From Resilience to Burnout in Healthcare Workers During the COVID-19 Emergency: The Role of the Ability to Tolerate Uncertainty

Trani, Michela Di; Mariani, Rachele; Ferri, Rosa; Berardinis, Daniela De; Frigo, Maria Grazia

doi:10.3389/fpsyg.2021.646435

Cited by 105 publications

(105 citation statements)

References 59 publications

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“…The third component of the MBI scale, Personal Accomplishment, detects no statistically significant difference on the average score ( p = 0.66). This data is in line with the available literature: Di Trani et al 45 found a higher level of MBI Personal Accomplishment in emergency professionals than in chronicity operators. In the same research, the “emergency group” expressed more feelings of competence, productivity, and successful achievement in one's work than the chronicity and service group.…”

Section: Discussionsupporting

confidence: 92%

Impact of COVID‐19 on the mental health in a cohort of Italian rehabilitation healthcare workers

Farì

Sire

Giorgio

et al. 2021

Journal of Medical Virology

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The COVID‐19 pandemic has had a strong impact on healthcare workers (HCWs), affecting their physical and mental health. In Italy, HCWs have been among the first exposed to unprecedented pressure, dealing with large numbers of infections during the first pandemic wave. However, the severe psychological consequences on HCWs find little evidence in the literature, especially in terms of comparison to the status quo ante pandemic. The aim of this study was to provide an assessment of the mental health burden in a cohort of Italian HCWs during the COVID‐19 pandemic, comparing their condition with that before the emergency, to direct the promotion of mental well‐being among HCWs worldwide. In this retrospective study, we included physicians, physical therapists, and nurses working in the Respiratory Intensive Care Unit, Neurology Unit, and Rehabilitation Unit from a Southern Italy University Hospital. All study participants underwent a battery of psychological tests, aimed at verifying their state of mental health during the COVID‐19 emergency and before it. Depressive, anxiety, and burnout symptoms were assessed using the following questionnaires: Maslach Burnout Inventory, Patient Health Questionnaire‐9 (PHQ‐9), and General Anxiety Disorder‐7. Depressive, anxiety, and burnout clinical relevance symptoms were present in HCWs during the COVID‐19 pandemic more than those before the emergency. Fifty percent of the HCWs obtained a score clinically significant during the emergency. Moreover, a depersonalization factor showed a statistically significant increase in average scores ( p < 0.0001). The PHQ‐9 scale showed that 47.1% of the operators reported depressive state presence. The number of operators scoring above the cut‐off for the anxiety scale tripled during the emergency ( p < 0.0001). The female gender conferred greater risks for depression. Taken together, the findings of this study showed that our sample of Italian HCWs showed a greater risk for depression, anxiety, and stress during the COVID‐19 pandemic. These data might be a starting point to plan mental health monitoring and prevention programs for HCWs, thus ensuring patients receive the best possible care performances even during healthcare crises such as the current pandemic.

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Section: Discussionsupporting

confidence: 92%

Impact of COVID‐19 on the mental health in a cohort of Italian rehabilitation healthcare workers

Farì

Sire

Giorgio

et al. 2021

Journal of Medical Virology

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“…All pandemics, including the one caused by COVID-19, being unexpected and unpredictable events, which affect large numbers of people, are sources of stress (i.e., they are cataclysmic stressors, according to Lazarus and Cohen's definition [42]), and uncertainty among both ordinary people and HCWs [43][44][45]. If ordinary people experience "uncertainty about getting infected, uncertainty about the seriousness of the infection, uncertainty about whether the people around you are infected, uncertainty about whether objects or surfaces (e.g., money, doorknobs) are infected, uncertainty about the optimal type of treatment or protective measures, and uncertainty about whether a pandemic is truly over" [44] (p. 43), HCWs experience also other types of uncertainty (both professional and personal), that differ during the different stages of virus diffusion.…”

Section: Intolerance Of Uncertainty Personality and Copingmentioning

confidence: 99%

“…"Measures"). It can be considered as a sub-trait of anxiety [44] (that is, in its turn, a facet of neuroticism), which has often been found in association with stress, distress, insomnia, psychosomatic symptoms, and other clinical conditions in several recent studies carried out on COVID-19 among the general population and HCWs (e.g., [45,[51][52][53][54][55][56]). It is a cognitive, emotional, and behavioral tendency to react negatively to uncertain or ambiguous situations and unpredictable future events [57,58], which biases information processing, leading to faulty appraisals of threat, and reduces coping abilities [59].…”

Section: Intolerance Of Uncertainty Personality and Copingmentioning

confidence: 99%

Associations between Personality Traits, Intolerance of Uncertainty, Coping Strategies, and Stress in Italian Frontline and Non-Frontline HCWs during the COVID-19 Pandemic—A Multi-Group Path-Analysis

et al. 2021

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The COVID-19 pandemic represented a very difficult physical and psychological challenge for the general population and even more for healthcare workers (HCWs). The main aim of the present study is to test whether there were significant differences between frontline and non-frontline Italian HCWs concerning (a) personality traits, intolerance of uncertainty, coping strategies and perceived stress, and (b) the models of their associations. A total of 682 Italian HCWs completed a self-report questionnaire: 280 employed in COVID-19 wards and 402 in other wards. The analysis of variance omnibus test revealed significant differences between the two groups only for perceived stress, which was higher among the frontline. The multi-group path analysis revealed significant differences in the structure of the associations between the two groups of HCWs, specifically concerning the relations between: personality traits and intolerance of uncertainty; intolerance of uncertainty and coping strategies. Regarding the relation between coping strategies and stress no difference was identified between the two groups. In both of them, emotionally focused coping was negatively related with perceived stress, whereas dysfunctional coping was positively related with stress. These results could be useful in planning actions aiming to reduce stress and improve the effectiveness of HCWs’ interventions. Training programs aimed to provide HCWs with a skillset to tackle uncertain and stressful circumstances could represent an appropriate support to develop a preventive approach during outbreaks.

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“…According to MD Trani, 56% of HCWs in Italy showed EE Abbreviations: COVID-19, Novel coronavirus disease; HCW, Healthcare worker; MBI scale, Maslach Burnout Inventory scale; EE, emotional exhaustion; DP, depersonalization; PA, personal accomplishment; PPE, personal protective equipment; CR, composite reliability; AVE, average variance extracted. (Di Trani et al, 2021). In Portugal, Duarte I et al concluded that more than half of HCWs had symptoms of personal burnout (Duarte et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

Prevalence and Factors Associated With Burnout of Frontline Healthcare Workers in Fighting Against the COVID-19 Pandemic: Evidence From China

et al. 2021

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ObjectivesThe sudden outbreak of the novel coronavirus disease (COVID-19) plunged healthcare workers (HCWs) into warfare. This study aimed to determine the prevalence of burnout and the factors associated with it among frontline HCWs fighting COVID-19.MethodsA cross-sectional survey was conducted among frontline HCWs fighting against the COVID-19 in Wuhan, Harbin, and Shenzhen during the period from February 18 to March 4. Finally, HCWs were recruited using cluster sampling, 1,163 HCWs were included in the final analysis. Burnout was measured using a 22-item Maslach Burnout Inventory scale (MBI scale).ResultsOf the participants, 48.6% suffered from burnout, and 21.8% showed a high degree of burnout. Doctors (b = 3.954, P = 0.011) and nurses (b = 3.067, P = 0.042) showed higher emotional exhaustion (EE) than administrators. Participants who worked continuously for more than 8 h a day (b = 3.392, P = 0.000), those who were unable to eat three regular daily meals (b = 2.225, P = 0.008), whose daily water intake was no more than 800 ml (b = 3.007, P = 0.000), who slept for no more than 6 h (b = 1.609, P = 0.036), and who were infected or had colleagues who were infected with COVID-19 (b = 4.182, P = 0.000) experienced much higher levels of EE, while those who could adhere to infection control procedures (b = −5.992, P = 0.000), who were satisfied with their hospital’s infection control measures(b = −3.709, P = 0.001), and who could receive sufficient psychological crisis intervention (b = −1.588, P = 0.039) reported lower levels of EE.ConclusionThe study reveals that burnout is prevalent among frontline HCWs and that the known factors associated with burnout, such as workload, and the factors directly associated with COVID-19, such as having insufficient protection, can affect burnout symptoms in frontline HCWs. Synergized and comprehensive interventions should be targeted at reducing its occurrence among frontline HCWs fighting COVID-19.

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From Resilience to Burnout in Healthcare Workers During the COVID-19 Emergency: The Role of the Ability to Tolerate Uncertainty

Cited by 105 publications

References 59 publications

Impact of COVID‐19 on the mental health in a cohort of Italian rehabilitation healthcare workers

Impact of COVID‐19 on the mental health in a cohort of Italian rehabilitation healthcare workers

Associations between Personality Traits, Intolerance of Uncertainty, Coping Strategies, and Stress in Italian Frontline and Non-Frontline HCWs during the COVID-19 Pandemic—A Multi-Group Path-Analysis

Prevalence and Factors Associated With Burnout of Frontline Healthcare Workers in Fighting Against the COVID-19 Pandemic: Evidence From China

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