Psychological distress and burnout among healthcare worker during COVID-19 pandemic in India—A cross-sectional study

Abstract

Background COVID-19 has inundated the entire world disrupting the lives of millions of people. The pandemic has stressed the healthcare system of India impacting the psychological status and functioning of health care workers. The aim of this study is to determine the burnout levels and factors associated with the risk of psychological distress among healthcare workers (HCW) engaged in the management of COVID 19 in India. Methods A cross-sectional study was conducted from 1 September 2020 to 30 November 2020 by telephonic interviews using a web-based Google form. Health facilities and community centres from 12 cities located in 10 states were selected for data collection. Data on socio-demographic and occupation-related variables like age, sex, type of family, income, type of occupation, hours of work and income were obtained was obtained from 967 participants, including doctors, nurses, ambulance drivers, emergency response teams, lab personnel, and others directly involved in COVID 19 patient care. Levels of psychological distress was assessed by the General health Questionnaire -GHQ-5 and levels of burnout was assessed using the ICMR-NIOH Burnout questionnaire. Multivariable logistic regression analysis was performed to identify factors associated with the risk of psychological distress. The third quartile values of the three subscales of burnout viz EE, DP and PA were used to identify burnout profiles of the healthcare workers. Results Overall, 52.9% of the participants had the risk of psychological distress that needed further evaluation. Risk of psychological distress was significantly associated with longer hours of work (≥ 8 hours a day) (AOR = 2.38, 95% CI(1.66–3.41), income≥20000(AOR = 1.74, 95% CI, (1.16–2.6); screening of COVID-19 patients (AOR = 1.63 95% CI (1.09–2.46), contact tracing (AOR = 2.05, 95% CI (1.1–3.81), High Emotional exhaustion score (EE ≥16) (AOR = 4.41 95% CI (3.14–6.28) and High Depersonalisation score (DP≥7) (AOR = 1.79, 95% CI (1.28–2.51)). About 4.7% of the HCWs were overextended (EE>18); 6.5% were disengaged (DP>8) and 9.7% HCWs were showing signs of burnout (high on all three dimensions). Conclusion The study has identified key factors that could have been likely triggers for psychological distress among healthcare workers who were engaged in management of COVID cases in India. The study also demonstrates the use of GHQ-5 and ICMR-NIOH Burnout questionnaire as important tools to identify persons at risk of psychological distress and occurrence of burnout symptoms respectively. The findings provide useful guide to planning interventions to mitigate mental health problems among HCW in future epidemic/pandemic scenarios in the country.

Shared sources and mechanisms of healthcare worker distress in COVID-19: a comparative qualitative study in Canada and the UK

“…Participants described distress that outbreaks were being blamed on HCW practices, such as whether they were donning and doffing PPE properly (rather than not being supplied adequate PPE or knowing which level of PPE to utilise). Case rates, PPE supply, workload, COVID-19 exposure at work, and feelings of being unsupported by health administration have been shown to contribute to the mental health burden of HCWs (Elkholy et al, 2021 ; Lai et al, 2020 ; Menon et al, 2022 ). That said, most studies of HCW distress relating to pandemics (whether in COVID-19, SARS, H1N1, or MERS) have focused on evaluating clinical symptoms such as anxiety, insomnia, depression, and PTSD (Shreffler et al, 2020 ) and predominantly amongst doctors and nurses with less frequent consideration of allied health professionals and almost no inclusion of support and administrative staff or managers (Cag et al, 2021 ; Ezzat et al, 2021 ; Orrù et al, 2021 ).…”

Mental Health, Burnout, and Job Stressors Among Healthcare Workers During the COVID-19 Pandemic in Iran: A Cross-Sectional Survey

“…This finding is similar to a number of international ( 7 , 9 – 11 ) and national ( 16 – 20 ) studies conducted at the time of the COVID-19 pandemic for assessing psychological distress and mental health problems among healthcare workers which have reported a high prevalence of anxiety and depression. One similar study performed a year earlier among healthcare workers from twelve different cities in India revealed that 52.9% of the participants had the risk of psychological distress that needed further evaluation ( 50 ). The higher prevalence of mental disorders among female healthcare workers found in our study has also been replicated in many studies ( 51 – 55 ).…”

Awareness, Psychological State, and Coping Skills among the Frontline Doctors during the COVID-19 Pandemic—A Cross-Sectional Study

“…30 For the aftermath of COVID-19, it has been observed that many frontline workers experienced the burnout, posttraumatic stress disorder, and even suicidal ideation with higher levels being in younger age group, residents, kind of work, and females emphasizing the need to focus on mental health along with physical health following a pandemic. 31 32 33…”