2023] Open
Abstract
Introduction Shift work of clinical faculty members in the COVID-19 pandemic may cause burnout and occupational fatigue and as a result, may reduce the quality of student education and disrupt the treatment of patients, so this study was conducted to evaluate this case. Materials and methods The statistical population of this cross-sectional research included all clinical faculty members of Ahvaz Jundishapur University of Medical Sciences in southwestern Iran, who experienced a shift work system (night shift from 8 p.m. to 8 a.m.) during the COVID-19 pandemic, and finally, 71 of them participated in it. The sampling method was also available. Two inventories were used to collect data, namely the Maslach Burnout Inventory [MBI-HSS (MP)] and the Swedish Occupational Fatigue Inventory (SOFI-20). Results The self-reported burnout of faculty members was high (mean ± SD = 98.18 ± 17.18), which was graded into the range of emotional exhaustion (38.01 ± 10.2), range of personal accomplishment, (33.75 ± 6.75), and the range of depersonalization (26.42 ± 3.5), respectively. Perceived occupational fatigue of faculty members was also high (M ± SD = 82.25 ± 34.79), which included the dimensions of lack of motivation (18.69 ± 8.65), drowsiness (17.43 ± 8.7), lack of energy (16.33 ± 7.67), physical discomfort (15.65 ± 8.62), and physical stress (13.51 ± 6.9), respectively. In terms of demographic characteristics, occupational fatigue was significantly more common among women. Discussion and conclusion The self-reported burnout and occupational fatigue of clinical faculty members due to shift work were reported to be high in this study. Although our knowledge of burnout has advanced in recent years, many gaps in our knowledge still remain. In order for clinical faculty members to properly fulfill their mission to treat patients, educate students, and promote public health, it is necessary to provide all the necessary conditions for their effective activity. Some interventions, such as improving organizational strategies and providing technical solutions, incentives, and occupational facilities, can help reduce or eliminate these problems.
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Bernales-Turpo D, Quispe-Velasquez R, Flores-Ticona D, Saintila J, Ruiz Mamani PG, Huancahuire-Vega S, Morales-García M, Morales-García WC. Burnout, Professional Self-Efficacy, and Life Satisfaction as Predictors of Job Performance in Health Care Workers: The Mediating Role of Work Engagement. J Prim Care Community Health 2022; 13:21501319221101845. [PMID: 35603465 PMCID: PMC9125607 DOI: 10.1177/21501319221101845] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: It is essential to identify the factors that influence the work performance
of health professionals working in health care facilities, especially in the
context of the COVID-19 pandemic, since these factors have an impact on the
quality of medical care provided to the population. Objective: This study aimed to analyze the mediating role of work engagement in the
relationship between job burnout, professional self-efficacy, life
satisfaction, and job performance in Peruvian health care workers. Methods: Cross-sectional explanatory study, with the voluntary participation of 508
health professionals (physicians and nurses) of both sexes (70.7% women,
29.3% men), and from different health facilities in the city of Lima. All
participants were administered the Single Burnout Item questionnaire, the
Professional Self-Efficacy Scale (AU-10), the Satisfaction with Life Scale
(SWL), the Individual Work Performance Questionnaire (IWPQ), and the Utrecht
Work Engagement Scale (UWES-9). Structural Equation Modeling (SEM) was used
for data analysis. Results: In the SEM analysis, it was found that for the mediation model the
incremental goodness-of-fit indices were significant
(χ2 = 2292.313, gl = 659, P < .001,
χ2/gl = 2.788). Career self-efficacy (β = .557,
P < .001) and life satisfaction (β = .289,
P < .001) were positive predictors of work
engagement. While burnout was a negative predictor (β = .878,
P < .001). The consistent mediation of work
engagement of professional self-efficacy, life satisfaction, and burnout had
a positive predictor effect on job performance (β = .878,
P < .001). Conclusion: Research provides evidence that professional self-efficacy, life
satisfaction, and burnout could influence job performance through work
engagement.
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Macaron MM, Segun-Omosehin OA, Matar RH, Beran A, Nakanishi H, Than CA, Abulseoud OA. A systematic review and meta analysis on burnout in physicians during the COVID-19 pandemic: A hidden healthcare crisis. Front Psychiatry 2022; 13:1071397. [PMID: 36713915 PMCID: PMC9877514 DOI: 10.3389/fpsyt.2022.1071397] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 12/28/2022] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE This systematic review and meta-analysis aims to explore overall prevalence of burnout among physicians during early and late COVID-19 pandemic and geographical differences in burnout. METHODS This review was registered prospectively with PROSPERO (CRD42022327959). A comprehensive search of several databases, including Ovid MEDLINE(R) and Epub Ahead of Print, In-Process & Other Non-Indexed Citations and Daily, Ovid Embase, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, PsycINFO, and Scopus, spanning from December 2019 to May 2022 was conducted. Eligible studies included physicians or medical professionals including physicians that worked directly or indirectly with COVID-19 patients, whilst reporting burnout outcomes using a validated scale. Literature that did not include physicians or did not occur in a hospital setting were excluded. Literature including medical students were also excluded. RESULTS Forty-five observational studies were included, all of which were cross-sectional studies. The pooled estimate of overall prevalence of burnout was 54.60% (95% CI: 46.7, 62.2). Mean emotional exhaustion, depersonalization, and personal accomplishment was found to be 22.06% (95% CI: 18.19, 25.94), 8.72 (95% CI: 6.48, 10.95) and 31.18 (95% CI: 27.33, 35.03) respectively. Frontline workers displayed higher rates of burnout than second-line healthcare workers (HCW) (OR: 1.64, 95% CI: 1.13, 2.37). Studies from the early pandemic period reported burnout prevalence of 60.7% (95% CI: 48.2, 72) compared to a prevalence of 49.3% (95% CI: 37.7, 60.9) from the late pandemic period. Geographically, burnout was highest amongst Middle East and North Africa (MENA) studies (66.6%, 95% CI: 54.7, 78.5), followed by Europe (48.8%, 95% CI: 40.3, 57.3) and then South America (42%, 95% CI: -0.4, 84.4). Lastly, burnout prevalence overall (OR = 0.77, 95% CI: 0.36, 1.67) emotional exhaustion (MD = -0.36, 95% CI: -4.64, 3.91), depersonalization (MD = -0.31, 95% CI: -1.80, 1.18), and personal accomplishment (MD = 0.55, 95% CI: -0.73, 1.83) were found comparable between physicians and nurses. CONCLUSION COVID-19 has had significant consequences on HCW burnout. Further research is needed to examine early signs of burnout and to develop effective coping strategies.
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Affiliation(s)
- Marie Michele Macaron
- School of Medicine, St. George's University of London, London, United Kingdom.,University of Nicosia Medical School, University of Nicosia, Nicosia, Cyprus
| | - Omotayo Ayomide Segun-Omosehin
- School of Medicine, St. George's University of London, London, United Kingdom.,University of Nicosia Medical School, University of Nicosia, Nicosia, Cyprus
| | - Reem H Matar
- School of Medicine, St. George's University of London, London, United Kingdom.,University of Nicosia Medical School, University of Nicosia, Nicosia, Cyprus.,Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, United States
| | - Azizullah Beran
- Division of Gastroenterology and Hepatology, Indiana University, Indianapolis, IN, United States
| | - Hayato Nakanishi
- School of Medicine, St. George's University of London, London, United Kingdom.,University of Nicosia Medical School, University of Nicosia, Nicosia, Cyprus
| | - Christian A Than
- School of Medicine, St. George's University of London, London, United Kingdom.,University of Nicosia Medical School, University of Nicosia, Nicosia, Cyprus.,School of Biomedical Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Osama A Abulseoud
- Department of Psychiatry and Psychology, Mayo Clinic Arizona, Phoenix, AZ, United States.,Department of Neuroscience, Mayo Clinic Arizona, Phoenix, AZ, United States
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