To burn-out or not to burn-out: a cross-sectional study in healthcare professionals in Spain during COVID-19 pandemic

ObjectiveTo assess the prevalence of burn-out syndrome in healthcare workers working on the front line (FL) in Spain during COVID-19.DesignCross-sectional, online survey-based study.SettingsSampling was performed between 21st April and 3rd May 2020. The survey collected demographic data and questions regarding participants’ working position since pandemic outbreak.ParticipantsSpanish healthcare workers working on the FL or usual ward were eligible. A total of 674 healthcare professionals answered the survey.Main outcomes and measuresBurn-out syndrome was assessed by the Maslach Burnout Inventory-Medical Personnel.ResultsOf the 643 eligible responding participants, 408 (63.5%) were physicians, 172 (26.8%) were nurses and 63 (9.8%) other technical occupations. 377 (58.6%) worked on the FL. Most participants were women (472 (73.4%)), aged 31–40 years (163 (25.3%)) and worked in tertiary hospitals (>600 beds) (260 (40.4%)). Prevalence of burn-out syndrome was 43.4% (95% CI 39.5% to 47.2%), higher in COVID-19 FL workers (49.6%, p<0.001) than in non- COVID-19 FL workers (34.6%, p<0.001). Women felt more burn-out (60.8%, p=0.016), were more afraid of self-infection (61.9%, p=0.021) and of their performance and quality of care provided to the patients (75.8%, p=0.015) than men. More burn-out were those between 20 and 30 years old (65.2%, p=0.026) and those with more than 15 years of experience (53.7%, p=0.035).Multivariable logistic regression analysis revealed that, working on COVID-19 FL (OR 1.93; 95% CI 1.37 to 2.71, p<0.001), being a woman (OR 1.56; 95% CI 1.06 to 2.29, p=0.022), being under 30 years old (OR 1.75; 95% CI 1.06 to 2.89, p=0.028) and being a physician (OR 1.64; 95% CI 1.11 to 2.41, p=0.011) were associated with high risk of burn-out syndrome.ConclusionsThis survey study of healthcare professionals reported high rates of burn-out syndrome. Interventions to promote mental well-being in healthcare workers exposed to COVID-19 need to be immediately implemented.

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Burnout of Healthcare Workers amid the COVID-19 Pandemic: A Japanese Cross-Sectional Survey

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18052434 ◽

2021 ◽

Vol 18 (5) ◽

pp. 2434

Author(s):

Yoshito Nishimura ◽

Tomoko Miyoshi ◽

Hideharu Hagiya ◽

Yoshinori Kosaki ◽

Fumio Otsuka

Keyword(s):

Healthcare Workers ◽

Healthcare Professionals ◽

Healthcare Delivery ◽

General Medicine ◽

Maslach Burnout Inventory ◽

University Hospital ◽

Survey Study ◽

Cross Sectional Survey ◽

Cross Sectional ◽

The Past

The coronavirus disease 2019 (COVID-19) global pandemic has drastically changed how we live and work. Amid the prolonged pandemic, burnout of the frontline healthcare professionals has become a significant concern. We conducted a cross-sectional survey study to provide data about the relationship between the COVID-19 pandemic and the prevalence of burnout in healthcare professionals in Japan. Healthcare workers in a single Japanese national university hospital participated in the survey, including basic demographics, whether a participant engaged in care of COVID-19 patients in the past 2 weeks and the Maslach Burnout Inventory. Of those, 25.4% fully answered the survey; 33.3% were doctors and 63.6% were nurses, and 36.3% engaged in care of COVID-19 patients in the past 2 weeks. Compared to those belonging to General Medicine, those in Emergency Intensive Care Unit were at higher risk of burnout (odds ratio (OR), 6.7; 95% CI, 1.1–42.1; p = 0.031). Of those who engaged in care of COVID-19 patients, 50% reported burnout while 6.1% did not (OR 8.5, 95% CI; 1.3–54.1; p = 0.014). The burnout of healthcare workers is a significant concern amid the pandemic, which needs to be addressed for sustainable healthcare delivery.

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The Role of Coping Behavior in Healthcare Workers' Distress and Somatization During the COVID-19 Pandemic

Frontiers in Psychology ◽

10.3389/fpsyg.2021.684618 ◽

2021 ◽

Vol 12 ◽

Author(s):

Erik Franck ◽

Filip Haegdorens ◽

Eva Goossens ◽

Yannic van Gils ◽

Michael Portzky ◽

...

Keyword(s):

Psychological Health ◽

Computer Games ◽

Healthcare Workers ◽

Online Survey ◽

Acute Stress ◽

Demographic Data ◽

Coping Behavior ◽

Well Being ◽

Cross Sectional

Background: Constantly searching for a balance between work demands and their own physical and psychological health has challenged medical and nursing staff during the immediate wake of this COVID-19 viral epidemic leading to acute stress reactions and psychosomatic symptoms. Coping behavior might be a buffer for work-related stress in relation to mental well-being. The present study aims to evaluate the role of positive and negative stress-reducing activities on healthcare workers' mental and physical well-being.Methods: This was a cross-sectional study using an online survey that was sent out using our network of healthcare workers at the University of Antwerp and through social media. Socio-demographic data, coping behavior with the Palliative Pallet Scale (P3), and distress and somatization using the Four-dimensional symptom checklist were collected. Surveys were completed by 1,376 participants.Results: The results clearly showed that positive stress-reducing activities are related to fewer symptoms of distress and somatization. Providing direct care to COVID-19 patients was associated with a higher decrease of applying positive stress-reducing activities during the peak of the pandemic compared to the ideal situation. Finally, fewer symptoms of distress and somatization were associated with the following activities: reading, mind sports games, keeping a hobby collection, studying; engaging in sexual activities with your partner; cleaning the house, tidying up, working in the garden, doing household chores; exercising alone; walking, or taking a trip together with someone; exercise together with someone; watching TV, listening/playing (to) music/, playing computer games; playing a card game or other board game; and preparing something extra tasteful outside regular meals.Conclusion: Our study demonstrated an association between concrete coping behaviors and distress and somatization in healthcare workers during the first peak of the COVID-19 pandemic. The results provide relevant and additional insights to develop and investigate interventions among others in personal leadership and resilience.

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Stress, Burnout, and Resilience among Healthcare Workers during the COVID-19 Emergency: The Role of Defense Mechanisms

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18105258 ◽

2021 ◽

Vol 18 (10) ◽

pp. 5258

Author(s):

Mariagrazia Di Giuseppe ◽

Gianni Nepa ◽

Tracy A. Prout ◽

Fabrizio Albertini ◽

Stefano Marcelli ◽

...

Keyword(s):

Healthcare Workers ◽

Defense Mechanisms ◽

Online Survey ◽

Healthcare Professionals ◽

Well Being ◽

Personal Accomplishment ◽

Traumatic Experience ◽

Psychological Resources ◽

Defensive Functioning ◽

The Impact

The experience of working on the frontlines of the COVID-19 healthcare crisis has presented a cumulative traumatic experience that affects healthcare professionals’ well-being. Psychological resources such as resilience and adaptive defense mechanisms are essential in protecting individuals from severe stress and burnout. During September 2020, 233 healthcare workers responded to an online survey to test the impact of demographic variables, COVID-19 exposure, and psychological resources in determining stress and burnout during the COVID-19 emergency. Frontline workers reported higher scores for stress, emotional exhaustion, and depersonalization (p < 0.001) as compared to colleagues working in units not directly serving patients with COVID-19. Mature defensive functioning was associated with resilience and personal accomplishment (r = 0.320; p < 0.001), while neurotic and immature defenses were related to perceived stress and burnout. Stress and burnout were predicted by lower age, female gender, greater exposure to COVID-19, lower resilience, and immature defensive functioning among healthcare professionals (R2 = 463; p < 0.001). Working on the frontlines of the COVID-19 pandemic appears to provoke greater stress and burnout. On the other hand, resilience and adaptive defense mechanisms predicted better adjustment. Future reaction plans should promote effective programs offering support for healthcare workers who provide direct care to patients with COVID-19.

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Doctors’ perception of support and the processes involved in complaints investigations and how these relate to welfare and defensive practice: a cross-sectional survey of the UK physicians

BMJ Open ◽

10.1136/bmjopen-2017-017856 ◽

2017 ◽

Vol 7 (11) ◽

pp. e017856 ◽

Cited By ~ 7

Author(s):

Tom Bourne ◽

Bavo De Cock ◽

Laure Wynants ◽

Mike Peters ◽

Chantal Van Audenhove ◽

...

Keyword(s):

Online Survey ◽

Well Being ◽

Adverse Outcomes ◽

Perceived Support ◽

Survey Study ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Final Sample ◽

Perception Of Support ◽

The Uk

ObjectiveHow adverse outcomes and complaints are managed may significantly impact on physician well-being and practice. We aimed to investigate how depression, anxiety and defensive medical practice are associated with doctors actual and perceived support, behaviour of colleagues and process issues regarding how complaints investigations are carried out.DesignA survey study. Respondents were classified into three groups: no complaint, recent/current complaint (within 6 months) or past complaint. Each group completed specific surveys.SettingBritish Medical Association (BMA) members were invited to complete an online survey.Participants95 636 members of the BMA were asked to participate. 7926 (8.3%) completed the survey, of whom 1780 (22.5%) had no complaint, 3889 (49.1%) had a past complaint and 2257 (28.5%) had a recent/current complaint. We excluded those with no complaints leaving 6144 in the final sample.Primary outcomes measuresWe measured anxiety and depression using the Generalised Anxiety Disorder Scale 7 and Physical Health Questionnaire 9. Defensive practice was assessed using a new measure for avoidance and hedging.ResultsMost felt supported by colleagues (61%), only 31% felt supported by management. Not following process (56%), protracted timescales (78%), vexatious complaints (49%), feeling bullied (39%) or victimised for whistleblowing (20%), and using complaints to undermine (31%) were reported. Perceived support by management (relative risk (RR) depression: 0.77, 95% CI 0.71 to 0.83; RR anxiety: 0.80, 95% CI 0.74 to 0.87), speaking to colleagues (RR depression: 0.64, 95% CI 0.48 to 0.84 and RR anxiety: 0.69, 95% CI 0.51 to 0.94, respectively), fair/accurate documentation (RR depression: 0.80, 95% CI 0.75 to 0.86; RR anxiety: 0.81, 95% CI 0.75 to 0.87), and being informed about rights (RR depression 0.96 (0.89 to 1.03) and anxiety 0.94 (0.87 to 1.02), correlated positively with well-being and reduced defensive practice. Doctors worried most about professional humiliation following a complaint investigation (80%).ConclusionPoor process, prolonged timescales and vexatious use of complaints systems are associated with decreased psychological welfare and increased defensive practice. In contrast, perceived support from colleagues and management is associated with a reduction in these effects.

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Knowledge, Attitude and Practice of Personal Safety Measures Adopted by Medical Practioners during the Covid-19 Pandemic

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/2021/190 ◽

2021 ◽

Vol 10 (12) ◽

pp. 883-887

Author(s):

Hemapriya L ◽

Maureen Prativa Tigga ◽

Anil Kumar M.R ◽

Prathap T ◽

Neha Wali ◽

...

Keyword(s):

Personal Protective Equipment ◽

Urban Areas ◽

Healthcare Workers ◽

Online Survey ◽

Healthcare Professionals ◽

Well Being ◽

World Health ◽

Protective Equipment ◽

Personal Safety ◽

Safety Measures

BACKGROUND A novel coronavirus (now termed as SARS-CoV-2) was detected as the causative agent of severe pneumonia in Wuhan, Hubei Province, China, in December 2019. Declared by the World Health Organization (WHO) as a global pandemic in March 2020, it has created profound changes in global economy and healthcare systems. This study evaluates the knowledge and practice with regard to various personal safety measures used by the healthcare professionals. METHODS We conducted a questionnaire study after obtaining approval, from the Institutional ethical committee. An online survey was conducted using a preformatted questionnaire consisting of multiple-choice questions which assessed the knowledge and practices adopted by various healthcare professionals. The survey was done between 1st and 30th of June 2020 and a total of 536 responses was analysed. RESULTS 58.4 % of the participants were females, 66 % of the healthcare workers worked at a private hospital / private medical college with 82.1 % being located in urban areas. Of the 536 respondents, 90.1 % practiced bathing immediately after returning home and 86.8 % sanitized their accessories. 86.9 % of the professionals used frequent sanitization with use of mask and gloves whereas only 12.3 % used full personal protective equipment. 58 % of females had used hydroxychloroquine as prophylaxis whereas only 41 % of males used it (statistically significant, P = 0.005). Healthcare workers in younger age group (23 - 40 years) were more likely to maintain distance with family members, and government doctors were significantly more likely to do so (P < 0.001) as compared to private practitioners. CONCLUSIONS With the medical professionals being at high risk for contracting the infection, the need to provide the healthcare professionals with adequate personal protective equipment is of utmost importance. There is also a need to maintain the well-being of the healthcare professionals as they are the weakest link in the chain. KEY WORDS Medical Practitioners, Personal Protective Equipment, Safety Measures

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The psychological impacts of COVID-19: a study of frontline physicians and nurses in the Arab world

Irish Journal of Psychological Medicine ◽

10.1017/ipm.2020.119 ◽

2020 ◽

pp. 1-6

Author(s):

N. Al Mahyijari ◽

A. Badahdah ◽

F. Khamis

Keyword(s):

Perceived Stress ◽

Healthcare Workers ◽

Online Survey ◽

Healthcare Professionals ◽

Arab World ◽

Close Contact ◽

Well Being ◽

Sultanate Of Oman ◽

Stress Scale ◽

Harmful Effects

Objectives: The COVID-19 (SARS-CoV2) pandemic is wreaking havoc on healthcare systems and causing serious economic, social, and psychological anguish around the globe. Healthcare workers (HCWs) who diagnose and care for COVID-19 patients have been shown to suffer burnout, stress, and anxiety. Methods: In this study, we collected data from 150 frontline HCWs who had close contact with COVID-19 patients at several health facilities in the Sultanate of Oman. The participants completed an online survey that included the Perceived Stress Scale, the Generalized Anxiety Disorder Scale, and the WHO-5 Well-Being Index. Results: The study found that a substantial number of healthcare professionals experienced relatively high levels of stress and anxiety, as well as suboptimal levels of well-being. Perceived stress and anxiety were significant predictors of HCWs’ well-being. Conclusions: This study adds to the increasing literature indicating harmful effects of COVID-19 on the mental health of HCWs.

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Impact of enhanced personal protective equipment on the physical and mental well-being of healthcare workers during COVID-19

Postgraduate Medical Journal ◽

10.1136/postgradmedj-2020-139150 ◽

2020 ◽

pp. postgradmedj-2020-139150 ◽

Cited By ~ 1

Author(s):

Ramanathan Swaminathan ◽

Bimantha Perera Mukundadura ◽

Shashi Prasad

Keyword(s):

Personal Protective Equipment ◽

Healthcare Workers ◽

Healthcare Professionals ◽

Negative Impact ◽

Well Being ◽

Cross Sectional Study ◽

Protective Equipment ◽

Cross Sectional ◽

The Impact ◽

Mental Well Being

BackgroundThe COVID-19 pandemic has necessitated the use of enhanced personal protective equipment (PPE) in healthcare workers in patient-facing roles. We describe the impact on the physical and mental well-being of healthcare professionals who use enhanced PPE consistently.MethodsWe conducted a single-centre, cross-sectional study among healthcare professionals who use enhanced PPE. A web-based questionnaire was disseminated to evaluate the effects on individuals’ physical and mental well-being. Physical and mental impact was assessed through a visual analogue scale.ResultsProspective analysis of the views of 72 respondents is reported. 63.9% were women and 36.1% were men. Physical impact included exhaustion, headache, skin changes, breathlessness and a negative impact on vision. Communication difficulties, somnolence, negative impact on overall performance and difficulties in using surgical instrumentation were reported.ConclusionOur study demonstrates the undeniable negative impact on the front-line healthcare workers using enhanced PPE and lays the ground for larger multicentric assessments given for it to potentially be the norm for the foreseeable future.

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Exploring the factors associated with the mental health of frontline healthcare workers during the COVID-19 pandemic in Cyprus

PLoS ONE ◽

10.1371/journal.pone.0258475 ◽

2021 ◽

Vol 16 (10) ◽

pp. e0258475

Author(s):

Konstantinos Kapetanos ◽

Stella Mazeri ◽

Despo Constantinou ◽

Anna Vavlitou ◽

Marios Karaiskakis ◽

...

Keyword(s):

Mental Health ◽

Healthcare Workers ◽

Healthcare Professionals ◽

Maslach Burnout Inventory ◽

Sample Population ◽

Negative Effects ◽

Cross Sectional ◽

Logistic Regression Models ◽

Factors Associated ◽

Frontline Healthcare Workers

Introduction The spread of COVID-19 into a global pandemic has negatively affected the mental health of frontline healthcare-workers. This study is a multi-centre, cross-sectional epidemiological study that uses nationwide data to assess the prevalence of stress, anxiety, depression and burnout among health care workers managing COVID-19 patients in Cyprus. The study also investigates the mechanism behind the manifestation of these pathologies, as to allow for the design of more effective protective measures. Methods Data on the mental health status of the healthcare workers were collected from healthcare professionals from all over the nation, who worked directly with Covid patients. This was done via the use of 64-item, self-administered questionnaire, which was comprised of the DASS21 questionnaire, the Maslach Burnout Inventory and a number of original questions. Multivariable logistic regression models were used to investigate factors associated with each of the mental health measures. Results The sample population was comprised of 381 healthcare professionals, out of which 72.7% were nursing staff, 12.9% were medical doctors and 14.4% belonged to other occupations. The prevalence of anxiety, stress and depression among the sample population were 28.6%, 18.11% and 15% respectively. The prevalence of burnout was 12.3%. This was in parallel with several changes in the lives of the healthcare professionals, including; working longer hours, spending time in isolation and being separated from family. Discussion This study indicates that the mental health of a significant portion of the nation’s workforce is compromised and, therefore, highlights the need for an urgent intervention particularly since many countries, including Cyprus, are suffering a second wave of the pandemic. The identified risk factors should offer guidance for employers aiming to protect their frontline healthcare workers from the negative effects of the COVID-19 pandemic.

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Reducing Objectification Could Tackle Stigma in the COVID-19 Pandemic: Evidence From China

Frontiers in Psychology ◽

10.3389/fpsyg.2021.664422 ◽

2021 ◽

Vol 12 ◽

Author(s):

Youli Chen ◽

Jiahui Jin ◽

Xiangyang Zhang ◽

Qi Zhang ◽

Weizhen Dong ◽

...

Keyword(s):

Healthcare Workers ◽

Online Survey ◽

Well Being ◽

Contributing Factors ◽

Cross Sectional ◽

Convenience Sample ◽

Social Motives ◽

Complex Issue ◽

Categorization Theory ◽

Related Stigma

Stigmatization associated with the coronavirus disease 2019 (COVID-19) is expected to be a complex issue and to extend into the later phases of the pandemic, which impairs social cohesion and relevant individuals' well-being. Identifying contributing factors and learning their roles in the stigmatization process may help tackle the problem. This study quantitatively assessed the severity of stigmatization against three different groups of people: people from major COVID-19 outbreak sites, those who had been quarantined, and healthcare workers; explored the factors associated with stigmatization within the frameworks of self-categorization theory and core social motives; and proposed solutions to resolve stigma. The cross-sectional online survey was carried out between April 21 and May 7, 2020, using a convenience sample, which yielded 1,388 valid responses. Employing data analysis methods like multivariate linear regression and moderation analysis, this study yields some main findings: (1) those from major COVID-19 outbreak sites received the highest level of stigma; (2) factors most closely associated with stigmatization, in descending order, are objectification and epidemic proximity in an autonomic aspect and fear of contracting COVID-19 in a controllable aspect; and (3) superordinate categorization is a buffering moderator in objectification–stigmatization relationship. These findings are important for further understanding COVID-19-related stigma, and they can be utilized to develop strategies to fight against relevant discrimination and bias. Specifically, reinforcing superordinate categorization by cultivating common in-group identity, such as volunteering and donating for containment of the pandemic, could reduce objectification and, thus, alleviate stigma.

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