Predictors of healthcare worker burnout during the COVID-19 pandemic

Abstract

Objective We aim to provide a snapshot of the levels of burnout, anxiety, depression and distress among healthcare workers during the COVID-19 pandemic. Design, setting, participants We distributed an online survey via social media in June 2020 that was open to any healthcare worker. The primary outcome measure was symptoms of burnout as measured using the Copenhagen Burnout Inventory (CBI). Secondary outcomes of depression, anxiety and distress as measured using the Patient Health Questionnaire-9, General Anxiety Scale-7, and Impact of Events Scale-Revised were recorded along with subjective measures of stress. Multivariate logistic regression analysis was performed to identify factors associated with burnout, depression, anxiety and distress. Results Of 539 persons responding to the survey, 90% were female, and 26% were aged 41-50 years, 53% were nurses. Participants with moderate-to-severe burnout were younger (49% [206/424] versus 33% [38/115] under 40 years, P=0.004), and more likely to have pre-existing comorbidities (21% versus 12%, P=0.031). They were twice as likely to have been redeployed from their usual role (22% versus 11%; adjusted odds ratio [OR] 2.2, 95% confidence interval [CI] 1.5-3.3, P=0.042), or to work in an area dedicated to COVID-19 patients (50% versus 32%, adjusted OR 1.6, 95% CI 1.4-1.8, P<0.001), and were almost 4-times more likely to have previous depression (24% versus 7%; adjusted OR 3.6, 95% CI 2.2-5.9, P=0.012). A supportive workplace team and male sex protected against burnout reducing the odds by 40% (adjusted OR 0.6, 95% CI 0.5-0.7, P<0.001) and 70% (adjusted OR 0.3, 95% CI 0.2-0.5, P=0.003), respectively. Conclusion Independent predictors of burnout were younger staff, redeployment to a new working area, working with patients with confirmed COVID-19 infection, and being female or having a previous history of depression. Evaluation of existing psychological support interventions is required with targeted approaches to ensure support is available to those most at risk.

Burnout Prevalence and Its Associated Factors among Malaysian Healthcare Workers during COVID-19 Pandemic: An Embedded Mixed-Method Study

“…Our quantitative findings indicated that more than half of the Malaysian HCW in this sample experienced burnout. These findings was similar to studies done on Singapore HCW (49.2%) and Indian HCW (44.6%) [ 39 , 40 ] and were lower than the prevalence obtained from a sample of United Kingdom HCW (79%) [ 41 ]. Through use of the Maslach Burnout Inventory, other studies revealed similar prevalences—Spanish HCW (15–82%), Romanian residents (76%), Italian HCW (25–53%), Wuhan HCW (13–61%), and Japanese HCW (31.4%) [ 42 , 43 , 44 , 45 , 46 ].…”

“…A medical condition might also predispose HCW more to exhaustion as compared to healthy HCW. While a study in Turkey found no association between having a medical condition and psychological distress during the pandemic [ 12 ], a study in United Kingdom HCW revealed a significant association between background illness and burnout [ 41 ]. HCW who receive adequate psychological support at work have an outlet to discuss their experiences, concerns, and emotions, and various studies have shown an association with HCW’s psychological well-being during COVID-19 [ 4 , 9 , 12 , 41 ].…”

Nurses’ burnout and associated risk factors during the COVID-19 pandemic: a systematic review and meta-analysis

“…Main characteristics of the 14 studies included in our systematic review are shown in Table 1. Study population included only nurses in five studies, 27,28,33,36,40 while nine studies 29–32,34,35,37–39 included HCWs in general. A total of 17,390 nurses were included in this systematic review, while two studies 37,38 did not report the number of nurses.…”

“…All studies were cross-sectional, while 12 studies 27–30,33–40 used a convenience sample method and two studies 31,32 used a snowball sampling method. Eight studies 27,28,30,33–35,37,40 was conducted in Asia (China, India, Japan, Turkey, Singapore, Taiwan, and Iran), four studies 29,32,36,39 in Europe (United Kingdom, Spain, and Italy), and two studies 31,38 in North America (USA and Puerto Rico). Eleven studies 27– 30,33,34,36–40 were published in journals and three studies 31,32,35 in pre-print services.…”

“…Five standardized and valid questionnaires were used to measure burnout among nurses. The majority of studies 27,28,31,33,35,37,40 used the Maslach Burnout Inventory (MBI), three studies 30,32,34 used the Copenhagen Burnout Inventory (CBI), two studies 29,39 used the Professional Quality of Life Scale version 5 (ProQOL-5), one study 38 used the Mini-Z and one study 36 used the Spanish Burnout Inventory (SBI). The MBI is the most widely used instrument to measure burnout comprising 22 items in three domains; emotional exhaustion, depersonalization and personal accomplishment 41 .…”