Burnout and Associated Factors Among Health Care Workers in Singapore During the COVID-19 Pandemic

Abstract

Objectives The strain on healthcare systems due to the COVID-19 pandemic has led to increased psychological distress among healthcare workers (HCWs). As this global crisis continues with little signs of abatement, we examine burnout and associated factors among HCWs. Design Cross-sectional survey study. Setting and Participants Doctors, nurses, allied health professionals, administrative and support staff in four public hospitals and one primary care service in Singapore 3 months after COVID-19 was declared a global pandemic. Methods Study questionnaire captured demographic and workplace environment information and comprised three validated instruments, namely the Oldenberg Burnout Inventory (OLBI), Safety Attitudes Questionnaire (SAQ), and Hospital Anxiety and Depression Scale (HADS). Multivariate mixed model regression analyses were employed to evaluate independent associations of mean OLBI-Disengagement and -Exhaustion scores. Further subgroup analysis was performed among redeployed HCWs. Results Among 11,286 invited HCWs, 3,075 valid responses were received, giving an overall response rate of 27.2%. Mean OLBI scores were 2.38 and 2.50 for Disengagement and Exhaustion respectively. Burnout thresholds in Disengagement and Exhaustion were met by 79.7% and 75.3% of respondents respectively. On multivariate regression analysis, Chinese or Malay ethnicity, HADS anxiety or depression scores ≥8, shifts lasting ≥8 hours and being redeployed were significantly associated with higher OLBI mean scores, while high SAQ scores were significantly associated with lower scores. Among redeployed HCWs, those redeployed to high-risk areas in a different facility (offsite) had lower burnout scores than those redeployed within their own work facility (onsite). A higher proportion of HCWs redeployed offsite assessed their training to be good or better compared to those redeployed onsite. Conclusions and Implications Every level of the healthcare workforce is susceptible to high levels of burnout during this pandemic. Modifiable workplace factors include adequate training, avoiding prolonged shifts ≥8 hours and promoting safe working environments. Mitigating strategies should target every level of the healthcare workforce including frontline and non-frontline staff. Addressing and ameliorating burnout among HCWs should be a key priority for the sustainment of efforts to care for patients in the face of a prolonged pandemic.

Financial Insecurity During the COVID-19 Pandemic: Spillover Effects on Burnout–Disengagement Relationships and Performance of Employees Who Moonlight

“…Our study also demonstrated that burnout symptoms that emerged during the COVID-19 crisis depreciate extra-role performance through the work disengagement mediator, conditional on financial insecurity (a boundary condition) for increased work disengagement. The present study provides empirical evidence on the direct link between burnout and disengagement of work, which is similar to previous findings ( Tan et al, 2020 ). Our study confirmed the significance of this direct relationship in congruence with the conditional on an elevated level of financial insecurity.…”

“…When their employers in mandatory quarantine are unable to provide job protection and income replacement, employees are likely to experience a complicated array of negative emotions and work stress that may impair their work effort and resources. Previous studies on post-coronavirus outbreaks have reported that employees who engaged in any outside employment tend to suffer from enormous financial stress, anxiety, and social isolation that affect their health and productivity ( Banerjee and Rai, 2020 ; Tan et al, 2020 ).…”

Occupational Burnout and Job Satisfaction Among Physicians in Times of COVID-19 Crisis: A Convergent Parallel Mixed-Method Study

“…Besides, our study ndings regarding predictors of burnout were found to be consistent with many studies that addressed HCPs were exposed to higher levels of psychological distress due to the risk of catching COVID-19 infection and higher workload during the pandemic crisis, making them vulnerable to burnout [44][45][46][47]. Higher workload and long duty hours lead to more exposure to patients, especially among physicians and other HCPs who work directly in managing COVID-19 cases and those who work at emergency units.…”

Depressive and Anxiety Symptoms of Healthcare Workers in Intensive Care Unit Under the COVID-19 Epidemic: An Online Cross-Sectional Study in China

“…To be noted, work experience was generally considered to be beneficial to mental health when treating with emergency public health incidence (25); in our study, longer ICU work time was unexpectedly identified detrimental to maintain mental health. This could be explained by the high prevalence of occupational burnout among ICU healthcare workers especially for those who had worked long years in current occupation, since occupational burnout had been proved to be associated with depressive and anxiety symptoms (26)(27)(28)(29)(30). This result raised concern about occupational burnout among ICU healthcare workers with long years of working.…”