Prevalence and correlates of burnout among Lebanese health care workers during the COVID-19 pandemic: a national cross-sectional survey
Tóm tắt
The COVID-19 pandemic has harshly burdened the healthcare systems. Health care workers (HCWs) are at substantial risk of infection and confronted several stressors as well leading them to experience burnout. This study aimed to assess the prevalence of burnout among Lebanese health HCWs and to identify its associated factors. A cross-sectional online survey was conducted between the first of November and the end of December 2020 among Lebanese HCWs working in all active hospitals operating across the country. Data were collected using an Arabic, anonymous, self-reported questionnaire comprising four sections: (a) basic sociodemographic characteristics, (b) exposure to COVID-19 covariates, (c) occupational factors, and (d) the measurements including the Copenhagen Burnout Inventory (CBI). CBI subscale cut-off score of 50 was used to assess the prevalence of burnout among HCWs. Multinomial logistic regression analyses were performed to examine the factors associated with the different aspects of burnout. Out of the 1751 respondents, personal burnout (PB) was detected in its moderate and high-level aspects among 86.3% of Lebanese HCWs. Moderate and high levels of work-related burnout (WB), and client-related burnout (CB) hit 79.2% and 83.3% of HCWs, respectively. HCWs who were females, married, physicians, having a poor health status and specific living conditions (dependent child, elderly at home, family member with comorbidities, and a low income) were more likely to exhibit a high level of PB compared to no/low burnout level. Moreover, frontline HCWs, those infected by COVID-19 or those having a colleague infected by COVID-19, and those exhibiting a high perception of threat were more prone to experience a high-level PB rather than a low/no burnout. Working in a public hospital, extensive working hours, and insufficient sleeping hours were also found positively associated with high PB. However, older age and altruism were negatively associated with high PB compared to no/low PB among HCWs. As for WB, similar factors were found either positively or negatively associated with a high level of WB except health status and living conditions factors (dependent child or family member). As for CB, older age of HCWs (> 30 years) and altruism were negatively associated with high CB compared to no/low burnout level. However, working in the frontline, high threat perception, extensive working hours, insufficient sleeping hours, and low income were positively associated with high CB among HCWs compared to no/low burnout. The prevalence of burnout among Lebanese HCWs during the pandemic was significant and alarming. Enacting and implementing preventive policies and effective interventions are urgently needed to cultivate wellness among HCWs.
Tài liệu tham khảo
Dubey S, Biswas P, Ghosh R, Chatterjee S, Dubey MJ, Chatterjee S, et al. Psychosocial impact of COVID-19. Diabetes Metab Syndr. 2020;14(5):779–88.
Susskind D, Vines D. The economics of the COVID-19 pandemic: an assessment. Oxford Rev Econ Policy. 2020. https://doi.org/10.1093/oxrep/graa036.
Xiong J, Lipsitz O, Nasri F, Lui LMW, Gill H, Phan L, et al. Impact of COVID-19 pandemic on mental health in the general population: a systematic review. J Affect Disord. 2020;277:55–64.
Spoorthy MS, Pratapa SK, Mahant S. Mental health problems faced by healthcare workers due to the COVID-19 pandemic-a review. Asian J Psychiatr. 2020;51: 102119.
Ghaleb Y, Lami F, Al Nsour M, Rashak HA, Samy S, Khader YS, et al. Mental health impacts of COVID-19 on healthcare workers in the Eastern Mediterranean Region: a multi-country study. J Public Health (Oxford, England). 2021;43(Suppl 3):iii34–42.
Algunmeeyn A, El-Dahiyat F, Altakhineh MM, Azab M, Babar ZU. Understanding the factors influencing healthcare providers’ burnout during the outbreak of COVID-19 in Jordanian hospitals. J Pharm Policy Pract. 2020;13:53.
Robertson E, Hershenfield K, Grace SL, Stewart DE. The psychosocial effects of being quarantined following exposure to SARS: a qualitative study of Toronto health care workers. Can J Psychiatry Revue canadienne de psychiatrie. 2004;49(6):403–7.
Gupta S, Sahoo S. Pandemic and mental health of the front-line healthcare workers: a review and implications in the Indian context amidst COVID-19. General psychiatry. 2020;33(5): e100284.
Cyr S, Marcil MJ, Marin MF, Tardif JC, Guay S, Guertin MC, et al. Factors associated with burnout, post-traumatic stress and anxio-depressive symptoms in healthcare workers 3 months into the COVID-19 pandemic: an observational study. Front Psych. 2021;12: 668278.
Maslach C, Leiter MP. Understanding the burnout experience: recent research and its implications for psychiatry. World Psychiatry. 2016;15(2):103–11.
Bunjak A, Černe M, Nagy N, Bruch H. Job demands and burnout: the multilevel boundary conditions of collective trust and competitive pressure. Human Relations. 2021:00187267211059826.
Shreffler J, Petrey J, Huecker M. The impact of COVID-19 on healthcare worker wellness: a scoping review. West J Emerg Med. 2020;21(5):1059–66.
Søvold LE, Naslund JA, Kousoulis AA, Saxena S, Qoronfleh MW, Grobler C, et al. Prioritizing the mental health and well-being of healthcare workers: an urgent global public health priority. Front Public Health. 2021;9: 679397.
Leo CG, Sabina S, Tumolo MR, Bodini A, Ponzini G, Sabato E, et al. Burnout among healthcare workers in the COVID 19 era: a review of the existing literature. Front Public Health. 2021;9: 750529.
Salvagioni DAJ, Melanda FN, Mesas AE, González AD, Gabani FL, Andrade SM. Physical, psychological and occupational consequences of job burnout: a systematic review of prospective studies. PLoS ONE. 2017;12(10): e0185781.
Hall LH, Johnson J, Watt I, Tsipa A, O’Connor DB. Healthcare staff wellbeing, burnout, and patient safety: a systematic review. PLoS ONE. 2016;11(7): e0159015.
Motluk A. Do doctors experiencing burnout make more errors? CMAJ Can Med Assoc J journal de l’Association medicale canadienne. 2018;190(40):E1216–7.
Bayani DBS, Tan SG. Health systems impact of COVID-19 in the Philippines. Center for Global Development; 2021.
BANK W. Lebanon Economic Monitor, Fall 2020: The Deliberate Depression. WORLD BANK; 2020.
Farran N. Mental health in Lebanon: tomorrow’s silent epidemic. Mental Health Prev. 2021;24: 200218.
BANK W. Lebanon Economic Monitor, Spring 2021: Lebanon Sinking (to the Top 3). WORLD BANK; 2021.
Esu MoPH. COVID-19 surveillance in Lebanon-daily report. Ministry of Public Health; 2020 (30 December 2020).
Sabbah I, Sabbah H, Sabbah S, Akoum H, Droubi N. Burnout among Lebanese nurses: psychometric properties of the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). Health. 2012;4:644–65249101.
Talih F, Warakian R, Ajaltouni J, Shehab AA, Tamim H. Correlates of depression and burnout among residents in a Lebanese academic medical center: a cross-sectional study. Acad Psychiatry. 2016;40(1):38–45.
Clinton M, Shehadeh Msn Rn R. Rasch Analysis of Lebanese Nurses’ responses to the Copenhagen burnout inventory alternative to the Maslach Burnout Inventory. SAGE Open Nurs. 2021;7:23779608211020919.
Bizri M, Kassir G, Tamim H, Kobeissy F, Hayek SE. Psychological distress experienced by physicians and nurses at a tertiary care center in Lebanon during the COVID-19 outbreak. J Health Psychol. 2022;27(6):1288–300.
Chong MY, Wang WC, Hsieh WC, Lee CY, Chiu NM, Yeh WC, et al. Psychological impact of severe acute respiratory syndrome on health workers in a tertiary hospital. Br J Psychiatry. 2004;185:127–33.
Msheik El Khoury F, Talih F, Khatib MFE, Abi Younes N, Siddik M, Siddik-Sayyid S. Factors associated with mental health outcomes: results from a tertiary referral hospital in Lebanon during the COVID-19 pandemic. Libyan J Med. 2021;16(1):1901438.
Youssef D, Abou-Abbas L, Youssef J. Feeling the burn in the era of COVID-19: cross-cultural adaptation and validation of the Arabic version of the Copenhagen Burnout Inventory among community pharmacists. J Pharm Policy Pract. 2022;15(1):21.
Huo L, Zhou Y, Li S, Ning Y, Zeng L, Liu Z, et al. Burnout and its relationship with depressive symptoms in medical staff during the COVID-19 epidemic in China. Front Psychol. 2021;12: 616369.
Khasne RW, Dhakulkar BS, Mahajan HC, Kulkarni AP. Burnout among healthcare workers during COVID-19 pandemic in India: results of a questionnaire-based survey. Indian J Crit Care Med. 2020;24(8):664–71.
Matsuo T, Kobayashi D, Taki F, Sakamoto F, Uehara Y, Mori N, et al. Prevalence of Health care worker burnout during the coronavirus disease 2019 (COVID-19) pandemic in Japan. JAMA Netw Open. 2020;3(8): e2017271.
Alsulimani LK, Farhat AM, Borah RA, AlKhalifah JA, Alyaseen SM, Alghamdi SM, et al. Health care worker burnout during the COVID-19 pandemic: a cross-sectional survey study in Saudi Arabia. Saudi Med J. 2021;42(3):306–14.
AlHumaid J, Ali S, Farooq I. The psychological effects of the COVID-19 pandemic and coping with them in Saudi Arabia. Psychol Trauma Theory Res Pract Policy. 2020;12(5):505–7.
Barello S, Palamenghi L, Graffigna G. Burnout and somatic symptoms among frontline healthcare professionals at the peak of the Italian COVID-19 pandemic. Psychiatry Res. 2020;290: 113129.
Lasalvia A, Bonetto C, Porru S, Carta A, Tardivo S, Bovo C, et al. Psychological impact of COVID-19 pandemic on healthcare workers in a highly burdened area of north-east Italy. Epidemiol Psychiatric Sci. 2020;30: e1.
Di Trani M, Mariani R, Ferri R, De Berardinis D, Frigo MG. From resilience to burnout in healthcare workers during the COVID-19 emergency: the role of the ability to tolerate uncertainty. Front Psychol. 2021;12: 646435.
Duarte I, Teixeira A, Castro L, Marina S, Ribeiro C, Jácome C, et al. Burnout among Portuguese healthcare workers during the COVID-19 pandemic. BMC Public Health. 2020;20(1):1885.
Elhadi M, Msherghi A, Elgzairi M, Alhashimi A, Bouhuwaish A, Biala M, et al. Burnout syndrome among hospital healthcare workers during the COVID-19 pandemic and civil war: a cross-sectional study. Front Psych. 2020;11: 579563.
Rotenstein LS, Torre M, Ramos MA, Rosales RC, Guille C, Sen S, et al. Prevalence of burnout among physicians: a systematic review. JAMA. 2018;320(11):1131–50.
Žutautienė R, Radišauskas R, Kaliniene G, Ustinaviciene R. The prevalence of burnout and its associations with psychosocial work environment among Kaunas Region (Lithuania) Hospitals’ physicians. Int J Environ Res Public Health. 2020;17(10).
Shanafelt TD. Enhancing meaning in work: a prescription for preventing physician burnout and promoting patient-centered care. JAMA. 2009;302(12):1338–40.
Houkes I, Winants Y, Twellaar M, Verdonk P. Development of burnout over time and the causal order of the three dimensions of burnout among male and female GPs. A three-wave panel study. BMC Public Health. 2011;11:240.
Gramaglia C, Marangon D, Azzolina D, Guerriero C, Lorenzini L, Probo M, et al. The mental health impact of 2019-nCOVID on healthcare workers from North-Eastern Piedmont, Italy. Focus on Burnout. Front Public Health. 2021;9:667379.
Prasad K, McLoughlin C, Stillman M, Poplau S, Goelz E, Taylor S, et al. Prevalence and correlates of stress and burnout among U.S. healthcare workers during the COVID-19 pandemic: a national cross-sectional survey study. EClinicalMedicine. 2021;35:100879.
Shanafelt TD, Boone S, Tan L, Dyrbye LN, Sotile W, Satele D, et al. Burnout and satisfaction with work-life balance among US physicians relative to the general US population. Arch Intern Med. 2012;172(18):1377–85.
Hodzi MB, Annor F, Darkwah E. An exploration of work-related experiences of domestic workers in Accra, Ghana. J Workplace Behav Health. 2021;36(4):309–34.
Gauche C, de Beer L, Rossouw L. Managing employee well-being: a qualitative study exploring job and personal resources of at-risk employees. SA J Human Resour Manag. 2017;15.
Blanch A, Aluja A. Social support (family and supervisor), work–family conflict, and burnout: sex differences. Human Relations. 2012;65(7):811–33.
Tung C. Review of servants of globalization: women, migration, and domestic work, by R. S. Parreñas. Am J Sociol. 2003;108(4):922–4.
Maher J. Nurse mothers valuing care at home and at work: beyond notions of care scarcity? J Sociol. 2012;50(4):531–44.
Lai J, Ma S, Wang Y, Cai Z, Hu J, Wei N, et al. Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Netw Open. 2020;3(3): e203976.
Nahrgang JD, Morgeson FP, Hofmann DA. Safety at work: a meta-analytic investigation of the link between job demands, job resources, burnout, engagement, and safety outcomes. J Appl Psychol. 2011;96(1):71–94.
Day A, Sibley A, Scott N, Tallon J, Ackroyd-Stolarz S. Workplace risks and stressors as predictors of burnout: the moderating impact of job control and team efficacy. Can J Adm Sci / Revue Canadienne des Sciences de l’Administration. 2009;26:7–22.
Nielsen MB, Mearns K, Matthiesen SB, Eid J. Using the Job Demands-Resources model to investigate risk perception, safety climate and job satisfaction in safety critical organizations. Scand J Psychol. 2011;52(5):465–75.
Xiao X, Zhu X, Fu S, Hu Y, Li X, Xiao J. Psychological impact of healthcare workers in China during COVID-19 pneumonia epidemic: a multi-center cross-sectional survey investigation. J Affect Disord. 2020;274:405–10.
Xanthopoulou D, Dollard M, Demerouti E, Schaufeli W, Taris T, Schreurs P. When do job demands particularly predict burnout? The moderating role of job resources. J Manag Psychol. 2007;22:766–86.
Wiederhold BK, Cipresso P, Pizzioli D, Wiederhold M, Riva G. Intervention for physician burnout: a systematic review. Open Med (Warsaw, Poland). 2018;13:253–63.
Post SG. Altuism, happiness, and health: it’s good to be good. Int J Behav Med. 2005;12(2):66–77.
Lin RT, Lin YT, Hsia YF, Kuo CC. Long working hours and burnout in health care workers: non-linear dose-response relationship and the effect mediated by sleeping hours-a cross-sectional study. J Occup Health. 2021;63(1): e12228.
Soares JJ, Grossi G, Sundin O. Burnout among women: associations with demographic/socio-economic, work, life-style and health factors. Arch Womens Ment Health. 2007;10(2):61–71.
Leiter MP. Perception of risk: an organizational model of occupational risk, burnout, and physical symptoms. Anxiety Stress Coping. 2005;18(2):131–44.